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09-26-2009by Colleen King
It’s been a couple of weeks now since the great ‘shout heard around the world’ by Rep. Joe Wilson’s (R-SC),constituting a serious breech of etiquette for Congress, but what it brought to light appears to have drastically changed what will happen with a specific portion of the proposals in health care reform.
What set Rep. Wilson off was President Obama’s statement that illegal aliens would not be covered by the new version of health care. Well, that is what it says in the House bill. What no one wants to cop to is that there was no enforcement mechanism, no provision for checking someone’s residence status when applying for public or subsidized health care. And it’s not like something would have to be created, there is already a database that can be checked and is used by 70 government programs currently. Why not this one?
The SAVE database, the Systematic Alien Verification for Entitlements program, Is used to check eligibility for government programs. Similar to when your doctor calls your insurance company to verify your eligibility for benefits. Except for the prospect of being deported if you aren’t found to be eligible. If you are in Los Angeles, you’ve heard a lot about this on the KFI 640 AM radio show with hosts John and Ken.
Many have said that this was omitted due to pressure to do something about immigration reform. I’ll leave that to another Examiner to comment on. It is estimated by the Congressional Budget Office (CBO) that to cover the 6 1/2 million illegal immigrants will cost $31 billion. So eliminating that will be a drop in the $900 billion estimated bucket that the reform plan will cost over the next 10 years. But since everything so far is an estimate, I’ll take the $31 billion, thank you.
But coming from a nursing background, once upon a time, the problem with NOT covering people here illegally is that their kids are in school with our kids. If they aren’t receiving care, such as immunizations, there is a public health risk potentially.
So what do we do? Suggestions?...read more
09-14-2009by Colleen King
Health Savings Accounts (HSAs) remain a popular adjunct to qualified high deductible health plans in finding ways to save on health insurance premiums. There are individual health plans and group health plans that you can get that will allow you to open an HSA. For a list of what you can and can’t use the money for, click here.
Every year the IRS sets the figures for maximum contributions, minimum deductibles and few other things that govern health savings accounts. Here are the numbers for 2010:
Maximum individual contribution to an HSA–$3050
Maximum family contribution to an HSA–$6150
Policy out of pocket maximum for individuals–$5950
Policy out of pocket maximum for families–$11,900
Minimum deductibles on plans for individuals–$1100
Minimum deductibles on plans for families–$2400
Catch up contribution for those over 55–$1000
That last one is potentially really important–for people over 55, if you have some extra cash floating around, you can put an additional $1000 in your HSA, above the annual maximum. This is another potential advantage to a couple both opening up an HSA. For 2009, you could both deposit the $3000 maximum AND an additional $1000. If you only have one account, it is an individual account so you could put the 2009 family max of $5950 plus $1000 for a total of $6950 for the year. If you each have separate HSAs, based on the 2009 figures, you could each put in $3000 to your accounts, plus another $1000 each, for a total of $8000.
But that only works if you are drowning in cash. I don’t consider an HSA to be the first place to stash extra money, most of us would rather put it in a retirement account. But if you’ve maxed out all your ‘pre-tax’ options, here’s one more place. And, it’s deductible on your federal tax return. Be well!
09-02-2009by Colleen King
Hey I couldn’t make this up. I’m assuming it’s the insurance industry that came up with this, not Hallmark or American Greeting since I haven’t seen any ‘Happy Life Insurance Awareness Month’ cards at the local retailers as yet in the card racks.
But as odd as it sounds, ‘Life Insurance Awareness Month,’ it is important for people to review what they have in the way of life insurance. Needs change over time, since there are times in your life when you need more coverage, and points where you can consider decreasing your coverage if you want to.
Agents are often taught that they should do annual reviews on what their clients have, but most of the time I think if you meet/talk with your agent every 2-3 years, that will work. You will need to contact them sooner if you have some life changes. Things like getting married, buying a home, having a baby, these are all times that increase your expenses so you don’t want to risk what you have by not have sufficient coverage in case the unthinkable happens. You need to consider the income of both spouses, multiply that anywhere from five to fifteen times depending on your liabilities and that will give you an idea of the amount of coverage you should consider. And if one spouse isn’t working, is the ‘stay at home’ partner, don’t assume you don’t need life insurance on them. If something happens to them, especially if you have kids, you may need to start paying for child care, need housekeeping help, and you aren’t necessarily going to be able to work as much. You may want to take time off for after school events. You may need to change jobs if you do something that makes you travel often. Just stave off a financial mess by insuring the non-working spouse, whatever your situation.
