From President Obama's latest speech, "We can no longer afford to put health care reform on hold." Good news for who? Bad news for who? Hard to be sure at this point, but we can't hope to go on with the double digit rise of the cost of health care.
As noted by Robert Frank in an artcle from February 2007 (when we weren't so wrapped up in the Economy and it's problems that we could rationally discuss health care issues), he noted that "...we spend more than twice as much on health care, on average, as the 21 countries in which life expectancy exceeds ours. American costs are so high in part because the reliance on private insurance multiplies administrative expenses, currently about 31 percent of total outlays." A certain target for the reformers will be this dubious spending on administrative costs in the system, not on customer care directly.
I am aware of a doctor group, and it's not an unusual situation for the industry, that has over 3 times as many administrative staff as doctors, mostly dealing with receivables. These receivables are a big headache, getting payed by the hundreds of insurance companies with different paperwork, dictates, and procedures, not to mention the complexities of Medicare, is a nightmare.
If the administrative costs are to be addressed, the big losers will be health care insurers, Aetna, the Blues, etc as described in today's article by Reed Abelson in the NY Times. The winners will be consumers, doctors, the companies who insure their workers, and the public in general from lower healthcare prices. This is something to anticipate and be prepared for, the later more so if you are on the insurers side.
Showing posts with label health care. Show all posts
Showing posts with label health care. Show all posts
Sunday, March 1, 2009
Tuesday, April 15, 2008
A New Hope for Small Business Health Care
In the push/pull for more affordable health care, the forces of the status quo (read insurers) are fighting to keep their money flowing. Meanwhile, health care premium costs have soared for small businesses. A recent study by the Kauffmann-Rand Institute found that health-care costs had nearly doubled between 2000 and 2005 for businesses with fewer than 25 employees. For these companies health care costs now exceed 10% of total payroll costs. Now a bi-partisan group led by Senators Durbin and Snow are trying to break the log jam.
The Small Business Health Options Program (or SHOP Act) would enable small businesses to set up health-care insurance pools and seeks to establish a nationwide pool by 2011. It also offers tax credits of more than $2,000 per family covered for employers that provide health-care to workers under this program. The national pooling feature has been fought by insurers as well as health advocacy groups (like the American Cancer Society) which do not want to see state regulations overturned. This bill addresses those concerns and as a result may have a better chance of passing. It is supported by the National Federation of Independent Businesses, the country's largest small business advocacy group.
No easy remedies have been proposed to address the overall ballooning of costs and inefficiency of our health care system. Short of a full overhaul, this bi-partisan program is a good start for small companies. Let's see if it gets through the Congressional battles, it is there where we'll see which entrenched money maker of the current system opposes it.
The Small Business Health Options Program (or SHOP Act) would enable small businesses to set up health-care insurance pools and seeks to establish a nationwide pool by 2011. It also offers tax credits of more than $2,000 per family covered for employers that provide health-care to workers under this program. The national pooling feature has been fought by insurers as well as health advocacy groups (like the American Cancer Society) which do not want to see state regulations overturned. This bill addresses those concerns and as a result may have a better chance of passing. It is supported by the National Federation of Independent Businesses, the country's largest small business advocacy group.
No easy remedies have been proposed to address the overall ballooning of costs and inefficiency of our health care system. Short of a full overhaul, this bi-partisan program is a good start for small companies. Let's see if it gets through the Congressional battles, it is there where we'll see which entrenched money maker of the current system opposes it.
Tuesday, February 5, 2008
Small businesses suffering under the current healthcare system
While large firms (those with 200 or more employees) unanimously provide health benefits to employees, not so for smaller companies. The reason is cost. As a result, it is time for small firms to add their voice to change the system.
According to the annual Kaiser Health Survey for 2007 (available at Kaiser Family Foundation) 99% of large firms provide coverage, and of those 95% cover at least 50% of the premium cost for families. With small firms (3-199 employees) coverage is provided by only 59% of the firms, and for those that do provide coverage they only cover 63% of premiums. Why is this discrepancy happening?? Cost increases are the obvious reason. From the Kaiser Survey we see that since the Spring of 2000 health premiums have risen more than 80% in total, or more than 10% annually, well out-pacing inflation and employee earnings.
