News In Healthcare

I am lucky. I have pretty good health insur­ance cov­er­age. But I have heard that peo­ple who do not have health insur­ance or those who don’t have great cov­er­age are check­ing web­sites like Groupon or Liv­ing Social for dis­counts for var­i­ous medical/dental ser­vices. Because I am curi­ous by nature, I checked Groupon to see what dis­counts were avail­able in my area. I found that the dis­counts were for mas­sages and cos­metic work. On Liv­ing Social I found dis­counts for den­tal exams in addi­tion to the stan­dard spa services.

It seems the dis­count sites are not yet pop­u­lar for med­ical ser­vices. This may change depend­ing upon the out­come of the US Supreme Court review of the fed­eral health law. In the mean­time, if you need med­ical ser­vices and you don’t have health insur­ance, don’t avoid the doc­tor. Most med­ical providers will offer dis­counts directly to their patients, even with­out a Groupon coupon.

We all know that there is a grow­ing cost to med­ical providers ren­der­ing ser­vices to the unin­sured pop­u­la­tion — approx­i­mately $42.7 bil­lion went unpaid last year.  We also know that some­one has to be con­tribut­ing to pay­ing for that care.  But did you know that that cost is being cov­ered through a hid­den tax on the pre­mi­ums of peo­ple with insur­ance?  Accord­ing to today’s USA Today, the aver­age U.S. fam­ily and their employ­ers paid an extra $1,017 in health care pre­mi­ums last year to com­pen­sate for the uninsured.

What is miss­ing from the stud­ies done and the state­ments made at the con­gres­sional hear­ings is that on top of pay­ing a “hid­den tax” on our pre­mi­ums, most insureds are actu­ally “under­in­sured” and end up foot­ing most of their health­care expenses because of high deductibles or insur­ance denials.  To be pay­ing a tax on top of that for health­care ser­vices not ren­dered to those indi­vid­u­als is just one more rea­son why the cur­rent health insur­ance indus­try needs imme­di­ate reform.

The fed­eral lit­i­ga­tion attack on not-for-profit hos­pi­tals might have ended in case dis­missals but that didn’t mean that the IRS didn’t pick up on the tax-exempt sta­tus issue.  In a recent news release,  the IRS sum­ma­rized its find­ings from a sur­vey con­ducted in 2006 of almost 500 tax-exempt hos­pi­tals.  In a nut­shell, the IRS found that there is no con­sis­tent def­i­n­i­tion of “uncom­pen­sated care” across all hos­pi­tals and there is no con­sis­tency of how the uncom­pen­sated care is reported.  One rec­om­men­da­tion that came out of the report is that a form 990 spe­cific to hos­pi­tals should be drafted.

 You may remem­ber that last sum­mer Sen­a­tor Chuck Grass­ley released find­ings from his own sur­vey of 10 tax-exempt hos­pi­tal sys­tems and found sim­i­lar results as the IRS.  See the Novem­ber 2006 blog entry which details his posi­tion that hos­pi­tals should adopt the Catholic Health­care Association’s stan­dard of report­ing com­mu­nity ben­e­fit to develop some consistency. 

And that is exactly what a board mem­ber of Grady Hos­pi­tal in Geor­gia did recently.  Fed up with unpaid expenses for treat­ing poor and unin­sured res­i­dents of a nearby county, Bill Loughrey took a $4 mil­lion dol­lar bill to the Cobb County Board of Com­mis­sion­ers for pay­ment.  The Atlanta Jour­nal Con­sti­tu­tion reports that Loughrey’s actions did not sit will with the Com­mis­sioner of Ful­ton County, the per­son who appointed him to the board, and Loughrey was replaced.  

Last week Pres­i­dent Bush announced that he is propos­ing a $15,000 per fam­ily tax cut for fam­i­lies with health insur­ance cov­er­age.  The move goes along with his theme of fix­ing the health­care cri­sis at the indi­vid­ual level as opposed to the gov­ern­ment level.  The tax cuts, along with the health sav­ings accounts he is so proud of, will allow fam­i­lies to pay for their own health­care expenses.  Or so he says. 

