Should People Overweight Pay More Taxes for Health Insurance?

Should People Overweight Pay More Taxes for Health Insurance? in General Healthcare

A comment by a member from Germany's parliament has sparked a lot of debate over the last few days. Marco Wanderwitz suggested that people who are overweight pay extra taxes because they cost more to provide health insurance benefits.

Wanderwitz said, "It's legitimate to ask the question if the immense costs that are caused by the excessive consumption of food should continue to be paid for by everyone else. I think that it would be sensible if those who deliberately lead unhealthy lives would be held financially accountable for that."

It is estimated that there are 9 million people who are overweight in Germany, which looks pretty meager when compared to fact that almost 130 million Americans are overweight or obese.

With rising health insurance costs, many Americans and people across the world have becoming increasingly worried about health care and its cost.

CBS News conducted a poll after the story was released last week. When asked whether people who are overweight should pay more — 52 percent of voters said yes and only 14 percent said no.

In 2008, $147 billion was spent on weight-related health care services in the United States. It is also estimated that around $1.8 trillion is spent a year on health care services associated with chronic diseases that are directly linked to smoking and being overweight. These costs will only rise as the number of obese and overweight people in America continues to climb.

Even though people already do pay more for health insurance when they reach a certain body mass index (BMI), it is hard to believe that you could possibly tax someone when genetic factors play a role. And is it any different than considering addiction a disease or other issues that have become medicalized over the past few years?

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A Health Care and Health Insurance Cost Driver: Brand Name Drugs

A Health Care and Health Insurance Cost Driver: Brand Name Drugs in General Healthcare

As health insurance costs and government spending on health care continues to increase, many people are looking for ways to reduce costs. A recent report by the American Enterprise Institute (AEI) examines the costs associated with name-brand drugs and Medicaid spending.

AEI observed two-thirds of the $21.8 billion spent by Medicaid on medications last year according to The Hill. The research conducted by AEI found that Medicaid could have saved $271 million using generics instead of name-brand drugs for just 20 prescription drugs. They also found that out of that $271 million, only 2 drugs made up for $95 million of the spending.     

Ralph Neas, the head of the National Coalition on Health Care, said, "Rising pharmaceutical costs, the aging population, and the increased use of costly specialty drugs makes containing drug-related spending an urgent health system priority closely linked to expanding access to care and improving quality."   

Unfortunately, health care reform did little to control rising costs of the health care industry and efforts to import drugs from Canada were squashed in the health care debate.    

Instead, health care reform focused on the health insurance industry without looking at reasons for increases health insurance costs. There are many drivers behind health insurance rates and paying for brand-name prescriptions is just one of them.    

Many health insurance companies offer better copayments for generics because they are a lot more affordable. Still many brand name drugs have patents protecting them for years. Until those patents run dry, brand name drug costs will remain high for the government, health insurance companies and Americans.

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Reading Doctors' Notes Could Improve Health Care

Reading Doctors' Notes Could Improve Health Care in General Healthcare

A new study, called the OpenNotes project, will provide patients online access to their doctors' notes within a short time period of a visit. It is designed to provide patients with a better understanding of their health care. Many providers already use electronic health records that tracks patient visits, prescriptions, surgeries and illnesses but they don't track health care providers' notes. 

According to The Associated Press, the study will involve 115 doctors and around 25,000 patients over a year. After a visit, each patient will get an email about their personal notes. The study will measure if patients read the notes, if they find errors and how they use the notes. The research will also measure the habits of doctors and whether they censor their notes or are more patient-friendly.  

There are concerns among doctors about the openness of the project. Doctors may be worried to jot down notes to look for certain types of cancer in future visits so they don't worry the patient. Others may be worried to hurt patients' feelings or record personal issues — like a patient being non-compliant.   

Patients may be offended by the doctor making a note that they are overweight or obese. But on the other hand, it may provide people with the motivation they need to change their lifestyle behaviors.   

There has been a recent push to become more consumer-friendly by the entire health care industry. Doctors, hospitals and health insurance companies are all creating ways to provide better and more understandable health services.

