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Massachusetts man dies after losing coverage for two months

December 17, 2013 in Health Insurance, Member Stories

The man I’ll call George died at a hospital in Massachusetts last April.  He had AIDS and Hepatitis C. George was managing both until February when his state subsidized insurance coverage ended.  He’d started earning too much money and no longer qualified.  George, a construction contractor, found an employer who let George sign on to the company plan.  He submitted the paperwork, but there was a delay. This happens. There might be some missing information or the first month’s payment is late.  For George, there was a 10 week gap between when his coverage through Commonwealth Care ended and his new insurance plan kicked in.

In February, while he was uninsured, George stopped taking his medicine.  He didn’t have the roughly $4400 a month to refill his AIDS prescriptions.  George skipped his meds again in March.  That month George got a bad cough.

He went to the hospital.  George had had pneumonia before and was pretty sure he had it again.  A doctor gave him a prescription and sent him home.  By the time George returned to the hospital, a virulent strain of pneumonia had settled into both lungs.  George, with his weakened immune system, couldn’t beat it.  Two months after George lost his coverage and stopped filling his prescriptions, he died. A letter telling George his new insurance was active arrived a few weeks later.

I heard this story from a doctor who treated George and his long term partner.  I don’t have all the details and am not using George’s real name because his family is embarrassed about the fact that he had AIDS.

I’m sharing what I do know of the story because the tragedy of George’s death is especially potent right now.  The state Health Connector website is still having problems.  Connector staff and board members have extended the current coverage for members in an effort to make sure that no one goes without health insurance while the re-enrollment problems continue.  But there are concerns that people will get frustrated and either give up or will put off going through the process of choosing a new plan.  Many of us push letters from our insurance companies aside, thinking they aren’t that important or won’t make sense if we do open them.

A lapse in coverage might not matter for most of us. We aren’t in the same precarious state as was George last February.  But don’t delay. Going without coverage for even a couple of months can be deadly.

 

 

 

Out-of-network Medical Costs Affect Everyone

October 5, 2013 in health care costs, Health Insurance, Hospital Bills, Insurance Bills, Medical Debt, Member Stories

According to a survey this year by America’s Health Insurance Plans, 12% of all medical claims received by insurance carriers were out-of-network in 2011. That translates into huge out-of-pocket costs for American consumers, and sometimes uncapped costs. Out-of-network charges can be nearly 100 times (100 times!!) the rate that Medicare allows (typically you will be no more than 2 or 3 times the Medicare rate with insurance).

Don’t think any of that applies to you because you have good insurance? Think again.

Excessive out-of-network fees are typically not covered by your insurance carrier to the full extent, and are often not applied to your deductible. This means you could not only be on the hook for large fees for some services, but those amounts could be uncapped, the equivalent of being uninsured, even while having a very good insurance plan. New Obamacare plans don’t solve this, as they are not required to cap out-of-network charges. And almost all carriers are shrinking their networks further for new exchange plans. How did this slip through the Affordable Care Act?

Health insurance carriers negotiate rates with a number of physicians and hospitals to get lower rates with its plan holders. These providers and facilities form a health plan’s “network”. When patients go to providers “in-network”, the insurance carrier pays significantly less. It is reasonable then that a plan might want to discourage you from going with a provider not in that network. It is also reasonable for a carrier to remove all but the lowest-cost providers from its network over time. The ACA also wants to keep people away from the highest-priced providers, in an effort to reduce healthcare costs overall.

The trouble is, sometimes going out-of-network is the best or only way to ensure critical healthcare. Specialists and key facilities in various parts of the country may not have a relationship with your carrier. There are also many cases when you end up receiving services from an out-of-network provider because of the nature of integrated care by professionals from a number of different companies. For example, even though you know your physician and hospital are in-network, you may not think to ask if the anesthesiologist is.

The 12% figure will surely rise under the ACA. More individuals will find that their preferred doctor is no longer in their plan’s network. Employers are beginning to cut spouses and children from plans, which will add to the confusion about which doctor you should be going to for which family member.

