Mar
12
Blue Cross and Blue Shield of Texas Insurance Coverage a Click away using System by Quotit(R) Corporation
Filed Under Insurance Company, Medical Insurance, USA Health Insurance | Leave a Comment
Individuals and families looking to apply online for insurance coverage provided by Blue Cross and Blue Shield of Texas (BCBSOT) may now do so through the Internet system developed by Quotit(R) Corporation, a division of The Word & Brown Companies.
The seamless integration between the Quotit quoting system and BCBSOT makes for an improved online shopping experience for applicants of insurance coverage. Users will save time by not having to repeat the input of information already stored in the secured database of BCBSOT.
People looking to apply for health insurance online face a complicated and often intimidating process that requires them to visit multiple websites in order to find the coverage best suited to their needs. The insurers accepting online applications for coverage require the users to input information that they may have already provided, thus opening the possibility of typing mistakes which translate into unnecessary delays when the information needs to be verified by the insurer and reconfirmed by the user. The system developed by Quotit targets the elimination of all these hassles.
The Quotit system has been designed in a way that it is easy to use, saves time and allows its users to apply for insurance coverage, all in a single website.
Companies mentioned:
Blue Cross and Blue Shield of Texas
Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation — the only statewide, customer-owned health insurer in Texas — is the largest provider of health benefits in the state, working with nearly 40,000 physicians and 400 hospitals to serve 4.4 million members in all 254 counties.
Quotit® Corporation, a division of The Word & Brown Companies, is the leading Internet application service provider for the health insurance and employee benefits industry. Quotit has relationships with more than 150 insurance carriers representing more than 11,300 plans in the health, life, dental and vision insurance markets, including Aetna, United Healthcare, Health Net, WellPoint, Assurant Health, Humana, Celtic and independent licenses of the Blue Cross and Blue Shield Association. Quotit’s database of carriers and plans extends to 50 states, including the District of Columbia.
Feb
26
Agreement reached between Implantable Provider Group and Blue Cross and Blue Shield of Florida
Filed Under Healthcare, Insurance Company, USA Health Insurance | 2 Comments
An agreement between Implantable Provider Group (IPG) and Blue Cross and Blue Shield of Florida, Inc. (BCBSF) has been reached allowing IPG to serve as the designated implantable device management vendor for the extensive provider network of BCBSF. IPG is one of the world’s leading providers of implanted surgical devices (such as pacemakers).
IPG streamlines the management and delivery of implantable medical devices by working directly with commercial insurance payers, clinical providers and facilities, and medical device manufacturers through its Implantable Device Management (IDM) solution. The IDM solution eliminates the complexity and the financial risks associated with the billing and reimbursement processes for providers, while maintaining patient access to innovative medical therapies that use life-saving and life-enhancing medical devices.
From now on, services such as device coordination, billing, replacement, tracking and other will be handled by IPG to the state-wide ambulatory surgery centre network of Blue Cross Blue Shield of Florida, which has over 4 million health insurance policyholders.
Companies Mentioned
Implantable Provider Group (IPG) works with commercial payors to manage all aspects of high-cost implantable medical devices. Founded in 2004, IPG primarily focuses on large, fast-growth device intensive markets, such as cardiology, neurology, orthopaedic and spine implants. The company’s Implantable Device Management SM solution simplifies the complex procurement, contracting and billing associated with these devices, thereby streamlining the process and normalizing costs for all parties, while also delivering many valuable ancillary capabilities. Implantable Device Management also offers benefits for health care providers and manufacturers.
Blue Cross and Blue Shield of Florida is the oldest and largest health plan provider in the state of Florida. The Blue Cross and Blue Shield system of plans consists of 39 independent and locally operated Blue plans with a total national enrolment of more than 100 million at year-end 2008, which equals one in three Americans. Blue Plans have experienced 14 consecutive years of positive enrolment.
Feb
23
U.S Insurers can exploit global opportunities
Filed Under Allianz, BUPA, CIGNA, Insurance Company, USA Health Insurance | 4 Comments
Conning Research and Consulting, a division of Conning & Company, has released a study which finds that insurers operating in the USA’s domestic insurance market should focus their attention overseas if they are to see continuing high rates of growth and profitability.
Conning, a leading provider of insurance industry and asset management research and consulting services, released the study “Global Opportunities for U.S. Health Insurers” to help provide a solid framework for insurance providers to work within when expanding to international markets.
Sherry Manetta, an analyst with the company said, “U.S. health insurers have been successful focusing almost exclusively on the U.S. market up until now… However, the U.S. now accounts for 80 percent of the global health insurance market, while representing just 4.6 percent of the world’s population. Looking forward, both profit pressures at home and higher growth rates overseas will drive increased multinational expansion interest among U.S. health insurers.”
The study comes at a time when increased expansion is at the forefront of many international insurance provider agendas. With companies such as CIGNA, Allianz Worldwide Care, Aetna Global Benefits, and BUPA International all actively moving to consolidate their positions in the growing international marketplace, the study by Conning is a timely notification for many American insurance companies looking to revitalize their services.
Regarding the study, Stephen Christiansen said “In reviewing growth opportunities in health insurance beyond the U.S. market, Asia and Europe represent key near-term opportunities.” The Conning Director of Research went on to further elaborate saying that “U.S. insurers have built and are managing the world’s most complex managed health care system. With this infrastructure and expertise, U.S. insurers have the potential to emerge as front-runners of a vast global managed health care system should they decide to enter the competition already underway with Western European and Canadian multinational insurers.”
