Category Archives: Health Insurance

Universal healthcare could save America trillions: what’s holding us back? | Opinion | The Guardian

More fuel to the fire on single payer from The Guardian, as a follow-up to my two previous posts on the subject, Healthcare Lobbying Group Double-Crossing Democratic Voters and Establishment looks to crush liberals on Medicare for All – POLITICO.

A slew of studies are confirming that America can afford real universal healthcare, but some call it economically infeasible

Source: Universal healthcare could save America trillions: what’s holding us back? | Opinion | The Guardian

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Employer Insurance Costs Growing Burden for Middle Class

The Commonwealth Fund today released a report that stated that the cost of employer-based insurance is a growing burden on middle-class families.

In 2017, more than half (56%) of people under age 65, about 152 million people, had insurance through an employer, either their own or a family member’s. In contrast, only 9 percent had a plan purchased on the individual market, including the marketplaces.

Here are the highlights from that brief:

Highlights

* After climbing modestly between 2011 and 2016, average premiums for employer health plans rose sharply in 2017. Annual single-person premiums climbed above $7,000 in eight states; family premiums were $20,000 or higher in seven states and D.C.

* Rising overall employer premiums increased the amount that workers and their families contribute. Average annual premium contributions for single-person plans ranged from $675 in Hawaii to $1,747 in Massachusetts; family plans ranged from $3,646 in Michigan to $6,533 in Delaware.

* Average employee premium contributions across single and family plans amounted to 6.9 percent of U.S. median income in 2017, up from 5.1 percent in 2008. In 11 states, premium contributions were 8 percent of median income or more, with a high of 10.2 percent in Louisiana.

* The average annual deductible for single-person policies rose to $1,808 in 2017, ranging from a low of $863 in Hawaii to a high of about $2,300 in Maine and New Hampshire. Average deductibles across single and family plans amounted to 4.8 percent of median income in 2017, up from 2.7 percent in 2008. In three states (Florida, Mississippi, and Tennessee), average deductibles comprised more than 6 percent of median income.

* Combined, average employee premium contributions and potential out-of-pocket spending to meet deductibles across single and family policies rose to $7,240 in 2017 and was $8,000 or more in eight states. Nationally, this potential spending amounted to 11.7 percent of median income in 2017, up from 7.8 percent a decade earlier. In Louisiana and Mississippi, these combined costs rose to 15 percent or more of median income.

Worker payments for employer coverage are growing faster than median income.

The average employee premium cost across single and family plans amounted to 6.9 percent of median income in 2017, up from 5.1 percent in 2008.

Average deductibles are also outpacing growth in median income.

In many states, even though costs are rising, people are not getting insurance that protects them more because deductibles are also increasing.

Still think that the free market works for health care? Guess again.

We are the only advanced nation that refuses to give its citizens universal health care like other similar nations do. This “growth” is unsustainable and will lead to single-payer health care.

 

This election is about your pre-existing medical condition – Managed Care Matters

Fellow blogger, Joe Paduda, summed up what is at stake for millions of Americans, your humble blogger included, if the GOP holds onto the House and Senate after the Midterm election thirteen days from today.

At the bottom of Joe’s post is a link to a Blue Cross/Blue Shield website. Scroll down to the part labeled “Medical Condition Rejection List.” It covers every conceivable illness and condition that human beings may suffer from, and included on that list is peritoneal dialysis, which I am undergoing, and hemodialysis also.

If the Republicans get their way, the only people who will have health insurance are perfect specimens, and we all know that there is no such thing as a perfectly healthy human being. We are all born with, or have the potential to get, some form of illness or disease at some time in our lives. It’s in our genes.

Unless of course, you are Superman/Superwoman.

Here is Joe’s post:

Will you be able to afford health insurance, and will that insurance cover your pre-existing medical conditions? For most, that’s the biggest issue in the upcoming election. Congressional Republicans are planning to pass legislation that allows insurers to: a) stop … Continue reading This election is about your pre-existing medical condition

Source: This election is about your pre-existing medical condition – Managed Care Matters

Critics pounce as CMS gives states more leeway to skirt ACA | Healthcare Dive

Slowly, but surely, we are moving inexorably towards the adoption of single payer healthcare, even though the current regime and the medical-industrial complex is doubling or tripling down on a free-market, for-profit health care system that will split into two classes – those who can afford it, and those who cannot.

So, it is no surprise that the people in charge of the US health care system are systematically dismantling the ACA, and pushing dubious, short-term limited plans that do nothing but line the pockets of the corporate health insurance sector. Appointments such as Mary Mayhew, the former DHHS Commissioner from Maine, and an aide to Governor Paul Le Page, as deputy administrator and director of Medicaid and CHIP, is symbolic of how the regime is attempting to roll back health care for Americans, and now that work requirements are being implemented, is throwing thousands off of rolls in some states.

The following from Healthcare Dive is instructive of this blatant attempt at destroying health care for millions of Americans who never had it, or couldn’t afford to pay large premiums.

