Regarding our votes and our viewpoints as the election spin continues and remote statistics for every sort of criteria for measuring how our country is doing are tossed out by different public figures depending on their point of view, it is here argued that the MOST important question is whether individuals feel like they’re better off than four years ago.
That’s right, the most important question is how WE think things are going in our lives that public figures claim is subjective as they pat us on our ignorant heads and recite some statistic indicating that we’re “factually” wrong.
For healthcare. The Patient Protection and Affordable Care Act (PPACA). THERE ARE NO FACTUAL ARGUMENTS TO DEFEND OR ATTACK THE PPACA REGARDING WHETHER CITIZENS ARE BETTER OFF.
President Obama will tout it as a “success” (mostly because he got it passed not because of its usefulness for citizens or based on any actual experience of citizens or even regarding whether it will be upheld as constitutional) and Mitt Romney will argue it’s a failure (mostly because everything Obama did or failed to do is a failure in his eyes).
All announcements that put forth conclusions such as US life expectancy is up are based on data that is OLD. That lag time between our experience and statistics that reflect our experience is over one year. This is significant when it comes to arguing healthcare reform.
The Affordable Care Act turned two years old in March after becoming law in March of 2010. The most recent STATISTICS (those numbers that are crunched and twisted and thrown out as factoids to individuals regarding basic information about US health such as life expectancy and healthcare costs) are publishing conclusions based on data comparing year 2009 to year 2010.
At most these statistics have nine months of experience with the Affordable Care Act with many provisions of the Act not beginning until after the year 2010. A great timeline of what became effective and when is put out by HealthCare.gov (http://www.healthcare.gov/law/timeline/index.html).
While it’s taken over a year and closer to two to produce documents representing the old data, it is significant to note that the data is old.
Now regarding this old data, there are sources to verify what we hear. For instance, a “new” report from the Health Care Cost Institute, a nonprofit organization declares, “Rising prices for care were the chief driver of health care costs for privately insured Americans in 2010.” http://healthcostinstitute.org/news-and-events/press-release-2010-health-care-cost-and-utilization-report
Breaking down cost increases including +2.6 percent for physician visits, lab work and imaging to +11 percent for increased costs in emergency room costs for one year, 2009 to 2010 the report goes on to note that “USE [emphasis added] of health care services declined by more than 5 percent.” http://healthcostinstitute.org/news-and-events/press-release-2010-health-care-cost-and-utilization-report
So we’re told that fewer patients USED healthcare but costs of healthcare rose.
Why the frustration? Let’s see. In 2008 this blog advised, “Affordable access to quality health care...all three are necessary to address the health services crisis and without cost controls on premium increases and medical costs, consumers will continue to pay for a system that puts their needs last.” http://conoutofconsumer.blogspot.com/2008/05/high-deductible-health-insurance.html
It should be noted that life expectancy data from the Centers for Disease Control announce that life expectancy went up in 2010 based on its preliminary report by 0.1 of a year.
“The preliminary estimate of life expectancy at birth for the total population in 2010 is 78.7 years. This represents an increase in life expectancy of 0.1 year relative to 2009.” Murphy SL, Xu JQ, Kochanek KD. Deaths: Preliminary Date for 2010. National Vital Statistics Reports; vol 60 no. 4, Hyattsville, MD: National Center for Health Statistics. 2012. http://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_04.pdf, “Trends in Numbers and Rates”, page 5.
The stat that we are living longer of up to one/tenth of a year based on information from 2010 can be used as all other statistics to bolster the incumbent’s position or for the challenger to scoff at the supposed “progress” that’s been made.
It can also be used to argue that Americans are taking better care of themselves or that holistic remedies are working since fewer Americans are using healthcare or that singing to the moon improves life expectancy.
The point is that at best the arguments we hear are OPINIONS based on the singular fact of an increase in life expectancy of 0.1 year based on research conducted from 2009 to 2010.
Regarding arguments we'll hear that at least we don’t have that socialized medicine that we’ve been told is so bad for citizens.
Except that the US ranks 50th in life expectancy according to the US government, “The World Fact Book” as posted on the CIA website. (Canada is 12th and the UK dropped to 30th and France is at 14th) and these statistics are dated 2012 in the source. https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html
Why the frustration? Because in 2007 this blog stated:
“In August, the US was ranked as 42nd in terms of life expectancy for its citizens.
http://www.cnn.com/2007/HEALTH/08/13/life.expectancy.ap/index.html
Whether the statistic is used to blame US citizens for obesity, laziness, or failure to have screenings or sufficient insurance, the facts are the facts and while we distract ourselves with blaming the citizenry for getting sick and dying, we are number 42. NOT in the top 10, not some super-power example of how fabulous life is here, FORTY TWO.”
