Category Archives: Health Care

The Fate of SCHIP — Surrogate Marker for Health Care Ideology?

Source: New England Journal of Medicine

How prominently SCHIP and the health care needs of uninsured children will figure in election-year debates is anybody’s guess, but one thing is certain: However the SCHIP saga ends, it will not lay to rest the larger issue of what level of public support uninsured people deserve as our employer-based insurance system continues to erode.

Prescription Drugs and Medicare Part D: A Report on Access, Satisfaction, and Cost

Source: AARP Policy & Research

Access, satisfaction, and cost issues related to prescription drugs in general and the Medicare Part D prescription drug benefit specifically were examined in this October 2007 telephone survey of 400 adults aged 50-64 not yet eligible for Medicare and 400 Medicare beneficiaries aged 65 and older with the drug benefit. Results suggest that people aged 50 and older are generally satisfied with their access to brand name and generic prescription drugs and are willing to talk to their physicians and other health professionals about their prescription drug options. Older adults who have Medicare Part D drug coverage report high levels of satisfaction with the plan and their premiums, with many stating that prescription drugs are more affordable now than they were prior to their enrollment.

Full Report (PDF; 462 KB)

Commission of Nation’s Leading Health Care Experts Issues Reform Recommendations for Next President

Source: Commonwealth Fund

Ensuring that everyone in the United States has health insurance is essential, but it is not enough to drive the kind of reform the health system needs, according to a new report released today by the Commonwealth Fund Commission on a High Performance Health System.

Guaranteeing affordable health insurance for all, changing the way doctors and other health care providers are paid, better organizing and coordinating care delivery, investing in implementing an electronic information system in a reasonable period of time (aiming for five years), and establishing national goals and doing what it takes to reach them through strong national leadership should all be on the next President’s health care agenda, says the report. Members of the commission are a diverse group of leading health policy experts from government, private industry, health care delivery organizations, academia, and professional associations.

Full Report (PDF; 187 KB)

Snapshot: California’s Uninsured 2007

Source: California Healthcare Foundation

The number of uninsured Californians under age 65 continues to rise as employer-sponsored health insurance declines. Some who lose insurance at their workplace are buying individual policies; others become eligible for coverage through public programs like Medi-Cal. But more than 20% of Californians remain uninsured. The problem, though national, is more prominent in California, which has a lower percentage of individuals with employer-sponsored coverage and a higher proportion of uninsured. And because of California’s large population, the number of people without insurance — 6.6 million — is the highest of any state.

Reacting to inaction at the federal level, California is pursuing solutions closer to home. In 2006, California enacted legislation (SB 1448) that provides $540 million in new federal funds for local efforts to expand health coverage and care to uninsured individuals. And, in 2007, coverage expansion and health reform are high on the Sacramento policy agenda.

Some findings from this year’s snapshot include:
* Workers at private-sector businesses of all sizes are experiencing an increased likelihood of being uninsured;
* More than a third of the uninsured have family incomes of more than $50,000 per year;
* Nearly 70% of uninsured children are in families where the head of the household has a full-time job; and
* Nearly 60% of the state’s uninsured are Latino.

Full Report (PDF; 538 KB)

How Much Value Do Workers Place on Health Benefits?

Source: Employee Benefits Research Institute

What value do workers place on employment-based health benefits? Would workers be willing to exchange their health benefits for an additional $7,500 in taxable income? Among employers that provide health benefits, that was about the average per-employee cost of health benefits for active workers and their dependents in 2006 (and it’s not counted as taxable income to employees).

The 2007 Health Confidence Survey, released recently by the nonpartisan Employee Benefit Research Institute (EBRI), asked several questions that sought to determine the value workers place on employer-based health benefits. Here are some of the findings:

• Perhaps because of the increased costs that many are experiencing, most Americans with employment-based health benefits value them above the actual dollar amount that employers pay toward the coverage.

