Posts Tagged ‘California’

Life Expectancy in the US Dropping

Wednesday, August 1st, 2012

In 2009, a baby born in America could expect to live an average of 78 years, according to estimates from the U.S. Centers for Disease Control (CDC).  But this is now changing: A study in the Journal of Health Metrics shows the United States now ranks behind 10 other developed countries when it comes to life expectancy, even though Americans spend more on health care than people in most other countries.

Another study by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, found that between 2000 and 2007, more than 80% of counties in the US fell in standing against the average of the 10 nations with the best life expectancies in the world. Five counties in Mississippi have the lowest life expectancies for women, all below 74.5 years, putting them behind Honduras, El Salvador, and Peru. Four of those counties, along with Humphreys County, MS, have the lowest life expectancies for men, all below 67 years, meaning they are behind Brazil, Latvia, and the Philippines.

Nationwide, women fare more poorly than men. The researchers found that women in 1,373 counties – about 40% of US counties – fell more than five years behind the nations with the best life expectancies. Journal of Health Metrics editor, Dr. Chris Murray says “It’s a real surprise to us in the study that women are faring so much worse than men. American women still live longer than men by five to eight years. But they have picked up some bad habits: Women are now smoking more.  The obesity epidemic in women is greater than in men. Progress in tackling blood pressure is much worse in women,” Murray added.

So, what we need right now is more Blue Zones in the US.  The phrase was coined by in 2004 by author, Dan Buettner, who teamed up with National Geographic and hired the world’s best longevity researchers to identify pockets around the world where people reach age 100 at rates 10 times greater than in the United States – the blue zones. Some of them are:

  • Okinawa, Japan
  • Sardinia, Italy
  • Loma Linda, California
  • Nicoya, Costa Rica
  • Ikaria, Greece

So, where are our Blue Zones? Women live the longest in Collier, FL, at 86 years on average, better than France, Switzerland, and Spain. Men live the longest in Fairfax County, VA, at 81.1 years, which is higher than life expectancies in Japan and Australia. Women are also living long lives in Teton, Wyoming; San Mateo and Marin, California; and Montgomery, Maryland. For men, long life spans also can be found in Marin, California; Montgomery, Maryland; Santa Clara, California; and Douglas, Colorado.

Will California Opt for the Public Option?

Wednesday, March 7th, 2012

Although Vermont became the first state in the union to adopt a public option in healthcare, it may soon have company.  As Vermont Governor Peter Shumlin said when signing the legislation, “We gather here today to launch the first single-payer healthcare system in America, to do in Vermont what has taken too long – have a healthcare system that is the best in the world, that treats health care as a right and not a privilege, where health care follows the individual, isn’t required by an employer –  that’s a huge jobs creator,” Shumlin said.

The enormity of creating a public option hasn’t stopped tiny Vermont, which might seem like an unlikely place for a major revamp of the health insurance system: “By most standards, Vermont’s health care system already is one of the nation’s best. The United Health Foundation has ranked Vermont the healthiest state in the country four years in a row. Fewer than 10 percent of Vermonters lack health insurance, one of the lowest rates in the country.”

And then there’s California.  In a giant warehouse in Alameda, an army of  phone operators are employed by a large health insurance plan, and they’re willing to go the extra mile for their customers. They’ll schedule a doctor who will make home visits, a pharmacist who will drop off a prescription, and even help fill out an application for food stamps.  “We do things for them that a traditional, commercial health plan doesn’t do,” says Ingrid Lamirault, chief executive officer of the Alameda Alliance for Health, a county-run, not-for-profit insurer.

Although the much celebrated, and much maligned, public option may have died in Congress, it’s alive and well in California, which is unique in the nation for having public health insurance plans that are run by its counties.  California’s plans stretch from San Francisco to the Mexican border and cover 2.5 million residents.

The Alameda Alliance for Health — like a private insurance company — has a network of doctors and hospitals and covers 200,000 people in Oakland and neighboring communities.  Much like private health insurance companies, the alliance also runs a managed care plan for Medicaid beneficiaries and additional plans for county workers.   The alliance’s Lamirault thinks this is just the beginning.  In 2014, when the Patient Protection and Affordable Care (ACA) becomes law, millions of Americans will be able to buy coverage through state-based insurance exchanges. In California, government-run public plans, like the Alameda Alliance for Health, will compete with private insurance companies for all those new customers, those who run the county plans believe they can offer a robust network of doctors and hospitals to bargain shoppers looking for affordable coverage. “I think when some people get to make a choice,” according to Lamirault, “having local offices they can walk into and get help with things and get their questions answered, and when they call customer service they get their calls answered in under two minutes. Those kinds of things are important to them.”