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Largest Medicare Fraud Case Goes to Court

Largest Medicare Fraud Case Goes to Court in General Healthcare

On July 10, 2010, 94 people were indicted in the largest Medicare fraud bust ever conducted. The bust was across five states and totaled $251 million dollars.   

Doctors and nurses across Miami, New York, Detroit, Houston, and Baton Rouge were arrested. And they were accused of falsely billing Medicare for the use of unnecessary equipment, home health care, physical therapy, medical equipment, and HIV treatments for patients who never received them.

Two doctors from Brooklyn that were involved have been charged with paying patients with cash to entice them to sign up for unnecessary treatments. According to Kaiser Health News, this group billed Medicare for $72 million dollars and received $46.9 million in reimbursements. This is but one scheme unveiled in the fraud bust, while fourteen other defendants are being held for separate schemes in Brooklyn.   

The arrests took place as Attorney General Eric H. Holder Jr. and the secretary of Health and Human Services, Kathleen Sebelius, held the first of a series of regional summits on health care fraud prevention in Miami, Florida. 

As health care reform and this new push to crack down on Medicare fraud has been unleashed – more and more cases of Medicare fraud are popping up. This shows that there can be a stop to Medicare fraud and that more should be done to rein in the billions of dollars wasted from fraud.

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Email Can Improve Your Health Care

Email Can Improve Your Health Care in General Healthcare

A recent study suggests that patients who conduct email correspondence with their doctor or health care providers are likely to be healthier and have a more positive outlook on their treatment and care. Researchers also found that patients who suffer from diseases such as diabetes and hypertension that email their doctors regularly have higher quality of care scores than patients who did not email their doctors.    

The Health Affairs study focused on 35,423 patients with diabetes and hypertension in the Southern California region. The patients that also used an electronic health records system had better cholesterol and blood pressure levels after two months than patients who did not utilize the system. The study shows that patients who have a higher correspondence with their providers, or utilize additional programs to help manage their care, are simply more confident about their level of treatment and their condition.

Dr. Terhilda Garrido, vice president for health information technology transformation and analytics at Kaiser said that having such systems as an email correspondence and electronic programs for patients to utilize makes the patient feel more in control of their condition and their care, and more empowered. This in turn makes the patient feel more confident as a whole.  

Even though the programs may help consumers feel more empowered about their health care, less than 10 percent of Americans use electronic programs or exchange emails with their health care providers. 

Americans have a lot to gain by utilizing online resources and controlling how their health insurance and health care works for them.

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Health Care Reform Preventive Services Issued

Health Care Reform Preventive Services Issued in General Healthcare

Health care reform legislation calls for preventive services to Americans across the country. The regulations regarding preventive services were issued yesterday. Starting in September, preventive services will be provided to Americans with health insurance at no-cost.

That means no copayment, deductible or coinsurance for the preventive service saving millions of Americans on visits every year. Still this measure is expected to rise premiums by 1.5 percent.

Health insurance plans will have to cover these set of preventive services at no charge to consumers:

• Routine vaccines for children and adults
• Well-baby visits, vision and hearing tests for children and counseling to children to help maintain a healthy weight will be covered along with other services recommended by the American Academy of Pediatrics
• Women's health screenings, which are still being defined and will be announced in August 2011
• Screenings that are strongly recommended by the United States Preventive Services Task Force with a grade of "A" or "B"

Right now the Preventive Services Task Force recommends screening pregnant women for vitamin deficiencies, colon cancer, tests for diabetes, high cholesterol, high blood pressure, and counseling to help smokers quit according to The Boston Globe.

With regards to this "over-medicalization" issue, over the past few months, many interest groups have been lobbying for certain preventive services to be covered under health care legislation. One interest group, Planned Parenthood has been lobbying heavily for contraceptives to be included on the preventive service list causing much controversy. Even though they weren't on this list, they could be on the list that will be announced in August 2011.

Making preventive services free for consumers and Medicare recipients will help a lot of people get the health care services they need, even if they are medicalized.

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Over Medicalized Health Care

Over Medicalized Health Care in General Healthcare

Want a new nose? Overweight but don’t want to exercise or diet? No problem. It’s commonplace in the health care world these days. Not only are we using these services more, we’re considering them practically medically necessary.

