Category: Health Insurance (Page 11 of 12)

      A changing medical system offers shorter workdays for physicians

      April 4, 2011 /

      Medical mistakes attributed to overworked doctors may soon become a thing of the past.

      Physicians working in large medical groups are given the opportunity for more traditional 9 to 5 work hours.

      “… many other young doctors are taking salaried jobs, working fewer hours, often going part time and even choosing specialties based on family reasons. The beepers and cellphones that once leashed doctors to their patients and practices on nights, weekends and holidays are being abandoned. Metaphorically, medicine has gone from being an individual to a team sport..”

      Doctors, Health Insurance, Hospitals, Quality Control

      Big insurance companies and the fight to protect profits

      November 11, 2010 /

      This story is disgusting.

      As health care costs soared nationally, a small Michigan firm gave Ford Motor Co. a proposal to cut its physical therapy costs. The automaker signed up for an in-state pilot program, which was so successful Ford expanded it last year to cover about 390,000 employees, retirees and their families nationwide.

      Yet the cost-saving program created by Pontiac-based TheraMatrix has come under attack from Blue Cross Blue Shield of Michigan.

      Court records allege Blue Cross used its position as the state’s dominant insurer to try to crush TheraMatrix as it worked to also sign up Chrysler and General Motors. A USA TODAY review of hundreds of pages of e-mails and internal documents that are part of a lawsuit TheraMatrix filed against Blue Cross indicates that TheraMatrix’s efforts to carve out a niche market in managing outpatient physical therapy costs was seen as a threat by officials at Blue Cross and by some Michigan hospitals.

      In one sense, it’s not surprising that a big company will play rough with an upstart competitor. But in the health care area, where costs are exploding, this is indefensible. Also, Blue Cross is a nonprofit – go figure.

      Alison Young then goes on to write the following, which gets to the crux of the issue:

      The aggressive tactics employed against TheraMatrix raise questions about whether relationships between hospitals and insurers are inflating medical prices and stifling competition needed to control costs.

      The government needs to get tough with insurance companies.

      Health Insurance, Hospitals

      Companies are shifting more health costs to higher earners

      November 10, 2010 /

      doctors on hospital floor

      With the costs of health insurance rising, companies are trying to find creative ways to ease the burden for lower wage workers who are getting crushed by higher premiums.

      With health care costs climbing even higher during this enrollment season, more employers are adopting a tiered system to pass on the bulk of those costs to their employees by assigning bigger contributions to workers in top salary brackets and offering some relief to workers who make less money.

      For years, employees have seen what they pay toward health care go up as companies ask them to contribute more to premiums and deductibles. But now, as people enroll in health plans for the coming year, the sticker shock is more jolting than ever because so many companies are passing on to their workers most, if not all, of the higher costs.

      A worker’s share of a family policy is approaching $4,000 a year on average, and is most certainly going to keep on rising through the next few years. For lower-salaried workers, those additional costs have only compounded their struggle in a brutal economy.

      More and more companies in the last year or so have begun signaling their recognition of the added burden shouldered by workers in low- and middle-income jobs by varying the premiums they pay based on salary. Consultants say the trend is likely to continue, as employers devise various ways of spreading increased health care costs among their staff and balancing that side of the ledger against fewer raises and other compensation.

      It will be interesting to see if the new health care law affects insurance rates over time.

      Health Care Policy, Health Insurance

      Lifetime caps on health insurance are now a thing of the past

      September 25, 2010 /

      The new health care law now prohibits lifetime caps. The result is that health insurance coverage will be extended to the 20,400 people that the government estimates may exceed their limits each year. The law also begins to restrict annual limits on benefits, eliminating them fully in 2014.

      The New York Times shares one example of a family who will benefit from this change.

      As a healthy couple in their mid-20s, Bill and Victoria Strong’s last concern when shopping for health insurance was a cap on lifetime benefits. Then Gwendolyn was born, and six months later was found to have spinal muscular atrophy Type I, a degenerative condition that typically kills its victims before age 2.

      Suddenly, it became vital that their family policy, with Health Net of California, had a generous $5 million limit on benefits. With the help of hugely expensive care at their home in Santa Barbara, Calif. — ventilators, nebulizers, feeding tubes, suction machines — Gwendolyn has defied the odds to survive to nearly 3. And she has already consumed $2 million in care, about half of it from three hospitalizations in her first eight months.

      “Anxiety was high,” said Mr. Strong, now 34, “because we were marching pretty quickly toward that $5 million cap. It was always in the back of my mind.”

      Now they don’t have to worry about the lifetime cap.

      This can happen to anybody. The idea behind health reform is that we should take some of the randomness out of the system. Any of us can experience this type of misfortune, so why not spread the risk?

      Health Care Policy, Health Insurance

      The chronically ill can now get health insurance coverage

      September 25, 2010 /

      Here’s a specific example of the new health care law changes things for the better:

      Joe and Mary Thompson had agreed to adopt Emily before her birth in 1999, and it never occurred to them to back out when she was born with spina bifida. But that same year, their residential remodeling business in Overland Park, Kan., went under, prompting job changes that left the family searching for health coverage with a child who was uninsurable.

      The insurers were willing to cover the Thompsons and their older daughter, but not Emily, who was later discovered to have mild autism as well, or her 13-year-old brother, who had a diagnosis of attention deficit disorder.

      Starting Thursday, the insurers will not be able to do that, as the new health care law prohibits them from denying coverage to children under 19 because of pre-existing health conditions. In 2014, the change will extend to people of all ages.

      This will change the lives of many people for the better.

      Health Care Policy, Health Insurance

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