News In Healthcare

In a recent report put out by Blue Cross Blue Shield, Pres­i­den­tial can­di­date John Edwards’ pol­icy pro­pos­als were put under scrutiny.   The pro­pos­als for uni­ver­sal health care, energy and putting an end to poverty in Amer­ica would cost more than $125 bil­lion per year, accord­ing to an Emory Uni­ver­sity researcher.    The report dis­cusses how Edwards plans on fund­ing these initiatives.

Sen­a­tor Hillary Clin­ton spoke with a group of moth­ers in New Hamp­shire (video of speach) dur­ing her cam­paign visit there recently.  Her mes­sage was that at a min­i­mum, we need to pro­vide health insur­ance cov­er­age to all chil­dren in the U.S.  She men­tions that her ulti­mate goal is to have uni­ver­sal cov­er­age for all Amer­i­cans, but cov­er­ing the chil­dren should def­i­nitely be the first priority.

Speak­ing to a group of roughly 400 union mem­bers in Tren­ton, New Jer­sey, Sen­a­tor Barack Obama (D.-Il) said that if elected Pres­i­dent, the U.S. would have health care for every­one in Amer­ica before the end of his first term.  The Asbury Park Press fur­ther reports that Obama would pay for the cov­er­age by sav­ing $75 bil­lion through empha­siz­ing pre­ven­ta­tive care, bet­ter care for the chron­i­cally ill, and reduc­ing paper­work.  Seems pretty sim­ple when you put it that way.  Why hasn’t any­one done this before?

Today, the Boston Globe gave a sta­tus update on the fund­ing of Mass­a­chu­setts uni­ver­sal health cov­er­age plan enacted under the admin­is­tra­tion of then-Governor Mitt Rom­ney.  The report indi­cates that all of the money to pay for the new pro­gram is com­ing from the tax­pay­ers as the state has not yet col­lected a penny from the busi­nesses that do not help insurer their work­ers.  For the next fis­cal year, which starts on July 1, the state is expected to col­lect $24 mil­lion from busi­nesses on an orig­i­nal expec­ta­tion of $76 million.  Why the shortfall?  According to some­one in the Gov­er­nor Patrick’s cur­rent admin­is­tra­tion, the Rom­ney admin­is­tra­tion “had no inten­tion of col­lect­ing it, so the infra­struc­ture was not put in place.”  The cur­rent admin­is­tra­tion is just now set­ting up the billing process to col­lect the money for next year.  Should this really be the model for other states con­tem­plat­ing uni­ver­sal health cov­er­age?  I am sure the tax­pay­ing cit­i­zens of those states would say NO.  

On Decem­ber 6, 2006, we reported on the ini­tial effects states were feel­ing as a result of the new doc­u­men­ta­tion require­ments for Med­ic­aid enroll­ment man­dated by the Deficit Reduc­tion Act of 2005 (DRA).  The George Wash­ing­ton Uni­ver­sity Depart­ment of Health Pol­icy recently issued a Pol­icy Brief detail­ing the find­ings of a sur­vey of 300 health cen­ters and the impact the doc­u­men­ta­tion require­ments have had on their facil­i­ties.  In brief, the sur­vey found:

 a.  Almost 90% of all health cen­ters reported enroll­ment dif­fi­cul­ties for patients of all ages, includ­ing new­born children;

b.  For those health cen­ters report­ing a decline in their Med­ic­aid pop­u­la­tion, two-thirds of the respon­dents cited the doc­u­men­ta­tion process as the rea­son for the decline;

c.  One-third of the respon­dents have had to increase staff to han­dle the addi­tional admin­is­tra­tive chal­lenges with the appli­ca­tion and enroll­ment process; and

d.  Ini­tial find­ings esti­mate that the doc­u­men­ta­tion require­ments will elim­i­nate Med­ic­aid cov­er­age for between 105,000 to 320,000 pedi­atric and adult patients.

A dis­cus­sion about this Pol­icy Brief was held and is avail­able for view­ing.

