As a firm supporter of families, I was happy to come across an article on healthreform.gov about how Obamacare has some changes that will directly protect families. For American families, average health insurance premiums purchased through an employer have skyrocketed by over 100 percent since 2000, and out-of-pocket costs have grown unsustainably. Escalating health care costs are forcing increasing numbers of Americans to go without health coverage and impeding access to secure and affordable health insurance choices for millions of Americans. As a result, families get lower quality coverage for their dollar; worse, many fall victim to crippling medical debts or avoid needed health care services altogether. Health insurance reform seeks to drive down costs, put more money in the hands of the American people, and ensure all Americans receive the health care services they need and deserve. These efforts won’t just help our health care system, they will also help our economy.

Here are some stats cited by the article:

• Lowering health care costs by 1 percent will create 320,000 jobs nationwide and raise median family income by $6,800 by 2030.
• Reform will drive down premiums and limit out-of-pocket costs that eat into the family budget.
• The number of people in working families who spend more than ten percent of their income on health care has more than tripled.
• 72 million, or 41 percent, of nonelderly adults have accumulated medical debt or had difficulty paying medical bills in the past year — and 61 percent of them had insurance.
• In 2009, the average premium for a family plan purchased through an employer is $13,375, more than double the premium in 2000.
• Premiums have grown more than three times faster than wages
• A recent study found that almost 75 percent of individuals looking for coverage on the individual market never bought a plan, with 61 percent of those that did not purchase insurance citing premium costs as the primary reason.
• The average family deductible increased by 44 percent in just three years for employer-based preferred provider organization (PPO) plans.
• And families who purchase health insurance on the individual market face even higher out-of-pocket costs – nearly 60 percent more in deductibles and copayments than a family that gets insurance through work
• In 2007, 45 percent of non-elderly adults reported difficulties getting needed care because of cost, up from 29 percent in 2001. Even among insured adults, more than one-third reported difficulty (more stats).

So what solutions are provided by the health reform to help families?

1. Health insurance reform will place a cap on what insurance companies can force families to pay in out-of-pocket expenses and deductibles. In addition, families will no longer face lifetime limits to their benefits, nor will coverage be denied or watered down based on medical history. As a result, under reform, health insurance will provide real protection from high health care costs.
2. Health insurance reform provides premium assistance to working families to make sure they can afford quality coverage. For those families that receive premium assistance, the Congressional Budget Office estimates that, under reform, average premiums will be less than half of what they would be without reform.
3. If health insurance premiums continue to rise faster than wages, even more of employees’ compensation will be eaten up by premiums, leaving even less in actual take-home pay. Health insurance reform will lower health care costs by streamlining the health care system, through reforms such as improving care coordination, reducing medical errors, and encouraging more efficient health plans. Lower health care costs mean more money to invest in businesses and to give to workers in take-home wages. A recent report estimates that such provisions could reduce the growth of health care costs by one percent, generating 320,000 jobs nationwide and raising median family income by $6,800 by 2030.
4. The cost of inefficient insurance paperwork has been estimated to be $23 to $31 billion per year. By simplifying and standardizing paperwork and computerizing medical records, reform will save billions of dollars each year, which translates to lower premiums for American families.
5. Through the health insurance exchange, reform will ensure that Americans have portable health insurance options, freeing millions of Americans who feel trapped in a job they do not like because of the fear of losing insurance and providing security to the millions of Americans who lose their jobs and coverage each year. The health insurance exchange will bring families and plans together into one organized marketplace so families can compare prices and health plans in order to decide which quality affordable option is right for them. Health insurance reform will guarantee every American a choice of quality, affordable health insurance options, even if someone loses a job, switches jobs, moves, or gets sick.
6. High health care costs burden businesses that provide coverage for employees, sometimes leading them to drop coverage. Reforms to improve efficiency and quality in our health care system, such as reducing preventable hospital readmissions, encouraging care coordination, and streamlining health plans, could save up to $3,000 per employee by 2019.
7. Health insurance reform will allow all young adults to remain on their families’ health insurance policies as dependents until the age of 26.
8. Health insurance reform will prevent any insurance company from denying coverage based on underlying health status, including genetic information. It will end insurance discrimination that charges families more if a family member has or had any illness, and limit differences in premiums based on age. Finally, it will prevent insurance companies from dropping or watering down coverage if a family member gets sick.

Although there is still more reform needed, we clearly have made some beneficial changes to help individuals and families alike. As we save families money, they are able to better provide for their children in health and other aspects to prepare for a brighter future for America.

