Letter: A Health Care Opportunity

Here's a Letter to the Editor to the Corvallis Gazette-Times by MVHCA Vice-Chair Tim Roach

December 01, 2015 5:00 am

Our nation's largest health insurer — UnitedHealth — is seriously considering pulling out of Obamacare as early as 2017 (BloombergBusiness, Nov. 19). The insurer has lost millions and anticipates losses of $500 million in 2016. The word is Anthem and Aetna are in a similar circumstance.

What happened? Insurers agreed to cover 10 categories of health care benefits; accept higher cost individuals; limit excess administrative costs and profits, and submit premium increases to insurance regulators for public scrutiny.

Thus the Affordable Care Act was crafted to keep premiums down and require greater cost sharing by patients. Government subsidies were provided to assist lower-income individuals. And when that was still not enough, insurers leveraged narrow provider networks to contract for cheaper medical services, and increased deductibles, shifting more of the costs to patients.

Guess what? It isn’t working — for insurers or patients! Congress created an administratively complex system that has made it almost impossible for insurers to offer a product that meets the required basic plan and has affordable premiums. Additionally, the combination of premiums and deductibles are pricing many patients out of health care. So now insurers are beginning to back out!

Well, that’s fine, because it offers the opportunity of replacing for-profit insurers with a financing plan designed for patient care, as is the case in almost all other developed countries around the world. A well-designed, publicly funded health care program would restore choices and make health care available to everyone. Health Care for ALL!


You can help MVHCA as we work for publicly funded universal health care like the rest of the developed world by donatinghosting a house party, signing up for the newsletter, and attending our monthly meetings. You can also Like us on Facebook, and Follow us on Twitter. Thank you.

Video: This Won't Hurt a Bit

Watch this informative/funny/tragic video by Mary Harron from the We The Economy channel on YouTube. It packs a lot of information into an entertaining video. Please share with your friends, neighbors, family, co-workers, and anyone else you can think of!

THIS WON'T HURT A BIT! | Mary Harron CHECK US OUT: http://www.wetheeconomy.com Why is healthcare so expensive? "This Won't Hurt a Bit" is a short film that tells the all too familiar tale of American healthcare. A patient enters a hospital with a migraine headache, unaware of the costs his visit will incur on the path to a diagnosis.

You can help MVHCA as we work for publicly funded universal health care like the rest of the developed world by donatinghosting a house party, signing up for the newsletter, and attending our monthly meetings. You can also Like us on Facebook, and Follow us on Twitter. Thank you.

This U.S. doctor is moving to Canada. Find out why.

This story of a U.S physician, Emily Queenan, moving to Canada so that she could care for patients without spending most of her time fighting with private insurance gives the flip side of the argument that if a universal publicly funded system is adopted in Oregon the physicians will flee to other states. Many physicians want to care for their patients without fighting insurance.

You can help MVHCA as we work for single payer health care by donatinghosting a house party, signing up for the newsletter, and attending our monthly meetings. You can also Like us on Facebook, and Follow us on Twitter. Thank you.

Here's the story as published in the blog of Kevin Pho MD:

I’m a U.S. family physician who has decided to relocate to Canada. The hassles of working in the dysfunctional health care “system” in the U.S. have simply become too intense.

I’m not alone. According to a physician recruiter in Windsor, Ont., over the past decade more than 100 U.S. doctors have relocated to her city alone. More generally, the Canadian Institute for Health Information reports that Canada has been gaining more physicians from international migration than it’s been losing.

Like many of my U.S. counterparts, I’m moving to Canada because I’m tired of doing daily battle with the same adversary that my patients face – the private health insurance industry, with its frequent errors in processing claims (the American Medical Association reports that one of every 14 claims submitted to commercial insurers are paid incorrectly); outright denials of payment (about one to five percent); and costly paperwork that consumes about 16 percent of physicians’ working time, according to a recent journal study.

I’ve also witnessed the painful and continual shifting of medical costs onto my patients’ shoulders through rising co-payments, deductibles, and other out-of-pocket expenses. According to a survey conducted by the Commonwealth Fund, 66 million — 36 percent of Americans — reported delaying or forgoing needed medical care in 2014 due to cost.