The experts are calling it “medicalization.”

In fact, according to a May report in Social Science and Medicine, Americans spent around $77 billion dollars on treatments, pills, and procedures thought to cure what were formerly non-medical problems — and that was our spending level five years ago.

Cue the collective “gasp” as to what we’re spending today in 2010. So what gives? Are we really taking advantage of our medical technology for cosmetic purposes?

It seems so.

The Social Science and Medicine study was the first to put a price on this so-called medicalization, the process of defining non-medical problems as medical problems that garner treatment. And apparently the price of over-medicalization is helping increase health insurance and health care costs. We’re talking procedures and drugs to “cure” obesity, wrinkles, and even sparse eyelashes.

Basically, if we were less vain, we’d save big on health care.

The research suggests that if Americans stopped spending the big bucks on cosmetic problems masking as medical conditions in need of treatment, we’d significantly lower overall health care costs.

Just to hammer the point home a bit further, here’s what we spend annually for some of these medical services: $12.4 billion for cosmetic procedures and plastic surgery, $1.1 billion for infertility, $10.9 billion for anxiety disorders, $1.8 billion for sleep disorders, $1.1 billion for erectile dysfunction, and $1.1 for male pattern baldness.

Thanks, Hollywood.

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Stronger Health Care Privacy Rights for Patients

Stronger Health Care Privacy Rights for Patients in General Healthcare

Recently, the U.S. Department of Health and Human Services (HHS) has issued new privacy rules that will improve patients' rights over their health information and how that information is handled in the future. As more hospitals and health care providers adopt electronic health records (EHRs) and as health care reform works to expand EHR usage, the HHS has established these new rules to protect the health information of patients.  

According to Fierce HealthCare the new patient protection rules will:  

• Increase patients' rights to access personal medical information and to restrict certain kinds of disclosures of health information to health insurance plans
• Set new limitations on the use and disclosure of protected medical information for marketing and fund raising
• Prohibiting the sale of protected health information without authorization from a patient and
• Require business associates of HIPAA-covered entities to follow the same rules.

David Blumenthal, the HHS coordinator for health information technology said, "Giving more Americans the ability to access their health information wherever, whenever, and in whatever form is a critical first step toward improving our health care system. Empowering Americans with real-time and secure access to the information they need to live healthier lives is paramount."  

Right now the Obama administration has the goal of providing every American with an electronic health record by 2014. Health care reform works to expand EHRs by providing subsidies and rewards to health care providers using the new paperless systems.  

Yet there still remains privacy issues as some health care providers have had problems keeping medical information safe and secure, which has to change within the next couple years.

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Early Retirees to See Health Insurance Help

Early Retirees to See Health Insurance Help in General Healthcare

Early retirees will soon be seeing relief with the new health care reform legislation through the provision called the Early Retiree Reinsurance Program (ERRP). Recently the Department of Health and Human Services (HHS) has started to collect applications that will provide health insurance to early retirees who are too young to receive Medicare assistance and do not have individual health insurance.

The ERRP is only a temporary program until early retirees will be able to find affordable health insurance on the state-based exchanges in 2014. Many early retirees are denied coverage because they have pre-existing conditions and are no longer on a group health insurance plan.

According to The Arizona Daily Star, the program will reimburse employers for health insurance costs incurred by retirees that are 55 years of age or older. The reimbursements will cover 80 percent of medical costs between $15,000 and $90,000.

Health care reform set aside $5 billion to provide financial assistance to employers until the exchanges are created. This provision will provide financial help to businesses, unions, nonprofits and governments.

HHS Secretary Kathleen Sebelius said, "The Affordable Care Act not only helps consumers cut their health care costs and have access to quality care, it also is designed to help employers afford coverage. The Early Retiree Reinsurance Program will help employers continue to provide much-needed health insurance to their retirees. Today, Americans who have retired but are not yet eligible for Medicare are often unable to find coverage that is affordable and meets their health care needs on the individual market. This program will help both retirees and employers facing spiraling health care costs, and ensure more Americans have access to the health care they need."

