Category : –The 2009 American Health Care Reform Debate

(Bloomberg) U.S. Health-Care System Ranks as One of the Least-Efficient in the World

The U.S. health-care system remains among the least-efficient in the world.

America was 50th out of 55 countries in 2014, according to a Bloomberg index that assesses life expectancy, health-care spending per capita and relative spending as a share of gross domestic product. Expenditures averaged $9,403 per person, about 17.1 percent of GDP, that year ”” the most recent for which data are available ”” and life expectancy was 78.9. Only Jordan, Colombia, Azerbaijan, Brazil and Russia ranked lower.

The U.S. has lagged near the bottom of the Bloomberg Health-Care Efficiency Index since it was created in 2012. Hong Kong and Singapore ”” consistently at the top ”” are smaller countries with less diverse populations. Their governments also play a stronger role in regulating and providing care, with spending per capita averaging $2,386 and longevity averaging about 83 years.

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Posted in * Culture-Watch, * Economics, Politics, * International News & Commentary, --The 2009 American Health Care Reform Debate, America/U.S.A., Anthropology, Corporations/Corporate Life, Economy, Ethics / Moral Theology, Globalization, Health & Medicine, Labor/Labor Unions/Labor Market, Personal Finance, Politics in General, Theology

A Chicago Tribune Editorial–Why Obamacare failed

Obamacare failed because it flunked Economics 101 and Human Nature 101. It straitjacketed insurers into providing overly expensive, soup-to-nuts policies. It wasn’t flexible enough so that people could buy as much coverage as they wanted and could afford ”” not what the government dictated. Many healthy people primarily want catastrophic coverage. Obamacare couldn’t lure them in, couldn’t persuade them to buy on the chance they’d get sick.

Obamacare failed because the penalties for going uncovered are too low when stacked against its skyrocketing premium costs. Next year, the penalty for staying uninsured is $695 per adult, or perhaps 2.5 percent of a family’s taxable household income. That’s far less than many Americans would pay for coverage. Financial incentive: Skip Obamacare….

Obamacare failed because it hasn’t tamed U.S. medical costs. Health care is about supply and demand: People who get coverage use it, especially if the law mandates free preventive care. Iron law of economics: Nothing is free; someone pays. To pretend otherwise was folly. Those forces combined to spike the costs of care, and thus insurance costs.

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Posted in * Culture-Watch, * Economics, Politics, * International News & Commentary, --The 2009 American Health Care Reform Debate, America/U.S.A., Anthropology, Consumer/consumer spending, Corporations/Corporate Life, Economy, Ethics / Moral Theology, Health & Medicine, Labor/Labor Unions/Labor Market, Law & Legal Issues, Pastoral Theology, Personal Finance, Politics in General, Theology

(LA Times) David Lazarus–Obamacare covers free annual physicals, right? Wrong

Banning resident Jim Bailey and his wife went in recently for their annual physicals. They came away with hundreds of dollars in charges for co-pays and tests.

Bailey, 78, told me that he feels duped.

“The Affordable Care Act dictates that all annual physicals be provided at no cost to the policyholders ”” no deductibles or co-pays,” he said. “But that wasn’t the case with us.”

Nor will it be the case with anyone else ”” even though many Americans believe otherwise.

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Posted in * Culture-Watch, * Economics, Politics, * International News & Commentary, --The 2009 American Health Care Reform Debate, America/U.S.A., Anthropology, Consumer/consumer spending, Economy, Ethics / Moral Theology, Health & Medicine, Personal Finance, Psychology, Theology

(W Post) Consumers could be facing biggest increase in ACA health premiums next year

Premiums for health plans sold through the federal insurance exchange could jump substantially next year, perhaps more than at any point since the Affordable Care Act marketplaces began in 2013.

An early analysis by the Kaiser Family Foundation shows that proposed rates for benchmark silver plans ”” the plans in that popular tier of coverage that determine enrollees’ tax subsidies ”” are projected to go up an average of 10 percent across 14 major metropolitan areas.

