MBA News http://milestonebenefits.com/mbanews Keeping our clients up to date with Healthcare Reform Fri, 04 May 2012 13:36:38 +0000 en hourly 1 http://wordpress.org/?v=3.3.1 Healthcare costs in the US are the highest in the world http://milestonebenefits.com/mbanews/?p=144 http://milestonebenefits.com/mbanews/?p=144#comments Fri, 04 May 2012 13:36:38 +0000 admin http://milestonebenefits.com/mbanews/?p=144 Continue reading →]]> Health care in America costs more than in other industrialized nation and we aren’t even getting the world’s best care for our dollars, according to a new study. The United States spent $7,960 per capita on health care in 2009, the most of 13 industrialized nations in the Organization for Economic Cooperation and Development.

Americans pay the highest prices for physician visits, hospital treatments and prescription drugs and get expensive diagnostic tests like MRIs at a higher-than-average rate. More Americans are obese, too, though the nation’s population is younger than all the other countries.

Escalating prices for health care and high use of potentially wasteful, inefficient and unnecessary medical services are the main reasons for the rapidly escalating cost of health insurance, the growing ranks of the uninsured and the fiscal burdens of Medicare and Medicaid. Big price tags also lead Americans, even those with health insurance, to go without care they need.

This high spending cannot be attributed to higher income, an older population or greater supply or utilization of hospitals and doctors. Instead, the findings suggest the higher spending is more likely due to higher prices and perhaps more readily accessible technology and greater obesity.

Source: http://worldofdtcmarketing.com/healthcare-costs-in-the-us-are-the-highest-in-the-world/cost-of-healthcare-in-the-u-s/

]]> http://milestonebenefits.com/mbanews/?feed=rss2&p=144 0 The costs of obesity cost us all http://milestonebenefits.com/mbanews/?p=142 http://milestonebenefits.com/mbanews/?p=142#comments Fri, 04 May 2012 13:35:37 +0000 admin http://milestonebenefits.com/mbanews/?p=142 Continue reading →]]> The U.S. health care reform law of 2010 allows employers to charge obese workers 30 percent to 50 percent more for health insurance if they decline to participate in a qualified wellness program.  Such measures do not sit well with all obese Americans. Advocacy groups formed to “end size discrimination” argue that it is possible to be healthy “at every size,” taking issue with the findings that obesity necessarily comes with added medical costs.

The percentage of Americans who are obese (with a BMI of 30 or higher) has tripled since 1960, to 34 percent, while the incidence of extreme or “morbid” obesity (BMI above 40) has risen sixfold, to 6 percent. The percentage of overweight Americans (BMI of 25 to 29.9) has held steady: It was 34 percent in 2008 and 32 percent in 1961. What seems to have happened is that for every healthy-weight person who “graduated” into overweight, an overweight person graduated into obesity.

Because obesity raises the risk of a host of medical conditions, from heart disease to chronic pain, the obese are absent from work more often than people of healthy weight.

The most obese men take 5.9 more sick days a year; the most obese women, 9.4 days more. Obesity-related absenteeism costs employers as much as $6.4 billion a year, health economists led by Eric Finkelstein of Duke University calculated.

Even when poor health doesn’t keep obese workers home, it can cut into productivity, as they grapple with pain or shortness of breath or other obstacles to working all-out. The very obese lose one month of productive work per year, costing employers an average of $3,792 per very obese male worker and $3,037 per female.Total annual cost  due to obesity: $30 billion.

The medical costs of obesity have long been the focus of health economists. A just-published analysis finds that it raises those costs more than thought.

Obese men rack up an additional $1,152 a year in medical spending, especially for hospitalizations and prescription drugs, Cawley and Chad Meyerhoefer of Lehigh University reported in January in the Journal of Health Economics. Obese women account for an extra $3,613 a year. Using data from 9,852 men (average BMI: 28) and 13,837 women (average BMI: 27) ages 20 to 64, among whom 28 percent were obese, the researchers found even higher costs among the uninsured: annual medical spending for an obese person was $3,271 compared with $512 for the non-obese.

Nationally, that comes to $190 billion a year in additional medical spending as a result of obesity, calculated Cawley, or 20.6 percent of U.S. health care expenditures.

Based on all this data is it discrimination to charge someone more for health insurance if they are obese ?  This author thinks not.  Let’s face it the majority of the obese are that way because of poor lifestyles and eating habits. Insurers working with physicians could take a proactive approach requiring patients who are overweight to meet with a registered dietician as well as someone who can recommend ways for them the increase their physical activity,   The bottom line is that we as a country cannot allow healthcare costs to increase because someone likes to eat cheeseburgers instead of salads.

 

Source: http://worldofdtcmarketing.com/the-costs-of-obesity-cost-us-all/cost-of-healthcare-in-the-u-s/

]]> http://milestonebenefits.com/mbanews/?feed=rss2&p=142 0 Employers given more time to comply with health benefits summary rule http://milestonebenefits.com/mbanews/?p=139 http://milestonebenefits.com/mbanews/?p=139#comments Fri, 10 Feb 2012 14:27:46 +0000 admin http://milestonebenefits.com/mbanews/?p=139 Continue reading →]]> February 9, 2012 – 3:00pm

What’s This?

WASHINGTON—Employers will have more time to comply with a health care reform law requirement that they provide employees with an “easy-to-understand” summary of benefits and coverage, the Obama administration announced Thursday.

Under the final rule, the new statement—known as an SBC—would apply for plan years beginning on or after Sept. 23.

For example, an employer with a plan year that starts Jan. 1 and an open enrollment period that runs from Oct. 1 to Nov. 1 would have to provide the SBC by Oct. 1.

Previously, the administration said the information would have had to be distributed by March 23, which benefit experts said would not have given employers enough time to prepare and distribute the information.

Changes ‘helpful’

The longer compliance period “will be very helpful to plan sponsors, although they still will need to devote significant time and resources to complying with the SBC by this date,” said Debbie Harrison, senior manager-public policy with the National Business Group on Health in Washington.

