More than 12 million of the nation's 15 million uninsured young adults ages 19 to 29 may be able to get health insurance in 2014 as a result of the healthcare reform law, according to a report released Friday by the Commonwealth Fund.
"By providing multiple insurance options for young adults at key life transition points, including graduation from high school and college, the law will significantly reduce both the short- and long-term gaps in health insurance that have historically plagued this age group at all income levels," wrote Sara Collins and Jennifer Nicholson, both of the Commonwealth Fund.
The number of uninsured young adults rose from 13.7 million in 2008 to 14.8 million in 2009. In addition, 5 million insured 20-somethings have very high out-of-pocket costs, leaving them effectively underinsured, the authors noted.
Sunday, October 10, 2010
Take a look at reality of health care reform
"A judgment is said to be true when it conforms to the external reality." - St. Thomas Aquinas
I loved the '90s supernatural drama "The X Files," with its ominous, blinking message - "The truth is out there." The "powers that be" seek to hide or distort the truth, that message whispered, but it won't stay cloaked forever.
The first round of Affordable Care Act (health reform) mandates, which took effect in September, reminded me of that message - that external realities exist, no matter how much wishful thinking or righteous indignation we throw at it.
Let's examine two sets of "external realities."
Consider first a young family without family health care coverage. According to the latest census findings, the majority of children live in households making $74,999 per year or less. Focus on the 0.7 percent who reside in households earning $35,000 to $49,999 and the 19.6 percent who live in households earning $50,000 to $74,999. These are typical middle-class households. Imagine for a moment that this family must either choose a sizable payroll deduction for family coverage or a premium for a "child-only" policy. There's the mortgage, taxes, utilities, car payments, car insurance, groceries, clothing, and a little recreation. Living paycheck to paycheck, would you choose to pay a premium for a healthy child who, at most, needs routine immunizations and the occasional office visit for colds? Or would you use that money for some other, seemingly more pressing, need? It is eminently understandable that such families would roll the dice and go without insurance. Before September, however, this was a risk with dire consequences should a child fall ill. Perhaps that risk served to pressure some families into taking the payroll deduction or buying a "child-only" policy.
Now imagine being an insurance company. By definition, insurance is an agreement that one party will assume a risk for a fee paid by the other. With life insurance, the buyer bets he will die, while the insurer, armed by the actuary, believes he will not. The few statistical aberrations are adequately paid for by the vast majority who make no claims. This majority forms a pool, which protects the solvency of the insurer and its continued ability to pay claims. With health insurance, the protective pool is formed by the healthy as a hedge against the claims of the sick. A pool composed entirely of the sick is called bankruptcy.
These two realities, of the family and of the insurer, crashed head on in September. As of Sept. 23, insurers are prohibited from denying coverage to children with pre-existing conditions. However, the mandate that everyone must purchase insurance doesn't kick in fully until 2016. If you are the young family, there is now absolutely no reason to worry about insurance. If your child stays healthy, as most children do, you can pocket the premium without guilt. Going without is no longer a gamble, because insurers have to cover your child if, God forbid, he or she should need an organ transplant or chemotherapy or some other treatment that costs in the hundreds of thousands of dollars.
I loved the '90s supernatural drama "The X Files," with its ominous, blinking message - "The truth is out there." The "powers that be" seek to hide or distort the truth, that message whispered, but it won't stay cloaked forever.
The first round of Affordable Care Act (health reform) mandates, which took effect in September, reminded me of that message - that external realities exist, no matter how much wishful thinking or righteous indignation we throw at it.
Let's examine two sets of "external realities."
Consider first a young family without family health care coverage. According to the latest census findings, the majority of children live in households making $74,999 per year or less. Focus on the 0.7 percent who reside in households earning $35,000 to $49,999 and the 19.6 percent who live in households earning $50,000 to $74,999. These are typical middle-class households. Imagine for a moment that this family must either choose a sizable payroll deduction for family coverage or a premium for a "child-only" policy. There's the mortgage, taxes, utilities, car payments, car insurance, groceries, clothing, and a little recreation. Living paycheck to paycheck, would you choose to pay a premium for a healthy child who, at most, needs routine immunizations and the occasional office visit for colds? Or would you use that money for some other, seemingly more pressing, need? It is eminently understandable that such families would roll the dice and go without insurance. Before September, however, this was a risk with dire consequences should a child fall ill. Perhaps that risk served to pressure some families into taking the payroll deduction or buying a "child-only" policy.
Now imagine being an insurance company. By definition, insurance is an agreement that one party will assume a risk for a fee paid by the other. With life insurance, the buyer bets he will die, while the insurer, armed by the actuary, believes he will not. The few statistical aberrations are adequately paid for by the vast majority who make no claims. This majority forms a pool, which protects the solvency of the insurer and its continued ability to pay claims. With health insurance, the protective pool is formed by the healthy as a hedge against the claims of the sick. A pool composed entirely of the sick is called bankruptcy.
