Thursday, May 30, 2013

Immigrants Contribute More To Medicare Than They Take Out

As Congress mulls changing America�s border and naturalization rules, a study finds that immigrant workers are helping buttress Medicare�s finances, because they contribute tens of billions a year more than immigrant retirees use in medical services.

�Immigrants, particularly noncitizens, heavily subsidize Medicare,� the researchers wrote in the journal Health Affairs. �Policies that reduce immigration would almost certainly weaken Medicare�s financial health, while an increasing flow of immigrants might bolster its sustainability.�

The Hospital Insurance Trust Fund, which pays for Medicare�s Part A inpatient hospital care, skilled nursing facilities, home health and hospice for the aged and disabled, had assets of $244 billion at the start of 2012 but is projected to run out of money in 2024 as the population ages, according to estimates of the Medicare trustees. It is financed by payroll and self-employment taxes.

The study examined the impact of 29 million immigrants counted in the Census on the financing of the Medicare program. It included those who had become U.S. citizens as well as those who hadn�t, but, the authors noted, probably excludes many illegal immigrants who dodged the survey.

The study found that in 2009, immigrants contributed $33 billion to the trust fund, nearly 15 percent of total contributions. They received $19 billion of expenditures, about 8 percent, giving the trust fund a surplus of $14 billion. People born in the United States, on the other hand, contributed $192 billion and received $223 billion, decreasing the trust fund by $31 billion, according to the paper�s lead author, Leah Zallman, a scientist at Cambridge Health Alliance in Massachusetts,

Between 2002 and 2009, immigrants generated a cumulative surplus of $115 billion for the trust fund, the study found. Most of the surplus contribution came from noncitizens. The immigrants created a net gain primarily because of demographics: There are 6.5 immigrants of working age for every one elderly immigrant, but only 4.7 working-age native citizens for every one retiree. Although that ratio could change in the future, the report notes that the Census Bureau projects that the share of immigrants in the United States will increase for the next 18 years.

Continue reading.

Health Law Spared Young Adults From High Hospital Bills

More From Shots - Health News HealthJoblessness Shortens Life Expectancy For White WomenHealthImmigrants Subsidize, Rather Than Drain, MedicareHealthMisplaced Blame On Childhood Ritalin For Later Substance AbuseHealthDisinfect All ICU Patients To Reduce 'Superbug' Infections

More From Shots - Health News

Comments   You must be signed in to leave a comment. Sign In / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Wednesday, May 29, 2013

Health Differences May Explain Medicare Spending Variation

More From Shots - Health News HealthDisinfect All ICU Patients To Reduce 'Superbug' InfectionsHealthMiddle East Coronavirus Called 'Threat To The Entire World'HealthHealth Law Spared Young Adults From High Hospital BillsHealthBird Flu Shrugs Off Tamiflu In 'Concerning' Development

More From Shots - Health News

Comments   You must be signed in to leave a comment. Sign In / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

New Hampshire AFL-CIO Endorses HR 676

From UnionsForSinglePayer.org –

�On Saturday, May 4th the New Hampshire AFL-CIO unanimously passed a resolution supporting HR 676 and the adoption of a national single payer health care system that covers all Americans for all necessary medical care including prescription drugs and dental,� reported President Mark MacKenzie.

New Hampshire is the 42nd State AFL-CIO Federation to endorse HR 676, Expanded and Improved Medicare for All, sponsored by Congressman John Conyers (D-MI).

�HR 676 will save hundreds of billions of dollars by eliminating the private health insurance industry with its high overhead and profits,� said MacKenzie.

�As President of the New Hampshire AFL-CIO I am proud to have our members actively participate in the movement to win passage of HR 676 and to make health care a human right.�

On May 21, 2013, HR 676 gained another co-sponsor in Congress with the addition of Danny Davis (IL-7). HR 676 now has 42 co-sponsors.