We’ve dropped eight places since then. Our healthcare system is arguably MORE broken based on our life expectancy compared to other countries.
Data takes time to gather, formulate, process and report. Statistics can be viewed in many different ways.
What is clear is that every individual’s experience is as valid as anyone quoting statistics about healthcare in the US.
Wednesday, May 30, 2012
Sunday, May 27, 2012
Negative Patient Reviews and Dr. Lawsuits
There may be a lot of good doctors but...Everyone knows someone with a horrible doctor story.
So should you share your horrible experience? The answer is maybe.
First, it's time to applaud the online reviewers. After all, they face the risk of physicians refusing them care since refusing patients is a physician right. They face the risk of being sued by a physician because suing is a physician right. They face the risk of being "outvoted" or ridiculed by phony fans of the physician because hiring reputation managers is a physician right. All this for the noble purpose of alerting others to what we all know sometimes goes on but have limited recourse to address.
So for online reviewers, it's my opinion you should make sure of the following:
Narrowly focus on what aspect of your lousy care you're focusing on whether it's a billing or a clinical complaint, a timing complaint, an outcome-based complaint or some other issue. You don't want to divulge more of your own medical history to the public than necessary.
Make sure any statement you're making is true or else write, "In my opinion." The fact/opinion dichotomy is crucial when you're attacking someone's reputation. If you present facts, those should be presented neutrally. Your conclusion from the facts is your opinion.
Include your efforts to discuss your experience with your physician. This will indicate more about a physician than you might think and will also help your audience understand that you're not simply being an unreasonable customer.
Finally, include any research supporting your claim in terms of others with complaints about the same provider or in terms of an industry practice.
For those who consider the above and still go forward with their physician and healthcare provider reviews the rest of us say, "Thank you."
So should you share your horrible experience? The answer is maybe.
First, it's time to applaud the online reviewers. After all, they face the risk of physicians refusing them care since refusing patients is a physician right. They face the risk of being sued by a physician because suing is a physician right. They face the risk of being "outvoted" or ridiculed by phony fans of the physician because hiring reputation managers is a physician right. All this for the noble purpose of alerting others to what we all know sometimes goes on but have limited recourse to address.
So for online reviewers, it's my opinion you should make sure of the following:
Narrowly focus on what aspect of your lousy care you're focusing on whether it's a billing or a clinical complaint, a timing complaint, an outcome-based complaint or some other issue. You don't want to divulge more of your own medical history to the public than necessary.
Make sure any statement you're making is true or else write, "In my opinion." The fact/opinion dichotomy is crucial when you're attacking someone's reputation. If you present facts, those should be presented neutrally. Your conclusion from the facts is your opinion.
Include your efforts to discuss your experience with your physician. This will indicate more about a physician than you might think and will also help your audience understand that you're not simply being an unreasonable customer.
Finally, include any research supporting your claim in terms of others with complaints about the same provider or in terms of an industry practice.
For those who consider the above and still go forward with their physician and healthcare provider reviews the rest of us say, "Thank you."
Sunday, April 29, 2012
Changing Attitudes: Is there a war on women's health?
When it comes to a significant drawback of our health insurance coverage difficulties we, each individual are partially to blame. Without a reconsideration of our own values the problem will persist and worsen.
Insurance was designed to help cover the costs of needed healthcare. So what went wrong?
First, costs rose so that the cost of needed healthcare became a larger cost to insurance companies providing coverage. Insurance companies raised rates to try to preserve their profits in the face of rising costs. As rates rose there was a backlash of employers and others paying for health insurance regarding the raise in insurance rates.
What we did wrong at this juncture was that those of us whose employers contributed or paid in full for our insurance coverage were largely oblivious to the increased costs of health insurance and those of us paying for our own insurance coverage were satisfied with what we could find as individuals purchasing health insurance.
No pressure was put on the healthcare industry or on government to address the rise in healthcare costs. This problem remains. Without cost controls health insurers will have to continue to preserve profits by providing less coverage and more expensive coverage.
Next insurance companies began breaking down types of coverage and putting limits on coverage in order to preserve their profits. What we did wrong at this juncture was we bought in. Individuals across the nation started examining each other and adopting the view that they didn't want to pay for another person's illness that might be traced to smoking or traced to pregnancy or traced to chronic illnesses.
