Universal Health Care Education Fund, 33 Harrison Ave, 5th Floor, Boston, MA 02111-2040
To the Editor:
Re "The Massachusetts Model" (editorial, June 16):
As a Massachusetts primary care physician, I dearly wish that your optimism for our state's health care plan were well placed. My fear, however, is that any plan that does not eliminate the colossal waste of multiple competing private health insurers is doomed to failure.
Costs can never be contained while supporting bloated private bureaucracies and for-profit medicine. Most physicians now support single-payer, national health insurance ("Medicare for all").
Alan Meyers, Boston, June 16, 2008
The writer is associate professor of pediatrics at Boston University School of Medicine and a founding member, Physicians for a National Health Program.
To the Editor:
You hail Massachusetts’ health reform as a promising model for the nation. But within the last year both the State Senate president and the executive director of the agency implementing the new law have publicly recognized that it will collapse if health care costs continue to rise by double digits, which they have.
No effective cost-control legislation is in sight. In Massachusetts we see history repeating itself: a large expansion of Medicaid in the mid-1990s added more than 300,000 residents to the rolls, cutting the uninsured population almost by half. A few short years of rising costs, however, were enough to erase those gains and place the state back to where it started.
Similar fates have befallen many "universal" state reforms hailed as models for the nation. Without eliminating the waste inherent in commercial health care systems and making comprehensive coverage a right, no country has ever been able to achieve universal health care.
We need a single-payer health care system that will be there for our children, not another unsustainable experiment with obvious math problems that won't be there just a few years from now.
Benjamin Day, Executive Director
Mass-Care: The Massachusetts Campaign for Single Payer Health Care
Boston, June 17, 2008
To the Editor:
Your editorial lauds the Massachusetts health care reforms as "off to a good start" and "heartening." The editorial addresses the reforms' higher than projected costs thus:
"The shortfall occurred mostly because the state underestimated the number of uninsured residents and how fast low-income people would sign up for subsidized coverage. It is a warning to other states to keep projections realistic."
I'm sorry, but if states can low-ball the cost of reforms to get them enacted, and still get praised by the paper of record, that's exactly what they'll do. Some "warning."
Michael F. Cannon, Director of Health Policy Studies
Cato Institute, Washington, June 18, 2008
http://www.nytimes.com/2008/06/19/opinion/l19health.html
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Anxiety Over Health Insurance Shapes Life Choices
By VICTORIA E. KNIGHT, The Wall Street Journal 6/10/08
Anxious over being caught uninsured or paying sky-high premiums, some people -- especially those with health problems -- are going to great lengths to get or keep job-based health coverage.
Wedding dates are being moved up to quickly get both husband and wife on a company plan. On the flip side, married couples are holding off on getting divorced so they will both stay on their existing plan. In some cases, those who are self-employed are going so far as to hire employees to qualify for group insurance.
Concern over coverage also is affecting a host of other major life decisions, insurance-industry watchers and financial advisers say, including the age of retirement and the state where people choose to live.
"People are turning themselves inside out to get health insurance," says Karen Politz, a research professor at Georgetown University's Health Policy Institute in Washington.
Under federal law, insurers are required to charge all participants the same for premiums in employer-sponsored group plans regardless of health status. In state-regulated individual markets, by contrast, people with health problems may end up paying high premiums, face exclusions for past or existing medical conditions or be denied coverage.
Financial advisers say health-coverage worries are rampant among clients. For those with medical conditions, conversations increasingly center on how to get or stay on a group policy or segue into the individual market in a way that prevents insurers from denying coverage or excluding pre-existing conditions.
In certain circumstances, two federal laws -- Cobra and Hipaa -- provide such protections, but the rules can be complicated. Insurers may not be limited in what they can charge participants, although some states may set limits. If you are young and healthy, you will likely find a less-expensive policy in the individual market.
"Access to coverage is a huge issue," says Leon Rousso, a certified financial planner in Ventura, Calif. "You may have the financial means to pay for premiums but not be able to get coverage, leaving you exposed to potentially catastrophic losses if you become ill."
Obtaining insurance through an employer is often the easiest way to get comprehensive coverage for those who don't qualify for Medicare or federal or state programs for the very poor.
Employers tend to subsidize premiums, making it more affordable for those in poor health who benefit from being part of a larger risk pool. The coverage tends to be more comprehensive and cost-effective in group policies.
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Monday, June 23, 2008
Tuesday, April 22, 2008
Massachusetts Health Care Containment
Dear Howard:
>
> Thank you for your advocacy – it made a difference!
>
> Last night, the Massachusetts Senate approved a health care cost containment bill with key provisions that may help to keep prescription drug costs down by limiting the marketing practices of the pharmaceutical industry.