My story is relatively brief. Six years ago, shortly after completing my residency in Rochester, New York, I opened a solo family medicine practice in what had become my adopted hometown.

I had a vision of cultivating a practice where patients felt heard and cared for, and where I could provide full-spectrum family medicine care, including obstetrical care. My practice embraced the principles of patient-centered collaborative care. It employed the latest in 21st-century technology.

I loved my work and my patients. But after five years of constant fighting with multiple private insurance companies in order to get paid, I ultimately made the heart-wrenching decision to close my practice down. The emotional stress was too great.

My spirit was being crushed. It broke my heart to have to pressure my patients to pay the bills their insurance companies said they owed. Private insurance never covers the whole bill and doesn’t kick in until patients have first paid down the deductible. For some, this means paying thousands of dollars out-of-pocket before insurance ever pays a penny. But because I had my own business to keep solvent, I was forced to pursue the balance owed.

Doctors deal with this conundrum in different ways. A recent New York Times article described how an increasing number of physicians are turning away from independent practice to join large employer groups (often owned by hospital systems) in order to be shielded from this side of our system. About 60 percent of family physicians are now salaried employees rather than independent practitioners.

That was a temptation for me, too. But too often I’ve seen in these large, corporate physician practices that the personal relationship between doctor and patient gets lost. Both are reduced to mere cogs in the machine of what the late Dr. Arnold Relman, former editor of The New England Journal of Medicine, called the medical-industrial complex in the U.S.

So I looked for alternatives. I spoke with other physicians, both inside and outside my specialty. We invariably ended up talking about the tumultuous time that the U.S. health care system is in — and the challenges physicians face in trying to achieve the twin goals of improved medical outcomes and reduced cost.

The rub, of course, is that we’re working in a fragmented, broken system where powerful, moneyed corporate interests thrive on this fragmentation, finding it easy to drive up costs and outmaneuver patients and doctors alike. And having multiple payers, each with their own rules, also drives up unnecessary administrative costs — about $375 billion in waste annually, according to another recent journal study.

I knew that Canada had largely resolved the problem of delivering affordable, universal care by establishing a publicly financed single-payer system. I also knew that Canada’s system operates much more efficiently than the U.S. system, as outlined in a landmark paper in The New England Journal of Medicine. So I decided to look at Canadian health care more closely.

I liked what I saw. I realized that I did not have to sacrifice my family medicine career because of the dysfunctional system on our side of the border.

In conversations with my husband, we decided we’d be willing to relocate our family so I could pursue the career in medicine that I love. I’ll be starting and growing my own practice in Penetanguishene on the tip of Georgian Bay this autumn.

I’m excited about resuming my practice, this time in a context that is not subject to the vagaries of backroom deals between moneyed, vested interests. I’m looking forward to being part of a larger system that values caring for the health of individuals, families and communities as a common good — where health care is valued as a human right.

I hope the U.S. will get there some day. I believe it will. Perhaps our neighbor to the north will help us find our way.

Emily S. Queenan is a family physician. This article originally appeared in Evidence Network.

Post the Price, Please

OSPIRG Report. Two bills claim to make health care prices transparent. Only one does. Here’s why.

The Oregon State Legislature is poised to debate the merits of two pieces of legislation with very different approaches to making health care prices more transparent and publicly available for consumers. Senate Bill 891 would require Oregon health care facilities to post their own prices publicly, like other businesses, and provide real-time price estimates on request. Senate Bill 900 would require the state to set up a website with aggregated data about average amounts collected by Oregon hospitals for the most common health care procedures.

While these bills may appear to be aimed at accomplishing the same ends, the differences are profound. Here are the key differences in a nutshell:

SB 891 would provide consumers with accurate, actionable information about prices that would be included in a bill. SB 900 would not.

Health insurance plans with deductibles and coinsurance have become more popular in part because they are perceived as giving consumers “skin in the game” and giving them more responsibility to control their own health care costs. However, it is impossible for consumers to use this responsibility without ready access to negotiated prices.

