Posts Tagged ‘healthcare coverage’

Bad News for Jobs Due to ObamaCare? Take the Long View.

Wednesday, February 12th, 2014

So, it’s been a rough January — a second month of anemic job creation, a new CBO report saying that ObamaCare could cost 250,000 jobs and continuing blasts of arctic froideur that have shut down even the redoubtable Alter Group offices for days.

This is when perspective matters: Cassidy Turley takes a 6-month long view in the US Employment Tracker to find good news:

Taking this approach, the U.S. economy is creating a monthly average of 178,000 net new jobs, consumer spending is growing at an annual rate of 3.1% and the ISM manufacturing index has been a robust 60.6.” Also, after the usual revisions in the economic data, we found that “real GDP grew at an annualized rate of 3.2% in the final quarter of 2013, driven by the largest increase in consumer spending in three years. Business confidence is now at an 11-year high; consumer confidence has held up; fiscal policy is less of a drag; and the Fed is now tapering because it generally likes what it sees. Commercial real estate fundamentals have been consistently tightening for three straight years. Although the past few weeks have allowed some doubt to resurface, the outlook remains upbeat.

Then there’s the matter of looking at the right statistics for you. Such as the fact that office-using jobs that drive so much of commercial real estate have been on a tear recently — 34,000 in January. Overall office-using jobs have surpassed pre-recession levels (after bottoming out in 2009).

We can’t take a long view on bone-chilling temperatures but let’s look at the Obamacare costing a quarter million jobs. Here’s portion of the CBO report, “The Budget and Economic Outlook: 2014 to 2024.”:

The ACA’s largest impact on labor markets will probably occur after 2016, once its major provisions have taken full effect and overall economic output nears its maximum sustainable level. CBO estimates that the ACA will reduce the total number of hours worked, on net, by about 1.5 percent to 2.0 percent during the period from 2017 to 2024, almost entirely because workers will choose to supply less labor —given the new taxes and other incentives they will face and the financial benefits some will receive.

And therein lies the key phrase — “choose”. In other words, it is not jobs that will be eliminated but workers who will elect to retire, stay at home to raise the kids or go to a 3-day schedule so they have time to get another degree. They won’t feel tethered to their current employment because of the fear of not having health coverage.

Commonwealth Fund Tackling Better Care for Uninsured, Minorities

Tuesday, October 18th, 2011

A new strategy report issued by the Commonwealth Fund Commission on a High Performance Health System  has the goal of creating a road map to improve healthcare for the uninsured, minorities and low-income Americans.

The commission, which looks for opportunities to enhance the delivery and financing of healthcare, recommends three broad strategies for achieving that improved care in the report, Ensuring Equity:  A Post-Reform Framework to Achieve High Performance Health Care for Vulnerable Populations.  The recommendations seek to assure the safety net’s stability and stimulate higher performance; strengthen delivery systems for susceptible populations; and coordinate healthcare delivery systems with public health services and community resources.

“Our current economic situation has increased the number and proportion of people who are vulnerable, leaving even more families at risk of suffering from our healthcare system’s inequities,” said Dr. David Blumenthal, chairman of the commission, and Samuel Their, professor of medicine and professor of health care policy at Massachusetts General Hospital/Partners HealthCare System and Harvard Medical School, Boston.

According to the report, there is a significant divide between vulnerable populations and their more secure counterparts in rates of receiving recommended screening and preventive care, control of chronic diseases, and hospital admissions for conditions that may be preventable with good primary care and community health outreach.  By way of example, only four of 10 low-income adults receive all recommended screenings and preventive care, compared with six of 10 higher-income adults.  Approximately three of 10 (29 percent) uninsured adults diagnosed with diabetes do not have it under control, twice the rate of the insured (15 percent).  Black adults are hospitalized for heart failure at rates (959 per 100,000) that are more than twice the rate for Hispanic adults (466 per 100,000); that’s nearly three times the rate for white adults (349 per 100,000).

