Health Access WeBlog

For the record, Obama's plan does NOT mandate health coverage, as Gov. Palin suggested last night. That was the big "difference'' between his plan and the Clinton plan.

Also, McCain's plan would leave an additional 20 million uninsured, not 5 million as Gwen Ifill had suggested. Biden later corrected this point. It's significant because -- in context -- it would result in a 150% increase in the uninsured.

That's all I can remember, at this very moment, that annoyed me (on health care specifically)....I guess ....other than the fact that Palin didn't answer the question about why the McCain health care plan would increase taxes on the middle class.

Here's a side-by-side of the two plans, by the way.

Labels: InTheNews, PresidentialCandidates

posted by Hanh Kim Quach | Permalink | 11:13 AM

Health care, according to the New York Times, remains a bright spot in the economy producing 17,000 jobs in September.

Too bad we just cut $1.1 billion out of California's health care budget -- about half of those dollars were federal dollars that will now go to other states. The cut will mean a loss of nearly 11,000 jobs. It will also mean a loss of $485 million in income for families that work in the health care sector, which means they won't be buying couches, or pizza and will barely be able to fill up their tanks. It means an additional loss of $1.3 billion for California's economy because families won't be spending more.

Labels: Budget, Economy, InTheNews

posted by Hanh Kim Quach | Permalink | 10:59 AM

More deflating news. The NY Times reports on how unpaid medical bills are creating more of a strain for families, according to a new study from the Center for Studying Health System Change.

The study shows a striking increase in the number of families with medical debt. Here are the highlights:

57 million Americans were in families that had problems paying medical bills last year -- a 33% increase from five years ago;
75% of people with medical debt *had* health insurance;
20% of those with medical bill problems considered filing bankruptcy. About 4% followed through with it (2.2 million Americans).

This study comes out as we see that health care premiums continue to outpace our stagnant wages. Health care, sadly, is becoming a luxury.

Labels: InTheNews, MedicalDebt, Research

posted by Hanh Kim Quach | Permalink | 1:33 PM

Americans - feeling poorer and dejected -- are cutting health care out of their budgets for the first time in a decade. The article was in the Wall Street Journal this week.

Here's a striking paragraph:

The number of prescriptions filled in the U.S. fell 0.5% in the first quarter and a steeper 1.97% in the second, compared with the same periods in 2007 -- the first negative quarters in at least a decade, according to data from market researcher IMS Health. Despite an aging and growing U.S. population, the number of physician office visits also has been declining since the end of 2006. Between July 2007 and 2008, the most recent month for which data are available, visits fell 1.2%, according to IMS.

And that survey only counts the first six months of this year. I can only imagine how the numbers will slide after the economic mayhem of this quarter.

In a survey by the National Association of Insurance Commissioners last month,
22% of 686 consumers said that economy-related woes were causing them to go
to the doctor less often. About 11% said they've scaled back on prescription
drugs to save money. Some of the areas being hit include hip and knee
replacements, mammograms, and visits to the emergency room, according to a
survey conducted by D2Hawkeye Inc., a Waltham, Mass., medical data analytics
firm, on behalf of The Wall Street Journal.

Unfortunately, health care reform will become a casualty of the current banking crisis at the national level, and has already become a casualty of state and local budget crises -- at a time when public options for health care and more efficient, quality and affordable health care are needed most.

Labels: InTheNews, MedicalDebt

posted by Hanh Kim Quach | Permalink | 11:15 AM

So I know that we're just loaning American International Group, Inc. $85 Billion (that's with a B) for two years while they sort out the mess they're in. And I know it comes from the federal governments reserve fund, not the main fund that pays for all of our programs. I get that.

And to be sure, officials are not sanguine about their decision to rescue the insurance giant. They came to it reluctantly after careful deliberation. That said, I still can't help but notice that the $85 billion that the feds are putting up to keep the gigantic insurer AIG from roiling the markets is about the same amount (actually, it's a little more) than what health and children's advocates have been asking for the past couple of years to help fund children's health insurance (SCHIP) -- and provide universal children's coverage -- that's the remaining 10 million uninsured children -- for five (5) years.