We don’t mean to be sar­cas­tic.  We are very happy with the title of a report in yesterday’s L.A. Times — “High Deductibles a Pain for Some Insured.”  The arti­cle very clearly explains why offer­ing higher deductible health plans at a lower pre­mium is not the answer to the unin­sured cri­sis in America.  

Lately, it seems we are hear­ing more and more about global warm­ing, organic foods, and car­ing for the envi­ron­ment.  Was it Earth Day last month that spawned all of this talk and activ­ity?  No.  It was fueld by Al Gore’s Oscar win­ning movie — An Incon­ve­nient Truth, hailed by the New York Times as a “nec­es­sary film.”  Well, we are about to get another nec­es­sary film, Sicko, to address the health­care cri­sis in Amer­ica.  Not yet released in the U.S., Sicko pre­miered at the Cannes Film Fes­ti­val recently and received very favor­able reviews.  The Insur­ance Jour­nal reports that the film by Michael Moore had more than 2,000 peo­ple applaud­ing in Cannes.   While it is expected that the film will not be pop­u­lar with con­ser­v­a­tive politi­cians in Wash­ing­ton, advo­cates are already try­ing to cap­i­tal­ize on the doc­u­men­tary.  A report in the San Fran­cisco Chron­i­cle details var­i­ous health care advo­cates from around the nation and what they expect the movie will do for the health­care issue.  As stated by Anthony Wright, Exec­u­tive Direc­tor of Health Access Cal­i­for­nia, “Peo­ple know there’s a prob­lem in the health care sys­tem, but most peo­ple don’t talk about it over din­ner.  This (film) will engen­der those dis­cus­sions around the coun­try.”  I am look­ing for­ward to it. 

Do you want to know how your state ranks in terms of health cov­er­age?  Check out Kaiser Fam­ily Foundation’s state-by-state syn­op­sis of what per­cent­age of your pop­u­la­tion is cov­ered by dif­fer­ent sources.  The infor­ma­tion was recently updated to show sta­tis­tics through 2005.

There have been many arti­cles on the suc­cess or fail­ure of Health Sav­ings Account.  See the Wichita Eagle for a recent arti­cle.  Remem­ber, HSAs were pro­moted by Pres­i­dent Bush in his State of the Union Address as a fix for the health­care cri­sis in Amer­ica.  But what all of those arti­cles are not tying together is that in order to have an HSA, the indi­vid­ual must have a high-deductible health plan.  In order for an HSA to be a suc­cess, you must have the funds to put into the HSA so that way you can pay your high-deductible.  Every­one can say that HSAs are not catch­ing on because of a lack of edu­ca­tion as to how they work.  How­ever, from the point of view of some­one who has a funded HSA, the rea­son they are not catch­ing on is because they must be funded in order to work and if peo­ple didn’t have funds to buy a reg­u­lar health plan, they prob­a­bly don’t have the funds to put into a health sav­ings account.  When the choice comes down to set­ting aside money monthly for future health expenses or pay­ing the elec­tric bill and buy­ing gro­ceries, peo­ple will usu­ally choose the latter.

While it may be effec­tive in adver­tis­ing, it isn’t as effec­tive with Hillary Clin­ton.  In a speech ear­lier this week, Sen­a­tor Clin­ton dis­cussed her idea for uni­ver­sal health­care.  While we have heard this idea uttered by prac­ti­cally all of the pres­i­den­tial can­di­dates, what makes this pre­sen­ta­tion unique is Sen­a­tor Clinton’s idea of estab­lish­ing a “Best Prac­tices Insti­tute.”  As explained by the New York Times, the group, funded by both pri­vate and pub­lic monies, would exam­ine new tech­nolo­gies and new drugs to deter­mine whether patients really are bet­ter off because of them or whether big busi­ness is more prof­itable because of them.    Accord­ing to Sen­a­tor Clin­ton, high pro­file drugs are not nec­es­sar­ily more effec­tive than the old stand-by drugs just because they are pro­moted with adver­tise­ments show­ing “peo­ple run­ning through fields of wild­flow­ers.”  Sen­a­tor Clinton’s idea of a “Best Prac­tices Insti­tute” is intrigu­ing to mem­bers of the health insur­ance industry.