Is Your Health Plan Crooked?

July 2nd, 2008

This article comes from Newsweek. This article illustrates why you should work with companies like Global Heath Insurance Marketing in order to avoid being ripped off.

“We panicked,” Jeanine Evans of Manitou Springs, Colo., told me over the phone. She’s thinking back to a terrifying day in February 2002. She’d stopped at a hospital pharmacy to pick up some essential drugs for her daughter, Krysta, a cystic-fibrosis patient who’d just endured a double lung transplant. But the druggist said, “No dice”; her husband’s group health insurance, written by American Benefit Plans, suddenly wasn’t any good. She’d have to pay $500 a month for drugs Krysta needed to keep her new lungs from being rejected. “I stood in the hospital in tears,” she says. “How would we get the medicine to save her life?” Worse, she learned she wasn’t covered for the $460,000 transplant cost.

American Benefit turned out to be one of many illegal health plans (not licensed by the state) that have trapped at least half a million people so far. They’re Ponzi schemes–taking in “premiums,” covering small medical bills, but stalling on large ones so the principals can skim off cash. Seemingly honest insurance agents peddle these policies. But eventually, fake insurers close up, or the state shuts them down, leaving you with unpayable medical debts. The plans’ soulless founders may promptly start the same phony deal in another state.

There’s a second kind of scam, which sounds like insurance but isn’t. I’m talking about the many discount health cards, sold by phone, mail and Internet. For a monthly or annual fee, you’ll be promised discounts “up to 80 percent” on medical and drug bills. But your actual savings may come to little or nothing, after other fees. Often the doctors and drugstores don’t even know about the card. (The few good discount cards, for prescription drugs, include those offered by AARP, YourXPlan and Together Rx–the latter for people on Medicare.) Click here to read the rest of  this article.

Decrease costs to increase care.

June 24th, 2008

This article comes from The Baltimore Sun.

During the recent presidential primary campaign, the candidates talked frequently about proposals to reduce the 47 million people in this country without health insurance by measures such as expanding eligibility for Medicaid and requiring that individuals buy coverage or pay a fine. What they failed to do is recognize that lack of coverage is merely a symptom of a larger problem: the high cost of medical care, which makes insurance unaffordable for many.

U.S. health expenditures as a percentage of gross domestic product run around 16 percent, far in excess of any other technologically advanced country. And we get less for it, as measured by statistics reflecting health status, such as life expectancy at birth and infant mortality rates. We can only hope that in the coming presidential election campaign, Sens. John McCain and Barack Obama will shift their focus from symptom to cause.

Reforms aimed at controlling medical care costs should recognize the following:

Much of the medical care delivered in the U.S. - perhaps 30 percent to 40 percent - is unnecessary, wasteful, even dangerous. Incentives to provide unnecessary care need to be removed. Providing reimbursement to providers on a capitated, rather than fee-for-service, basis might help. Capitation means the provider is compensated on the basis of the number of people for whose medical care he is responsible rather than the cost of the services provided, motivating the provider to keep costs low. Click here to read the rest of this article.

Fewer Employees, Higher Health Insurance Costs.

June 17th, 2008

This article is from U.S. News and World Report.

I’ve written about how one of the biggest problems small-business owners have to deal with is buying health insurance for their employees when the costs are rising so dramatically. The National Association for the Self-Employed released the results of a survey today that gives us some more hard data on the issue. The survey is based on a sample of 4,000 “micro-businesses”—those with 10 or fewer employees—so it tells us about only the smallest of small businesses.

The results drive home how much more expensive it is for small businesses to pay insurance premiums—median costs rose from 3.7 percent of a business’s total revenue to 5.5 percent. But they also offer some surprising statistics that aren’t so negative—some of the smallest firms of this already small group actually saw a greater increase in access to health insurance than other firms. In 2005, 13.8 percent of businesses with under $50,000 in gross sales offered health insurance in 2005. Now that number is up to 40 percent.

The share of micro-business owners who have health insurance for themselves grew from 54.9 percent in 2005 to 67 percent in 2008. Some of that increase, however, might have been made possible for micro-businesses by cutting back on health spending for their employees. The proportion of respondents who buy coverage for their full-time employees dramatically fell from 46.2 percent to 18.6 percent.

High cost of health in golden years could be a much as $376,000.

