Premiums, mandates and penalties

I posted a couple weeks ago that health insurance companies wanted to increase the penalty I mean tax on people who ignored the individual coverage mandate. The companies fear the penalty tax, only $95 the first year, is not stiff enough.

Well, according to recently released information from the IRS and the Department of Health and Human Services (overseers of the health law), the insurance companies have cause for worry. Not because so many people will ignore the mandate, but because so many people will be exempt.

Related reading from National Review Online: Obamacare’s pressure points

Who will be exempt? … Continue reading

Disneyland – The happiest last place on earth

palliative and hospice careDisneyland, here I come!

I have a plan. If I get cancer (or when, because according to news reports just about everything causes cancer eventually) and my doctors have nothing left to offer but last-ditch, statistically-improbable treatments that cost a fortune, I’m saving my money and booking a suite at the Disneyland Hotel.

Last summer I read a blog post titled “How Doctors Die.” The author, a physician, made the simple statement that “Doctors don’t die like the rest of us.” Why? Because “they know enough about modern medicine to know its limits.”

He shares his and other health professionals’ … Continue reading

Avoidable risk?

Last fall saw a frightening outbreak of fungal meningitis that resulted in the severe illness of almost 700 people and, tragically, the deaths of 45 others. Contaminated steroid injections were found to be the cause.

The Institute for Safe Medication Practices now reports that 13% of pharmacists found contamination in their supposedly sterile, compounded (made in the pharmacy) drugs last year, and almost 75% fear that such a horrific outbreak could happen again.

Several agencies are swaming the compounding pharmacies in a belated attempt to make sure it doesn’t happen again. But will their efforts be enough?

Maybe, but there … Continue reading

Taxes, income and subsidies

Yesterday, the IRS finally began processing 2012 tax returns.

In 2014, if and when you apply for individual health insurance through one of the state-run exchanges, it will be important to know your 2012 income. Why? Because that figure will determine whether or not you will be eligible for a federal tax credit to help cover the cost of premiums.

In a previous post, I explained how the federal subsidies will work. In short, individuals and families earning up to 400% of federal poverty level (FPL) will be eligible, and the savings could be substantial—over $10,000 a year in some … Continue reading

At risk: Unbiased medical research

On March 1, if Congress and the president do not reach some kind of fiscal accord, mandatory cuts to federal programs—sequestration—will take effect.

One of the many victims of such massive spending cuts will be the National Institutes of Health (NIH), the medical research arm of the Department of Health and Human Services. According to its director, Francis Collins, MD, the NIH, in a “profound and devastating blow,” will lose 6.4% of its budget.

Their loss, however, could be the drug industry’s gain.

Overdosed America: The Broken Promise of American Medicine

In his book Overdosed America: The Broken Promise of American Medicine, John Abramson, MD, … Continue reading

The CPAP machine – An American success story?

Have you ever heard of a company called ResMed? If you suffer from obstructive sleep apnea and have been prescribed a CPAP (continuous positive airway pressure) machine, you probably have.

Or, if you follow the stock market, you might recognize ResMed as one of its rising stars. Rising because, according to its website, ResMed ‘s revenues and profits have grown every quarter since it was formed in 1989. In 2012, ResMed reported revenues of approximately $1.4 billion.

What is the secret to ResMed’s amazing success? Our country’s poor health.

Obstructive sleep apnea (OSA) is the common condition in which … Continue reading

Obamacare’s Y2K: Coverage for pre-existing conditions

Starting in 2014, one of the signature features of the Affordable Care Act (ACA) will be implemented: No adult with a pre-existing condition can be denied health insurance.

But it seems from recent news reports that both the administration and the nation’s health insurance carriers are getting a little nervous about exactly how much that will cost and whether sufficient funds will be available.

