Category Archive - Issues and Opinion

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Can Healthcare Reform “Repeal and Replace” Promises Be Trusted?

Friday, September 24th, 2010

Image: Keven Law under CC 3.0

The Republican party is staunchly against the Obama administration’s healthcare reform law. So much so, that its politicians promise that if they regain the majority in Congress, one of their first tasks will be to repeal “Obamacare”. Then, they promise that they will replace it with a more moderate, business-friendly solution.

What they promote sounds like a good idea–retaining the popular measures, such as making it easier for people with pre-existing conditions to buy a health insurance plan; while dropping the potentially troublesome elements like the individual mandate.

However, history may make some skeptical of the GOP’s pledge. After helping to torpedo President Bill Clinton’s health insurance reform proposal in the early 1990s, they basically ignored the issue for over a decade of controlling the House of Representatives and the Senate. In the meantime, the issue became more pressing–and may need more drastic solutions than it did back then.

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Carter: Ted Kennedy Killed Affordable Health Insurance Reform

Tuesday, September 21st, 2010

Image: Mitchell Weinstock under CC 3.0

Saying that the late Ted Kennedy stood in the way of comprehensive healthcare reform seems strange: the liberal Democrat took on that issue for decades before his death last year. But that’s what former President Jimmy Carter claims.

Specifically, Carter accuses Kennedy of shooting progressives’ cause in the foot because he opposed a Carter administration proposal in 1978. Kennedy supported a single-payer national health insurance system and considered it a civil right, similar to the “public option” touted in recent years. Labor unions also funded the Campaign for National Health Insurance, which convinced Kennedy to back out of a compromise proposal with Republican Gerald Ford in 1975 due to the potential for soon having a Democrat in office. However, Carter was more moderate than they expected.

In retrospect, it may have made more sense to accept the affordable health insurance reform Carter offered–which would have been effect for decades by now. Washington, D.C. has only become more conservative and polarized since then, and subsequent policy proposals were even more narrow.

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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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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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Health Insurance Plan Agents May Suffer Under Reform

Friday, August 27th, 2010
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Image: Jennifer Feuchter under CC 3.0

Although healthcare reform tries to help many, it will end up hurting at least some. For example, the business model of many health insurance brokerages and agencies is in danger.

Provisions involving medical loss ratios, which include agent commissions in the “administrative” category that will be regulated and limited, will have a negative effect. In addition, brokerages may be made redundant by the state insurance exchanges and accompanying websites that must be launched by 2014. On the bright side for them, the National Association of Insurance Commissioners passed a resolution that affirmed the importance of licensed insurance professionals.

With the possibility of a double-dip recession looming, more job losses is obviously a downside. However, industry experts predict that these companies have several options for adaptation. Hopefully, their experience in navigating the complexity of the market and helping people decide on a health insurance plan will still be in demand. Their compensation model may also be adjusted in favor of flat fees instead of commissions.

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Republicans Vow To Repeal Healthcare Reform If They Win Midterms

Friday, August 20th, 2010

Image: Republican Party of Shelby County under CC 3.0

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The heated midterm election battles are underway. Control of the House of Representatives and Senate is at stake in November. Democrats are looking to retain their majority, but what if they don’t?

Tennessee Republican representative Marsha Blackburn recently stated that the GOP will repeal the Obama administration’s healthcare reform law if they regain control. The law is controversial largely due to provisions that create a mandate for individuals and companies to buy a health insurance plan.

However, Rep. Blackburn’s promises may be more election rhetoric than reality. While the Republican party may take a few steps in the direction of eliminating the law, President Obama is guaranteed to veto any bill that would repeal it. Although political pundits predict that Republicans may win a significant number of seats, they may not reach the essential two-thirds of the Senate that would be necessary to override a presidential veto.

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Statistics About Massachusetts’ Uninsured

Wednesday, August 18th, 2010
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Image: David Paul Ohmer under CC 3.0

Largely due to the state’s first-in-the-nation healthcare reform, Massachusetts residents are the most likely in America to have a health insurance plan. Still, the expansion has not succeeded in providing universal coverage. Why?

A recent study from the Urban Institute and the Robert Wood Johnson Foundation’s State Access Reform Evaluation looked to identify the 4.1 percent who were still uninsured.

Here are their findings on the average Massachusetts resident without health insurance:

  • From 19 to 64 years old
  • male
  • an ethnic or racial minority (African-American, Hispanic, etc.)
  • unmarried
  • lack of proficency in the English language; either their own or that of an adult who lives with them
  • less educated
  • not a U.S. citizen
  • more likely to be unemployed
  • could be eligible for public Medicaid coverage

The study’s authors believe that the state’s message may not be getting across to its attempted demographic. Suggestions include rewriting the program information in order for it to be understandable with a 4th to 8th grade reading level.

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Health Coverage and HIV/AIDS

Tuesday, July 13th, 2010

Image: Sully Pixel under CC 3.0

With its affordable health insurance legislation under its belt, the Obama administration has begun tackling a new health issue: the HIV/AIDS crisis. Although new infections have slowed since their peak in the ’80s, many people are still affected.

It is a two-pronged effort, aimed at reducing new infections while increasing access to health care for those who already have it. Instead of allocating significant amounts of new funding, existing funding will be redirected to high-risk populations like African-Americans and gay/bisexual men.

Some fear that the new comprehensive strategy won’t be enough, however. The economy has resulted in many people losing their jobs, which for many also means losing health coverage. Although there are medications that allow HIV patients to live longer and healthier lives, they are still very expensive. The out-of-pocket cost is almost out of reach for the uninsured. In addition, a person with HIV or AIDS would find it almost impossible to buy health insurance on the open market for the next several years.

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Your Health Coverage Can Be Canceled for One Penny

Friday, July 9th, 2010


Image: stevendepolo under CC 3.0

In order for your coverage to remain secure, it is essential to pay every single penny of your health insurance premium–literally.

A woman with cancer lost her job, but got COBRA to continue her group health insurance benefits. Last year’s stimulus package gave her a 35% subsidy to help cover the cost. However, her insurance company never sent her the reduced bill.

Therefore, she calculated the smaller amount herself and sent in the premium. Unfortunately, the insurer’s calculations didn’t agree: they said her payment should be one cent higher. As a result, they canceled her plan entirely for nonpayment! She was unable to send a check for $0.01 because she was in the hospital undergoing chemotherapy at the time.

The good news is that they eventually overturned their decision and reinstated her coverage.

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Germany Struggling With Health Insurance Costs, Too

Wednesday, July 7th, 2010

Image: Aenneken under CC 3.0

While the Germans are dominating the World Cup, the situation regarding their health insurance doesn’t look so bright. Just like the United States, their economy has been dealt several blows, and the nation is dealing with a major budget deficit.

Some believe that more direct government intervention will lower the cost of affordable health plans in the U.S., but Germany is proving that point wrong. Chancellor Angela Merkel (the German equivalent of our president) recently agreed to increase premiums for virtually all residents, from 14.9% to 15.5% of their gross pay–split between employers and employees. Insurers will also be allowed to ask for an extra premium to cover additional costs.

On the positive side, nearly 90% of the population is covered through their mandate. Unfortunately, they have failed to control severe jump in health care expenses.

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