Sunday, October 10, 2010

Health Reform to Cover Most Young Adults by 2014

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.

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.

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.

Saturday, September 18, 2010

Students 'should consider the value of their belongings' when searching for a house insurance quote

Students searching for a house contents insurance policy to cover them when they are away from their parent's home could do well to evaluate how much their belongings are worth.

This is according to Graeme Trudgill, technical and corporate affairs executive at the British Insurance Brokers' Association (BIBA), who explained that consumers should account for designer clothes, their computer, printer and gadgets like iPads - as when combined their value could be very high.

"People have a lot of stuff and you have got to make sure that you just add it all up. It doesn't take long - you can do a quick check and your insurance broker can help talk you through it to make sure you have covered everything," he continued.

However, students - of which UCAS states there will be 470,789 attending new courses this year - may not have to shell out for their own individual policy, as some providers offer home-from-home deals where parents extend their policy to cover the youngsters' possessions while they study elsewhere.

Aetna gets OK to hike rates on individual health policies in California

More than 1 million Californians will see their health insurance premiums rise Oct. 1 now that regulators have wrapped up their review of a plan by Aetna Inc. to raise rates an average of 19% for 65,000 individual policyholders.



Aetna was cleared Friday by the state Department of Insurance to proceed with its new plan. It was the last of four major insurers to be reviewed by the department, which has OKd double-digit rate increases by Anthem Blue Cross, Blue Shield of California and Health Net Inc. in the last month.



Regulators stepped up their scrutiny of the insurers after Anthem announced plans earlier this year to raise premiums by as much as 39%, triggering a backlash among policyholders, lawmakers and the White House. The insurer canceled the hikes and sought smaller increases that were allowed.



The insurance department has no authority to block rate hikes as long as they comply with California law, which requires insurers to devote at least 70 cents of every premium dollar to medical claims.



Aetna's plan met that threshold, the state concluded Friday. All of the hikes reviewed by the state take effect Oct. 1.



"The Department of Insurance in no way condones or supports these insurance rate increases on California policyholders, but the unfortunate reality is that legally insurers are entitled if their rate filings are found to be in line with state law," spokesman Ioannis Kazanis said.



Aetna welcomed the insurance department's decision and defended its rate increase as a necessary move to keep up with rising healthcare costs. The company said its maximum increase for a fraction of its members would be 30%.



"We are pleased that, after extensive and thorough review, the [department] has accepted the rates for Aetna's individual products in California," said Beth Anderson, president of Aetna's west region.



"Rate increases are never easy, but the growing market trends we are seeing in California — such as the increasing prices for hospital care, prescription drugs, doctor's visits and other healthcare services — directly impacts what our members pay."



Some Aetna policyholders voiced alarm at the coming increase, saying double-digit hikes each year could soon put insurance beyond their reach. Dave and Jo Nixon, for example, will see their annual cost rise 23%, to $17,676 from $14,340. The San Jose couple also have a $3,000 deductible.



"The trend is just crazy," said Dave Nixon, 56. "In two or three years, I'll be paying more for my health insurance than my rent."



Aetna and the other insurers had put their rate increases on hold since July while an outside consultant to the insurance department reviewed their paperwork.



Aetna announced last month that it was going forward with its Oct. 1 increases before the consultant had finished his review. The state would not give its consent until that work was finished.