Mental health care in California will suffer a severe blow when the state’s Department of Mental Health’s proposed plan to overhaul its mental health care system is implemented in 2012, effectively eliminating over 600 positions (five percent of the workforce). This comprehensive revamping of the way care is provided for the mentally ill includes replacing the California Department of Mental Health with a new Department of State Hospitals which will reduce the budget by almost $195 million. With over 6000 state hospital and prison patients presently under the state’s mental health plan, Governor Jerry Brown wants to shift this burden away from the state and into the control of local management services by concentrating on only the most critically mentally ill patients.

Debate About the Proposal

photo credit: SamWebsyntax

According to details of the new plan, staff members would be responsible for assigning mentally ill patients to one of California’s five mental hospitals or one of two prison psychiatric programs, based on the severity of their illness. This committee, referred to as “Safety Now”, will be comprised of physicians, psychiatric technicians and pertinent state hospital employees. However, opponents of this plan say that by adopting this new committee, patient-to-staff ratio will be reduced by at least one-third.

Members of the opposition further reiterate the fact that over two million residents say they need mental health services but do not have access to the care they require due to an already overworked and understaffed system. They also point to results of a recent California Health Interview Survey in which nearly 90 percent of uninsured state residents needed mental health services but did not receive it. In addition, almost 80 percent of adults responding to this survey who had private insurance and needed mental health services could not access such care and 65 percent of those with Medicaid had unmet mental health needs.

Many who are unsettled by this proposed plan bring up worker safety conditions at prisons and state-run hospitals. For example, in 2010, a psychiatric technician named Donna Gross was killed at the Napa State Hospital by Jess Willard Massey, an individual with an extensive criminal history carrying a sentence of 25 years to life. Investigation of the murder resulted in the Division of Occupational Safety and Health fining Napa Hospital over $100,000 for six violations they say facilitated the death of Ms. Gross. Among these violations were inadequate police presence and lack of proper enforcement of safety procedures and policies.

Kathy Gaither, acting chief deputy director of the Department of Mental health says that this plan will save money but still maintain an optimal level of care for the mentally ill. However, the president of the Union of American Physicians and Dentists states otherwise. “We all know that if treatment staff are reduced,” says Stuart Bussey, president of the UAPD, “patient safety will almost surely deteriorate, resulting in an increase of assaults.”

Email a friend

It’s difficult to come up with the exact number of Americans without health insurance because varying methods are used. Some methods count a person as not having coverage at all if he/she is without health insurance at any time during the year, while other methods take into account the period of time without coverage. This can skew the reported figures significantly.

Nevertheless, the number of Americans without health coverage is growing. As difficult times affect businesses, they’re dropping health insurance for their employees or making employee coinsurance portions higher, which means that some workers simply drop the insurance because they can’t afford to pay for it. While some have savings to pay for critical medical care, many do without or make use of local charity programs when they can. Often, non-critical medical procedures and preventative care are simply not addressed.

The Number is Growing

photo credit: storyvillegirl

The New York Times reported that almost a million more Americans were without health insurance in 2010 than were in 2009. That means that over 52 million were without health insurance in 2010, a figure that continues to climb. The number is not out for 2011 yet, but it is expected to be higher than 2010.

Unemployment has made the situation even worse, as some unemployed simply do without health insurance, while others rely on government or charity assistance for their medical needs. According to Bloomberg, nearly one third of all Americans depend on the government for health care through Medicare, Medicaid, Children’s Health Care Programs and various other national, state and local programs.

State Statistics

photo credit: Rishabh Mishra (possible248)

The state with the lowest number of Americans without health insurance is Massachusetts, which has a state health insurance plan. Even with the state health plan, 5.6% of the state population has no health care.

Texas is the state with the highest number of uninsured, with 24.6%, meaning nearly one out of every four people don’t have health coverage.

These two extremes show how varied the numbers are, but most Americans are concerned about insurance for health care. Those who cannot afford it must find alternative ways to pay for medical care and those who can afford it are shouldering more and more of the burden.

Where will it all end? Some say that Obama Care will end American health concerns while others point to a high-coverage state like Massachusetts and say, “What about the almost 6% who have no health care there?”

References:

Bleak News on Health Insurance. http://www.nytimes.com/2011/09/15/opinion/bleak-news-on-health-insurance.html?_r=1

Americans Without Health Insurance Rise to 52 Million on Job Loss, Expense. Wechsler, Pat. http://www.bloomberg.com/news/2011-03-16/americans-without-health-insurance-rose-to-52-million-on-job-loss-expense.html

Number of people without health insurance climbs. Christie, Les. http://money.cnn.com/2011/09/13/news/economy/census_bureau_health_insurance/index.htm

Email a friend

One key to understanding and utilizing your health insurance is to understand the health insurance terms that explain your policy. These terms can be confusing to many different people, and can cause payment issues when you use your insurance. It is important to understand your health insurance policy completely, so that you understand what you are responsible for paying.