Monday, May 27, 2013

Overweight People Are More Apt To Ditch Doctors

More From Shots - Health News HealthFor Many, Affordable Care Act Won't Cover Bariatric SurgeryHealthOverweight People Are More Apt To Ditch DoctorsHealthA Token Gift May Encourage Gift Of LifeHealthHeart Failure Treatment Improves, But Death Rate Remains High

More From Shots - Health News

Comments   You must be signed in to leave a comment. Sign In / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Friday, May 24, 2013

Healthcare For A Family Now Costs More Than Groceries To Feed Them For A Year

As medical costs continue to rise, the annual health expenses for a family of four now exceed the typical of cost of their groceries during the same time period, according to a new report from consulting firm Milliman, Inc.

The firm estimates that a typical family of four with an employer-sponsored health plan will end up incurring about $22,030 for all of their medical costs in 2013. That represents a 6.3 increase from last year, when the typical family racked up $20,728.

Some of that total sum ends up being covered by the family�s health insurance plan � the firm�s analysts found that employers paid about 58 percent of the total health care costs � but a big chunk of it falls onto the family itself. The average family pays more than $9,000 in payroll deductions and out-of-pocket bills for their health care, which is more than they typically spend on groceries and gas for an entire year:

�It is a huge expense,� Chris Girod, principal and consulting actuary at Milliman Inc. said in an interview. �Although the trends are slowing down, the total dollar amount has risen $1,300 per year each of the last four years.�

Meanwhile, the share a family and employees pay continues to rise as employers push more costs onto their workers. Therefore, the total share of the overall costs continues to mount, surpassing other household milestones like food and a year�s worth of gas.

�The total share of this cost borne directly by the family � $9,144 in payroll deductions and out-of-pocket costs � now exceeds the cost of groceries for the (Milliman Medical Index�s) typical family of four,� the study says. �The out-of-pocket cost alone � $3,600 for co-pays, coinsurance and other cost sharing, is more than the average U.S. household spends on gas in a year.�

That�s been a consistent trend over the past several years. As the cost of health care increases, Americans� contributions to their health plans have risen at a much faster rate than their employers� share. Since 2003, workers in every single state have had to increase their contributions to their family health plans by nearly 75 percent. At the same time, workers� wages have stagnated. As struggling Americans aren�t able to afford the treatment they need, they�re putting off doctor�s visits and skipping out on their medication.

And, if the regular health costs that a typical American family incurs over the course of the year already represent such a big expense, it�s easy to see how just one catastrophic medical event could plunge Americans into serious debt. The average trip to an emergency room costs 40 percent more than what most Americans spend on monthly rent. It�s even worse for those with ongoing conditions that need expensive treatment � for instance, the Americans who are battling cancer are twice as likely to go bankrupt, even if they have health insurance.

Wednesday, May 22, 2013

Texas Medicaid Debate Complicated By Politics And Poverty

More From Shots - Health News HealthBoomer Housemates Have More FunHealthThe Scramble At Moore Medical Center As The Tornado HitHealthA Catch For Insurers That Cut Deductibles For Healthy PeopleHealth CareLatest Health Hurdle: Buying Insurance Without A Bank Account

More From Shots - Health News

Comments   You must be signed in to leave a comment. Sign In / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Friday, May 17, 2013

Oregon Single-Payer Activists Keep Dream of Universal Healthcare Alive

In Oregon, a separate measure, giving state sponsorship of a comprehensive study on universal healthcare financing, makes its way through the Committee on Ways & Means.

May 15, 2013 � Wes Brain was uninsured last winter when a tonsillectomy showed signs of throat cancer. He qualified for the high-risk Oregon Medical Insurance Pool, which the state has administered through Regence BlueCross BlueShield.

But gaining access to that insurance soon proved a big obstacle for the Ashland resident, when Regence erroneously told him he hadn�t submitted his driver�s license.

�Denial and delay, denial and delay are the way these insurance companies work. They make money this way,� Brain vented to the House Health Committee on Tuesday. He had previously lost his daughter after a nine-year struggle with leukemia while contending with insurance companies over access to necessary healthcare services.

Eventually, his policy was approved. He paid $2400 � three month�s premium. His doctor ordered a PET scan for March 1. But then Regence came back and told him no, he�d have to wait until March 1 to even begin authorization.

His clock was ticking. His throat cancer could be spreading.

He enlisted his local Rep. Peter Buckley, D-Ashland, to help him. He got the state Insurance Division on his case.