In addition, the amount of information employers would have to provide is reduced compared to the administration’s previous proposal, which said employers would have to provide sample cost information for having a baby, managing Type 2 diabetes and treating breast cancer. Providing an example of the cost of treating breast cancer no longer is required.

]]> http://milestonebenefits.com/mbanews/?feed=rss2&p=139 0 What Will Health Care Look Like in 2025? http://milestonebenefits.com/mbanews/?p=134 http://milestonebenefits.com/mbanews/?p=134#comments Tue, 31 Jan 2012 15:13:06 +0000 admin http://milestonebenefits.com/mbanews/?p=134 Continue reading →]]> ALEXANDRIA, Va., Jan. 24, 2012 /PRNewswire-USNewswire/ — By 2025, patient-doctor relationships and health care delivery will look radically different than they do today, according to the Institute for Alternative Futures. In the Institute’s new report Primary Care 2025: A Scenario Exploration, available here, the nationally recognized futurists give readers a preview of how Americans could select, pay for and receive primary care.

Working with more than 50 national health care leaders, the Institute for Alternative Futures, a nonprofit think tank based in Alexandria, Virginia, has created four scenarios—coherent stories describing alternative futures—to show what primary care might look like in 2025. The scenarios (summarized below) take into consideration the nation’s economic challenges, political polarization, and opportunities afforded by technological advances and new delivery systems.

Clem Bezold, Institute for Alternative Futures chair and senior futurist, said the organization’s projections reflect how primary care may be shaped by factors such as a slow economic recovery or another recession, federal debt, an aging population, unsustainable health care costs, pressure for cuts in Medicare and Medicaid payments, an explosion of information available through the Internet and social media, and empowered, motivated consumers.

Nationally, health care cost $2.57 trillion in 2011, 17 percent of the gross domestic product, and is expected to grow to 20 percent of the gross domestic product by 2020. Bezold said while other sectors—including retail, manufacturing, finance, insurance and real estate—learned to do more with less, the number of health care employees grew between 1990 and 2010, resulting in lower per capita productivity. Health care premiums have increased 131 percent since 1999, compared to a 38 percent increase in workers’ earnings and an overall inflation rate of 28 percent during the same period.

“The four scenarios provide the means to bound the uncertainty of the future. They include our best estimates. For example, in all four scenarios we forecast that electronic records will become ubiquitous. Community health centers will give high-quality care to  low-income people, and a small persistent group of affluent will receive great fee-for-service ‘concierge’ health care,” Bezold said. “You will see more virtual care, personal health avatars and doctors operating remotely. But the scenarios also include challenging and visionary possibilities. We identify what is likely, what is challenging and what is preferable so policymakers, health care professionals and consumers can think about and help shape the future.”

The scenarios:

#1. “Many Needs, Many Models.” This scenario is a natural extension of health care as many Americans know it. The scenario forecasts a shortage of primary care physicians, increased emphasis on disease prevention, growth in electronic medical recordkeeping, a shift from employee-based insurance to health insurance exchanges, and growing disparities in access to and quality of primary care based on income and where people live.

#2. “Lost Decade, Lost Health.” This scenario forecasts a shortage of primary care physicians, declining income for practicing physicians, and more uninsured patients, some of whom resort to black market care and unreliable online advice. Patients with good insurance have access to great care enhanced by advanced technology.

#3. “Primary Care that Works for All.” This scenario assumes nearly universal health care coverage, with 85 percent of patients using integrated systems staffed by collaborative teams of health care providers, including physician assistants, nurse practitioners and health coaches who work closely with patients. Seeking to provide better care at lower cost while improving the health of the population they serve, primary care teams join with community partners to address factors that affect a community’s health, including employment, educational attainment, housing, transportation, and access to fruits and vegetables.

#4. “I Am My Own Medical Home.” Under this scenario, four of 10 patients opt for consumer directed health plans, which include catastrophic insurance with high deductibles. For the most part, savvy consumers use advanced technologies, including noninvasive biomonitors and wellness and disease management apps, to stay healthy. Large vendors offer free avatar-based health coaching to consumers who purchase other integrated health products and services. Consumers shop for the best doctor and buy on the basis of high quality and low price.

In addition to the full report, the project’s website includes instructions for using the scenarios in workshops: www.altfutures.org/primarycare2025.

The Institute for Alternative Futures’ Primary Care 2025: A Scenario Exploration is supported by a grant from the Kresge Foundation as part of the foundation’s mission to improve the delivery and financing of health care in the United States.

“Primary Care 2025 already is starting to shape our thinking about primary care,” said David Fukuzawa, Kresge’s program director for Health. “It confirms that primary care will not be a continuation of what we’ve been doing and encourages us to think about the future we prefer. It also contains information and guidance particularly pertinent to the primary care safety net, one of our major focus areas. In thinking about a transformational future, it helps to know the direction we’re heading instead of supporting what exists. In the future, community health centers will be as much about community health as about individual patient care.”

The Kresge Foundation is a $3.1 billion private, national foundation that seeks to influence the quality of life for future generations through its support of nonprofit organizations working in its seven program areas: Arts and Culture, Community Development, Detroit, Education, Environment, Health, and Human Services. In 2011, the Board of Trustees approved 346 awards totaling $170 million; $140 million was paid out to grantees over the course of the year. For more information, visit kresge.org.

SOURCE Institute for Alternative Futures

http://www.insurancebroadcasting.com/news/Institute-Alternative-Futures-2721448-1.html?utm_source=editorial&utm_medium=email&utm_campaign=Voluntary_inBrief_010411_013012

]]> http://milestonebenefits.com/mbanews/?feed=rss2&p=134 0 GOP Presidential Hopefuls: Where They Stand On Health Care http://milestonebenefits.com/mbanews/?p=132 http://milestonebenefits.com/mbanews/?p=132#comments Thu, 19 Jan 2012 17:10:19 +0000 admin http://milestonebenefits.com/mbanews/?p=132 Continue reading →]]> At first glance, Rep. Michele Bachmann of Minnesota, former House Speaker Newt Gingrich, former Utah Gov. John Huntsman, Rep. Ron Paul and Gov. Rick Perry, both from Texas, former Mass. Gov. Mitt Romney, and former Pennsylvania Sen. Rick Santorum seem virtually identical in their health policy platforms, as does former candidate Herman Cain. They are unanimously opposed to last year’s health law, favor reducing federal investment in Medicare and expanding state flexibility in managing Medicaid.