It's interesting to look at the panicked language associated with the decision to rescue the insurer. From the New York Times:

If A.I.G. had collapsed — and been unable to pay all of its insurance
claims — institutional investors around the world would have been instantly
forced to reappraise the value of those securities, and that in turn would have
reduced their own capital and the value of their own debt. Small investors,
including anyone who owned money market funds with A.I.G. securities, could have been hurt, too. And some insurance policy holders were worried, even though they have some protections.

“It would have been a chain reaction,” said Uwe Reinhardt, a professor of
economics at Princeton University. “The spillover effects could have been incredible.” (Uwe Reinhardt, by the way, is also very interesting and entertaining when speaking of health policy and economics...)

Ok. We're worried there's going to be lots of pain everywhere. Lots of people with investments aren't going to have as much anymore. Lots of people, who have been paying for insurance, on the case that their factory goes down in flames would be SOL if their factory went down in flames after AIG declared bankruptcy. It's very sad when people lose their money. I don't like losing money, ESPECIALLY when I've played by the rules. It took regulators a couple days, but the came to the table and said they said, "We have to do this. It's too important not to do.''

The public is annoyed, but gets it. We don't want the economy to get any worse. We want to be number 1 again.

By contrast, the issue of whether to insure children -- with roughly the same amount of public resources (Again, i recognize it's a totally different process and comes from a totally different fund) remains a subject of intense debate. Ten million children, the majority of whom are in working families who play by the rules, need health coverage. But there is no rush to their side. I would argue that the "spillover effects" of uninsurance are just as tragic as a fallen market.

Children can't see a dentist to get cavities filled. They get abscesses and die. Children can't get to an eye doctor. They can't see the chalkboard. They get behind and frustrated in school. They can't live up to their intellectual potential. Children get asthma. They can't see a doctor. They can't get an inhaler. They miss school. They get behind. Schools lose money.

I'm not saying that money used to rescue AIG should be redirected to children's healthcare. I'm just miffed at the level of frenzy surrounding financiers, and I'm not sure why that frenzy and drive to take action is not as strong when it comes to those born to families that can't afford health insurance.

Labels: InTheNews, SCHIPHealthyFamilies, Uninsured

posted by Hanh Kim Quach | Permalink | 4:56 PM

In this Wall Street Journal story from yesterday, Wellpoint's CEO is appallingly frank:

In calls with analysts and investors, WellPoint executives have stressed that it
is working to keep its more-profitable business and that the customers leaving
tend to be costlier ones. "We're keeping good members and healthy lives that we
had been concerned about [losing] in the past," Ms. Braly told analysts last
month.

Translation: "Awesome. We won't have to spend money paying for sick people.''
(This is how Sarah Palin thinks the market should work?)

The story, however, touches on a familiar trend throughout the insurance industry -- the loss of employer-sponsored plans. Since 2001, the percentage of firms offering coverage has slipped nearly 10% in less than a decade to 59%.

Nevertheless, Wellpoint increased premiums yesterday to placate investors and as a result expects about 150,000 more business members (on top of the 189,000 business members they've already lost this year) to drop coverage.

Sidenote: Of course, we can expect the number of employers that would drop coverage to *increase* if McCain/Palin win office, as their plan allows insurers to run amok and tax businesses for providing this basic benefit to workers, making the individual market (least efficient, most expensive) more attractive.

Labels: BlueCross, Employers, InTheNews, PresidentialCandidates

posted by Hanh Kim Quach | Permalink | 11:34 AM

The Wall Street Journal today contains an analysis of Rep. Veep candidate Sarah Palin's policy record. Here are the relevant health portions:

Gov. Palin didn't make health care one of her top priorities, but where she did take a strong stand on health, it was for the free market.

