Posts Tagged ‘Medicaid’
Wednesday, March 10th, 2010
The real cost of failure to pass healthcare reform legislation could mean that 275,000 Americans nationwide will die unnecessarily over the next 10 years - simply because they lack insurance. According to a new study by Families USA, “This is only the tip of the iceberg, and the most severe consequence, which is death,” said Kathleen Stoll, director of health policy at Families USA.
The states with the largest populations were found to be the ones where the majority of projected premature deaths would occur. The top states are California (34,600 early deaths); Texas (31,700); Florida (25,400); and New York (13,900). Families USA estimates that 68 adults under the age of 65 die every day because they lack healthcare insurance coverage. Unless a significant change occurs, that figure will climb to 84 by 2019.
Research exploring the connection between a lack of health insurance and an increased risk of death has found that the uninsured are more likely to avoid screenings and preventive care. As a result, their medical problems tend to be diagnosed later when they are advanced and difficult to treat. “The bottom line is that if you don’t get a disease picked up early and you don’t get necessary treatment, you’re more likely to die,” said Stan Dorn, a senior fellow at the Urban Institute and author of an earlier study of premature deaths.
Healthcare experts warn that the Families USA’s study’s premature death estimate errs on the side of caution, although the report calculated that a lack of insurance increases mortality rates by 25 percent. More recent research found that people who do not have healthcare research are 40 percent more likely to die early.
Tags: Census Bureau, Children Health Insurance Program, Congress, Congressional Budget Office, Families USA, healthcare reform, Institute of Medicine, Medicaid, uninsured Americans, Urban Institute
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Wednesday, February 17th, 2010
The rationale for healthcare reform is simple - cover most of the population and rein in rising costs. But what happens if healthcare reform isn’t enacted? The answer is not good.
“Failure to enact health reform will result in increasing numbers of people without health insurance because fewer employers will offer it and many employees will not be able to pay the cost of plans that are available,” says Stephen Zuckerman, a health economist at the Urban Institute think tank in Washington, D.C. “For people not offered employer coverage, many will not be able to get coverage due to pre-existing conditions that insurers won’t cover or because premiums won’t be affordable. Even people with coverage will find costs becoming a greater financial burden.”
The numbers are startling. Americans paid $2.5 trillion for healthcare in 2009, equal to 17.3 percent of the nation’s GDP. As the economy starts to grow again, so will healthcare costs. The federal Centers for Medicare and Medicaid Services (CMS) estimates that without reform, healthcare will rise to 19.3 percent of the GDP by 2019. According to Urban Institute statistics, if healthcare reform is not enacted, the number of Americans without insurance will climb to 57 million or 20.1 percent of the population - and that is the best-case scenario.
The 16.5 percent of Americans now covered by Medicaid and the Children’s Health Insurance Program will rise to 18.3 percent. Medicare and Medicaid spending will cost approximately $725 billion in 2010, 50 percent more than Congress appropriates for all other domestic agencies. By 2014, the cost is projected to be $950 billion.
Inaction will only increase the budget deficit. Peter Orszag, the White House budget director, warns that “The fiscal course that we’re on, out in 2020 and 2030 and 2040, is unsustainable and needs to be addressed. If we don’t address rising healthcare costs, there’s nothing else that we’re going to be able to do that will alter that basic fact.”
Tags: Centers for Medicaid Services, Centers for Medicare, compromise, Congress, health economist, healthcare reform, House of Representatives, insurance premiums, Medicaid, Peter Orszag, pre-existing conditions, President Barack Obama, Senate, Stephen Zuckerman, think tank, Urban Institute
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Tuesday, February 2nd, 2010
Americans spent an average of $7,681 per person on healthcare during 2008, just a 3.5 percent rise over the previous year - the slowest growth rate in 48 years. According to a report issued by the Department of Health and Human Services, healthcare spending totaled $2.3 trillion in 2008 and accounted for 16.2 percent of the GDP.
The culprit is the recession, which achieved what a generation of public officials attempted without success. Federal officials said the slowdown in health spending resulted from the soft economy, people delaying elective procedures, for example, and did not cite any factors that will alter the long-term outlook for continued increases as baby boomers age and physicians rely more on new technologies to treat patients.
According to Micah Hartman, a government statistician who contributed to the report, federal spending for health services and supplies grew 10.4 percent in 2008 and equaled 36 percent of federal receipts, up from 28 percent in 2007. “In 2008, federal Medicaid spending increased 8.4 percent - the highest rate of growth since 2003 - while state spending declined by 0.1 percent, the first decline in these expenditures in program history,” Hartman said. “Spending for healthcare by private businesses grew just 1.2 percent in 2008, in part because of a drop in the proportion of employer-sponsored insurance paid by employers. Private business’ health spending remained relatively flat as a share of compensation at 7.9 percent.”