We began seeing one another as the cause for our increased health insurance rates still failing to examine the lack of limits on what we could be charged by healthcare providers.
Once we as a society had been broken down into more expensive groups and less expensive groups, the groups solidified their separateness by organizing to fight for their interests from health insurers.
Instead of focusing on the original need and concept of health insurance that would charge everyone premiums to cover the cost of needed healthcare for some and balance that out with the reduced or negligible costs of healthcare for others and demanding limits on increases in costs for healthcare, individuals gave up their power of being part of the larger group of citizens and started believing they could do better by throwing their sicker counterparts under the bus.
Then insurance companies reinforced the new vision of citizens that they were better off as healthy individuals ignoring the plight of their sicker neighbors by providing "perks" that were an insurer's dream, the preventive exam, that affordable and finite, known expense that actually is not insurance in terms of helping to pay for needed healthcare since preventive exams do not indicate poor health nor do they involve unknown expenses.
Insurers threw in "preventive" and further limited treatment coverage, eroding the very concept of health insurance itself.
Suddenly getting a checkup for free or for a small co-payment dazzled the healthy so that they didn't pay attention to the fact that fewer treatments for illness and lower percentages of the costs of those treatments were covered by insurers.
So is there a war on women? No more than the war on smokers, the war on the obese, the war on those with mental illness, the war on those with chronic disease, the war on those with genetic disease or the countless other factions that we allowed to form because at every juncture we forgot what health insurance was supposed to do and we forgot that controlling costs of healthcare services was a crucial part of the formula. All these distinctions omit other groups such as motorcycle riders, those who drink too much,those who play football or ski.
Certainly they too will come under the microscope at some point in time if we don't reassess what we expect from our healthcare providers in terms of reasonable costs and from our health insurers in terms of helping to pay for needed medical expenses.
It looks like a "war" on women but in fact it's still about money. In fact the higher rates charged to women are based on the same statistical analysis that weeded out smokers, the obese, those with chronic diseases, cancer survivors, those with high blood pressure as the "THEM" before the current "war."
So where can cost controls come in? Three simple steps follow: Insurers themselves should prevent insurance claim fraud. We are paying for their failure to monitor their payments for fraudulent claims amounting according to some estimates into the billions of dollars a year. Insurers themselves should adopt better standards for negotiating fee payments to healthcare providers in order to prevent continued healthcare cost increases. Insurers should stop paying for items that have finite costs such as a checkup. And third insurers should require that none of the dollars paid in premiums by their members should be used for anything but medical costs of care for their members including fees charged by hospitals for research or for treating the uninsured.
Until citizens redefine themselves as "WE" in the healthcare, health insurance environment of today there remains no incentive for insurance companies, governments or healthcare providers to modify current trends.
Insurance was designed to help cover the costs of needed healthcare. So what went wrong?
First, costs rose so that the cost of needed healthcare became a larger cost to insurance companies providing coverage. Insurance companies raised rates to try to preserve their profits in the face of rising costs. As rates rose there was a backlash of employers and others paying for health insurance regarding the raise in insurance rates.
What we did wrong at this juncture was that those of us whose employers contributed or paid in full for our insurance coverage were largely oblivious to the increased costs of health insurance and those of us paying for our own insurance coverage were satisfied with what we could find as individuals purchasing health insurance.
No pressure was put on the healthcare industry or on government to address the rise in healthcare costs. This problem remains. Without cost controls health insurers will have to continue to preserve profits by providing less coverage and more expensive coverage.
Next insurance companies began breaking down types of coverage and putting limits on coverage in order to preserve their profits. What we did wrong at this juncture was we bought in. Individuals across the nation started examining each other and adopting the view that they didn't want to pay for another person's illness that might be traced to smoking or traced to pregnancy or traced to chronic illnesses.
We began seeing one another as the cause for our increased health insurance rates still failing to examine the lack of limits on what we could be charged by healthcare providers.
Once we as a society had been broken down into more expensive groups and less expensive groups, the groups solidified their separateness by organizing to fight for their interests from health insurers.
Instead of focusing on the original need and concept of health insurance that would charge everyone premiums to cover the cost of needed healthcare for some and balance that out with the reduced or negligible costs of healthcare for others and demanding limits on increases in costs for healthcare, individuals gave up their power of being part of the larger group of citizens and started believing they could do better by throwing their sicker counterparts under the bus.
Then insurance companies reinforced the new vision of citizens that they were better off as healthy individuals ignoring the plight of their sicker neighbors by providing "perks" that were an insurer's dream, the preventive exam, that affordable and finite, known expense that actually is not insurance in terms of helping to pay for needed healthcare since preventive exams do not indicate poor health nor do they involve unknown expenses.
