[…] Data like this indicates that simply providing health insurance to everyone is not the key to actually improving our overall health (which should really be the end goal of health care reform). Providing real access to health care should indeed be the first step, but it is far from the last step. Personal responsibility plays a huge part in protecting our health, but so do government policies. Hopefully health care – and the real preservation of health – will continue to be a priority.
Blog
Dentists And HIV Screening
[…] Even if the cost of the test is only counted towards a patient’s deductible (as might be the case if the patient has an HSA qualified plan, for example), just knowing that it will be billed to the health insurance company might make a patient more likely to get the test. In addition, billing the test to a health insurance company is likely to result in a lowered final price for the patient based on network negotiated rates. All around, it makes sense for dental offices that provide HIV screening to be able to bill a patient’s health insurance company for the test.
HSA Helps To Balance Emergency Savings With Investing
[…] The number of people with HSA qualified plans has been steadily increasing over the last few years, and the plans are very popular with our Colorado clients who purchase their own health insurance. For anyone who doesn’t want to have to choose between investing and saving for a medical emergency, HSAs are a perfect fit.
Average Total Premium Not The Same As What Families Really Pay
[…] We know that there are families out there who are paying more than a thousand dollars a month for their health insurance. But they are the exception rather than the rule. The Daily Kos article makes it sound like the average family will end the year with nearly $7000 in their pockets from premium savings, and that just doesn’t add up.
Lessons From The Taiwanese Health Insurance System
[…] job of convincing people that we really don’t need a lot of the health care services that are currently viewed as essential. 16% of our GDP is spent on health care, tens of millions of Americans have no health insurance and have to rely on free clinics and crowded emergency rooms for care, more than half of all bankruptcies in this country stem from medical problems… all of this, and our life expectancy is only a few weeks longer than that of people in Taiwan.
Expanding Medicare Would Require Additional Taxes
[…] No insurance company – public or private – can withstand a significant influx of sick insureds without balancing it out by adding additional healthy insureds. That’s why the mandate requiring everyone to purchase health insurance is a necessary part of the reform bills that would require health insurance companies to accept all applicants, regardless of health history.
Health Insurance Across State Lines Not As Simple As It Sounds
[…] I’m not opposed to the idea of health insurance companies that could operate on a national basis, allowing people to keep their health insurance if they move to another state. But such a plan would have to be overseen by federal guidelines. Simply opening things up to allowing health insurance companies to base themselves in any state they choose, operate under that state’s laws, and sell health insurance in all states, would take us to the lowest common denominator in terms of consumer protections.
Maternity Coverage And Access To Midwifery Care
[…] Amy Romano has written an outstanding article comparing modern American maternity care with SUVs. Since maternity care takes up such a huge portion of our health care budget, this article is a worthwhile read for anyone concerned about the spiraling cost of health care. Hopefully the points that Amy makes will be taken into consideration when lawmakers decide what services should be covered by all health insurance policies.
Why Health Care Reform Is Important
[…] Basically, we can’t have it both ways. If we want smaller government, we have to accept that it comes with fewer regulations. And that means more control in the hands of industry and less in the hands of consumers. If we want regulation over things like premium increases and pre-existing condition limitations, we have to accept that it means more government intervention. In the case of health care and health insurance, we’ve obviously got some flaws in our current system. In some states, a person without access to an employer-sponsored health insurance policy cannot get coverage at all. That is a problem any way you look at it.
Yes, some of the problems stem from personal irresponsibility (although hopefully mandatory health insurance will help to address this issue). But some of the problems are built into the health care system, and that is why reform in the shape of government intervention is such an important task. Because a consumer versus an industry isn’t really a fair match-up.
Reform Worth The Costs
[…] Because individual policies are medically underwritten in Colorado, and because our family is healthy, the individual option is quite a bit less expensive than a group policy would be.
If the health care reform bill makes it through the senate and ends up becoming law, that will probably change. We’ll still have a few more years of the status quo, but in 2013 we’ll likely see significantly higher premiums for those of us who are healthy and buy our own health insurance. The difference in premium between a group plan and an individual plan for our family will likely be much less than it is today, due to both the increased benefit mandates and the end of medical underwriting that is expected in the individual market […]
Premiums In The Individual Market
[…] I think that perhaps the WSJ article confused average group health insurance premiums with those in the individual market. Under current law, which allows for medical underwriting in most states, individual health insurance is significantly less expensive than group coverage – for those who can qualify based on medical history. If we end up with reform that adds additional mandatory coverage (like maternity care) to all individual policies and requires coverage to be guaranteed issue without mandating that everyone be part of the insurance pool, we might well end up with premiums for individual policies that are similar to what was mentioned in the WSJ article. But for now, individual health insurance premiums aren’t even close to that amount.