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Coverage Corner Answers: How To Purchase Coverage for Children?

Coverage Corner Answers: How To Purchase Coverage for Children? in General Healthcare

Many consumers wonder how they can purchase coverage for their children. It is extremely important that children have health care coverage. Children will receive dental care with any health insurance plan and receive the preventive services they need.

Consumers can start by comparing health insurance quotes or by using the health insurance finder for a family. Then they can compare plans for the whole family and get the coverage that they are looking for.

Some consumers need coverage for their children that are going away to college. Depending on your current health insurance plan, a child that is going away to school or is taking time off from school —may not be covered by your policy. In that case, purchase student health insurance coverage for that child. There are colleges that offer student health insurance plans but those plans aren’t typically as comprehensive and have certain exclusions.

Many consumers need to purchase health insurance coverage for children in different states or only want coverage for their children. It is best for consumers in this situation to talk to one of our insurance agents by calling 1-888-250-3409. An insurance agent will be able to help you find the coverage that your children will need.

Until September, children may be denied coverage for pre-existing conditions. Then every child in the United States will have access to health care. A short-term insurance policy can cover a child up to that time, which will pay for emergency medical expenses.

Getting health insurance coverage for children is extremely important for their health and the future of their health so don’t wait to purchase coverage.

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Health Insurance Companies to Add More Customer Service

Health Insurance Companies to Add More Customer Service in General Healthcare

As many as 24 million Americans will be purchasing health insurance by 2014. As health insurance companies compete for all of these new consumers, they are adding and measuring customer service programs to give consumers a better and more efficient health care experience.

Over the past few years, health insurance companies have been making efforts to provide benefits to consumers like wellness and preventive services. These benefits provide access to programs they may not be able to afford — like smoking cessation classes, weight-loss programs or discounts for gym memberships.

Now health insurers are adding new customer service benefits to their plans. According to The Los Angeles Times, insurers are making it easier for consumers to understand insurance by cutting out the “health insurance jargon out of their communications.”

Highmark, Inc., a Blue Cross Blue Shield carrier in Pennsylvania is opening up retail stores to help people answer questions and to offer wellness classes. This insurer already has two retails stores and is planning to open three more this year.

Joe Mondy, the spokesman for CIGNA said, “We see the stakes in terms of customer service going higher and higher.”

For some consumers picking the right plan that offers the best customer service could improve their health care. More health insurance companies may advertise their customer service rankings as they compete for more consumers and work to keep consumers on their health insurance plans.

The competition in customer service will ultimately improve the overall consumer experience when finding the appropriate health insurance coverage.

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Physician Groups File Suit against New Health Reform Regulations

Physician Groups File Suit against New Health Reform Regulations in General Healthcare

As if the federal government didn’t have enough to worry about the lawsuit over the constitutionality of health insurance reform, they will now have to defend themselves against another lawsuit. This lawsuit was filed by the American Medical Association, the American Osteopathic Association and the Medical Society of the District of Columbia that would block to Federal Trade Commission from imposing new regulations on doctors.

According to ModernHealthcare.com, these regulations will require doctors to implement “red flags” rules that would help prevent, detect and mitigate identity fraud and theft. Currently financial institutions, banks and mortgage lenders have to comply with the “red flags” regulations but many argue that health care providers are not financial institutions.

The FTC believes that physicians and health care providers are creditors because they extend credit to patients.  Based on the fact that they provide health care services without upfront payment and then bill health insurance companies-thus deferring the debt.

The red flag regulations have been pushed back in the past but unless lawmakers push back the regulations again, health care providers will have to comply with the rules by June 1. The regulations require physicians to examine their risk for insurance fraud and then place a program to respond to “red flags” to alert them. Physicians that do not comply with the law could face up a $2,500 fine for each violation.

These new regulations could require more administrative support and place additional burdens on physicians. The government may be trying to fight Medicare fraud but should realize the impact the regulations will have on physicians without providing any benefit to patients.