“This policy framework builds on the great strides we expect to be made for vulnerable populations once the Affordable Care Act takes full effect in 2014,” said Commonwealth Fund Executive Vice President for Programs Anthony Shih, M.D. “By addressing crucial issues like access to care, affordability, quality improvement, and better coordinated care, these recommendations seek to assure that the uninsured, those with low incomes, and racial and ethnic minorities see the full promise of health reform and experience a truly equitable healthcare system.” 

“The Affordable Care Act is a big step forward in terms of addressing the significant needs of vulnerable groups and the healthcare providers who serve them,” said Commonwealth Fund President Karen Davis. “However, the inequity in our healthcare system is significant and” as defined in the Commission’s report, “more work must be done to close that gap and assure that we have a healthcare system that provides all of us with access to high quality healthcare.”

Nine Million Americans Lost Healthcare Coverage During the Recession

Monday, April 4th, 2011

The financial crisis not only robbed nine million Americans of their jobs – but also their healthcare insurance. According to a new study by The Commonwealth Fund, only 25 percent of Americans who lost employer-sponsored healthcare coverage succeeded at finding another source.  As a result, an estimated 52 million Americans did not have healthcare coverage in 2010.  Even though the federal government provides a subsidy, just 14 percent of people who lost their jobs continued their coverage through COBRA.

According to The Commonwealth Fund Biennial Health Insurance Survey of 2010, “Using data from The Commonwealth Biennial Health Insurance Survey of 2010 and prior years, this report examines the effect of the recession on the health insurance coverage of adults between the ages of 19 and 64 and the implications for both their finances and their access to healthcare.  The survey of 3,033 adults, conducted by Princeton Survey Research Associates International from July 2010 to November 2010, finds that in the last two years a majority of men and women who lost a job that had health benefits became uninsured.  Adults who sought coverage on the individual insurance market over the past three years struggled to find plans they could afford and many were charged higher premiums, had a health condition excluded from their coverage, or were denied coverage altogether because of a pre-existing condition.  Meanwhile, Americans with health insurance had higher deductibles and consequently greater exposure to medical costs.  And millions were struggling to pay medical bills, facing cost-related barriers to getting the care they need, or skipping or delaying needed care, including prescription medications, because of the cost.”

Just 50 percent of adults aged 64 or less are current with preventive care.  Fully 49 million employed Americans spent 10 percent or more of their yearly income on out-of-pocket costs and insurance premiums, a sharp increase from the 31 million reported in 2001.  Once the Patient Protection and Affordable Care Act (ACA) goes into full effect in 2014, the situation is likely to improve dramatically.  “These reforms have enormous potential to begin solving the problems identified in this report,” said Sara Collins, vice president of The Commonwealth Fund, a private foundation that promotes a high performing healthcare system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable, including low-income people, the uninsured, minority Americans, children, and the elderly.

“The report tells the story of the continuing deterioration of healthcare accessibility, efficiency, safety and affordability over the past decade,” said The Commonwealth Fund president Karen Davis. “All this despite the fact that the United States spends more than any other country on healthcare.  Most recently it has failed the millions of Americans who lost their jobs during the recession and lost health benefits as well, leaving them with no place to turn for affordable healthcare coverage.  The silver lining is that the Patient Protection and Affordable Care Act has already begun to bring relief to families,” Davis said.  “Once the new law is fully implemented, we can be confident that no future recession will have the power to strip so many Americans of their health security.”

Of those people who attempted to buy an individual plan during the study’s timeframe — 19 million individuals – or 71 percent found it difficult or impossible to locate a plan they could afford and met their needs, were denied coverage or charged extra because of a pre-existing medical condition.  Adults with family incomes of less than $22,050 for a family of four were hardest hit with 54 percent having no healthcare insurance.  An additional 41 percent of families with incomes of between $22,050 and $44,100 had no coverage.  Of higher-income families, just 13 percent lacked healthcare coverage in 2010.

Conservative groups such as the Heritage Foundation are critical of the healthcare reform law.  The Washington, D.C.-based think tank wants changes made to the healthcare system to make it less reliant on government and to have individuals “own and control their own healthcare policies.”  Additionally, Heritage believes that the healthcare law will increase government spending.  “Of course there’s some people who will benefit from the law, but just focusing on individuals with benefits is misleading,” said Brian Blase, a policy analyst in health studies.  “You have to look at the law in its totality.”