They came through. He received his PET scan, and spent four days at Oregon Health & Science University, receiving additional tonsil surgery. �They cut the hell out of me,� said Brain, who’s now cancer-free.

�There is no way that Regence should have delayed my care at all,� Brain added. �That�s how they do business. They kill people doing it. Let�s get them the hell out of it, and let�s pass this bill.�

Buckley and 23 other Democrats have signed on to support House Bill 2922, which would throw out the private health insurance industry and set up a single-payer health insurance system administered by the Oregon Health Authority.

The bill has no chance of passage this session, but House Health Committee Chairman Rep. Mitch Greenlick allowed fellow Portland Democrat and chief sponsor Rep. Michael Dembrow to lead single-payer health care advocates in an informational public hearing.

Brain and other activists aired their support for a privately delivered, government-sponsored health system that would revolutionize Oregon healthcare and make it similar to health systems in Japan, Europe, Canada and the rest of the developed world.

HB 2922 closely parallels House Bill 3510 from the 2011 session, but at 76 pages, it�s 30 percent longer than the previous measure, repealing newly acted reforms such as Cover Oregon, which offers subsidized private insurance for people with moderate incomes.

No Republicans have yet come on board as supporters, but the single-payer bill has twice as many sponsors this session from Democrats across the state, including rural districts as well as Portland and Eugene. Two of the state’s largest unions � the Oregon Nurses Association and the Oregon Education Association � have also thrown their support behind the measure.

Study Bill Moves Forward

Dembrow has also sponsored House Bill 3260, which had a budget hearing on Tuesday. That bill, which passed unanimously earlier this session from the House Health Committee, would solicit $250,000 to $600,000 in private funds to comprehensively study how best to implement universal healthcare in Oregon.

The study will look at several different options, including single-payer, a public option and the basic health plan envisioned for low-income people who wouldn’t qualify for Medicaid by the Affordable Care Act.

Chunhuei Chi, a professor at Oregon State University�s College of Public Health and Human Sciences, told The Lund Report the study would aim for transparency, be replicable and available for peer review. The Oregon Health Authority could either choose Oregon State or another entity to conduct the study.

Previously, Health Care for All Oregon, which supports the single-payer bill, had considered asking the Northwest Health Foundation to conduct such a study. But according to Dembrow, a state-sanctioned study would lend more credibility.

Earlier, he told The Lund Report that while he expects single payer the best route to universal healthcare, he believes the underlying bill is written well enough to turn into the best solution for Oregon, and he will support its recommendations.

�This is exactly the way it�s done,� said Sen. Elizabeth Steiner Hayward, D-Portland, who favors doing such a study but has not come out in support of the single-payer option. �I like that you�ve laid out a menu of options, and that it doesn�t make a predetermined decision,� she added, calling the study outcome-based rather than motivated by political ideology.

Contrasting Systems

Alan Journet, a retired professor and dual British-U.S. citizen, pointed out that in Great Britain, socialized medicine is so popular even Conservative icon, former Prime Minister Margaret Thatcher, was a big supporter.

While living in the U.S., he came down with cancer and was given two months to live, absent treatment. �Thanks to insurance, I didn�t have to worry much about the cost of treatment, but I did constantly have to worry about the insurance company approving doctor-recommended treatment,� Journet said.

Journet said he felt lucky � his insurance company approved his treatment, unlike his sister-in-law who fell ill earlier.

�Her insurance company denied treatment, and she died,� Journet said. �We often hear the complaint that we should fear government functionaries making decisions on treatment, as though we are better served having insurance company functionaries make such decisions, employees whose income encourages denying treatment and generating a sizable profit.�

Dembrow said his passion for single-payer healthcare started following the birth of his two children. His daughter, who was born in France, received exemplary care, including house calls from physicians for just a small co-payment and a tax taken out of the family paychecks.

His son, on the other hand, was born in Indiana. At the time, insurance companies weren’t required to cover infants for the first 30 days of their life. His son had a digestive abnormality called pyloric stenosis that required surgery. A graduate student at the time, Dembrow and his wife had to deplete their savings to pay for the care.

�The contrast of those experiences have committed me to try to do things differently in this country,� Dembrow said.

