Monday, March 18, 2013
Individuals under age 65, with Individual Medical or Employer based Medical insurance, can receive a variety of tests. Some are for all, some based on age, some for females, and some for children. Details are on this page of the Healthcare.gov site.
Individuals eligible for Medicare: During the first 12 months of Medicare’s Part B coverage a person can receive a “Welcome to Medicare” preventive visit. During the following years a person can receive a wellness visit. The Healthcare.gov site indicates:
“This exam is a one-time review of your health as well as education and counseling about preventive services and other care. If you’ve had Part B for longer than 12 months, you can get a yearly wellness visit to develop or update a personalized prevention plan based on your current health and risk factors. “
Friday, March 15, 2013
When people get more involved in their health and take steps to make improvements the result usually is a better life and fewer medical treatment costs. This thinking is common in employers who have implemented various kinds of wellness efforts to encourage better health and to decrease the cost of their medical benefit plan.
Regretfully however a study reported in last month’s Health Affairs Journal indicated – “a majority of patients didn’t want to factor costs into their medical decisions, nor did they want their doctors to do so.” The study investigated the attitudes of 211 participants in focus groups held in Washington DC and Santa Monica CA.
There was one point in the findings I am all to familiar with. “People did not generally understand how insurance works and felt little personal responsibility for helping to solve the problem of rising health care costs.”
The article also reported on a conversation with Susan Dorr Goold a professor of internal medicine and health management and policy at the Center for Bioethics and Social Sciences in Medicine at the University of Michigan. She was the co- author of this study.
She was asked several questions about the findings. One was:
“You found that some participants seemed motivated to choose expensive care ‘out of spite’ because they were antagonistic toward their insurance company. What’s going on there?”
Professor Goold indicated:
There was almost a vengeful attitude toward insurance companies, the idea that “I’ve been paying in now I am going to get what I’m owed or I’m going to get them back for all the money I’ve paid in all these years.
She also indicated more research is needed in this area. “The motivation that I’m sick and I don’t want to think about the money, ”that’s understandable. But “I want to hurt the insurance company.” Why? Those health care payments come from money all of us have paid to insurers.
The exact questions and the way participants were asked is not known. However, these findings cannot be considered a “not to worry” situation. They are important considerations which employer benefit specialists, medical insurance company staff, and health insurance professionals, like myself, must focus on.
John C Parker, RHU, LTCP
Thursday, March 07, 2013
With more and more details being firmed up on federal health reform I wanted to share the conclusion from a March 2013 report prepared by three Congressional committees. It is based on a review of over 30 studies. (I added bold to some text.)
Taking into account empirical evidence from past state-level experiences, as well as future projections, upon implementation Obamacare will make coverage dramatically more expensive and unaffordable for individuals and families. In short, Obamacare breaks its core promise to make health care coverage affordable as Americans across the country swallow higher premiums. From young adults to middle class families, higher premiums will soon be the harsh reality of Obamacare.
The Committees that published this March 2013 report are:
+ House Committee on Energy and Commerce, Majority Staff,
+ Senate Committee on Finance, Minority Staff, and
+ Senate Committee on Health, Education, Labor & Pensions, Minority Staff