>
> Did you know that the pharmaceutical industry spends over $7 billion annually marketing to physicians, and that 94% of physicians receive meals and other payments from pharmaceutical companies? The cost of that marketing is passed along to consumers and other purchasers in the price of prescription drugs.
>
> Today, pharmaceutical industry salespeople are the primary source of providers’ information about medications. The Senate bill includes a program in which medical professionals will provide physicians with unbiased data they need to make appropriate prescribing decisions, unlike pharmaceutical sales representatives who provide promotional information.
>
> There are several additional steps in the legislative process before this becomes law but now is the time to thank the Senate for their leadership.
>
> Thank you for your advocacy – it made a difference!
>
> Last night, the Massachusetts Senate approved a health care cost containment bill with key provisions that may help to keep prescription drug costs down by limiting the marketing practices of the pharmaceutical industry.
>
> Did you know that the pharmaceutical industry spends over $7 billion annually marketing to physicians, and that 94% of physicians receive meals and other payments from pharmaceutical companies? The cost of that marketing is passed along to consumers and other purchasers in the price of prescription drugs.
>
> Today, pharmaceutical industry salespeople are the primary source of providers’ information about medications. The Senate bill includes a program in which medical professionals will provide physicians with unbiased data they need to make appropriate prescribing decisions, unlike pharmaceutical sales representatives who provide promotional information.
>
> There are several additional steps in the legislative process before this becomes law but now is the time to thank the Senate for their leadership.
Sunday, April 20, 2008
CVS PHARMACY
has asked Massachusetts health officials for approval to open the first of 20 to 30 planned "MinuteClinics" in Boston-area stores that executives said will offer patients fast, inexpensive care in a region struggling with packed emergency rooms and closed doctors' practices.
RETAIL CLINICS Show how the lure of profits creates opportunities for competition and quality care at an affordable price.
In a world where consumers are able to control more of their own routine health care spending.
The presciption for the clinics success;
Strict protocols to ensure high-quality care
Low prices that are clearly posted
Convenience
RETAIL CLINICS Show how the lure of profits creates opportunities for competition and quality care at an affordable price.
In a world where consumers are able to control more of their own routine health care spending.
The presciption for the clinics success;
Strict protocols to ensure high-quality care
Low prices that are clearly posted
Convenience
Competition won't ail you
The convenient-care clinic model arose from the mitmatch between what consumers need and what the Health care System was offering them.
QuickMedx runs stripped-down medical clinics in Cub Foods stores in the Twin Cities. Patients pay a flat $35 fee, and the clinics try to get people in and out in 15 minutes.
The clinics can charge lower fees than other clinics because they use nurse practitioners who diagnose and prescribe medications for about a dozen common ailments. They refer more complicated problems elsewhere.
This year marks the first time since opening in May 2000 that the company is taking its kiosk outside of a grocery store. Whitman said a local corporation — yet to be announced — has invited QuickMedx to open a clinic on its campus
Sunday, April 13, 2008
Senior Long Term Care
Baby boomers beware: The safety net you might be relying on to take care of you when you're old and sick is full of holes, a new study warns.
Many are relying on Medicaid, the government's health-care program for the needy, to pick up the tab for their nursing home and other long-term care expenses one day.
But there's a catch: Medicaid won't cover long-term care until your own resources are exhausted, warns Jeffrey Brown, director of the Center on Business and Public Policy at the University of Illinois College of Business and a co-author of the study.
"Medicaid basically forces you to impoverish yourself before it will pay for long-term care," he said. "Then you come out of care, and you've got nothing left."
What's more, the study contends, the government is encouraging people to rely on Medicaid by loading the program with disincentives to buy private long-term care insurance – which would be a better option because it protects assets and provides broader coverage.
Brown said economists have been puzzled about why so many Americans spurn long-term care insurance when they typically insure themselves against other financially damaging events and they face about a 40 percent chance of needing care in a nursing home one day.
"And if they need it, it can be financially devastating for many families, because a nursing home can cost $60,000 or $70,000 a year," he said.
As it turns out, the study found, Medicaid is choking the demand for private insurance because people prefer bad benefits at no charge to good benefits they'd have to buy.
And even for those who want private insurance, Medicaid makes it "not a good deal" for many, Brown said.
Once the benefits Medicaid picks up for free are factored in, the net benefits of long-term care insurance are just 20 cents to 40 cents on every dollar spent on private coverage premiums, the study found.
Another disincentive: Medicaid is a secondary payer, meaning it pays only after a private policy has paid first. So even when people do invest in private coverage, they might still end up exhausting all their resources.
"It will just take them longer to do so," Brown said.
Why not just rely on Medicaid, then?