That’s because consumers are often required to pay all or part of the price that their insurer pays for health care services they use. This number is called the “allowed amount,” but will be referred to as “the price” in this paper. The price is negotiated between health care payers and providers, can vary widely between different insurers, and traditionally has been kept secret from consumers.

SB 891 would require health care facilities to post these prices publicly, both online and at the facility, broken down by each of the top health care payers in the state. In contrast, SB 900 would require the government to aggregate historical claims data from commercial insurers and government programs. Since the price for a procedure can vary widely between different insurers, the aggregate number would not be actionable for a consumer.

Even the leader of Oregon’s hospital trade group admits this. From the Salem Statesman Journal (3/16/2015):

“Andy Davidson, president and CEO of Oregon Association of Hospitals and Health Systems, admitted the database might be more of an educational and awareness tool rather than something to plan personal finances around.”[i]

One defense of keeping prices a secret is that the actual portion of the price that a consumer will pay will vary depending on the details of their insurance plan, and thus the price isn’t meaningful for consumers. However, this ignores the fact that our private insurance system makes it necessary for consumers to do some math in order to calculate their out-of-pocket obligation. That’s the reality of ensuring that consumers have “skin in the game”.

The data provided by SB 900 would not be completely meaningless. It would have some uses, including providing policymakers and the public with some information about average price variations across Oregon hospitals. But it would not provide an accurate price signal to Oregon consumers – and that’s what our goal should be.

SB 891 would enable the creation of consumer-friendly tools and shopping guides that would help Oregonians shop around and identify high-value health care. The impact of SB 900 would be much more limited.

The online price postings included in SB 891 would be required to adopt a consistent machine-readable format. This detail is important because it would empower outside organizations and companies to make the data more useful for consumers via the development of apps and web tools, as well as shopping guides like those produced by Consumer Reports.

The success of health care price transparency services like Castlight Health and HealthSparq demonstrates that there is a market for this data. The business model of these organizations is currently based on developing proprietary contractual arrangements with insurers and large employers, but with broader public access to data, these innovative companies could create tools for a broader audience that could enable more informed consumerism in health care. They could also explore combining the data from the price posting required by SB 891 with existing public data on health care quality to help consumers make decisions about value, not just cost.

SB 900 would not enable the development of this kind of tool. The data posted to the OHA website could be used to inform consumers about average price variations between hospitals, but this kind of information is of limited use to consumers on a limited budget who need to know the actual cost of services in advance.

SB 891 would enable consumers to request an actionable estimate in real time, at the point of service. SB 900 does not include any provisions to this effect.

SB 891 would require health care facilities to provide an estimate upon request without unreasonable delay, in a timely enough fashion to enable consumers to make an informed decision about whether to access a health care service.

This estimate would include both the posted price for the service and any ancillary charges that might be included in a bill, including facility fees and out-of-network fees. With consumers increasingly aware of the danger of receiving surprise bills when out-of-network providers participate in procedures in in-network facilities, this provision will be especially important.

SB 900 does not include a provision for in-person estimates. The Oregon Association of Hospitals and Health Systems has recently stated that their membership has volunteered to provide price estimates on request to uninsured and self-pay patients, but this is not included in the bill.[ii] This voluntary agreement does not appear to extend to providing estimates to insured patients, even if they may face thousands of dollars in out-of-pocket costs in deductibles and coinsurance.

SB 900 requires the state to engage in a complex IT project, at significant cost to Oregon taxpayers. SB 891 puts the responsibility on health care facilities themselves to post their prices, like other businesses.

Unlike SB 900, SB 891 will not require the state government to spend additional funds to implement its requirements. Under SB 891, the role of the state is limited to defining a standard format for health care facilities to use to post their prices, and enforcing these requirements through its existing licensure program.

Some health care industry interests have expressed concern that SB 891 will create an administrative burden. While it is true that posting prices will require health care facilities to change their current practices, these changes simply hold health care providers to the same standard as any other business, and are quite reasonable to expect given the consumer need for actionable price information.

Moreover, hospitals and other facilities already have staff and resources devoted to billing and managing reimbursement rates; SB 891 simply requires that those activities are made more public and transparent for patients.

