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Don't fall for an Obamacare scam!
Fraudsters are trying to cash in on the fact that there is still mass confusion about health reform. State insurance regulators are warning consumers that scam artists are trying to sell fake "Obamacare" policies door-to-door. They try to create a sense of urgency by telling you that there is a limited enrollment period and coverage is required by law. Another red flag to watch out for is if the "agent" can't explain what is covered by the policy. Don't sign before you check out the company with your state insurance commissioner. The National Association of Insurance Commissioners has additional guidance - click here for more information.
Some insurers start coverage early for young invincibles
One feature of the health reform law that's likely to be popular is coverage for "young invincibles" - young people who are no longer full-time students and don't have health insurance. In many cases, the reason they don't have insurance is not that they think they're invincible - but that they don't have easy access to affordable coverage. The health reform law would allow them to remain on their parents' insurance until 26. However, that won't be in effect until fall.
Meanwhile, some insurers are getting on the bandwagon early. The list now includes Blue Cross/Blue Shield, Humana, Kaiser, Wellpoint and United.
Online Heart Assessments Reach Out to At Risk Patients
Part of the trend in lowering health care costs through preventative medicine is offering subsidized or free screenings for major health issues. One organization steps further and offers a simple, user-friendly online risk assessment that links patients at risk for cardiovascular disease to these screenings at their local hospitals.
HeartAware Network (www.heartaware.com) sponsors this user-friendly preventative method, helping interested hospitals set up and run the program on their web sites in exchange for a monthly fee. Since its creation just five years ago, 85 hospitals have signed on and 600,000 have taken the risk assessment[1].
The basic model asks fifteen simple questions based on known major cardiovascular risk factors such as blood pressure, weight and family history. HeartAware also allows hospitals to add additional questions for such purposes as region-specific factors or for data use in studies. Despite this, the complete information from individual tests is sealed tight and only disclosed to doctors or screeners connected to a patient’s care. After a patient completes the questionnaire, the results arrive within minutes. If a patient has several risk factors, the patient is advised to receive a free cardiovascular screening through the hospital[2].
The idea behind this program just expands on the abstract understanding that when patients are more knowledgeable about their health and about what causes health problems, they are more able and likely to take active steps to staying healthy. The free screenings introduce patients to doctors who can decode their medical information and offer steps to keeping illness at bay. Most crucially, they get high-risk patients in the door to begin receiving treatment before their circumstances become more deadly and they are racked with paralyzing emergency room costs.
There are some who are opposed to this new option. They claim it encourages patients to buy into unnecessary services, citing that along with the free screening, hospitals sometimes recommend heart scans that are not covered under the program[3].
But while primary care is as important as specialized screening and can often give the same degree of education, an online test is an easy way to get the most at-risk patients care quickly. Also, only 20,000 of patients who took the assessment were determined to be at-risk, meaning that the other several hundred-thousand were not offered the free assessment and not recommended to come in at all[4].
Some hospitals have even partnered with insurance companies in which hospitals receive reimbursements for policyholders using HeartAware. HeartAware Network plans to build similar online screenings for other health issues such as various forms of cancer, with similar connected hospital screenings. This is just one step to getting Americans back in control of their health, and consequently in control of their health care costs by keeping sickness at bay.
[1] Johnson, Cynthia. "Change of Heart: Online Assessment Reaches Patients Before They Enter ER." Health Leaders Media. 28 Sept. 2009. Web. 30 Sept. 2009. .
[2] Ibid.
[3] Ibid.
[4] Ibid.
Employer Insurance Contributions Declining, Raises Tough Questions for Employees
It should come as no surprise that the frantic behavior on Capitol Hill on health care points to looming issues and big changes in the realm of health insurance. More and more statistics are pointing towards the rising costs of health care, and how even average Americans with existing employer-sponsored packages are being impacted.
The Milliman Medical Index reports that in 2008, employees paid 24% of their health care coverage through regular contributions and 17% in staggering out-of-pocket expenses, totaling 41%. Even worse, the report predicts that in 2009, employees will have paid 15% more than that in premiums and deductibles and 5% more in out-of-pocket expenses[1].