Insurers threw in "preventive" and further limited treatment coverage, eroding the very concept of health insurance itself.
Suddenly getting a checkup for free or for a small co-payment dazzled the healthy so that they didn't pay attention to the fact that fewer treatments for illness and lower percentages of the costs of those treatments were covered by insurers.
So is there a war on women? No more than the war on smokers, the war on the obese, the war on those with mental illness, the war on those with chronic disease, the war on those with genetic disease or the countless other factions that we allowed to form because at every juncture we forgot what health insurance was supposed to do and we forgot that controlling costs of healthcare services was a crucial part of the formula. All these distinctions omit other groups such as motorcycle riders, those who drink too much,those who play football or ski.
Certainly they too will come under the microscope at some point in time if we don't reassess what we expect from our healthcare providers in terms of reasonable costs and from our health insurers in terms of helping to pay for needed medical expenses.
It looks like a "war" on women but in fact it's still about money. In fact the higher rates charged to women are based on the same statistical analysis that weeded out smokers, the obese, those with chronic diseases, cancer survivors, those with high blood pressure as the "THEM" before the current "war."
So where can cost controls come in? Three simple steps follow: Insurers themselves should prevent insurance claim fraud. We are paying for their failure to monitor their payments for fraudulent claims amounting according to some estimates into the billions of dollars a year. Insurers themselves should adopt better standards for negotiating fee payments to healthcare providers in order to prevent continued healthcare cost increases. Insurers should stop paying for items that have finite costs such as a checkup. And third insurers should require that none of the dollars paid in premiums by their members should be used for anything but medical costs of care for their members including fees charged by hospitals for research or for treating the uninsured.
Until citizens redefine themselves as "WE" in the healthcare, health insurance environment of today there remains no incentive for insurance companies, governments or healthcare providers to modify current trends.
Friday, April 20, 2012
Looking for Your Affordable Insurance Exchange in 2014
Affordable insurance exchanges are based on a theory that they will encourage competition among insurers and provide consumers with a specific location for finding the best health insurance they can. While their availability is anticipated in 2014, the Federal budget allots money for and many state governments have already begun work to create the affordable insurance exchanges for their states.
Those against healthcare reform primarily worry about the Federal role in creating and maintaining the exchanges and those for healthcare reform supporters worry that individuals will be separated out based on their healthcare needs. Both concerns have merit but it makes sense to pursue the affordable insurance exchanges as a means of encouraging transparency and convenience for insurance shoppers.
It is also noteworthy that although members of Congress and their staff will be required to use the exchanges many other Federal workers will not which perpetuates the best plans being available to those with bargaining power with health insurers offering, "We'll give you more customers in exchange for better rates."
We also don't yet know whether Congress members and their staffs will be given a pay raise that essentially will transfer possible additional costs from health insurance purchased over the exchanges into additional pay benefits making the participation of Congress in the healthcare exchanges more of a "gesture" than a means of equalizing the playing field for consumers shopping for their own health insurance.
Rules for implementing the exchanges include some that indicate that your experience using an affordable insurance exchange to shop for insurance can vary drastically based on your state. Consumers should follow their affordable insurance exchange as it develops in their own states.
An especially troublesome rule is that states can limit the insurers they permit onto the exchange. It is not clear how the states will limit insurance company participation and whether consumers will miss out on affordable opportunities because of this option.
Overall however, the new rules which are extensive,covering hundreds of pages for state run and federally subsidized healthcare exchanges seem to be a step in the right direction.
Much of the criticism from insurers comes from threats that they'll have to raise their prices to cover increased administrative costs, a common insurance company threat that never seems to be accompanied by a similar promise to keep rates down if specific administrative actions aren't taken.
It's a while away and may be impacted by the current pending Supreme Court consideration of healthcare but the affordable insurance exchange for health insurance shopping could be good for consumers.You can read more about the new rules for implementing the affordable insurance exchanges on the Department of Health and Human services website at HHS.gov.
Those against healthcare reform primarily worry about the Federal role in creating and maintaining the exchanges and those for healthcare reform supporters worry that individuals will be separated out based on their healthcare needs. Both concerns have merit but it makes sense to pursue the affordable insurance exchanges as a means of encouraging transparency and convenience for insurance shoppers.
It is also noteworthy that although members of Congress and their staff will be required to use the exchanges many other Federal workers will not which perpetuates the best plans being available to those with bargaining power with health insurers offering, "We'll give you more customers in exchange for better rates."