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Medical Schools Teaching Students Costs of Health Care

Medical Schools Teaching Students Costs of Health Care in General Healthcare

Over the past decade, doctors and medical students have spent little time teaching or learning about the costs of health care services. Now after the year long debate about health insurance reform and the rising costs of health care, medical schools are starting to offer classes based on health care costs. Many schools are now offering medical students classes based on the costs of health care services and how the insurance system works. 

The former senior vice president for medical education at the American Association of Medical Colleges, Dr. Michael Whitcomb, feels that, “Medical schools have done a really terrible job over the years in educating students about the system that they’re going to encounter.”

According to The New York Times, accrediting organizations are now requiring schools to teach students about health care costs and cost-effective practices. The A.A.M.C. established these rules in 1998 and then in 2007, residency programs were forced to implement cost effective ideas in caring for patients.

Right now around 60 percent of medical schools include information about health care costs in student materials but the amount of time and discussion spent on these issues varies. 

Dr. Neel Shah from Brigham and Women’s Hospital in Boston said, “It’s a very odd system where we make purchasing decisions on behalf of patients but we don’t know what anything costs. There’s no disincentive to ordering tests-all we have to do is click a button and we’re ordered it.”

Doctors that are well-informed about the costs of health care will make the best decisions for their patients, and help battle the rising costs of health care.

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Hospital to Cut Health Care Costs by Putting Patients in Hotels

Hospital to Cut Health Care Costs by Putting Patients in Hotels in General Healthcare

A pilot program at a hospital in Birmingham, Minnesota is taking patients from the hospital and putting them into the Hilton across the street. Tria Orthopaedic Center has teamed up with health insurance companies and a Hilton to cut health care costs while providing better care for some patients. The program started in 2008 and has served around 70 patients. 

Allowing patients to stay in a hotel instead of a hospital can cut the cost of a surgery by 15 to 20 percent according to The Star Tribune. Patients that are sent to the hotel have a nurse on hand 24 hours a day.  The idea behind the program is expanding day surgeries, when a patient has a surgery during the day and then stays at a hotel overnight.

The patients that utilize the program have to be healthy without other chronic diseases, and must have a family member or friend stay overnight in the hotel room. They are patients that had surgeries for partial knee replacements, multiple ligament reconstruction, hamstring repair or fracture repairs.

Jim McManus spokesman of the pilot program said, “As with every pilot program, we evaluate many factors, with patient safety being of paramount importance. They will also look at costs, health outcomes, and if this approach possibly represents a more family friendly environment, which can have a significant impact on a patient’s recovery.”

Currently the program receives 5 out of 5 from 98 percent of the patients who have participated in the program. The hospital hopes to expand the program and why not? 

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Incorrect Patient Information Becoming Problem among Health Care Providers

Incorrect Patient Information Becoming Problem among Health Care Providers in General Healthcare

Health care providers across America are encountering a problem with patients giving incorrect contact information at the time of receiving medical treatments.

It’s apparently a growing trend and becoming a major problem. Patients are now more commonly providing incorrect information in emergency rooms and actually leave before test results are final.

People will leave hospitals with potentially serious and life-threatening illnesses without being aware.  Health care providers then try contacting the patient to give the results and are unable to get a hold of the patient. Some hospitals have to hire people-finders, send registered letters and call the police to find the missing patient. 

According to MSNBC, it is uncertain how many patients leave the wrong or incorrect phone numbers at hospitals.  But a 2000 study showed that out of 1,136 patients, only 42 percent could be directly contacted with the phone numbers that were provided. The other people gave wrong or disconnected numbers or were not home, didn’t answer and couldn’t be reached.

Here are a few reasons patients would leave incorrect numbers could stem from, writes the MSNBC article:

• A patient is uninsured and doesn’t want to pay hefty medical bills;
• The patient is an immigrant and afraid to leave correct information, and;
• Short-term cell phone contracts have become more popular and few people have landline phone numbers.

Dr. James Feldman from the Boston Medical Center’s Emergency Medicine department said, “People don’t understand that it does threaten your safety. It’s vital to have the most accurate and reliable way to contact them, in an emergency department more than any other department in the hospital.”

Really, this issue is part of controlling health care costs. Incorrect information leads to hospitals raising their rates to subsidize these errors, which leads to higher health insurance premiums.

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