But there are important distinctions in policy and tone. For instance, Perry wants states to be able to opt out of Medicare. Huntsman helped to create Utah’s health insurance exchange. Romney signed Massachusetts’ health reform, which requires most people to buy insurance. Bachmann, the founder of the House tea party caucus, has called the reform law “socialized medicine.” Paul opposes limiting malpractice awards, instead advocating tax credits for “negative outcomes” insurance so patients can be compensated for medical mistakes. Santorum, who has said Democrats “love” entitlement programs, is often associated with strong social conservative positions.

KHN has assembled this chart to show in detail where all eight currently stand on major health care issues. To compare and contrast their positions, you can scroll down the page or jump to from these links:

 

Medicare & Aging | Marketplace | Health Reform Philosophy | Medicaid

Medicare & Aging Michele Bachmann (campaign suspended on Jan. 4)

  • Voted for the Ryan budget plan, but later qualified her support, saying she thought it could hurt senior citizens.
  • Supports reducing future Medicare benefits for people who are now 55 or younger.
  • Claimed during the health overhaul debate that the law would create death panels and lead to rationing.
  • Opposes creation of the 15-member Independent Payment Advisory Board, saying the panel, charged with making binding recommendations to reduce Medicare spending, will cause seniors to lose control over their care.
  • Voted against allowing the government to bargain with pharmaceutical companies to get lower drug prices for Medicare Part D, arguing it would lead to draconian price controls.
  • Voted to override President Bush’s veto of the Medicare Improvements for Patients and Providers Act of 2008, which temporarily blocked a Medicare pay cut for physicians, prohibited some Medicare Advantage marketing practices, expanded coverage of mental health services and authorized Medicare to cover new preventive services.
“Senior citizens will lose control over what they actually get in Medicare, because a politically appointed 15-member board that’s unelected and unresponsive to the will of the people called IPAB will make the decisions about what care we get and what care we don’t.” – Bachmann to conservative bloggers, June 2011
Herman Cain (campaign suspended on Dec. 3)

  • Supports the Ryan plan to revamp Medicare. Embraces the concept of a voucher system for Medicare and has said that the program needs a total restructuring as outlined in that proposal.
  • Cain’s 9-9-9 tax plan would eliminate the payroll tax which currently funds Medicare and Social Security.
“We don’t need to come up with another plan. The people who are backing away from Ryan’s plan, which is very well thought out … they simply lack courage. Don’t back away from something simply because it’s controversial or because it’s difficult to explain to the American people.” – Fox News interview, May 2011
Newt Gingrich

  • Spoke out early in the campaign season against the Medicare voucher plan advanced by House Budget Committee Chairman Paul Ryan, R-Wis., calling it “a big jump” and “radical” for Americans. His May 15 appearance on NBC’s Meet the Press drew a lot of media attention.
  • In December commended Ryan for backing off his earlier plan and teaming with Sen. Ron Wyden, D-Ore., on an altered premium support proposal that would allow seniors to stay in traditional fee-for-service Medicare.
  • Supports making structural changes to Medicare that would give beneficiaries more options and less government control while seeing to it that seniors have more ‘skin-in-the-game.’
  • Wants to “create more choices in Medicare,” allowing consumers to choose either the current structure of the program or a private option thereby creating “price competition to lower costs.” Health savings accounts would be among the options. Currently, Medicare beneficiaries are not allowed to sign up for HSAs.
  • Supports restructuring Medicare’s reimbursement systems to reflect quality of care and give entitlement programs like Medicare “latitude to design benefits to encourage, incentivize, and reward healthy behaviors.”
Jon Huntsman (campaign suspended on Jan. 16)

  • Backed the Ryan budget plan, which proposed turning Medicare into a “premium support” program to curb spending.
  • Supported the August 2011 debt-ceiling deal, which leaves entitlement programs untouched in its first phase; the only GOP presidential hopeful to take this position.
“I admire Congressman Paul Ryan’s honest attempt to save Medicare. Those who disagree with his approach incur a moral responsibility to propose reforms that would ensure Medicare’s ability to meet its responsibilities to retirees without imposing an unaffordable tax burden on future generations of Americans.” – Wall Street Journal, May 31, 2011
Ron Paul

  • Argues that Medicare and other entitlement programs create undesirable dependence on the government, worsening the nation’s financial woes.
  • Views the Medicare’s Part D prescription drug program as an unwarranted expansion of the government’s role in health care and a “reminder that the GOP sometimes can’t resist the temptation of big government.”
  • Didn’t take part in Medicare when he practiced medicine; offered low-cost or free care to those who couldn’t afford his services.
  • Proposes redirecting resources from defense spending and foreign aid to fund Medicare for those already enrolled, while weaning younger people away from such assistance programs in favor of free market approaches.
“Why exactly should Americans be required, by force of taxation, to fund retirement or medical care for senior citizens, especially senior citizens who are comfortable financially? And if taxpayers provide retirement and health care benefits to some older Americans who are less well off, can’t we just call it welfare instead of maintaining the charade about ‘insurance’ and ‘trust funds’?” – Texas Straight Talk weekly address, Nov. 2010
Rick Perry (campaign suspended on Jan. 19)

  • Argues that, based on the 10th Amendment, states should be able to opt out of Medicare and develop their own means of providing health care.
  • Led the charge in 2005 against a provision of the Medicare Part D program, which was designed to relieve states of prescription drug costs for low-income elderly people. The policy required states to pay a portion – known as “clawback payments” – of their savings back to the federal government. Perry argued this was unfair to states that had already reduced their Medicaid drug spending. His administration filed a lawsuit in 2006 charging that the policy was unconstitutional.
“I think every program needs to stand the sunshine of righteous scrutiny. Whether it’s Social Security, whether it’s Medicaid, whether it’s Medicare. You’ve got $115 trillion worth of unfunded liability in those three. They’re bankrupt. They’re a Ponzi scheme.” – Newsweek interview, Aug. 12, 2011
Mitt Romney