Deductible

The deductible on your insurance policy is the amount you must pay before the insurance will begin picking up the bill. Some insurance companies do not count doctor’s visits towards the deductible, and you will just need to make your copayment at your doctor’s office. The deductible will be met when you have a test or procedure done or you visit the hospital.

Copayment

photo credit: natloans

The copayment is the amount you pay to the doctor or hospital whenever you have a visit. The amount should be listed on your insurance card. You will need to make the payment each time you visit the doctor. Copayments do not count towards your maximum insurance amount or your deductible amount.

Coinsurance

photo credit: Maxim34374

The coinsurance is the amount that you must pay after the health insurance has picked up a portion of your payment. This is usually listed on your policy as 80/20 or 70/30, for example. You will be responsible for the second number listed as a percentage, so twenty or thirty percent of the bill from the hospital.

In-Network and Out-of-Network

In-network and out-of-network refer to whether or not the doctor or hospital has made an agreement with the insurance company to reduce payment amounts for their customers. The insurance company may require you to pay higher co-payments and coinsurance if you choose to visit doctors who are not in their network of approved doctors.

When you read your hospital bills and insurance statements you should see that the insurance reduces the amount of the bill, because of agreements between the hospital and insurance company. You should always wait for your insurance statements to go through before paying the coinsurance on a bill. If you pay too much, you can request a refund from the hospital or doctor, but it can take some time to process.

Understanding health insurance terms will make it easier to use your insurance. It allows you to determine how much to pay, when to pay it and to make sure you are being billed the correct amount. It makes dealing with the billing process much easier.

Email a friend

Ohio Issue three is a measure that calls for the exemption of Ohio residents from any national healthcare mandates. Sponsored by the Ohio Project, the measure, which has been referred many times as a constitutional amendment in the state, is in direct response to “Obama care,” or the legislation signed by Pres. Barack Obama initiating a national healthcare mandate for all US citizens.

The measure was approved as a referendum on Senate Bill five, which came up for vote on November 8, 2011. Ohio Issue three past with a yes to no ratio of about 2 to 1. The vote was roundly seen as a rebuke of Obama care, and Republicans quickly took that vote as a measure of national distaste of the public for a healthcare mandate.

Issue Three History

Ohio Issue three has a history – the first version being citizen initiated in 2010, and proposed for the statewide ballot to take place on November 2, 2010. However, the measure was killed by the Ohio Ballot Board, and was considered dead until the Ohio Supreme Court ruled that the amendment could appear as a single issue on April 29, 2010. Supporters of the measure then started a petition drive to receive access to the 2010 ballot, but they were unable to produce enough signatures. The effort was then switched to the 2011 statewide ballot.

There was also a legislative version of Ohio Issue three as well. The measure failed during the state legislative sessions of 2011 in the state House of Representatives.

Ohio Liberty Council Support

The version that was finally introduced as a constitutional amendment put forward on Senate Bill five was supported by the Ohio Liberty Council, the Ohio Right to Life, a pro-life group in the state of Ohio, and Bob Peterson, the Ohio State Senator, as well as the Ohio Consumers for Health Coverage. The measure was opposed by The League of Women Voters of Ohio, the Ohio Democratic Party, and others.

The measure was opposed by the Ohio Democratic Party because many legislators thought that the bill was poorly drafted. They thought that it would interfere with other state laws and bolster their claim with healthcare experts and law professors.

Email a friend

There are many perks to being self-employed. You get to make your own hours, work with whoever you want and you get the autonomy that comes with being your own boss. Getting good health coverage isn’t necessarily one of the perks of working for yourself though. While most freelancers only get a paycheck for their efforts, there is insurance available for those who work for themselves.

Most Insurers Have Plans Specifically For The Self-Employed

Most major medical insurance providers will have plans that are available only for those who are self-employed. These self-employed health insurance plans are usually cheaper and cover the essentials for anyone who works for themselves. A self employed health insurance plan usually is for an individual, but there are options for those who want to cover family members as well in most cases.

Group Plans

If you run a business, you may be able to get your whole company insured under a group plan. These plans are cheaper as the risk is spread among more individuals. The only problem is that you have to have a group in order to get the group plan in most states. However, if you can apply for it, it is a great way to provide for yourself and for those who work under you. It could help you attract more talented workers.

Tax Write-Offs

For those who have medical expenses, some of those expenses can be written off of your taxes. Once your expense equal more than a certain percentage of your income, that becomes a tax write off and you overall taxable income is reduced. It should be mentioned that this only applies to those who are self-employed. There are other tax breaks for those who are employed by a company.

Getting insurance for yourself, or your company, as a self-employed person may seem like a challenge. However, there are plenty of opportunities out there to get insured and have some level of coverage. It might not be the same coverage that an employer might be willing to give you, but having some level of protection can result in peace of mind should anything happen to you.

Sources:

http://echealthinsurance.com/health101/one-man-groups/

http://ptmoney.com/buying-health-insurance-as-a-self-employed-individual/

Email a friend

Google is a search engine that offers a wealth of information — and misinformation — to the masses. Among this information are countless medical advice websites and articles. People often use Google to find these articles when they have anything from a minor ailment, such as a rash, to a major ailment, such as cancer. It has become so popular that when a person is sick and uncertain of what is wrong, we often hear the term, “Google it!” The question is, is the doctor “Googling it.” when you are ill and he or she is not sure what ails you?

