Deferred deductible plans – a new option?

I was driving through Seattle the other day when a billboard caught my eye. The large multi-specialty clinic where I worked for many years, and which I still use for my primary care, was advertising something called a “12-month deferred deductible plan”.

Huh, I thought, and as soon as I got home I jumped on their website to find out more.

Acknowledging the problematic trend of high-deductible health insurance plans, the clinic created a program by which patients can extend their deductible payments over a 12-month period, rather than pay the entire amount at once.

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Forced into Medicaid

I read an article in the New York Post this week by a young man who was upset because he lost his student health plan and couldn’t find an affordable new health plan. His income was too low for a subsidy, so his only option under the Affordable Care Act was to sign up for Medicaid.

So there I was: A struggling grad student with no health insurance, and unable to afford unsubsidized ObamaCare plans I’d hardly, if ever, use.

But Uncle Sam was there on his white horse, ready to save my day with . . . Medicaid?


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Protecting your personal health data

Almost since it went online, experts have been pointing out multiple security flaws in the federal health insurance exchange website,

And I’ve reported about security problems in my state-run exchange, as well.

But the latest information about a security issue affecting your personal data isn’t the result of poor design—it’s intentional—and that makes it even more egregious: Sends Personal Data to Dozens of Tracking Websites

The digital watchdog group, Electronic Freedom Foundation (EFF) reports:

EFF researchers have independently confirmed that is sending personal health information to at least 14 third party domains, even if the

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Controlling health care costs

The fact is, when you need health care the most, you are least able to “shop around.”

That’s why one of health care reform’s goals of pushing consumers to “have more skin in the game” won’t always work.

Sure, when our health concerns are not urgent we can take time (lots of it) to make phone calls to providers and insurance companies. But when we are sick or injured, we can’t. And sky-high deductibles and narrow provider networks make controlling costs more difficult.

A pediatrician on his blog writes the following post:

In today’s enlightened times, health care isn’t

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Obamacare: “America’s Bitter Pill”?

obamacare america's bitter pillTwo days ago, author Steven Brill was interviewed on 60 Minutes about his recently published book, America’s Bitter Pill: Money, Politics, Back-Room Deals, and the Fight to Fix Our Broken Healthcare System.

Brill came to the nation’s attention two years ago when he wrote a lengthy article for Time magazine titled “Bitter Pill: Why Medical Bills are Killing Us.” He introduced us to the term “chargemaster”—the hospital pricing list that is kept hidden, perhaps because the prices are outrageous and irrational.

But his book reads like a season of House of Cards; Brill even says in the 60 MinutesContinue reading

High deductibles = delayed care

Last week USA Today published an excellent article about the problems with the new trend of really high-deductible health care plans:

It explains how the overarching goal of Obamacare to provide coverage for the sick and low income demographic has had a rather unfortunate (although not unforeseen) unintended consequence.

Physician Praveen Arla is witnessing a reversal of health care fortunes: Poor, long-uninsured patients are getting Medicaid through Obamacare and finally coming to his office for care. But middle-class workers are increasingly staying away.

“It’s flip-flopped,” says Arla, who helps his father run a

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More find health care unaffordable, are underinsured

Despite reforms, health care is less affordable for many

CBS News and The New York Times recently conducted a poll and I found the results both interesting and alarming (although not surprising).

Fifty-two percent of Americans say they find basic medical care affordable, but that’s down from 61 percent last December. Today, for 46 percent of Americans, paying for medical care is a hardship, up 10 points.

Most attribute the rise of out-of-pocket costs to more expensive medical treatment, rather than an increase in the amount of treatment they are receiving.

When Americans are asked about some specific ways they

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Obamacare, taxes and subsidies

An email from a friend this weekend made it clear that many people don’t understand how the much-lauded Obamacare subsidies work.

That’s understandable, if they are not directly affected. However, it seems even those who qualify for and receive subsidies don’t necessarily understand how they work.

The devil is in the details, as they say, and Obamacare is nothing if not full of fine print and unintended consequences.

Unfortunately, not knowing the details of how the subsidies work will result in nasty financial surprises for some families, especially when tax time rolls around next year.