June 4th, 2008

This post comes from CNN Money.

How much money do you need to pay the doctor’s bills in retirement? The answer: More than you probably think.

According to a report released Tuesday, the retirement health tab can run between $64,000 and $122,000 for a 65-year-old man whose former employer pays his insurance premiums, and between $86,000 and $140,000 for a woman of the same age. For retirees who don’t have access to an employer-offered plan, the costs - mostly for prescription drugs - run even higher.

“Given the magnitude of money people will need in retirement, they need to prepare for this now,” said Paul Fronstin, director of health research and education programs at the Employee Benefit Research Institute. “They can’t wait for a year or two before retirement to start saving,” he added.

EBRI, a Washington, D.C.-based public policy group, calculated the likelihood that retirees would be able to afford their health bills. It sorted retirees into three categories: covered by Medicare with premiums paid by a former employer’s health plan; covered by Medicare and in a former employer’s plan but receiving no subsidy; covered by Medicare and with purchased supplemental insurance.

According to Fronstin, there are about 9 million retirees who supplement Medicare with employer-sponsored health plans. That’s nearly 22% of the 42 million people currently benefiting from Medicare.

Fronstin, one of the authors of the report, said saving for health care costs in retirement is a more urgent issue than most people believe. He believes that employers will phase out health care benefits to retired employees and that Medicare will become less generous.

He also said many employees mistakenly believe that they will have employee-sponsored health benefits when they retire.

“They’re thinking it’s going to be there for them when it’s not,” Fronstin said.

The report broke down its findings based on the amount of risk retirees are willing to take in having enough money to cover medical bills. At the high-risk level, retirees have a 50% chance of having enough money; the medium risk, a 75% chance; and the low risk, a 90% chance. Click here to read more details and the rest of this interesting article.

Effort to find ineligible Medi-Cal recipients worries some.

June 2nd, 2008

This article comes from the San Jose Mercury News.

The ailing California budget has state officials looking at ways to cut the ranks of Medi-Cal recipients who are no longer eligible for the program that provides critical medical coverage for the poor, elderly and disabled.Advocacy groups, however, worry that a proposal by Gov. Arnold Schwarzenegger requiring recipients to provide more frequent updates on their financial and residential status amounts to a sneaky way to cut benefits for those who are eligible, including children.

“The intent of that proposal is that a percentage of those families on Medi-Cal will for some reason not fill out the paperwork and fall off the coverage, though they remain eligible,” said Anthony Wright, executive director of the nonprofit advocacy group Health Access California.

The governor’s office and the state Department of Health Care Services said the effort is not intended to deprive eligible people of benefits.

They added, however, that the state’s anticipated $17 billion budget deficit leaves little choice about taking a closer look at who receives Medi-Cal.

“People become ineligible; they may move, they may get a job and get higher income, and they don’t typically remember to tell us of this change. But we continue to cover people,” said Stan Rosenstein, chief deputy director of health care programs for the California Department of Health Care Services. Click here to read the rest of this interesting article.

Google Health is announced by Google Inc. via press release.

May 21st, 2008

Google Health https://www.google.com/health is online after a year and a half since Adam Bosworth announced a health product from Google. Google Health proposes to:

  • Organize your health information all in one place
  • Gather your medical records from doctors, hospitals, and pharmacies
  • Keep your doctors up to date about your health
  • Be more informed about important health issues
  • According to the Google Health FAQ, “You can store records of current and past medications, allergies, procedures, immunizations, conditions, and test results. You can enter any of this information on your own, or you can import your medical records from a list of Google Health integrated partners, such as hospitals or neighborhood pharmacies.”

Google Health has been designed as a PHR (Personal Health Record), but it is also a bit of a different model. “We believe it’s not enough to offer a place where you can store, manage, and share your health information. You need to act on your health information to better manage your health needs on a daily basis. This is why we provide a directory of online health services to you. You must elect to sign up with a service and decide what level of personal data you want to share in exchange for the customized services those companies offer”, is mentioned on Google Health pages.

Small Businesses Face Monumental Choice on Health Care.

May 16th, 2008

This article comes from All Business.com and is written by Keith Girard.

“Who should get health insurance, how should they get it, and who pays? Those three questions are at the forefront of the current controversy over health care and will provide the framework for the great debate that will begin once the presidential primaries end and the general election begins.

