The Number of Uninsured Adults is Rising
The number of adults who were uninsured or underinsured in the United States has risen 80% from 2003 to 2010, according to a report published by the Commonwealth Fund in Health Affairs.
The Commonwealth Fund defines underinsured adults as those who say yes to at least one of the following criteria:
- Out of pocket family medical care spending that makes up over 10% of income (not including premiums)
- Medical expenses that represent over 5% of income (in families whose income is below 200% of federal poverty level).
The researchers gathered data from the Commonwealth Fund 2010 Health Insurance Survey, which included telephone surveys from 4,005 people aged 19 years and up in the United States. These adults were asked about out of pocket expenses, insurance, care experiences, their health, income status and other demographic information.
They found that as of 2003, 16 million adults were underinsured. In 2010, 29 million were underinsured. 61 million adults were either underinsured or uninsured in 2003, and 75 million were the same in 2007. 81 million adults were either underinsured or uninsured in 2010, making up 44% of the country’s adult population. 77% of adults whose income was lower than 13% of the poverty level were under or uninsured, and 58% of adults whose incomes were between 133% and 200% below the poverty level were under or uninsured in 2010.
While those under the poverty level are more likely to be under or uninsured, those considered not in poverty are increasingly foregoing insurance as well. As of 2010, 16% of adults earning between $40,000 and $60,000 a year were under or uninsured.
Adults who are underinsured are twice as likely to do without medical care and three times as likely to do so if they are uninsured. This means not following up with treatments, not filling prescriptions, or seeking a doctor’s care during an illness.
The Affordable Care Act is seeking to reach adults with lower incomes who are under or uninsured, to help them find medical care that is within their budget.
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Teens Long Work Shifts Can Increase Risk of MS
According to recent research, there is a possible link between teenagers who work long shifts at their job, more specifically, night shifts or rotating shifts, and increasing the risk of developing multiple sclerosis (MS). Those who are under 20 years of age, who engaged in long hours of employment in the evening hours, may be at a higher risk of developing MS due to disruption in their circadian rhythm and sleep patterns.
Previous research done has suggested that shift work – working during the night, or working overtime hours in the evening – increases the risk of cardiovascular disease, thyroid disorders, and cancer. Circadian disruption and sleep restriction are associated with working night shifts. It is believed that these factors disturb melatonin secretion and increase inflammatory responses, further promoting disease.
Multiple Sclerosis is a central nervous system autoimmune inflammatory disorder that has an environmental component. It can be brought on by sleep loss related to work, and other lifestyle risk factors.
The study was done by Dr. Anna Karin Hedstrom and colleagues from the Karolinska Institute in Stockholm. They analyzed data from two population-based studies. One of the studies had 1343 incident cases of MS and 2900 controls. The other had 5,129 prevalent MS cases and 4509 controls. All of the study subjects lived in Sweden and were between the ages of 16 and 70.
According to Dr. Hedstrom, “Our analysis revealed a significant association between working a shift at a young age and occurrence of MS.” She continued, “Given the association was observed in two independent studies strongly supports a true relationship between shift work and disease risk.”
Further investigation will be needed to determine just how much of a risk youth may face when working evening shifts.
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Individual States Re-Examining Medicaid
Several states are re-examining their Medicaid plans, researching who is covered, and what it is costing. Among those states struggling with their current Medicaid plans and recently implemented changes are Arizona, Oregon, Florida, and several others.
Medicaid managed care plans in Florida’s five “Medicaid Reform” counties have been granted a 10.8% rate increase because of the increasing hospital costs. This was confirmed by the president of the Florida Association of Health Plans. The managed-care plans in most counties of Florida were granted an average 1.3% rate increase.
Florida economists are predicting a modest Medicaid growth as the once booming program is now slowing its numbers. Medicaid will increase by a modest $1.3 billion, or 6%, in the next fiscal year. This is due mainly to the expiration of temporary federal assistance of $550 million.
Sharp drops are being seen in adults covered by Arizona Medicaid. Over 14,000 low-income, childless adults in Arizona lost state-provided health coverage last month. This s the biggest decrease since the state froze enrollment in July. Enrollment has dropped from 217,718 to 192,011 since the state stopped accepting new applicants and began blocking re-enrollment from people in the program who did not renew coverage. Several experts stated that while the numbers were definitely down, it was not as bad as originally anticipated.
Oregon saw their Medicaid rates cut by 15%. Their hospitals are not happy with the decision by Governor Kitzhaber, one that reduced Medicaid payments by 15% on October 1st. According to Andy Van Pelt, director of communications at the Oregon Association of Hospitals and Health Systems, “Hospitals were extremely disappointed in this post-session budget decision that was made outside of the legislative process.” They also blamed the lagging economy for the decision.
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Rising Health Care Costs Hurting Income
Rapidly rising health care costs have exhausted most American family’s disposable income, according to a new study conducted by RAND Corporation.
