Posts Tagged ‘health insurance’
Thursday, January 14th, 2010
There’s one element of healthcare reform legislation on which many liberals and conservatives agree - the mandate. Both the Senate and House versions of the healthcare reform bill contain a mandate requiring that all Americans be insured - whether it is through their job, the government or the private market.
From the right, there’s criticism from Michael Cannon, a health policy analyst at the libertarian Cato Institute, who says “The federal government does not have the power to force you to purchase a private product.” From the left, Jim Dean, chairman of Democracy for America, notes that “We’d like to see the individual mandate stripped. It was fair given the presence of a government entity that could provide competition and control the cost. It’s not fair if people are required to buy insurance from the same insurance industry that caused this problem.”
The reasoning behind the mandate reflects the basic concept that underlies all insurance. A large pool of people pays fairly small premiums to create a fund large enough to take care of people who need help. The idea that people of all ages participate is of particular importance in healthcare, because costly medical conditions are found primarily in Americans who are middle-aged or older. When younger and healthier people don’t have insurance, the others pay higher premiums.
The insurance industry has a totally different reason for disliking the mandate - they think it’s too mild. Robert Zirkelbach, spokesman for America’s Health Insurance Plans, believes that “We think there’s more that (the bill) needs to do. There’s still a strong incentive for people to wait until they are sick to purchase insurance.” Zirkelbach is referring to one of the legislation’s hallmark features - the requirement that insurers treat those with pre-existing conditions the same as all other patients and bans denying coverage.
Tags: Cato Institute, government, health insurance, healthcare reform, medical costs, Michael Cannon, Senate
Posted in Healthcare, Healthcare Village | No Comments »
Wednesday, October 14th, 2009
Senator Tom Harkin (D-IA), the liberal who succeeded Senator Ted Kennedy as chairman of the Senate Health Committee, is predicting that Congress will pass healthcare reform with a public option before year’s end.
Harkin, who recognizes that there is opposition to the Health Committee’s bill, believes his fellow Democrats will join with President Barack Obama to pass a wide-ranging healthcare reform bill that the late Kennedy described as “the cause of my life.”
President Obama is championing an insurance marketplace where people who lack employer-provided healthcare can purchase coverage. This exchange would encompass private insurance companies and a public option to create competition aimed at driving down high premium prices. The majority of Republicans and some conservative Blue Dog Democrats oppose the public option, claiming it would have an unfair competitive advantage by offering lower prices. They reason that this would drive private insurers out of the market.
Because of Senate procedural rules, Democrats need 60 votes to avoid a Republican filibuster to delay the legislation. With Massachusetts Governor Deval Patrick’s appointment of Paul Kirk to fill Ted Kennedy’s Senate seat until next January’s special election, the Democrats now have that bullet-proof majority - assuming Harkin can bring the Blue Dogs into line.
“I’m convinced we’re going to have a healthcare reform bill on the president’s desk before we go home for Christmas,” Harkin said. “And there will be some form of public option. There’s a lot of support for it. We’re not going to accept defeat.”
Tags: health insurance, healthcare reform, President Obama, private insurance, Ted Kennedy, Tom Harkin
Posted in Healthcare, Hospital Systems | No Comments »
Tuesday, October 13th, 2009
Amidst all the commotion at town hall meetings and attacks on President Barack Obama’s healthcare reform guidelines, the question arises: where is the Republican Party’s plan? The answer is that Republican Congressional leaders chose not to draft a bill encapsulating their own vision.
Some Republicans are challenging this “party of no” moniker. Louisiana Governor Bobby Jindal, who has 2012 presidential aspirations, said it’s time for the GOP “to pivot and say, in addition to emphasizing what we oppose, here are our proposals” for healthcare reform. Responding to Jindal, Senator Richard Durbin (D-IL) sees an opportunity to counter Republican attacks on Obama’s proposals, noting that “The Grand Old Party’s coffers are empty when it comes to healthcare reform.”
A “Republican Solutions Handbook” created by the House Republican Conference possibly has the most comprehensive summary of GOP healthcare proposals. The single-page document offers plans to limit medical malpractice lawsuits and dedicate more resources to stopping “waste, fraud and abuse” in Medicare and Medicaid. Proposed tax cuts would go to workers without employer-provided health plans and to low-income people to help them buy private insurance.
Representative Roy Blunt (R-MO) has been of two minds on the issue. On June 17, he said “I guarantee you, we will bring you a bill that costs far less, far less than the Democrats’ and will provide better results for the American people.” A month later, Blunt wrote on his blog: “Our bill is never going to get to the floor, so why confuse the focus? We clearly have principles; we could have the language, but why start diverting attention from this really bad piece of work they’ve got to whatever we’re offering right now.”
Tags: health insurance, healthcare reform, malpractice lawsuits, Medicaid, Medicare, President Barack Obama, Republican, tax cuts
Posted in General, Healthcare, Hospital Systems, Wellness Centers | No Comments »
Tuesday, October 6th, 2009
The name Olympia Snowe (R-ME) has been prominent in the debate on healthcare reform – and for good reason. Snowe is the lone Republican member of the Senate Finance Committee who is still talking with Democrats to shape the ultimate bill. This willingness to engage the opposition party gives Snowe significant leverage because she may provide the 60th vote that Democrats need to prevent a Republican filibuster. In return, Snowe is likely to get what she wants in healthcare reform legislation — affordability.