  • Said, as president, he would sign the Ryan proposal, but also pledged to put out his own plan for reforming Medicare and Social Security.
  • Wants to publish federal yearly balance sheet to help people understand the impact of entitlement spending on the budget and economy.
  • Promises he won’t slice benefits for current seniors or jeopardize their retirement security.
Rick Santorum

  • Supports the Medicare changes advanced by House Budget Committee Chairman Paul Ryan, R-Wis., including replacing the current program with a voucher system.
  • Considers his 2003 vote for the Medicare prescription drug program to be a “mistake” because it is “universal” in nature when only about 15 percent of seniors had trouble with drug coverage.
Marketplace Michele Bachmann (campaign suspended on Jan. 4)

  • Cites her experience as co-owner with her husband of Bachmann and Associates, a Christian-based mental health care counseling center that employs nearly 50 people.
  • Sponsored a bill in 2009 that she says would make medical expenses, including insurance premiums, tax deductible for everyone.
  • Supports the expansion of high-deductible health savings accounts.
  • Seeks to allow small businesses to band together through trade associations to purchase health insurance for their employees at a lower cost than they can get individually.
  • Backs tort reform to curb medical malpractice awards.
Herman Cain (campaign suspended on Dec. 3)

“When I ran the National Restaurant Association, which today has 14 million employees, we wanted to design a system for health insurance that was going to be customized for our industry. We could not do that. We need to be allowed to do that, and so should other organizations and other associations.” – GOP debate, Sept. 2011
Newt Gingrich

  • Supports tort reform to decrease unnecessary and costly law suits.
  • Promotes a 21st-century personalized intelligent health system that would empower patients to access accurate and timely knowledge about their health and treatment options through the use of information technology.
  • Believes market competition allows consumers to make better health choices at lower prices and that patients and consumers should have access to information to make more informed choices.
  • Believes in several insurance reforms including giving people the choice of a generous tax credit or the ability to deduct a certain amount of the value of their health insurance, allowing the purchase of insurance across state lines and strengthening laws that prohibit insurers from cancelling or increasing rate increases to those who become sick while insured.
  • Supports expanding Health Savings Accounts (HSAs) throughout the health care system. Was an early, strong proponent of tax-preferred medical savings accounts, which preceded health savings accounts. Successfully advocated for Congress to create the first demonstration project for MSAs in 1996.
  • Advocates rewarding health and wellness by giving health plans, employers, Medicare, and Medicaid more flexibility to encourage healthy behaviors.
  • Proposes encouraging medical breakthroughs to patients by reforming the Food and Drug Administration.
  • Wants to invest in research for health solutions that are urgent national priorities, such as brain conditions that are costly for the system including Alzheimer’s, autism and mental health.
“The lesson of nearly four hundred years of entrepreneurial, technology and science-based free market capitalism is very clear. You should expect to get more choices of higher quality at falling prices. This is the opposite of the rationing mentality of some left-wing politicians and the scarcity mentality of too many bureaucrats. We need to bring these concepts into health and health care. We must insist that doctors, hospitals, medical technologies, and drugs have both quality and cost information available on-line so people can make informed decisions.” — “Winning The Future“
Jon Huntsman (campaign suspended on Jan. 16)

  • Pushed as governor for the completion of Utah’s all-payer claims database.
  • Campaigned for reelection in Utah promising to overhaul the state’s health system and trim the number of uninsured residents.
  • Signed Utah laws that established a task force to consider comprehensive health system changes, created a tax credit for individuals purchasing a health insurance policy on their own and began setting up an electronic medical records system.
“It is unacceptable that a young father in Clarkston, Utah who works for a small business and wants to buy insurance for his family is denied coverage because of minor ailments. Should eczema or post-partum depression preclude a family from getting affordable health insurance?” State of the State speech, 2008
Ron Paul

  • Introduced legislation in 2009 to allow patients and physicians to opt out of the electronic medical records system set up by the federal government, to refuse to have those records shared with a third party and to repeal a federal program establishing a “unique health identifier” for each patient.
  • Supports creating tax credits and deductions for all medical expenses, exempting terminally ill people from paying the employee portion of payroll taxes, providing a payroll deduction to workers who are caring for a spouse, parent or child with a terminal illness.
  • Opposes caps on awards in medical liability cases.
  • Endorses a new tax credit for “negative outcomes” insurance bought by patients before medical treatment so they can be compensated for medical mistakes. Says it would reduce “the burden of costly malpractice litigation.”
  • Supports allowing insurers to sell across state lines, as well as association health plans.
  • Wants to expand high-deductible health savings accounts.
Rick Perry (campaign suspended on Jan. 19)

  • Believes policymakers can best improve access to health care by working to improve the economy and increase jobs so that more people are covered under employer-sponsored health plans.
  • Opposes any federal action that would undermine states’ ability to regulate the health insurance and protect consumers.
  • Supports medical liability reform/tort reform to reduce frivolous lawsuits and reduce health care costs; cites a Texas measure that became law in 2003 as evidence of effectiveness.
  • Promoted investments in adult stem cell infusion and helped pass a health care measure that authorized creation of a state adult stem cell bank. He also personally received lab-grown stem cells during a spinal fusion to help with a back injury.
  • Supports allowing insurance companies to sell across state lines and efforts to help small businesses get better rates on health care plans.
Mitt Romney

  • Wants to “strengthen” high-deductible health savings accounts by allowing consumers to use them to pay insurance premiums.
  • Seeks to cap non-economic damage awards in medical malpractices law suits and favors giving states grants to fund other ways to deal with the liability issue, such as health care courts.
  • Urges restricting federal regulation of health care insurance, although he supports limited rules to bar insurers from denying coverage to those with preexisting conditions when they have had coverage for a specified period of time.
  • Says insurers should be allowed to sell their products across state lines.
  • Supports creating a tax deduction for people who obtain health insurance on their own.
  • Favors allowing individuals and small businesses to join together to buy insurance.
Rick Santorum
Health Reform Philosophy Michele Bachmann (campaign suspended on Jan. 4)