In other findings, the report noted that “private health insurance premiums and benefits grew in 2008 at their slowest rate since 1967, 3.1 percent and 3.9 percent respectively.” The slowdown reflects a drop in the number of Americans with private health insurance. That fell to 195.4 million in 2008, compared with 196.4 percent in 2007.
Tags: GDP, Healthcare, healthcare reform legislation, healthcare spending, Medicaid, Medicare, Micah Hartman, President Barack Obama, recession
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Thursday, January 21st, 2010
“The Terminator” thinks it is time for the federal government to take care of California - especially when it comes to healthcare reform legislation. At a time when Congress is poised to pass sweeping healthcare reform, Governor Arnold Schwarzenegger (R-CA) thinks that President Obama should rethink the legislation. In fact, Schwarzenegger thinks that healthcare reform is “something that ultimately would beat up on California,” as moderator David Gregory remarked during a recent “Meet the Press” interview.
According to Schwarzenegger, “Right now it is. And I just cannot imagine why we would have, like I said, our senators and congressional people, how they would vote for something like that where they’re representing Nebraska and not us. And, by the way, as I said in my State of the State, that’s the biggest rip-off. That is against the law to buy a vote.”
Schwarzenegger is referring to the Equitable Support for Certain States, which will provide Nebraska — as well as Massachusetts and Vermont — support in paying its share of additional costs to Medicaid in the health legislation. The provision, which Republicans have mocked as the “Cornhusker Kickback,” actually provides Nebraska the least of the three states. Vermont will receive $600 million over 10 years, while Massachusetts will receive $500 million. The money to Nebraska is expected to total $100 million.
The Congressional Budget Office (CBO) disagrees with Schwarzenegger - who says it will cost $3 to $ billion over 10 years — on the total cost of the Equitable Support for Certain States program. According to CBO statistics, the section of the manager’s amendment to the Senate’s health bill would cost $1.2 billion over 10 years.
Tags: Arnold Schwarzenegger, Ben Nelson, California, Congress, Congressional Budget Office, David Gregory, healthcare reform, Medicaid, nebraska, President Barack Obama
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Wednesday, January 6th, 2010
In an historic move, the Senate voted to reform the way healthcare coverage is structured in the United States. The 2,077-page Patient Protection and Affordable Care Act, which passed 60 - 39, has the goal of restructuring the $2.5 trillion annual healthcare sector in just 10 years.
With an $871 billion price tag, the legislation will extend coverage to 41,000,000 Americans who currently lack any healthcare insurance. According to the Congressional Budget Office, 94 percent of citizens will have healthcare coverage by 2019. Of that, 26,000,000 will have coverage through innovative insurance exchanges; an additional 15,000,000 will be covered by expanded Medicaid and children’s health insurance programs.
In essence, the bill requires all legal residents to buy healthcare insurance. To offset the cost, the government will offer hundreds of billions of dollars of subsidies and expands Medicaid to people earning less than 133 percent of the federal poverty level. Individuals who fail to buy coverage face a $95 penalty in 2014, which rises to $750 in 2016. Companies with more than 50 employees who do not offer coverage would be subject to a $750 penalty for each full-time worker who has subsidized coverage through an insurance exchange.
In one little-discussed provision, the legislation creates an Independent Payment Advisory Board, which would control Medicare payment formulas. The board also would make yearly recommendations to the president, Congress and private entities on actions they would like to take to improve quality and control the rate of cost growth in the private sector. The Medicare recommendations are non-binding in years where growth is slower than the targeted rate.
Tags: Congressional Budget Office, healthcare reform, insurance exchanges, Medicaid, Medicare, Senate, subsidies
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Wednesday, December 30th, 2009
It’s almost - but not quite - a house call.
A new healthcare concept called “medical home” is emerging across the country, especially in Illinois. It is primary care devoted to prevention and to helping people with chronic conditions such as diabetes or arthritis manage their illness. In a medical home, a physician oversees a team of nurses, physicians’ assistants and health coaches who make certain that their patients get the care, support and education they need. Another benefit is that the plan frees up the doctor’s time to focus on the more serious medical issues.
Medicare recently announced a similar initiative, and healthcare reform legislation could champion medical homes. One pioneer in the field is Group Health Cooperative, a Seattle-based HMO that plans to convert 26 clinics in Washington and Idaho to medical homes. The pilot program, established two years ago, reduced ER visits by 29 percent and hospitalizations by 11 percent while improving the quality of care, according to a report in the September issue of the American Journal of Managed Care.
For medical homes to function properly, physician compensation will have to change, says Dr. David Swieskowski, chief executive of the Des Moines-based Mercy Clinics, Inc. The model works optimally when physicians are full-time, salaried employees. This payment arrangement is fairly rare, and insurance companies don’t reimburse physicians for taking extra time to talk to patients.
