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Prenuptial Agreements to Lose Weight, Have Sex
Tweet Share on Facebook August 28, 2008 Comment (17)In a film I saw not too long ago, a scene about a prenuptial agreement stuck in my mind (about the only thing that did, since I can't even remember the film's name). The groom, on his way to church to be married, was still haggling over the details of his prenup. The biggest sticking point was how often he could expect to have sex with his new wife in exchange for agreeing to lose 10 pounds.
This must just be satire, I thought. No one would actually write such things into a prenuptial agreement, would they? Well, they would, as it turns out. Health-related clauses that dictate weight requirements, ban smoking, or spell out a plan to get pregnant within a certain time period are unusual, but they are indeed starting to turn up, say matrimonial lawyers. "As people become more health conscious, you find more of this stuff in prenuptial agreements," says Raoul Felder, a prominent matrimonial lawyer in New York City.
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Obama's Plan Wins at Covering the Uninsured
Tweet Share on Facebook August 27, 2008 Comment (26)Nobody's celebrating over the new Census Bureau figures showing that the number of people without health insurance dipped slightly last year, to 45.7 million, from 47 million in 2006. It doesn't indicate a trend, say experts.
Things seemed different when 2007 began. Back then, many experts were cautiously optimistic that other states might follow Massachusetts's lead and aim for universal healthcare or at least expand coverage significantly for more children and uninsured adults.
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4 Ways to Save on Your Medical Bills
Tweet Share on Facebook August 21, 2008 Comment (15)The number of Americans struggling to pay their medical bills is on the rise, and medical debt increasingly affects people at every income level, according to a new report from the Commonwealth Fund. The report, "Losing Ground: How the Loss of Adequate Health Insurance Is Burdening Working Families," paints a pretty bleak picture of how high healthcare costs are not only causing people to avoid getting the medical care they need but also straining their ability to pay for basic necessities like housing and food.
Letting the bills pile up unopened is a popular but ineffective way to address the problem. "They will come back to haunt you," says Mark Rukavina, executive director of the Access Project, a research and advocacy group that helps people tackle medical debt. There are much better strategies, says Rukavina, concrete steps you can take to reduce the amount you owe up front and manage any debt you've accumulated. Here's what he suggests:
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Harry and Louise Want Healthcare Fixed Now
Tweet Share on Facebook August 20, 2008 Comment (2)They're back. Harry and Louise, that famously frustrated fictional couple whose negative comments about the Clinton healthcare reform plan back in the early 1990s helped sink it, are taking to the airwaves again. But this time, they're urging the next president to make healthcare reform a priority. The new ad, which was unveiled yesterday, will run from August 24 through September 7, on local TV stations in Denver and Minneapolis-St. Paul during the Democratic and Republican conventions as well as national cable and network programs.
The ad is sponsored by five groups—the National Federation of Independent Business, Families USA, the American Cancer Society Cancer Action Network, the American Hospital Association, and the Catholic Health Association—that do not always see eye to eye on healthcare issues. Employers and business groups, for example, often favor the expansion of "consumer driven" healthcare, with high-deductible health plans that offer lower premiums. Many consumer advocacy groups argue that these plans leave sick patients with high medical bills that they can't afford. But all agree that the time has come for sweeping change. According to the press release announcing the ad campaign, "The joint campaign effort by the five organizations is intended to communicate the urgency of this crisis and demonstrate the commitment of these diverse groups to meaningful healthcare reform." Fair enough, but the original Harry and Louise ads represented partisan politics at their nastiest. You'd think the new ad's sponsors might have chosen a less divisive symbol to advocate for shared goals. Check it out, and see what you think.
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What 401(k)'s Can Teach Us About Consumer-Driven Health Plans
Tweet Share on Facebook August 14, 2008 Comment (18)I've written in the past about how consumer-driven health plans haven't exactly caught fire with consumers. Turns out the high-deductible health plans often end up costing consumers more out-of-pocket than they can afford, especially if they actually, you know, get sick and need to use them. Plus, the plans are complicated: You've got your high-deductible plan, with its myriad coverage rules and limitations, and then you've got the tax-advantaged health savings account that goes along with it, which has its own raft of rules.