Companies Mentioned
Conning Research and Consulting
A provider of asset management research and consulting services to the insurance industry, Conning Research and Consulting has over 50 years experience in providing far reaching analysis to key industry decision makers.
BUPA is an international health insurance company that provides health insurance for individuals and companies all over the world. This company has offices on three continents and over 7 million customers’ world wide. As a provident association BUPA has no shareholders, because of this it uses its profits to invest in healthcare and medical facilities around the world.
For more than 125 years, CIGNA has been helping people lead healthier, more secure lives. The company provides health care and related benefits offered through the workplace. Key product lines include health care products and services (medical, pharmacy, behavioral health, clinical information management, dental and vision benefits, and case and disease management); and group disability, life and accident insurance. In addition, CIGNA also provides life, accident, health and expatriate employee benefits insurance coverage in selected international markets, primarily in Asia and Europe.
Allianz Worldwide Care was established in 2000 as the international medical insurance specialist of the Allianz Group. Allianz Worldwide Care is dedicated to providing superior health insurance policies to expatriates and their families all over the world. Headquartered in Ireland, this insurer has regional offices in Africa, the Middle East, Europe, and Asia, serving to provide their clients with the most comprehensive support network available.
Nov
10
Rationing US Healthcare – Are you Ready?
Filed Under Expat Insurance, Health Insurance, Healthcare, International Healthcare, Medical Insurance, USA Health Insurance | 1 Comment
U.S. President Barack Obama made a major address to Congress in early September 2009, in which he outlined
his plan to fix the country’s US$ 2.5 trillion healthcare system. The healthcare reform plan must pass by the two chambers, the House of Representatives and Senate, before Obama can sign it into law. The current cost estimate for healthcare reform is US$ 1 trillion over the next 10 years by no means a meager price tag; and one which has borne the brunt of the Republican ire. On Saturday night (7th November 2009), after a 12-hour debate with 220-215 vote, the House of Representatives narrowly passed a healthcare reform bill, which clears the way for the Senate to begin to consider the passage of the legislation. The House vote was a vital victory for Obama, who staked much of his political capital on the healthcare battle. With the vote now going to the Senate, the fate of healthcare reform and the Obama’s presidency hangs in the balance.
Senate Democrats will require 60 out of 100 votes to end the debate and bring the legislation to the final vote. Currently, there are a number of moderate Democratic senators whom still have reservations. If the Senate does pass the bill it would need to be reconciled with the House version by a panel of lawmakers, from both chambers, before legislation is presented for final approval. On the other hand, if the Senate does not pass the bill, the House and Senate would have to reconcile their differences and agree on one bill to be passed again, and sent to Obama for his signature.
The President and his officials have repeatedly said that the healthcare bill would be signed into law by the end of 2009. It is their target to get health insurance reform done in 2009, and they are determined to achieve that. The White House has pushed hard to get a bill passed this year; the primary aim was always to establish momentum and call a vote prior to the beginning of the Congressional campaign season, because passing major legislation in a Congressional election year is considered more difficult. The calendar is not looking friendly, it is just less than one month away till end of 2009, and the self-imposed deadline by President Obama means that it will be tough to get approval from the Senate to pass the healthcare reform bill, yet there is still time to see whether the President can adhere to the target.
Healthcare reform involves a permanent change to the entire healthcare system in the USA and it has a, potentially, far greater and longer effect on the US nation than any single other piece of legislation. As mentioned in our 7th August, 2009 post, we have outlined the goals of the Obama administration reforms. In this month’s update, we would like to review some concerns and reasons not to support the healthcare reform bills.
Before we review the concerns or reasons not to support healthcare reform, let us look at why healthcare reform is being considered. Unlike in other countries, under the current healthcare system in the USA, an individual will never be refused admission to a hospital or left on the street by an ambulance just because one cannot produce a credit card or proof of insurance. It is however essential that you are insured for medical expenses because medical costs are highly inflated in the USA. There are currently more than 46 million Americans without health insurance of any kind, approximately another 25 million people are underinsured, meaning their coverage is inadequate for their needs. With the recent economic downturn, there are additional hundreds of thousands of people sent into the category of uninsured as unemployment rates increase. This comes down to the basic economic principle of supply and demand. Another contributing factor to the underinsured and uninsured is that medical costs continue to rise. It has been reported that US$2.2 trillion was spent on US healthcare in 2007, accounting for 16% of GDP, about twice the average of other OECD countries. The rising healthcare costs in turn means that more and more people in America are unable to afford healthcare and rising costs also mean that the Government is spending more and more on Medicare and Medicaid.
There are ongoing debates as to whether to approve the healthcare reform bills. While Americans are concerned about what will happen to their own healthcare if reform passes, they are also concerned about what will happen if reform does not pass. Some of the concerns and reasons not to support the healthcare reform bills are outlined below.
It seems that it is the wrong time for the United States to pursue healthcare reform right now. After all, the US has been in the middle of two wars and a recession. President Obama mentioned that the cost of the healthcare system remaining in its present state is much higher than the cost of healthcare reform. The United States spends more than US$ 2 trillion on healthcare each year, in which about US$700 billion is spent on unnecessary treatments. President Obama has promised that he will only sign a healthcare reform bill that is deficit neutral, meaning that it will not incur one extra cent to the deficit in 10 years. The current estimate is that if healthcare reform passes, it will costs US$1 trillion over the next 10 years. President Obama believes that it can be funded with the removal of waste in the system, in which, some of these savings may not be recognized by the Congressional Budget Office. A few key financing options that are currently on the table include squeezing savings out of Medicare and Medicaid, Taxation on the wealthy, Taxation on employee health insurance benefits, limit the itemized deductions of the wealthy, impose or raise taxes on sugary soft drinks and alcohol, penalize employers who do not offer health insurance and lower the insurance subsidy threshold. Types of funding is however yet to be finalized. If funding is not considered properly, it will add to the burden of an already unstable system.