Pre-Existing Medical Conditions Impact As Many As Half of All Americans

Wednesday, February 9th, 2011

A Department of Health and Human Services (HHS) study reveals that as many as half of all Americans under the age of 65 have pre-existing medical conditions, which could mean rejection by insurance companies or having to pay more for coverage.  According to HHS Secretary Kathleen Sebelius, that totals approximately 169 million people.  The report says that, of those Americans who are uninsured, 17 to 46 percent have pre-existing medical conditions, depending on the definition used. Such health problems are particularly common among adults aged 55 to 64 – a group long recognized as a problem spot in the healthcare system, because people of that age tend to have higher medical expenses but are too young to qualify for Medicare.

A Democratic analysis, released last fall by Representative Henry A. Waxman (D-CA), then the chairman of the House Energy and Commerce Committee, said that between 2007 and 2009, the nation’s four largest private health insurers denied coverage to about 650,000 people based on their medical history.

“Not surprisingly, as people age, their likelihood of having – or having had – a health condition increases,” according to Sebelius.  “Looking only at pre-existing conditions used in determining eligibility for high-risk pools, the percentage of Americans with these health conditions ranges from five percent of children to 48 percent of people ages 55 to 64.  Adding in common conditions that major insurers generally use in medical underwriting raises the risk to 24 percent for children, increasing to 86 percent for people ages 55 to 64.”

Robert Zirkelbach, a spokesman for America’s Health Insurance Plans (AHIP), the industry’s lobbying group, offers a different opinion, noting that “We’ve long supported reforming the individual insurance market so that everybody can have access to health-care coverage, regardless of their preexisting medical conditions.  But this report exaggerates the number of people who are impacted.”

Rick Ungar, who writes for Forbes, offers another perspective and asks if pre-existing conditions are an indication that the American Dream is dead.  According to Ungar — who is an attorney in Southern California, and a frequent writer, speaker and consultant on healthcare policy and politics – his initial reaction to the government report was “Yeah…it made me suspicious too.  Go figure that this extraordinary government revelation would surface on the very day the House is taking up debate on the repeal of healthcare reform.”

Ungar’s suspicion eased when he read this additional quote from Zirkelbach.  “Most of the Americans included in the figures currently have insurance. They would be at risk,” he said, “only if they needed to change coverage and buy it on their own.  People who get insurance through their jobs are guaranteed coverage.” Alter+Care Inspire notes that an additional reason might be people losing their jobs – something to consider at a time when the private sector has been so sluggish.

“And there it was,” according to Ungar.  “This spokesman for the nation’s pre-eminent health insurance lobby was not only acknowledging that there are millions upon millions of people with pre-existing conditions who could be denied healthcare coverage, he was actually telling us that we need not worry about them because – so long as they continue to get their insurance through their job – it’s all good.  But what if they want to leave their job to engage in some good, old-fashioned American entrepreneurialism?  Did Mr. Zirkelbach inadvertently direct our attention to the depressing reality that up to one-half of all Americans may not be free to pursue their futures and fortunes as they see fit because they are trapped in their jobs by their healthcare benefits?  You bet he did.”

Do the Right Thing

Tuesday, October 20th, 2009

3912_healthcare-debateA political paradox in the healthcare debate lies in the fact that some members of Congress – whose constituents will benefit the most from reform legislation – oppose the bill. A study by the Urban Institute found there are 20 congressional districts where more than 30 percent of the residents lack even the most basic form of healthcare coverage.  California, Florida and Texas are home to 18 of those districts.

In three Florida districts where the uninsured comprise one-third of the population, the Republican representatives are solid in their opposition to healthcare reform.  Republican Representative Mario Diaz-Balart, whose south Florida district has 31 percent uninsured residents, bases his opposition on the belief that none of the Democrats’ proposals will cover all of his constituents.  “My constituents, they also understand that they are the ones that get stuck with the bills,” he said.