Small business owners, of course, have a huge stake in the outcome of both the election and the debate. Of the 47 million people currently without health insurance, the overwhelming majority either own or are employed by a small business. That means health care should be one of the key decision points for choosing the next president. So where do the presidential candidates stand and what does the public think?” Click here to read the rest of this article which includes the positions of the Presidential candidates.

Healthcare costs pinch employers.

May 8th, 2008

This post comes from the L.A. Times. U.S. manufacturers who provide health insurance spend an average of $2.38 per worker per hour on healthcare — more than twice as much as their foreign competitors, an analysis released Tuesday found.

The study provides support for the now-familiar lament of employers — that rising healthcare costs are eating into the corporate bottom line.

American automakers say employee health coverage adds $1,500 to the price of each car, and many U.S. manufacturers have blamed rising healthcare costs for decisions to drop health benefits for workers or shift jobs overseas.

But many economists have pooh-poohed the idea that U.S. businesses are hurt by their comparatively high healthcare costs. Instead, they have suggested that companies would pass those costs onto workers by lowering wages or onto consumers by raising prices. Click here to read the rest of this article.

Employers Have High Confidence They Can Control Health Care Costs With Proper Tools.

April 23rd, 2008

This article comes from Fox Business News. United Benefit Advisors LLC one of the nation’s leading employee benefits advisory organizations, today announced key findings from its 2008 UBA Employer Opinion Survey, which delineates employers’ specific health care strategies, health benefits philosophy and opinion, health plan management, and Consumer Driven Health Care.The release of the 2008 UBA Employer Opinion Survey contains representative responses from employers by both region and employer size. Of the 1,664 employers polled, 72.5% have or want to have a wellness program that utilizes a health risk assessment; and 59.2% have or desire to implement a chronic disease management program. The survey also found that employers with 200 or more employees were 54% more likely to describe themselves as “leading edge” or “fairly quick” to adopt wellness programs. Firms with more than 1,000 employees produced results that indicated they were two-and-a-half times as likely to describe themselves as “leading edge” or “fairly quick” concerning disease management program adoption.

“The tide has clearly turned in that the majority of employers believe in the long-term value and positive impact that comprehensive wellness and disease management programs provide,” said William Stafford, Vice President, Member Services for UBA. “Keeping the healthy employees healthy while stabilizing and/or improving the health of employees with chronic conditions will dramatically improve everyone’s health and quality of life.” Click here to read the rest of the survey results and article.

Aetna Launches Health Info Search Site.

April 13th, 2008

This post comes from Fox News and AP Wire Services.

Aetna’s SmartSource search site would ramp up the way electronic health information is used, even as privacy concerns rise with an increased interest among companies to find new applications for electronic health records.

SmartSource crunches data such as gender, age, ZIP code, employer, health care plan and information from the customer’s personal health records.

The search engine generates information tailored to individuals about diseases and medical conditions, treatments, health care costs and local health care providers.

Aetna will make the search engine available as a pilot program this year to between 20 and 25 employers with up to 1.5 million eligible employees, and make the service available to more customers next year.

Healthline Networks, a privately held San Francisco-based health search engine that was founded in 1999 as YourDoctor.com, is providing the technology platform for Aetna’s search engine.

The Hartford-based insurer is banking on strong interest in Web-based health information and the drive to make patients better informed and in charge of their own health care.

But privacy advocates have been wary about electronic health records, warning about possible security breaches even though insurers insist information is secure.

Aetna officials said the Web site uses encryption standards similar to the banking industry and access to its Web site takes customers to Healthline’s secure site.

Mohit Ghose, a spokesman for America’s Health Insurance Plans, a trade group of 1,300 health insurance plans, said insurance customers are protected by many safeguards, the Health Insurance Portability and Accountability Act, commonly called HIPAA, and state privacy laws.

But Sue Blevins, president of the Institute for Health Freedom in Washington, D.C., said the new ways health records are used raises concerns. For example, customers should be notified when their health information is transferred, whether from Aetna to Healthline Networks or other companies, she said.

Blevins also said it’s not clear that HIPAA covers companies that store electronic records, and that the federal law may need to be updated.

Google Inc. announced last month it will begin storing medical records of a few thousand people. The service is not yet available publicly. And Microsoft Corp. last year introduced a service called HealthVault that manages health information.

 

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