ZERO:

the amount you have to pay for preventive health care! As of September 23, 2010, insurers are required to pay the full cost of recommended preventive services, without charging a deductible, co-pay or co-insurance. Read more about it here

FIFTY:

The number of states that now offer options for people with pre-existing conditions. The Pre-Existing Condition Insurance Plan program makes it possible for people who may have previously been denied coverage to purchase health insurance. More information on each State’s plan is available on HealthCare.gov.

ONE MILLION:

the number of checks mailed to seniors. As of August 2010, 1 million rebate checks had been mailed to American seniors who had reached the gap in Medicare’s prescription drug coverage, often called the ‘donut hole’. Read more about it here

EIGHT BILLION:

the number of dollars saved through the law’s new provisions in just two years. Provisions in the Affordable Care Act are expected to save Medicare an estimated $8 billion in the next two years and almost $418 billion by 2019.

TWENTY-SIX:

The age at which children can be insured under their parents’ plan. Beginning on September 23, 2010 all insurance plans will be offering young adults up to age 26 options for being covered under their parents plan.

Here is a funny little video against Obamacare…and kind of our government as a whole. Don’t get me wrong, i do not agree with everything in the video, but it definitely provides some good laughs! Humor is often a great way to promote health issues and advocate for reforms.  You can get the video from youtube if you would like to share it or if the video below does not work. For more reliable information on health care reform check out the government’s site on it.

Although many things in this video are wrong or make fun of our government, I do like that it has some facts in it such as states being able to pass their own health laws. State health care reform may be the best solution at this point.  I do have to somewhat agree that Obama was hasty to pass health care reform without coming up with the best solution to help his image and just create change. Obama needs to learn that any change is not a good change. There is still much to be done to fix our health care system.

As I was reading updates on health reform, I came across this article which is very pertinent to us as young adults! I originally was planning on summarizing it but I thought the article was better left copy pasted since it is short and will be more helpful and detailed. You can find the original at the White House site. It is great to see that there are benefits for young adults, when often we are overlooked in health issues.

Better Benefits, Better Health for Young Adults

Posted by Mayra Alvarez on March 25, 2011 at 09:20 AM EDT

A year ago, young adults were one of the most vulnerable groups of Americans in the health insurance market. However, since the Affordable Care Act was signed into law, many of you can now stay on your parent’s family plan until you turn 26. It doesn’t matter whether you’re married, living with your parents, in school, or financially independent. This is a huge improvement that is freeing people to make decisions about their education, their careers, and their lives without being hemmed in by outdated insurance rules.

Before President Obama signed the health law, you typically had to go off your parent’s plan at 19 or whenever you left school. This put many young people in a tight spot, especially if they were living with a pre-existing condition like cancer, diabetes, or asthma—since it was very hard to get quality, affordable health insurance. Now, thanks to the Affordable Care Act, the class of 2011 will be the first to graduate with this new option on the books. Already, nearly 1.2 million young Americans will be able to gain insurance coverage this year as a result. This means as you start your career, you can pursue the jobs or opportunities that are best for you without worrying about health insurance.

Check out our facebook page on this to learn more, or watch this video with step-by-step instructions on how to access this important benefit.

There are other benefits, too, that are already in place:

• If you are in a new insurance plan, insurance companies cannot charge you a deductible or copays for recommended preventive services, like flu shots and other immunizations. Click here to find a list of preventive services that will be covered without a deductible or copays.
• Insurance companies are prohibited from capping the dollar amount of care you can receive in a lifetime, or dropping your coverage due to a mistake on your application when you get sick.
• Most health plans cannot deny coverage to children under age 19 because of pre-existing conditions.
• If you have been uninsured because of a pre-existing condition, you may be eligible to join the Pre-Existing Condition Insurance Plan. To find out about plans available in your State, please visit: www.pcip.gov.

These are just a few of the new benefits and protections that Americans of all ages are enjoying across the country. I encourage you to go to HealthCare.gov to access more information about the law, including a personalized list of private insurance plans, public programs and community services that are available.

I must applaud Obama on his openness to suggestions for change in healthcare. I suppose it is fitting considering his whole presidential “Change” campaign.  Recently he released a statement encouraging states to find solutions to health care.

He said, “If your State can create a plan that covers as many people as affordably and comprehensively as the Affordable Care Act does – without increasing the deficit – you can implement that plan, and we’ll work with you to do it.  I’ve said before, I don’t believe that either party holds a monopoly on good ideas.  And I will go to bat for whatever works, no matter who or where it comes from.”

The Department of Health and Human Services and the Treasury proposed rules for states implementing their own health strategies on March 10,2011. Their goal is for states to help residents obtain high quality, affordable health care while nationwide health reform is still underway.

State Innovation Waivers are designed to allow States to implement policies that differ from the new law so long as they:

• Provide coverage that is at least as comprehensive as the coverage offered under the Affordable Care Act.
• Make coverage at least as affordable as it would have been through the Affordable Care Act.
• Provide coverage to at least as many residents as the Affordable Care Act would have provided.
• Do not increase the Federal deficit.