  • Founded the House tea party caucus and is a vociferous critic of the health law.
  • Co-sponsored legislation in the House to defund the health law.
  • Introduced in Jan. 2009 the “Health Care Freedom of Choice Act” to allow individuals to deduct all medical expenses.
“The American people spoke soundly and clearly at the ballot box in November and they said to us, ‘Mr. Speaker, in no uncertain terms, repeal this bill.’” – Remarks to the House of Representatives, Jan. 19, 2011
Herman Cain (campaign suspended on Dec. 3)

  • Supports repealing the 2010 health law “in its entirety.”
  • Believes in less government regulation and taxation of the health care marketplace, and favors “patient-centered, free market reforms.”
  • Refers to the 2010 “health reform” law as “health deform” on his campaign website.
  • Opposes the individual mandate.
  • Says he would have died of cancer if the health law had been in place in 2006. Politifact later rated this statement to be “false.”
  • Opposed the 1994 health reform effort led by Hillary Clinton Challenged President Bill Clinton on Hillary Clinton’s 1994 health reform efforts, questioning its effects on business during a nationally televised town hall meeting in 1994.
Newt Gingrich

  • Advocates for tax credits or deductions for purchasing insurance. For those who choose to remain uninsured, he has exploreddiverting the subsidy they could have gotten to safety net medical providers, who would deliver any needed care.
  • Founded the Center for Health Transformation, a corporate for-profit organization focused on the health care industry. The Center, which has been the topic of coverage by news outlets including The Washington Post and The New York Times, advances a range of market-based reform concepts and has been a vocal opponent of the 2010 health law.
  • Has worked on healthcare issues since 1974 and wrote a book called “Saving Lives & Saving Money” in 2002, which outlines proposals to “transform” the health care system by improving quality and reducing errors through increased transparency, better use of technology such as electronic medical records, and giving consumers greater ability to make decisions.
  • Says in his “21st Century Contract with America” that repealing the 2010 health law will be the first task of his administration.
  • Supports replacing the health law with proposals that include medical liability reform, insurance portability, improved price competition, and that emphasize electronic records and health savings accounts.
  • Opposes the 2010 health law’s individual mandate, but has been criticized for his previous support of it. Gingrich advocated the concept, in collaboration with the Heritage Foundation, when he opposed Hillary Clinton’s health care reform efforts in the 1990s. Many credit the conservative think tank as the original source of the mandate idea.
  • Calls for states to set up high risk pools to cover uninsured people who have become too sick to buy health insurance.
“As I carry the banner in fighting for the repeal of Obamacare, I will advocate for specific replacement health policies that will create a free market framework for healthcare, provide affordable, portable, and reliable healthcare coverage, and establish a healthcare safety net focused on those in need. This system will assure healthcare for all with no individual mandate or employer mandate of any kind.” – 21st Century Contract with America
Jon Huntsman (campaign suspended on Jan. 16)

  • Supports repealing the health law, which he says is “top-heavy” and “government-centric.”
  • Signed in 2008, while governor of Utah, a law to overhaul health care and set up an insurance exchange –- one of only two in the United States.
  • Opposes a federal mandate to require individuals to have health insurance.
Ron Paul

  • Outspoken opponent of the health law on policy, procedural and constitutional grounds.
  • Believes the individual mandate is unconstitutional; introduced legislation to end the mandate
  • Cites his experience as a physician to oppose the implementation of managed care: “We don’t have a right to medical care.”
  • Introduced legislation to create a market-based system “that reflects consumer choices while rationally pricing services.”
“If medical care is provided by government, this can only be achieved by an authoritarian government unconcerned about the rights of the individual.” – Statement, Sept. 23, 2009
Rick Perry (campaign suspended on Jan. 19)

“The federal government’s attempt to force every American to buy government-approved health insurance is an egregious violation of our Constitutional rights. The 10th Amendment and individual liberties must be protected, and I am committed to fighting the overreach of Obamacare and challenging these unconstitutional mandates, which have gone far beyond both the letter and spirit of the Constitution.” – Statement about district court ruling in Florida vs. HHS, Dec. 13, 2010
Mitt Romney

  • Known for working with Massachusetts Democrats to enact the precedent-setting 2006 state law requiring most residents to have insurance.
  • Supported – as part of this law – the creation of an online marketplace called the Health Connector, through which individuals and businesses can purchase insurance.
  • Argues that the federal law didn’t grow out of the Massachusetts law, saying the state reforms were tailored specifically to meet the needs of the state.
  • Says, if elected, he’d allow states to opt out of the federal health law and encourage Congress to repeal it.
“Mr. President, if, in fact, you did look at what we did in Massachusetts, why didn’t you give me a call and ask what worked and what didn’t? … I would have told you, Mr. President, that what you’re doing will not work. It’s a huge power grab by the federal government. It’s going to be massively expensive, raising taxes, cutting Medicare.” – GOP candidate debate, June 13, 2011
Rick Santorum

  • Places high priority on repeal of the health law.
  • During a speech at the 67th anniversary of D-Day, Santorum criticized the health care law and said that American soldiers stormed the beaches of Normandy and “risked everything to make sure you could make your own decisions on your healthcare plan.”
  • Strongly opposes more federal funding for health coverage and involvement in health programs. Has said that Democrats love entitlement programs and are trying to get more people “hooked” on health care benefits.
Medicaid Michele Bachmann (campaign suspended on Jan. 4)

  • Strongly opposes the expansion of Medicaid and other low-income health programs such as CHIP; repeatedly has criticized the expansion of Medicaid under the health care law.
  • Voted against the 2009 stimulus package, which included a temporary enhanced federal matching rate for the Medicaid program, as well as short-term COBRA continuation assistance.
  • Voted against expanding CHIP in 2009 and 2007.
  • Denounced last year’s decision by Minnesota Gov. Mark Dayton to expand Medicaid coverage to nearly 100,000 state residents.
  • Came under scrutiny after media outlets reported that the Christian counseling business she and her husband own received federal and state government funding, including Medicaid payments.
Herman Cain (campaign suspended on Dec. 3)