Dembrow praised the reform efforts of Gov. Kitzhaber to deliver healthcare for the poor through coordinated care organizations and also lauded many of the aspects of the Affordable Care Act, including the expanded Oregon Health Plan and the insurance exchange. Yet, he said these reforms fall far short of an equitable universal healthcare system.

�We�ll continue to have jobs kept temporary or part-time for no good reason other than to keep workers from being eligible for coverage,� he said. �Our system will still rely on private insurance companies who charge high administrative fees, create administrative burdens for doctors and other healthcare professionals, and whose primary interest is their own profits. � At best what we�re going to continue to have an expensive, complicated patchwork system.�

Wednesday, May 15, 2013

Obamacare Issues Beg the Questions that Single-Payer Answers

In recent days, many of us have read and tried to follow the reports that Congressional offices are engaged in discussions about how to make sure their health insurance coverage available under the Affordable Care Act (Obamacare) remains affordable for Congresspersons and their staff members. If you�d like to read more about the hullabaloo, this piece from the Washington Post probably explains it as clearly as any.

Basically, a mischievous amendment drafted and inserted by Republicans and later agreed to by Democrats anxious to pass the ACA leaves some challenging issues to be resolved regarding the employer�s (in this case the Federal government, a.k.a., you and me) contributions to paying their share of premiums for Congressional members and their staff members. Negotiations and discussions continue, but some fear that some Congressional staff may leave their positions rather than take on the bigger financial burdens of paying more of their health insurance premiums. Stay tuned, if you are worried about how this plays out.

For the human beings involved who have health needs and families to support just as the rest of us do, I hope a fair resolution is reached in the short term. In the longer term, this should serve as yet another reinforcement of the need to move well beyond the incredibly unaffordable Affordable Care Act to the common sense, common decency, and simplicity of a single-payer, Medicare for all for life model for our dysfunctional health care system.

If Congressional members and their staffs are having difficulties comprehending and navigating the details of the ACA, imagine the millions and millions of �average� Americans who will face incredible confusion, expense, and delays of access to needed health care as we slog through the details of the ACA. Most of us will not have anyone to negotiate or advocate for us when we try to make decisions about health coverage. We will have �navigators� who will explain various plans available on the exchanges but that�s vastly different from having true advocates to make sure we aren�t overburdened with costs or enrolling in coverage that really isn�t coverage at all but simply compliance with the mandate to carry the financial product that is insurance. I am already worried, just as millions of others are.

Why would single-payer, Medicare for all for life be so much better? Simplicity � everybody is in, nobody is out. Vastly reduced administrative costs � strip out the profit made on misery and deception and advertising and claims denials and delays. Incredibly improved access to providers of our choice. No need to navigate me to one plan or another. No need to bankrupt me with co-pays, deductibles and out-of-pocket expenses. No need for anyone in charge of profit-making to lemon drop (get rid of those with costly medical conditions or who are aging) or cherry pick (keep the healthy, less costly folks enrolled). We all have one single standard of high quality care under a social insurance model, not a model aimed at maximizing profits.

Some of us will face harsh realities more quickly than Congressional members of staffers on the Hill. In just four days, I must decide once and for all whether or not to spend more than $800 a month on my coverage for the next several months or just go bare until the exchange (more stealthily named the �marketplace�) is up and running here in Colorado in January 2014. No matter what I, as a two time cancer survivor and 58 year old, think is possible financially for me or even wisest from a health standpoint over the next eight months, once I get to October of this year, I will be able to begin exploring what I may be able to find under the ACA for my coverage. I am so grateful that my husband is covered under Medicare and a supplemental (as are many member of Congress, I suspect).

When my time comes to decide about my health and my life, there will be no committee convened that worries about my costs or my coverage as is the case with the current effort on behalf of the Congressional members and staffs my tax dollars cover. I will decide alone, likely in front of my computer screen, making calculations about paying my bills and other living expenses. And I guarantee that my coverage will be bare bones as no one will want to cover me and though under the ACA they will not be able to deny me coverage, insurance companies will be able to age-rate my premiums and make sure they factor in my health history. My premiums will likely be so high that I will either have to opt to pay a penalty for not having coverage or I will be grossly under-insured.