On the opposite side of the aisle, Texas Democratic Representative Henry Cuellar, whose district is in 10th place on the uninsured list, fears that cuts in Medicare will be used to pay for the expanded coverage.  Cuellar’s district includes a significant senior citizen population.

By contrast, Southern California’s districts with the most uninsured residents are Los Angeles and Orange County, home to many immigrants and low-income groups.  These areas are represented by Democrats who support healthcare reform, which would provide significant benefits to their constituents.

Safeway Creates a Proactive Healthcare Coverage Model

Thursday, September 3rd, 2009

Supermarket giant Safeway, Inc., takes a proactive approach to its healthcare coverage and is in the forefront of the movement toward reform, according to Steven A. Burd, CEO.

Safeway’s voluntary Healthy Measures program, in which 74 percent of the non-union workforce participates, lets employees receive premium discounts for every behavior test they pass.  Employees who pass all four tests have their annual premiums reduced $780 for individuals and $1,560 for families.safeway_cart

Burd, who also founded the Coalition to Advance Healthcare Reform, believes that well thought-out healthcare reform, using market-based solutions, will reduce the nation’s cost of coverage by 40 percent.  That is more than enough to provide coverage for the 47 million Americans who currently lack insurance.

According to Burd, “At Safeway, we are building a culture of health and fitness.  The key to achieving these savings is healthcare plans that reward healthy behavior.  As a self-insured employer, Safeway designed a plan in 2005 and has made improvements every year.  During this four-year period, we have kept our per capita healthcare costs flat (this includes both the employee and the employer portion), while most American companies’ costs have increased 38 percent.”

Safeway’s plan focuses on the fact that 70 percent of healthcare costs are the result of behavior, and that 74 percent of all costs are due to four chronic conditions – cardiovascular disease, cancer, diabetes and obesity.  The firm also learned that 80 percent of cardiovascular disease and diabetes, 60 percent of cancers and 90 percent of obesity are all preventable.

“As much as we would like to take credit for being a healthcare innovator, Safeway has done nothing more than borrow from the well-tested automobile insurance model,” Burd said.  “For decades, driving behavior has been correlated with accident risk and has therefore translated into premium differences among drivers.  Stated somewhat differently, the auto insurance industry has long recognized the role of personal responsibility.  As a result, bad behaviors (like speeding, tickets for failure to follow the rules of the road, and frequency of accidents) are considered when establishing insurance premiums.  Bad driver premiums are not subsidized by the good driver premiums.”

RIP: The Senate’s Liberal Lion and Healthcare Reform Champion

Tuesday, September 1st, 2009

ted-kennedy-dies-001Ted Kennedy’s passing deprives President Obama of a critical political ally in his efforts to reform healthcare.  In his role as chairman of the Senate Health, Education, Labor & Pensions committee, Kennedy fought tirelessly for decades to reform a system that today deprives 47 million Americans of affordable, accessible healthcare coverage.

In The Guardian, Michael Tomasky notes that, “The heavens somehow conspired to make this Kennedy death, however expected it might have been, nearly as heartbreaking as those of his vigorous younger brothers.  It’s not just that the great cause of the last 40 years of his life, reforming America’s healthcare system, sits at a perilous juncture, although it certainly is that, in part.  But the tragic irony of the timing is even greater, because we see in the very healthcare debate that so needed his input the precarious state of the institution to which he devoted his life, and which he shaped and influenced more than probably any other senator in history.”

Kennedy, writing in the July 27, 2009, Newsweek, declared that healthcare reform is “the cause of my life”. “In 1973, when I was first fighting in the Senate for universal coverage, we learned that my 12-year-old son Teddy had bone cancer.  He had to have his right leg amputated above the knee.  The pathology report showed that some of the cancer cells were very aggressive.  I decided his best chance for survival was a clinical trial involving massive doses of chemotherapy,” according to Kennedy.

“During those many hours at the hospital, I came to know other parents whose children had been stricken with the same deadly disease.  We all hoped that our child’s life would be saved by this experimental treatment.  Because this was part of a clinical trial, none of us paid for it.  Then the trial was declared a success and terminated before some patients had completed their treatments.  That meant families had to have insurance to cover the rest or pay for them out of pocket.  Our family had the necessary resources as well as excellent insurance coverage.”

