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Medicare Spending on Patients Varies Widely by State, Region
Tweet Share on Facebook February 27, 2009 Comment (16)There's no good explanation for why Medicare spent more than $9,500 per patient on healthcare in New York in 2006 but just over $5,300 per patient in Hawaii. Long winters may take a toll on people, but seniors in New York are just not that much sicklier than those in Hawaii. (You can click here to check out how Medicare spending in you area stacks up.) For more than 20 years, the Dartmouth Atlas Project has been documenting such regional variations, and their new analysis of Medicare spending between 1992 and 2006, published this week in the New England Journal of Medicine, once again illustrates the point, for anyone who still needs convincing, that more healthcare doesn't necessarily result in better health.
The authors make the case that differences in spending growth exist largely because doctors' treatment decisions are influenced by such local conditions as the availability of hospital beds, imaging centers, and the like. So, for example, a patient suffering from mild pneumonia might be admitted to the hospital in a city where there are lots of available beds, whereas he might be sent home to recuperate if he lives somewhere where hospitals beds are scarce. Another contributor: The healthcare system rewards doctors more for seeing patients and for performing procedures than for actually improving patients' health.
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Obama Budget Squeezes Medicare—and Wealthier Seniors
Tweet Share on Facebook February 26, 2009 Comment (33)President Obama's budget proposal to create a $634 billion fund to finance healthcare reform stomps on plenty of special interest toes. One target group: Some seniors may experience unwelcome changes to their healthcare benefits and costs.
Wealthy individuals earning more than $85,000 would reportedly be asked to shell out higher premiums for their Medicare drug coverage starting in 2011, a change that would affect about 2.3 million of the roughly 45 million Medicare enrollees. In addition, the budget proposal would halt the higher payments that the government gives insurers who cover Medicare beneficiaries through private Medicare Advantage plans. That would undoubtedly mean higher premiums and reduced benefits for some of the 10 million or so beneficiaries enrolled in such plans.
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Stimulus Bill to Cover 65 Percent of COBRA Costs for 9 Months
Tweet Share on Facebook February 13, 2009 Comment (214)The economic stimulus bill that the House and Senate are expected to vote on today will do precious little to ensure that people who've lost their jobs can get the healthcare they need. During earlier debate, a number of proposals were floated that were aimed at low-income and older workers. One would have allowed low-income workers who lost their jobs to apply for Medicaid if their jobs didn't offer health insurance. Another would have let laid off workers ages 55 and older keep their employer health coverage under COBRA for longer than the usual 18 months.
Neither of those proposals made it into the final compromise bill, zeroed out amid worries that once a benefit is extended to a particular group it won't ever be pulled back. Former Medicaid recipients in many cash-strapped states can attest that entitlements are not, in fact, forever. So can all the workers who've seen their 401(k) employer match nixed this year. But no matter. It's a predictable objection that gets trotted out regularly.
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4 Strategies to Reduce the Cost of Cancer Care
Tweet Share on Facebook February 6, 2009 Comment (11)Cancer is one of the most common diseases, and one of the most costly to treat. If you get it—and 1 in 3 women and half of all men will—you'd like to feel confident that having health insurance will ensure that you get the care you need without too much financial pain. But as a new report documents, our private health insurance system is riddled with holes that force many patients either to forgo or delay care or to rack up huge bills that put them and their families in financial jeopardy. I went looking for ways to mitigate the problems, and found precious few. This is no surprise; if there were easy, affordable solutions, there would be no need for this report.
"Spending to Survive: Cancer Patients Confront Holes in the Health Insurance System" is a report produced jointly by the American Cancer Society and the Kaiser Family Foundation. It describes the difficulties encountered by 20 cancer patients who had private health insurance and who should, by all rights, have been able to count on their health plans to cover most, if not all, of their care. It didn't work out that way. They ran into caps on coverage and bumped up against lifetime benefit limits. Their cancer forced them to quit working, but they couldn't afford to continue their former employers' coverage under COBRA. And so on. The specifics varied, but the outcome was often the same: treatment glitches and a mountain of debt to join the weight of worry they already faced over their health.
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Diabetes Health Plan: New Insurance Plan Cuts Cost of Having Diabetes
Tweet Share on Facebook February 2, 2009 Comment (4)Many people with type 2 diabetes pay hundreds or even thousands of dollars out of pocket every year to cover their share of the cost of drugs, testing supplies, and doctor visits that keep the disease in check. If they have serious complications, the costs can be exponentially higher, for both patients and the companies that employ them. Now, insurance giant UnitedHealthcare has developed a new health plan
targeted specifically at employees who have diabetes or are at risk for developing the disease.By giving workers extra financial and coaching support to prevent or manage diabetes, the insurer is betting that both workers and their employers will save money in the long run. How much employers will save is an open question. But for workers this plan looks like a home run, especially if employers absorb the higher premium costs, as United says they have done so far.