What is this doing to small businesses? It is forcing them to drop coverage in increasing numbers. It is also pushing creative solutions including funding health costs outside of traditional programs. In many cases employees are forced into individual high deductible plans, which are fine for healthy consumers, but devastating for health challenged workers. In either event, these issues help make these firms look unattractive to new workers when compared to larger firms.
Would a national health plan fix this discrepancy, yes, but only if the overall costs per capita are the same or lower. More study is needed, but it looks like small businesses should be looking for a change in policy compared to their larger competitors.
As I have argued before, we cannot keep paying the increasing costs of the broken US health care system, and we can now see that it's finally time for small companies break with the US Chamber of Commerce, which advocates augmenting the current system, and add their voice to the Physicians for a National Health Program.
According to the annual Kaiser Health Survey for 2007 (available at Kaiser Family Foundation) 99% of large firms provide coverage, and of those 95% cover at least 50% of the premium cost for families. With small firms (3-199 employees) coverage is provided by only 59% of the firms, and for those that do provide coverage they only cover 63% of premiums. Why is this discrepancy happening?? Cost increases are the obvious reason. From the Kaiser Survey we see that since the Spring of 2000 health premiums have risen more than 80% in total, or more than 10% annually, well out-pacing inflation and employee earnings.
What is this doing to small businesses? It is forcing them to drop coverage in increasing numbers. It is also pushing creative solutions including funding health costs outside of traditional programs. In many cases employees are forced into individual high deductible plans, which are fine for healthy consumers, but devastating for health challenged workers. In either event, these issues help make these firms look unattractive to new workers when compared to larger firms.
Would a national health plan fix this discrepancy, yes, but only if the overall costs per capita are the same or lower. More study is needed, but it looks like small businesses should be looking for a change in policy compared to their larger competitors.
As I have argued before, we cannot keep paying the increasing costs of the broken US health care system, and we can now see that it's finally time for small companies break with the US Chamber of Commerce, which advocates augmenting the current system, and add their voice to the Physicians for a National Health Program.
Tuesday, February 27, 2007
A macro and micro view of US Health Care
An issue at the base of the system (me the consumer), and a big, overview of the whole enchilada...
The guy who writes the Health Care blog has written a nice summary of the overarching problems with US health care, you can read it at:
http://abcnews.go.com
Mr. Holt makes an informed case about the problems, and does point out that vested interests will fight any change. The insurance companies, as payers, are the obvious opposition, they benefit in employment and profits from the way things are. The providers (doctors, hospitals) are less obvious. The thinking is that providers get payed no matter who is paying. But Holt points out that there are so many inefficiencies in the system, such that any rational fix will lower payments to the end providers. A majority of doctors see this problem and oppose any fix, but they are not all together on this, witness the Physicians for a National Health Program (www.pnhp.org). Some estimate that 40% of physicians are for a National program, probably to rationalize it and keep more of their power.
Holt's conclusion is that it will take much political will to overcome the opposition, and I think we'll have to wait for 2008 for that to happen.
My trip to my dentist shows a basic problem with the current system in action.
During my last trip for a cleaning I was given an option for a wipe swab in my mouth which would more easily show early signs of oral cancer. Currently, without this option, the doc looks around and tries to see anything unusual. The new option is unproven, but if it works would be a benefit to all...hmm or maybe just to me as the system would possibly lose a full-blown cancer patient - BIG BUCKS!
Now, the hygienist told me if they get enough evidence of success, then the insurers would pay for the procedure. The insurers are not paying for this procedure since evidence is lacking, but why should I pay for research?? Because, if I can afford it, it's to my benefit. But how do I know if it works?? Is $50 cheap enough to make me participate in a study? Not in this case. I have faith in my dentist.
Shouldn't this be the wipe maker's problem? The problem for the maker is they have multiple insurance company payers to deal with, raising costs and squeezing out good but marginal solutions. But is it rational for the maker to ask me and other individuals to pay?? In this crazy market why not?
If we had a single payer system it would be much cleaner, easier and successful for all. A procedure/solution set for all would be defined, and whether the wipe procedure is in or out, and it would only be accepted if proven.
