Archive for the ‘Economics’ Category
Wednesday, July 21st, 2010
Healthy San Francisco, the innovative program that provides affordable healthcare services to an estimated 53,000 uninsured, was given the green light when the Supreme Court turned down a business group’s challenge. The Supreme Court decision “is a victory for the 53,0000 San Franciscans who have healthcare today through our groundbreaking universal healthcare program,” said Mayor Gavin Newsom, who spearheaded the program. “The high court’s decision…ensures we can continue providing healthcare coverage to thousands who otherwise would go without.”
Healthy San Francisco won unanimous approval from the city’s Board of Supervisors in 2006 and went into effect on January 1, 2008. The law requires businesses with 20 or more workers to provide a certain degree of healthcare coverage for their employees. Alternatively, they can pay a fixed amount into a city healthcare pool for every hour the uninsured employee works. The Golden Gate Restaurant Association sued to overturn the law, claiming that the city could not legally force businesses to provide health benefits to its workers or participate in the city pool. The Ninth U.S. Circuit Court of Appeals rejected that argument, as did the Supreme Court.
Healthy San Francisco provides a safety net to the city’s adults who have lacked healthcare insurance for 90 days. It provides access to a network of hospitals and public and private clinics that provide low- or no-cost-care. Tangerine Brigham, the program’s director, notes that “So far, about 1,100 employers have selected Healthy San Francisco as their option.” Because participants are given a personal physician, expensive ER visits to San Francisco General Hospital fell 27 percent in the first years of the program. A 2009 study by the Kaiser Family Foundation determined that 94 percent of participants were satisfied with Healthy San Francisco.
Tags: Board of Supervisors, Healthy San Francisco, Kaiser Family Foundation, medical home, San Francisco, United States Supreme Court
Posted in Economics, Healthcare, Hospital Systems, Wellness Centers | No Comments »
Thursday, July 15th, 2010
A suburban Chicago teenager had her healthcare coverage rescinded when her parents’ insurance company learned that she had been diagnosed with an overbite at age eight. An orthodontist and braces cured the overbite, but the insurer cancelled the girl’s coverage by claiming it was a pre-existing condition. The girl’s parents fought back and – thanks to strong support from Illinois insurance regulators – the coverage has now been reinstated.
Thanks to healthcare reform legislation, this practice – known as rescission – will no longer be allowed as of late September except in cases where fraud is involved. Illinois has one of the nation’s highest rescission rates with 12.9 for every 1,000 policies written. The girl’s father, an attorney employed at a small firm, buys individual coverage for his family. Insurance regulators say that rescission is most common in these circumstances. People who are covered by company-sponsored programs rarely face rescission. According to the girl’s father, “We didn’t try to hide anything. Our orthodontist told us her mandibular hypoplasia was routine, and it was nothing the insurance company even asked us about on our application. From our perspective, they didn’t even ask for the names of any of our children’s dentists or orthodontists.”
“There’s now a defined legal standard for when a rescission is appropriate,” said Michael McRaith, Illinois Insurance Director. “In Illinois, our law was ambiguous, vague and left wide latitude and discretion with the insurance industry.” The insurance industry defends rescissions as a necessary business practice when people misrepresented or lied about their medical histories on their applications. Rescissions affect approximately seven percent of the population with private insurance who purchase individual policies. Robert Zirkelbach, spokesman for America’s Health Insurance Plans, a lobbying group, said “Rescissions are very rare. They are only used as a last resort.”
Congressional Democrats take another view. “It was viewed by Congress as the tip of the spear,” said Representative Jan Schakowsky (D-IL). “It typifies the practices of the insurance industry to maximize their profits that were so clearly anti-consumer and harmful to people who were counting on their health insurance at the moment they needed it the most.”
Tags: Congressional Democrats, healthcare reform, Jan Schakowsky, National Association of Insurance Commissioners, pre-existing conditions, pre-existing medical conditions
Posted in Economics, General, Healthcare, Hospital Systems, Physician Recruitment, Wellness Centers | No Comments »
Monday, May 24th, 2010
Although healthcare reform legislation is now the law of the land, Representative John Boehner (R-OH), the House Minority Leader, is still not shy about communicating his distaste for the bill. Recently, Boehner sent a letter to Kathleen Sebelius, Secretary of Health and Human Services, citing increased cost estimates, job-loss information and what he perceives as a lack of follow-through on an executive order regarding abortion coverage that the GOP finds troubling.
