Archive for February, 2013

Healthy Young Adults Could See Insurance Soar

Wednesday, February 27th, 2013

There are a lot of Americans who should be helped when it comes to the new health care laws taking effect in 2014.  People with pre-existing conditions will have to be offered coverage from health insurance companies or will be able to find it in state run exchanges.  Older Americans who have often been charged up to five times the amount for their coverage as their younger counterparts cannot be charged more than three times more now.  And many Americans who simply didn’t think they could afford health insurance will likely be able to find better health quotes and be helped with government subsidies after the full law goes into effect.  But the youngest, healthiest Americans could possibly be hurt the most as their health insurance rises to make up for all of the others.  This information comes from N.C. Aizenman of The Washington Post’s article, “Young Adults Face Health Insurance Rate Scare.”

Insurance companies are worried that they will face a lot of criticism when rates rise, so they are trying to prepare by warning consumers about the “rate shock” that is to come.  They blame this on the fact that they will have to offer customers more comprehensive coverage, they have to offer plans to people who are already sick (ie have pre-existing conditions,) and they can’t charge the elderly sky high rates anymore.  While supporters of the law do understand this, they argue that using the term “rate shock” is just a scare tactic and point out the fact that government subsidies will help pay for part of people’s health insurance increases.  A lot of healthy people in their 20s purposefully have plans with less coverage, but will now be forced into carrying more comprehensive plans that will cost them more, whether they like it or not.  Rates are not likely to double for those with employer sponsored health plans, but individual and small group coverage rates could jump anywhere from 10% to more than 50%.

Can the Postal Service Run Its Own Health Insurance?

Tuesday, February 19th, 2013

The U.S. Postmaster General and the management team for the postal service strongly believe that they have the ability to run their own health insurance program.  By doing so, they say that they could save the struggling institution billions of dollars.  In Sean Reilly’s Federal Times article, “Health Insurance: What the Postal Service has in Mind,” he summarized a Senate hearing about the state of the postal service’s finances that took place last week.  Of course the big news at the hearing was that the post offices will no longer maintain their Saturday delivery service in an effort to cut costs.  But Postmaster General Pat Donahoe also stressed the importance of the post office leaving the Federal Employees Health Benefits Program.

Employees, retirees, and the federal government are skeptical that the post office can run its own health insurance program.  They believe that the Federal Employee health insurance program is successful and that employees and retirees are well cared for under the plan.  In contract talks with the National Association of Letter Carriers, no agreement could be reached regarding the implementation of a completely different health insurance plan, run solely by the post office itself.  The main reason for all of the dissent is that the Postmaster General hasn’t released any details about what this health insurance plan would look like and how much it would cost employees and retirees.

Mr. Donahoe says that the post office spends $0.20 of each dollar they receive simply to pay for the health insurance of their employees.  He argues that around $52 billion would be saved by the organization if they offer their own health insurance plan.  Some of the biggest savings would occur by having older employees and retirees switch to Medicare health insurance coverage.  With the government already worried about Medicare costs, I don’t know how this could positively affect them in any way.  Mr. Donahoe claims that the 1.1 million U.S. Postal Service employees and retirees would get as good or better health insurance for less expense.  I hope that is the case, but am skeptical that they could make this work when the federal government already offers a good plan with affordable costs.

Doctors Must Adapt to Health Care Reform

Wednesday, February 13th, 2013

Americans are divided on the good, the bad, and the ugly of our new healthcare reform laws.  One thing I don’t think many consumers have thought about is how these big changes are affecting doctors, especially those who run their own practice.  In the Med City News’ “Seven survival strategies for doctors in the new world of healthcare reform.”, John Mandrola M.D. introduces a guess posting by another doctor, Edward J. Schloss.  Dr. Jay Schloss gives us “Tips for survival in the new healthcare environment.”  He works at Cincinnati, Ohio’s Christ Hospital as the medical director of cardiac electrophysiology.

The first tip is to have good technology.  Dr. Schloss recommends having your own computer to take with you from the office to the hospital to your home.  You save time logging in and out and experience fewer crashes.  Since a lot of the job has become dealing with paperwork and computer tasks, having the most efficient way to do that will save time and headaches.  His next tip is to “minimize the BS”.  Make sure to follow regulations and minimize the risk of lawsuits, but don’t worry about doing all of the busywork perfectly.  Also, delegate some of said busywork to others.  He gives a great analogy as doctors being the quarterback of the medical team.  They can run the plays, but need good quality teammates to work with them.

I have to say that this one shocked me.  Dr. Schloss says that doctors should not bill for every little thing.  Be sure to provide the highest quality care and if you are just giving quick information to the patient and referring doctor, save the system some expense and don’t go through the long process of billing.  The next tip is to be a voice for change and not take all of these changes without speaking up.  Whether you use twitter, a personal blog, social media, or conversations with administrators; speak up for yourself and other doctors.

Many doctors are feeling like their patient care is losing its value and they are not feeling important.  Dr. Schloss says if this is the case, find another outlet for professional development.  Whether you work for a charity, do consulting work, start a research project, or organize a speaking engagement, it could help you feel more fulfilled.  Finally, he wants to ensure that doctors don’t lose sight of their patient care, even when administrators and regulators aren’t measuring what doctors know is important.  If you have to see fewer patients to maintain great care, then do it.  This is some great insight into challenges facing doctors with healthcare reform, when we often as consumers only see our own changes or difficulties.


45% of Health Insurance Applicants Denied in Montana

Wednesday, February 6th, 2013

In a recent study done by HealthPocket, they determined that 22% of people applying for health insurance coverage are denied.  This information comes from Fox Business’ article, “Health Insurance Application Denied? Here are 5 Options,” by Mark Chalon Smith.  Luckily for them, President Obama has made it mandatory for insurance companies to offer coverage to those with pre-existing conditions, so that number will be down to almost zero in 2014.  Until then, there are a few things you can do to try and get yourself or your entire family covered by health insurance.  Pre-existing conditions are the top reason why consumers are denied health insurance coverage.  Insurance companies worry that they will be taking on too much risk and will shell out too much money to cover those who are already sick.

Montana is by far the worst offender when it comes to denying health insurance applicants.  Close to 50% of those who apply are denied coverage.  Other states with more than 30% of applicants getting denials are Alabama, the District of Columbia, Arkansas, Alaska, and New Mexico.  One of the main reasons that these states have such high denial numbers is that they typically have fewer health insurers offering plans in their area, so there is less competition.  Individual insurers with the worst denial rates include John Alden Life Insurance Company in South Dakota, Time Insurance Company in Kentucky, and Assurant Health in Utah, North Dakota, and Idaho.  Assurant Health defends their denial rates by saying that they do offer some type of more expensive plan for consumers who were denied their plan of choice, so they weren’t denied altogether.

In New York and Massachusetts, the denial rate for health insurance applications is already zero because those states mandate coverage for people with pre-existing conditions.  If you don’t happen to live in those states though, there are a few ways to try and get health insurance after a denied application.  Try multiple insurers and be sure to ask if there is any plan for which you qualify, even if you were denied your first application.  States offer pre-existing conditions insurance plans (PCIP’s) which have to cover you, even though the rates will be high.  There are also high risk health insurance plans in 35 states that have to cover you, another option that could be costly.  Low income families can get government help through Medicaid or the State Children’s Health Insurance Program (SCHIP).  You can also try to join a professional group like a Chamber of Commerce or union to apply for their group coverage.  Keep in mind that it will all be temporary until coverage can no longer be denied in 2014.