As you get older, those are times you may be able to either decrease your coverage, or elect to convert your term policy to a permanent policy, either a whole or universal life policy. If your kids are grown AND have left the nest (being grown doesn’t necessarily mean they’ve moved out on their own these days) you may be able to get by with less coverage. If your home is paid off or the mortgage balance is very low, something that current savings could pay off, you may be able to decrease your coverage.
But before you cancel or decrease coverage, evaluate the overall worth of your estate. One reason to maybe buy MORE at this point in life is to facilitate a transfer of wealth. Life insurance proceeds are tax free to the beneficiaries; some people spend a couple hundred thousand dollars to buy a million dollar policy, thereby increasing what they leave to their heirs. Also having life insurance paid to your beneficiaries can help them pay off the inheritance taxes a large estate can incur.
So for a little extra help in figuring out what you need, check out this life insurance calculator in addition to talking with an agent or financial advisor.
So, Happy Life Insurance Awareness Month–Be well!...read more
08-26-2009by Colleen King
Health insurance is on everyone’s mind these days–either you don’t have it, can’t get it and want it, you’re upset about what you are paying for it, or you turned on the daily news and there it is, the topic is right in your face again.
A Health Savings Account (HSA) is an account that you are eligible to open if you have a specific type of health plan, also known as a qualified high deductible health plan. Generally the only benefits you have prior to meeting the deductible are preventive, but check the benefits before you buy–some plans now are not offering preventive coverage prior to meeting the deductible. I think they should, but they didn’t ask me. These types of plans are available in both the individual health insurance market and the group health insurance market.
Anyway, I’ve included in this article an excerpt from a study that United Healthcare relating to ‘transparency’ of health care costs when people have what’s referred to as consumer driven health plans. What it boils down to is if you you see how much things cost, you are more prone to looking at less expensive alternatives, just like any other area you might spend money:
“Study Reveals HSA Plan Effects on Cost and Utilization
The latest UnitedHealthcare study is among the first to examine the impact of plans eligible for health savings accounts (HSAs) on health care costs and utilization among both large and small employers. Some highlights of the study:
The positive impact of HSA plans continued through the second year of enrollment.
This is meaningful because some first year differences in cost and use may have been attributable to a redistribution of elective care services as employees rushed to get care in the baseline year before an anticipated change in their benefits. This dynamic typically levels out in year two, providing a better view of consumer decision-making.
Employers who implemented HSAs showed greater declines in hospital admissions and emergency room visits. At the same time, the number of prescriptions increased over time in the HSA. However, pharmacy costs decreased in the HSA population. This suggests that HSA members are making more prudent health care choices, such as using lower-cost drugs.
Full replacement strategies appear to deepen the impact of HSA plans. When comparing cost and use across employers’ full populations (including traditional plan enrollees when the HSA was offered as an option), employers adopting a full replacement HSA had better cost results for both medical and pharmacy than employers offering an HSA option.
The utilization analysis suggests that large full replacement employers realize lower costs due to a decrease in emergency room visits and lab usage. This highlights the possibility that full replacement members are making more appropriate use of emergency room and lab services.
The study results are consistent with other cross-sectional studies done by UnitedHealthcare on CDH plans. HSAs, especially those with a full replacement strategy, have great potential to slow the growth in health care costs compared to more traditional plans, even after adjusting for the better health found among those with an HSA. The study also confirms that we see a favorable impact for smaller companies.
Consumerism in Health: Insights from Experience
The positive impact of CDH plans has been widely documented, largely based on the experience of health reimbursement account (HRA) and HSA programs. Over the last nine years, UnitedHealthcare has compiled a body of work that measures if and how CDH strategies deliver on their promise – to provide lower costs through better consumer decisions – when compared to more traditional plans. Similarly, UnitedHealthcare has investigated market concerns that threaten to slow the adoption of CDH plans.”
So doesn’t it make sense? How can you save money on your health care, if appropriate, if you think a $5 co-pay is all it costs to see a doctor? Be well!...read more
07-25-2009by Colleen King
This article was put out by the Associated Press on July 4 and it brings out a lot of points that people aren’t aware of within the European health care systems. You know, the ‘free’ ones that everyone thinks we should go to. Well, I’ve tried to edit it down a bit because it’s long, but I think you’ll find it really enlightening!
July 4: London – As President Barack Obama pushes to overhaul the American health care system, the role of government is at the heart of the debate. In Europe, free, state-run health care is a given.