"Health care must be market- and business-driven, rather than restricted by
government," her office said in a January statement.
Her overall approach is much like Sen. McCain's -- loosen government regulations to allow for greater competition, along with more information for patients to make good
choices.
Addressing the uninsured was less of an issue for Gov. Palin, much as it is less significant for Sen. McCain. She was reluctant to support a significant expansion of the state's version of the Children's Health Insurance Program, called Denali KidCare. She signed a bill that raised eligibility to allow families with incomes up to 175% of the poverty level -- stingy compared with other states.

Great. So she doesn't *really* think addressing the uninsured is an issue. Yet, Alaska, according to the latest Census Report, her state (and it's teeny tiny population of 664,000) has nearly the same proportion of uninsured as California -- 17.3 percent (to our 18.6 percent). The number of uninsured in her state could populate the entire town of Costa Mesa -- home to South Coast Plaza and 113,955 Orange Countians. (AK's uninsured is 115,000).

Labels: InTheNews, P, PresidentialCandidates, Republicans, Uninsured

posted by Hanh Kim Quach | Permalink | 11:03 AM

We just posted our bill list. The legislative year in review for health bills is also covered by Victoria Colliver at the San Francisco Chronicle, and Jordan Rau at the Los Angeles Times.

We were obviously disappointed that some big, important consumer bills stalled. But there's still a lot of good bills heading to the Governor's desk, ones help people have a little more confidence in their coverage: that benefits will be covered; that their policies won't be retroactively yanked away; that they won't be balance billed when going to an emergency room; that their premium dollars goes to patient care rather than administration and profit; and that if they seek coverage, they won't be left with no place to turn if denied for "pre-existing conditions." Health advocates will make their case for the Governor to sign them.

Labels: InTheNews, Legislation

posted by Anthony Wright | Permalink | 12:03 AM

The state budget impasse is nearing the end of its second month and shows no signs of abating. For every day that California goes without a budget, we get anxious because it means that more cuts are possible.

The May Revise budget contained nearly $1 billion in cuts to health services, which would have translated to more than one million additional uninsured Californians by the end of the Schwarzenegger administration. The Conference Committee restored many cuts, but the Conference Committee budget would result in the loss of health coverage for nearly 300,000 children by the the Schwarzenegger administration. The LA Times had a story this weekend.

As the budget debate drags on, and Republicans refuse to agree to increased revenues to fund our state's basic needs, more lives will be on the line. There have been rumored mutterings of more cuts -- meaning more children will be unable to get eyeglasses, teeth cleanings and basic health services that would keep them healthy and in school for years to come.

Labels: Budget, InTheNews, Republicans, Uninsured

posted by Hanh Kim Quach | Permalink | 10:33 AM

After years of making progress of covering children, California may be going backwards, reports Jordan Rau in Sunday's Los Angeles Times. Actually, it's heartbreaking that there will be kids that are being dropped from coverage, in Alameda County now, and soon statewide.

The budget debate is no longer should kids be discouraged and denied away from coverage, but how many. The Democratic proposal would increase premiums in Healthy Families, and increase reporting in Medi-Cal--both that are expected to decrease enrollment. If we raise less than the $8 billion+ in revenues, then the cuts would need to be even steeper.

Or we can decide covering California kids is a prioirity, and raise the money to finish the job.

Labels: Budget, InTheNews, MediCal, SCHIPHealthyFamilies

posted by Anthony Wright | Permalink | 12:08 AM

California's budget is now 50 days late and we are headed toward our longest budget impasse *ever*. But today brought a bit of good news: A Los Angeles judge has blocked the state's 10% Medi-Cal reimbursement cut, which took effect July 1.

In order to get a jump start on closing the state's $17.2 billion shortfall, lawmakers and the governor approved a bunch of borrowing and initial cuts. One of the cuts was to reduce the reimbursement rates paid to providers caring for Medi-Cal patients. California already ranks among the lowest-paying states for Medicaid providers -- this cut made things even worse, as Anthony pointed out in the Sacramento Bee article today.