The fundamental question on healthcare reform is that who will pay for all of these government healthcare costs? The answer is of course the taxpayers across America. The difference between the healthcare system that is in place now and President Obama’s healthcare reform is that under the current system, citizens have a choice to buy insurance. Should this healthcare reform bill pass, an individual will no longer have that option. It is compulsory for everyone to pay for healthcare whether you like it or not. The Government will be in charge of the citizen’s healthcare, the taxation to support it as well as the co-payments associated.
For those people who are struggling to receive healthcare under the current system, it might be great news to them with the passage of the healthcare reform bill in the House. Any individual will be able to enter hospitals in any city in the US and receive healthcare despite whether or not they are covered by insurance. However, questions will likely arise with the Government controlling healthcare; will treatments be provided to all people on an equal basis? Currently in US, many people with disabilities may already be enrolled on the Social Security Disability Income (SSDI) program and obtain cash benefits to support their living, with the passage of the healthcare reform bill, will these people receive the same medical treatment as any other US citizens? Moreover, the current Government is already running many programs like SSDI, Medicare and Medicaid, even more recently,the Cash-for-Clunkers program (a tiny program compared to the budget projected for healthcare), which the United States Government is struggling with running adequately. There are funding and management issues with these few Government programs. With the passage of the healthcare reform bill, the competency of Government Management is surely in question. Will the same Government be able to proficiently run and manage the national healthcare program as well as all the other programs that are already in place?
If healthcare is universal for all Americans, it is likely that there will be a long waiting lists for people to obtain standard healthcare. Individuals who do not have healthcare coverage would however be happy, since there is at least a line that they could wait on. For these people, a waiting line is much better than the alternative of having no medical care. The Government will need to address the issue on resources such as the number of primary care providers available in the US to manage the number of new patients who will be able to access healthcare once the healthcare reform is passed. If there is a shortage of healthcare providers to provide adequate care to patients, then the poor and elderly will likely be put last in line to receive treatment, which brings back to the point stated above on whether treatment will be given to all citizens equally.
Previous American Presidents have tried to bring US into the community of nations that provide healthcare to all citizens. They have attempted seven times but encountered a number of roadblocks and the efforts all failed. Whether the healthcare reform will follow the same path as previous administrations have tried or there will be changes in the whole American healthcare system, it is yet to be seen. After all, rationing a nation’s healthcare system involves plenty of changes. With the pass of the healthcare reform by the House of Representatives, this already signified a historical moment in the history of the nation. Now, we shall wait and see what the Senate brings in and whether Obama can be the last President that can take up the cause on healthcare reform.
Whether the healthcare reform is to the better or worse of the USA, in the midst of all changes, if you do not want to be one of the “victims”, it is best to put in place a private healthcare insurance plan in order to give full protection to yourself and your family.
Sep
21
Dirty water, clean to drink
Filed Under Health Insurance, Healthcare, Medical Insurance, USA Health Insurance | 3 Comments
Many nations around the world are faced with a wide range of water problems. This is especially true in many developing countries such as the Republic of Congo, Mauritania, Bangladesh and India. These countries are facing severe shortages in drinking water and the technology to improve water quality. There is no equipment or facilities available to make the water safe to drink. The leaders of these countries cannot provide quality clean water required by their residents. Citizens have no choice other than to consume water that is in the form readily available to them, even knowing that the water is unclean and may contain a number of hazardous diseases, including ailments such as Diarrhea, Cholera, and Malaria. The lack of clean and safe water has caused deaths to millions of people all over the world.
If you think that failure to provide safe drinking water to all people only happens in third world countries, well then think again. While unclean water is a problem in many developing countries, it is shocking to learn that tap water in many parts of the USA has been contaminated with pollutants such as heavy metals, chemicals and inorganic toxins. These constituents in the water are highly harmful to human bodies and they are mainly released from chemical factories, manufacturing plants and coal mines.
The USA has the largest and most technologically powerful economy in the world, with a per capita GDP of US$ 47,000.The country is full of technological pioneers especially in computers, medical, aerospace, and military equipment. The nation is supposed to have one of the safest public drinking water supplies in the world. Most Americans get their tap water from a community water system. The US Environmental Protection Agency (EPA) regulates drinking water quality in public water systems and sets maximum concentration levels for water chemicals and pollutants.
Despite this attempt at instituting a fully formed regulatory system, contaminants have been identified in water systems throughout the United States, raising major concerns about the safety of “supposedly” potable water in America. Tap water in West Virginia was found contaminated with arsenic, barium, lead and manganese. Pesticides (Atrazine) were found in drinking water in Chicago and across a number of states in the Mid-West US. In addition to this, chemical contaminants were shown in drinking water wells near natural gas drilling rigs in Philadelphia and Wyoming. Failure to provide even the most basic water services for billions of people in the USA and the devastating human health problems associated with this failure are at the heart of the country’s water problems, and perhaps contribute to the current poor health of the American populace as a whole.
Recently, in Charleston West Virginia, heavy metals runoff from the coal industry have been poisoning the whole community. Analysis of the potable water supply has shown the existence of contaminants like arsenic, barium, lead and manganese at concentrations that could lead to cancer, and cause damage to an individual’s kidneys and nervous system. Some immediate effects were already found on residents that have had contact with the contaminated water, and whom developed symptoms such as rashes on the body and tooth enamel being dissolved. Residents are complaining of increasing health problems such as gall bladder diseases, fertility problems, miscarriages and kidney and thyroid problems. Some of the symptoms may take longer to detect as heavy metals accumulate in the body, and may link industrial contamination of municipal water supplies to cancer, birth defects and neurological disorders.