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Posted in * Culture-Watch, * Economics, Politics, * International News & Commentary, --The 2009 American Health Care Reform Debate, America/U.S.A., Consumer/consumer spending, Economy, Health & Medicine, Personal Finance

(Time) The Hidden Cost of ”˜Surprise’ Medical Bills

Danny and his wife Linda, who teaches fourth grade at a public school in Canton, Ga., got their health insurance through the state’s Blue Cross Blue Shield plan. Because Danny had torn his Achilles tendon earlier that summer playing basketball, the family had already blown through their $5,000 deductible. Linda’s doctor and their local hospital were both listed as in-network providers, so the Postells didn’t expect they’d have to pay any more out of pocket for Luke’s birth.

But then a stream of mysterious bills started rolling in. Why hadn’t anyone told them there’d be a $1,746 fee for an initial neonatal visit? What is the $240-per-day charge for Luke’s “supervision of care”? Wasn’t this all”“$4,279 in the end”“supposed to be covered by insurance?

Danny, who knew something about medical billing from his work as a pharmacist, quickly discovered the cause. While the local hospital was considered an in-network provider, the neonatal intensive-care unit at that same facility was not. Once Luke was whisked across that invisible line, wham: everything was out of network. “You’d think someone at some point would have told us that,” Danny says.

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Posted in * Culture-Watch, * Economics, Politics, --The 2009 American Health Care Reform Debate, Economy, Health & Medicine, Personal Finance

(NYT front page) Experts were wrong about Healthcare Costs

As part of his push for the Affordable Care Act in 2009, President Obama came to Central High School to laud this community as a model of better, cheaper health care. “You’re getting better results while wasting less money,” he told the crowd. His visit had come amid similar praise from television broadcasts, a documentary film and a much-read New Yorker article.

All of the attention stemmed from academic work showing that Grand Junction spent far less money on Medicare treatments ”“ with no apparent detriment to people’s health. The lesson seemed obvious: If the rest of the country became more like Grand Junction, this nation’s notoriously high medical costs would fall.

But a new study casts doubt on that simple message.

Price has been ignored in public policy,” said Dr. Robert Berenson, a fellow at the Urban Institute, who was unconnected with the research. Dr. Berenson is a former vice chairman of the Medicare Payment Advisory Commision, which recommends policies to Congress. “That has been counterproductive.”

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Posted in * Culture-Watch, * Economics, Politics, * International News & Commentary, --The 2009 American Health Care Reform Debate, America/U.S.A., Consumer/consumer spending, Corporations/Corporate Life, Economy, Ethics / Moral Theology, Health & Medicine, Personal Finance, Politics in General, Theology

(NYT) Many Say High Deductibles Make Their Health Law Insurance All but Useless

“The deductible, $3,000 a year, makes it impossible to actually go to the doctor,” said David R. Reines, 60, of Jefferson Township, N.J., a former hardware salesman with chronic knee pain. “We have insurance, but can’t afford to use it.”

In many states, more than half the plans offered for sale through HealthCare.gov, the federal online marketplace, have a deductible of $3,000 or more, a New York Times review has found. Those deductibles are causing concern among Democrats ”” and some Republican detractors of the health law, who once pushed high-deductible health plans in the belief that consumers would be more cost-conscious if they had more of a financial stake or skin in the game.

“We could not afford the deductible,” said Kevin Fanning, 59, who lives in North Texas, near Wichita Falls. “Basically I was paying for insurance I could not afford to use.”

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Posted in * Culture-Watch, * Economics, Politics, * International News & Commentary, --The 2009 American Health Care Reform Debate, America/U.S.A., Consumer/consumer spending, Corporations/Corporate Life, Economy, Ethics / Moral Theology, Health & Medicine, Law & Legal Issues, Personal Finance, Politics in General, Theology

(Yahoo Finance) Rick Newman–Even After Yesterday's decision, ACA still faces big challenges

….the controversial law still faces a bumpy future. Here are five challenges the ACA will face during the next several years:

Healthcare costs are still too high. As many enrollees are discovering, the “Affordable” Care Act is somewhat misnamed. Healthcare costs continue to rise faster than wages or overall inflation, putting a financial burden even on people who have healthcare. A recent study by the Commonwealth Fund found that 23% of Americans who have healthcare coverage are “underinsured,” meaning their out-of-pocket spending on healthcare is more than 10% of their income in a given year. Deductibles and other out-of-pocket costs have been rising because consumers and businesses have been opting for plans with lower premiums””which usually require the patient to bear more of the cost before 100% coverage kicks in. The irony is that insurance has gotten more affordable, but actual healthcare hasn’t.