California is unique in that many public county systems also contract with private physicians and top-notch research hospitals. They even share the same lobbying group as the big-named insurance companies, the California Association of Health Plans.  Some of those companies don’t have a lot of love for their public brethren. “Certainly, there are some health plans that didn’t like the idea of having to compete with these public plans,” said Anthony Wright, a public plan booster and executive director of Health Access, a Sacramento-based health care consumer advocacy group. “Especially ones that, having come out of the Medicaid program, are used to providing care at cheaper rate.”

Some California insurance companies say they will happily compete on price so long as the public plans do not get preferential treatment.  Doctors and hospitals already accept low reimbursement rates from public plans, often as part of their charity care. That lets the public plans keep their premiums low, although private plans say they are charged higher prices.

The preferential treatment is not likely to last beyond the 2014 opening of the exchanges in California to people with higher incomes, the government-run plans will have to pay providers more than they do now, according to Sumi Sousa, officer of policy development at the San Francisco Health Plan. Sousa says the belief that public plans always cost less just isn’t true. “Some commercial providers, because they’re so large, they’re able to spread their cost over a much broader network,” Sousa said. That’s not the case for many county-run health plans in California, which are quite small.  Still, says Sousa, the public plans do have low overhead: Executives earn a fraction of the salary paid to the big CEOs, and they have no stockholders.

Additionally, the public option is likely to be on California’s 2012 ballot.   Jamie Court, executive director of Consumer Watchdog, a Santa Monica-based consumer advocacy group, plans to put an initiative to add a state-run healthcare public option on the ballot. Opponents say the initiative doesn’t improve the way healthcare is delivered and paid for.  Despite critics, Court says he’ll push forward on his plans to circulate a petition to the public.  “We believe the premium regulation is definitely something that Californians overwhelmingly favor, and we think the public option is something that they still favor,” Court said.  Court has written that health insurance requirements are a motivating force for the initiative: “By 2014, all of us will be required to buy health insurance or face tax penalties. The problem is that health insurance companies can charge whatever they like and raise premiums at will in California.”

In opposition, Micah Weinberg of the Bay Area Council, say rising rates reflect rising health care costs and extended life spans, and the government should let competition keep rates down. Weinberg calls himself an “enthusiastic supporter of healthcare reform,” and argued on KPCC’s Patt Morrison Tuesday that the system is already making reforms — reforms he feels the public option doesn’t address.  “We’re expanding insurance coverage by giving people insurance subsidies to purchase insurance through the exchanges, so that’s exactly what we’re doing.  A public option doesn’t get us any closer to that goal and it’s not a helpful addition to what we’re trying to accomplish,” says Weinberg.

Medicare for All!

Thursday, June 2nd, 2011

As Vermont becomes the first state in the nation to enact single-payer healthcare coverage, Senator Bernie Sanders (I-VT) and Representative Jim McDermott (D-WA) have introduced legislation to make Medicare for all the law of the land. Called the American Health Security Act of 2011, Senator Sanders said the legislation is necessary because “The United States is the only major nation in the industrialized world that does not guarantee healthcare as right to its people.  Meanwhile, we spend about twice as much per capita on healthcare with worse results than others that spend far less.  It is time that we bring about a fundamental transformation of the American healthcare system.  It is time for us to end private, for-profit participation in delivering basic coverage.  It is time for the United States to provide a Medicare-for-all single-payer health coverage program.”

Sanders and McDermott have strong backing from Arlene Holt Baker, executive vice president of the AFL-CIO; Jean Ross, co-president of the National Nurses United; and Greg Junemann, president of the International Federation of Professional and Technical Engineers.  All three groups are encouraging this fight for real reform.  “Providing a single standard of high quality care for all is a priority for registered nurses who have seen their abilities to act as patient advocates made more difficult as for-profit interests control more patient care decisions,” said Ross, whose union has been in the forefront of the fight for single-payer. “We commend Senator Sanders and Representative McDermott for their vision and passion to help registered nurses create a more just healthcare system through the American Health Security Act and applaud our brother and sisters in labor for their support,”  Physicians for a National Health Program, which consists of doctors and medical students who want real reform, also are supporting the national legislation, which is unlikely to end up on President Obama’s desk for signature.

Writing in the British newspaper the Guardian,  Sanders says that “Under our dysfunctional system, 45,000 Americans a year die because they delay seeking care they cannot afford.  We spent 17.6 percent of our GDP on healthcare in 2009, which is projected to go up to 20 percent by 2020, yet we still rank 26th among major, developed nations on life expectancy, and 31st on infant mortality.  We must demand a better model of health coverage that emphasizes preventive and primary care for every single person without regard for their ability to pay.  It is certainly a step forward that the new health reform law is projected to cover 32 million additional Americans, out of the more than 50 million uninsured today.  Yet projections suggest that roughly 23 million will still be without insurance in 2019, while healthcare costs will continue to skyrocket.”