Of note: HD Palmer in the Department of Finance says the judge's ruling would "cost'' the state $575 million. We would argue that NOT paying providers their normal, abysmally low reimbursement rates would cost the state -- not only $575 million in matching federal dollars, but:

$1.4 billion in business activity,
11,400 jobs and
$517.5 million in wages.

(Per FamiliesUSA Medicaid Calculator)

Labels: Budget, InTheNews, MediCal

posted by Hanh Kim Quach | Permalink | 11:38 AM

Anthem Blue Cross offered *all California hospitals* a piddling $11.8 million to settle a class action lawsuit that was filed after the hospitals were left with millions in unpaid medical bills (not to mention the patients who also suffered financially, emotionally and health-wise) when Blue Cross retroactively cancelled patients' coverage, according to the Sacramento Business Journal.

$11.8 million might sound like a lot, until you consider that the state fined the company $10 million over 1,770 rescissions made since 2004. The hospitals' suit covers a longer time frame.

...and don't forget the $950 million in our premium dollars that the company sent *out of California* to its parent.

Labels: BlueCross, InTheNews, Rescissions

posted by Hanh Kim Quach | Permalink | 2:00 PM

Lots of research and studying going on lately, and it seems the general consensus is that lots of people aren't getting sufficient health care, and many need it:

In the Central Valley, UC Davis is looking at farmworker health, finding that lots of farmworkers have chronic musculoskeletal pain, allergies and are overweight;
In the Latino community, many don't seek out regular care;
Americans, generally, are going to the doctor less and cutting back on prescription drugs during the recession.

It's an interesting cluster of studies that shows the need to make health care more *accessible,* both culturally and financially, and that those elements need to be key parts of health reform discussions as we head into our next round....soon.

Labels: InTheNews, Research

posted by Hanh Kim Quach | Permalink | 11:12 AM

Insurance brokerage giant Aon Corporation released a study today showing that even though health care premiums next year will still outpace inflation by more than 3.6 times, at least it's slowing. In the next year, health premiums are expected to increase approximately 10.6 percent. It's been going down steadily since 2002, when increases hovered around 16 percent.

The San Francisco Chronicle also reports on the study.

One of the reasons for the slowed increase, the study director says in the SF Chronicle, is that businesses are being much better about ensuring their workers stay well -- through disease management programs -- and attacking underlying reasons for increased costs rather than purely making workers pay more, but allowing them to live less healthy and medically expensive lives.

What I found interesting was the rate of increase for a managed-care plan and consumer-directed plan (many of which are low-premium, low-value, high-deductible and intended to save money by allowing consumers to take control) were approximately the same -- 10.5 and 10.5, respectively.

Here's a related report from PriceWaterhouseCoopers

Labels: Insurers, InTheNews, Research

posted by Hanh Kim Quach | Permalink | 1:06 PM

On Day 42 of the budget impasse, I guess I find it somewhat encouraging that Senate Republican Leader Dave Cogdill said over the weekend he didn't believe we could have a cuts only budget. Republicans, so far (and as in previous years), have rejected the Conference Committee proposal which balances cuts against taxes. The Legislature needs a two-thirds vote to pass a budget, which means getting Republican support for the budget.

Cogdill has instead said he'd rather borrow money and repay it with lottery proceeds. But after the borrowing this year, what happens next year?

Of course, Cogdill and his Republican colleagues in the past have derided bonds and borrowing as mortgaging our children's future. Really, though, will there be any future for some children if their schools aren't properly funded, they can't see a doctor and can't afford a public university education.

For us, the May Revise Budget means 1 million more uninsured over the next three years. It means seniors and disabled Californians who live on fewer than $1,000 a month will have to spend their meager allowances paying for -- or going without -- eyeglasses, dental exams even incontinence creams and washes. Is this the kind of state we are?