John Edwards, 2008 demo­c­ra­tic pres­i­den­tial can­di­date, is a man with a plan.  Sure he joins the other demo­c­ra­tic can­di­dates in say­ing that health care reform is one of his plat­forms for the race.  How­ever, he is actu­ally lay­ing out a plan to extend health insur­ance to every Amer­i­can.  The Raleigh News & Observer reports that the Edwards plan would require every Amer­i­can to have health cov­er­age by 2012.  Employ­ers would be required to either pro­vide cov­er­age to their employ­ees or to fund cov­er­age through some other means.  Insur­ance com­pa­nies would be required to sell cov­er­age at a fair price regard­less of a person’s med­ical his­tory.  Tax cred­its would be offered to help indi­vid­u­als of mod­est means to pur­chase health insur­ance.  How much would this cost?  Edwards says between $90 bil­lion to $120 bil­lion per year — which would be paid for by repeal­ing tax cuts Pres­i­dent Bush pre­vi­ously pushed through on fam­i­lies with tax­able incomes of more than $200,000 per year.

America’s Health Insur­ance Plans (AHIP) released the results from its sur­vey of insur­ance plans and noted that 4.5 mil­lion peo­ple have enrolled in health insur­ance plans with health sav­ings accounts as of Jan­u­ary 2007.    The Amer­i­can Med­ical News report explains that the increase of 1.3 mil­lion over the pre­vi­ous year (43% growth) is sig­nif­i­cant but far less than the increase in enroll­ment between Jan­u­ary 2005 and Jan­u­ary 2006.  Dur­ing that time period, enroll­ment increased by 220%.

But let’s read this infor­ma­tion another way.  As stated in the AHIP press release, the sur­vey shows 4.5 mil­lion Amer­i­cans are now cov­ered lower-premium, high-deductible health insur­ance plans that are offered in con­junc­tion with an HSA.  Open­ing an HSA is not manda­tory and ear­lier stud­ies have shown that a large major­ity of the pop­u­la­tion does not open the HSA.  So, what we are left with is a report that states that 4.5 mil­lion Amer­i­cans now have to pay more out of their pock­ets because their deductibles are much higher.

Well, maybe not but they are going to give it a try.  The chair­man of the Safe­way Gro­cery chain has founded a coali­tion of large busi­nesses that will launch a cam­paign call­ing for med­ical insur­ance to be extended to every­one.  The cam­paign is very sim­i­lar to California’s uni­ver­sal cov­er­age plan.  The L.A. Times reports that the coali­tion includes some of the nation’s largest employ­ers includ­ing Pep­siCo, Gen­eral Mills, The Kroger Co., Aetna, Blue Shield of Cal­i­for­nia, and Eli Lilly.  The coali­tion, called the Coali­tion to Advance Health­care Reform, hopes to help employ­ers to see that inac­tion would be deves­tat­ing.  The Coali­tion plans to start press­ing fed­eral law­mak­ers today in Wash­ing­ton, D.C.   

Hillary Clin­ton learned a lot from her first go around with try­ing to get uni­ver­sal health care in place in Amer­ica.  Now, she says she is ready and she is mak­ing uni­ver­sal health cov­er­age her goal as Pres­i­dent.  In a Fox News report, Clin­ton said it will be eas­ier this time around because pres­sure for change has built in the last decade.   And while she says it will be eas­ier, she hasn’t laid out a plan as to how she would achieve uni­ver­sal cov­er­age.  She says she first wants to hear from the vot­ers what kind of plan they would favor because “[w]e are big­ger and more diverse and peo­ple like their choice.”

A recent arti­cle in the Chicago Sun-Times about how great health sav­ings accounts are was obvi­ously writ­ten by United Health­care or United Health­Group.  The arti­cle explains that it was Golden Rule Insur­ance Co., part of United Health­care, that devel­oped HSAs about 15 years ago and so far its mem­bers have saved $165 mil­lion in their accounts.  The arti­cle goes on to say how great HSAs are for small busi­nesses or the self-employed.  This may be true from a busi­ness point of you.  How­ever, as an indi­vid­ual with a high deductible health plan and a funded HSA, the admin­is­tra­tive has­sle of mak­ing sure I am pay­ing only for what I am sup­posed to be pay­ing for is no pic­nic.  I would like to see an arti­cle on how best to keep track of all of the EOBs, allowed amounts, deductible amounts, account deduc­tions, etc.