Other heartbroken parents were not able to pay for the continued treatment and that made Kennedy realize that “No parent should suffer that torment.  Not in this country.  Not in the richest country in the world.”  So passionate was Kennedy that Americans have access to healthcare that he often paid for others’ treatment out of his own pocket when they could not afford it.

Kennedy made healthcare reform his lifelong passion, vowing “We will end the disgrace of America as the only major industrialized nation in the world that doesn’t guarantee healthcare for all of its people.”

Wherever you stand on the issue, there is no doubt that Kennedy was a great senator, a statesman that Republicans and Democrats respected and emulated.  He did not live to see the healthcare bill passed, but perhaps his death will quell partisan dissension and bring us closer to a solution.

Congress and its Dueling Healthcare Plans

Thursday, July 30th, 2009

There are so many healthcare reform trial balloons being launched in Washington, D.C., that it’s difficult to keep up with who wants what.  Following is a rundown of what the current proposals say.

The Senate Health, Education, Labor and Pensions Committee’s proposal would require most people to have qualifying healthcare coverage, though with some exceptions.  People who do not participate face a tax penalty of at least 50 percent of the average yearly premium cost of the basic plan.  Employers would have to offer healthcare coverage and pay a minimum of 60 percent of the premium, or $750 for every full-time employee.  Individual and small business coverage would be managed through state-based “gateways” that provide consumers with information to help them decide on the right plan.  This is likely to cost $1 trillion over 10 years, according to the Congressional Budget Office (CBO).

The House Tri-Committee bill would require individuals to carry “acceptable health coverage”. People who opt out would pay a penalty of 2.5 percent of their modified adjusted gross income to the cost of the average national premium for individual or family coverage.  Employers must offer healthcare coverage and pay a minimum of 72.5 percent for single coverage and 65 percent for family coverage into the cheapest qualifying plan.  Alternatively, employers would pay eight percent of payroll into a health insurance trust fund.  The CBO estimates that this plan will cost $1 trillion over 10 years.  Medicare and Medicaid savings would pay for this, with the remainder covered by a surcharge on high-income individuals and families.

health_care_debate

Several other proposals are under consideration.  The Senate Finance committee is debating allowing people aged 55 – 64 to buy in to Medicare, as well as taxing insurance companies to fund the healthcare plan.  Conservative Democrats on the Energy and Commerce committee want the government to pay rural healthcare providers at a higher rate to assure better access to quality care.

With no vote expected prior to Congress’ annual August recess, we may see even more evolution in the proposals currently on the table.

Top-Rated Cleveland Clinic Holds the Line on Healthcare Costs

Thursday, July 9th, 2009

In an era when healthcare costs are projected to rise to $4 trillion by 2016, it’s heartening to know that one of the nation’s highest-rated hospitals has some of the lowest costs.  The Cleveland Clinic is regularly consulted by lawmakers and officials from the Obama Administration in their efforts at achieving healthcare reform – yet it operates more efficiently than most of its competitors.cleveland-clinic

“Everything we do is done with the patient at the center, not the doctor at the center,” said Dr. Steven Nissen.  One way the Clinic provides exceptional care at reasonable cost is by using a model in which medical professionals practice side-by-side rather than in separate and — frequently — competitive departments.

President Barack Obama gave kudos to the Cleveland Clinic for its success. “Without a serious, sustained effort to reduce the growth rate of health care costs, affordable healthcare coverage will remain out of reach.  So we must attack the root causes of the inflation in healthcare.  That means promoting the best practices, not simply the most expensive.  We should ask why places like the Mayo Clinic, the Cleveland Clinic, and other institutions can offer the highest quality care at costs well below the national norm.  We need to learn from their successes and replicate those best practices.  That’s how we can achieve reform that preserves and strengthens what’s best about our healthcare system, while fixing what is broken.”

As part of its road to excellence, the Clinic also promotes employee wellness.  It doesn’t hire smokers; it sponsors a farmers’ market at its main campus, stocks its cafeterias with healthy foods and conducts yoga classes for patients and employees.