• When employed Americans with health coverage were asked whether they would prefer $7,500 in employment-based health insurance coverage or an additional $7,500 in taxable income, three-quarters (76 percent) chose the employer-provided health coverage. Of those, about one-quarter each said their employer would have to give them an additional $10,000¬$14,999 (22 percent) or $15,000 or more (25 percent) in taxable income for them to willingly give up their coverage.

• Fifteen percent stated no amount of taxable income would be enough. Six percent said they would accept less than $10,000, while 3 in 10 (31 percent) were unsure of the amount. These results are consistent with the results of similar questions asked in previous years.

• Most of those with employment-based coverage would prefer to continue receiving their current level of health benefits from their employer even if some of the premium were taxed (62 percent). About one-quarter (27 percent) would choose to reduce the level of health benefits they receive from their employer so that they paid no taxes on the premium. About 1 in 10 (9 percent) were not sure which they would prefer.

Most Americans with employment-based health benefits are confident that their employer or union will continue to offer health insurance for its workers. Almost 3 in 10 (28 percent) in the survey were extremely confident that this will continue to be the case. This represents a decrease from the 35 percent extremely confident in 2004, but is statistically equivalent to the levels measured in 2000 and 2002. About 3 in 10 each in the 2007 survey were very (30 percent) or somewhat (28 percent) confident.

The Long-Term Outlook for Health Care Spending

Source: Congressional Budget Office

Spending on health care has been growing faster than the economy for many years, representing a challenge both for the government’s two major health insurance programs, Medicare and Medicaid, and for the private sector. A prologue to the Congressional Budget Office’s (CBO’s) upcoming long-term budget outlook, to be released next month, this study (PDF; 832 KB) presents the agency’s projections of federal spending on Medicare and Medicaid and national spending on health care over the next 75 years. The goal of the projections is to examine the implications of a continuation of current federal law, rather than to make a prediction of the future. In reality, federal law will change; nevertheless, the projections provide a useful measure of the scope of the problem facing the nation under current law.

The Joint Commission Annual Report Shows Further Improvement in Health Care Quality in Nation’s Hospitals

Source: Joint Commission

From the news release:

American hospitals are making measurable strides in the quality of care provided for patients with heart attacks, heart failure, pneumonia and surgical conditions, according to the Joint Commission’s second annual report on health care quality and patient safety in the nation’s hospitals. The detailed report portrays the aggregate performance of accredited hospitals against the Joint Commission’s standardized national performance measures and its National Patient Safety Goals.

Improving America’s Hospitals: The Joint Commission’s Annual Report on Quality and Safety 2007 also shows, however, that whether or not patients receive proven treatments for these common reasons for hospitalization often depends on where they live. For example, statewide performance of hospitals on the measure of providing discharge instructions to patients with heart failure ranges from 49 percent to 91 percent.

The Joint Commission issues this annual report as part of its on-going efforts to emphasize the health importance of accountability and continuous improvement for hospitals, and to empower consumers with information that will make them more active participants in their health care. This report examines how America’s accredited hospitals performed against quality-related performance measures and safety goals during 2006 and in previous years.

Direct to Full Text, 2007 Annual Report

As Tough Times Wane, States Act to Improve Medicaid Coverage and Quality: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2007 and 2008

Source: Vernon Smith, Kathleen Gifford, Eileen Ellis, Robin Rudowitz, Molly O’Malley and Caryn Marks, Kaiser Commission on Medicaid and the Uninsured, October 2007

From the summary:
The annual 50-state survey of state officials on Medicaid and state budget actions reports enrollment in Medicaid declined for the first time in nearly a decade. The 0.5 percent enrollment decline in fiscal year 2007 was driven primarily by two factors. States reported that the new citizenship documentation requirements were causing significant delays in processing applications, affecting mostly individuals already eligible for the program. State officials also cited the good economy and lower unemployment for reducing enrollment. Faced with an improving economy, 42 states expect to expand coverage to the uninsured in the next year.
See also:
Executive Summary
Press Release