Some of the largest carriers like UnitedHealthcare and Aetna will only cover out-of-network fees up to what they consider a “fair” amount, and then you have to pay the rest yourself, even if you’ve already met your deductible. Good luck finding out what the cost will be beforehand. Doctors and nurses don’t know, and many facilities are known to not provide that information even if you call their billing department.

For more information on out-of-network services and payment, see FairHealth’s website. You can also see the websites of UnitedHealthcare and Aetna on how they deal with out-of-network costs.

 

Randy Cox
Founder & CEO of Pricing Healthcare

Reframing Healthcare in the Minds of Younger Americans

August 27, 2013 in fitness, health care costs, health care quality, Health Insurance, lifestyle, mental health, nutrition

The clock is ticking towards October 1, 2013 when public insurance exchanges are set to go live and begin offering health plan benefits to an estimated 30 million previously uninsured Americans. And as that day draws closer, all parties involved—plans, providers, employers, and patients—are scrambling to figure out just what it will mean to them from a cost and quality of care perspective. Yet, perhaps one of the biggest conundrums associated with the health insurance marketplace is how to deal with the potential sticker shock facing younger Americans and the ripple effect it could have on everyone. Specifically, with an age band as narrow as 3:1, there is a possibility that premiums for younger people (who tend to be lighter users of service) will be considerably higher in order to compensate for older Americans, who typically utilize more health care services. When combined with a relatively low penalty for not getting coverage, there is a very real fear that many of these ‘young invincibles’ will forgo coverage and simply choose to pay the penalty.

So, the question becomes, ‘how do we articulate the value of health coverage to this younger generation?’ or, in other words, convince them that coverage is relevant (and worth it) to them?

We need to help this younger population understand and believe that healthcare is not solely about supporting the sick – support is also critical for the well. For example: a recent college grad that is just starting out in his/her career and may have issues dealing with the stress of that new job; the twenty-something who runs marathons but wants to improve their nutrition; the new mother who wants to start a workout program to shed some of the baby weight; or the avid skier who suffers a knee injury on the slopes and wants to understand what treatment options are available to them.

These scenarios play out each day across the U.S. and could happen to just about anyone between the ages of 18-35, not solely older people or those with chronic conditions. And there are programs, resources and tools focused on shared decision making and wellness that are critical components of modern healthcare that young people can take advantage of. So at the core, the solution for this current dilemma needs to be about making the younger population aware of these resources because they support behaviors that contribute to better health and wellbeing. Specifically, we need to create a  culture that encourages all people—including the younger population—to think differently about their health, make more informed choices, and understand not only the resources at their disposal but also the value they provide.  If we can do that, we will go a long way in positively impacting the health and wellness of these younger generations and controlling spiraling healthcare costs.

Robert Mandel, MD, MBA, is the CEO of Health Dialog and has more than 15 years’ experience in senior leadership positions in health systems and health plan management. 

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by HCSavvy

Valiant effort to persuade the young invicibles…you need health insurance

August 14, 2013 in Health Insurance

Picture 11This guy is definitely going do some damage to his back – hard to say how much and where.  The MRI alone could cost more the penalty he’d pay next year for not having insurance.  But will the young invicibles sign up?  It’s going to be tough sell.

What Really Drives Up Health Insurance Premiums

July 19, 2013 in Health Insurance

Every year it seems that we are paying more and more for health insurance. According to an informative infographic Carrington College, the health care costs in the United States have grown 2.4 percent faster than the GDP, meaning that as of 2010, people were paying more than 8,000 dollars per person, and that money represented about 18 percent of the United States’ economy.

There are several factors, which have contributed to the rising price of health insurance. For example, one benefit which has had unexpected costs is the medical technology that is now being used. The technology that is used to diagnose and treat illnesses accounts for at least 50 percent of the growth of medical expenditures since the 1960s, putting an increased burden on the people paying for their health insurance.

Another factor that affects the health insurance rate for most people is the failure to use a primary care physician. With more people only going to see doctors for emergencies, there is actually less money being spent on primary care doctors, a practice which has been shown to lower costs. In comparison with other industrialized countries, the United States spends three to six times as much money on specialist doctors.