Labels: Budget, InTheNews, Republicans

posted by Hanh Kim Quach | Permalink | 11:19 AM

The WSJ Health Care Blog today reports that ER visits are at an all time high at a time when the number of emergency rooms is *shrinking.*

What's going on?

While conventional wisdom suggests that the uninsured are crowding the ER, the data suggest that’s not what’s going on. The uninsured (comprised in this survey of those who paid themselves, and those who didn’t pay) accounted for between 17% and 18% of ER traffic in both 1996 ( see this report) and 2006.

A recent study in the Annals of Emergency Medicine noted a similar trend, and found that the biggest rise came from well-off people who typically get their care at a doctor’s office. The real problem, the authors suggested, isn’t the lack of care for the uninsured, but the inability of the insured to get prompt care at the doctor’s office.

Labels: Hospitals, InTheNews, Uninsured

posted by Hanh Kim Quach | Permalink | 10:59 AM

The Governor is finally talking about raising some revenues to prevent the devastating cuts currently in discussion in budget cuts, according to Jim Sanders at the Sacramento Bee.

It's a good thing that the Governor has put a tax on the table, which will raise crucial revenues needed to prevent ugly cuts. It shows progress from the Governor's "cuts only" approach in May.

Some issues that need to continue to be discussed:
* The sales tax proposed is not enough--it would only raise $4-5 billion. The Legislative Conference Committee's budget raises $9 billion--through the upper-tax bracket and other means--and still makes severe cuts--so severe that around a quarter of a million children would still lose health coverage. The additional $4 billion more in cuts would be truly devastating.
* The Governor's proposal is temporary, and the tax increase would go away after a couple of years--or even become a tax cut, further staving key public services... As if the health and education needs of Californian will somehow decrease in three or four years.
* The Governor is also seeking "budget reform," which has included spending caps and proposals to give himself unilateral power to make cuts. It's a short-term gain for a long-term limitation of health, education and other vital services that are important to California's future.

There's clearly more discussion needed. But one hopes that this development signals that there is some movement away from a "cuts only" approach. There's just a lot more movement that is needed, and not much time.

Labels: Budget, InTheNews

posted by Anthony Wright | Permalink | 12:56 AM

Ed Mendel at the San Diego Union Tribune reports that our protracted, though expected, budget stalemate is leaving lots of rural hospitals in a bind. Many of these hospitals, which run on really thin margins as it is, are having to seek emergency loans from banks, which are also stretched thin because of larger economic issues -- like that mortage thing.

To exacerbate health care access, beginning next week, the state will not be paying Medi-Cal to the state's 600 community clinics. The clinics, which serve 3.6 million people annually, are the most efficient way to deliver regular preventive care to the Medi-Cal and uninsured population.

Ironically, the rural areas that are experiencing the most immediate problems are represented by Republicans, who have talked about how they don't want to cut provider rates and make sure health care access is preserved, but in conference committee voted against all of the rate reimbursement increases for providers who care for Medi-Cal recipients.

Labels: Budget, InTheNews, MediCal, Republicans

posted by Hanh Kim Quach | Permalink | 11:29 AM

Last week had a startling article by Julie Appleby at the USA Today about the result of a 36-state investigation of HealthMarkets, resulting in a $20 million settlement, for duping lots of health care consumers into buying substandard health coverage.

The investigation, prompted by numerous complaints, found that insurer HealthMarkets failed to properly train its sales agents, who didn't always fully disclose the limits of its health policies to consumers and sometimes did not pay for medical services promptly.

HealthMarkets, owned by three private-equity firms including the Blackstone Group, has about 612,000 policyholders in 44 states through its subsidiaries: Mega Life and Health Insurance, Mid-West National Life Insurance and Chesapeake Life Insurance.

The company sells an array of plans, many of which pay only limited amounts toward medical care. The settlement follows the January release of the investigators' findings, which covered company practices from 2000 to 2005.

"The severity of their actions certainly warranted that level of penalty. They hurt a lot of people," says Washington Insurance Commissioner Mike Kreidler, whose state and Alaska led the investigation. Since 2002, HealthMarkets has been fined by at least seven states and faced lawsuits from dozens of policyholders.