None of this is necessary. None of it. Under a Medicare for all for life, single-payer model, we are all in one risk pool, we all pay a fair and progressive tax or premium for our coverage, and our medical and health decisions will no longer be business calculations. We will be free of this mess. We must thunder forward through the confusion of this difficult transition to the unnecessary complexity of the ACA to the day when we all are covered simply as a matter of human right and public good.

Donna Smith is the Executive Director of Health Care for All Colorado and the Health Care for All Colorado Foundation.

Feds Push For Lower Alcohol Limits For Drivers

More From Shots - Health News HealthFeds Push For Lower Alcohol Limits For DriversHealthHow A Florida Medical School Cares For Communities In NeedHealthA Sharper Abortion Debate After Gosnell VerdictHealthAngelina Jolie And The Rise Of Preventive Mastectomies

More From Shots - Health News

Comments   You must be signed in to leave a comment. Sign In / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Tuesday, May 14, 2013

It Came From Norway To Take On A Medical Goliath

More From Shots - Health News HealthParents Get Crib Sheets For Talking With Kids About DrinkingHealthMiddle East Virus Spreads Between Hospitalized PatientsHealthTeens Who Text And Drive Often Take Other RisksHealthCases Of Mysterious Valley Fever Rise In American Southwest

More From Shots - Health News

Comments   You must be signed in to leave a comment. Sign In / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Friday, May 10, 2013

It Came From Norway To Take On A Medical Goliath

More From Shots - Health News HealthJudge Denies Administration's Request To Delay Plan-B RulingHealthKids With Autism Quick To Detect MotionHealthIt Came From Norway To Take On A Medical GoliathHealthHow Can Identical Twins Turn Out So Different?

More From Shots - Health News

Comments   You must be signed in to leave a comment. Sign In / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

California Weighs Expanded Role For Nurse Practitioners

More From Shots - Health News HealthHow Can Identical Twins Turn Out So Different?HealthUsing Bacteria To Swat Malaria Inside MosquitoesHealthPrice Break For Cervical Cancer Shots In Developing WorldHealth CareCalifornia Weighs Expanded Role For Nurse Practitioners

More From Shots - Health News

Comments   You must be signed in to leave a comment. Sign In / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Wednesday, May 8, 2013

Veterans Have Unusual Choice Thanks To Health Exchanges

More From Shots - Health News HealthOfficials Prepare For Another Flu Pandemic � Just In CaseHealthWhat's In A Flu Name? Hs And Ns Tell A TaleHealthVeterans Have Unusual Choice Thanks To Health ExchangesHealthSaving Newborns: 'Kangaroo Care' Could Go A Long Way

More From Shots - Health News

Comments   You must be signed in to leave a comment. Sign In / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Friday, May 3, 2013

Suicide Rate Climbs For Middle-Aged Americans

More From Shots - Health News NewsOutbreak Of New SARS-Like Virus Kills 5 In Saudi ArabiaHealthWomen's Health Groups Angered By Morning-After Pill MovesHealthColorado Weighs Reopening Psychiatric Hospital For HomelessHealthSuicide Rate Climbs For Middle-Aged Americans

More From Shots - Health News

Comments   You must be signed in to leave a comment. Sign In / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Suicide Rate Climbs For Middle-Aged Americans

More From Shots - Health News NewsOutbreak Of New SARS-Like Virus Kills 5 In Saudi ArabiaHealthWomen's Health Groups Angered By Morning-After Pill MovesHealthColorado Weighs Reopening Psychiatric Hospital For HomelessHealthSuicide Rate Climbs For Middle-Aged Americans

More From Shots - Health News

Comments   You must be signed in to leave a comment. Sign In / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Thursday, May 2, 2013

Ratting Out TB: Scientists Train Rodents To Diagnose Disease

More From Shots - Health News HealthRecovery Begins For Mother, Daughter Injured In BostonHealthImagine A Flying Pig: How Words Take Shape In The BrainHealthMate Doesn't Have Your Back? That Boosts Depression RiskHealthSecond Thoughts On Medicaid From Oregon's Unique Experiment

More From Shots - Health News

Comments   You must be signed in to leave a comment. Sign In / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.