One of the contributing factors, which leads to the occurrence of these incidents is primarily due to companies that are violating the Clean Water Act by discharging excessive amounts of toxic waste into the environment. It was reported that the largest U.S. industrial, municipal and federal facilities discharging dangerous chemicals were in serious violation of the Clean Water Act, and had disposed over 500,000 times more industrial waste into the water system in 2009 than in the last five years. Most of the violations have gone unpunished, with state regulators taking significant action in just 3% of all cases.
Another reported case on contaminated water takes place in Chicago where pesticides (Atrazine) have contaminated watersheds and drinking water throughout most of the central United States. The states with the most severe contamination of drinking water included Missouri, Illinois, Indiana, Nebraska, and Iowa. Atrazine is the most commonly detected pesticide in the U.S. water system and is a known endocrine disruptor, which means that it affects human and animal hormones. Atrazine is actually one of the chemicals regulated by the U.S. Environmental Protection Agency (EPA). Under the Safe Drinking Water Act (SDWA), it was determined that if an annual average of no more than 3 parts per billion (ppb) of atrazine is present in drinking water, it is “safe” to drink. Atrazine concentrations in the water system in Versailles, Indiana and Mt. Olive, Illinois were found to be at 4.6 ppb and 3.79 ppb respectively.
However, there are possible flaws when setting the maximum contamination limit. Setting acceptable standards based on the annual averages means that there is a serious risk of running on faulty assumptions; Atrazine contamination levels will fluctuate throughout a reporting period, peaking at extremely high levels which may go unrecorded. Long term exposure to Atrazine could have a considerable impact on an individual’s reproductive system. Moreover, the regulations are set based on a safe level of consumption for an average weighted adult with presence of one chemical; they do not, however, take into account the combined toxicity effect of two or more chemicals. The strength of combining two or more chemicals may not increase in a linear manner proportion to the number of chemicals present in the water, it can be an exponential increase in a magnitude of 1,000 times. In addition to this, the terrible health effects of consuming these highly toxic chemicals are magnified many times over for small children, since their systems are more sensitive and are less developed; their bodies are unable to detoxify certain harmful chemicals. Small children also tend to consume a much larger volume of fluids per unit of their body weight, and as such children absorb a much higher dose of these toxic chemicals into their body. Unfortunately, EPA has not taken into account any of these factors when setting the maximum contaminant levels.
While there is no doubt that the big manufacturing companies have contributed to the water contamination problems, we as individuals are also the ones to blame. The majority of the contaminants found in our drinking water can be traced to improper or excessive use of ordinary compounds like lawn chemicals, gasoline, cleaning products and even prescription drugs. Once we realise that whatever goes down to the drain eventually winds up in our water supplies, we need to be extra cautious in what we flush down the drain.
US Government scientists have found contaminants in drinking water wells near natural gas drilling rigs during August, 2009 in Philadelphia. The gas drilling companies involved repeatedly told the public that the gas drilling technique that they were using were safe. The drilling technique involves injecting water and other fluids into the well and have the potential to create cross-contamination. Residents who live close to the drilling vicinity are still highly concerned over the gas-extraction technique used, which may possibly have adverse impacts to their health. One can understand the worries of the local residents as some said that their well water had become discolored, foul-smelling or tasted bad, in some cases water was black and oily. Up to date, there is still no conclusion on the cause of contamination but the gas drilling technique is a highly suspect cause of contamination.
Earlier in March and May this year (2009), the EPA also found contaminants in 11 out of 39 wells tested around the Wyoming town of Pavillion. Chemicals found may cause illnesses such as cancer, kidney failure, anemia and fertility problems. Among the contaminants found in some of the wells was a solvent used in natural gas extraction, 2-butoyethanol (or 2-BE), which may cause breakdown of red blood cells, leading to blood in the urine and feces, and can damage the kidneys, liver, spleen and bone marrow.
Since 1999, the number of violations of the Clean Water Act has increased, while the number of inspections carried out by EPA remained roughly the same. There seems to be a shortage of resources to perform the work effectively. The EPA seems to be failing in its task of ensuring that companies comply with the regulations and at the same time carrying out the enforcement activity for those companies breaking the law; ultimately to ensure no polluters escape from any punishment. People put a lot of effort in establishing their lives, families and businesses in these cities. What is it all worth when a simple necessity of clean water supply cannot be fulfilled, especially in a developed country like the USA.
Globally, there are about 2.3 billion people suffering from diseases linked to dirty water each year. Among this number, approximately 3.6 million people die from water-related diseases, it is estimated that about 98% of water-related deaths occur in the developing countries and about 43% of water-related deaths are due to diarrhea. In the USA, roughly 19.5 million Americans fall ill per year from drinking contaminated water with parasites, bacteria or viruses. This figure is excluding water-related illnesses caused by toxins and chemicals. Given that the USA is a more developed country, people suffer from water related diseases in the country is about 1% of the total, which is deemed high.
It is a good intention that President Obama has committed to ratify healthcare reform to provide healthcare stability and security for all Americans. However, it is not going to help when fulfilling the basic needs of safe water is not even available. If contaminants are continuously found in water leading to adverse health problems in US residents, there is no point in carrying out health reform. US citizens all deserve the right to know what polluters are dumping into the communities. While the former Bush Administration severely limited the information disclosed to the public about toxic pollution released into the communities, we hope that the new Obama Administration will keep his word and will be able to make a change as he had promised. After all, president Obama does not want to be interrupted by people like Joe Wilson yet again, telling him that “You lie!”.