Regardless of the merits of spending taxpayer funds to create the website outlined in SB 900, putting all of the responsibility on Oregon’s state government to provide health care price data to consumers could appear to absolve the health care industry of their responsibility to make their prices available to their customers, like other businesses.

SB 891 would strengthen the doctor-patient relationship and begin a needed transformation of the practice of medicine.

Today, physicians are often unable to have frank conversations with their patients about the costs and benefits of health care services.

This poses a key obstacle for physicians who want to treat the whole person, not just the medical condition. It can also lead to mistrust, and can sometimes cause patients to forgo needed care out of concerns about cost that could be alleviated with greater access to information. 

It is also a missed opportunity to lower the cost of care. Recent research indicates that making prices available for individual procedures can bring down costs by encouraging active consumerism and fostering price competition.[iii]

SB 900 will not represent a significant step in this direction. While physicians could potentially use the OHA data to provide their patients with advice about which hospitals are generally more expensive, this information would not necessarily be enough to inform an individual patient about where to go to get the best value.

SB 891 applies to all health care facilities; SB 900 only applies to hospitals and hospital outpatient clinics.

Hospitals are not the only provider of expensive health care services. Ambulatory surgery centers, independent imaging centers and other non-hospital clinics are key health care providers for many Oregonians, and their prices may vary significantly from hospital prices. SB 891 would enable Oregonians to make a better-informed decision about whether a hospital or another kind of health care facility would be the best place to receive the care they need. SB 900 would not provide this information.

Released by: OSPIRG

Release date: Wednesday, March 25, 2015

> Read News Release

> Download Report (PDF

Notes:

[i] The Statesman-Journal’s full coverage is available at http://www.statesmanjournal.com/story/news/health/2015/03/17/two-oregon-bills-target-health-care-cost-transparency/24898103/

[ii] For more on this voluntary agreement, read the Bend Bulletin’s coverage of the issue, available at http://www.bendbulletin.com/health/2965469-151/oregon-bills-seek-price-transparency-for-medical-services

[iii] E.g., a demonstration project showed that providing up-front prices for MRI scans increased use of less costly providers and encouraged price competition. The study is available at http://content.healthaffairs.org/content/33/8/1391.abstract

Krugman: Government Does Health Insurance Better

The New York Times
April 10, 2015
Where Government Excels
By Paul Krugman

Like all advanced nations, America mainly relies on private markets and
private initiatives to provide its citizens with the things they want and
need, and hardly anyone in our political discourse would propose changing
that. The days when it sounded like a good idea to have the government
directly run large parts of the economy are long past.

Yet we also know that some things more or less must be done by government.
Every economics textbooks talks about “public goods” like national defense
and air traffic control that can’t be made available to anyone without
being made available to everyone, and which profit-seeking firms,
therefore, have no incentive to provide. But are public goods the only area
where the government outperforms the private sector? By no means.

One classic example of government doing it better is health insurance. Yes,
conservatives constantly agitate for more privatization — in particular,
they want to convert Medicare into nothing more than vouchers for the
purchase of private insurance — but all the evidence says this would move
us in precisely the wrong direction. Medicare and Medicaid are
substantially cheaper and more efficient than private insurance; they even
involve less bureaucracy. Internationally, the American health system is
unique in the extent to which it relies on the private sector, and it’s
also unique in its incredible inefficiency and high costs.

And there’s another major example of government superiority: providing retirement security... (more here).

Krugman1.jpg


Comment by Don McCanne of PNHP

Next week, when the Senate returns from its break, they will likely approve
House-passed H.R.2 - the “SGR fix” - a bill that is being used as a vehicle
to move Medicare closer to privatization by taking small incremental steps
in increasing Medicare premiums and deductibles - features that are more
characteristic of private individual plans than public social insurance
programs.

Paul Krugman reminds us that governments are better at providing health
insurance. So we should reject the current bipartisan efforts that are
moving us further in the direction of converting Medicare from a public
insurance program into a premium support model (defined contribution
vouchers) of a market of private health plans.

