Archive for the ‘Health Insurance’ Category

In an effort to curb healthcare spending, some insurance companies have tried to increase copays for outpatient visits in an effort to decrease the overall rate of visits to the doctor’s office. However, a new study from Brown University published in the Jan. 28 issue of the New England Journal of Medicine is showing that this strategy has some unintended consequences. After looking at some Medicare managed care plans that implemented such copay hikes between 2001 to 2006, the researchers noted an increase in hospital usage. Although these plans had 19.8 fewer annual outpatient visits per enrollee, they consequently had 2.2 additional hospital admissions and 13.4 more inpatient days per 100 enrollees. And as we all know being hospitalized is PRICEY. The authors estimate that by increasing outpatient copays in the short term Medicare plans might save $7,150 per 100 enrollees, but inpatient spending would swell by $24,000 per 100 enrollees in the year after the co-payment increase, thus not really saving any money at all. [via Medline Plus]

Share your comments here.

Tweet This Share on Facebook

The big news in U.S. health care came early Monday morning (1 am to be exact) as a 60-Senator majority  agreed upon their plan for health care reform. The Senate bill would make health insurance mandatory for almost all citizens of the union, covering nearly 30 million currently uninsured Americans. But, if there is any indication as to whether this most recent bill favors the American individual or the private, for-profit insurance companies all one needs to do is to look towards the ticker. Shares of major U.S. health insurance companies rose Monday, including Aetna, Cigna, Humana, United Health and Wellpoint – all hitting 52-week highs. According to Businessweek, “Investors have been worried for months that a public option would provide unfair competition to private insurers in part because it would receive government financial backing and could set reimbursement at artificially low levels.” But, worry no more since the lobbying efforts of these companies continue to pay off as lawmakers continue to pass bills that put our money into the pockets of insurers rather than spending the majority of it on caring for our health. [via Businessweek]

Share your comments here.

Tweet This Share on Facebook

As you may know, the latest news in the US health care reform debate is whether private for-profit insurance companies can honestly and competently offer comprehensive health insurance at prices which every American can afford. Senators are working on a proposed bill which will give a federal agency, the Office of Personnel Management, the power to negotiate with insurance companies to offer national health plans similar to those offered to members of Congress. If these plans do not meet criteria set forth to make coverage affordable for all, it would trigger the government to offer a “public option” which will compete with private insurers. But many, including lawmakers, do not support such reform which would replace the public option with a purely private approach. However, if acceptable, affordable and comprehensive coverage existed, does it matter who administers it? Perhaps not, provided that certain measures were in place. Other capitalist countries like Japan, Germany, and Switzerland all mandate that each citizen have health insurance, be it through private insurers, community-based plans, etc. The catch is that insurers cannot make a profit on basic health care or deny anyone based on preexisting conditions. If the government is able to successfully negotiate with insurance companies and also offer some public assistance to pay for premiums, then perhaps this proposal can be a capitalist compromise that will bring forth some much needed social change.

Read more about Health Care Reform.

Share your comments here.

Tweet This Share on Facebook

A Canadian woman recently lost her health disability insurance benefits over photos of her found on Facebook. Due to a diagnosis of major depression, Nathalie Blanchard was on sick leave from her job at IBM. However, her payments stopped this fall after her insurance agent apparently found several pictures of her in which she appeared to be having fun – at a Chippendales bar show, at her birthday party and on a getaway vacation. However, having depression doesn’t mean you are depressed all the time. Depressed individuals can have fleeting moments of joy, only to return back to their feelings of sadness afterwords. In her own defense, Ms. Blanchard states it was her physician’s advice to try and interject some fun into her life. She is currently working with her lawyer to regain her benefits. [via Yahoo! News]

Visit our Guide To Major Depression.

Share your comments here.

Tweet This Share on Facebook

The Genetic Information Nondiscrimination Act (GINA) is a federal law that protects Americans from being treated unfairly due to differences in their DNA which may affect their health. The parts of the law pertaining to employers took effect Saturday November 21, 2009. The act prohibits employers from requesting genetic testing or using an employee’s genetic background when making decisions about hiring, firing or promotions. It also protects Americans from being forced by their employers to undergo genetic testing. In addition, it makes it illegal for health insurance companies and group plans to use a customer’s genetic information – such as a family history of a certain disease – to deny coverage or to set premiums and deductibles. [via Health Day]

Share your comments here.

Tweet This Share on Facebook

If you’re considering Botox injections to diminish wrinkles or other cosmetic procedures, such as liposuction or face lifts, to turn back the hands of time, now would be a good time to do it if you don’t want to pay a 5% tax on these services. The $848 billion health care bill unveiled this past week by the Senate includes a 5% tax on aesthetic procedures and surgeries which is estimated to raise $5 billion over the next decade to fund the health care bill. Plastic surgeons are, not surprisingly, against such a tax due to its potential effect on income. On the other hand, proponents of the tax reason that some cosmetic procedures are luxury services and should be taxed as such. Approximately 12 million cosmetic procedures and surgeries  (which are usually not covered by insurance) were performed last year, at a total cost of $10.3 billion, according to the American Society of Plastic Surgeons. [via Kaiser Health News]

The following were the most popular cosmetic procedures of 2008, and their costs:

Top Five Minimally Invasive Procedures

• Botox – $391
• Hyaluronic Acid (to fill in wrinkles) – $578
• Chemical Peel – $815
• Laser Hair Removal – $456
• Microdermabrasion – $200

Top Five Surgical Procedures

• Breast Augmentation – $3,348
• Nose Reshaping – $4,197
• Liposuction – $2,881
• Eyelid Surgery – $2,963
• Tummy Tuck – $5,167

Share your comments here.

Tweet This Share on Facebook

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]

Share your comments here.

Tweet This Share on Facebook

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]

Visit the official Michelle’s Law homepage and share your comments here.

Tweet This Share on Facebook

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]

Share your comments here.

Tweet This Share on Facebook

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]

Share your comments here.

Tweet This Share on Facebook