Surtax Not That Much Of A Burden
[…] But let’s look at the actual impact of the tax as it’s currently written in the Senate bill. It wouldn’t take effect until the beginning of 2013, so wealthy Americans would have three years to squirrel away savings before they had to start paying a little extra in taxes. And the actual amount of the tax is set at half of a percent of income above the $200,000 threshold. Let’s consider a CEO who earns a million dollars a year, filing on his own. $800,000 of her income would be subject to the healthcare surtax, at a rate of 0.5 percent. Half of one percent is not a large chunk of anything. In this case, it would amount to $4,000 ($800,000 times 0.005). So we would be asking a person earning a million dollars a year to kick in an extra $4000 to help pay for healthcare. My vote? That is perfectly fair. Her million dollar a year salary puts her above nearly every other American in terms of earnings, and $4000 doesn’t make much of a dent in a million dollars. […]
Not All States Have A Guaranteed Issue Option
[…] High risk pools are definitely better than nothing, but they don’t solve all insurance problems for people who have pre-existing conditions, and they don’t exist at all in some states. One of the aims of reform ought to include truly making health insurance available – in all states – to all applicants who want to purchase it. If we make all health insurance policies guaranteed issue (without also significantly expanding the pool of healthy insureds via a strong mandate), we’ll likely see higher costs for all insureds. But a good start would be to make sure that everyone, regardless of where they live, has access to at least one guaranteed issue health insurance policy (and no, discount plans and limited benefit policies don’t count).
Chamber Of Commerce Short On Solutions
The Chamber of Commerce has been vehemently opposed to the health care reform bills that have been debated in the House and Senate this year, so it isn’t much of a surprise to see that they are raising money to pay an economist who can “prove” that the proposed reform would increase unemployment and harm the US economy […]
Public Opinion Of A Mandate
[…] When it came to the mandate, however, things got a little stickier. I believe that lawmakers understood that allowing people to purchase health insurance without medical underwriting, while also allowing them to choose whether or not to obtain coverage, would amount to much higher premiums for the people who choose to have coverage. Initially they drafted a reasonably strong mandate, but caved in to criticism and weakened the mandate to the point where the fine for not carrying health insurance will only amount to a fraction of the cost of buying a policy […]
Imerica Placed In Rehabilitation
[…] If it is determined that Imerica can be rehabilitated, they will continue to do business under the rehabilitation plan. If not, Imerica would be liquidated, and policyholder claims not paid by Imerica would become the responsibility of the life and health insurance guaranty funds in the states where Imerica was licensed. In Colorado, this group is known as the Life and Health Insurance Protections Assocation (LHIPA). LHIPA has a maximum benefit of $500,000 for major medical insurance, which is significantly lower than most of the benefit maximums offered on private health insurance policies in Colorado (including Imerica, which offered policies with lifetime maximums ranging from $2 million to $8 million) […]
An Office Visit In France
The Healthcare Economist’s Jason Shafrin has written an interesting article about how the French healthcare system utilizes hyperbolic discounting in order to avoid moral hazard. Basically, their system requires the patient to pay up front for a visit to the doctor, but then health insurance reimburses the patient 70% of the cost. This has two advantages over a system like ours which only requires the patient to pay their copay at the time of service. First, it conveys the value of the visit. Here in the US, people who have health insurance with copays for office visit are often unaware of the actual cost of the visit. They pay their copay and the rest is billed to the health insurance company. People who read their EOBs will see the actual billed amount and the amount that the insurance company paid, but I doubt that everyone reads their EOBs […]
Addressing The Problem Of Cost
Ezra Klein recently interviewed George Halvorson, Chairman and CEO of Kaiser Permanente (which operates our largest HMO here in Colorado). Both the questions and answers were insightful and on target in terms of addressing the cost conundrum that is so often glossed-over in the health care reform debate.
Mr. Halvorson pointed out that while many developed countries have some form of private health insurance, they also have medical fee schedules that are set by the government and are far lower than average costs for the same procedures in the US. When average fees for various medical procedures in several countries are shown on graphs, the US bar looks like a giraffe standing in a herd of gazelles.
But Halvorson acknowledged that while fees in other countries are even lower than Medicare reimbursement amounts here in the US, half of hospitals here are losing money, and do so especially when they treat Medicare patients. So it’s not as simple as just saying that we need to create set fee schedules that are more in line with those of other countries […]
Grand Rounds Vol. 6 No. 8
How To Cope With Pain brings us a truly amazing video. It’s a reminder to be thankful for all that we have, and for the things in life (like this video) that inspire us. It’s well worth the five minutes it takes to watch it.
Amy Tenderich of Diabetes Mine shares a “would you rather…?” moment from her 9-year old daughter. It’s a poignant reminder, seen through the eyes of a child, that all of the parts of our lives – even the bad parts – combine to make us who we are […]
Health Wonk Review
Welcome to the Health Wonk Review. 2009 has been an exciting year for health care reform, and last Saturday’s passage of HR3962, the Affordable Health Care for America Act, has given us plenty to talk about. For anyone who hasn’t kept up on the details of the House reform bill, I want to start things off with a four-part series from Tim Jost, who holds the Robert L Willett Family Professorship of Law at the Washington and Lee University School of Law. His articles were published at Health Affairs Blog, and amount to an excellent primer, written in plain English, for people who want to understand HR3962, but don’t have time to read all 1990 pages […]
Accepting Grand Rounds Submissions
We will be hosting Grand Rounds, the weekly collection of great health and medical blogging, on Tuesday, November 17th. Please send me your article to louise (at) healthinsurancecolorado (dot) net, indicating Grand Rounds in the subject. Please do so before midnight on Sunday, November 15th, mountain time.