  • Advocates turning Medicaid into a block grant program and allowing states greater flexibility to set their own rules.
  • Suggests providing federally subsidized vouchers to help those with incomes up to three times the federal poverty level to buy coverage.
  • Would use Medicaid for high risk insurance pools or other options to help individuals with pre-existing conditions or at high-risk for illness obtain coverage.
Newt Gingrich

  • Supports giving states more freedom and flexibility to customize their Medicaid programs into block grants, a policy he pushed for unsuccessfully while speaker of the House in the mid-1990s.
  • Believes Medicaid reforms must recognize three distinct populations: people with disabilities, the poor and the elderly poor.
  • Supports adjusting Medicaid reimbursement models to reward quality of care and create incentives for beneficiaries to seek out facilities that deliver the best care at the lowest cost.
  • Says Medicaid beneficiaries should be free to choose a health savings account as part of their coverage.
  • Voted for the creation of the Children’s Health Insurance Program as part of the Balanced Budget Act 1997 and supported an extension of the program 2007.
  • Did not support the 2009 stimulus package, which included increased federal funding to states for Medicaid.
Jon Huntsman (campaign suspended on Jan. 16)

“Let states determine what the percentage of poverty levels are, and let public officials rise or fall on how local citizens feel about those decisions. They’re in a much better position to understand their vulnerable populations than at the federal level.” – Wall Street Journal, June 25, 2011
Ron Paul

  • Voted against expanding CHIP in 2009 and 2007.
  • Opposed stimulus package, which included a temporary enhanced federal Medicaid contribution and short-term extension of COBRA coverage.
Rick Perry (campaign suspended on Jan. 19)
Mitt Romney

  • Opposes the health law’s expansion of Medicaid coverage to more than 30 million people.
  • Backs block grants for Medicaid to allow states to use capped federal contributions to run Medicaid as they see fit.
Rick Santorum

  • Supports dramatically overhauling Medicaid in order to reduce national spending.
  • Cites the 1996 welfare reform law, which substantially reconstructed the nation’s welfare system and turned much of its administration over to the states, as a model for how Medicaid should be revamped. Santorum was a member of the Senate when that legislation was drafted.

–Compiled by Marilyn Werber Serafini, Stephanie Stapleton, Lexie Verdon, Shefali Kulkarni, Jessica Marcy, Juan Gastelum and Karl Eisenhower.

 

Source: http://www.kaiserhealthnews.org/Stories/2011/August/26/GOP-candidate-health-care-platforms.aspx?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+khn%2Ffulltext+%28All+Kaiser+Health+News+%28Full+Text%29%29

]]> http://milestonebenefits.com/mbanews/?feed=rss2&p=132 0 A Health Exchange Progress Report, Sort Of … http://milestonebenefits.com/mbanews/?p=129 http://milestonebenefits.com/mbanews/?p=129#comments Thu, 19 Jan 2012 15:38:45 +0000 admin http://milestonebenefits.com/mbanews/?p=129 Continue reading →]]> By Julie Appleby

January 18th, 2012, 12:08 PM

They’re making progress!  Well, at least 28 of them and the District of Columbia are.

That was the main talking point from the White House this morning during a press briefing revolving around a report stating that 28 states are “on their way” to establishing new marketplaces, called exchanges, where consumers can begin to shop for health insurance starting in late 2013. The report outlines some of the actions taken in those states — run by Democrats and Republicans — to get started on the exchanges.

When asked if that meant 22 states would not be ready in time, an administration official noted that “it would be premature at this point” to draw that conclusion.

He added that regulators are reviewing another round of grant proposals that, if all are approved, could bring the total to “well over 30 states” that have received some federal funding. A total of $729 million in grants have gone to 49 states and the District, with only Alaska not seeking any, according to a chart in the report.

The report comes as some states, including Wisconsin and Kansas, have either said they won’t use their grants or will give them back. Last week, South Dakota’s governor said there is too much uncertainty for the state to move ahead with an exchange until after it learns the results of the Supreme Court case challenging the law, and the outcome of the November Presidential election.

Will that be too late?

“If states decide after the Supreme Court decision, we will work with them to get them as far down the path as possible,” said the official, noting that a state initially could do a partnership with the federal government, if necessary, then get certified to run its exchange solo after that. Residents in states that can’t — or won’t — run their own exchanges will be directed to a federally facilitated fallback exchange.

Still, some policy experts have questioned whether the federal government will have its backup system up and running by the time enrollment is set to open in the fall of 2013. “We are making substantial progress of development of federal exchanges,” the official said Wednesday, including signing  contracts with private sector vendors to create the systems. He gave few additional details.

The federal exchange – like the state models – would be a one-stop website where individuals and small businesses could compare insurance policy offerings on price, coverage and quality.

Like many White House press briefings, this one was held under the condition that speakers not be identified by name, even though the report had already been issued and contained little or nothing controversial.

Source: http://capsules.kaiserhealthnews.org/index.php/2012/01/a-health-exchange-progress-report-sort-of/

]]> http://milestonebenefits.com/mbanews/?feed=rss2&p=129 0 Administration pulls plug on health reform law LTC program http://milestonebenefits.com/mbanews/?p=125 http://milestonebenefits.com/mbanews/?p=125#comments Mon, 17 Oct 2011 12:07:51 +0000 admin http://milestonebenefits.com/mbanews/?p=125 Continue reading →]]> WASHINGTON—The Obama administration on Friday pulled the plug on a voluntary long-term care program that was part of the health care reform law.

“We have not identified a way to make CLASS work at this time,” Health and Human Services Secretary Kathleen Sebelius said, referring to the Community Living Assistance Services and Support Act.

Under the program, participants would have paid a monthly premium for five years, after which they would have become eligible for a cash benefit of at least $50 a day that could be used to offset the cost of long-term care services. The program was not expected to begin until next year.

Vicious cycle feared

The law directed the HHS secretary to establish automatic enrollment procedures that employers could have used in which employees would have had to opt out if they didn’t want to participate.

Because the program was voluntary, critics say it would have resulted in adverse selection, a point Ms. Sebelius conceded. “This could have led to a vicious cycle where premiums would have to be set higher and higher to cover the likely costs of the benefits, leading fewer and fewer healthier people to sign up for the program,” she said.