We also don't yet know whether Congress members and their staffs will be given a pay raise that essentially will transfer possible additional costs from health insurance purchased over the exchanges into additional pay benefits making the participation of Congress in the healthcare exchanges more of a "gesture" than a means of equalizing the playing field for consumers shopping for their own health insurance.
Rules for implementing the exchanges include some that indicate that your experience using an affordable insurance exchange to shop for insurance can vary drastically based on your state. Consumers should follow their affordable insurance exchange as it develops in their own states.
An especially troublesome rule is that states can limit the insurers they permit onto the exchange. It is not clear how the states will limit insurance company participation and whether consumers will miss out on affordable opportunities because of this option.
Overall however, the new rules which are extensive,covering hundreds of pages for state run and federally subsidized healthcare exchanges seem to be a step in the right direction.
Much of the criticism from insurers comes from threats that they'll have to raise their prices to cover increased administrative costs, a common insurance company threat that never seems to be accompanied by a similar promise to keep rates down if specific administrative actions aren't taken.
It's a while away and may be impacted by the current pending Supreme Court consideration of healthcare but the affordable insurance exchange for health insurance shopping could be good for consumers.You can read more about the new rules for implementing the affordable insurance exchanges on the Department of Health and Human services website at HHS.gov.
Thursday, April 19, 2012
By the Numbers How President Obama Lost Young Voters
With the importance of young voters aged 18 to 25 it is remarkable what a bad job President Obama has done in retaining their support. (And this is not to say that the President will not be reelected which likely has less to do with his performance than his competitors.)
Many young people were inspired to vote in the 2008 Presidential election and helped put President Obama in office (see articles like the one at http://www.time.com/time/magazine/article/0,9171,1708836,00.html). But four years of politics as usual when it comes to youth voters promises to make a lackluster showing and an unexciting reelection for President Obama.
With all the talk of Obamacare and the implementation of extensions providing for parents to be able to carry their young adults on their own insurance until the age of 26 there has been a small decrease in the number of young adults who are uninsured estimated as a drop from 2009 levels of 28.2 percent to 24.5% (http://www.gallup.com/poll/152162/americans-uninsured-2011.aspx). Most of this positive change is attributed to parents paying for children's insurance coverage. More noteworthy for young adults, President Obama's healthcare plan provides for a penalty for individuals who cannot afford healthcare.
Youth unemployment last summer as of July was at 51.2% according to government statistics you can read at http://www.bls.gov/news.release/youth.nr0.htm.
It's not even necessary to find one specific site discussing the crushing student loan debts our young adults are carrying from education expenses if they went to college. Simply search around the Internet or ask a bunch of young people and you'll know.
Interest rates at all-time lows that discourage responsible savings in risk-free vehicles like CDs, money markets and savings accounts.
Checking account fees that penalize those without direct deposit or those who do not maintain large balances.
President Obama is seriously out of touch with the young adults who put him in office. His promises for change have omitted the very individuals whose lives have seen little positive change since he took office.
The lack of excitement among young people is justified.
Many young people were inspired to vote in the 2008 Presidential election and helped put President Obama in office (see articles like the one at http://www.time.com/time/magazine/article/0,9171,1708836,00.html). But four years of politics as usual when it comes to youth voters promises to make a lackluster showing and an unexciting reelection for President Obama.
With all the talk of Obamacare and the implementation of extensions providing for parents to be able to carry their young adults on their own insurance until the age of 26 there has been a small decrease in the number of young adults who are uninsured estimated as a drop from 2009 levels of 28.2 percent to 24.5% (http://www.gallup.com/poll/152162/americans-uninsured-2011.aspx). Most of this positive change is attributed to parents paying for children's insurance coverage. More noteworthy for young adults, President Obama's healthcare plan provides for a penalty for individuals who cannot afford healthcare.
Youth unemployment last summer as of July was at 51.2% according to government statistics you can read at http://www.bls.gov/news.release/youth.nr0.htm.
It's not even necessary to find one specific site discussing the crushing student loan debts our young adults are carrying from education expenses if they went to college. Simply search around the Internet or ask a bunch of young people and you'll know.
Interest rates at all-time lows that discourage responsible savings in risk-free vehicles like CDs, money markets and savings accounts.
Checking account fees that penalize those without direct deposit or those who do not maintain large balances.
President Obama is seriously out of touch with the young adults who put him in office. His promises for change have omitted the very individuals whose lives have seen little positive change since he took office.
The lack of excitement among young people is justified.
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