According to a survey by Wolters Kluwer Health, 46 percent of the survey’s American Medical Association subjects said they use web browsers as references in their research to diagnose and treat patients. Of course, they use other sources, such as medical journals and other medical professionals. However, as the survey shows, nearly half of them use what they find on browsers like Google to supplement the other information available to them.

A seasoned Google user can tell you that Google has search parameter functions that allow you to search only scholarly pages and government pages, if you wish. That leaves great sources, such as the Centers for Disease Control and medical learning institutes. However, many of the surveyed professionals — 42 percent, to be exact — said they used free use sites like WebMD to find answers to their medical questions. That means that the very same information that is at the fingertips of most of the world is being used to diagnose and treat patients.

Interestingly, roughly one-fifth of the professionals surveyed believe that search engine’s leading to patients having so much medical information at their fingertips has been, “detrimental, leading to misinformation and incorrect self-diagnosis.” Whether these were the same professionals that use Google to find medical information is unclear. On the other hand, 53 percent said that it has had, “a positive impact on the doctor-patient relationship.”

It is important to note that doctors have additional training that aids them in medical Google searches. They understand medical terminology better than the average person. They know how to search medical information accurately, pinpointing the symptoms of any given patient, rather than using generic search terms, as a layperson would. Doctors are not using only the information on Google, but rather using it in conjunction with their own training and experience.

Email a friend

On Tuesday, the Wisconsin State Senate passed Bill 203, which exempts health care benefits for adult dependent children from taxation. This was long called a “hidden tax” by Wisconsin Legislators, as Wisconsin was the only state in the Union to count healthcare benefits for adult dependent children as taxable income. The bill is expected to eliminate the tax for more than 15,000 Wisconsin families, and extend the age in which a dependent child can be covered by insurance to age 27. In passing, Wisconsin follows the lead of more than a dozen other states who have passed similar legislation this year.

The bill was written by Representative Pat Strachota (R-West Bend) and Senator Van Wanggaard (R-Racine).

The Hidden Tax

Wanggard called the law a hidden tax that many in Wisconsin’s workforce were unaware existed, and said it would be a burden on taxpayers at the end of the year. He added that legislators have an obligation to lower the tax burden on struggling citizens instead of raising it unexpectedly.

Both Wisconsin and the federal government require dependent children to be covered by health insurance companies under most circumstances. However, the state and federal laws differ in the time and form in which they were passed, which confusion among Wisconsin’s workforce. This bill will adjust state law to conform to federal requirements, therefore eliminating any loopholes that would allow Wisconsin to become a tax island for imputed income.

Wanggaard noted the potential of administrative hardship if the law was not passed. Employers would have had to spend additional time and resources to determine the value of this benefit for tax purposes. Wangaard said those resources can now be spent towards creating more jobs in Wisconsin.

$1.8 million Decreased Revenue

The bill is expected to decrease state revenue by $1.8 million annually, and will be applied retroactively to January 1, 2011.

Representative Joe Liebham (R-Sheboygan) said “”Numerous constituents have contacted me who recently received information from their employer that due to state law their income would be taxed on the fair market value of the health insurance coverage extended to their non-dependent children.”

“For many families, this will equate to thousands of dollars of additional tax liability,” Liebham added.

Senate Bill 203 passed the Senate on a unanimous 33-0 vote. It now moves to the Assembly, where it is expected to pass next week. Governor Scott Walker released a statement commending the Senate for the unanimous approval of the bill and praising the effect it will have on Wisconsin families.

Email a friend

Vermont became the first US state to install a single-payer healthcare system. This means that all citizens of the Green Mountain State are entitled to health insurance. Called Green Mountain Care, there are seven reasons single-payer health care will be great for Vermont business.

• Guarantees

Health care is a contentious issue nationally in the United States. There is no federal mandate for healthcare, but on the state level in Vermont, every citizen now is guaranteed healthcare. This improves quality of life for all people and can help workers feel assured that their health costs are going to be covered in some way. This increases worker confidence and worker morale.

• Employee

This single-payer system specifically helps a business since most businesses have to invest money in an employee’s health care. This means a company can remove a cost from their business, promoting the business to invest and hire workers instead of paying for healthcare.

• Entrepreneurship

Entrepreneurship will increase exponentially now in the Green Mountain State. If a Vermonter has to worry about losing healthcare before they quit their job to start a business, then entrepreneurship is stifled. Here, entrepreneurship can blossom since there are no fears of not having health insurance for a worker and their family.

• Privacy

Healthcare through employers wraps people’s identity to care. Now, Vermont businesses do not have to mix themselves into the private health lives of individual workers.

• Controls Cost

Single-payer often controls healthcare costs. Because of small taxes across the board, such as through payroll and income, every person in the state can have health insurance. This helps the state purchase health services and health goods, like medicine, in bulk. Because the taxation is spread all around, a business just needs to put in a minor investment for an incredibly fruitful societal investment that removes a good chunk of a business’ yearly fiscal spending.