No wonder consumers to date haven't embraced these plans, no matter how much employers try to encourage their use. What we're experiencing with consumer-driven healthcare, benefits consultants say, is very similar to what happened 30-odd years ago when employers began to shift away from regular company pension plans and into 401(k) plans. Remember those days, when you not only had to start funding your own retirement but also learn the intricacies of asset allocation and rebalancing your portfolio? A similar shift is happening today with consumers and healthcare, these experts say.
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Where to Turn for Immediate Medical Care
Tweet Share on Facebook August 7, 2008 Comment (4)Going to the emergency room to get a child's ear infection attended to is like using a proverbial shotgun to kill a mosquito. But thousands of people wind up at the ER all the time with such not-necessarily-critical ailments because they can't get an appointment to see their regular doctor in a timely fashion or because an accident or illness strikes outside of regular business hours.
In fact, a new survey found that 73 percent of people said they had difficulty getting access to their doctor when they needed to. Thirty percent reported that it was hard to get a next-day appointment when they were sick; twice that number said it was difficult to get care on weekends or in the evening from their regular doctor. More than 40 percent of respondents said that, even during regular business hours, they had trouble getting advice from their doctor on the telephone. So they end up at the emergency room, where care is much pricier than at the doctor's office. (ER patients often shell out a copayment of $100 or more for a visit that might cost them just $20 elsewhere.)
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How to Stretch Your Dollars in Dental Care
Tweet Share on Facebook July 31, 2008 Comment (7)It doesn't take a whole lot to derail people from keeping a date with their dentist. Even if you have dental insurance—and about 100 million people don't—it generally maxes out after just a few thousand dollars. With the economy uncertain and prices high, it's easy to put off making time to pay someone to poke around in your mouth.
But instead of avoiding your dentist entirely, do yourself a favor and keep up with your regular preventive care. As in so many things, you'll save yourself pain and expense if you prevent dental problems from occurring in the first place, experts say.
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Long-Term Care Insurance: Not Always a Good Buy
Tweet Share on Facebook July 24, 2008 Comment (28)Long-term care has been in the spotlight this week, with a Government Accountability Office report just out, a congressional hearing today, and new survey results on the subject. But all the concerned commentary about how we're going to meet the need for long-term care as baby boomers age really only highlights how elusive solutions are.
Today, Medicaid and other government programs pay for most long-term care, whether it's in a nursing home or for assisted-living services at home. Only about 10 percent of long-term care costs are covered by private insurance. But as many as two thirds of people over 65 eventually may need some sort of long-term care, according to some estimates. Many policy experts, estate planners, and others advocate long-term care insurance as a good way to provide financial security and stability for people against this unknown as well as to relieve the burden on an already stretched Medicaid program.
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More Bad Grades for U.S. Healthcare
Tweet Share on Facebook July 18, 2008 Comment (9)Anyone who's had to use our healthcare system lately will not be surprised to learn that a performance scorecard released this week found several areas in need of improvement. Access to care is one example. In that category, the Commonwealth Fund report gave the United States a score of 58 out of 100 in 2008, nearly 10 points lower than in 2006, when the first national scorecard was released. That's in part because last year, 42 percent of adults—some 75 million people—were either uninsured or underinsured, the report found, compared with 35 percent in 2003.
Overall, the country scored a 65, down slightly from 67 in 2006, based on indicators in five areas: healthcare outcomes, quality, access, efficiency, and equity.
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Employers Plan to Expand Wellness Programs Despite Unpopularity
Tweet Share on Facebook July 10, 2008 Comment (9)According to a new study, employees don't like wellness programs very much, and employers don't think they're very effective at mitigating healthcare costs or improving employee performance. Yet nearly half of the 561 companies that responded to the PricewaterhouseCoopers survey said they plan to expand their wellness programs over the next two years. What's up with that?
After years of asking employees to pick up more of the tab for their health insurance, many employers believe they're reaching the limit on how much they can shift costs, says Michael Thompson, a principal in the firm's New York health and welfare practice. But costs continue to rise. Premiums rose 6.1 percent in 2007, less than the double-digit growth earlier in the decade but still far outstripping the 3.7 percent increase in worker earnings, according to the Kaiser Family Foundation. Something's got to give, and employers hope healthier employees will cost them less. "There's a strong belief that we need to get at the underlying issues and decrease the demand for healthcare, and a major way to do that is to change lifestyle," says Thompson.
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