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Health and Insurance, 2014

Posted on Feb 10, 2014 by Ailee Slater ()  | Tags: Obamacare, Affordable Care Act, ER visits, China GSK scandal, China bribery, China anti-corruption, health insurance Africa, chikungunya virus, mosquito-borne disease, MERS, SARS

Last year, the world saw health care cures and conundrums; vaccines and victories, along with new disease and unexpected outbreaks of old foes. Legislation, medical science and the patterns of the past year point to a few trends we may likely see in 2014. 

The United States: More Visits To The ER 

As reported by the New York Times, Americans receiving a new insurance policy through Obamacare may be more liable to go to the emergency room. It’s a trend that doesn’t follow what policymakers had predicted. Obamacare proponents have long argued that with insurance, Americans will be more likely to seek preventative care and will therefore be less likely to go in for sudden, costly care at the ER. However, a recent study in the journal Science has reported just the opposite: finding that new Medicaid policy holders went to the emergency room 40 percent more often than people of a similar socioeconomic status who had not qualified for Medicaid. 

The Science journal study observed thousands of people in Oregon, but it’s uncertain whether this trend might extend to the rest of the nation. The Affordable Care Act states that starting in March 2014, every American must hold health insurance or pay a fine; if a slew of newly insured policy holders make more visits to the ER, that could mean higher costs for hospitals and health insurance companies – and potentially higher insurance premiums in the future. 

China: Anti-Corruption Efforts In The Drug Industry 

Following investigations of the GSK pharmaceutical scandal in 2013, China has announced that in the coming year it will create a blacklist of drugmakers suspected of bribery. Any pharmaceutical manufacturer or representative caught offering bribes to doctors, hospitals or health authorities will be placed on the blacklist and banned from the industry (regionally after the first offense and nationally after the second) for two years. 

Health care advocates are hopeful that stopping bribery can make for more fair medical practices and encourage international interest in entering the medical market in China. However, ending corruption in the Chinese health care system may take more than just a blacklist: doctors and authorities will often accept bribes due to low wages, so if corruption is to be stopped, health care pay and working conditions must be addressed as well. Luckily, China’s health system reforms over the past 10 years show that the nation is interested in keeping its populace healthy, including those who cannot afford bribery or the higher industry costs that the practice naturally leads to. 

East Africa: New Health And Insurance Opportunities 

For a long time, health care in Africa was divided into two sectors: care for the rich, and care for the poor. Recently, however, insurance firms are offering inexpensive coverage to people who can afford the cost of no-frills, catastrophic coverage. A November 2013 article in The Economist recounts the story of Stephen Ombedho, a Kenyan man who pays around US$200 per year to guarantee access to better hospitals and shorter waiting times. 

The Economist further reports that health care investment in Eastern Africa is growing, leading to more outpatient clinics, hospitals and health insurance firms. By 2016, we may see a medical care market worth more than $30 billion dollars. This year, it’s likely that the insurance market will continue to grow, aided by better telecommunication payment systems and informal agreements between community members pooling their resources to fund medical care when the need arises. 

Europe And The Americas: Stopping The Virus Chikungunya 

Most travelers have heard of dengue fever and malaria, but chikungunya - although it is found in the same areas and can spread in the same way as other mosquito-borne disease - will probably be unfamiliar. The symptoms of chikungunya are similar to dengue fever, and has been designated a problem of epidemic proportions by the World Health Organization, despite receiving little recognition outside of affected areas such as Africa and the Indian subcontinent. 

At the end of 2013, however, the chikungunya virus was found to be spreading to the Americas, and the Caribbean in particular. The Centers for Disease Control in the U.S. issued a holiday travel warning to tourists visiting the Caribbean, and a report by the European Centre for Disease Prevention and Control (ECDC) warned that trends in global travel could make it difficult to contain a chikungunya outbreak. The fact that the disease is carried by tiger mosquitoes, which can live in colder temperatures than many of their insect brethren, may increase European and North American action against the spread of chikungunya in the coming year. 

The Middle East: MERS And How To Contain It 

On the 1st of January, 2014, it was reported that the Middle Eastern coronavirus (MERS) had claimed yet another life, this time of a 59-year-old man in Oman. MERS - a virus similar to SARS in its respiratory symptoms and highly transmissible nature - is now responsible for the deaths of more than 70 people, and although the virus is considered relatively well-contained, the Middle East will no doubt be on high alert for more breakouts and transmissions in the coming year. 

First discovered in Saudi Arabia in 2012, MERS has thus far avoided becoming a SARS-like epidemic, thanks in part to the fact that MERS is less transmissible (although more likely to cause fatalities) as well as due to local and international efforts to keep the disease contained. Going forward in 2014, more research into the origin of MERS is likely to occur, and in the meantime, people in the Middle East and abroad will continue receiving recommendations on good daily hygiene, recognizing the symptoms of MERS, and avoiding close contact with patients who show signs of the virus.


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