The concept has been enshrined in Europe for generations. Health systems are built so inclusive that even illegal immigrants are entitled to free treatment beyond just emergency care. Europeans have some of the world’s best hospitals and have made great strides in fighting problems like obesity and heart disease.
But the system is far from perfect. In Britain, France, Switzerland and elsewhere, public health systems have become political punching bags for opposition parties, costs have skyrocketed and in some cases, patients have needlessly suffered and died. Obama has pointedly said he does not want to bring European-style health care to the U.S. and that he intends to introduce a government-run plan to compete with private insurance, not replace it.
Critics fear Obama’s reforms will lead to more government control over health care and cite problems faced by European health systems as examples of what not to do. Other experts say Americans could learn from countries like Germany, the Netherlands and Switzerland, especially in the debate on how to reorganize health insurance.
“These countries are in some way an inspiration for our reforms,” said Uwe Reinhardt, a health economist at Princeton University. “All of these countries somehow manage to assess risk and compensate for it … we could learn from that.”
Many European health officials applaud Obama’s attempt to provide health care to millions more Americans, but they also advise him to proceed with caution.
“What we can be proud of in Europe is the ground rules, that everyone has the right to health care,” said Jose Martin-Moreno, a health expert at the University of Valencia in Spain. “But the implementation has been difficult and one size does not fit all.”
Private health care is also available in Europe, creating in some instances a two-tier system that critics say defeats the egalitarian impulse on which national systems were built. When Britain’s National Health System was founded 61 years ago, it pledged that with few exceptions, patients would not be charged for anything. All prescription drugs are covered, and the government regularly sets health targets, like maximum waiting times in emergency rooms or for having an operation.
Critics say the policies are often driven more by politics than science. Last week, Prime Minister Gordon Brown promised that patients unable to see cancer experts within two weeks would get cash to pay for private care. Brown had previously argued against paying for private providers and some say the reversal may be a gimmick to boost his sagging popularity.
More serious problems in Britain’s health care were reported last month, when cancer researchers announced that as many as 15,000 people over age 75 were dying prematurely from cancer every year. Experts said those deaths could have been avoided if those patients had been diagnosed and treated earlier. “There is nothing inherently different about cancer in the U.S. and Britain to explain why more people are dying here,” said Dr. Karol Sikora, of Cancer Partners UK.
The U.S. already spends the most worldwide on health care. According to the Organization for Economic Co-operation and Development, the U.S. spent $7,290 per person in 2007, while Britain spent $2,992 and France spent $3,601.
Still, experts say that before committing the U.S. to footing the bill for universal health care, Obama should consider it has cost Europe. A World Health Organization survey in 2000 found that France had the world’s best health system. But that has come at a high price; health budgets have been in the red since 1988. In 1996, France introduced targets for health insurance spending. But a decade later, the deficit had doubled to 49 billion euros ($69 billion).
“I would warn Americans that once the government gets its nose into health care, it’s hard to stop the dangerous effects later,” said Valentin Petkantchin, of the Institut Economique Molinari in France. He said many private providers have been pushed out, forcing a dependence on an overstretched public system.
Similar scenarios have been unfolding in the Netherlands and Switzerland, where everyone must buy health insurance. “The minute you make health insurance mandatory, people start overusing it,” said Dr. Alphonse Crespo, an orthopedic surgeon and research director at Switzerland’s Institut Constant de Rebecque. “If I have a cold, I might go see a doctor because I am already paying a health insurance premium.”
Cost-cutting has also hit Switzerland. The numbers of beds have dropped, hospitals have merged, and specialist care has become harder to find. A 2007 survey found that in some hospitals in Geneva and Lausanne, the rates of medical mistakes had jumped by up to 40 percent. Long ranked among the world’s top four health systems, Switzerland dropped to 8th place in a Europe-wide survey last year.
Government influence in health care may also stifle innovation, other experts warn. Bureaucracies are slow to adopt new medical technologies. In Britain and Germany, even after new drugs are approved, access to them is complicated because independent agencies must decide if they are worth buying.
When the breast cancer drug Herceptin was proven to be effective in 1998, it was available almost immediately in the U.S. But it took another four years for the U.K. to start buying it for British breast cancer patients.
“Government control of health care is not a panacea,” said Philip Stevens, of International Policy Network, a London think-tank. “The U.S. health system is a bit of a mess, but based on what’s happened in some countries in Europe, I’d be nervous about recommending more government involvement.”
And that’s coming from someone without a vested interest in US health care reform–Be Well!...read more