Cartoon – 15 Minutes of Healthcare Coverage
Tag Archives: Health Insurance Coverage
Cartoon – What I can sell You
WHY IT MATTERS: Health Care
http://bigstory.ap.org/article/a6c6a83bd9f7435ca6f79423f1240c4d/why-it-matters-health-care
About 9 in 10 Americans now have health insurance, more than at any time in history. But progress is incomplete, and the future far from certain. Millions remain uninsured. Quality is still uneven. Costs are high and trending up again. Medicare’s insolvency is two years closer, now projected in 2028. Every family has a stake.
Patients from all over the world come to America for treatment. U.S. research keeps expanding humanity’s ability to confront disease. But the U.S. still spends far more than any advanced country, and its people are not much healthier.
Obama’s progress reducing the number of uninsured may be reaching its limits. Premiums are expected to rise sharply in many communities for people covered by his namesake law, raising concerns about the future.
The health care overhaul did not solve the nation’s longstanding problem with costs. Total health spending is picking up again, underscoring that the system is financially unsustainable over the long run. Employers keep shifting costs to workers and their families.
No one can be denied coverage anymore because of a pre-existing condition, but high costs are still a barrier to access for many, including insured people facing high deductibles and copayments. Prescription drug prices — even for some generics — are another major worry.
The election offers a choice between a candidate of continuity — Clinton — and a Republican who seems to have some core beliefs about health care, but lacks a coherent plan.
If the presidential candidates do not engage the nation in debating the future of health care, it still matters.
Transgender bias case against Dignity Health could set off religious freedom clash
Dignity Health has answered a federal discrimination lawsuit filed by a transgender nurse by arguing that civil rights law does not require its self-insured employer health plan to cover gender reassignment-related care. It says Title VII of the Civil Rights Act does not cover transgender status as a protected classification.
The San Francisco-based hospital chain also argued last month in response to the closely watched suit—one of the first of its kind in the country—that HHS’ May rule barring categorical exclusion of coverage for gender transition services does not take effect until Jan. 1, 2017. Prior to that, it argues, federal law does not require an employer to provide health coverage for “sex transformation” treatment.
In addition, the new federal anti-bias rule does not bar self-insured employer health plans from excluding benefits for services that are not medically necessary, according to Dignity’s motion for dismissal. It said “the medical efficacy of sex transformation surgery remains the subject of debate.”
But lawyers for the American Civil Liberties Union who are representing nurse Josef Robinson say both Title VII and the new HHS rule interpreting Section 1557of the Affordable Care Act clearly require employers and health plans to cover treatment related to gender dysphoria. That’s the name for the condition where people feel they are not the gender they were assigned at birth.
Legal experts expect more such lawsuits following HHS’ issuance of the anti-bias rule in May.
Doctors Get Innovative To Escape Insurer-Driven ‘Hamster Wheel’ Model Of Care
She’s one of a growing number of doctors who have cut loose from what she calls the “assembly-line, volume approach” and is now using a health care delivery model called direct primary care. She has scaled back the number of patients she sees and takes longer with the ones she does. She doesn’t take insurance and deals mostly in cash; she charges each time she sees a patient, but most direct primary care doctors charge a monthly fee for unlimited visits. In her previous practice, (Lorraine) Page says, the pressure to see more patients in less time wore her down, as did the need for an army of support staff to process the copious paperwork required by insurance companies.
Worthwhile California initiative
At a time when health care spending seems only to go up, an initiative in California has slashed the prices of many common procedures.
The California Public Employees’ Retirement System (Calpers) started paying hospitals differently for 450,000 of its members beginning in 2011. It set a maximum contribution it would make toward what a hospital was paid for knee and hip replacement surgery,colonoscopies,cataract removal surgery and several other elective procedures. Under the new approach, called reference pricing, patients who wished to get a procedure at a higher-priced hospital paid the difference themselves.
Faces of the Newly Insured
Healthcare Coverage Reform Proposals
Mortgages For Expensive Health Care? Some Experts Think It Can Work
A Massachusetts Institute of Technology economist and Harvard oncologist have a proposal to get highly effective but prohibitively expensive drugs into consumers’ hands: health care installment loans.
Writing last month in the journal Science Translational Medicine, the authors liken drug loans to mortgages, noting that both can enable consumers to buy big-ticket items requiring a hefty up-front payment that they could not otherwise afford.
Some consumer advocates and health insurance experts see it differently.
“Isn’t this why we have health insurance?” asked Mark Rukavina, a Boston-based health care consultant whose work has focused on affordability and medical debt. “Insurance used to protect people from financial ruin for these unpredictable, costly occurrences. Now, with large deductibles, we’ve got coverage for preventive care but not for treatment.”
Andrew Lo, a financial economist at MIT’s Sloan School of Management, and Dr. David Weinstock, an oncologist at the Harvard-affiliated Dana-Farber Cancer Institute, agree that insurance would be a better option. But for many consumers that isn’t enough protection these days.
Cartoon – Employee Healthcare Plan Choice
HENRY KOTULA 