This week’s taxpayer boost given by the Obama administration to the private
Medicare Advantage plans - the fourth such devious boost in the past four
years - enhances the private plans to set them up as a model for privatized
Medicare. Is there no stopping this?

Help MVHCA as we work for Improved Medicare for All by donatinghosting a house party, signing up for the newsletter, and attending our monthly meetings. You can also Like us on Facebook, and Follow us on Twitter. Thank you.



Information About Signing up for Health Insurance, and Renewing OHP

From the Community Partner Outreach Team, here are some tips to help with your application:

HEALTHCARE.GOV
On the question on HealthCare.gov application about current health coverage, when you fill out an application on HealthCare.gov, one of the questions asks you about your current health coverage. This only refers to private insurance. It does not refer to the Oregon Health Plan
or Healthy Kids. Please put "no" if the only insurance you have is OHP or Healthy Kids. Answering
 "yes" may result in an incorrect eligibility determination.

OHP REMINDER LETTERS

Many OHP members will received or have received a letter reminding them to renew their coverage. Waves of notices were sent to fast-track individuals on Friday, December 12, reminding Oregon Health Plan members to renew their coverage. Please note: Due to the need  to get reminder notices out as soon as possible, the Oregon Health Authority was unable to match renewals already submitted for processing with the reminder mailing list. Therefore, members who have already responded to their initial renewal letter may receive a reminder notice. If they have submitted their application, they have done what they need to do, and their benefits will continue while OHA processes their  application. These members do not need to call Customer Service.

OHP RENEWALS
OHP members will remain covered through January 31, 2015 while their renewal applications
are processed. Members should still submit their renewal applications as soon as  possible. Right now, and through the end of the year, many Oregon Health Plan  members are scheduled to renew their coverage. This means that there is an extremely large number of paper and online renewal applications still being processed for the months of November and December. Not all renewal applications can be processed by the time many members are scheduled to lose their OHP coverage on December 31. This may cause a disruption in a member's care and is counter to our goals of ensuring people have coordinated and continuous care. Therefore, to ensure that members can continue to access care while their renewal applications are processed, their coverage will continue through January 31, 2015.
If they are part of a coordinated care organization, their CCO enrollment will also
continue through January 2015.

* Anyone who received an expedited or full application renewal letter and has not
already taken action should do so immediately so there is no gap in coverage. Members
should follow the directions in their letter for the best way to renew by the end
of the year. OHA will notify them once their application has been processed.

* Members who already submitted a renewal application do not need to call OHP Customer
Service. They will process their application as soon as possible. Their benefits will
remain open while their application is processed. OHA will send them a letter after
we process their renewal application.

NOTE: Not all fast-track members will have their coverage continue. Some fast-track members will still lose benefits on December 31, 2014.
* Fast-track members who already submitted a renewal application and who no longer
qualify for OHP coverage
* People in the MAGI Adult program, and who are also receiving Medicare, per federal
requirements.

DECEMBER 15 DEADLINE EXCEPTION
Exceptions to the December 15 deadline to enroll in a Qualified Health Plan through
HealthCare.gov:
People who are closed or denied OHP have until the end of the month to choose a
Qualified Health Plan that starts on the first of the next month. This is because
they lost their "Minimal Essential Coverage".

Some callers tried to reach HealthCare.gov by phone on December 15 and were given
the option to leave a message due to the high call volume. When these applicants
 get a call back from HealthCare.gov customer service, they will be able to enroll
in a plan effective January 1, 2015.

PROCESSING TIMES
Expect full 45-day processing for applications

As we mentioned above, many Oregon Health Plan members are renewing their coverage.
Due to the volume of applications being submitted, it is appropriate to expect a
 full 45 days for processing. This includes the online PDF or the paper application.
Please keep this in mind as you consider follow up.

More information at Healthcare.gov, Oregon Health Authority, or your county Health Department.

 

 


 

 

 

 

Female Workforce Pays More for Health Benefits

Behind in Pay, Behind in Benefits

By Beth Umland
Mercer, October 17, 2014

It’s well known that working women earn less money than their male counterparts, but they may also be at a disadvantage when it comes to health benefits.