In theory, the individual mandate ensures that enough healthy young people buy insurance to keep premiums affordable and provide enough money to cover the care of the already sick. But no one knows with any certainty … Continue reading

The demise of competition

I read with concern yesterday that one of the victims of the recent fiscal cliff deal was the program funding the creation of new non-profit health insurance carriers. Consumer Operated and Oriented Plans, CO-OPs for short, were meant to provide some much-needed competition to the private carriers on the health insurance exchanges and keep premiums more affordable.

At least, that was the theory.

But now Congress has sliced the program’s budget from $6 billion to $2.4 billion. And the money is in the form of loans, not grants. Besides the many other challenges facing these start-ups, they have a very … Continue reading

A touch of irony

I shook my head in wonder last night when I read this article: FDA requires lower doses for Ambien, other sleep meds

Doses for women, at least, will be cut in half.

Different bodies metabolize drugs at different rates. Apparently, studies have shown that the morning level of zolpidem (Ambien) remains high enough in some patients, especially women, that their driving skills are impaired.

According to the article, “the FDA has received a number of reports of car accidents connected to zolpidem over the years.”

I couldn’t help but think of the recent news, and my recent post, about… Continue reading

Flu update

It appears that the 2012-13 flu season is especially severe and has not yet reached its peak, which is when the maximum number of cases have been reported and we start to see a downward trend.

In early November, I posted about the advantages, health-wise and financial, of getting a flu shot.

It’s still not too late, and there is ample vaccine available.

FYI, it takes about two weeks for the vaccine to reach its full effectiveness.

FN

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Beware that bonus!

Two days ago I wrote a post about the proposed health insurance exchanges and the federal premium subsidies.

Beginning in 2014, if you buy health insurance from a state-run exchange, your estimated 2014 income will determine if you qualify for a subsidy.

You will need to supply that information to the insurance exchange when you sign up for health insurance. If you qualify for a subsidy, the exchange will then apply to the federal government for the extra funds to cover your premiums.

When you prepare your 2014 tax return (in 2015), you will discover how accurately you guestimated.

The … Continue reading

Sticker shock

My family does not have an employer-provided health plan, and we live in a state that will set up a state-run health insurance exchange, so I wanted to learn more about the exchanges and proposed subsidies.

Several recent articles have warned of “sticker shock.” Beginning in 2014, state exchanges must offer plans that cover all “essential health benefits” as defined by the government. In other words, there will be no more “catastrophic” plans with low monthly premiums and high deductibles. (Except perhaps for young adults under 30, but information on this point remains unclear.)

To make such comprehensive … Continue reading

Nightmare

Last night I dreamt that my husband was diagnosed with metastatic melanoma.

He was lying on an exam table for some reason when the nurse spied a large, red spot on his head (he’s not bald, but in my dream he was!) and said “Oh my, that doesn’t look too good.” The doctor then looked and said “It’s a melanoma. I’ll take it off.”

Immediately the doctor excised the melanoma as well as some cervical (neck) lymph nodes, which were also cancerous. The melanoma had spread.

As I watched the operation, I thought Oh, please let this be a dream. Continue reading

A picture worth a thousand words

Last week, the publication of three short health care reports caught my eye. Separately, each is a “bad-news-as-usual” snapshot of health concerns; spliced together, however, they create a bigger, grimmer picture of the health and financial future of our country.

First, the Centers for Disease Control and Prevention (CDC) reported that between 1995 and 2010, the incidence of adults diagnosed with diabetes has almost doubled.

Part of the rate increase is explained by improved diagnosis and diabetics living longer, but the report’s authors concluded that the “major driver” is that “the increase in diabetes prevalence coincides with the increase in … Continue reading

How much does an MRI cost?

Sorry, wrong code

I read a story on Kaiser Health News this morning about the author’s struggle to be a responsible and informed health care consumer: How much for an MRI?

I can completely relate!

I had a similar experience with a heart ultrasound two years ago. It’s a cycle of frustration: You can’t get a price without a procedure code, but you can’t get the correct code until after the procedure is done. Classic.

Health care costs have long been kept hidden from the public—until after you get the bill.

And here’s a funny video put out by the … Continue reading