The ACA includes several long-term provisions meant to explore ways to lower costs, but they may not be nearly enough to offset other trends pushing costs up, such as the retirement of the baby boomers and the development of expensive new drugs. If Congress ever gets serious about improving the ACA rather that faux-repealing it, cost will be the thing to focus on.

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Posted in * Culture-Watch, * Economics, Politics, --The 2009 American Health Care Reform Debate, Anthropology, Consumer/consumer spending, Corporations/Corporate Life, Economy, Ethics / Moral Theology, Health & Medicine, House of Representatives, Law & Legal Issues, Office of the President, Personal Finance, Politics in General, Senate, Theology

(AP via local paper) High-cost, skimpy health insurance next big campaign issue for Democrats

A different health care issue has emerged for Democrats, in sync with the party’s pitch to workers and middle-class voters ahead of next year’s elections.

It’s not the uninsured, but rather the problem of high out-of-pocket costs for people already covered.

Democrats call it “underinsurance.”

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I will take comments on this submitted by email only to KSHarmon[at]mindspring[dot]com.

Posted in * Culture-Watch, * Economics, Politics, * International News & Commentary, --The 2009 American Health Care Reform Debate, America/U.S.A., Consumer/consumer spending, Corporations/Corporate Life, Economy, Ethics / Moral Theology, Health & Medicine, House of Representatives, Labor/Labor Unions/Labor Market, Law & Legal Issues, Office of the President, Personal Finance, Politics in General, Senate, Theology

(Seattle Times) Banking on faith: Cost-sharing ministries offer Obamacare alternative

When Melissa Mira suffered sudden heart failure at the end of her second pregnancy last year, she worried first about her health and her baby ”” then about the more than $200,000 in medical bills that began rolling in.

“Your world is just crashing down around you and you wonder: ”˜How is this going to be covered?’”‰” recalled Mira, 30, who spent more than a month away from her Tacoma home, hospitalized at the University of Washington Medical Center.

For Mira and her family, the answer came not through traditional health insurance, but through faith that fellow Christians would step forward to pay the bills.

The Miras ”” including daughter Jael, 4, and baby Sienna Rain, now a healthy 9-month-old ”” are among the growing numbers of people looking to “health care-sharing ministries” across the U.S.

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Posted in * Christian Life / Church Life, * Culture-Watch, * Economics, Politics, --The 2009 American Health Care Reform Debate, Anthropology, Children, Economy, Ethics / Moral Theology, Health & Medicine, Law & Legal Issues, Marriage & Family, Parish Ministry, Pastoral Theology, Personal Finance, Religion & Culture, Stewardship, Theology

(NYT Op-Ed) Thomas Edsall–Does Emphasizing Inequality cause voters to Trust the Government Less?

Even worse for Democrats, the Saez paper found that “information about inequality also makes respondents trust government less,” decreasing “by nearly twenty percent the share of respondents who ”˜trust government’ most of the time:”

Hence, emphasizing the severity of a social or economic problem appears to undercut respondents’ willingness to trust the government to fix it ”” the existence of the problem could act as evidence of the government’s limited capacity to improve outcomes.

The findings of the Saez group are consistent with Luttig’s. Taken together, they suggest that even if Democrats win the presidency and the Senate in 2016, largely on the basis of favorable demographic trends, the party will confront serious hurdles if it attempts to deliver material support to working men and women and the very poor. Redistribution is in trouble, and that is likely to tie American politics in knots for many years to come.

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Posted in * Culture-Watch, * Economics, Politics, --The 2009 American Health Care Reform Debate, Anthropology, Consumer/consumer spending, Corporations/Corporate Life, Economy, Ethics / Moral Theology, Health & Medicine, History, House of Representatives, Labor/Labor Unions/Labor Market, Office of the President, Personal Finance, Politics in General, Senate, Taxes, The U.S. Government, Theology

(CNBC) Obamacare sticks some enrollees with unexpected bill

Last year, a study found that about four out of every 10 people who received financial help from the government while buying their Obamacare health plans had no idea they were getting any assistance.