There has been lots of commentary on the web about these practices, and these products--at sites like Managed Care Matters, and The Health Care Blog which includes a report that these insurers and issues are active in California.

Recently, the Sacramento Bee profiled a story of a couple that got snookered into buying "junk insurance" by one of the companies listed above. That article, spotlighted the pending SB1522(Steinberg), sponsored by Health Access California, as a legislative remedy, to begin to address this troubling issue.

Labels: InTheNews, Legislation, OtherBlogs, OtherStates, Underinsurance

posted by Anthony Wright | Permalink | 12:50 AM

The NYTimes had a story this week about paying doctors more so they can do more preventive maintenance for their patients.

What a concept.

It seems that we learn really basic concepts at a very early age: that often (not 100% of the time, but frequently) you get what you pay. If you want higher quality, you pay more. We also learned that if you do things right and carefully the first time, you won't have to redo it later (I admit, this is a lesson I'm STILL trying to master).

The trend for our medical system, however, has been the opposite, leading to what we have now, which is harried doctors rushing from patient to patient paying a few minutes of attention.

But the NYTimes story points out that insurers are now applying these adages to medicine (as is Medicaid and Medicare). Higher compensation enables doctors to hire more staff to follow up with patients, answer questions when they call/e-mail and make sure they're up to date on tests.

It seems funny to say this is an innovation (because it seems like common sense to focus on wellness up front before patients get too sick after receiving episodic or inattentive care)....but hope the trend continues

Labels: Insurers, InTheNews, Prevention

posted by Hanh Kim Quach | Permalink | 10:53 AM

The LA Times today reveals that LA City Attorney Rocky Delgadillo is suing Blue Shield (for once, we're not picking on Blue Cross) for rescissions.

The featured story is this poor Portuguese couple, left with $60,000 in medical bills after Blue Shield retroactively cancelled their coverage. The insurer scrutinized the family's applications after the wife needed emergency surgery to remove her gall bladder. They couldn't find anything wrong with her application, so they mined her husband's application and VOILA -- he had a high cholesterol reading he had not disclosed: cancel!

Turns out, the poor man didn't even *realize* he had high cholesterol. He took Lipitor, but he was told by his doctor that "men his age often needed it.'' He doesn't speak English well. The agent filled out the application for them.

I always get nervous when I read these stories because it helps to illustrate exactly how vulnerable each and every one of us really is. This story, though, particularly touching because I have immigrant parents and my immigrant mother misunderstands things all the time -- *ALL* the time. She doesn't get jokes, and she can't tell stories without getting at least three facts wrong.

So, if she were ever at the mercy of the individual insurance market (if the myriad pre-existing conditions she and my father have don't already disqualify them from coverage), I would be reading about her rescinded coverage in the LA Times. Thank God for the retiree health care she has -- for now.....

Labels: Insurers, InTheNews, Rescissions

posted by Hanh Kim Quach | Permalink | 11:07 AM

Last week, one aspect of the McCain health plan was highlighted by Kevin Sack of the New York Times , in an article entitled, "McCain Plan to Aid States on Health Could Be Costly." It lays out the problem:

"If Senator John McCain’s radical plan for remaking American health care is to work, he will have to find a way to cover people like Chaim Benamor, 52, a self-employed renovator in this Baltimore suburb.... After being rejected by a number of commercial carriers, he turned to the Maryland Health Insurance Plan, one of 35 state programs for high-risk applicants whom no private company is willing to insure."

The McCain plan would eliminate the tax benefits for employer-based coverage, and thus push people from on-the-job group coverage into the individual market, where consumers (except in a few states) can be denied for "pre-existing conditions."

So what happens if one is denied? In California, your only option is the state's "high-risk" pool, MRMIP, the Major Risk Medical Insurance Program... but that now has a waiting period of over 1,000 patients!

