Obamacare Chipping Away at Uninsured Numbers

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With all the hype and controversy over Obamacare, once in a while it’s nice to look at the facts. And here are recent numbers – on the percent of Americans who lack health insurance, a figure that has dropped significantly in recent months with the expansion of Medicaid and the opening of the health insurance exchanges:

percent uninsured

These numbers should improve even more the next few years, barring some new roadblocks to this law. At some point, we might not even lag the rest of the developed world in access to affordable healthcare. Okay – I’m getting carried away.
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Has the Obamacare Medicaid Expansion Already Reached Its Peak?

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The Affordable Care Act expanded Medicaid eligibility this year in those states which decided to follow its provisions. That means lots of people are now newly eligible for Medicaid. However, the number of people signing up for Medicaid in the states has been underwhelming. Which raises a question: how much can we expect enrollment numbers to increase over the next few years?
To begin to answer that question, a group of researchers studied what happened in four locations – California, Connecticut, Minnesota and Washington DC – which in 2010 chose to expand their Medicaid coverage earlier than required, for low income childless adults. The researchers studied how quickly these newly eligible people signed up for Medicaid…(Read more and view comments at Forbes)

People in the US Are Footing the Bill for Switzerland's Medical Care

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People have criticized The Affordable Care Act for amounting to a large transfer of wealth, from wealthy Americans to those not as well off. But the real transfer of wealth has been from United States to other developed nations, whose healthcare costs we have subsidized for many years by paying so generously for many of our healthcare services. No better example of this comes to mind than the price we pay for pharmaceuticals in the US versus elsewhere. Below is a picture of what we pay  for brand-name drugs here compared to peer nations.
Pharmaceutical products are cheaper abroad in part because companies know they can make money in the US market, and thus are willing to tolerate smaller profit margins in other countries… (Read more and view comments at Forbes)

Has Obamacare Made Restaurants Partisan?

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Politics in the US is discouragingly partisan. National politics has become increasingly partisan since at least the late ’60s, when the passage of civil rights legislation influenced many conservative southern Democrats to join the Republican Party. Even state politics has become more partisan, where even famously nice people in Wisconsin have found themselves battling their neighbors across political divisions. Fortunately, most of life does not force us to confront our political differences, meaning we can go out to dinner with our family and friends, sharing space with other diners free from concern that we will be confronted with partisan rhetoric.
Until now.
According to a report on CNN Money, some restaurants in Florida are now making sure their patrons recognize the burdens being placed upon them by the Affordable Care Act. Here’s a copy of a receipt from one of these restaurants…(Read more and view comments at Forbes)

Where in the World are the ACOs?

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The Affordable Care Act established several programs to promote the formation of Accountable Care Organizations. These ACOs are a relatively new way of organizing healthcare delivery, in which healthcare providers join together – perhaps across physician groups and hospitals – to care for a population of patients, and are then held accountable both for the cost and quality of the care they deliver to those patients. This accountability cuts both ways – if they spend too much money on such patients and provide low quality of care, they might face financial repercussions, but if they offer high quality at a lower than expected cost, they might be rewarded with part of those cost savings.
A recent study gives us a glimpse of where the ACOs are forming in the United States. You will see they are not being formed everywhere, but instead are heavily concentrated in the southern and eastern United States:

map mar27

The study also shows that these organizations are disproportionately made up of large, nonprofit healthcare systems, but not ones classified as public hospitals.
tab mar27
 
This is just a snapshot of what’s happening right now, which I thought I would pass along for those of you policy geeks interested in some of these rich details. Now we get to find out whether these organizations can thrive, and whether they will truly prove to be a win-win idea – lowering healthcare costs while maintaining or improving healthcare quality.

How Long Will It Take to Get a Doctor’s Appointment?

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A report on the Kaiser Family Foundation website shows how long it takes to get appointments with primary care doctors and subspecialists. The most dramatic finding comes out of Boston, where you can expect to wait more than two months to see a family physician.
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I expect the delay in seeing a family physician results not only from the over specialization of physicians in Massachusetts, but also the expansion of health care coverage under the Massachusetts Health Plan. I wonder if this predicts access problems that will be happening across the nation over the next few years.

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The Cost of Saying No to Medicaid Expansion

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Here is a nice picture, from a HuffPo article , showing how much money states are losing by not expanding Medicaid in accordance with the Affordable Care Act:
healthjpgNot a small change, by any measure. Shows how much it means to some folks to prove their anti-ACA bonafides. What is too often lost, in this political maneuvering, are the millions of people who will not have access to health insurance coverage. Very sad.

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Does Health Insurance Improve Health? Evidence from Massachusetts

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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)

Percent of Americans Without Health Insurance Drops

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A recent Gallup poll shows that the percent of Americans without health insurance has dropped significantly in recent months. Here’s a picture of their findings:

uninsured

This drop has occurred largely in response to Obamacare – to the expansion of Medicaid in those states which went along with that provision of the law, and with the introduction of the health insurance exchanges, which subsidizes the cost of insurance for low income people who do not qualify for Medicaid. I expect these numbers to continue moving this direction for a while, as more people find insurance through the exchanges, and as states continue to expand their Medicaid numbers. But I do not expect, anytime soon, for us to have a figures we can brag about to our peers in the developed world. The United States is still likely to lead them all in the percent of its population that has no health insurance.

PeterUbel