What’s Really Scary about Obamacare

This cartoon made the rounds of twitter a few weeks ago, and was first brought to my attention by Timothy McBride (@mcbridetd). But it is such an entertaining cartoon, I thought I would circulate it again:
Scary About OBAMAcareFor all its flaws, Obamacare has done more to increase access to health insurance than any government program since Medicare.

Health Insurance Prices Declining under Obamacare

One year does not a trend make, but it does look like prices for health insurance under Obamacare next year will decline, on average. Ezra Klein, over at Vox.com, produced a nice picture of these prices:
Benchmark plan percentage change 2014-2015
Who knows: in the long run, maybe the name of this law – The Affordable Care Act – will be deserved.

Financial Counseling for Cancer Patients: A Growth Industry?

A former student of mine who now works at the Advisory Board recently emailed me some figures her company put together, offering a snapshot of how many people are being hired in oncology practices to help patients with their financial concerns:
blog figure 8.12.14
I am very eager to see what these figures look like over the next couple years. I will be surprised if these numbers don’t grow significantly. Cancer-related treatment costs are a really big deal!

Does Health Insurance Improve Health? Evidence from Massachusetts

massachusettsIt is always important to remember that healthcare and health insurance are two very different things, and neither of them is a guarantee of good health. Therefore, when people talk about Obamacare providing people with medical care, we have to remember that it primarily provides people with health care insurance. And as I have written about previously, insurance coverage does not guarantee the receipt of quality healthcare, with many Medicaid recipients having a hard time finding doctors willing to see them.
Now comes a new study from Massachusetts, exploring whether expansion of health insurance within that state through Romneycare has improved the health of that state’s citizens. In the study, the researchers conducted a before/after look at the health of people in Massachusetts. The idea here is that if people’s health improves after they receive insurance coverage, that could result from the receipt of such coverage. Recognizing that other factors could also affect the health of people over time, the researchers also conducted a before/after look at other states in New England. The main idea here is simple: if over the same period of time, people in Massachusetts experience improvements in their health relative to their neighbors, we have evidence suggesting that the expansion of health insurance in Massachusetts benefited its citizens.
The answer? Across a number of measures, the researchers found relative improvements in the health of people in Massachusetts… (Read more and view comments at Forbes)

Is the Profit Motive Ruining American Healthcare?

Greedy-Insurance-GuyWe all know that healthcare costs in the U.S. are too high.  But why is American healthcare so expensive?  Some experts blame the desire for profit.  Russell Andrews, a  neurosurgeon and author of Too Big To Succeed laments “the morphing of American medicine from a function of a humanitarian society into a revenue stream for healthcare profits, drug and medical device companies, hospitals, and insurance companies.  In essence, we have transformed healthcare in the U.S. into an industry whose goal is to profitable.”  Andrews goes on to characterize the profit motive as “a virus” infecting the system.
Sachin Shah, a physician affiliated with Doctors For America, contrasts the struggles patients have paying for their medical bills to the enormous profits of American insurance companies:

“The five largest health insurance companies – WellPoint, United Health, Aetna, Humana, and Cigna – … earned over $3.3 billion in profits [between April and June 2011].”  Shah goes on to contend that “Profit in the health insurance industry is the single greatest barrier to building an efficient, sustainable system of healthcare in this country.”

David Goldhill is not convinced that profits are the problem.  Author of Catastrophic Care: How American Healthcare Killed My Father and How We Can Fix It, Goldhill points out how small those profits are in the face of overall healthcare spending… (Read more and view comments at Forbes)

Where in the United States Do the Uninsured Live?

In a recent post, I wrote about ethnic variation in the likelihood of going without health insurance. There’s also quite a bit of geographic variation in uninsurance, based on 2008 data – before the passage of the Affordable Care Act. Here is a picture showing the percentage of people in the continental United States who went without health insurance for at least a portion of time:

map of uninsured

I’m not the first person to point this out, but it is still worth noting that the states which have most aggressively opposed Obamacare are also the ones that stand to benefit most from the law, if they expand Medicaid and work to make their health insurance exchanges operate smoothly. Really a shame we don’t have a cooperative political climate, where we can confront our differences while still implementing laws that stand to benefit millions of Americans.
(Click here to view comments)

How Much Are You Spending on Healthcare, and How Much Is Your Insurer?

I have been writing a lot lately about out-of-pocket costs for health care in United States. In my research on this topic, I came across the following picture, which shows how much insurers are spending on healthcare, among people in the United States receiving insurance through their employers, and also how much those employees are spending out-of-pocket for their medical care. Both are rising, but out-of-pocket spending is rising much more quickly.

insurer vs oop spending

No evidence yet that my obsession with healthcare costs is misplaced.
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The US is Number One: in Out-of-Pocket Costs!

I have been writing a fair amount lately about the out-of-pocket costs that many Americans face when they receive healthcare services. A new report by The Commonwealth Fund provides a picture of the scope of this issue. It compares the US to 10 other developed countries, and shows not only that people in the US spend more out-of-pocket than folks in those other countries, but also have a much harder time paying for the services they need:

oop costs by country

Other notable facts in the report:

        — About a third (32%) U.S. adults spent a lot of time dealing with insurance paperwork and disputes or were either denied payment for a claim or paid less than expected.
        –Nearly one-quarter (23%) of U.S. adults either had serious problems paying medical bills or were unable to pay them

If or when Obamacare is fully implemented, we will find out whether any of these numbers improve substantially.
(Click here to view comments)

How the Obamacare Employer Mandate Promotes Fairer Markets

Mixtec Immigrant Picking StrawberriesObamacare has come under intense criticism for harming businesses, which will see their employee costs rise as a result of the ACA employer mandate.  A recent New York Times article reported that complying with Obamacare regulations would “cost about $1 per hour per employee” for agricultural companies paying people to work in the fields.  That is a big increase in the cost of doing business, an increase that will lead to some combination of higher prices and lower sales, and therefore fewer jobs.

To this terrible news I say: Hurrah!  It is about time for agricultural companies—and anyone else not providing health insurance to their employees—to start paying the full price of doing business.
I am a fan of efficient markets.  I believe that in most circumstances, the world is better off if people have transparent information about the price of consumer goods, and the freedom to decide whether to part with their hard earned money in order to purchase such goods.  It is wonderful that I can go to the grocery store and decide whether or not I want to buy strawberries priced at $4 a pint.
One result of efficient markets, often, is that the price of goods is brought down by competition, making life better for us consumers.  I’m a fan, in other words, of low prices.
But I’m also a fan of fair prices, and here is where I get bothered by companies that free ride on the nation’s healthcare system… (Read more and view comments at Forbes)

PeterUbel