Boehner’s letter is a response to a recent statement by Secretary Sebelius, which stressed the law’s initial deliverables, including health insurance reform and tax credits available to small businesses. “Now I’ve seen my fair share of propaganda, but this letter must have been written in an alternate universe,” Boehner said. Republicans have uniformly opposed the healthcare bill throughout the process; the majority claim that it will increase costs. Additionally, the GOP hopes that the healthcare law will guarantee them a majority victory over Democrats in November’s mid-term elections. The GOP is expected to win more mid-term elections in the House versus the Senate.
Sebelius said that “Now, I want to be clear: the Affordable Care Act is not a magic pill that will cure all the problems in our health care system. It will take time for all the benefits to kick in. And if you look at the history of major social legislation, you see that there are always revisions and adjustments along the way.”
Speaker of the House Nancy Pelosi sides with Sebelius, saying “We’re very pleased with the unfolding of the healthcare bill, In a bigger sense, it is about a healthier America.”
Tags: Democrats, Department of Health and Human Services, executive orders, GOP, healthcare reform, House Minority Leader, John Boehner, Kathleen Sebelius, mid-term elections, Nancy Pelosi, Ohio, propaganda, Republicans, tax credits
Posted in Economics, Healthcare | 1 Comment »
Monday, April 26th, 2010
Confused about what healthcare reform means to you? Following is a handy guide to links that clarify the new rules and have timelines detailing when the various elements will kick in.
The Kaiser Family Foundation summarizes what healthcare reform means under Its “New & Noteworthy” section. Click on the “summary of the law” for an outline and on the “timeline”.
Families USA, a non-profit advocate for healthcare consumers has a “Health Reform Central” that provides a full rundown of the changes.
This website has a “Health Care Reform” button that links to an easy-to-read timeline. Be aware that the site belongs to an insurance broker.
This is the Obama administration’s explanation of how healthcare reform will work.
Consumer Reports presents useful information at the “Health-care reform” button towards the bottom of the home page.
Although this website is used primarily by house buyers looking for low mortgage rates, it presents a good summary of healthcare costs. Type “reform” into the search box, then click on the “What’s in it for you” button.
The March’s website summarizes important new provisions impacting women and children. Access it by clicking on “In the news.”
The Medicare Rights Center reviews important new provisions impacting senior citizens. Click on the box that says “learn more about health reform and Medicare.”
The Department of Health and Human services is planning to launch a website on healthcare reform that will include links to insurance options that it considers to be affordable on a state-by-state basis.
Tags: bankrate.com, Consumer Reports, Department of Health and Human Services, Families USA, healthcare reform, Kaiser Family Foundation, March of Dimes, Medicare, Medicare Rights Center, White House
Posted in Economics, Healthcare | No Comments »
Monday, March 8th, 2010
Economic indicators show that the recession is over. This is the opinion of Rick Mattoon, a senior economist and advisor in the economic research department of the Federal Reserve Bank of Chicago and a lecturer at the Kellogg School of Management at Northwestern University. Rick’s primary research focuses on issues facing the Midwest regional economy.
In a recent interview for the Alter Inspire Podcasts, Mattoon warned that most people probably don’t feel like the nation is coming out of a recession because there are few signs of job creation or easier access to credit. One of the major concerns economists have is that this will be a double-dip “W-shaped” recession because once the bump from the $787 billion stimulus ends, there will be scant pent-up consumer demand for products and services to take the place of government spending.
One positive sign is an uptick in hiring by temporary employment agencies, which usually is considered to be a good harbinger of what future demand will be. Another interesting theory about this particular recession in terms of jobs is the idea that companies adjusted their employee levels much more aggressively at the beginning of this cycle. As a result, they are operating at extremely lean levels and so may hire earlier rather than later.