Here is the article:

New guidance on 1332 Medicaid waivers makes it easier for states to use association and short-term health plans that limit coverage for pre-existing conditions.

Source: Critics pounce as CMS gives states more leeway to skirt ACA | Healthcare Dive

Immigrants Pay More In Private Insurance Premiums Than They Receive In Benefits | Health Affairs

A press release from Dr. Carol Paris of the Physicians for a National Health Program (PNHP) reported the following article from yesterday’s Health Affairs journal.

Two of the authors of the study, Steffie Woolhandler and David U. Himmelstein are regular contributors to many articles appearing in Health Affairs, and you may remember them from my review of the book they published along with Howard Waitzkin and others, Health Care Under the Knife: Moving Beyond Capitalism for Our Health.

Here is the press release in full:

FOR IMMEDIATE RELEASE:

Despite recent claims that immigrants are a drain on the American economy and health system, a study published yesterday in Health Affairs shows that immigrants make a net contribution to private health insurance plans. The research team, which included several PNHP members, found that as a group, immigrants paid $88.7 billion in private insurance premiums but used only $64.0 billion in insurer-paid health care, generating a surplus of $24.7 billion in 2014.

In “Immigrants Pay More in Private Insurance Premiums Than They Receive in Benefits,” researchers Leah Zallman, M.D., M.P.H., Steffie Woolhandler, M.D., M.P.H., Sharon Touw, M.P.H., David Himmelstein, M.D., and Karen Finnegan, Ph.D. found that between 2008 and 2014, immigrants generated a cumulative surplus of $174.4 billion for private insurers, heavily subsidizing the the benefits of U.S.-born enrollees and boosting the profits of insurance companies. On a per-enrollee basis, immigrants provided an average premium-over-payout surplus of $1,123 each, while U.S.-born Americans incurred an average deficit of $163 each. Undocumented immigrants, who generally use little medical care, generated the largest surplus at $1,445 per enrollee.

While recent studies have examined the financial impact of immigrants on public health programs like Medicare, this project was the first to look specifically at immigrants’ role in financing private health insurance. Since undocumented immigrants or those residing legally in the U.S. for fewer than five years are not eligible for Medicaid and Medicare, private insurance is often immigrants’ only coverage option. Even so, many immigrants are afraid to use the coverage that they earn and pay for.

“Almost every day I see immigrant patients who avoid seeking the care they need to stay healthy,” said lead author Dr. Leah Zallman, who is director of research at the Institute for Community Health, physician at Cambridge Health Alliance, and assistant professor of medicine at Harvard Medical School. “Political leaders have created a climate of fear by blaming immigrants for driving up health care costs. However, this study and our prior research shows that by paying more into the system than they receive, immigrants actually subsidize both private insurance and Medicare for U.S.-born citizens.”

Don McCanne added the following on his post this afternoon about immigrants and private health insurance premiums.

From the Discussion

Immigrants contributed far more in premiums for private coverage in 2014 than their insurers paid out for their care, with undocumented immigrants generating the largest per enrollee surplus. This net surplus offset a deficit incurred by US natives and exceeded total insurance industry profits by about $10 billion that year. Our 2014 findings were not anomalous: Immigrants made large net contributions in every year in the period 2008–14, with little change over time.

While immigrants’ premiums were similar to those for US natives, immigrants incurred much lower expenditures—a disparity that was present in analyses limited to working-age adults. Among immigrants, expenditures increased with duration of time in the US, a phenomenon documented previously. This may reflect worsening health habits related to acculturation, increased care-seeking behaviors, and increased educational standing with time in the US. However, because premium contributions also increased with time in the US, immigrants made a net contribution to private health insurance regardless of their length of residence in the US.

Our findings contradict assertions that people born in the US are systematically subsidizing the medical care of immigrants, particularly those who are undocumented. On the contrary, immigrants subsidize US natives in the private health insurance market, just as they are propping up the Medicare Trust Funds.

Immigrants’ subsidies to private insurance and Medicare likely reflect their relative youth and good health, as well as the reluctance of many to seek care. Policies that curtail the flow of immigration to the US are likely to result in a declining number of such “actuarially desirable” persons, which could worsen the private insurance risk pool.

Source: Immigrants Pay More In Private Insurance Premiums Than They Receive In Benefits | Health Affairs

Healthcare Lobbying Group Double-Crossing Democratic Voters

For nearly a year now, I have been advocating single payer health care ever since I was diagnosed with end-stage renal disease. BTW, I am doing fine, even if I have been rejected twice for access to transplant centers due to personal reasons I won’t go into here.

Today, I found an article on The Intercept.com that reported that several candidates for Congress and other offices in Hawaii and other states have secretly secured opposition to “Medicare for All” single payer healthcare, even though they have told their voters that they support it.

According to the article, the candidates in Hawaii’s 1st Congressional District, former state Sen. Donna Mercado Kim, Hawaii Lt. Gov. Doug Chin, and Honolulu City Council Member Ernest Martin are taking heat from opponents for talking to an industry-friendly group, the Healthcare Leadership Council (HLC).