• Time

Businesses no longer have to waste their time managing healthcare concerns with their workers. Only if they do provide healthcare services that work above and beyond the state’s single-payer healthcare will a company have to worry about every healthcare detail. More time on marketing, advertising, and investment can be spent instead on human services.

• Spending

With lower costs in healthcare services, consumers in Vermont will be able to purchase more goods and services in this state. This will help boost the economy.

These seven reasons single-payer health care will be great for Vermont business are just a few reasons why it is important to have single-payer healthcare.

Email a friend

The follow-up by the government continues into the manufacturing problems of GlaxoSmithKline in Puerto Rico preceding the news that the corporation would pay a $750 million settlement for both civil and criminal complaints for contaminated products.

Months of Discussion

For a number of months, investigators working for the federal government have been discussing a rehabilitated fortitude to hold the company officials, not just the entities of the corporation, accountable for the false claims that have been filed with the government health programs to purchase such products. Thanks to the federal False Claims Act, billions of dollars has been recovered for healthcare fraud, but it is the companies, not the executives, that are signing these plea deals.

The case started for GlaxoSmithKline when a whistle blower filed a complaint in 2004. That complaint was filed by the former quality control manager for the plant. Her case came to a close on October 26, 2010, with a $96 million portion of the recovery.

When asked whether she believe that there was still any individual accountability in GlaxoSmithKline’s case, Massachusetts state attorney Carmen Ortiz replied, “I really shouldn’t comment specifically in relation to this case,” she continued, “because the investigation is ongoing.” She went on to say, “The corporate aspect is finally settled.”

Federal Misdemeanor Prosecutions

Under most conditions, since the complaint was filed in 2004, it would fall outside the statute of limitations on federal misdemeanor prosecutions, which is only five years. However, the government is able to pursue under the stern liability standard of the Park doctrine, which is a prosecution line that has a number of pharmaceutical executives deeply concerned.

The Park doctrine, which was named following a Supreme Court case in 1975, allows company officials to be prosecuted with a misdemeanor for violation of the Food, Drug and Cosmetic Act, even if they did not know about the violations.

photo credit: doug_wertman / Cha già José

Email a friend

Another death has occurred in Arizona because someone was denied transplant coverage due to state budget cuts. On October 1, the state of Arizona reduced the Medicaid coverage for organ transplants in order to help close the shortfall in the budget.

Jo Marie Gellerman is a representative for University Medical Center. She said that the patient passed away on Tuesday, December 28 at a different medical facility. The patient had been removed from University Medical Center’s transplant list for a new liver because they suffered from Hepatitis C. Gellerman declined to release any specific information regarding the patient.

Death Caused By Reduction of Coverage

According to hospital officials, the death “most likely” resulted from the reduction of coverage for transplants. Although there is no way to say for sure if the patient would have lived if they received the transplant, Gellerman said, “but we do know that his condition has gotten more severe since he was taken off the list.” In addition, the worsening condition of the patient would have elevated their position on the transplant place.

Mark Price, a man from the Phoenix area, passed away on November 28 from complication with preparations for a privately funded bone marrow transplant. Funding for the procedure was donated anonymously following reports by The Associated Press and other media outlets. Price received notification about two possible bone marrow donors on October 1, which just happens to be the same day his coverage was reduced because of the budget cuts.

According to Governor Jan Brewer, “The bottom line is … that was one of those areas that we could cut and we moved forward on that.” Senate Minority Leader David Schapira said, “Failure to restore this funding is a death sentence for people who have committed no crimes.”

photo credit: xoque

Email a friend

In the United States, there has been a significant increase in the number of pregnancy-related strokes. This is primarily due to the risk factors that are associated with high blood pressure and obesity, according to reserchers with the CDC, whose report can be found in the July 28 online issue of Stroke: Journal of the American Heart Association.

Dr. Elena Kuklina, the lead author on the recently released report, is the senior service fellow and epidemiologist for the Centers for Disease Control and Prevention’s Division for Heart Disease and Stroke Prevention located in Atlanta, Georgia. She told media representatives that she was surprised by such a “substantial” increase in the number of strokes experienced by pregnant women.

Kuklina said, “Our results indicate an urgent need to take a closer look. Stroke is such a debilitating condition. We need to put more effort into prevention.”

Dr. Elena Kuklina, along with a number of her colleagues report that overall the number of women having strokes while pregnant or within three months after giving birth increased over a 12-year period up to 2007 by as much as 54%. The cause that they suggest is the increase in obesity and high blood pressure.

To complete the study, data was used from five to eight million discharge records, from a thousand hospitals from 1994 to 2007. From this data, it was possible for them to see that the rate of strokes had increased in women going to the hospital while pregnant, to deliver and soon after the birth of their children.