And that's a program that has never been advertised, that's more expensive premiums than already-expensive market rates, and that caps annual benefits at a mere $75,000--less than a week in many hospitals.

Even though we suspect that the number of willing-to-pay-but-"uninsurable" customers are in the hundreds of thousands, the McCain plan would make this worse. And his only solution is to provide some federal assistance to plans like MRMIP. The question is: will it be enough?

With the new attention on the individual insurance market and "high-risk" pools, the Kaiser Family Foundation is hosting an "Ask the Experts" webcast tomorrow (Tuesday) at 10am Pacific Time on the subject. One of the experts is California's own Lesley Cummings, executive director of the MRMIB, which runs MRMIP. It should be interesting to hear her answers to question coming from a national perspective.

Don't get me wrong: MRMIP needs help and resources as soon as possible--AB2(Dymally) is a longstanding pending bill on this subject that Health Access California supports.

But the real solution is to reduce the number of people denied by insurance companies in the first place, either through the market power of group coverage, or by significantly regulating the individual market. Even in the context of health reform that does both, like in AB x1 1, it made sense to maintain and improve the high-risk pool to make sure the safety net was in place and strengthened for those who fall through the cracks.

What makes no sense is to make the problem worse, and pretend these already struggling problems are the solution.

Labels: Federal, GuaranteedIssue, Insurers, InTheNews

posted by Anthony Wright | Permalink | 7:02 PM

Paul Krugman of The New York Times talks about the prospect of health reform, and how the dramatic Medicare vote in the US Senate bodes well for the fight--as does the new Health Care for America Now! (HCAN) effort.

Both Jonathan Cohn at The New Republic and Ezra Klein at the blog of the American Prospect report on how the HCAN principles are inclusive of a single-payer solution, and how they advance the single-payer cause strategically. The opportunity to advance elements of a single-payer solution--greatly expanded public coverage; defined benefits; group purchasing power; costs based on what patients can afford rather than how sick they are--is there, if we take advantage of it.

Labels: Federal, InTheNews, SB840, YearOfReform

posted by Anthony Wright | Permalink | 6:23 PM

Our friends at CALPIRG recently released a new study on cost containment in health care.

It's described in opinion piece by CALPIRG's Michael Russo in the California Progress Report, and in an article by Keith Darce of the San Diego Union Tribune.

It's a useful compilation of the research out there on cost containment, brought together in a readable package. The core message is that there are significant ways to cuts costs beyond the typical attempts to cut costs by cutting care.

While there is no one silver bullet to bring down health prices, there are several strategies that, together, can have a big impact. Health Access has a one-page fact sheet on controlling costs with a similar message, but the CALPIRG report gives good policy detail, especially in areas about reducing regional disparities in health spending, in administrative duplication, and in prescription drug purchasing. It's worth a read.

Labels: CostContainment, InTheNews, OtherBlogs, Research

posted by Anthony Wright | Permalink | 6:12 PM

The Sacramento Bee just posted this Hospital charge database of the 25 most common procedures by hospital. The Bee has compiled all the information reported to the Office of Statewide Health Planning and Development in 2006 and put it in an easy-to-use scroll down format.

The charges reflect what consumers would pay if they didn't have insurance -- in other words, the sticker price. Insurance companies negotiate far lower rates.

I'm finding it weirdly entertaining to see how broke I'd be if I ever found myself uninsured.

If I ever needed a hip replacement, it'd cost *as little* as $40,000 at Mercy Hospital in Folsom or *as much as* $1o9,000 at UC Davis Med Center down the street from me.

If I ever got pneumonia, and needed a breathing tube: $362,000 at Mercy San Juan, a whopping $850,000 at Sutter Memorial.

Play with it. Have a heart attack. (Get an angioplasty -- $94,000 at Sutter, $140,000 at UC Davis.) Pass comprehensive health reform so no one gets these sticker prices.

