Ready, Set, . . .
With the implementation of the Affordable Care Act (ACA) fast approaching, and summer deadlines for insurance companies that want to offer plans on the new insurance exchanges, this week has seen a lot of news stories related to Obamacare.
California revealed its new exchange plans and the first look seems to indicate that premiums will be much lower than anticipated, even though several of the largest insurance companies opted out of participating in the exchanges.
But a closer look at the plans reveals two important considerations:
- The plans are “narrow-network” plans. To keep costs
… Continue reading
Cancer and bankruptcy
A large study looking at the cost of cancer was released yesterday by the Hutchinson Institute for Cancer Outcomes Research in Seattle. It offers a somber but perhaps not surprising conclusion that cancer patients are “2.5 times as likely as others [non cancer patients] to file for bankruptcy.”
The highest rates are seen among young women, largely because young people are often uninsured, have little savings, and have part-time or entry-level jobs. But as the study points out, even those with insurance can face “financial distress” because of the high cost of deductibles, co-pays and other non-covered … Continue reading
I’ve finally realized there are just too many health-related news stories every week for me to comment on in a timely manner. And some news tidbits are interesting or funny, but really not worth a whole post.
But I would still like to share with you the stories that caught my eye over the week, so on Fridays I will start posting a weekly summing up, or “rounds” to use health care lingo, of what I have found of interest.
Don’t grocery shop when you’re hungry. Really?
In the did-we-really-need-a-study-to-tell-us-this? file, a research letter published in Journal of the American … Continue reading
It’s no surprise to anyone in the health care industry, but Medicare just released a report that shows the incredible variation of health care costs across the country.
Many patients are unaware of these price differences because, as I’ve posted about before, it’s nearly impossible for health care consumers to get information about the cost of a procedure before having the procedure done.
Coming so soon after Stephen Brill’s brilliant (yet depressing) Time magazine article, “Bitter Pill: Why Medical Bills are Killing Us,“ the numbers presented in the report will hopefully provoke consumers to demand more fairness and … Continue reading
I try to be as vigilant as possible when it comes to medical expenses, but I can still be caught napping on occasion.
Last summer while working in my garden I was stung on the ankle by a wasp. Within 24 hours, my leg from the knee down was swollen to twice its normal size.
Although technically not an allergic reaction, it was a severe local reaction. I wondered what would happen if I were stung on the face or neck. So, last month when I saw my doctor for my annual exam, I asked her if it might be … Continue reading
I mentioned in a previous post that three years ago my husband almost died from a series of medical, um, misjudgments, let’s say. I know sometimes things go wrong for no reason, but I also know his three-day ICU stay could have been prevented.
He never received a “mea culpa” from the doctors or hospital; all we got were the medical bills. Our insurance, a catastrophic/health savings account (HSA) plan, paid 100% of the costs after we met our deductible and out-of-pocket maximum ($10,000). At that point we stopped receiving bills, so I don’t know the exact total of … Continue reading
Yesterday I posted about the bomb blasts in Boston and questioned how the enormous medical bills would be paid.
Later, I was surprised to read an article on NBC News online that seemed to answer my question, at least in part: “Bomb’s medical costs could be in the millions, experts say.” The reporter gave an initial—and probably low—estimate of about $9 million.
According to a health economist quoted in the article, “It’s probably on the magnitude of $40,000, $50,000 (per person for emergency-room care). But for the people who will be hospitalized for weeks, you could easily be looking at … Continue reading
Like many others, I’m still trying to understand Monday’s horrific bombings at the Boston Marathon. Who did this, and why?
What I do know is that our emergency response and medical teams are the best in the world; I used to work in the OR of a large, level-one trauma center and have seen these teams in action. The injured will receive swift and highly-skilled care without regard to pre-existing conditions or insurance status.
However, a different team, the patient accounts personnel, will work quickly to document victims’ names, addresses and insurance carriers (if any).
It seems a second tragedy … Continue reading
That is the opinion of the health exchange boards in Washington, D.C., California, Connecticut, Massachusetts, Rhode Island and Vermont (so far).
Each state (and D.C.) that creates a health insurance exchange under the Affordable Care Act (ACA) has an exchange board that is responsible for establishing certain rules and guidelines. Some definitions in the federal reform law have proved to be ill-defined and open to interpretation, such as “pre-existing condition.”
Most insurers that sell individual health plans charge smokers higher premiums because smokers … Continue reading
Medical errors happen
The other day I saw my doctor for an annual exam.
This year I was determined to ask my doctor NOT to order a vitamin D level.
I have had my vitamin D level tested for the last three years and it costs me approximately $100 out of pocket. (It is not considered preventive by the Affordable Care Act.)
Earlier this year, the health advocacy group Choosing Wisely recommended against routine screening for Vitamin D level in healthy adults. Well, I am a healthy adult, and my previous vitamin D levels have been normal—albeit at the lower … Continue reading
A few days ago, more bad news came out about the cost of individual health insurance in 2014. The Society of Actuaries (the financial risk experts that determine insurance costs) reported that next year insurance companies must anticipate paying out at least 32% more in medical claims.
The Affordable Care Act (ACA) will require insurance plans to provide more comprehensive coverage (essential benefits) and cover millions more people with pre-existing conditions. There is considerable doubt about how many young, healthy people and how many small businesses will participate in the insurance exchanges. If they don’t, premiums will rise even … Continue reading
Under the Affordable Care Act (ACA), small businesses and individuals will be offered “robust” coverage and “affordable” premiums on the soon-to-be-running health insurance exchanges.
By grouping together these two traditionally under-served populations, the risk pool will become large enough (theoretically) to allow everyone (most notably those with pre-existing conditions) access to health insurance, and will help keep premiums affordable (again, theoretically).
But there is a problem: small businesses are jumping ship.
According to the National Review Online, “Small firms and the specialized insurers that serve them may have found the lifeboats (to borrow Texas governor Rick Perry’s comparison of … Continue reading
For the last 15 years, my family has purchased an individual health insurance policy. Individual plans, as opposed to employer-based insurance, usually don’t cover vision. We could buy a separate vision policy, but in an average year the premiums would cost more than our annual eye exams, glasses and contacts combined.
Even Medicare doesn’t pay for routine eye exams and corrective lenses, except one pair after cataract surgery.
Of course, eye diseases and injuries (your mother always told you not to run with pointy objects, didn’t she?) are covered as medical care.
But I’ve always wondered why screening exams for … Continue reading
During the presidential campaign last year, Paul Ryan, the vice-presidential candidate, presented his plan for what we all know is much-needed Medicare reform (too many baby boomers; too little money). Under his plan, seniors would choose a “Medicare certified” private health insurance plan and, depending on the senior’s income, a percentage of the premium would be subsidized.
His plan sounds a lot like the new health insurance exchanges that are set to begin in 2014, doesn’t it?
Yesterday, an article on the National Review Online caught my attention because the author presented a compelling scenario by which the government could … Continue reading
Last fall I blogged about an inherent unfairness in our health insurance system. (I know, there’s more than one.) In short, those with employer-sponsored insurance (ESI) generally have lower premiums, lower out-of-pocket costs, and better coverage than those of us that buy health insurance through the individual market.
With the new insurance exchanges, the Affordable Care Act (ACA) is supposed to decrease costs and improve coverage. Because of the law’s mandates for preventive services and essential benefits, coverage will be more equitable with the large, ESI plans. Whether premiums will be more affordable continues to be a topic of much … Continue reading