There are many factors that tie into the rise of health insurance costs, including things like medical billing fraud and an aging population, so check out this informative infographic to learn more about what really drives up those premiums.

Why is Health Insurance So Expensive

 

Another example of the insanity of “pricing” in the US health care “system”

July 16, 2013 in health care costs, Health Insurance, Insurance Bills

A family member had some lab work done by Quest Diagnostics, which is under contract with Harvard Pilgrim Health Care, our health insurer.  Because we have a high deductible plan, we were expecting a bill.  No problem.  The bill comes and it lists each test’s CPT Code along with a description – although admittedly I have no idea what these tests are – as well as the “charge” the “insurance discount” and a column that indicates “patient owes,” among others.

Here’s what was listed on the laboratory invoice:

Date CPT Code Test Description

Charge

Insurance Discount

Insurance Paid

Medicare/ Medicaid Paid

Patient Paid

Patient Owes

05/29/13 86036 ANA SCREEN, IFA

78.00

05/29/13 82784 GAMMAGLOBULIN

$56.15

05/29/13 83516 TISSUE TRANSGLUTAMIN

$157.04

05/29/13 83516 GLIADIN (DEAMIDATED)

$227.76

05/29/13 86039 ANA TITIER

$44.72

06/26/13 ADJUSTMENT

($483.20)

$563.68

(438.20)

$0.00

$0.00

$0.00

$80.48

 

I called Quest to get an explanation about the invoice.  In particular, I didn’t understand what they meant by “Insurance Discount” vis-à-vis the “Charge.”  After some back and forth, it was explained that the insurance discount is the difference between what Quest charges someone without insurance – i.e., their “list” price – and the amount that Harvard Pilgrim pays them for the test.  In my instance, it’s the difference between what I would pay if I didn’t have insurance and the amount that I owed because we’re covered through Harvard Pilgrim.

Their so-called charge for these services – the amount that they would charge me if I were to walk in off the street and get some routine blood work done – is more than SEVEN times the amount that they charge my insurance company.  Read the rest of this entry →

Claim Modifiers: More Code-Speak on Your Medical Bills

April 26, 2013 in health care costs, Health Insurance, Hospital Bills, Insurance Bills

If you have ever been hospitalized or had a major test/procedure performed, you may have received a frustratingly hard to decipher medical bill from your provider. And, if you are insured, you will also have received a similarly cryptic Explanation of Benefits (EOB) describing your insurance company’s payment decision. (The EOBs can sometimes be a bit clearer and more detailed than the average provider bill.) To the average lay person, medical bill jargon does not sync with customer psychology in the way that other bills, like retail, residential services, etc. do. Most other industries present their bills in a careful way, focusing on clear billing, to make sure that customers know why they have financial responsibility.

CPT and Claim Modifier Codes

With that in mind, let’s look more closely at some of the usual suspects that show up on an unreadable medical bill. One type of common code is called a Current Procedural Terminology or CPT code. This code, in plain English, represents a service that a doctor (or other medical professional) provides.

CPTs often do not “read” well. Patients not involved in the medical industry themselves may have no idea what one of these codes represents on a bill. Looking at the charge associated with it can be frustrating when there’s no common-vocabulary explanation to make the patient remember just what was done in the provider office. This means that patients who are proactively concerned about their care, and costs, will often call providers or insurers just to ask “what does this CPT code mean?”

About Claim Modifiers

Claim modifiers are additional digits attached to a CPT to explain to an insurer or other party how a procedure may have differed from “the norm.” Some modifiers are also used to differentiate a core service from an advanced service level based on the doctor’s documentation. Read the rest of this entry →

Should Medicare fund sex change surgery?

March 30, 2013 in Health Insurance, Medical Care

I had a WOAH moment yesterday when I opened this email from a doctor who passes along developments in the exploding world of transgender health:

Medicare announced that beginning March 28, 2013 and for a 30 day period, it is inviting comments from the public regarding reconsideration of its current policy to deny coverage of sexual reassignment surgery.