Snowe’s perspective may be due to the fact that she represents a relatively poor state whose health insurance market is dominated by a single large firm that charges some of the country’s highest premiums. Maine insurance costs are rising at nearly four times the rate of wages, hurting the small businesses that form the core of the state’s economy.
Even though Democrats are actively courting Snowe, her “yes” vote is not guaranteed. She voted with Senate Finance Committee Republicans when they insisted that Senator Max Baucus (D-MT) submit his measure to the Congressional Budget Office to determine the bill’s price tag. Additionally, Snowe was the sole member of Baucus’ bipartisan “Gang of Six” who complained that the federal subsidies included in the bill to help low- and middle-income people buy insurance were too small. Baucus’ response was to increase the size of the subsidies.
Snowe’s most provocative input to the healthcare debate is her proposal for a trigger that would set in motion a Medicare-like, government-run public option to provide affordable coverage if private insurers don’t step up to the plate. “It would be a safety net, a fallback mechanism,” Snowe says. She points out that a similar idea was effective to stimulate competition in the Medicare prescription-drug program.
Tags: Capitol Hill, Democrats, health insurance, healthcare reform, Medicare, President Barack Obama, Republican-led filibuster, Senate Finance Committee
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Monday, September 28th, 2009
One instructive lesson in reforming American healthcare may be to adopt the Swiss model, which is regulated by the Federal Health Insurance Act of 1994, and made health insurance compulsory for all residents. Previously, Switzerland had an American-style system, which became a national outrage when studies revealed that five percent of the population lacked any coverage.
Today, 99.5 percent of the Swiss people are insured with coverage funded by the individual who generally pays the full cost of premiums. Government subsidies are provided for the poor, with approximately one-third of all Swiss citizens receiving the subsidy. “These subsidies are designed to prevent any individual from having to pay more than 10 percent of income on insurance.” All insurance is private and physician compensation is negotiated between the insurance companies and doctors on a canton-by-canton basis.
The down side is that Swiss healthcare is expensive, with costs rising 10 to 20 percent every year. Monthly health insurance costs for a family with one child can amount to CHF 1,000 ($944). Deductibles can be adjusted, though, from CHF 300 ($283) to CHF 2,500 ($2,360). The state will help with the costs if income (married/without children) is around CHF 30,000 ($28,920) or (married/with children) around CHF 60,000 ($56,581). In those circumstances, the government pays half the cost of insurance. Options are available that will lower the monthly costs, similar to the American HMO model. In these plans, the person must consult with their physician prior to seeing a specialist.
“The mix that Switzerland represents between private enterprise and general state regulations that make healthcare accessible to everyone is really an interesting example for the United States,” said Felix Gutzwiller, a Radical Party senator and head of Zurich University’s department of public health. In Switzerland, administrative costs consume on average five percent of health insurance revenue. In the United States, it’s closer to 20 percent.
In terms of satisfaction, the World Health Organization puts Switzerland in 20th place in its rankings of healthcare systems around the world. The United States ranks 37th, sandwiched between Costa Rica and Slovenia.
Tags: health insurance, healthcare reform, healthcare system, HMO, public health, Switzerland, World Health Organization
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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 »
Monday, September 21st, 2009
A random survey of 2,130 physicians found that 73 percent support a public option as one element of healthcare reform legislation. That breaks down to 63 percent of physicians supporting both public and private options; 10 percent supporting a public option only; and 27 percent favoring private options only. The poll was conducted by New York’s Mount Sinai School of Medicine internists and researchers Dr. Salomeh Keyhani and Dr. Alex Federman.
The majority of physicians who favor giving their patients a choice of public or private insurance are in tune with President Barack Obama’s position and that of many congressional Democrats. Polls of average Americans have found that between 50 and 70 percent support a public option. In other words, physicians support the public option more strongly than the general population. This contradicts one of the canards of the healthcare debate - that doctors will resist reform for fear of seeing their incomes erode.
“Whether they lived in southern regions of the United States or traditionally liberal parts of the country, we found that physicians - whether they were salaried or they were practice owners, regardless of whether they were specialists of primary care providers, regardless of where they lived - the support for the public option was broad and widespread,” Dr. Keyhani said.
The survey was published Monday, September 14, in the online New England Journal of Medicine. It was funded by the Robert Wood Johnson Foundation, a healthcare research organization that supports reform legislation.
Tags: Democrats, health insurance, Healthcare, healthcare research, internists, patients, physicians, President Barack Obama, private option, public option, researchers, specialist
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Tuesday, September 15th, 2009
President Barack Obama’s prime-time speech to a joint session of Congress made a strong case for including a public option, along with a combination of choices designed to keep the insurance industry in check. Recalling Theodore Roosevelt’s efforts to reform healthcare during the 1912 election, Obama said “I am not the first president to take up this cause, but I am determined to be the last. Well, the time for bickering is over. The time for games has passed,” Obama said. “Now is the season for action.”