The Healthcare Leadership Council seeks to advance the goals of the largest players in the private health care industry. These candidates are talking to the HLC even as public opinion is moving towards positions opposed by giant health care companies.

Kaniela Ing, a state lawmaker running for the seat on a democratic socialist platform stated that, “Democrats running in a primary election will say they support ‘Medicare for All,” but what do they say to lobbyists behind the scenes?”

In fact, the article reports, one leading candidate has campaigned on a pledge to crack down on over-priced pharmaceuticals and promote single payer, but told the consultant sent from the HLC that he would maintain drug industry friendly pricing policies and views Medicare for All with skepticism.

HLC spends over $5 million a year on industry advocacy and brings together chief executives of major health corporations, and represents an array of health industries — from insurers, hospitals, drugmakers, medical device manufacturers, pharmacies, health product distributers, and information technology companies.

HLC’s outreach in Hawaii began in January. The group told candidates, in an email obtained by The Intercept, that it was in the process of forming a coalition to “jointly develop policies, plans, and programs to achieve their vision of a 21st century system that makes affordable, high-quality care accessible to all Americans.”

This language obscures their national campaign to monitor and blunt the energy behind progressive policy reform. In an email to The Intercept, Michael Freeman, executive vice president of HLC said that they survey “congressional candidates every election cycle regarding their views on a wide range of healthcare issues.”

Former state Sen. Kim’s dossier profile said she is very pro-market, opposes any attempt at single payer, does not support price controls on pharmaceuticals and agrees that Medicare and Medicaid need to be managed by the private market.

It would seem that besides the opposition from the insurance companies and the pharmaceutical industry, single payer, Medicare for All, is under assault below the radar of most voters, if not most Democratic voters during the primaries.

Despite alleged strong support for bills such as the one Bernie Sanders introduced, lobbyists for the medical-industrial complex are fighting hard to defeat health care reform for all Americans, and no matter what the public attitude is, they will prevent at all costs, the transition to single payer.

HLC also keeps tabs on candidates who could be a threat to their agenda, such as Ing, stating that she vocally supports a single payer, public health care system.

Lobbyists have told executives in the health care industry to be vigilant about the threat of single payer.

“It would be a mistake for us to overlook the growing number of lawmakers who are supportive of measures to expand significantly government’s role in healthcare,” according to a report HLC published at the end of last year. The report went on to say that while these ideas do not have the political support to pass at the moment, the “momentum on the Democratic side of the aisle is undeniable,” They have dispatched teams of lobbyists to keep tabs on rising candidates.

So, even if you vote for a Democrat in November, chances are, that they will double-cross you when it comes to supporting Medicare for All. Which is wrong-headed on their part, especially the hospitals and pharmaceutical companies.

If more people are covered, and the government pays for their health care, hospitals will get more patients covered under the plan and thus more revenue, even if they charge lower prices than for private insurance, and drug companies will sell more drugs to these patients, even if the prices are brought under control.

What difference does it make if a patient gets their health are from a government plan like Medicare or Medicaid, as many already do, or if they get it through private insurance? The hospitals and drug companies still make money, just a smaller amount. The number of newly insured will offset any assumed loss of profit, thereby increasing profit, and just not from a select group of people who can afford health care on their own.

Advocates for single payer need to be vigilant also. Don’t buy a pig in a poke. Confront these and other candidates for office to see if they really believe in single payer, or are pigs with lipstick.

 

 

 

Update to Cayman Islands Hospital Delivers Lower Cost Care

Last week, The Economist published a short article on how the medical travel industry  thrives.

I had intended to write about the article, but there was not much there to go on, except for the part that mentioned Health City Cayman Islands. (See post, Cayman Islands Hospital Delivers Lower Cost Care).

As reported in The Economist, when the work first began on the 2,000-bed hospital, the $2 billion project was expected to attract more than 17,000 foreign patients annually, mostly from the US.

However, when the first wing opened in 2014, fewer than 1,000 overseas patients arrived in its first year, according to the International Medical Travel Journal.

One reason give for this was that the backers of the project based their projections of customer numbers on a flawed study, according to an investigation by a government public-accounts committee.

Fewer Americans came, the article said, partly because health care insurance companies were not interested in sending people overseas.

This is not unexpected, even if the backers themselves expected more patients to come from the US. American exceptionalism and the belief that the American health care system is the best in the world, is one reason for the reluctance of US insurers to send patients out of the country.

The other reason is that doing so would not bring in more profit from the ever-growing health care systems that hospitals are building as they purchase more and more practices, and add on more services like insurance that used to be separate from the provider community.

Until health care providers travel overseas to treat patients, as The Economist reports, the lack of patients at Health City Cayman Islands and elsewhere will continue. During the Olympics a few years ago, Dubai Health City advertised regularly during commercial breaks, Perhaps that is what Health City Cayman Islands should do.