According to Dr. Kuklina, it is best to have the best possible cardiovascular health when you become pregnant without any other risk factors. She said, “Since pregnancy by itself is a risk factor, if you have one of these other stroke risk factors, it doubles the risk.”

photo credit: Emery Co Photo

Email a friend

A hospital in Seattle, Washington, has announced the launching of new 3D mammography imaging technology, or tomosynthesis, as it is better known, and its availability for patient appointments. This technological development makes a more precise reading possible, reducing the need for follow up appointments by as much as forty percent. This will save all parties involves a considerable amount of money.

The amazing new procedure for detecting breast cancer uses exact, 3D digital imaging in order to create a full reconstruction of the breast being examined. This will make it possible for radiologists to identify any abnormalities that may otherwise be difficult to detect, such as with traditional mammography screening using 2D technology.

All diagnostic and screening mammography patients will benefit from tomosynthesis. However, it is especially beneficial to women who need a baseline screening, women age 40 to 60, women with dense breast tissue and women who have had breast cancer in the past.

Available to all diagnostic and screening patients, this new technology comes from the Evergreen Breast Center, which is known for their comprehensive breast health services. Patients are able to request an appointment for tomosynthesis screening now.

CEO Robert Malte of Evergreen Hospital said, “We are proud to continue Evergreen’s tradition of innovative, advanced breast cancer care through this remarkable technology. Our sincerest thanks go out to all the generous donors to the Evergreen Healthcare Foundation for their benevolence and support in helping to bring tomosynthesis to Evergreen and our surrounding community.”

In addition, the medical director for the Evergreen Breast Center Dr. Kara Carlson said, “The introduction of tomosynthesis helps us stay at the forefront of important technological advances in breast-health screening and diagnostic tools. This helps us deliver on our commitment to achieving positive outcomes through early detection.”

photo credit: Muffet

Email a friend

The goal of tort reform statutes is the assumption that too many tort claims are filed and that court awards tend to be excessive. Such claims consist of punitive damages, which are used to penalize a defendant for willful and wanton conduct. Pain and suffering is another common claim used against doctors and hospitals.  Tort reforms propose to limit the amount that can be awarded for such non-economic damages, as well as to aim to make it less worthwhile to pursue minor cases. Thus in turn, reduces the number of malpractice cases. Other tort reforms seek to limit liability by making it more difficult to pursue cases against multiple defendants. Still other reforms focus on procedural changes, again making it less likely that marginal cases will be pursued.

Over $10 Billion Dollars In Savings!

In 1995 the Texas Legislature passed a string of bills to reform the state’s civil justice system. The bills addressed issues of limits of punitive damages, joint and several liabilities, modifications to trade practices, limits on out of state filings, and medical malpractice reform. This impacted the Texas economy greatly. In 2000 the total cost of the Texas tort system was $15.482 billion. Without the reforms in place, the estimated total cost would have been $25.889 billion, which is a significant decrease. With this decrease more money was able to directly benefit consumer, $2.542 billion went to the consumers.

In September 2003, Texas Constitution prohibited caps on awards. Proposition 12 amended the constitution regarding caps. This cut the number of medical malpractice cases filed in the state of Texas in half which then led directly to causing the number of practicing doctors to increase. This in turn influenced the five largest physician malpractice insurance companies in the state to announce rate cuts totaling approximately $50 million in premium saving to doctors and hospitals.

Whats The Cap On Each Occurrence?

The statutory reforms included in House Bill 4 far exceed what many other states have passed. Caps on non-economic damages are: $250,000 per occurrence for all physicians; $250,000 per occurrence for a health care institution; and a second $250,000 per occurrence for any other, completely separate, institution. This has decreased the number of frivolous lawsuits in the state of Texas.

Does The Tort System Work?

Texas has proven that the tort system does work. Not only does it encourage doctors to practice in the state of Texas, tort reform brings the economic system up. Tort reform allows room for more jobs, economic growth, and brings more doctors into the community.

photo credit: gurdonark, Miran Rijavec

Email a friend

Email a friend

Email a friend

Over 50 million Americans are currently without health insurance, with more losing coverage each day. But what is health insurance, and why is it important?

What is Health Insurance?

Health insurance is a type of insurance policy that pays a portion of medical expenses. For instance, if you need to visit a doctor, have surgery, purchase prescription drugs or get medical tests (like x-rays), health insurance will pay a portion of the expenses incurred. The portion of expenses paid varies by policy.

Vaccines, check-ups, routine physical exams—each is important to maintaining health. But those without health insurance are less likely to receive potentially life-saving preventive care.

What Does Health Insurance Cover?

A standard health insurance policy covers:

• Visits to primary care doctors and specialists
• Emergency services, including visits to the emergency room
• Medical check-ups, including blood tests, pap smears, etc.
• Medically necessary procedures (surgery, MRIs, CAT Scans)
• Prescription drugs

Health insurance won’t cover 100 percent of medical costs, though. Patients are responsible for small fees—co-payments—when visiting medical providers or purchasing prescription drugs.

Health Insurance Covers Prescription Drugs

Without health insurance, you probably can’t afford prescription drugs. It’s not uncommon for a prescription drug to cost hundreds out-of-pocket. In fact, the average cost for a prescription drug is now $71, according to the Kaiser Family Foundation.