All Vermont residents will be eligible for coverage under the system, known as Green Mountain Care.” Originally promoted as a “single-payer plan,” the measure is referred to as a “universal and unified health system.”  Governor Peter Shumlin has said he will sign the bill into law.  “This really is an extraordinarily exciting moment for Vermont,” according to Shumlin.  “We have a long way to travel, but I am convinced we can get healthcare right and this is the bill that will get us there.”

Meanwhile in California, some legislators have revived a bill to create a single-payer healthcare system.  It would replace President Obama’s healthcare reform legislation with a more comprehensive system – one that would cost no more than what people already pay.  Opponents categorically deny that assertion.  One academic observer of healthcare policy said, “If you think the fight over affordable care was nasty, you haven’t seen anything yet.  This plan is going to gore a lot of oxen,” said Gerald F. Kominski, associate director for UCLA Center Health Policy Research.  “No.1 is the insurance industry. They are not about to see their business go up in smoke.”

California’s proposed plan establishes a single- payer “Medicare for All” type of program by pooling the money that government, employers, and individuals already pay and using that money more efficiently by cutting out the middle man – insurance companies.  “There are some 6,000 health plans in California, and health care providers spend about one-third of their resources just getting paid,” said State Senator Mark Leno of San Francisco.  There will be other saving opportunities as well – such as bulk purchasing power for everything from pharmaceuticals to hearing aids, eyeglasses and the investment in primary and preventive care.

When asked if he thought the legislation has a chance to become reality in California, Kominski said, “I’ve seen enough things happen to never say ‘never.’  I don’t know how the ongoing financial crises might change public opinion on healthcare to vote for a more fundamental change of healthcare delivery.”

Arnold Schwarzenegger Breaks With Republicans to Support Healthcare Reform

Thursday, May 20th, 2010

Schwarzenegger breaks with Republicans to support healthcare reform.  “The Terminator” has changed his mind.  Although he originally opposed healthcare reform as the legislation moved through Congress, California Governor Arnold Schwarzenegger now fully supports the new federal law.  In a speech at the University of California at Davis Medical Center, the governor – who cannot run for re-election because of term limits — broke rank with his fellow Republicans, many of whom have announced their intention to sue the federal government to overturn the law.

“California is not part of this fight, and I’ll tell you why,” according to Schwarzenegger.  “When you don’t have health insurance and you go to the hospital, you are forcing other people to pay for your healthcare.”  Twenty percent of California residents lack healthcare insurance, a situation that Schwarzenegger says is a crisis that requires resolution.  “The bottom line is the plan is not without flaws, but it is a good law,” he said.  To fill the void, California is launching a temporary high-risk insurance pool to cover the uninsured that will be funded by $761 million in Department of Health and Human Services money through 2014.

Schwarzenegger also vowed to enforce the law, to the point of making certain that the state’s insurers comply with bans on lifetime spending caps.  If necessary, he will call the state Legislature into a special session to make statutory changes to comply with the act’s provisions.  “We’re ready to roll up our sleeves and work with the federal government to get this done,” the governor said.

“The Terminator” Thinks Healthcare Reform Needs Rethinking

Thursday, January 21st, 2010

California Governor Schwarzenegger thinks healthcare reform beats up on California.  “The Terminator” thinks it is time for the federal government to take care of California – especially when it comes to healthcare reform legislation.  At a time when Congress is poised to pass sweeping healthcare reform, Governor Arnold Schwarzenegger (R-CA) thinks that President Obama should rethink the legislation.  In fact, Schwarzenegger thinks that healthcare reform is “something that ultimately would beat up on California,” as moderator David Gregory remarked during a recent “Meet the Press” interview.

According to Schwarzenegger, “Right now it is.  And I just cannot imagine why we would have, like I said, our senators and congressional people, how they would vote for something like that where they’re representing Nebraska and not us.  And, by the way, as I said in my State of the State, that’s the biggest rip-off.  That is against the law to buy a vote.”

Schwarzenegger is referring to the Equitable Support for Certain States, which will provide Nebraska — as well as Massachusetts and Vermont — support in paying its share of additional costs to Medicaid in the health legislation.  The provision, which Republicans have mocked as the “Cornhusker Kickback,” actually provides Nebraska the least of the three states.  Vermont will receive $600 million over 10 years, while Massachusetts will receive $500 million.  The money to Nebraska is expected to total $100 million.

The Congressional Budget Office (CBO) disagrees with Schwarzenegger – who says it will cost $3 to $ billion over 10 years — on the total cost of the Equitable Support for Certain States program.  According to CBO statistics, the section of the manager’s amendment to the Senate’s health bill would cost $1.2 billion over 10 years.