Archive for the ‘Health Insurance’ Category

In the midst of the U.S. healthcare debate comes another reason why everyone of us should have basic health coverage. A new study by Harvard University researchers found that uninsured patients with traumatic injuries (such as car crashes, falls and gunshot wounds) were almost twice as likely to die in the hospital as similarly injured patients with health insurance. Taking into account injury severity, race, gender and age uninsured patients were still 80% more likely to die than those with insurance, including Medicaid. It’s shocking and unclear just why the uninsured fare worse in terms of ER care, since it’s largely assumed – and federally mandated – that all unstable patient receive equal care in ERs. One reason this might occur is that private hospitals can transfer uninsured patients to public hospitals once patients are stable. A transfer could then worsen a patient’s condition by delaying treatment. The findings are based on an analysis of data from the National Trauma Data Bank, which includes more than 900 U.S. hospitals. [via New York Times]

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A new law, which took effect last Friday, is allowing U.S. college students to take up to one year away from school for medical reasons while remaining on their family’s health insurance plan. “Michelle’s Law” is named after college student Michelle Morse who decided to remain a full time student, against the recommendation of her doctors, while undergoing chemotherapy for colon cancer because she could not afford to be dropped from her parents’ health insurance policy. Previously, students between the ages of 19-24 could continue their health coverage under their parent’s policy as long as they remained as a full-time student (12 credits). If they became too ill to continue as a full time student they would either lose their insurance or could continue their coverage under the C.O.B.R.A. portion of the parent’s policy for an additional premium. By law C.O.B.R.A. can be as much as 102% of the premium for up to 36 months; many families cannot afford this expense.  Michelle Morse was an aspiring teacher who died six months after she graduated from college at the age of 22. [via Businessweek]

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San Francisco is the first city in the US to offer a health plan for its uninsured citizens. The plan, called “Healthy San Francisco,”  was launched two years ago and has received high marks in independent studies. Currently, three-quarters of San Francisco’s uninsured adults have enrolled in the program which guarantees access to medical services. “Healthy San Francisco is not insurance,” and doesn’t function outside of the city limits. But ”any uninsured adult who lives in San Francisco and earns up to 500% of the federal poverty level annually is eligible. … Patients must pick a medical home out of a network of more than 30 public and private clinics, physician groups and hospitals within the city limits. The idea is that patients get consistent care and the system avoids duplicating services. … Preventative services, care for illness and chronic conditions, hospital stays and prescriptions are all covered.” The funding for the program comes from public funds as well as an employer mandate. Restaurants and businesses may also contribute to the fund by way of an additional “fee” added to their patron’s bills. [Los Angeles Times via Kaiser Health News]

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If you have doubts that lack of health insurance can have deadly consequences, consider these new findings from the American Journal of Public Health: Americans without health insurance are 40% more likely to die than those with private insurance. The Harvard study reiterates a 1993 Institute of Medicine study, which found a 25% higher death risk among those without insurance compared with privately insured adults. Why does the uninsured face this greater risk? The Institute of Medicine identifies three factors that influence health outcomes: not getting care when needed, not having a regular source of care, and not getting continuity of coverage – all of these are difficult goals to accomplish for the uninsured. Approximately 45,000 Americans of working age die each year because they lack health insurance. [via Yahoo! News]

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I’ve had quite a number of patients come in lately for general check-ups because they will soon be losing their job-sponsored health insurance coverage. I commend them for coming in. After all, late is sometimes better than never. Therefore, for today’s post I’d like to share some tips on things you should consider when your coverage is about to end.

1. Get an annual physical exam, including a skin check for possible skin cancers. It could get pricey should you need a biopsy and subsequent treatment.

2. Get your routine tests done. Those over 50 years of age should get a colonoscopy every 10 years. Women over 40 should have an annual mammogram. Women should also get annual pap smears.

3. Know your numbers: check your blood pressure, cholesterol, basic chemistries, urine analysis.

4. If you’re a smoker, speak to your doctor about ways to help you quit. Quitting smoking greatly reduces your risk of cancers and cardiovascular disease.