Medicaid introduced a version of medical homes in Illinois through Medicaid in 2006 and 2007. During that time, Medicaid assigned 1.9 million people to physicians who agreed to coordinate care for an extra monthly fee. As a result, immunizations, vision screenings and other types of basic care have improved, state officials say.
Tags: Group Health Cooperative, health coaches, HMO, Medicaid, medical homes, Medicare, Mercy Clinics, nurses, physician assistant, physicians
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Thursday, December 10th, 2009
Declaring that “failure is not an option” on healthcare reform, Senator Charles Schumer (D-NY) said that the legislation will be passed with or without Republican support. “We’re not going to not pass a bill,” Schumer said, pointing to a healthcare system that is broken because some 47 million Americans lack any kind of insurance coverage.
Before this can happen, Senate Majority Leader Harry Reid (D-NV) has the task of resolving issues within his own party regarding abortion, taxes and allowing the government to sell health insurance in competition with private insurers. Democratic leaders are working to persuade Senator Olympia Snow (R-ME) to cross party lines and vote in favor of the ultimate bill, even though she sided with her fellow Republicans on the recent procedural vote to move the debate to the full Senate floor.
Both the Senate and House of Representatives bills require all Americans to have healthcare insurance, and plan to make government subsidies available to help pay premiums. Insurance companies would be banned from denying coverage or charging extra for individuals with pre-existing conditions. New insurance marketplaces would be created for those Americans who have difficulty finding affordable coverage - such as the self-employed and those who own small businesses. Americans who currently have employer-provided coverage won’t see any big changes in their coverage. Senior citizens will see improvement in their prescription coverage.
As for paying for these bills? The House bill depends primarily on an income tax hike on upper-income individuals. The Senate bill would tax Cadillac insurance plans, increase the Medicare payroll tax for the wealthy and mandate fees on medical industries.
Tags: Blue Dog Democrats, Cadillac insurance plans, Democrats, Healthcare, House of Representatives, Medicaid, Medicare, President Barack Obama, public option, Republican, Senate, Senator Ben Nelson, Senator Blanche Lincoln, Senator Charles Schumer, Senator Harry Reid, Senator Olympia Snowe
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Monday, December 7th, 2009
Prescription drug prices have risen 9.3 percent since October of 2008, according to a finding by the AARP Rx Watchdog Report. In remarks on the price increase, AARP Executive Vice President John Rother said, “This report confirms what most older Americans already know: drug makers are raising their prices and enjoying windfall profits, even as the rest of the economy is suffering. The pharmaceutical industry should be embarrassed when it sees its own price increases put side-by-side with the general inflation rate. Even as the cost of most goods and services drops, a person taking just one brand name drug now pays $200 more per year than a year ago.”
Another study found that consumer advertising might boost the price of prescription drugs. A case in point is the blood-thinning drug Plavix, which is heavily advertised on television. An article in the Archives of Internal Medicine, http://news.yahoo.com/s/nm/20091124/hl_nm/us_consumer_ads written by Dr. Michael R. Law of the University of British Columbia in Vancouver, found that Medicaid costs for Plavix rose after manufacturer Bristol Myers Squibb/Sanofi-Aventis began advertising the drug to consumers in 2001. After the ad campaign started, Plavix cost 40 cents more per pill, a 12 percent increase that added $207 million to Medicaid spending on prescription medicines.
Earlier research conducted by Dr. Law found that advertising didn’t result in an increase in people taking the medication. “The public should rightly wonder why they’re paying millions in extra drug costs to pay for advertising campaigns that don’t work,” Dr. Law said. In response, Plavix’s manufacturer notes that “The Bristol Myers Squibb/Sanofi pharmaceutical partnership support direct-to-consumer advertising as a way to encourage consumers to play a more active role in their healthcare.”
Tags: AARP, Food and Drug Administration, John Rother, Medicaid, Plavix, prescription drugs
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Wednesday, October 28th, 2009
The way healthcare is delivered from state to state shows wide variations in cost and quality of care. According to a recent study by the nonpartisan Commonwealth Fund, those disparities highlight the difficulty in reforming healthcare - the United States has at least 50 healthcare systems, not just one. And each has its own social, demographic and economic characteristics.
Generally speaking, the rankings correlate with income and access to insurance, said Cathy Schoen, one of the study’s authors. “Access and quality are tightly related. People who don’t have much access receive much lower levels of preventive care. We need federal action to raise the floor (for minimum coverage) across the country. The states are not going to be able to do that on their own.”
The highest ranking states tend to be wealthier, though there were interesting exceptions. Maine, for example, ranks 35th in median household income and 28th in people living in poverty. Yet is ranks fifth in the Commonwealth study, partly because Maine is one of the few states that extends Medicaid coverage to adults without children.
Illinois fell from 32nd to 42nd place, a slippage caused in part by declines in quality measures, such as the number of nursing home residents needing hospitalization and of patients re-admitted after discharge from hospitals.
Tags: healthcare reform, Medicaid
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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
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