Employer groups welcomed the decision.

“Since employers did not have to offer the plan, it didn’t really affect them directly, but if the government set it up, employers might have had to waste time explaining it and answering questions. Plus, if the government put it in and it failed because of the poor insurance design—which it certainly would have—the taxpayers would get stuck with another bailout. Employers might have been taxed for a program that made no sense,” said Helen Darling, president of the National Business Group on Health in Washington.

Source: http://www.businessinsurance.com/article/20111014/NEWS03/111019928?tags=58%7C74%7C62

 

 

]]> http://milestonebenefits.com/mbanews/?feed=rss2&p=125 0 Health Insurance Costs to Rise Sharply in 2011: How to Cope http://milestonebenefits.com/mbanews/?p=123 http://milestonebenefits.com/mbanews/?p=123#comments Wed, 28 Sep 2011 15:31:34 +0000 admin http://milestonebenefits.com/mbanews/?p=123 Continue reading →]]> By | Aug 23, 2010

Well, there’s one area where deflation will definitely not be at play in 2011: health insurance.  A survey of large businesses reports that employers expect their health care insurance costs to rise by an average of 8.9 percent in 2011. And to help  cover those rising health insurance costs, more than six out of 10 employers also expect to raise their employees’ share of the premium cost. Given that the average salary raise for 2011 is expected to be in the vicinity of 3 percent, it’s likely many Americans are going to see any bump in their compensation eaten up by having to pay more for health insurance.

As Derek Thompson laid out in a post last week at The Atlantic we may need to get used to that sad fact. Thompson highlighted this 2009 chart from the President’s Council of Economic Advisers:

Source: CEA

Yes, the chart was ginned up pre-health care reform, but the final legislation pretty much punted on health care cost containment, so there’s no reason to expect the trajectories in the chart will change anytime soon.

 

Paying More for the Less Coverage

According to the National Business Group on Health survey, paying more of your overall premium is just one  extra cost you may face in 2011; out-pocket maximums and bigger in-network deductibles are the next two “most popular” options employers will enlist to share the pain of rising insurance coverage.

 

A Coping Strategy for the Healthy

With open enrollment season just around the corner, this may be the year to consider a high deductible health insurance plan that you can then pair with  a Health Savings Account. More firms are offering these plans; if you are in relatively good health, you can reduce your premium by opting for a high-deductible plan. For this year that means a family deductible of at least $2,400, or $1,200 for an individual policy.

Once you enroll in a qualifying high-deductible plan you’re then eligible to contribute to your own HSA. You get a tax break on contributions into the HSA and withdrawals used to pay for medical expenses are not taxed. The maximum family contribution to an HSA this year is $6,150. ($3,050 for individuals.) The maximums for 2011 have yet to be announced; they probably won’t budge given the low general rate of inflation.

You can also let the money sit in the HSA and grow; unlike a flexible spending account there is no “use it or lose it provision.” Your balance can be used for future medical expenses decades from now. Or once you turn 65 you are free to use your HSA balance for anything. though you will owe income tax on your withdrawals. Just like with a Traditional IRA.

 

Related Articles on MoneyWatch

 

Cut Your Medical Expenses

How to Shop for Health Insurance

Read more: http://moneywatch.bnet.com/retirement-planning/blog/retirement-beat/health-insurance-costs-to-rise-sharply-in-2011-how-to-cope/911/#ixzz1ZGHSuPY9

]]> http://milestonebenefits.com/mbanews/?feed=rss2&p=123 0 10 Top-Selling Drugs Coming Off Patent http://milestonebenefits.com/mbanews/?p=121 http://milestonebenefits.com/mbanews/?p=121#comments Tue, 27 Sep 2011 20:53:56 +0000 admin http://milestonebenefits.com/mbanews/?p=121 Continue reading →]]>
By KATIE MOISSE
July 25, 2011
ABCNEWS.com

Ten of the world’s top-selling prescription drugs are about to get cheaper.

Over the next 17 months, the patents on brand-name medications like the cholesterol-lowering drug Lipitor and the blood thinner Plavix will expire, opening the door for generic versions that could cost up to 80 percent less. Name brand drug costs could also fall because of the new competition. It might be bad news for drug makers, but good news for patients.

Here’s a look at the 10 blockbuster drugs coming off patent.

Blockbuster Drugs Coming Off Patent

Plavix

When a clot builds up or lodges in a blood vessel, it restricts blood flow and could cause a heart attack or stroke. Plavix, which belongs to a class of drugs called blood-thinners or anti-platelets, can help keep blood flowing smoothly — for about $162 per month. In 2010, Plavix earned co-marketers Bristol-Myers Squibb and Sanofi-Aventis more than $6.1 billion in U.S. sales. A generic version could be available in the U.S. in May 2012.

MORE COVERAGE

  • Do Drug Ads Make Meds More Expensive?

Blockbuster Drugs Coming Off Patent

Lipitor

High blood levels of cholesterol can lead to a build-up of fat on the inside of blood vessels, narrowing the opening through which the blood can flow and increasing the risk of heart attack and stroke. Lipitor, which belongs to a class of drugs called statins, can decrease the amount of cholesterol in the blood and lower heart attack and stroke risk. It can cost up to $168 per month. In 2010, Lipitor earned Pfizer more than $5.3 billion in U.S. sales. A generic version could be available in the U.S. in November 2011.

MORE COVERAGE

  • Generic Statin Switch May Lead to Wrong Dose

Blockbuster Drugs Coming Off Patent

Seroquel

Seroquel is used to treat the symptoms of schizophrenia and bipolar disorder. It belongs to a class of drugs called atypical antipsychotics, which work by changing the activity of certain chemicals in the brain. Depending on the dose, the drug costs about $549 per month. In 2010, Seroquel earned AstraZeneca more than $3.7 billion in U.S. sales. A generic version could be available in the U.S. in the spring of 2012.

