Fixing Medicare

When ideas of healthcare reform began the question being asked was: Should we fix Medicare? With debates about the federal deficit swirling, the question has now become: How should we fix Medicare? The shift in positions and increase in urgency has come from the acknowledgement that Medicare is broken, and its costing the U.S. a ton of money.

It's easy to say we should fix Medicare; Actually figuring out how is a tad more difficult. As outlined in this New York Times article, President Obama's deficit reduction committee has considered a number of options. These options include (but are not limited to) :

1) Increasing the eligibility age for Medicare from 65 to 67
2) Requiring beneficiaries to pay higher premiums
3) Charging Co-payments for home health services
4) Paying doctors in "lump" amounts for entire treatments as opposed to paying for each step (tests, procedures) individually

The list goes on. For the complete range of options, check out the article. It's hard to say which option is best because all have pros and cons. For example, raising the eligibility age would save the government money for those two years, but those 65 and 66 year old patients might now be eligible for Medicaid. This just displaces the cost from Medicare to Medicaid.

Whichever solution is chosen, it will have to be supplemented with one thing: more efficient care. Changing the structure of Medicare will do nothing if health care is still administered in an inefficient way. This means, reducing medical errors, hospital infections, and administrative costs. More efficient care means cheaper care in the long run.

Fixing Medicare will probably require a pretty creative solution. What do you think is the best way to tackle this problem? Do you agree that any change needs to be supplemented with better health care? Will raising premiums do anything?

A Solution to Ignorance about the Affordable Care Act

One of my earlier posts titled Ignorance & Healthcare presented research from the Kaiser Family Foundation about America's knowledge about the health care reform. A new website was launched this week that intends to better educate Americans on the Affordable Care Act (health care reform). The site is www.healthcareandyou.org and it was developed by a coalition of health care advocacy groups including the American Medical Association and the American Nurses Association.

The great thing about the site is its simplicity. Gone is the political debate that often clouds the facts of the Affordable Care Act. The site delivers the facts about the law tailored to each individual person. Users are greeted by a simple map of the United States and a clean home page. Once a user selects their state, they are directed to a page that contains everything citizens in that state need to know about health care reform. Further, this page gives users the option to classify themselves as "Under 65," "Over 65," or as an "Owner of a Small Business." The site then provides tailored information based on which role you choose. No advertisements, No Political Messages....Just the facts.

A site like this should have been established the moment the Affordable Care Act became relevant; but better late than never. What do you think about the ease of this educational website? Do you think it will be effective in helping American's understand this important legislation? Please feel free to share any comments you have.

Giving in On Health Care Reform?

On Monday President Obama took a significant step back on his health care reform bill. President Obama said that he is willing to amend the law to allow individual states to  opt out of the most critical aspect of the law: the insurance mandate. Under this amendment, states would have the option of not mandating health insurance for all citizens, as long as it could create some other viable option for coverage. In order to be approved for this waiver, the state must meet two requirements:

  1) The state must create another plan that will cover as many citizens as the original health care bill would.
  2) This alternative plan cannot further increase the federal deficit.

If this amendment is passed, states that earn a waiver will still be given the same money by the government to support their new plan.

Although the original law allowed for waivers to be applied for in 2017, Obama's offer to move this date up to 2014 is a significant step back for health care reform. The most important aspect of the bill is being diluted.

Should states be allowed to opt out of this insurance mandate or was the original health care law the best idea? Is this a political move to curb skepticism of the health care reform bill?

Insurance on the open market? Good Luck.

The New York Times recently posted an op-ed article about the difficulty of purchasing health insurance in the individual market. If you have the time to read the whole story, I highly recommend it. It shows just how hard it is to purchase health insurance if you aren't receiving it from your employer. The family in the story is not poor, unemployed or in bad health. Yet the U.S. health insurance system is so twisted, that this family was denied coverage several times before finally attaining it.

Although frightening, the story shows what life is like for those who do not obtain employee based health insurance. This family had the means to fully pay for insurance and still could not get accepted. Imagine what life is like for those in poorer health who cannot afford insurance.

Some major issues this story raises:
1) U.S. reliance on employee sponsored health insurance
2) The difficulty of getting health insurance with "pre-existing conditions"

Is the U.S. relying too much on employee based insurance? Is it fair for people to be denied individual health insurance based on minor procedures and ailments? Should congress really be working to repeal the health care reform bill that protects against all of this? It really is a tough call...so let's get a discussion going. 

Ignorance and Healthcare

The Affordable Care Act (health care reform) has generated an overwhelming amount of controversy. Political insults have been traded all amidst rumors of socialism and "government death panels."

Everyone is a critic. But when we open our mouths to talk about health care reform do we know what we are talking about? It would appear that an alarming amount of people don't. A professor recently passed a report along to me from the Kaiser Family Foundation on America's knowledge of the health care reform bill. The report surveyed a nationally representative sample of 1,207 adults and asked them questions about the elements of the Affordable Care Act. Below I've attached a chart with the results of this study.

Notice the percentage of wrong answers to questions on some very important elements of the act. A staggering 40 percent of people surveyed actually believe the U.S. government has the ability to make end of life decisions for patients. 65 percent wrongfully believe that all U.S. businesses will be required to provide health care insurance to employees. These aren't numbers that can be brushed aside. The Affordable Care Act is one of the most significant pieces of legislation passed in years, and a good portion of the citizens it applies to have no idea what it says. 

 I am of the belief that everyone is entitled to an opinion, as long as its a rational one. Some good questions: Why do you think there is such a disconnect here? Whose job is it to educate the American public on such important legislation? Let's hear it.