The guy who writes the Health Care blog has written a nice summary of the overarching problems with US health care, you can read it at:
http://abcnews.go.com
Mr. Holt makes an informed case about the problems, and does point out that vested interests will fight any change. The insurance companies, as payers, are the obvious opposition, they benefit in employment and profits from the way things are. The providers (doctors, hospitals) are less obvious. The thinking is that providers get payed no matter who is paying. But Holt points out that there are so many inefficiencies in the system, such that any rational fix will lower payments to the end providers. A majority of doctors see this problem and oppose any fix, but they are not all together on this, witness the Physicians for a National Health Program (www.pnhp.org). Some estimate that 40% of physicians are for a National program, probably to rationalize it and keep more of their power.
Holt's conclusion is that it will take much political will to overcome the opposition, and I think we'll have to wait for 2008 for that to happen.
My trip to my dentist shows a basic problem with the current system in action.
During my last trip for a cleaning I was given an option for a wipe swab in my mouth which would more easily show early signs of oral cancer. Currently, without this option, the doc looks around and tries to see anything unusual. The new option is unproven, but if it works would be a benefit to all...hmm or maybe just to me as the system would possibly lose a full-blown cancer patient - BIG BUCKS!
Now, the hygienist told me if they get enough evidence of success, then the insurers would pay for the procedure. The insurers are not paying for this procedure since evidence is lacking, but why should I pay for research?? Because, if I can afford it, it's to my benefit. But how do I know if it works?? Is $50 cheap enough to make me participate in a study? Not in this case. I have faith in my dentist.
Shouldn't this be the wipe maker's problem? The problem for the maker is they have multiple insurance company payers to deal with, raising costs and squeezing out good but marginal solutions. But is it rational for the maker to ask me and other individuals to pay?? In this crazy market why not?
If we had a single payer system it would be much cleaner, easier and successful for all. A procedure/solution set for all would be defined, and whether the wipe procedure is in or out, and it would only be accepted if proven.
Monday, February 19, 2007
A solution for rational Health Care in the USA
Well, it didn't make the top 25 emailed articles in the past week, or even the top 10 in the Business section of the NY Times (I am a watcher and subscriber), but the Robert Frank article of February 15 entitled "A Health Care Plan So Simple, Even Stephen Colbert Couldn’t Simplify It", http://www.nytimes.com/2007/02/15/business/15scene.html, was a nice, short, thoughtful piece on our Health Care problems. It might be the most detailed proposal out there so far. Our Democratic hopefuls should take a look.
The Fuchs/Emanuel Plan outlines a single payer voucher plan that can work. Unlike the President's latest proposal, which is kinda goofy as per the Colbert quote in the article, and it focuses on strengthening the hold of private insurance and taking away the tax exemption that people who pay their insurance premiums though company plans. The latter is a good idea, to continue the dominion of the former is goofy. Why? Because as is we end up spending double what other advanced countries do for administrative costs, and we still have some 45 million uncovered Americans. Under the Fuchs/Emanuel plan, a single payer voucher system would save us $300 Billion per year in administrative costs. It would also:
This plan make so much sense economically (full coverage and more efficient), maybe not politically, but that's for the politicians to try.
The plan cited is actually from Victor Fuchs, a respected health economist at Stanford University, and Dr. Ezekiel Emanuel, chairman of the department of clinical bioethics at the National Institutes of Health.
The Fuchs/Emanuel Plan outlines a single payer voucher plan that can work. Unlike the President's latest proposal, which is kinda goofy as per the Colbert quote in the article, and it focuses on strengthening the hold of private insurance and taking away the tax exemption that people who pay their insurance premiums though company plans. The latter is a good idea, to continue the dominion of the former is goofy. Why? Because as is we end up spending double what other advanced countries do for administrative costs, and we still have some 45 million uncovered Americans. Under the Fuchs/Emanuel plan, a single payer voucher system would save us $300 Billion per year in administrative costs. It would also:
- cover every American under the age of 65
- allow free choice of health plans
- freedom to purchase services beyond the standard allotment with after-tax dollars
- the private delivery system remains in place
- eliminates the need for Medicaid and other means-tested programs
- would eventually replace Medicare
- managed by a Federal Health Board modeled on the Federal Reserve System
This plan make so much sense economically (full coverage and more efficient), maybe not politically, but that's for the politicians to try.
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