Fears tied to these facts rise for both employees and employers alike. The Centers for Disease Control and Prevention report that only 65% of nonelderly Americans had private health insurance in 2008 – a two point drop from 2007. That compares to just about two decades ago when 80% were covered under private insurance – and should costs rise as expected in the coming few years, some are predicting that number to continue to freefall[2].
For many employees, paying even higher costs for health care is too great a burden. Some worry that should the current health care system be allowed to continue, more and more Americans will drop coverage completely to balance costs, but even if they don’t, major life changes will have to occur. Many have already stopped taking medication or going to regular doctor’s visits because of high costs, which could be just as dangerous. Whether the system completely plummets or maintains this steady decline, the future would be a sick, weak working population.
Many employers see few options besides cutting benefits and raising employee contributions in order for businesses to stay alive. However, some are beginning to invest in their employees’ health as a means of cutting costs. Many companies offer lowered premiums for employees who participate in wellness activities like regular exercise or groups to quit smoking, as well as having regular risk assessments and disease screenings[3]. The hope is that if employees can stay healthier overall and catch illnesses earlier, costs will be lowered. The same idea is present in Senator Max Baucus’s overhaul bill.
Beyond added programs, the competition to private insurance agencies and coverage for the uninsured, the current health care overhaul bills offer piece of mind to those already with insurance. Even if costs stay the same with a government program, the health exchange would inform consumers on all options, allowing all to find programs suited to their needs. It is also possible that health care costs could turn for the worse, in which case a government option would provide a landing net for those in need. But even not considering the benefits of a government option, consumers must recognize that things are not all well with health care, even for those with coverage, and change is already happening.
[1] Masterson, Les. "Health Plans: At the Tipping Point?" Health Leaders Media. 22 Sept. 2009. Web. 24 Sept. 2009. .
[2] Ibid.
[3] Ibid.
Kaiser Report Reveals Future Rise in Out-of-Pocket Expenses for Employees
The hordes of protestors terrified that a health care overhaul would dismantle their employer-sponsored health insurance are about to be silenced. With the economic downturn making everything – not just health care – more expensive for businesses, many employees are about to see their out-of-pocket expenses soar.
Of the 2,000 private and public sector employers surveyed by the Kaiser Family Foundation and the Health Research & Educational Trust, 41% say they are somewhat or very likely to ask require employees to contribute more for insurance packages, with many specifying higher copays and deductibles for doctor visits and prescription drugs. As a whole, 9% claim they will tighten eligibility for coverage and 8% say they will cut coverage completely. In a separate survey from Mercer consulting firm, nearly two-thirds of employers surveyed say they will raise out-of-pocket costs. Tying this up, a leading business lobby believes that annual health care costs for businesses will rise by 166% in just ten years if changes are not made to the system[1]. Already costs for family coverage are up to $13,375, the Kaiser survey finds, with employees paying roughly a quarter of that cost. The staggering rise of 5% in family premiums follows a drop in inflation and only a 3.1% rise in wages[2]. This hints at several different explanations for the increase beyond the simple solution of insurance company greed. Some companies may be raising these costs to help cover losses due to the economy. While many companies report planning to implement cost-cutting strategies like wellness incentives and health assessments, in the Kaiser survey, 21% of employers surveyed have already reduced benefits and 15% have raised premiums[3]. This shows that it is not only outrage against the existing insurance industry that drives the overhaul. There is some fundamental frailty in the system of employer-sponsored health insurance as well as the corporate greed that stems from insurance companies. Both have benefitted some in the past, but they cannot be the only sources that people rely on when it comes to staying well.
[1] Hilzenrath, David S. "Many Employers to Raise Cost of Health Benefits, Survey Finds." The Washington Post 16 Sept. 2009, Business sec. The Washington Post. 16 Sept. 2009. Web. 18 Sept. 2009. .
[2] The Kaiser Family Foundation. Costs/Insurance. Family Health Premiums Reach $13,375 Annually in 2009 Up 5 Percent as Inflation Fell Nearly 1 Percent. Www.kff.org. 15 Sept. 2009. Web. 18 Sept. 2009. .
[3] Ibid.