Anyone wanting to recommend a change of this policy and to advocate for medicare covering sexual reassignment surgery, the website to go to is

http://www.cms.gov/medicare-coverage-database/details/nca-tracking-sheet.aspx?NCAId=269

Don’t bother trying to open the link. Less than 24 hours after the Centers

graphic courtesy of Wikimedia

for Medicare and Medicaid Services posted this announcement, they took it down. A spokesperson told The Hill the agency decided not to take public comments while a challenge to the agency’s policy is “working its way through the proper administrative challenges.”

Medicare and Medicare, and almost all commercial insurance plans, don’t fund surgery for men or women who feel like they were born into the wrong body.

So since Medicare can’t or won’t ask, we will:

Should Medicare and Medicaid fund sex change or gender reassignment surgery?

You, your employer and your health

March 19, 2013 in health care costs, Health Insurance, News

Is your employer offering rewards or penalties if you participate in a wellness program, stop smoking or lose weight?

photo credit (www.pgcompanies.com)

CVS is joining a growing list of employers who tie wellness participation to rewards and penalties. In this case, the pharmacy chain says employees can save $50 a month on their insurance if they have a series of tests (body mass index, blood pressure, etc.).  Employees who don’t have the tests lose the money, $600 a year.

CVS Caremark spokesman Michael D’Angelis told the Boston Herald that the policy will help “colleagues take more responsibility for improving their health and managing health-associated costs.” The company says a third party will review and manage the employees’ test results. Some privacy advocates worry CVS and other firms will use the information to discriminate against less healthy workers who drive up health care costs.

More companies are expected to follow the example of CVS by offering incentives/penalties in exchange for monitoring employees’ health.  Affordable Care Act rules that encourage these options take effect January 1, 2014.  The Obama administration says expanding wellness programs “may offer our nation the opportunity to not only improve the health of Americans, but also help control health care spending.”

What’s happening in your workplace?

 

Here’s one reason you can’t find health care prices…

March 18, 2013 in Health Insurance, Hospital Bills, Member Stories

Most states don’t have laws requiring hospitals and other providers to tell you how much anything costs.

That’s the finding of a report that gives 29 states an “F” for transparency in health care pricing and nine a “D.” As Kaiser Health News reports, a group that includes some of the country’s largest employers plans to issue annual report cards on transparency.

Massachusetts and New Hampshire are the only two states (in blue) that get “A”s. The provision of the Massachusetts law that says insurers and providers will have to give you a price for an MRI, if you call, takes effect later this year. I’ve tried to find out how much hospitals and labs in the Bay State charge for services; it’s very difficult.  So for now, the “A” awarded to Massachusetts must be for intent, not action.

Affordable Care Act looks to prevent chronic diseases in women

March 12, 2013 in health care costs, Health Insurance, Medical Care, Women's care

Like many people in the United States, I’m aware that the Affordable Care Act was signed into law by President Obama and that it aims to make sure that everyone has healthcare; however, until now I hadn’t taken the time to ask how it affects women like me. A quick glance at the services provided under the umbrella of the Affordable Care Act shows that there are a handful of preventive services that I never knew I should consider, let alone take advantage of.

photo credit (qualityquest.org)

One of the major elements of the act is encouraging women to visit their doctor in regards to preventive care services since, according to HealthCare.gov, chronic diseases that are often preventable are responsible for 7 of 10 deaths among Americans each year and account for 75% of the nation’s health spending. If the preventive services cut down on the percentage of people with chronic diseases, then the nation’s spending spent on health will presumably go down.

Some of the services offered to women are screenings for anemia, cervical cancer, gestational diabetes, gonorrhea, Hepatitis B, and osteoporosis. Additionally, in August 2011 the Affordable Care Act introduced eight new preventive care services for women including Read the rest of this entry →

Should annual physicals actually be annual?