These two realities, of the family and of the insurer, crashed head on in September. As of Sept. 23, insurers are prohibited from denying coverage to children with pre-existing conditions. However, the mandate that everyone must purchase insurance doesn't kick in fully until 2016. If you are the young family, there is now absolutely no reason to worry about insurance. If your child stays healthy, as most children do, you can pocket the premium without guilt. Going without is no longer a gamble, because insurers have to cover your child if, God forbid, he or she should need an organ transplant or chemotherapy or some other treatment that costs in the hundreds of thousands of dollars.
Lagging U.S. life expectancy ranking blamed on health system
The United States is falling sharply behind in worldwide rankings of life expectancy, and shortcomings in the U.S. health care system may be to blame, scientists say.
Researchers studying the issue concluded that obesity, smoking, traffic accidents and homicide can’t account for the drop—“leading us to believe that failings in the U.S. health care system, such as costly specialized and fragmented care, are likely playing a large role,” said Peter Muennig of Columbia University, lead author of the study.
In the research, which appears in the Oct. 7 online issue of the journal Health Affairs, Muennig and co-author Sherry Glied of Columbia cite the growing lack of health insurance among Americans as a possible culprit.
The study looked at health spending, behavioral risk factors like obesity and smoking, and survival rates for men and women ages 45 and 65 in the U.S. and 12 other industrialized nations.
While the U.S. has achieved gains in 15-year survival rates decade by decade from 1975 to 2005, the researchers found that other countries enjoyed even greater gains. So the U.S. slipped in the ranking, even as per capita health care spending rose at more than twice the rate of the other countries.
Around 1950, the United States ranked 5th for life expectancy at birth for women and 10th for men among developed countries, according to research cited by Muennig and Glied. The most recent figures, from the CIA World Factbook, rank the United States 22nd among those same countries.
Muennig and Glied found similar trends in the 13 countries that they studied, though they only examined 15-year survival rates for people at age 45 and 65.
When they compared risk factors, they found very little difference in smoking habits between the U.S. and the comparison countries—in fact, U.S. smoking rates declined more quickly than most other countries.
And while people are more likely to be obese in the U.S. than elsewhere, this was also the case in 1975, when the U.S. was less far behind in life expectancy, the investigators noted. Moreover, they said, the percentage of obese people actually grew faster in most of the other countries between 1975 and 2005.
Homicide and traffic deaths, meanwhile, have accounted for a stable share of U.S. deaths over time, and can’t explain the drop in life-expectancy ranking, the scientists said.
The most likely remaining explanation is flaws in the health care system, said Muennig and Glied, pointing to the role of unregulated fee-for-service payments and high reliance on specialty care amid skyrocketing costs.
Researchers studying the issue concluded that obesity, smoking, traffic accidents and homicide can’t account for the drop—“leading us to believe that failings in the U.S. health care system, such as costly specialized and fragmented care, are likely playing a large role,” said Peter Muennig of Columbia University, lead author of the study.
In the research, which appears in the Oct. 7 online issue of the journal Health Affairs, Muennig and co-author Sherry Glied of Columbia cite the growing lack of health insurance among Americans as a possible culprit.
The study looked at health spending, behavioral risk factors like obesity and smoking, and survival rates for men and women ages 45 and 65 in the U.S. and 12 other industrialized nations.
While the U.S. has achieved gains in 15-year survival rates decade by decade from 1975 to 2005, the researchers found that other countries enjoyed even greater gains. So the U.S. slipped in the ranking, even as per capita health care spending rose at more than twice the rate of the other countries.
Around 1950, the United States ranked 5th for life expectancy at birth for women and 10th for men among developed countries, according to research cited by Muennig and Glied. The most recent figures, from the CIA World Factbook, rank the United States 22nd among those same countries.
Muennig and Glied found similar trends in the 13 countries that they studied, though they only examined 15-year survival rates for people at age 45 and 65.
When they compared risk factors, they found very little difference in smoking habits between the U.S. and the comparison countries—in fact, U.S. smoking rates declined more quickly than most other countries.
And while people are more likely to be obese in the U.S. than elsewhere, this was also the case in 1975, when the U.S. was less far behind in life expectancy, the investigators noted. Moreover, they said, the percentage of obese people actually grew faster in most of the other countries between 1975 and 2005.
Homicide and traffic deaths, meanwhile, have accounted for a stable share of U.S. deaths over time, and can’t explain the drop in life-expectancy ranking, the scientists said.
The most likely remaining explanation is flaws in the health care system, said Muennig and Glied, pointing to the role of unregulated fee-for-service payments and high reliance on specialty care amid skyrocketing costs.
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