This tax season, many of those people may be in for a rude surprise when they’re asked to pay some””or even all””of that money back….

“I wasn’t very happy,” said Mike Highsmith, 61, a retired US Airways flight attendant who learned after having his taxes done that he has to pay back every cent of the $6,624 in federal subsidies that helped pay the lion’s share of his HealthCare.gov-purchased plan.

“This shocked me … I didn’t know this was coming.”

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Posted in * Culture-Watch, * Economics, Politics, --The 2009 American Health Care Reform Debate, Consumer/consumer spending, Economy, Ethics / Moral Theology, Health & Medicine, Law & Legal Issues, Personal Finance, Taxes, The U.S. Government, Theology

(LA Times) Rising healthcare costs are pressuring patients

A recent survey by private health insurance exchange EHealth highlights the pressure Americans are feeling. It found that more than 6 in 10 people say they’re more worried about the financial effect of expensive medical emergencies and paying for healthcare than about funding retirement or covering their kids’ education.

People who get health insurance through work and on their own have seen their costs rise dramatically over the last decade.

According to the Commonwealth Fund, a New York think tank, annual increases in work-based health plan premiums rose three times faster than wages from 2003 to 2013. Out-of-pocket costs have also been climbing.

“More people have deductibles than ever before,” says Sara Collins, a Commonwealth Fund vice president. From 2003 to 2013, the size of deductibles has grown nearly 150%.

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Posted in * Culture-Watch, * Economics, Politics, --The 2009 American Health Care Reform Debate, Anthropology, Consumer/consumer spending, Corporations/Corporate Life, Economy, Ethics / Moral Theology, Health & Medicine, Labor/Labor Unions/Labor Market, Personal Finance, Theology

(Forbes) U.S. Doctor Shortage Could Hit 90,000 By 2025

The nation’s shortage of doctors will rise to between 46,000 and 90,000 by 2025 as the U.S. population grows, more Americans gain health insurance and new alternative primary care sites proliferate.

A new study announced by the Association of American Medical Colleges (AAMC), a lobby for medical schools and teaching hospitals, said “the doctor shortage is real” with total physician demand projected to grow by up to 17 percent as a population of baby boomers ages and the Affordable Care Act is implemented.

“It’s particularly serious for the kind of medical care that our aging population is going to need,” said Dr. Darrell Kirch, AAMC’s president in a statement accompanying the analysis by research firm IHS.

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Posted in * Culture-Watch, * Economics, Politics, * International News & Commentary, --The 2009 American Health Care Reform Debate, Aging / the Elderly, America/U.S.A., Anthropology, Consumer/consumer spending, Corporations/Corporate Life, Economy, Ethics / Moral Theology, Health & Medicine, Labor/Labor Unions/Labor Market, Personal Finance, Politics in General, The U.S. Government, Theology

(WP Wonkblog) Five key takeaways from the Supreme Court’s Obamacare hearing yesterday

Based on oral arguments this morning, the latest Supreme Court showdown over Obamacare could lead to another narrow ruling determining the fate of the health-care program. Here are five important takeaways from the hearing in King v. Burwell, a challenge an IRS rule providing financial assistance to millions purchasing health insurance through federal-run exchanges offered in states that did not create their own online marketplaces….

(1) The vote will be close. The four justices from the court’s liberal wing appear on board with the Obama administration’s argument that all exchanges — whether state or federal — can offer subsidies. Justice Anthony Kennedy and Chief Justice John Roberts are still potential swing votes. Justices Antonin Scalia and Samuel Alito seem to sympathize with the plaintiffs’ argument that the text of the Affordable Care Act only authorizes subsidies in state-run exchanges….

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Posted in * Culture-Watch, * Economics, Politics, --The 2009 American Health Care Reform Debate, Consumer/consumer spending, Corporations/Corporate Life, Economy, Ethics / Moral Theology, Health & Medicine, Law & Legal Issues, Personal Finance, Politics in General, Theology