Related posts:

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Harvoni, Solvadi and hepatitis C screening

harvoni hepatitis c treatmentNew treatments for hepatitis C

I read an article online the other day in which the author practically shouted at her readers to “Run as fast as you can to your doctor’s office and get screened for hepatitis C!”

OK, what she actually wrote was:

Overall, the outlook for patients with hepatitis C is much better than it was just a couple of years ago. So if you’re a baby boomer who hasn’t been screened for hepatitis C yet, don’t wait. 

Still, let’s step back and look at the big picture.

Hepatitis C screening has been in the news a … Continue reading

The Open Payments database

Lots of data, but not user friendly

Have you ever wondered if your physician receives a substantial amount of money from a pharmaceutical or medical device company?

Is your physician’s decision to write you a prescription for the newest brand-name drug, or replace your knee with a state-of-the-art joint, based on corporate influences? Conflicts of interest run rampant in health care, and it would be nice to know, wouldn’t it?

Earlier this fall, the Centers for Medicare and Medicaid Services (CMS) launched a new website called Open Payments. It’s part of the Sunshine Act, which in turn … Continue reading

The problem with for-profit health care

for profit health careOr whose best interests are being served?

It’s no secret that our health care system is filled with conflicts of interest.

That’s because, for the most part, the doctors, hospitals and insurance companies that are the framework of the system are for-profit businesses. Like any other for-profit industry, health care sells a product and encourages you (or your insurance company) to buy it.

A friend of mine had a recent experience with for-profit health care that she wanted to share:

In my opinion, anyone who has been told they “must” replace their orthotic inserts every year or every few years Continue reading

Be informed: Read Elisabeth Rosenthal

Investigating the high costs of health care

Over the last year, Elisabeth Rosenthal, a journalist and science editor for The New York Times, has written a brilliant series of articles titled Paying Till it Hurts:

In her series on the costs of health care, Elisabeth Rosenthal of The New York Times examines the price of medical care in the United States, interviewing patients, physicians, economists, and hospital and industry officials. In each installment, readers were invited to share their perspectives on managing costs and treatment.

I’ve been reading the series, and the truly shocking charging and billing practices she … Continue reading

Researching health care costs

It’s not that simple

Last night on the local news I watched a story about health care costs. The reporter, a consumer affairs specialist, talked about the expanding trend in health care of high-deductible medical insurance plans. Under the ACA, family annual deductibles can reach up to $12,700 (increasing to $12,900 for 2015); whatever your deductible, you pay your medical bills out of pocket until that deductible is met.

The uninsured, of course, just pay out of pocket.

Related post: Health insurance basics, part 1

The reporter encouraged us to

…take some time to research, and see what the

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How “lump-sum” cancer insurance policies work

lump sum cancer insurance policiesThis is a guest post by Kristen Reineke of I’ve posted previously about Alternatives to Obamacare, and critical illness plans are a relatively simple supplement to standard comprehensive health insurance plans. Cancer, specifically, is an expensive diagnosis, and my new ACA-compliant health plan not only has costly premiums, but a huge deductible (over $10,000). Most of the leading cancer hospitals in Seattle (University Medical Center, Fred Hutch Cancer Research Center, and Seattle Cancer Care Alliance) are not in my network, which could also lead to higher out-of-pocket costs. Kristen explains how these critical illness or “lump-sum” policies Continue reading

Do you need an annual pelvic exam?

annual pelvic exams unnecessaryYet another screening exam found unhelpful

Earlier this month, the American College of Physicians (ACP) published its recommendation in the Annals of Internal Medicine that routine annual pelvic exams are unnecessary for healthy, non-pregnant women with no gynecologic symptoms (bleeding, discharge, pain, etc.).

The ACP looked at evidence on pelvic examinations dating back almost 70 years and concluded:

… no data support the use of routine pelvic examination (excluding cervical cytologic [Pap] examination) for reducing the morbidity [disease] or mortality [death] of any condition. Furthermore, limited evidence suggests that screening pelvic examinations may be associated with pain, discomfort, fear, anxiety,

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