Pay and benefits tend to go hand in hand. The health benefits at organizations with predominantly female workforces are also less generous than in those with predominantly male workforces. Because women generally use health services more than men, the disparity in benefit levels has an even greater financial impact. Women use maternity services, and childbirth, the leading cause of hospitalization in the US, accounts for a quarter of all hospital stays. We found that average employee contributions as a monthly dollar amount are higher in mostly female companies: For coverage in a PPO, the most common type of medical plan, the monthly contribution for family coverage is 31% higher. In addition, average in-network and out-of-network deductibles and out-of-pocket maximums are consistently higher. For example, the average in-network PPO deductibles in mostly female companies are $727 and $1,614, respectively, for individual and family coverage, compared to $557 and $1,318 at mostly male companies. Full article here.

Comment By Don McCanne, MD, Physicians for a National Health Program

It's shameful. Although the Affordable Care Act (ACA) specifically prohibits discrimination based on sex, employers are still able to provide plans that are based on the underwriting characteristics of their employees. This Mercer report compares workforces that are over 65% female with those over 65% male and shows that females receive less generous health benefits - paying 31% more for deductibles and 31% more for the premium contribution for family coverage.

This is a direct result of the fact that ACA was designed to perpetuate employer-sponsored health plans. Had Congress enacted a single payer national health program instead, not only would sex-based underwriting have been eliminated, the financing of the entire health care system would have been changed to an equitable system based strictly on ability to pay.

Female workforces are paid about $10,000 less than male workforces. Under single payer, their share of health care financing would have been less than for males, since income taxes are progressive. For men who might think it is unfair that women should pay less in health care taxes, they could help fix that by supporting pay equity.

Watch the video of Economist Gerald Friedman's talk for more.


Report on Cover Oregon Consumer Advisory Committee

by Roberta Hall,  Oct. 17, 2014

Despite all the bad news about Cover Oregon, its CAC met Oct. 17, with new Executive Director Aaron Patnode in attendance throughout. As a final comment, he reported that there is NO option for any state NOT to have an exchange, though Cover Oregon likely will be housed under another agency. A brief update concerning 2015 and for details contact member Bobbi Hall at rlhall@peak.org:

Budget will be 12 to 15 million dollars, down from 90 million this year; expanded Medicaid enrollees who entered via Fast-Track (Food-Stamp recipients) will need to apply, but other current enrollees will be sent a form to certify that their financial situation has not changed (or has); most people will apply via Healthcare.gov; new OHP clients can enroll anytime as can tribal members and certain others, but for most, enrollment begins Nov. 15; Navigators as well as Agents are receiving training on the use of Healthcare.gov. This past year approximately 100 small businesses (with 2 to 50 employees) were enrolled; they did not use the website and again will enroll directly but the federal government has told Cover Oregon that internet access must be ready for these businesses before the end of 2015.

Main news is the numbers: Medicaid increased 58% this year, from 614,000 to 976,000; about 77,000 Oregonians enrolled in a Qualified Health Plan. Currently  about 1,694,657 people are in either OHP or Medicare, out of 3,961,514 people so that makes ~43% covered by what is primarily federally-paid health insurance. About 5.1% of the population now lack health insurance (down from 14%) while about 5.5% have private insurance and ~46.5% have group insurance (mostly through employers). Much insurance covers an average of 70% of health care costs, however. 

Cancer Survivors Struggle With Work, Money Problems

By Charles Bankhead, Staff Writer, MedPage Today

A third of cancer survivors reported financial or work-related hardships that persisted well beyond treatment of their disease, a survey of 1,600 survivors showed.

One in four (27%) survey participants reported high debt, bankruptcy, and other financial difficulties, and 37% of the patients said they had to modify work plans, which included extended periods of leave and delayed retirement.

Almost all of the patients reported lifestyle alterations resulting from cancer:

  • Reduced spending on leisure activities: 77%
  • Spending less on basics: 57%
  • Borrowing money: 54%
  • Spending savings: 50%
  • Sold possessions: 18%
  • Family worked more: 15%
    Full article here

Despite ObamaCare, US Health System Still a Complete Mess

In this recent article in the Daily Beast by Molly Worthen, the author writes about how difficult it is to find out what medical procedures will cost and how much insurance will pay. She makes the point that single payer health care would be a much simpler system.