Aug
7
Medical Cash for Clunkers: Rejuvination on the way?
Filed Under Healthcare, Medical Insurance, USA Health Insurance, Uncategorized | 1 Comment
The hot topic currently dominating American news headlines is President Obama’s proposed healthcare reforms, and with both Congress and the Senate on their August recess until September 8th speculation is running rampant as to what actions, if any, will be implemented by the proposed House Healthcare Bill titled “America’s Affordable Health Choices Act of 2009”. There has been much argument on both sides of the political arena as to the need of such an act, and the need for reform. However, with so much spin flying left and right it is understandable that the average American might be slightly confused about the facts. As promised in our last post, we are here to try and dig through the deluge of misinformation and try to enlighten you as to the truth of healthcare reform in modern
By now it should come as no surprise that the
Step forward President Obama.
It is not news that even as a Senator, Obama was keen to implement changes to a necrotic, decrepit, and rapidly deteriorating medical system. As we mentioned in our June 18, 2008 post however, he planned to accomplish a rejuvenation of the system primarily by forcing the extinction of paper as a medium to convey patient information and medical records. The paperless healthcare system is still a primary goal for the now president, but a wider range of initiatives are potentially on the books. The goals of the Obama administration reforms include, among other things:
Reduce long-term growth of health care costs for businesses and government
Protect families from bankruptcy or debt because of health care costs
Guarantee choice of doctors and health plans
Invest in prevention and wellness
Improve patient safety and quality of care
Assure affordable, quality health coverage for all Americans
Maintain coverage when you change or lose your job
End barriers to coverage for people with pre-existing medical conditions
It would seem that these objectives are relatively straight forwards, full of common sense, and indeed necessary to revitalize the system and ensure that American citizens are no longer beholden to the insurance organizations “protecting their health”. However, as always in the 
Let’s be quite clear on one thing, the reforms are not meant to establish a universal healthcare system. Yes, there has been debate on the subject, but the reality is that, due to the very makeup of the US political system any Bill or Legislation that aims to create an NHS style healthcare network would fail miserably (remember that both the Senate and Congress must pass a bill in order for it to become law). The Republicans would scream bloody murder at the merest hint of such reform, and the more fiscally conservative Democrats would be none too pleased either.
No, Obama’s current objective is to create an equal playing field for all Americans to receive comprehensive healthcare coverage (whether received by a private health insurance company or through a government run program like Medicare or Medicaid), and ensure that should they loose their job, or suffer a major illness, the coverage will not cease. In addition to this, the President has placed a large emphasis on the ability of the American consumer to choose their healthcare plan. If the goal was to institute a universal healthcare system, it would be a case of “one plan fits all”, by clearly stating that his aim is to give the consumer freedom of choice when it comes to their medical protection, the President has given us a great deal of insight to his driving force – let the market be free and active, but also competitive and fair. The idea here being that the insurance companies offering the best coverage conditions will thrive, while those that impose hefty exclusions, automatically large deductibles or excesses, and engage in the dubious practice of recision will fail.
However, as part of the usual everyday politicization that occurs in the
Town hall meetings across the
The objective of reforming the healthcare system in the
In addition to this, the American health insurance industry stands to learn a thing or two from current “best practice” as it exists in the international marketplace. Current international health insurance plans will automatically allow a policyholder to visit the hospital or doctor of their choice, anywhere in the world – which is quite a big step up from freedom of choice in your home town. Guaranteed renewals, self selected deductibles, very high coverage limits, and a range of other standard benefits make global health insurance a radically different product to the insurance options currently available in the USA, and at the end of the day President Obama’s reforms really only emulate that which is standard in the international community.
Here at International Insurance News we believe in giving the consumer all the information that they need to make an informed decision. Any reforms which would see coverage improved and extended cannot help but make for a better product, at the end of the day it will encourage healthy competition and eliminate bad business practices. But it is the American consumer who will need to be vocal on the issue and see beyond politicized fabrication by special interest groups.
All this huffing and puffing and there hasn’t even been a vote yet. It will be interesting to see what happens in the coming weeks, and as always, we will keep you updated.
Jul
10
Leaps and Bounds: Progress in Stem Cell Research
Filed Under Healthcare, USA Health Insurance | 1 Comment
In recent years, much of the debate and controversy surrounding stem cells has been about the ethics of stem cells and embryonic stem cells in particular. However, recent scientific advancements not just in the possible future applications of stem cells, but also in how to produce or create stem cells may render a large amount of ideologically based criticism irrelevant.
Just to be clear, the only way to get embryonic stem cells is to cultivate them from fertilized human eggs. However, the reason for the interest into them is that embryonic stem cells are what are known as pluripotent, which means they are capable of developing into almost any type of cell in the body. While research into stem cells has continued unhindered in many places around the world, other places such as the United States have previously placed limits on federal funding for research into embryonic stem cells.
During George W. Bush’s presidency federal monies were only permitted to be given to research into non-embryonic stem cells and generations of stem cells derived from embryos before August 9, 2001. Despite the fact U.S. legislators passed bills in support of broadening federal funding for embryonic stem cells on multiple occasions during Bush’s presidency, even going so far as to include ethical restraints and requirements on the source of the embryos, Bush vetoed them out of hand. However, President Obama removed certain restrictions on federal funding by executive order in March this year but left the drawing up of legal and ethical rules involved in who is eligible to receive money to the National Institute of Health.