One problem is that there is a skills mismatch in the economy. Many people who have lost their jobs don’t possess the right skills to find employment in growth industries such as clean energy or healthcare. The challenge is training these individuals to bring their skills up to par.
Rick Mattoon: Is the Recession Over? :
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Tags: American Recovery and Reinvestment Act, Chicago, deficit, Federal Reserve Bank, GDP, Great Recession, inflation, Rick Matton, stimulus bill, treasury bills, United States economic health, wage growth
Posted in Economics, Financing | 1 Comment »
Tuesday, January 12th, 2010
The Commonwealth of Massachusetts will elect a new senator on Tuesday, January 19, to replace the late Senator Ted Kennedy (D-MA). If the Kennedy family has their way, the winning candidate will be Martha Coakley, who is currently the Bay State’s Attorney General. Coakley, if she wins the election in this heavily Democratic state, plans to continue the legacy of the late Senator Kennedy in assuring that meaningful healthcare reform legislation is passed this year.
At a rally attended by members of the Kennedy family – including Vicki Reggie Kennedy – Coakley said “The choice is very simple. With your help and your vote on January 19, we can make Senator Kennedy’s vision of affordable, quality healthcare for all Americans a reality.” Coakley is a strong supporter of healthcare reform legislation, which Ted Kennedy called “the cause of my life”. The other candidates on the ballot – including Republican Scott Brown – have said they would vote against the bills currently pending in Congress.
According to Kennedy, Coakley would continue the “world-class” representation provided by her late husband. “We can’t take this election for granted. Our enemy is complacency,” said Vicki Kennedy. “As Ted would say, ‘January 19 is the date, Martha Coakley is the candidate.’ “
Tags: Attorney General, Congress, Edward Markey, healthcare reform, Kennedy family, Martha Coakley, Massachusetts, Senate race, Senator Paul Kirk, Ted Kennedy, Vicki Kennedy
Posted in Economics, Healthcare | No Comments »
Tuesday, September 29th, 2009
Price transparency may be one welcome element in healthcare reform legislation. The proposed bipartisan bill written by Senator Max Baucus (D-MT) and his Senate Finance Committee includes a provision that will require hospitals to list standard charges for their services.
As the system currently works, insurance companies enter into agreements with hospitals and physicians to determine how much they will pay for hip replacement surgeries, cataract procedures and MRIs — all long before the patient enters the scene. Hospitals and doctors tend to charge the uninsured significantly higher rates than they do the insured. Medicare sets its own rates, which typically are lower than commercial rates.
“The pricing model is ridiculous,” said Brad Myers, a founder of Pensacola, FL-based NewChoiceHealth, Inc., an online tool that allows consumers to compare healthcare prices. Myers bases his information on estimates gleaned from Medicare data.
The states of Maine and New Hampshire have addressed this partially with online cost comparison websites that are accurate because they are based on insurance claims paid for real procedures. Consumers can use the information posted to shop around or to get the best deal possible. A visit to the Maine website finds that one hospital charges the uninsured $1,326 for a colonoscopy. The insured pay the hospital between $800 and $950 for the same procedure, depending on who carries their coverage. Medicare pays the same hospital just $793.
Tags: colonoscopy, doctor, healthcare reform, hospitals, insurance company, legislation, Medicare, MRIs, surgery
Posted in Economics, Healthcare, Hospital Systems | No Comments »
Tuesday, September 22nd, 2009
Senator Max Baucus’ (D-MT) long-awaited centrist healthcare reform bill was met with strong objections by both liberal Democrats (who decried the lack of a public option) and Republicans (who oppose any expanded government role in healthcare).
Still, the Baucus proposal could serve as a blueprint for the ultimate compromise healthcare legislation that President Obama calls the “defining struggle of this generation” when it finally emerges from Congress. Baucus’ proposal would expand consumer protections and require that all Americans have medical insurance with the government providing financial help to pay premiums for low- and middle-income people. Insurers would no longer be able to deny coverage to people with pre-existing conditions or cancel policies after people get sick. The Baucus bill would create private healthcare insurance cooperatives, which centrist Democrats prefer in place of the public option supported by liberals.