It is great that Obama is creating flexibility for states to reform health without so much red tape, but it does make me wonder a bit if it is a cop-out for not knowing how to change America for the better by himself.  Maybe he is hoping that one of the states will come up with a stellar plan that can then be implemented nationwide…which would not be a bad thing because it maybe be better and quicker than the solutions that Obama comes up with. These innovation experiments can’t hurt because as stated above it guarantees that citizens are receiving at least as good of coverage as the Affordable Care Act. Passing the torch to the states might just be the best health idea Obama has had yet!

Read more on the topic here

While reading the Wall Street Journal this morning I came across an article entitled

“In Health Law, Rx for Trouble” which brought up a part of the new health law that flew under the radar when passed through Congress apparently. The law states that people must have a prescription in order to buy items under a “flexible-spending account” in order to receive a tax break. As shown in the figure to the right, 20% of Americans have a flexible-spending account so it affects a large proportion of the population. This law has resulted in many doctors being weighed down by useless appointments for patients to receive prescriptions for over the counter drugs such as baby rash cream or ibuprofen. Not only is it wasted time in appointments, but in extra paperwork. It also causes more work for pharmacists because it means more prescriptions to fill and more labels to print on 15,000 everyday products that people used to just take off the shelf and buy.

The idea behind the law was that it would limit tax breaks on over-the-counter drugs and prevent wasteful spending on health products, but lawmakers didn’t anticipate people finding ways around it to maximize tax savings. Not only has it wasted time of health professionals, but can be more harmful for patients because they may not be able to purchase the over the counter drugs without the flexible-spending account money, but are not able to get a doctor’s appointment and thus go without the medication. A main priority in health reform should be to increase preventive and initial treatment of illnesses so that it is easier and cheaper to treat. This small regulation is just one example of reforms needed within the Obamacare plan.

Obama has proposed a solution for all of these problems and more with a new health care plan that is starting to be implemented. According to the White House, under the Affordable Care Act, which was passed March 3, 2010, health insurance is mandated for all citizens—similar to current car insurance.  To make this possible, it will have the largest tax cuts for health care in history for the middle class—it will make it possible for tens of millions of families and small business owners to afford insurance.  It also lays out stricter rules for insurance companies to keep premiums low.  Also in an effort to make insurance available and affordable for every citizen, it illegalized discrimination against pre-existing conditions.  Another bill that was signed into law is the Children’s Health Insurance Reauthorization Act, which provides quality health care to 11 million children – 4 million who were previously uninsured.  Obama’s plan is aiming to shorten the gap of health disparities in America.

Although all of these parts of the Affordable Care Act sound great, the act poses a few problems as well. First, it will lower the amount paid to doctors for medical services under Medicaid and Medicare.  Insurance companies pay a certain percentage above Medicaid/care costs so as the government lowers the amount paid, the insurance price will also be lowered.  For example, a surgery costs $1,500 through Medicaid.  A person with private insurance will pay 20% more equaling $1,800.  If the law mandates that the government will only pay $1,000 now then the insurance companies will lower their amount paid to $1,200.  Granted, some doctors make more money than reasonable and can afford that pay cut, but some doctors may not be able to continue practicing and many may shut their doors to government patients.  This is especially a relevant problem now because there are shortages of primary care providers because of so many physicians going into specialties.

Second, Obama’s health care plan spends much more money than before and could be detrimental to America’s economy. According to Republicans in Congress, the health care plan includes almost $1 trillion dollars in spending and will cause health spending to jump even more than the originally projected 16.6% to 17.6% of GDP (gross domestic product) this year alone.  Six billion dollars of this budget is proposed to help cancer research—yet the law also imposes pharmaceutical cost controls that will discourage companies from wanting to invest in developing new cancer treatments.  With the Affordable Care Act, many businesses will be required to provide insurance to their employees or put money into a government fund to cover the uninsured.  With the desperate state of the economy now, this financial burden is the last thing businesses need. Obama’s plan may prove to be successful in the end with a few amendments, but there are still a few bumps in the road on the journey to efficient and effective health care in the U.S.

As discussed in the last post, the WHO ranked nations’ health care systems and the United States were 37th while France ranked 1st. Let’s take a look France’s health care system and why they are the best. Maybe the United States could learn a thing or two. The French National Health Insurance (NHI) is a mix of government universal healthcare and private insurance.  Citizens are automatically enrolled into government insurance plans based on their occupational status. It operates on a fee-for-service basis for ambulatory and acute hospital situations in which the patients are reimbursed under NHI. Although it is far from perfect, it has created high customer satisfaction and health in its country.

