Injured Worker Arrested When Employer Could Not Cut WC Benefits

The Charlotte Observer today reported on the case of an injured worker who suffered a brain injury after a fall in 2003 at his employer’s workplace. And because they could not cut off his benefits, they had him arrested.

In case you find this incredible, here is the link to the article:

https://www.charlotteobserver.com/news/local/article217808590.html

Is this what it has come to today in Workers’ Comp? That insurance companies refuse to continue lifelong payments to injured workers because they believe he is faking his injuries, so they and his employer have him arrested?

This is more than harsh; this is despicable.

 

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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

GSK is paying docs again — and patients are the worse off

A shout out to Maria Todd for bringing this to my attention.

This would not be happening if we did what every other Western nation does, and give our citizens universal health care that does not line the pockets of multinational corporations, drug companies, medical device manufacturers, and Wall Street investors.

Health care should not be subject to the pursuit of profit.

One of the world’s largest drug makers, GSK promised it would no longer pay doctors to promote its medicines. Now it says doing so put it at a disadvantage.

Source: GSK is paying docs again — and patients are the worse off

Health Care Costs Rising for Workers

Axios is reporting that health care costs for workers is rising while overall costs of employer-based health benefits is growing modestly from year to year.

This is slowly eating up all of the average workers wage increases, and then some, as reported by the Kaiser Family Foundation’s  2018 Employer Health Benefits Survey.

The survey covers the last ten years, from 2008 to 2018. Most of where the employees are paying for health care comes from deductibles, which has seen a +212% increase over that period, and is out of pocket. These costs, the survey said, is rising faster than inflation and wages.

Premiums for families have risen over this period +55%, while workers’ earnings have risen +26%, and inflation has risen +17%.

According to Kaiser, employees are paying an average of about $1,200 per year in premiums. That’s 65% more than what they paid in 2008, for single coverage plans that cover only the worker, no family members.

Besides the increase in deductibles, the number of employees who have a deductible has gone up, and the number of employees with above-average deductibles is up as well.

Three takeaways:

  • More patients are more attuned to the high costs of care.
  • The underlying cost of health care services is growing relatively slowly right now, compared to historical trends.
  • But there’s a sense, at least among some liberal-leaning health care experts, that employers have just about maxed out their ability to shift more costs onto employees — meaning that once price increases start to pick up steam again, businesses and workers will both feel the pain quickly.

What does this mean?

As workers’ wages are stagnant, and health care costs are rising, shifting the cost of health care onto the backs of workers is not only counterproductive to lowering the cost of health care, it puts an undue burden on those who can least afford to shell out more of their hard earned income on health care, especially when they have a serious medical issue to deal with.

Single payer will relieve the worker from having to pay out of pocket when wages are stagnant, and when wages rise again. This will enable them to have more money to spend on things that otherwise would have been prohibitive before.

To do no less is to saddle the working class with perpetual debt and decreased economic power. Not a good way to run an economy.

Nation’s First Medicaid Work Requirement Sheds Thousands From Rolls In Arkansas

Last month, you may recall, I posted an article about Medicaid work requirements in Arkansas from an article in Health Affairs.

Today, Health Affairs posted a follow-up article that reported that thousands are being shed from the Medicaid rolls in Arkansas.

According to the article, the Arkansas Department of Human Services officials announced on Sept. 12 that 4,353 people who were enrolled in the state’s Medicaid expansion program had been locked out of coverage for failing to comply with the work requirement for three months.

The agency has said those people will have until October 5 to apply for a good cause exemption if they were unable to access an online reporting portal because of network server issues that affected it and other agencies.

Source: Nation’s First Medicaid Work Requirement Sheds Thousands From Rolls In Arkansas

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