February 26, 2013 in Health Insurance, Medical Care, Member Stories

I’ve been going to my childhood doctor every year for as long as I can remember. She’s helped me through the chicken pox, flu shots, ear infections, and the perils of puberty. But as my mom pointed out a couple of weeks ago, I’m now in my twenties, which is too old to still be going to a pediatrician. The nostalgia in me wants to scream, “No, you can’t make me go to a new doctor,” but the logic in me says, “I guess it’s time I go to a doctor’s office where the waiting room isn’t filled with Legos.”

My healthcare conscience mother and me.

My healthcare conscience mother and me.

But how urgent is it for me to find a new doctor for my annual physical? Here are the facts: I’m a 22-year-old female, I haven’t had a physical in almost 14 months, and I don’t believe that I have a serious illness that has surfaced since my last visit. Can’t I just skip a year and wait until I’ve found a new doctor that I like?

While my mom might say no, my pediatrician says yes. Dr. Marilyn Lange, a doctor in Los Angeles and a graduate of Tufts University School of Medicine, says that a woman of my age can get away with only having a physical every three to four years unless she has a medical problem. “There are definitely reasons to do it,” says Dr. Lange, “but if you want to skip a year, that’s fine.”

An article published by Duke Medicine supports Dr. Lange’s claim and says that how often you get a physical depends on your age and disease risk factors. Assuming you are healthy, the article suggests you get a physical every two to three years if you’re under 30, every one to two years if you’re between 30 and 40, and every year if you’re over 50.

Additionally, a Danish study released in 2012 found Read the rest of this entry →

Preventing Child Medical Identity Theft

January 29, 2013 in health care costs, Health Insurance, Hospital Bills, Insurance Bills, Medical Care

Along with being able to talk to providers and insurance companies from an informed standpoint, you will also benefit from knowing more about how criminals work to fraudulently bill others for various items including health care services. There has been a flurry of reports about a growing practice that’s pretty disturbing, especially to new parents. It involves criminals simply using children’s identities to bill medical services and other items to credit accounts.

Doesn’t The Government Check a Consumer’s Age?

You would think that children would be safe from identity theft because of their age. But, the reality is that with the complex database systems of many governments and private businesses, it’s often possible for criminals to commit fraud by using the Social Security number and other identifying information of a minor. At the same time, many of these efforts are successful specifically because nobody else is checking the credit account for a minor. Since a child can’t usually make purchases or access his or her credit, everyone figures the accounts will be dormant. What some unlucky parents are finding out, though, is that to many government agencies and businesses, one Social Security number is as good as another, and the issue of age does not factor into many of these fraudulent accounts. In some cases, criminals who open these kind of accounts can keep using them for months or even years.

What To Do About Child Identity Theft

Much of what consumer advocates recommend in terms of deterring child identity theft is the same as what you would do to prevent adult identity theft. Read the rest of this entry →

The Rise of U.S. Health Care Consumers: Lessons from Abroad

January 5, 2013 in health care costs, Health Insurance, International Health Care, Medical Care, Quality of care

Can you imagine buying gas from a station with no signs to let you know the prices? Or having the clerk at a clothing store pick the “right” jeans for you, with no opportunity to figure out for yourself which ones fit best? In a sense, this is how Americans buy something far more important: health care.

Economists and policy makers have long emphasized the challenges in treating health care as a consumer good. Supply generally drives demand; there is little correlation between cost and quality; and end users have neither visibility into costs, nor much incentive to find out. Lack of price transparency makes it nearly impossible to find health care cost information even for someone motivated to look for it. Consumers also have little basis for evaluating quality; often the data that is available is dense and hard to interpret. In other words, most Americans do not have the practice or capacity, let alone the information they would need, to make informed health care decisions.

But it does not need to stay this way – and, indeed, it cannot if health care reform is to succeed. Under the Affordable Care Act, 12 million consumers are expected to purchase their own health insurance via a health insurance exchange by 2014, growing to 28 million in 2019. Americans, including lower-income individuals qualifying for subsidized health insurance, will have new health plan choices, and new means of comparison shopping. Even without reform, health insurers are designing and employers are increasingly offering products that shift costs and choices to the consumer.