Thankfully the previous administration’s intransigence on the subject seems to have done little to hinder serious progress in many areas. Recent news has witnessed the explosion in stem cell related scientific discoveries that could lead to impressive developments in treating serious diseases and illnesses. One recent study by the University of South Florida in conjunction with the James A. Hadley Hospital found that a human growth factor or hormone called the granulocyte-colony stimulating factor (GCSF) can help improve memory and learning behavior in mice with Alzheimer’s. GCSF is a hormone that promotes white blood cells and blood stem cells in the body’s bone marrow and is usually administered to cancer patients who have gone through chemo or radiation therapy.
The study’s authors found that mice with Alzheimer’s that were given filgrastim (a commercially available GCSF compound) injections under the skin showed remarkably improved memory after 3 weeks of treatment. Beta amyloid, a protein that builds up in the brain and is considered to be one of the main causes of Alzheimer’s, was found to have been reduced by 36-42 % in mice with Alzheimer’s symptoms. This could lead to an effective therapy for patients with Alzheimer’s and the Alzheimer’s Drug Discovery Foundation has already decided to fund a small clinical trial in the University of South Florida’s Byrd Alzheimer’s Center to test the safety and effectiveness on human Alzheimer’s patients.
In other mouse related science news, researchers at the Hebrew University-Hadassah Medical School found that injections of stem cells can reverse neural birth defects. The test mice’s mothers were given heroin during pregnancy to induce defects in the brain, the test mice then received injections of transplanted neural stem cells from embryonic mice directly into the brain. The tests showed that even though most of the transplanted stem cells didn’t survive, they seemed to spur the brain to repair itself. By a function called the bystander or chaperone effect, the stem cells seem to not only produce replacement cells but also send out signals that induce other cells in the body to start repairing and maintaining organs. There are concerns, however, as the cells used were extracted from mice embryos they are sometimes considered a foreign object by the body’s immune system and may in some cases lead to tumors forming in the body.
But what if you didn’t need to use embryonic stem cells? If the need for a fertilized egg to make stem cells was removed, then moral complaints against stem cell research and treatment from vociferous anti-abortion factions have no legs to stand on. Enter the testicle. Kinarm Ko, Hans Schöler and a team at the Max Planck Institute for Molecular Biomedicine in Münster have been able to extract a certain type of cell from mice testes and turn them into pluripotent stem cells without the need to apply genes, viruses or reprogramming proteins to affect the change. They started with a type of cell called a germline stem cell which is not only rare in the testis (you will only find a few in the 10,000 or so cells in tissue of a mouse testis) but also rarely tends to reproduce itself. This germline stem cell tends to do only one thing in its natural environment, and that one job is to make lots and lots of sperm. In an unusual twist, the researchers found it was barely more than a simple trick to get these cells to reprogram themselves. Given a little space in a Petri dish, these germline stem cells will alter themselves to become pluripotent in as little as two weeks, after which they start reproducing very quickly. While further testing will be needed to determine whether this could be applied to humans, so far the germline cells extracted from the mice testis are capable of generating the same kinds of cells as embryonic stem cells and far surpass previous attempts to artificially reprogram a cell in both safety and the ease of producing them.
Breakthroughs like this and others such as the ability to reprogram DNA from adult skin cells to make induced pluripotent stem cells (iPS for short) allow us to understand stem cells’ roll in the body more thoroughly and could eventually lead us to a less ethically questionable ways to produce stem cells which may also be safer for us medicinally as well. Not only could this lead to a wide variety of treatments for debilitating illnesses like Alzheimer’s, brain damage, cancer and many more, but also the ability to treat these issues while maintaining a high level of ethical standards.
Jun
29
Market Competition: American and International insurance
Filed Under Health Insurance, Healthcare, Income Protection, International Healthcare, Medical Insurance, USA Health Insurance | Leave a Comment
Despite the fact that recent polls show approximately 72% of the American populace are in favor of a government-sponsored health insurance plan and the common sense idea that sooner would be better than later, the legislative leaders of the country seem to have instead let the discussion drift into politics.
Various Democrats have proposed plans either involving a public plan, an individual mandate to force people to buy insurance (probably with some form of government subsidy), or some kind of reform with a “trigger”, whereby if the market for health insurance does not rectify itself within a period of time then a public plan would be introduced. On the flipside, Republicans leaders have put forward a plan for health insurance reform which, to be fair, is somewhat less than substantive as it does not include any numbers or data.
While most of Washington has been consumed by the bickering, not all have been sitting on their hands. After an investigation by the New York attorney general’s office as well as a congressional investigation, it came to light that American insurance companies have been using a database run by Ingenix, a subsidiary of managed health care company UnitedHealth Group, that allowed many American insurers to routinely underpay U.S. doctors and hospitals for out-of-network care administered to American patients, ultimately saddling average Americans with the remainder of the costs. A separate congressional hearing has landed some insurers in hot water over the practice known as recission, where they have revoked some individuals’ coverage based on medical history after the individuals’ had already paid their premiums.
The Ingenix database worked by taking claims data submitted by its customers, the insurers, and developing payment rates for out-of-network medical services. Here’s the rub, the insurers were found to have been cleaning up their claims data before sending it to the database by removing many high costing data points. Ingenix itself would then use highly suspect statistical analysis to arrive at rate estimates for how much insurers should pay for medical services provided by medical facilities not in their insurance networks. The end result being that the reduced cost of the initial data, along with statistical tweaking, forcibly and falsely pushes down the amount they have to pay on a claim and also increasing the amount the patient has to pay out of pocket.