“How can we tell how much we’ll have to pay in total, assuming it’s a routine birth?” my husband asked.

“Oh, I couldn’t tell you that,” Tami said. Despite churning through droves of pregnant patients each year—many of whom are, like me, insured by the Blue Cross Blue Shield state employee plan—she had no information on what anything would ultimately cost. “Call your insurance company,” Tami said.

This is the evil genius of the American insurance system. No one has any information, and no one is responsible. I was reminded of the opening scene in Franz Kafka’s The Trial, when the officials who rouse Josef K. from bed to arrest him on an unexplained charge tell him they have no idea why he is under arrest: “We’re lowly employees who can barely make our way through such documents,” one says. 

All are part of the growing economy of people—all very nice people, I’m sure—who have college degrees in medical billing and coding, who make their living feeding the bureaucratic beast that cost consumers $200 billion in excess administrative fees in 2009. Much of that waste would vanish if the United States adopted a public single-payer system of the kind that most developed countries favor.

A truly free market requires all parties to have access to the same information—and the time and expertise to interpret that information. Healthcare, by contrast, is an economy of specialized goods that most lay people don’t fully understand, in which insurance companies and many healthcare providers have a vested interest in concealing prices from consumers. And I’m always surprised by how few doctors seem to know the cost of treatments they prescribe. The Affordable Care Act may be better than no reform at all, but the law subsidizes this broken private insurance system. It also adds over 10,000 pages of regulations to the already byzantine bureaucracy that makes American healthcare one of the least cost-efficient in the world—behind even Venezuela and Iran.

For more information about single payer health care, check out our FAQ page.

August Recess Letter Writing Opportunity

Community Catalyst, a co-grantee in MVHCA's Community Voices for Change grant has organized a letter to the editor contest called "August Recess Challenge." MVHCA has been invited to participate in the contest. We are encouraged to write op-eds and letters to the editor between now and September 5.

I

Ideas for topics include:

  • Helping consumers understand their insurance coverage through consumer assistance (health insurance literacy).

  • Personal stories about consumers benefiting from the ACA, e.g. getting covered, receiving prevention benefits, finding a Medical Loss Ratio (MLR) rebate in your mailbox, finally affording quality coverage.

  • Educating our communities about the importance of Children's Health Insurance Program (CHIP).

Entries will be evaluated using the following criteria:

  • Variety of issues covered.

  • Variety of messengers (Navigators and assisters, consumers, etc.).

  • Range of outlets - from traditional to online.

  • Geographic reach.

  • Use of social media to promote published letters.

  • Number of letters placed.

When you submit your letter, please report it to  this website so we can track and promote the letters on social media.

For more information and ideas, contact us and we can help.

Thank you for participating. Your letters and personal stories are a great way to reach out to the larger community.

 

The Illogic of Employer-Sponsored Health Insurance

Imagine yourself in a bar where a pickpocket takes money out of your wallet and with it buys you a glass of chardonnay. Although you would have preferred a pinot noir, you decide not to look that gift horse in the mouth and thank the stranger profusely for the kindness, assuming he paid for it. You might feel differently, of course, if you knew that you actually had paid for it yourself.

Persuaded by both theory and empirical research, most economists believe that employer-based health insurance is an analogue of this bar scene.

The argument is that the premiums ostensibly paid by employers to buy health insurance coverage for their employees are actually part of the employee’s total pay package – the price of labor, in economic parlance – and that the cost of that fringe benefit is recovered from employees through commensurate reductions in take-home pay.

Evidently the majority of Supreme Court justices who just ruled in Burwell v. Hobby Lobby case do not buy the economists’ theory. These justices seem to believe that the owners of “closely held” business firms buy health insurance for their employees out of the kindness of their hearts and with the owners’ money. On that belief, they accord these owners the right to impose some of their personal preferences – in this case their religious beliefs — on their employee’s health insurance.

Full Article here.