According to the data, had health care costs risen only as fast as the cost of other goods and services in the United States from 1999- 2009, the average American family of four would have approximately $545 per month to spend in disposable income after paying for expenses. However, the average American family of four only has around $95 left over in disposable income in actuality, a direct result of rising health care costs.
The findings were published in the September edition of the health journal Health Affairs. David Auerbach, the study’s lead author and an economist at RAND Corporation, said, “Accelerating health care costs are a primary reason that so many American families feel like they are treading water financially. Unless we reverse the trend, Americans increasingly will notice that health costs compromise their other spending options.”
Between the years of 1999 and 2009, total spending for health care in the United States nearly doubled from $1.3 trillion dollars to $2.5 trillion dollars. The percentage of the nation’s gross domestic product devoted to health care climbed from 13.8% to 17.6% during the same time. Per person health care costs grew from $4,600 to $8,000 a year approximately.
According to researchers, people don’t often realize just how much of a dent health care costs put into their income, because the numbers often get hidden. Health care can affect a family in two ways – through the monthly premiums they pay for their health insurance, and also through out of pocket expenses for things like co-pays, deductibles, medications, and more.
In addition, other hidden costs can come into play, like private health insurance, federal and state taxes for programs like Medicare and Medicaid, and more.
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Health Insurance Premiums Depend on Where You Live
According to the latest News and Numbers from the Agency for Healthcare Research and Quality, private-sector employees with single coverage contributed 21% of the cost of their health insurance and employees with family coverage paid 27%.
According to data from the federal agency, health insurance premiums nationwide averaged around $4,940 for single coverage and around $13,871 for family coverage in 2010. Among the 10 largest states, the annual cost of single coverage ranged from #4,669 in Ohio, to $5,220 in New York. Family coverage ranged from $13,083 in Ohio to $15,032 in Florida. Around 18% of employees with single coverage and 10% of employees with family coverage were not required to pay for any part of their employer-sponsored health insurance.
Among the 10 largest states in 2010, employees who did not pay premiums for single coverage ranged from around 12% in Illinois to around 24% in California. The range for employees with family coverage was around 3% in Florida, compared to 17.5% in Pennsylvania.
These figures were provided by the Agency for Healthcare Research and Quality (AHRQ). This health news summary is provided by InsuranceChaser.com. When you need health insurance, our helpful health insurance advisors can work with you to find a quality plan. We serve the state of Ohio with popular plans from Anthem of Ohio and many more. Contact us at (877) 775-4321 for more information and to speak with an agent.
Mammograms Have Risk of False Positives
A new study suggests that mammograms have a high risk of false positive results. The news came at a particularly bad time, during breast cancer week, which seeks to raise awareness for the need to undergo mammograms to screen for breast cancer.
The study looked at nearly 170,000 women between the ages of 40- 59 from seven different regions around the United States. It will be published in the Annals of Internal Medicine. The study was led by the Group Health Research Institute of Seattle for the Breast Cancer Surveillance Consortium. It included around 4,500 women with invasive breast cancer.
The study was co-authored by Karla Kerlikowske, a professor of medicine at UCSF School of Medicine, who said, “This study provides accurate estimates of the risk of a false-positive mammography and breast biopsy for women undergoing repeat mammography in community practice, and so provides important information about the potential harms of undergoing regular mammography.”
The study also found that women who get annual screenings earlier are more likely to get false positive results over their lifetime. While they would simply go back for a second test, it could cause undue stress and worry and expose the patients to x-rays and procedures that were not necessary. Doctors argue that regular screening is unnecessary, with the procedure itself being mechanically aggressive for the breast tissue, and that the radiation levels can be harmful to women, even affecting DNA.
According to Rebecca Hubbard, PhD, an assistant investigator at the Group Health Research, “We conducted this study to help women know what to expect when they get regular screening mammograms over the course of many years…we hope that if women know what to expect with screening, they’ll feel less anxiety if or when they are called back for more testing. In the vast majority of cases, it does not mean they have cancer.”
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Low Quality of Lung Cancer Care among Medicaid Recipients
A new study has found that lung cancer patients treated in hospitals that care for a high percentage of uninsured or Medicaid recipients (otherwise known as “high safety-net burden facilities”) were significantly less likely to undergo surgery that was intended to cure cancer. This was in comparison to patients treated at “low safety net” burden facilities. The difference was still present even after controlling for other factors that significantly decreased the likelihood of curative-intent surgery, including race, insurance status, stage, and female gender as well as some other factors.
The study was the first of its kind to examine the impact that safety-net burden status can make on access to certain surgeries in regards to lung cancer. The research was conducted and led by Katherine S. Virgo, Ph.D., and used data provided by the National Cancer Database (NCDB). They reviewed the treatment of more than 50,000 patients diagnosed with non-small cell lung cancer who were treated at American College of Surgeons Commission on Cancer accredited facilities throughout the United States.