Remarkably, as a nation and a health care industry, we have not prepared our population for the increased responsibility and decision-making power they will soon assume. Yet there are places around the world that have a lot to teach us in this arena, and they’re not necessarily the ones you might guess – or the ones health economists tend to focus on. Read the rest of this entry →

Protect Yourself from Medical Debt Overload with Self-Advocacy

December 27, 2012 in health care costs, Health Insurance, Hospital Bills, Insurance Bills, Medical Debt

You or someone you know may be closing out the year with large amounts of medical debt even after insurance payments or what you thought were relatively minor surgeries or other procedures. In fact, you may feel like you’ve been hit by a blizzard by the sheer number of bills related to that one procedure. And they keep on coming.

One step you can do is confirm or validate the bill, especially if a lot of time has elapsed since the initial service. This simply means you want proof that you had the services rendered and do in fact owe the balance due. Under the Fair Credit Reporting Act, credit agencies are supposed to help consumers to ensure that bills are correct and fair before payment is rendered. But without good knowledge of these laws and taking the time necessary to investigate, you could end up paying much more than you owe. Here are a few other ways to stand up for yourself and your bottom line.

Keep Proof of Charges

The bad apples that pollute our debt collection environment may be operating on an entirely fraudulent basis. There have been many news stories of consumers receiving calls from phone bank operators, posing fraudulently as legitimate debt collectors. A tip off is that in many instances, the caller will fail to fully identify him/herself, their company, and the nature of the call. There are also reports that unprincipled companies are using ‘bread crumbs’ of financial data in order to manufacture phony debts that their workers demand payment for during outbound telephone calls. Collectors have been known to threaten litigation or other legal action without any legal basis as well as fail to provide written proof that a debt is owed when requested by the consumer.

One big part of your arsenal is the paper trail of charges, as well as Explanation of Benefits (or EOBs) that show whether or not the insurance company paid their fair share. Keep all of these documents on hand so that you can prove any overcharges and trigger an analysis by a credit agency.

Get Credit Bureaus In On the Action Read the rest of this entry →

What is Being Done About Medical Billing Fraud?

November 19, 2012 in health care costs, Health Insurance, Insurance Bills, Medical Care, Member Stories

Over the last few years, healthcare insurers have been focusing on fraud detection. Their efforts have been undertaken with the cooperation of the National Health Care Anti-Fraud Association (NHCAA). The increasing numbers of suspected fraudulent medical claims are related to the economy, legislative attempts to help the consumer and general changes in ethical behavior. Also, a real danger exists because when medical service providers and attorneys are working in cahoots with fraudsters, prescribed treatment can be unnecessary and may even cause harm to patients.

The property and casualty insurance industry is also stepping up to implement fraud control. That’s because a significant amount of healthcare fraud starts with an incident related to property casualty insurance. For example, in the New York City area, about one in five no-fault auto insurance claims appear to contain elements of fraud. In addition, as much as one in three claims appear to be inflated.

Recently the National Insurance Crime Bureau (NCIB) asked leading property/casualty insurers to participate in a project to analyze medical billing data and place it in a single database. It is hoped that the ongoing participation of these insurers on supplying data for this project will enable the industry to be aware of emerging trends regarding potential fraud around medical billing. Read the rest of this entry →

Plan Ahead for International Travel Medical Bills

November 2, 2012 in health care costs, Health Insurance, Insurance Bills, lifestyle, Medical Care, Medicare, Member Stories

You may be closing out 2011 with a holiday trip, domestically or internationally. If you plan to leave the country, you may want to consider the following when it comes to your health:

  • You may not have health insurance coverage for illnesses or injuries that are treated abroad, even if you have US based medical coverage. Confirm with your benefits administrator.
  • Generally, Medicare does not provide coverage for hospital or medical costs incurred abroad, however, rare circumstances may be covered.
  • AARP can assist with obtaining foreign medical coverage and offers valuable travel tips.
  • US consulate personnel will help you locate health care providers and facilities and even contact family members, if necessary.
  • You can purchase travel insurance that covers health care needs and pays for medical evacuation if you need to be transported back to the US for treatment.