5. Ask your doctor about your risk for osteoporosis. In general all women over the age of 65 should get a DEXA bone densitometry scan at least once.

6. Speak to your doctor about weight loss. Keeping your weight under control can reduce your risk of diabetes, heart disease, high blood pressure, osteoarthritis, and high cholesterol, among a multitude of other diseases.

7. Get a flu shot and update your vaccinations. For adults these may include hepatitis A and B, herpes zoster (shingles), Tdap, chickenpox. If you are aged 65 or older you should have a pneumovax vaccination as well.

8. Refill your medications. Depending on the medicine, it may be possible for your physician to give you more refills. Similarly, if you are diabetic make sure your doctor gives you plenty of refills for glucose testing supplies.

*There are always exceptions to the rules. These are only general guidelines. Speak to your doctor to find out what is appropriate for you.

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According to an analysis released by The Commonwealth Fund this week, private insurance premiums for employer-sponsored coverage will rise by 94% by the year 2020. This is on top of the 119% increase that has already occurred between 1999-2008. These premium increases were greater than four times the rise in family incomes during the same period, even prior to the current recession. And these are only the premiums alone, not including out-of-pocket costs – deductibles, co-pays, and miscellaneous fees – which have also risen. This is why medical bills have become the number one cause in 62% of bankruptcies. Yet, instead of reining in cost and saving us money, private insurance companies will continue to increase their premiums. Regardless of how we end up dealing with our current health care situation, any genuine reform must counter the rising cost of health insurance premiums. [via The Commonwealth Fund]

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Wal-Mart Stores, Inc. surprised US companies this week by backing President Obama’s health care plan which, in part, requires all but small employers to provide insurance coverage for workers. ”As a company, we believe the present health-care system is unsustainable and making the country’s businesses less competitive in the global economy,” said Wal-Mart. However, some believe this is simply Wal-Mart’s strategy to circumvent a measure that is being considered by the Senate Finance Committee which will result in more burdensome health insurance requirements for companies that employ lower-wage workers. Whatever the case may be, it is the rising cost of health care in this country that is hurting both businesses and workers – by restricting wages and growth of businesses. Good health is not a commodity, an economic product that can only be purchased by those with wealth. Companies should not be making money off of our health care needs.

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New legislation being introduced this week by Senators Jeanne Shaheen (D-NH) and Susan Collins (R-ME) aims to help patients with post-hospital needs. The bill, called the “Medicare Transitional Care Act”, would create a new Medicare benefit to coordinate care during a person’s transition from inpatient to outpatient settings. This includes assistance with equipment needs, referrals for care, scheduling needs, and even medication instruction assistance. The goal is to ensure smooth and successful transitions to home or living facility in order to avoid re-admission to the hospital. Statistics show that 20% of people with Medicare who visit the hospital will return within a month.

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President Barack Obama addressed physicians this week at the 158th annual meeting of the American Medical Association (AMA) in Chicago.  His goal was to gain the support of the nation’s doctors for his healthcare plan which he said for the first time will cost an estimated $1 trillion dollars, perhaps even more. To help fund the costs obama wants to cut federal payments to hospitals by about $200 billion and cut $313 billion from Medicare and Medicaid over 10 years, in addition to a new $635 billion in tax increases and spending cuts in the health care system. The goal is to formulate a streamlined health care system that costs less, yet delivers more. Whatever the cost – or the plan – reforming our broken health care system will not be cheap. With more than 50 million uninsured Americans something needs to be done.

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A Congressional staff briefing on the state of health care in the US will take place on Tuesday March 24. The briefing will include the release of a new report, Primary Care Access: An Essential Building Block of Health Reform, which will reveal that nearly 60 million Americans are currently without a regular source of preventitive and primary health care. This is attributable to many factors, including economic instability, as well as the worsening shortage of primary care physicians and a growing scarcity of providers willing to treat the uninsured or publicly insured.

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