healthcare

The Genetic Information Non-Discrimination Act (GINA) prohibits the improper use of genetic information in health insurance and employment.

Why do I have such a hard time believing people's motives are so good and in the best interests of the insured in this story via a tweet from 23andMe.

A healthcare industry group (The Care Continuum Alliance or DMAA)

and employer groups are urging for a moratorium on GINA fearing that the law's restrictions on "underwriting" activities will harm enrollment in wellness programs,

A new Quinnipiac University Poll says that 69% of Americans want a government-run health insurance option, while only 28% of the respondents would use it. What is really telling is:

Only 15 percent of voters would be willing to pay $500 to $1,000 more in taxes each year for a health care plan that reduces costs and covers those who don't have health insurance. Another 27 percent would pay less than $500 per year, with 3 percent who would pay $1,000 to $3,000 and 45 percent who don't want to pay additional taxes.

This is interesting for two reasons:

1. The average family with health insurance already pays an extra $1,000 a year in premiums to pay for health care for the uninsured, while the average individual pays an extra $370 according to a report by Families USA.
2. A government-run health insurance option will have "significant price advantages" over private health insurers according to Republican Senator Olympia Snowe and Conservative columnist George Will.

So, in effect a public option would probably reduce costs by insuring the uninsured and forcing private health insurance companies to become more cost competitive. Yet, pollsters are asking questions about paying more in taxes for a public option without debating the fact that costs would likely significantly decrease.

But what about government bureaucrats running health care and getting between you and your doctor? That is already occurring, the bureaucrats are just working at for-profit insurance companies who have already testified before Congress that they would not commit to limiting rescissions to only policyholders who intentionally lie or commit fraud to obtain coverage. A policy where:

an investigation by the House Subcommittee on Oversight and Investigations showed that health insurers WellPoint Inc., UnitedHealth Group and Assurant Inc. canceled the coverage of more than 20,000 people, allowing the companies to avoid paying more than $300 million in medical claims over a five-year period.

It also found that policyholders with breast cancer, lymphoma and more than 1,000 other conditions were targeted for rescission and that employees were praised in performance reviews for terminating the policies of customers with expensive illnesses.

Do you really want to trust the private health insurance companies more? They are the ones who

have forced consumers to pay billions of dollars in medical bills that the insurers themselves should have paid, according to a report released yesterday by the staff of the Senate Commerce Committee.

Congress has passed and President Obama signed the reauthorization of the Children's Health Insurance Program or CHIP. CHIP funds health care for families who don't qualify for Medicaid but still can't afford private insurance

Headline: Drug price controls may shorten lives: report

Imposing European-style price controls on prescription drugs in the United States would result in modest cost savings that would be more than offset by shortened life spans as the pace of drug innovation slows, U.S. researchers said on Tuesday.

Buried in the article: All five papers in the section were funded by a grant from the pharmaceutical company Pfizer Inc.

Via the LA Times:

Borrowing a community organizing technique, the incoming administration is asking Americans to host meetings to come up with ideas. They'll send discussion packets to anyone who signs up.

Sign up here to host a Health Care Community Discussion anytime from December 15th to 31st. Senator Tom Daschle, the leader of the Transition's Health Policy Team and the prospective HHS Cabinet Secretary , will even choose one discussion to attend in person. You can also directly submit your ideas and thoughts on healthcare to the transition team here

A recent conversation reminded me of this 2006 story in Time Magazine on medical tourists and how some companies are even giving incentives to employees to adjust their health plans so more procedures can be done overseas.

Well, Newsweek has gotten on the band wagon as well with this more recent article. However, this article discusses that US hospital chains are also building hospitals outside the US to benefit local populations as well as cater to US clientele. Also, insurance companies are getting into the act, especially in border states such as Texas and California.