With health insurance, a small co-payment is usually all that’s necessary to purchase a prescription drug.

Choosing the Best Health Insurance Plan

When choosing the health insurance plan that best fits your needs, consider these tips:

• Find out what is covered. Is your family doctor covered, or specialists like chiropractors?
• Conversely, learn what isn’t covered. For instance, some health insurance policies won’t cover acupuncture of treatment for mood disorders
• Choose between HMO and PPO. HMOs are generally cheaper, but PPOs offer greater flexibility
• Make sure your health insurance plan covers the prescription drugs you need

As medical costs continue to soar, health insurance is more important than ever. The average cost of a three-day hospital stay is nearly $30,000, according to Blue Cross. Keeping these numbers in mind, it’s no surprise that over half of bankruptcies are related to medical expenses.

Compare individual health insurance quotes right now and find coverage that fits your needs and your budget.

Email a friend

Need health insurance you can afford? Follow these 10 money-saving tips and find cheap coverage.

#1 Shop Around for the Best Rate

Health insurance premiums can vary greatly by company—sometimes as much as 50% for similar plans. So it pays to shop around.

#2 Raise Your Deductible

The higher your deductible, the lower your monthly health insurance premium. So crank up your deductible and save money.

#3 Explore Alternatives to COBRA

If you lose your job, you can maintain your health insurance through COBRA–but it’s extremely pricey. If you’re relatively healthy, you might find cheaper coverage with an individual health insurance policy.

#4 Make Sure Your Plan Covers Your Doctor

Most plans contract with a network of “preferred providers.” These plans pay more of the medical cost if you use the services of doctors within this network. If you go to a doctor or hospital outside the network, the health insurance company may cover only part of the bill.

#5 Consider a Health Savings Account (HSA)

An HSA allows you to set aside pre-taxed earnings into an account that you can draw on to pay most medical expenses, including prescription co-pays.

#6 Have Dependents? Be Wary of Employer-Based Health Insurance

Some employer-based plans do not contribute health care benefits toward dependents. So, if you have dependents, you may be getting ripped off by your employer’s health care plan. If your dependents are relatively healthy, you could save money by purchasing an individual or family health insurance policy that is separate from your employer’s plan.

#7 Government Assistance Health Programs

Are you below the poverty level? If so, you may qualify for Medicaid or other assistance. Contact your state’s insurance department for details.

#8 Consider Separate Health Insurance Policies

It may be more affordable to purchase separate policies. For instance, you may be able to save money if older members of your family purchase their own health insurance policies. Additionally, it may make sense to purchase separate coverage for children 18 and under.

#9 Factor in Co-Insurance

Co-insurance is the amount the insurer will pay after you meet your deductible. Most companies will pay 80 percent of the medical bill after the deductible up to an annual maximum of typically $5,000 to $10,000. Medical bills in excess of this annual maximum will be covered at 100% by the health insurance company.

#10 Stay Healthy

It’s in your best interest to keep your body healthy to make sure you qualify for low-cost health insurance. The unhealthier you are, the more you will pay for health insurance.

Email a friend

Recently, the House voted to repeal oppressive tax-reporting requirements imposed on small businesses in order to aid in paying for the extension of health care coverage according to the recently passed health care law.

However, no speedy relief is expected for small businesses because the Senate and the House do not agree on the methods for paying for the anticipated revenue loss, which is over twenty billion over a decade. Although it supports the repeal, the White House has made no recommendations for offsetting the cost.

Republicans Support The Measure

The vote was 314 to 112 on the House bill, with as many as 76 Democrats coming together with 238 Republicans to support the measure. Every single one of the no votes came from Democrats.

Democratic Representative Lloyd Doggett from Austin, Texas, opposed the measure. However, Republican Representatives Michael McCaul from Austin, Lamar Smith from San Antonio and John Carter from Round Rock were all in favor of the measure.

Republican’s Want Small Business to Focus on Job Creation

Republican Representative Lamar Smith said recently in a news release, “This measure will help employers focus more on job creation and less on government red tape.” While Representative John Carter said, “This victory today is certainly a win against very bad regulations, but it is also a win for cleaning up the way this House operates.”

Lawmakers stated that the goal to repeal the paperwork mandate was almost universally supported by Congress. The Senate supported a similar change recently; however, it way financed in a completely different manner.

Such a deadlock highlights the struggle of making even the smallest changes to the new health care law, which is one of the achievements by President Barack Obama that makes him the most proud.

A spokesperson for the National Federation of Independent Businesses, Stephanie Cathcart, said that the indecision is frustrating, especially to small businesses.

photo credit: Kansas City District

Email a friend

When it comes to providing necessary medications to their citizenry, Europe continues to outshine the United States. However, their lead over American drugmakers isn’t as profound as it was just two short years ago.

The Access to Medications Index

The Access to Medicines Index, or AMI, an index produced by a Dutch-based foundation that collectively, with 22 institutional investors and fund managers, manages more than 3 trillion dollars in assets, released the index this week; the second release since AMI was launched in 2008.