MORE COVERAGE

  • The Heavy Toll of Childhood Schizophrenia

Blockbuster Drugs Coming Off-Patent

Actos

Actos is used to treat type 2 diabetes — a chronic disease that’s on the rise nationwide. The drug belongs to a class of medications called thiazolidinediones and can increase the body’s sensitivity to insulin and help control blood sugar levels. It costs up to $241 per month. In 2010, Actos earned Japanese manufacturer Takeda more than $3.3 billion in U.S. sales. A generic version could be available in the U.S. in August 2012.

MORE COVERAGE

  • FDA Warns of Bladder Cancer Risk With Actos

Blockbuster Drugs Coming Off-Patent

Enbrel

Enbrel is used to treat the autoimmune diseases rheumatoid arthritis and psoriasis. The drug, which belongs to a class of medications called tumor necrosis factor (TNF)-alpha inhibitors, acts as a decoy receptor in the body and soaks chemicals that propagate the autoimmune reaction. It costs up to $2,784 per month. In 2010, Enbrel earned Amgen more than $3.3 billion in U.S. sales. The patent expires in August 2012. But because the drug is a “biologic” that mimics the body’s own receptor, it’s subject to different laws and companies can’t manufacture a generic version in the U.S.

MORE COVERAGE

  • First Person With RA Conquers Mt. Everest

Blockbuster Drugs Coming Off-Patent

Singulair

Singulair is used to prevent symptoms of asthma and allergies. In 2010, Singulair earned Merck over $3.2 billion in U.S. sales. A generic version could be available in the U.S. in August 2012.

MORE COVERAGE

  • Asthma Study Demonstrates Power of Placebo

Blockbuster Drugs Coming Off-Patent

Levaquin

Levaquin is an injectable antibiotic used to treat pneumonia as well as infections of the sinus, urinary tract, kidney and skin. A generic version of the drug, which belongs to a class of bacteria-killing medications called fluoroquinolones, is available in tablet form. But the injectable form is still under patent. In 2010, Levaquin earned over Johnson & Johnson $1.3 billion in U.S. sales.

MORE COVERAGE

  • Scientists Discover Strain of ‘Super Gonorrhea’

Blockbuster Drugs Coming Off-Patent

Zyprexa

Zyprexa, like Seroquel, is an atypical antipsychotic used to treat the symptoms of schizophrenia and bipolar disorder. It costs up to $641 per month. In 2010, Zyprexa earned Eli Lilly almost $3.5 billion in U.S. sales. A generic version could be available in the U.S. in October 2011.

MORE COVERAGE

  • Catherine Zeta-Jones Sheds Light on Bipolar Disorder

Blockbuster Drugs Coming Off-Patent

Concerta

Concerta is used to control symptoms of attention deficit hyperactivity disorder (ADHD) — a condition marked by difficulty focusing and remaining still or quiet that affects adults and children. It’s also used to treat narcolepsy. The drug, which belongs to a class of medications called central nervous system stimulants, works by changing the concentrations of certain chemicals in the brain. It costs up to $236 per month. In 2010, Concerta earned Johnson & Johnson $929 million in U.S. sales. A generic version could be available in the U.S. in 2011.

MORE COVERAGE

  • When Your Kid’s Too Rambunctious for Camp

Blockbuster Drugs Coming Off-Patent

Protonix

Protonix is used to treat gastroesophageal reflux disease and conditions that cause the stomach to produce too much acid. The drug, which belongs to a class of medications called proton-pump inhibitors, works by decreasing the amount of acid made in the stomach. It costs up to $173 per month. In 2010, Protonix earned Pfizer $690 million in U.S. sales. A generic version could be available in the U.S. in 2011.

]]> http://milestonebenefits.com/mbanews/?feed=rss2&p=121 0 Kaiser: PPACA is Here http://milestonebenefits.com/mbanews/?p=119 http://milestonebenefits.com/mbanews/?p=119#comments Tue, 27 Sep 2011 20:52:10 +0000 admin http://milestonebenefits.com/mbanews/?p=119 Continue reading →]]> The Patient Protection and Affordable Care Act of 2010 (PPACA) is starting to have noticeable effects on group health coverage, researchers say.

The researchers, at the Henry J. Kaiser Family Foundation, Menlo Park, Calif., and the Health Research & Educational Trust, Washington, have reported that finding in a report based on a survey of 2,088 U.S. employers.

The researchers found that the overall percentage of participating employers offering health benefits fell to 60% this year, from 69% in 2010.

The percentage of firms with 200 or more workers offering health benefits held steady at about 99%, but the percentage of firms with 3 to 199 workers offering health benefits dropped to 59%, from 68%.

The percentage of firms with 10 to 24 workers offering health benefits slipped to 71%, from 76%, and the percentage of firms with 3 to 9 workers offering benefits plunged to 48%, from 59%.

The average annual single premium increased 8%, to $5,429, and the average annual family premium increased 9%, to $15,073.

The researchers also found that the shift to high-deductible plans is continuing, with 17% of covered workers now in high-deductible plans, with or without access to special savings accounts, compared with 55% who are in preferred provider organization plans (PPO), 17% who are in health maintenance organization plans, 10% who are in point-of-service plans and 1% in traditional indemnity plans,

The percentage now in high-deductible plans has increased from 13% in 2010.

About 21% of workers in ordinary PPO plans now have deductibles of $1,000 or higher, even though, technically, they are not classified as being in high-deductible plans, researchers say.

When the researchers asked about the effects of PPACA provisions that have already taken effect, the found that:

- About 15% of firms with 3 to 49 employees and no health coverage have considered adding health insurance because of the existence of a new PPACA small business tax credit.

- About 20% of all firms, and about 70% of large firms, said they have enrolled at least one additional adult child because of the PPACA provision that requires large and midsize group plans to offer workers access to dependent to coverage up to age 26,

- About 23% of all plans, and 28% of plans with 200 or more workers, said they have changed preventive care copayment or coinsurance rules because of a PPACA provision that requires non-grandfathered plans with 200 or more workers to provide first-dollar preventive care services coverage.

- Allison Bell

 

Source: http://www.lifeandhealthinsurancenews.com/News/2011/9/Pages/Kaiser-PPACA-is-Here.aspx?nul

 

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