Posts Tagged ‘health insurance’
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
Posted in Healthcare, Hospital Systems | No Comments »
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 | 1 Comment »
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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Friday, August 7th, 2009
Healthcare reform was on the table more than 75 years ago when President Franklin Delano Roosevelt opened a national dialog on the need for comprehensive health insurance.
It was November 14, 1934, when Roosevelt noted the problem of “economic loss due to sickness”, which he described as “a very serious problem for many families with and without income.” Roosevelt was far-sighted as catastrophic illness remains the leading cause of personal bankruptcies. According to FDR, “Whether we come to this form of insurance sooner or later on, I am confident that we can devise a system which 
will enhance and not hinder the remarkable progress which has been and is being made in the practice of the professions of medicine and surgery in the United States.”
Roosevelt then set his Committee on Economic Security (CES) to work on the issue prior to passing the Social Security Act of 1935. The CES admitted to “differences of opinion” regarding the “advisability of establishing compulsory health insurance”, which it believed to be “essential.” The American Medical Association put up strong resistance, characterizing the concept as reeking of communism or socialism. As a result, Roosevelt did not include healthcare insurance in his Social Security legislation.
During his second administration, Roosevelt convened the Interdepartmental Committee on Health to research national health insurance. At a National Health Conference in July of 1938, the committee decided that they “must take into account that millions of citizens lack the individual means to pay for adequate medical care.”
Based on the conference’s findings, FDR considered sending a healthcare reform bill to Congress. Once again, he was forced to back off because of resistance from the medical community; instead, he asked for legislation to encourage state governments to take the lead in initiating healthcare reform.
It’s interesting to note that – 70 years later – the American Medical Association now supports the concept.
Tags: American Medical Association, bankruptcy, Congress, economic issues, health insurance, healthcare insurance, healthcare reform
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Thursday, August 6th, 2009
Conservative Washington Post columnist Charles Krauthammer thinks ObamaCare is a fantasy that the president will not be able to deliver.
According to Krauthammer, President Obama promised healthcare reform claiming that medical costs are ruining the economy. Now, the Congressional Budget Office has said that the Democrats’ healthcare plan will increase costs by more than $1 trillion.
“In response, the president retreated to a demand that any bill he sign be revenue neutral,” Krauthammer said. “But that’s a classic misdirection: If the fierce urgency of healthcare reform is to radically reduce costs that are producing b
udget-destroying deficits, revenue neutrality (by definition) leaves us on precisely the same path to insolvency that Obama himself declares unsustainable.”
Democratic Senator Max Baucus of Montana, chairman of the Senate Finance Committee, said that the president was “unhelpful” for ruling out taxing employer-provided insurance plans to help pay for coverage. The House’s conservative Blue Dog Democrats are wincing at what they see as skyrocketing healthcare reform costs.
Krauthammer contends that “The president is therefore understandably eager to make this a contest between progressive Democrats and reactionary Republicans. He seized on Republican Senator Jim DeMint’s comment that stopping Obama on healthcare would break his presidency to protest, with perfect disingenuousness, that ‘this isn’t about me. This isn’t about politics.’”
Considering that the Clinton administration is considered successful by many despite its inability to pass healthcare reform, Krauthammer’s opinion may be overly negative if current efforts fail. Plus, characterizing a cause that 74 percent of Americans support as a personal whim of the president seems unfair. Also, 30 states have the same form of a public option for health insurance and studies show that residents support it overwhelmingly. The issue is really about how to pay for it and here, the president will have to level with the American people about the real cost.
Tags: American, Barack Obama, Democrats, economy, health insurance, Healthcare plan, healthcare reform, Obamacare, President Obama, revenue
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Friday, May 22nd, 2009
Conservative columnist Charles Krauthammer’s negative assessment of President Barack Obama’s healthcare reform package is based on his belief that the plan is economically feasible only if that care is rationed.
To quote Krauthammer: “Rationing is not quite as alien to America as we think. We already ration kidneys and hearts for transplant according to survivability criteria, as well as by queuing. A nationalized health insurance system would ration everything from MRIs to intensive care by myriad similar criteria.”
Krauthammer’s personal preference is “for a highly competitive, privatized health insurance system with a government-subsidized transition to portability, breaking the absurd and ruinous link between health insurance and employment. But if you believe healthcare is a public good to be guaranteed by the state, then a single-payer system is the next best alternative. Unfortunately, it is fiscally unsustainable without rationing.”
Krauthammer is wrong! In the United States, healthcare is rationed but it is according to your income and insurance status. And for the 47 million Americans who don’t have insurance, we ARE already rationing everything, “from MRIs to intensive care (to use Krauthammer’s examples)”. We have to accept that no matter what the system is that we adopt, that rationing will occur. The issue is rationing that is unethical and doesn’t meet the mission of healthcare. The way to mitigate rationing in a nationalized system may be to do what the British Medical Association has suggested, which is to define a set of core services – cardiac care, for example – -which may fall under the rubric of life threatening. These would never be rationed regardless of who you are. More elective procedures or non life-threatening procedures, on the other hand, would be rationed. We can’t expect our health system to do it all and this seems a modest proposal.
Tags: America, British Medical Association, cardiac care, Charles Krauthammer, employment, government-subsidized transition, health insurance, health system, Healthcare, healthcare reform, intensive care, MRIs, nationalized health insurance system, non life-threatening procedures, President Barack Obama, President Obama, privatized health insurance system, single-payer system, survivability criteria, United States
Posted in Economics, Healthcare, Healthcare Village, Wellness Centers | 2 Comments »