The index ranks 20 of the world’s largest pharmaceutical companies with regard to their individual efforts to ensure that medicines are made for, and reach citizens of developing companies. The index is a tool that investors can use when comparing how socially responsible these pharmaceutical companies are.

The rankings

The U.S.’s Merck & Co, Switzerland’s Novartis, Gilead Sciences (Based in the United States) and France’s Sanofi-Aventis fell in behind GlaxoSmithKline. Six of the ten highest-ranked pharmaceutical companies included in the index are European-based while only four are U.S.-based. However, the previous index ranked seven European-based companies in the top ten and only three U.S.-based companies.

The positive indications

The original index showed huge differences between these pharmaceutical giants with regard to their efforts to provide literally millions of low-income people affordable, and life-saving medicines and vaccinations. The most recent index shows that these gaping differences are getting better with time as more and more of the 20 companies included in the index are making greater efforts to be socially responsible.

Although the index shows the greatest areas of improvement have been in research and development and pricing equality, it also indicates that there is still a lot to be done in order to make medication equality a universal reality.

photo credit: Wonderdawg777, Samuel M. Livingston

Email a friend

Rising profits and premiums in the industry of health insurance are alarming to say the least. Recently, the Obama administration demanded that insurance companies justify projected rate increases that exceed ten percent, beginning in September 2011.

The Secretary of Health and Human Services Finally Put There Foot Down!

The Secretary of Health and Human Services, Kathleen Sebelius, issued the final rule to establish procedures for state and federal insurance specialists to analyze coverage premiums. She said that insurers are going to have to substantiate rate increases in an atmosphere in which they are doing financially well. In fact, the profits exceed the expectations of a number of analysts on Wall Street.

Sebelius said, “Health insurance companies have recently reported some of their highest profits in years and are holding record reserves.” She also stated, “Insurers are seeing lower medical costs as people put off care and treatment in a recovering economy, but many insurance companies continue to raise their rates. Often, these increases come without any explanation or justification.”

Who Proposed 10% of Threshold In December 2010

The industry of health care insurance condemned it as an indiscriminate test that could label many rate increases as presumptively irrational. However, the administration denied such criticism, insisting on the ten percent standard with the final rule.

What to Expect In September 2012

Beginning in September 2012, the government will set separate thresholds for each state, which will reflect trends in health care and insurance costs. In a number of states, such as New Hampshire, groups of over twenty workers have witnessed increases in premiums as high as twenty percent, while other groups have experienced premium increases of forty percent or more. Simultaneously, insurers claim coverage is declining as deductibles increase and insurance companies are limiting patients’ hospital choices.

In order to make sure “consumers get value for their dollars” the new law requires an annual review of “unreasonable increases in premiums.”

photo credit: US Embassy New Zealand

Email a friend

Serious objections are being raised by the Obama administration to a new law in Indiana, cutting off federal and state funding for Planned Parenthood clinics that offer care to women on Medicaid with low incomes.

With these objections, the stage is set for a battle between Republican Governor Mitch Daniels and the White House over an issue that ignites strong passions on both sides.

Officials with the Obama administration have made it clear that they are not going to approve any form changes that the state adopts. In addition, all of these changes in the state of Indiana will be subject to review and approval by the federal government.

Will This Impact Other States?

Although the federal officials are allowed ninety days to take action, they may feel somewhat pressured to take quicker action due to the fact that Indiana is enforcing the law, which went into effect in May of 2011. In addition, legislators in other states across the country are working on comparable actions.

If the Medicaid program in a specific state does not comply with federal regulations and law, corrective action may be taken by federal officials. This includes “the total or partial withholding” of federal funding for Medicaid. Just the threat of this penalty is often all that is necessary to encourage states to be in compliance with the federal government. In fact, imposing such a penalty would, in a number of cases, being harm the people that Medicaid is actually intended to help.

According to officials with the White House administration, the law in Indian inflicts impermissible constraints on Medicaid recipients’ freedom to select the health care provider that they want to use.

Indiana is one of at least six states taking aim at Planned Parenthood. This is primarily due to the fact that abortions are performed through such clinics.

photo credit: Neon Tommy

Email a friend

Finding an effective cure for the common cold has long been one of medical science’s most basic and elusive goals, but it might now be within our sights, thanks to the completion of research to decode the genome of the common cold virus.

A team of researchers at the University of Maryland and the University of Wisconsin recently announced that they had decoded the genomes of all 99 strains of the virus which causes the common cold. In addition, they said, they had also cataloged the virus’s basic vulnerabilities. Those vulnerabilities could, with the right targeted research, be used to develop drugs which might prove to be effective treatments, even cures, for the common cold.

A Cold Isn’t a Big Deal

It’s unpleasant to deal with, but not dangerous. But for the twenty million people with asthma, and the millions of others suffering from chronic obstructive pulmonary diseases, a cold can be a serious, even life-threatening, disease. In fact, it’s thought that the common cold triggers approximately half of all asthma attacks.

Developing a cold cure has been difficult simply because the Rhinovirus virus that causes the cold is highly variable, with 99 different strains known to cause infection.