Despite tailoring his proposal to cost less and limit government involvement in healthcare,Baucus’ proposal is unlikely to win much support from Republican Senators. According to Senate Minority Leader Mitch McConnell (R-KY), “Americans don’t think a bigger role for government in healthcare would improve the system. Yet despite this, every proposal we’ve seen would lead to a vast expansion of the government’s role in the healthcare system.”
The Baucus bill is unpopular with liberal Democrats who insist that a public option be included in any healthcare reform legislation. Speaker Nancy Pelosi said the House bill, drafted by Democrats, was superior and “clearly does more to make coverage affordable for more Americans.” The Congressional Budget Office said the expansion of coverage would cost $774 billion over 10 years, compared with price tags of more than $1 trillion for the other measures.
Tags: affordable healthcare, Democrats, health insurance, healthcare reform, Max Baucus, Nancy Pelosi, President Obam, private healthcare, public option, Republicans
Posted in Economics, Healthcare | No Comments »
Thursday, September 10th, 2009
Here’s a story that illustrates one way that our healthcare delivery system is broken. Michael Napientek has been through healthcare insurance hell – and survived the ordeal. Last fall, the doorman underwent back surgery after obtaining a preauthorization number for payment from his insurance company. Napientek’s health insurance is provided by his wife Sandie’s employer, Accelerated Health Systems. The policy is a self-insured plan funded by Accelerated Health Systems, and which is administered by Wausau, WI-based UMR, a UnitedHealthcare subsidiary.
Imagine the Napienteks’ surprise when bills totaling $148,000 started appearing in their mailbox. The insurer was refusing to pay for the surgery, even though it had preauthorized the procedure. Three appeals against the claim were denied on the grounds that Napientek had not exhausted all means of pain relief. Sandie Napientek complained to a UMR representative and was told that preauthorization did not guarantee payment because they had not provided documents that proved the “appropriateness” of the surgery.
Frustrated, the Napienteks turned to the Chicago Tribune’s “What’s Your Problem?” columnist Jon Yates to see if he could intervene. Yates contacted UMR, who referred him to United Healthcare. The Napienteks’ next communication from UMR was a letter saying it would pay the entire $148,000. According to the letter, UMR changed its mind “based on additional information submitted and the opinion of an independent physician.”
This story represents a classic example of an insurance company bureaucrat standing between the patient and his physician – after preapproved surgery had been performed.
Tags: back surgery, Healthcare, healthcare insurance, insurance company, insurer, pain relief, self-insured, surgery
Posted in Economics, Healthcare, Healthcare Village, Hospital Systems, Physician Recruitment, Wellness Centers | No Comments »
Wednesday, July 22nd, 2009
The House of Representatives has proposed a $1.5 trillion package that would make healthcare coverage a right and a responsibility for all citizens. If passed, medical providers, employers and the wealthy would pick up the tab. The United States is the only developed nation that lacks healthcare coverage for all citizens, and approximately 50 
million people do not have access to insurance.
“We cannot allow this issue to be delayed. We cannot put it off again,” says Representative Henry Waxman, a California Democrat and chairman of the House Energy and Commerce committee. “We quite frankly cannot go home for a recess unless the House and the Senate both pass bills to reform and restructure our healthcare system.”
President Obama is promoting healthcare reform every chance he gets. In a Michigan speech about spending for community colleges, he said, “There’s going to be a major debate over the next three weeks. And don’t be fooled by folks trying to scare you saying we can’t change the healthcare system. We have no choice but to change the healthcare system because right now it’s broken for many Americans.”
Organizing for America – Obama’s campaign organization – is launching a series of 30-second television ads on healthcare reform that will air in Washington D.C., on cable networks nationally and on local stations in eight states. The ads depict ordinary citizens telling their stories about problems with the current healthcare system.
Tags: American, Democrat, Healthcare, healthcare reform, healthcare system, House Energy and Commerce committe, insurance, medical providers, Michigan, Obama campaign, President Obama, Senate, United States, Washington DC
Posted in Economics, Healthcare, Hospital Systems | No Comments »