The study found that over 16% of patients treated at high safety-net burden hospitals underwent surgery to cure their disease. This is in contrast to the 77% of those at low safety-net burden centers.
According to Dr. Virgo, “This study adds to the growing literature about the ability of the so called safety net to catch patients in need of care. It demonstrates that access to high quality lung cancer care is less optimal at high safety net burden facilities.”
The authors of the study suggested that the reasons for the disparities are not fully understand, though it seems that reimbursement issues may play a part. Some care centers also lack full and unrestricted availability and participation of specialists, including some surgeons.
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High Blood Pressure in Pregnancy
New research is suggesting that high blood pressure during pregnancy can raise the risk of major birth defects, more so than medicines used to control the condition, as previously thought.
For years, pregnant women have been warned to avoid certain drugs, such as ACE inhibitors, during the later stages of their pregnancy, to avoid the possibility of causing birth defects. Doctors have been unclear as to whether or not taking the drug would be harmful in the first trimester of pregnancy.
A 2006 study had concluded that they were safe in the first trimester, and two later studies done found a slightly increased risk when combined with other blood pressure medications.
Researchers are now saying that the drugs aren’t to blame – it’s the high blood pressure itself that is the cause for increased risk of birth defects. Compared to women who did not have high blood pressure, those with the condition were more likely to have babies born with congenital heart, brain or spinal cord defects, no matter whether they were taking ACE inhibitors or other medications or not.
Dr. De-Kun Li and other team members from the Kaiser Permanente Institute in California examined data covering over 460,000 pregnant women and their infants from the years 1995 to 2008. The study was funded by several groups including the U.S. Agency for Healthcare Research and Quality and the Department of Health and Human Services.
Dr. James Walker, a spokesman for Britain’s Royal College of Obstetricians and Gynecologists, was not linked to the study, but said, “What this study does is reassure us women can stay on the drug until they are pregnant and then stop. You never know how long someone is going to take to get pregnant and if they come off a blood pressure drug for too long, it could be bad for them.”
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Consolidation of Health Care Could Lower Costs
Increased consolidation among health plans nationally could benefit consumers by lowering hospital prices, in the regions where health plans are the most consolidated. This finding was recently published in a new RAND Corporation study.
Researchers who worked on the study found that hospital prices were about 12% lower in the metropolitan areas with the fewest health plans, lending support to the view that when health plans become bigger, they can negotiate lower prices from health care providers.
The study was published in the September issue of the journal Health Affairs. It also discovered that regions where hospital ownership is more consolidated generally have higher hospital prices. The prices can be driven lower when health plans are also consolidated.
According to Glenn A. Melnick, an economist at RAND and Blue Cross of California, “There may be a benefit for consumers when health insurance plans are more consolidated because it tends to drive down hospital costs. As long as there is enough competition to keep health plans honest, the consolidation has a good result on prices.”
Hospital workers and doctors have expressed concern over the past few years that ongoing consolidations could depress prices as they concentrate on so much market power.
Researchers examined various data and information about health plans, hospitals and health costs in metropolitan areas across the United States in 2001 and 2004 to determine the market concentration in health plans and hospitals. The study didn’t look at fees charged by health plans.
The study discovered that 64% of hospitals operate in markets where health plans are not very consolidated, and 7% were in the most concentrated health plan markets. More research was to be done in the study to determine more factors.
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Congenital Heart Patients with Highest Surgery Costs More Likely to Die
According to a new study published in the journal of the American Heart Association, Circulation: Quality and Outcomes, higher surgical costs for adult congenital heart patients is associated with higher rates of inpatient death, in comparison with admissions that have lower costs. The study also found that adult patients who have had congenital heart problems since birth are likely to still visit a pediatrician for care and procedures.
Researchers who worked on the study were seeking to understand the resource use by adults who were undergoing surgery for a congenital heart condition in pediatric hospitals, to analyze the association between high resource use and inpatient death, and identify the risk factors involved. They found that while the number of adults undergoing the surgery is increasing, adult congenital heart patients are not using a disproportionate amount of hospital resources.
They were able to identify five factors that are often associated with higher inpatient charges, including surgical complexity, government assisted insurance, DiGeorge Syndrome, weekend admissions, and depression. DiGeorge Syndrome is a disorder found in the genes that can affect the thymus and thyroid, which also happens to cause heart defects.
Most of congenital heart patients survive into adulthood, and those adults now outnumber pediatric congenital heart patients. Great deals of adults who have congenital heart problems continue to receive medical and surgical care at pediatric hospitals.
According to Oscar J. Benavidez, M.D., the lead author of the study, “The most interesting and actionable of our findings was that depression is a risk factor for high resource use among the surgical population. While we cannot change a patient’s surgery complexity or presence of DiGeorge Syndrome, we might be able to implement a treatment strategy for a potentially modifiable risk factor such as depression.”
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