Some interesting quotes from the Newsweek article include:

• Procedures performed in CHRISTUS's Mexican locations cost a third to two-thirds less than they would in America.
• The industry [medical tourism] grossed an estimated $60 billion in 2006 and is expected to hit $100 billion by 2012

I doubt this means jobs in healthcare are no longer recession proof. However, there will be more competition as the world gets smaller.

Washington Post article with 5 Myths About Our Ailing Health-Care System:

1. America has the best health care in the world.
2. Somebody else is paying for your health insurance.
3. We would save a lot if we could cut the administrative waste of private insurance.
4. Health-care reform is going to cost a bundle.
5. Americans aren't ready for a major overhaul of the health-care system.

When the patients, the doctors and employers big and small are complaining about health insurance, you know there is a problem. And anyone that says otherwise is lying or cannot be trusted with major decisions.

Here are some interesting statistics from the articles:

• 49 percent of primary-care physicians in the U.S. said they'd consider leaving medicine. Many said they are overwhelmed with their practices, not because they have too many patients, but because there's too much red tape generated from insurance companies and government agencies.
• GM's healthcare costs in 2008 were expected to be more than $1,900 for each car and truck it builds in the U.S.
• As small businesses begin to receive their annual renewal notices, employers and health-insurance brokers in the South, Midwest and California report noticeably steeper rises. Some premium increases being quoted to employers are double those quoted just a few months ago.
• Only 55 percent of U.S. patients get treatments that scientific studies show to work, such as beta blockers for heart disease, found a 2003 study in The New England Journal of Medicine. One reason is that when insurance is tied to employment, you may have to switch doctors when you change jobs.

The issue is not going away and is also putting an increased burden on employers that makes them less competitive around the world. Therefore, even though you may have good insurance now, it is threatened by the economic downturn.

Healthcare costs have risen dramatically in the past few years and one that has gotten a lot of scrutiny is the high cost of co-payments. What is different about co-pays is that they do not count towards out-of-pocket maximums on many insurance plans or specific services and/or prescriptions are not included. Many studies have shown that overall healthcare costs go down when some types of prescription drugs or medical procedures have lower co-pays.

What is often not talked about is how co-pays came about and how the idea behind co-pays is now being abused. Though the co-pay is often only a small portion of the actual cost of the medical service, it is thought to prevent people from seeking medical care that may not be necessary (eg: a common cold), which can result in substantial savings for insurance companies. This is to prevent the perception that medical care is "free" once insurance is obtained. The term often used is moral hazard:

the prospect that a party insulated from risk may behave differently from the way it would behave if it were fully exposed to the risk.

However, the co-pay is now being used as a means to reduce costs to the insurer and not as a means to ensure usage of the health service is required. That is not a plan with co-pays, but a co-insurance plan. If it is a means to reduce costs, it should be considered part of the out-of-pocket maximum and there should be variability in costs based upon the necessity of the service and who is issuing the service. I’ll give two examples to illustrate.

• If I visit my neurologist or my neurologist’s RN for a follow-up, I am charged the same co-pay. No offense to the RN, but she is not a neurologist and the reduced cost to the doctor’s office should be passed on to the insurance carrier and the patient. This would also encourage patients to use Physicians Assistants (PA) and RN’s, instead of insisting on seeing the doctor. It would also free up doctors to spend more time with patients who truly need to see an MD.
• In college I broke my leg and after getting the cast off, required weeks of Physical Therapy. In today’s market, each PT session would be charged a co-pay, oftentimes at Specialist’s rates. As co-pays go up, patients would be more apt to reduce or eliminate this cost and not heal fully or correctly. Future health care costs might then increase because of continuing pain or a reduction in abilities due to improper treatment. Having a separate, lower rate after a number of visits per year would ensure that the services are necessary and hopefully prevent abuses of the system, but would also ensure people get the services they require.

Some of this may seem naïve, but I hope it makes someone think.

Headline: Copper door handles and taps kill 95% of superbugs in hospitals

Last sentence in article: The research was funded by the copper industry.