Because it's not free. Taxpayers are footing $135 billion worth of long-term care expenses a year through Medicaid, and the burden can only grow as more baby boomers age, the study points out.
If there's a good way out of this conundrum, Brown said he hasn't found one yet.
The country could eliminate Medicaid coverage and let taxpayers spend their money on their own long-term care coverage, but there will always be people who won't have coverage and won't be able to afford nursing home care, Brown said.
"Are we as a society prepared to tell these people, 'You didn't insure, you didn't save enough, you're on your own?' I don't think this country is prepared to do that," he said.
Should Medicare, the government's health program for the elderly, take over long-term care expenses?
Talk about really breaking the federal budget, Brown said.
"We've already got under-funded (Medicare) benefits," he added.
Should the government require people to purchase long-term care insurance?
How could that be enforced? Brown said.
"One of the difficult things about this study is we've identified a very difficult public policy problem for which there is not an obvious solution," he said.
The nation's long-term care insurance industry is a bit more optimistic that more Americans will buy policies.
Some 400,000 long-term care policies were purchased last year, says Jesse Slome, executive director of the American Association for Long Term Care Insurance.
"It's growing slowly and steadily," he contends.
Last year, long-term care insurers paid out $3.5 billion in claims, about $200 million more than 2006, Slome said. As more people have positive experiences with this kind of coverage, he predicts more will want to buy it.
But it's going to take time. Before the baby boomer generation, the elderly lived closer to their children and didn't need to rely so heavily on nursing home care. People didn't live quite so long, either, Slome said.
"Prior generations didn't have to think about long-term care," he added.
Slome thinks the real impediment to buying long-term care insurance is human nature: Many folks just aren't good planners, and they procrastinate.
"The fact of the matter is, first of all, people don't live their lives planning to go on welfare. They live their lives without planning, but nobody who's 65 looks and says, 'Gee, I've worked my whole life. I was independent. I saved. I had a retirement plan. I did everything I was supposed to, and in my last years, I want to go on welfare to see what it's really like,'" he said.
The long-term care industry's challenge is to convince more people to start thinking about the costs of nursing home care before they become so old, or their health deteriorates so much, that insurance is going to be prohibitively expensive, he said.
Nearly 45 percent of people applying for long-term care coverage in their 50s qualify for good health discounts, but only about 19 percent of those who wait to apply in their 70s qualify for these discounts, a 2006 report done by Slome's association found.
Another challenge may be today's economy.
Slome said a single person at age 55 can buy decent long-term care coverage for about $1,000 a year, and a married couple at that age can buy decent coverage for both people at about $1,300 a year.
But with the rising cost of health care, many people are finding it difficult enough to pay for insurance they need right now, let alone pay for coverage they may need in their golden years.
Slome's advice for getting the best deal: Work with a professional who can find you the best long-term care insurance coverage for your needs and lock in the rates. The price of coverage varies widely, and every company has its own premium rate sweet spot depending on the client's age, marital status and health status, he said.
"Medicare and Medicaid are already strapped, and it's only going to get worse," Slome warned. "The government can only tax so much."
Should you buy long-term coverage?
It depends on what you've got to lose, says Paul McNamara, a professor and Extension specialist at the University of Illinois Department of Agricultural and Consumer Economics.
His advice:
— Consider buying coverage if you can afford it and want to have assets to leave your heirs or a surviving spouse.
— Know the premiums are more reasonable before you become elderly and fall into poor health. But keep in mind when you buy coverage younger that you're going to have to keep up the premium payments for a long time.
— Don't neglect the bigger picture: Consider long-term care insurance as part of your overall retirement planning. It wouldn't make sense to pay for a long-term care policy if you can't afford to fund your retirement savings.
— When it's not a good deal: If your income is anywhere near Medicaid eligibility level, you don't have a lot of assets now and likely won't have enough assets at retirement to protect.
Find this article at: http://www.news-gazette.com/news/2008/04/13/seniors_warned_about_longterm_care
Comments
Many are relying on Medicaid, the government's health-care program for the needy, to pick up the tab for their nursing home and other long-term care expenses one day.
But there's a catch: Medicaid won't cover long-term care until your own resources are exhausted, warns Jeffrey Brown, director of the Center on Business and Public Policy at the University of Illinois College of Business and a co-author of the study.
"Medicaid basically forces you to impoverish yourself before it will pay for long-term care," he said. "Then you come out of care, and you've got nothing left."
What's more, the study contends, the government is encouraging people to rely on Medicaid by loading the program with disincentives to buy private long-term care insurance – which would be a better option because it protects assets and provides broader coverage.
Brown said economists have been puzzled about why so many Americans spurn long-term care insurance when they typically insure themselves against other financially damaging events and they face about a 40 percent chance of needing care in a nursing home one day.