Obtaining medical treatment in another country can be expensive and a medical evacuation can cost over $50,000. Plus, you may encounter challenges with deciphering charges while abroad. Be vigilant, prepared, and follow the same self-advocacy steps you would while receiving medical care in your home state.

If you choose to purchase medical expense coverage while travelling abroad, double check you’ve carefully researched the following:

Your health data could be worth over $3,000 / year

October 21, 2012 in health care costs, Health Insurance

In a recent post about the new MA Health Information Exchange, I suggested that a patient-accessible connection to the HIE could save a patient thousands of dollars per year. And now there’s a real-world, peer-reviewed example of what we/’re talking about. Research of medicare Part D beneficiaries published in October 2012 issue of Health Affairs (sorry, it’s paywalled) shows:

“Nationwide, beneficiaries on average spent $368 more annually than they would have spent had they purchased the cheapest plan available in their region, given their medication needs. More than a fifth of beneficiaries spent at least $500 a year more than they needed to.”

and

“Our findings suggest that beneficiaries need more targeted assistance from the government to help them choose plans, such as customized communications about the most cost-effective plans that would cover their medication needs.”

Prescription drugs, as covered by Part D, represent about 10% of the nation’s overall healthcare cost. If, as a gross estimate, we took $368 from this study to be 10% of what a person would save if their overall health insurance was appropriate to their specific needs, then the annual per/beneficiary saving would be over $3,000.

To save this kind of money, patients will need to be able to pay an accountant or similar trusted advocate to match their specific health care costs Read the rest of this entry →

US Healthcare: an oxymoron

October 19, 2012 in Health Insurance, Hospital Bills, Insurance Bills, Medical Care, Medical Debt

It was very exciting to read about Amanda’s grass roots Twitter research.  Amanda, you have started an activist conversation that we, the people, need to have.  Comments from so many people on what Amanda started touched on a deep and growing moral and economic issue for which we must demand answers: loss of a job means loss of insurance, medical debt, loss of shelter and bankruptcy is not a rarity, unaffordable insurance premiums as the norm for the middle class, poor medical care for the disenfranchised, etc.  I will add another observation.  Do you know that if you have a very serious mental illness, have MassHealth, and need to be in hospital, you may wait 2-3 days in an ER for a bed?  Or, if you have poor insurance, be treated in the ER, and when you are medicated and are saner, sent home? There also were a couple of comments from folks who wanted to know why the US did not have systems of care like The UK and Canada.  People want to move to Vermont where there is a progressive move toward single payer healthcare for everybody.  There IS an organization in the US committed to healthcare for all. PNHP was started by public health physicians in 1985!

Does anyone wonder why there is no political will in the US? PNHP started in 1985 with the inception of “managed care”, also viewed by many of us as for-profit healthcare. In this case “healthcare” is an oxymoron, isn’t it? Read the rest of this entry →

Check This! @amandapalmer’s #insurancepoll

October 16, 2012 in health care costs, Health Insurance, Insurance Bills, Medical Debt

As you read this, there’s a fascinating conversation about health insurance in America and abroad taking place on Twitter and on musician Amanda Palmer’s blog. It’s an outpouring of stories about medical bankruptcy, asking a friend to stitch up a deep finger wound, skipping medications and losing loved ones who couldn’t afford needed care.

The conversation started shortly after Palmer read Nick Kristof’s column about a college buddy with stage 4 prostate cancer, cancer he didn’t catch sooner because he didn’t have health insurance.

Palmer decided to poll her 698k Twitter followers about their health insurance, She asked these four questions:

1) COUNTRY?! 2) profession? 3) insured? 4) if not, why not, if so, at what cost per month (or covered by job)?

Palmer has a couple of volunteers now tallying the results, which keep coming in (check the hashtag #insurancepoll).

Many of Palmer’s followers live in Germany, the UK or France and are baffled by the stories on Palmer’s blog about the cracks in the American health care system.

In Massachusetts, Read the rest of this entry →