First, the French system provides better health care for less money.  Thirty percent of Americans have problem accessing health care due to payment problems or access to care.   Access to health care is directly related to income and race in the United States.  Since health care is universal in France, citizens receive more preventive and equal care thus resulting in living healthier, longer lives.  Rodwin (2003) states, “Existing data indicate consistently that, compared with Americans, the French consult their doctors more often, are admitted to the hospital more often, and purchase more prescription drugs.”  As citizens have greater access to health care, they are able to get more preventative care, screenings, and immediate treatments creating lower costs and better health.  The French also have an outstanding cancer program and more radiation therapy than any other nation.   France has higher health rates across the board in categories accounted for in the WHO report. According to OECD (2010), the cost per person in health care in France is far less than in America: $3,601compared to $7,290.

Second, the French health care model offers freedom of choice.  There are thriving nonprofit and commercial hospitals and insurance sectors in France.  Rodwin goes on to say, that the public health insurance system covers about 75% of total health expenditures and 90% of people have private insurance in addition to the government provided insurance.  The NHI laws protect the right of patient’s choice of practitioner, the practitioner’s choice of workplace, guaranteed physicians’ control over medical decision-making, and medical confidentiality.  In fact, there are more options under the French NHI because it covers services ranging from hospital care, outpatient services, prescription drugs (including homeopathic products), thermal cures in spas, nursing home care, cash benefits, and to a lesser extent, dental and vision care.  Patients can see any specialists that they desire as well, thus giving them more opportunities to top treatments.  The preservation of freedom of choice is essential in creating a better health care system in America.

In 2000, the World Health Organization (WHO) conducted the first analysis and ranking of 191 countries’ health care systems.  This study shocked the world when the United States, one of the most powerful and successful nations, was ranked only 37th. The World Health Organization ranking system was based on five main indicators of health care: overall level of population health, health inequalities, overall level of health system responsiveness, distribution of responsiveness, and distribution of financial burden.  Overall level of population health takes into account factors such as lifespan, years of healthy life, infant mortality rate, and maternal health.  Health inequalities measures the gaps of health care coverage and access in the population.  Health system responsiveness and distribution of responsiveness has to do with the satisfaction and surveys within communities.  Distribution of financial burden measures the cost to the government, employers, and individuals.  The final results ranked France as 1^st and the United States 37^th Although the U.S. has a lower ranking, it spends the most amount on health care of any other nation (in fact double France per citizen).

So why is America so behind in health care when we spend so much and have some of the best doctors and educated medical personal in the world? The first evident problem is the lack of universal coverage that creates a gap of uninsured between the government covered and privately insured. I have not been one to increase government control, but it studies have shown that universal health care makes health systems more efficient and cheaper. Around 30% of Americans have problems accessing health care and 17% of Americans are without health insurance. This leads into the second problem of lowered population health. If people are delaying health care because of lack of insurance or money, the health issue escalates to a more complicated and expensive problem to treat. Also, the American lifestyle is all about fast, cheap, and easy which is hardly the most healthy. Sixty million Americans, 20 years and older are obese; eight out of ten adults over the age of 25 are overweight.  Nine million children and teens ages 6-19 are overweight; obesity rates in children have quadrupled in the last 25 years. A third cause of the low ranking is medical costs in the United States.  The United States spends at least 40% more per capita on health care than any other industrialized country and a 2005 study showed that nearly half (46.2%) of personal bankruptcies are due to illness and high medical costs. The United States has much room for improvement that would save lives of many citizens. It has the resources and potential to have the best health care system in the world, but the trick is how do we get there?

Read the complete report here!

What a better way to start off a blog than with the State of the Union address with the start of the year! Just days ago, President Obama addressed the nation around the theme of  “winning the future”. Healthcare reform, as expected, was one of the top priorities in winning the future.  As our baby boomers are aging and the nation is going more into debt (check out the current debt and breakdown), we need to get Medicaid, Medicare, and our health system organized and under control.

President Obama received laughs when he joked that, “Now, I have heard rumors that a few of you still have concerns about our new health care law.”  He went on to say that anything can be improved and is eager to work to create better and more affordable care.  Among needed changes, he states removing, “unnecessary bookkeeping burden on small businesses”. He talked about the importance that the insurance companies should not deny coverage to those with preexisting conditions and used specific stories of people to pull on the heart strings of listeners, yet did not really address issues of health care besides that he is willing to change. He ended with, “So I say to this chamber tonight, instead of re-fighting the battles of the last two years, let’s fix what needs fixing and let’s move forward.”  I give him accolades for recognizing the need for health care reform, but there does come a point at which there is too much to fix and it is easier to just start over.

To watch or read the address for yourself click here.