"And if they need it, it can be financially devastating for many families, because a nursing home can cost $60,000 or $70,000 a year," he said.
As it turns out, the study found, Medicaid is choking the demand for private insurance because people prefer bad benefits at no charge to good benefits they'd have to buy.
And even for those who want private insurance, Medicaid makes it "not a good deal" for many, Brown said.
Once the benefits Medicaid picks up for free are factored in, the net benefits of long-term care insurance are just 20 cents to 40 cents on every dollar spent on private coverage premiums, the study found.
Another disincentive: Medicaid is a secondary payer, meaning it pays only after a private policy has paid first. So even when people do invest in private coverage, they might still end up exhausting all their resources.
"It will just take them longer to do so," Brown said.
Why not just rely on Medicaid, then?
Because it's not free. Taxpayers are footing $135 billion worth of long-term care expenses a year through Medicaid, and the burden can only grow as more baby boomers age, the study points out.
If there's a good way out of this conundrum, Brown said he hasn't found one yet.
The country could eliminate Medicaid coverage and let taxpayers spend their money on their own long-term care coverage, but there will always be people who won't have coverage and won't be able to afford nursing home care, Brown said.
"Are we as a society prepared to tell these people, 'You didn't insure, you didn't save enough, you're on your own?' I don't think this country is prepared to do that," he said.
Should Medicare, the government's health program for the elderly, take over long-term care expenses?
Talk about really breaking the federal budget, Brown said.
"We've already got under-funded (Medicare) benefits," he added.
Should the government require people to purchase long-term care insurance?
How could that be enforced? Brown said.
"One of the difficult things about this study is we've identified a very difficult public policy problem for which there is not an obvious solution," he said.
The nation's long-term care insurance industry is a bit more optimistic that more Americans will buy policies.
Some 400,000 long-term care policies were purchased last year, says Jesse Slome, executive director of the American Association for Long Term Care Insurance.
"It's growing slowly and steadily," he contends.
Last year, long-term care insurers paid out $3.5 billion in claims, about $200 million more than 2006, Slome said. As more people have positive experiences with this kind of coverage, he predicts more will want to buy it.
But it's going to take time. Before the baby boomer generation, the elderly lived closer to their children and didn't need to rely so heavily on nursing home care. People didn't live quite so long, either, Slome said.
"Prior generations didn't have to think about long-term care," he added.
Slome thinks the real impediment to buying long-term care insurance is human nature: Many folks just aren't good planners, and they procrastinate.
"The fact of the matter is, first of all, people don't live their lives planning to go on welfare. They live their lives without planning, but nobody who's 65 looks and says, 'Gee, I've worked my whole life. I was independent. I saved. I had a retirement plan. I did everything I was supposed to, and in my last years, I want to go on welfare to see what it's really like,'" he said.
The long-term care industry's challenge is to convince more people to start thinking about the costs of nursing home care before they become so old, or their health deteriorates so much, that insurance is going to be prohibitively expensive, he said.
Nearly 45 percent of people applying for long-term care coverage in their 50s qualify for good health discounts, but only about 19 percent of those who wait to apply in their 70s qualify for these discounts, a 2006 report done by Slome's association found.
Another challenge may be today's economy.
Slome said a single person at age 55 can buy decent long-term care coverage for about $1,000 a year, and a married couple at that age can buy decent coverage for both people at about $1,300 a year.
But with the rising cost of health care, many people are finding it difficult enough to pay for insurance they need right now, let alone pay for coverage they may need in their golden years.
Slome's advice for getting the best deal: Work with a professional who can find you the best long-term care insurance coverage for your needs and lock in the rates. The price of coverage varies widely, and every company has its own premium rate sweet spot depending on the client's age, marital status and health status, he said.
"Medicare and Medicaid are already strapped, and it's only going to get worse," Slome warned. "The government can only tax so much."
Should you buy long-term coverage?
It depends on what you've got to lose, says Paul McNamara, a professor and Extension specialist at the University of Illinois Department of Agricultural and Consumer Economics.
His advice:
— Consider buying coverage if you can afford it and want to have assets to leave your heirs or a surviving spouse.
— Know the premiums are more reasonable before you become elderly and fall into poor health. But keep in mind when you buy coverage younger that you're going to have to keep up the premium payments for a long time.
— Don't neglect the bigger picture: Consider long-term care insurance as part of your overall retirement planning. It wouldn't make sense to pay for a long-term care policy if you can't afford to fund your retirement savings.
— When it's not a good deal: If your income is anywhere near Medicaid eligibility level, you don't have a lot of assets now and likely won't have enough assets at retirement to protect.
Find this article at: http://www.news-gazette.com/news/2008/04/13/seniors_warned_about_longterm_care
Comments
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