Archive by Month - September, 2010

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Should Health Insurance Plans Cover Gastric Bypass Surgery?

Thursday, September 16th, 2010

Image: EmerandSam under CC 3.0

Obesity is a condition that impacts the health of millions of Americans. There are several options in dealing with it: diet and exercise is the most obvious. An increasing number of health insurers are encouraging the former through wellness programs.

However, success rates are relatively low. Some are proposing gastric bypass surgery as a solution. Some health insurance plans cover the $30,000 surgical procedure for the morbidly obese, but others believe that the investment in preventative care. Obese teenagers, especially, are increasingly taking advantage of it.

By no means is surgery a panacea: some people manage to regain all their weight (though fewer than the 95% who do so with diet and exercise), and up to a third of patients have medical complications. Still, in most cases gastric bypass seems to cure type 2 diabetes (which is expensive to treat for many years). The Atlantic‘s Marc Ambinder, himself a gastric bypass patient, speculates that paying for the procedure for all obese Americans would end up costing less than the medical complications associated with obesity. However, it is an extreme option of last-resort, and is an over $30 billion-worth pipe dream.

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Health Insurance Plan Reform Lawsuit Will Probably Continue

Wednesday, September 15th, 2010

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The healthcare reform lawsuit launched by 20 states is currently being argued in a federal district court. According to the judge presiding over it, Roger Vinson, he will probably rule that the states have general jurisdiction to sue the federal government.

Vinson does not appear to be much of a sympathetic ear for the Obama administration’s lawyers, who claim that the health insurance plan mandate inherent in the bill should be considered as a tax–which they are allowed to impose.

When he decides on the lawsuit’s fate on October 14, Vinson predicts that the bulk of the lawsuit will be allowed to proceed to further arguments on December 16. However, some of it will probably be dismissed; a bittersweet fate for health insurance reform opponents.

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Predicted Health Insurance Reform Savings Misleading?

Tuesday, September 14th, 2010

Image: University of Tennessee

According to the Obama administration’s director of healthcare reform, Nancy-Ann DeParle, the law will result in a slight reduction in the cost of health insurance. Specifically, each insured person will save up to $1,000 on their health insurance plan by 2019.

While this sounds positive, it does not cancel out the fact that the government’s Medicare actuary predicted a modest cost increase. That is because that cost will be divided among more people–the law seeks to expand coverage to 93 percent of the American population.

Some may consider the relatively small increase a worthwhile investment in our society for helping others, but that trade-off should be presented honestly.

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Affordable Health Insurance Grants for Utah’s Native Americans

Monday, September 13th, 2010

Image: Bob Rosenberg under CC 3.0

Native Americans are one of the demographics most likely to be uninsured. Although a majority of them are eligible for affordable health insurance through CHIP (the Children’s Health Insurance Program) and Medicaid, they still struggle with access, especially on reservations.

The new healthcare reform law includes a grant for nearly $1 million to help Utah’s many tribes access health care. The smaller tribes are less likely to have charitable clinics established.

What will the grants cover? Their purposes include outreach from the Utah Navajo Health System to the nearby town of White Mesa, where there is a large American Indian population. 10 to 15 percent of children living there are enrolled in CHIP, when up to 95 percent are estimated to be eligible for that Utah health insurance plan. Several other walk-in clinics in the state will also receive grants.

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Affordable Health Insurance and Tort Reform: Overhyped?

Friday, September 10th, 2010

Image: John of Austin under CC 3.0

Are the accusations levied at trial lawyers for medical malpractice lawsuits jacking up health insurance costs overblown? A new analysis of U.S. Department of Health and Human Services data by Harvard researchers indicates that they may be.

According to the data, 2.4% of all health care spending in 2008 was related to medical malpractice and defensive medicine (intended to avoid lawsuit). While reducing that percentage could help in bringing about more affordable health insurance, tort reform isn’t a panacea in itself. States with strong tort reform have seen their health insurance costs rise just as sharply over the years.

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Will Health Insurance Plan Provider Pay $10 Billion Fine?

Thursday, September 9th, 2010

One of the many complexities associated with health care is the constant mergers and buyouts. The worst-case scenario is that when your health insurance plan is caught in the middle, your health falls by the wayside.

That’s what the state of California’s insurance commissioner accuses PacifiCare of doing after being acquired by United HealthCare several years ago. Former PPO patients state that their documents were lost or incorrectly entered into the system, causing their claims to be denied. This allegedly went on for several years, from 2006 (shortly after the merger) until 2008.

The insurer is unlikely to pay out the entire sum: it’s only the maximum they could be liable for, based on a fine of $100,000 per count for nearly a million counts. In the vast majority of cases, they will settle with the state.

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Employer-Based Health Insurance Plans Providing Less Care for More Money

Friday, September 3rd, 2010

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When employees look at their health insurance plans today, they see more responsibility (and cost) on their end with fewer benefits. That’s according to a new survey from the Kaiser Family Foundation.

In a struggling economy, companies look for different methods of saving money. One of them is shifting the cost of health coverage to employees. Unfortunately, workers must pay for those costs with the same or even smaller (for those who have taken pay cuts) incomes! Wages have not grown with the cost of health insurance for several decades now.

The average employee is paying 14% more for health care in 2010.

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Pennsylvania Insurer Wants Health Insurance Plan Rate Hikes

Wednesday, September 1st, 2010
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As of January 1st, your health insurance plan could become more expensive if you live in certain regions of Pennsylvania.

Blue Cross of Northeast Pennsylvania wants up to $10 million worth of premium hikes. For now, eight plans would be affected, including those targeted towards lower-income individuals–including a guaranteed issue policy for the recently unemployed. Some of the plans are subsidized.

Pennsylvania health insurance customers have one month to comment on the proposal before the state’s insurance department makes a decision on BCNEPA’s request..

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