Optional theme, because of the upcoming Thanksgiving holiday, will be articles about something you’re thankful for.
The theme is optional. Grand Rounds will include all other important topics you write about. Looking forward a thankful edition!
HB1355 Now In Effect For All Small Groups In Colorado
[…] Critics are questioning why insurers keep bringing up HB1355, as the trend in national health care reform these days is towards guaranteed issue health insurance without underwriting – which is what HB 1355 was all about. But while HB1355 was beneficial to groups with unhealthy members, the majority of small groups in Colorado had a discount before HB1355 took effect. And if those groups are unable to afford their new, higher rates, they can opt to cancel their coverage – which leads to higher prices for groups that remain covered. On a national level, as far as individual health insurance is concerned, HB1355 should be considered a warning sign. Getting rid of medical underwriting is the right, and fair, thing to do. But not if people can come and go as they please in the insurance system. We’ve seen what the impact will be on premiums if guaranteed issue coverage takes effect without a strong mandate requiring people to carry health insurance. I think this is why insurers are still bringing up HB1355. It’s impacting all small groups in Colorado now – there’s no more putting it off. And significant rate hikes for healthy groups should serve as a warning for what we’ll likely see in the individual market if reform passes without a way to make sure that everyone is part of the insurance pool.
Colorado Premiums Rising Faster Than National Average
Across the US, employers will see a 9% increase in health insurance premiums next year. But in Colorado, the increase will be an average of 11.8%. The Lockton Group has released its 2010 Colorado Employer Benefits Survey Report, and it indicates that Colorado will see bigger premium increases than the country as a whole. This puts Colorado businesses at a disadvantage in terms of direct operating expenses, as health insurance makes up a large portion of business overhead. It also makes it harder for Colorado businesses to compete for the best employees, since premium increases are being passed along to employees in the form of higher premiums and fewer benefits. Not surprisingly, Colorado businesses are much less likely to offer pricey HMOs than they were a decade ago (32% now, versus 89% in 2000), and far more of them are offering HSA qualified, high deductible health insurance policies (which have lower premiums) for their employees (27% now, versus only 3% in 2003).
Colorado residents tend to be healthier than the average American. We’re thinner, and have lower incidence of hypertension and diabetes than most of the rest of the country. So why would health insurance rates be rising faster here than in the rest of the country? My guess is that it has something to do our higher-than-average percentage of the population without health insurance. 17.2% of Colorado residents are uninsured, compared with national numbers that tend to be in the 15 – 16% range. When uninsured patients are treated by our health care providers (emergency rooms are a good example of this), the providers have to recoup their losses somehow. This usually translates into higher reimbursement rates being negotiated with health insurance companies. The insurance companies pass on their higher costs to customers in the form of higher premiums and/or reduced benefits. […]
Health Insurance Premiums And The Public Option
David Williams has written an insightful article about how big business concerns about a public health insurance option might be overly dramatic. I do understand the concerns that business owners have, since they believe that a public option will lead to costs being pushed onto private health insurance carriers, who in turn would charge higher premiums. There is no doubt that businesses have felt the sting of rising health insurance premiums for years now. In Colorado, employer-sponsored health insurance premiums rose by almost 87% between 2000 and 2009, while wages increased by only 20.5% over those years. Employees are increasingly seeing higher premiums deducted from their pay, combined with higher deductibles and copays. But employers still pay the lion’s share of many employees’ health insurance premiums, and the prospect of even higher premiums isn’t likely to sit well with them […]
Women And The House Health Care Reform Bill
Not surprisingly, House Democrats are going after the female vote by including several provisions in the current draft of their health care reform bill that are designed to expand coverage and reduce premiums for women. For starters, the bill includes a ban on using gender as a factor in setting premiums. This will result in lower premiums for women, but higher premiums for men. In Colorado, men are currently more likely than women to be uninsured. Raising their rates to compensate for lowered rates for women might result in more men being uninsured. But in terms of overall fairness, it does make sense to charge the same rates for men and women.
Specifically forbidding the practice of denying coverage to domestic violence victims is also part of the House bill, and will likely receive widespread support from both women and men alike. But in the eight years since we started selling medically underwritten health insurance, I can’t remember a single time that an applicant was declined for being a victim of domestic violence, nor have I ever seen a question on any application asking if the applicant has been abused. So while this provision makes sense, and will no doubt be beneficial for a few people, I imagine its strongest impact will be in helping to rid us of “blaming the victim” mentality […]