That action includes a provision that protects uninsurable individuals from catastrophic healthcare expenses. Another proposal is a series of pilot programs that will study how to reform the medical tort process.
Following is a brief summary of the Obama healthcare plan, which has a projected price tag of just under $1 trillion over 10 years (as a point of comparison, the U.S. spends half this in a single year on military spending):
- Healthcare reform will provide more security and stability to Americans who currently have insurance, and it will provide coverage to those who don’t. It will slow the growth of healthcare costs.
- Americans who already have health insurance through their employers, Medicare, Medicaid, or the VA, will see their coverage improve. The plan will make it illegal to deny coverage for pre-existing conditions. Insurers will no longer be able to place a cap on the amount of coverage a patient receives. Additionally, insurance companies will be required to cover routine checkups and preventive care like mammograms and colonoscopies.
- Coverage will be portable (if a person changes jobs or starts a small business) through the creation of an insurance exchange - a marketplace that will provide access to health insurance at competitive prices. The benefit to insurance companies is that the exchange lets them compete for millions of new customers.
- For Americans who currently lack health insurance, Obama proposed a public option where government-subsidies would be available to make premiums affordable. Individuals would be required to obtain coverage, and their employers would have to contribute. Most Senate Republicans and some Blue Dog Democrats oppose this proposal, while Speaker of the House Nancy Pelosi has said that the House’s version of the healthcare bill will include a public option.
Obama’s flexibility may not please the more liberal members of Congress, but reflects the political reality that exists on Capitol Hill.
Tags: Blue Dog Democrats, colonoscopy, Edward Kennedy, health insurance, healthcare bill, healthcare costs, healthcare expenses, healthcare reform, mammogram, Medicaid, medical, Medicare, Nancy Pelosi, patient, pilot program, President Barack Obama, President Theodore Roosevelt, public option, Republican, security, uninsurable
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Thursday, August 13th, 2009
If healthcare reform is to successfully overcome the realities of Washington politics, there is one problem in covering the millions of Americans who lack insurance coverage - the physician shortage. Currently, there is a 30 percent shortage of primary-care physicians, and with less than 10 percent of 2008 medical school graduates choosing that career track. When Massachusetts enacted mandates for universal health insurance in 2006, the state’s primary-care physicians
were overwhelmed. A similar scenario could occur on a national scale.
Nurse practitioners — who have advanced nursing degrees, are licensed by the state and often are allowed to prescribe medications — may fill that void because they can treat and diagnose patients at less cost than physicians. Medicare reimburses nurse practitioners at 80 percent of what they pay doctors for similar services.
Nurse practitioners are vital to healthcare reform because they focus on patient-centered care and preventive medicine. The House of Representatives has listed nurse practitioners as primary-care providers on their healthcare reform legislation bill. The profession lobbied intensely to include this legislative language so they can play an important role in a revamped health system.
“We seem to be healthcare’s best-kept secret,” said Jan Powers, health policy director for the Academy of Nurse Practitioners. Although nurse practitioners typically have less medical education than physicians, they are well trained in skills such as bedside manner and counseling. “In the United States, we are so physician-centric in our health system. But it should be about wellness and prevention, not about procedures and disease management,” said Rebecca Patton, president of the American Nursing Association.
Tags: Disease management, health insurance, health system, healthcare reform, healthcare system, medical education, medical school, Medicare, nurse practitioners, physician shortage, physicians, prevention, preventive focused, primary-care physician, wellness
Posted in General, Healthcare, Hospital Systems, Wellness Centers | No Comments »
Tuesday, August 11th, 2009
Harry Truman had been Vice President for just 82 days when Franklin Delano Roosevelt’s death catapulted him into the presidency and the spotlight. One of his earliest initiatives was to propose a new national healthcare program in a November 19, 1945 message to Congress.
Truman argued that the federal government should be a major player in the healthcare arena. “The health of American children, like their education, should be recognized as a definite public responsibility.” The most 
controversial aspect of Truman’s plan was an optional national health insurance fund, which would be run by the federal government and open to all Americans. Participants would pay a monthly fee, which would cover all of their medical expenses. The government would pay physicians who joined the program for services rendered, and reimburse the policy holder for lost wages due to illness or injury.
The legislation introduced into the Senate and House of Representatives ran headlong into the American Medical Association’s (AMA) strong opposition. “The AMA characterized the bill as ’socialized medicine’, and in a forerunner to the rhetoric of the McCarthy era, called Truman White House staffers ‘followers of the Moscow party line’”.
Once the Korean War started, Truman was forced to abandon his healthcare bill. Despite his failure, he successfully brought the issue of healthcare in America to the forefront. When Lyndon Johnson signed Medicare into law at the Harry S. Truman library, he said it “all started really with the man from Independence.”
Tags: American Medical Association, federal government, health insurance, Healthcare plan, illness, Medicare, national healthcare, physicians
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