However, the researchers have discovered that all 99 strains have certain genetic sequences in common – and these shared sequences could be used as a drug target. In essence, a targeted drug could be an effective treatment for all 99 strains – including those that trigger problems for people with asthma and other respiratory conditions.

Even so, the possibility of a cold cure doesn’t mean that drug companies will be lining up to start development. With the typical cost of drug development running to $700 million, many companies may decide it’s simply not worth it.

Drug development is a long process often punctuated with problems from legislators, financiers, and others. Colds, however, are generally not serious or lengthy illnesses, and that means most consumers won’t be willing to pay for an expensive cure, no matter how effective it might be.

Another potential problem is the fact that any drug with potentially serious side effects isn’t likely to get FDA approval, since the common cold is generally a mild disease.

photo credit: Meg Stewart

Email a friend

NCHS (which is part of the Centers for Disease Control) sent out a mail Do you check your medical bills? Every document you receive from your doctor’s office and from your insurance company? If you don’t, it’s definitely time to start, according to a report from the National Center for Health Statistics.

To achieve their results, the survey to two thousand office-based American doctors during 2008.

The NCHS report looks at American doctors who use electronic records and billing systems, and the functionality and efficiency of those systems. The results are definitely not encouraging.

Around 40% of American doctors use electronic systems for maintaining medical records. That sounds good – but many of those doctors admit that the systems they use are fairly minimal. This portion of the survey population reported that they used partial or full electronic systems, and that these systems didn’t include billing records.

In fact, just 4% of the doctors surveyed said their systems were fully functional (including medical billing), and that means a very large number of U.S. doctors are relying on medical recording and billing systems that are extremely out-of-date in terms of technology.

Experts say that a fully electronic records and billing system will improve healthcare standards, prevent errors in record-keeping, treatment, and billing, and will save money too. It will also bring America up to standards set by countries such as the Netherlands and Britain, where 98% and 89% of doctors respectively use electronic medical record systems.

During his campaign, President-elect Barack Obama announced healthcare reform plans which would see the medical records and billing system revolutionized with new technology, but more recently has said funding such a system is going to be a stumbling block. Unfortunately, given the current economic situation and the details released so far of the planned bail-out, it doesn’t seem likely that healthcare is going to see a huge amount of reform next year.

And until then? With 60% of doctors still using paper-based systems, and a large percentage of the remaining 40% relying on minimally functional systems, it’s more important than ever that you don’t stick your head in the sand when it comes to your own healthcare and insurance.

photo credit: Inha Leex Hale

Email a friend

Vermont moved closer to establishing a state-run health plan Thursday when its governor signed a bill designed to offer universal health insurance for state residents.

The bill signed by Gov. Peter Shumlin creates a five-member panel whose goal is to determine how to fund the new single-payer health care system. The governor’s office says additional taxes would account for a portion of the cost.

Vermont Health Insurance Panel

The panel will decide the best way in which to provide health insurance to the state’s 620,000 residents while minimizing the cost of health care.

Under a single-payer system, the state would cover most health care costs, with residents paying a small portion through co-payments when they receive care. Residents would receive a “Green Mountain Care” card that is electronically linked to their medical records and treatment history.

The bill also provides tax credits to make coverage more affordable for uninsured residents.

The idea is based on a system in which health care is funded by a public fund to which many parties—the state, employers, employees—contribute. It is popular in a number of foreign nations and is championed by liberals in the U.S.

Opponents claim the state-funded system is too expensive and excludes too many residents.  They also claim that a state-run system lacks the free-market incentives to improve the quality and reduce the cost of health care services.

Health insurance companies, worried that a state-run health care system would effectively drive them out of the state, are actively opposing the plan.

photo credit: woody1778a

Email a friend

The price of health insurance for retired and active duty military personnel has gone up from $19 billion just a decade ago to $49 billion in the last year. Now, TRICARE, the government health insurance program, makes up nine percent of the total budget for the Pentagon.

Health Insurance High Costs Due to Beneficiaries Increasing

The rise in cost is partially due to the fact that the number of eligible beneficiaries continues to increase. However, according to the Government Accountability Office, the price hike could also be linked to employers offering financial incentives to beneficiaries who are eligible for TRICARE to opt-out of insurance paid by their employer, shifting the cost of care over to the Pentagon.

Attempting to cut back costs, the National Defense Authorization Act of 2007 forbids employers with over twenty employees working for them from providing financial or any other type of incentives to TRICARE-eligible beneficiaries if they decline health insurance coverage from an employer-paid program, or to terminate private insurance enrollment in order to seek coverage through the Pentagon.

Pentagon Plans to Save $430 Million Plus on Health Insurance by 2015

Subsequently, the Pentagon is expecting to save more than $430 million by the year 2015. However, even if a great number of people opt out of coverage, the TRICARE program may still pay for their health insurance expenses because it works as a second payer for any eligible beneficiaries that have coverage through a private insurance program.

Did you know that it costs close to four thousand dollars on average to insure a retiree and their dependent under the TRICARE insurance program? This includes the cost of administration, pharmaceuticals and medical care.

photo credit: michael baird

Email a friend