On top of all this, Americans are paying more than ever for health insurance and health care. A report from the U.S. Department of Health & Human Services shows that not only are rising premiums a concern, but deductibles, the amount of money you must pay for medical expenses before insurance covers the rest, and copayments, the amount of money you pay each time you see a doctor, have also risen steeply over the years. Average deductibles for families have risen in price by 30% over two years and the number of people with employer-based insurance and copayments over US$25 rose from 1 in 5 to 1 in 3 between 2004 and 2008. So what exactly is wrong with local American insurance policies that are causing such problems?
One reason is because of the way the U.S. health insurance market is set up to begin with. Because each state is entitled to a large amount of self-governance, there are, in effect, 50 different markets, each one is its own particular mishmash of state and federal rules, and each one quite distinct from the others. In and of itself this isn’t a problem, however, it does make it easier to gain a majority of market share. A recent report shows that there have been 400 mergers involving health insurance companies in the last thirteen years. The result of this has been that 94% of American statewide health insurance markets are now considered “Highly concentrated” by U.S. Department of Justice guidelines. By the aforementioned guidelines, a market can be considered as “highly concentrated” if more than 42% of the market’s share is controlled by one company. Experts have noted that healthy competition in the market place is a key way of keeping costs and premiums down.
Thankfully, this is not a problem for companies providing international insurance policies. As we saw earlier, local American policies, much like local health insurance policies everywhere, are restricted in their choice of medical facilities and doctors based upon the insurer they have and the network of medical facilities that will accept their coverage. Most international health insurance plans do have two areas of coverage, one being worldwide, and the other being worldwide excluding the U.S., due to the fact that the cost of health care in America is so high. Still, international health and medical insurance plans will generally afford you access to any hospital or doctor of your choice and pay your claim up to the limits of your policy. Even a policy excluding coverage in the U.S. will often provide emergency coverage if you are traveling through the country.
The fact that the vast majority of international health and medical insurance plans’ give you access to global network of participating medical facilities means that insurers have access to similar networks and must work for market share through offering products that compete through benefits and costs. This keeps down the price of premiums as well as out of pocket costs like deductibles and coinsurance.
The constant competition for customers in the international health insurance marketplace means that customers are as important to insurers as the insurance is to the customer. In order to provide products that are attractive to customers over the long term, international health and medical insurance plans are community rated and guaranteed renewable for life. Being community rated means that each age groups’ premium is based upon the average cost to insure the most average of people. Basically, should you develop a costly or chronic condition, you are guaranteed to be able to renew your insurance for the rest of your life if you wish, without having your premiums raised significantly every year due to your claims history.
While local health insurance plans in America and elsewhere may initially appear cheaper, often times they end up being cumulatively more expensive as people age or if they fall seriously ill causing their premiums and out of pocket costs to rise. Because of a more fluid, open market in the international health insurance industry, the inflation of insurance costs to consumers is kept down and plans have become more competitive over a longer period of time.
Apr
28
Towards the Edge: Recession Presses Need for Change
Filed Under Health Insurance, Healthcare, Income Protection, Medical Insurance, USA Health Insurance | Leave a Comment
America has been in need of healthcare reform for some time now with government health services slated to become an ever larger part of the budget in the future, while the increasing cost of private health insurance has outstripped growth in income by about 3 to 1 over the previous years. While the government debates reform, the recession is having an increasing impact on people and may be a driving force in the widest ranging healthcare reforms in the United States in years.
One fact about the American healthcare system that is fast becoming apparent is that it doesn’t function very smoothly. America has the highest medical costs in the world and the price tag does not always guarantee the highest quality care. Private insurance is prohibitively expensive unless purchased through an employer-based plan, while government run insurance manages to be under funded with an enormous budget at the same time. One thing is for certain, the current mix of public and private insurance have not excelled over time.
A recent survey carried out by David Cutler of Harvard University and Alexander Gelber of the Wharton School show that over the last two decades, a larger number of Americans are losing health insurance coverage at some point during the year. Using data from the US Census Bureau, the authors compared statistics from 1983-1986 and 2001-2004, finding that the percentage of the population that lost their insurance coverage during a 12 month period increased from 19.8% to 21.8% during the two decades or so in between the data sets. The percentage of people losing insurance as you look at the poor and those not in perfect health increases alarmingly.
There is good news though, in that for most of those losing their private insurance, many of them seek coverage under various government healthcare programs. The most recent Census Bureau figures for 2006-2007 show a minor dip in private insurance from 67.9% to 67.5% of the population, but the number of uninsured people in the country went down from 47 million to 45.7 million people. Government health insurance seems to have absorbed most of these people, growing from 80.3 million people covered to 83 million in the 2006-2007 period.
While it’s nice to see that government programs are stepping in to fill the gap, the problem is that its old news. It does not even begin to take into account the massive shifts brought on by the recent recession. The consequences are beginning to take a heavy toll on the health of the country in a myriad of ways. Since the start of the downturn in December 2007, employers have cut 5.1 million jobs. The number of people currently on continuing unemployment benefits is at 6.13 million, bringing the national unemployment rate to 8.5%. Because many people in the US receive their medical insurance through their employers, lost jobs means lost insurance. The Kaiser Family Foundation says that a 1% increase in the unemployment rate means an increase of 1 million enrollments in Medicaid and the Child Health Insurance Program (CHIP), and also a 1.1 million increase in uninsured people.
This high rate of lost jobs, estimated to be as high as 14,000 jobs per day, is pushing people out of their employer-based insurance and either into a government health insurance program or, if they are too young for Medicare or simply not poor enough to qualify for Medicaid, are forced to purchase private individual health insurance plans if they would like to have health insurance at all. An investigation by Consumer Reports has found this trend to carry problems of its own.