Labels: Hospitals, InTheNews, Underinsurance

posted by Hanh Kim Quach | Permalink | 5:38 PM

With the Budget Conference Committee scheduled to come in on Sunday to make further decisions on the budget, Matthias Gafni in the Contra Costa Times has a great article about how multiple cuts are impacting a local community.

The article cites a report and compilation of statistics, done in collaboration with local organizations and leaders, spearheaded by Health Access and our outstanding organizer Jessica Rothhaar. She's worked in the area for years, and was able to help pull it together from an unusually set of community groups. It is available here:
Contra Costa County Local Impacts Report

The partnership with other groups was important because the report did go beyond health issues to education, social services, and other areas that Health Access traditionally does not touch. But with the budget cuts being so broadly based, it made sense to get a look at how the full range of cuts is impacting the community as a whole.

Health Access working with organizations in other counties to do a similar analysis, but the results are similar: the scale of the cuts is devastating, and together they are even more so. These cuts need to be prevented, even if we need to raise revenues to do so.

Labels: Budget, InTheNews

posted by Anthony Wright | Permalink | 1:13 AM

NYTimes has a horror story about diabetes and how it creeps up on you and "eat(s) you alive,'' as one doctor described it. In addition to being the leading cause of blindness and amputation, diabetes also affects the afflicted in a myriad other ways from head to toe -- depression, sleep issues, stroke, dental and hearing problems, liver and kidney problems, *paralysis (!)* of the stomach, ulcers, and various sexual problems.

Cases of diabetes are growing -- 8 percent of the US population had it in 2007. And by 2050, it could be 25%, according to the Centers for Disease Control.

I'm fixating on this for two reasons. 1) I'm genetically predisposed to diabetes; my father was diagnosed in his mid-40s. 2) Our insurance coverage trends make it very difficult for people to maintain and keep this perfectly treatable disease at bay.

As more people (not us, mind you) advocate for more stripped down health plans, devoid of disease maintenance, it creates all kinds of barriers to getting the meds and seeing the doctor -- all necessities for a person with diabetes.

I'll do a quick, shameless plug for our SB1522 here, which not only would organize the individual insurance market, but also establish minimum benefits -- such as doctors, hospitals and preventive services. It's one of the ways we could begin to tame the unruly individual insurance market, which has been rapidly degenerating over the past few years.... unless we want a nation of diabetic zombies by 2050.

Labels: Insurers, InTheNews, Legislation, Steinberg, Underinsurance

posted by Hanh Kim Quach

Veep Debate Fact Check

Friday, October 03, 2008

Economy and Health Care and Jobs

Further sad economic news that will get even worse..

Thursday, September 25, 2008

Another economic indicator...

Links!

Thursday, September 18, 2008

Values Judgements

Wednesday, September 17, 2008

More on the sausage-making..

Tuesday, September 09, 2008

Profits over People

Thursday, September 04, 2008

Veepy views on health care

Legislative Year in Review...

For the children....

Monday, August 25, 2008

The wrong direction on kids coverage...

Money matters

Wednesday, August 20, 2008

Insulting

Monday, August 18, 2008

Lots of Studying Going on

Wednesday, August 13, 2008

Slowing, but still increasing

Tuesday, August 12, 2008

Somewhat encouraging?

Monday, August 11, 2008

This is interesting...

Wednesday, August 06, 2008

Some movement?

Tuesday, August 05, 2008

Cash Starved

Thursday, July 31, 2008

Mega problems with mini-coverage...

Tuesday, July 29, 2008

A novel concept

Wednesday, July 23, 2008

More Blues for Blues

Thursday, July 17, 2008

High-Risk policies, indeed...

Monday, July 14, 2008

A inclusive strategy to win...

Friday, July 11, 2008

Controlling costs, not curbing care...

Thursday, July 10, 2008

Sick, Twisted and Fun

Tuesday, July 08, 2008

Whoopsy

Monday, July 07, 2008

The many impacts of cuts to a community...

Saturday, July 05, 2008

Killing us softly...

Wednesday, July 02, 2008