Today is Tuesday, May 21, 2013


Health insurance for 50-64 cohort offered by AARP

The Washington Post reports that AARP and UnitedHealthcare Group are offering kind of gap insurance for those between 50 and 64 years old, and that health insurance experts say the promise is greater than the actual benefits.

 

Association health plans could increase cost of health insurance

Association health plans (AHP) could make health insurance more expensive for small businesses instead of reducing their health care costss, said Len M. Nichols, Ph.D., of the Center for Health System Change, in an in-depth essay on Association Health Plans and Alternative Ways to Increase Health Insurance coverage for small businesses. In Feb. 5, 2003, testimony before Congress, Nichols argued that AHPs ultimately would cost small employers more due to adverse selection and the instability in the market. He also said that he believes mandated benefits imposed by states do little to increase premiums for small businesses. And he suggested putting small businesses into states’ risk pools or Medicaid risk pools, which seems impractical and politically difficult, especially since those risk pools may be riskier than community-rated pools of non-governmental beneficiaries. He also suggested that businesses join health insurance purchasing cooperatives, but most states’ laws are written to favor insurers. So few, if any small business purchasing cooperatives are doing well. In any case, if you’re really interested in a profile of the small groups health insurance market, this is testimony is well done. 

Specialists have more freedom from managed care rules

If small business owners wonder why health insurance premiums are soaring, they can thank the patient backlash against HMOs that dominated the news in the mid and late 1990s. UPI reports on a study by the Center for Health System Change that found specialists have more freedom in treating their patients under current managed care (HMO, PPO) contracts than they had several years ago. This is one reason health care costs are going up faster than they used to, and it is an example of how managed care organizations have implemented their own “patients bill of rights” without legislation. “HSC researchers found that between 1997 and 2001 the proportion of specialists that believe they gained more power over clinical decisions increased from 72.7 percent to 85.7 percent. They also found a marked increase in the proportion of specialists who believe they can maintain their income level while making the best clinical decisions and sustaining long-term relationships with patients,” UPI’s Christian Bourge reported.

$98.9 billion spent on uninsured patients; $35 billion in uncompensated care

The Kaiser Family Foundation released an Urban Institute study on government spending on uninsured , saying some $98.9 billion is spent on the uninsured (see below). And about $35 billion is uncompensated care The $35 billion number is derived from government and provider surveys conducted to estimate the amount of uncompensated care. The question is whether those numbers are based on highly inflated list prices, or charges, or on transaction costs, or the contract rates paid by managed care organizations, Medicaid and Medicare. In the Health Affairs article on the survey, the authors report that providers ask what they would have been paid by private insurers for services provided to the uninsured. Here’s Reuters

take on the story.

Bloomberg reports on The Business Word’s health costs

How The Business Word has responded to rising health insurance costs leads this Bloomberg.com [link no longer available] story about the impact of rising health insurance premiums on small business and large business hiring. This story doesn’t put us in the best light, but it shows how we’ve had to deal with economic reality even though we’ve provided the best possible (affordable) health insurance to our employees since we started the company 17 years ago.

-more-

S. Dakota senate votes to strip mandated benefits

Utah considering mandated benefits

At least one Utah legislator still hasn’t gotten the message—-small businesses can’t and won’t afford more mandated benefits. Brooke Adams reports in the Salt Lake Tribune that a state legislator wants several preventive procedures to be covered by insurers. That makes as much sense as asking Allstate to cover oil changes and winterizing your car. Why should consumers pay insurers to hold their money for them until they get around to getting a physical, if they ever do? This is just a make work bill for already busy physicians, and it won’t save enough lives or money to pay for itself. What it is is enforced common sense for patients who won’t pay for the procedures themselves. Many states are trying to cut mandated benefits, not add new ones.

Small businesses want health insurance help in Montana

Small businesses are paying $1.25 to $1.30 for each $1 worth of hospital services due to cost shifting from Medicaid in Montana, and the legislature is considering increasing tobacco taxes to provide some relief, reports Peter Johnson in the Great Falls Tribune. This is a state dominated by one carrier, Blue Cross, and small employers. Legislative proposals include “. . . a tax credit for small businesses and individuals buying health insurance, expansion of the state health insurance program for children from low-income families, a tax credit to help seniors pay for prescription drugs, help for school districts to pay health insurance costs and money to help the Department of Public Health and Human Services restore some programs.” Problem is, tax credits will be of little use to the lower income people who pay few income taxes, and where is the state going to get the money for these programs?

 

Washington may eliminate rate bands, hurt older workers

Business groups in Washington are proposing legislation that would allow insurers to raise rates as much as they want for older employees and workers in small business groups (2-50 employees) and in risky industries, reports Peter Neurath in the Puget Sound Business Journal. The NFIB and other business groups also want to eliminate mandated coverage of alternative providers such as chiropractors, who are fighting the legislation. It appears insurers are getting their ways with state legislators everywhere, and older and sicker people, many of whom bought insurance when they were healthy, will lose their coverage.

 

New Mexico’s small businesses drop health insurance

Small businesses in New Mexico are dropping health insurance coverage as premiums soar in a risk rating system state with only four major insurers, according to Dennis Domrzalski in the New Mexico Business Weekly.

 

Florida’s new risk rating system fails to help small employers

Florida dropped its modified community rating system in favor of rate bands and risk rating by health insurers, but this has failed to help small businesses buy insurance for their employees, according to the Palm Beach Post. In its news report, fewer Florida firms offering health insurance, the Post reports on a Chamber of Commerce survey that shows premiums are rising and more employers are being forced to drop coverage.

 

Superficial NBC coverage of the uninsured

David Gregory and NBC Nightly News in uninsured on the rise give the usual TV news superficial coverage of the problem of caring for the uninsured. Note the key numbers: Cost of serving the uninsured is $35 billion a year, which about eats up President Bush’s 2001 tax cut; 25% of uninsured earn $50,000 or more—-they are gaming the system and gambling with their health and their lives. Their choice, but at the expense of the rest of us.

Colorado Medicaid budget problems

Colorado’s Medicaid budget problems could be at least partially relieved by Medicaid HMOs, according to an article on today’s Rocky Mountain News op-ed page by Leonard J. Dryer, chairman of the Colorado Access board and CFO of the Children’s Hospital. In “Medicaid HMOs a bargain for state,” he describes how an HMO would provide pre-natal care and counseling to a pregnant beneficiary, saving the state the potential cost of treating a premie with costly medical complications. Problem is the state has a history of under-paying its Medicaid HMOs, and it’s not a good business because it’s vulnerable to irresponsible state legislators seeking cheap budget cuts.

Health cost increases may slow over next decade

Many of us have been saying health care costs can’t continue to soar at current rates, and an article in the new issue of Health Affairs comes to the same conclusion, but perhaps for different reasons than we’ve been thinking about.

Return on investment in health care is tremendous

For anyone whose life has been saved, improved or extended by modern medicine (since the 1940s), the cost of health care is not an issue. The benefits are priceless. And that is why neither politicians nor employers dare deny asscess to even the most costly procedures, although they try rather unsuccessfully to give consumers incentives to think twice about the cost of services before they use them.