The investigation showed that personal health insurance is regularly more expensive than the equivalent cover would be through an employer-based plan. It is often extremely expensive or completely out of reach for people of meager income and less than stellar health. Consumer protection in this area is also an issue where, once again, America demonstrates the importance of appropriate regulation by not having it. Consumer Reports found that most state insurance regulators are not charged with evaluating the coverage these products offer and most disclosure requirements are decidedly limp-wristed at best. So, trying to compare plans, figure out prior to purchase what is and is not covered, or approximately calculating the out-of-pocket liability for any serious medical procedure is nigh impossible. While affordable, these low-end personal plans often come with extensive exclusions and loopholes which often leave people in serious medical debt if they suffer a medical catastrophe.
As everyday American consumers are continuing to feel financial pressure, recent polls have shown an increasing trend to put off medical care. A poll released by Thomson Reuters this month showed that over the past year, 20% of American households have either delayed or cancelled receiving medical care. Out of those who did cancel or delay care, 24.1 attributed it to the cost. The last time this poll was administered in 2006, the number of people delaying or canceling care was at 15.9% and the main reason for delays and cancellations was lack of time. Another chilling figure from the poll was that 21% of American adults were anticipating they would have difficulties paying for either health insurance or healthcare services within the next three months.
As the financial implications on healthcare snowball for the consumers, so too does it snowball for medical practitioners. One instance of this is in North Carolina, which has the fourth highest unemployment rate in the country at 10.7%. The increasing numbers of unemployed and uninsured people have led to a remarkable increase in traffic in free or discounted clinics and also emergency rooms, where hospitals are obliged to administer treatment to everyone, insurance or no. This often means hospitals are performing millions of dollars worth of healthcare services and not seeing any money from it. On top of this, people who do have insurance and actually pay the hospitals for their services are shying away from optional procedures and surgeries which would usually help generate income to keep the hospital running. At the moment, hospitals under financial pressure from both the shrinkage of revenue generating procedures and the amount of “uncompensated care” hospitals are offering to those in need, in some cases only staying functional through infusions of federal monies from the stimulus package.
The picture of American healthcare is looking increasingly bleak. Record numbers of Americans are losing their livelihoods and insurance, forcing the federal government to widen enrollment to more people and ratchet up spending on government programs which receive regular sniping from conservatives for being too expensive already. Not only that, but the health and finances of the people may suffer in the long run as they either cannot get the healthcare they need, or go into medical debt receiving it. One thing is for certain, the current hodge-podge of public and private in the healthcare system is a mess that is only getting worse with the limping economy. It can no longer be fixed by piecemeal measures and requires an alteration at the fundamental level of which the system operates.
Feb
25
Even as Obama speaks, healthcare costs go up.
Filed Under Expat Insurance, Health Insurance, Healthcare, USA Health Insurance | Leave a Comment
Tuesday night Eastern Standard Time, President Obama addressed a joint session of congress in an effort to outline his plan on managing the current economic crisis and to praise legislators for their quick actions in getting the US$ 787 Billion stimulus package passed. Obama told congress that he would eliminate all wasteful spending from the budget (line by line no less), create a new and decisive policy for Iraq and Afghanistan, pass initiatives to create or save approximately 5.5 million American jobs, and that he would take immediate action on dealing with the massive costs of modern healthcare.
While one can be slightly optimistic about the rapid response from the new administration with regards to the myriad of current economic, political, and social woes plaguing the
You see, according to a Department of Health and Human Services report, released yesterday, healthcare costs during 2009 will average approximately US$ 8,000 per American. Remember, this report comes before legislators have met to discuss the issue, and with the credit crisis dominating most of the political agenda it may be a while before any concrete action is taken on health care.
Through no fault of his own, Obama has inherited a healthcare service which is woeful at best. In fact, the Medicare and Medicaid services are so overstretched that analysts forecast their insolvency by 2016 and, that by 2018 $1 out of every $5 in the budget will be spent on healthcare. Couple this alarming prediction with the fact that the number of uninsured Americans has reached a record high of approximately 48 million, and the whole healthcare outlook for the
What does this mean?
For a start, the current economic crisis has provided a clear indication that universal healthcare is not the answer; the system is struggling to cope with the 45 million people that it currently covers. Considering that the
It comes as no surprise that the cost of receiving treatment in the
Whilst on the campaign trail, President Obama frequently mentioned the need for radical healthcare reform. What was Obama’s major campaign proposal to reduce healthcare spending? Move to a paperless healthcare system where patient records are stored electronically. The US$ 77 billion in estimated savings was laughed off by industry analysts at the time, and seems even more ludicrous now, in the midst of the worst economic downturn of the last 20 years. Further to this, he has publicly stated on a number of occasions that he supports expanding the scope of Medicare and Medicaid to include increased numbers of low income earners.
Looking at the current state of the American financial system, and considering the afore mentioned DHHS report, it becomes fairly evident that taking the small step of eliminating paper from the healthcare system will still leave a host of other expenditure issues to contend with. Remember that 2016 is the estimated cutoff date for funding of public healthcare in the
Many American citizens will decry the insurance industry as to blame for the current healthcare fiasco, but this may be more out of experience with insurance companies, rather than any actual understanding of the issues. Health Insurance in the
This is the crux of the problem. And yes, it would follow that you do get what you pay for, and in the
Whatever the response from Obama’s government, it is clear that action will need to be taken quickly. The money is running out.