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SUMMARIES OF RECENT REPORTS
Final six months of 2006 (most recent at bottom)
MANY FOREIGN-BORN NEW YORKERS, PARTICULARLY SPANISH-SPEAKERS, FACE DIFFICULTIES ACCESSING HEALTH SERVICES
Findings from "The Health of Immigrants in New York City", prepared by the New York City Department of Health and Human Hygiene, reveal that foreign-born immigrants are less likely than U.S.-born New Yorkers to have a regular primary care provider and to receive preventive services, such as blood pressure and cholesterol checks and colon and cervical cancer screenings. While foreign-born New Yorkers arrive in the city in better health than U.S.-born New Yorkers, with lower rates of smoking, obesity, and HIV, immigrants who have been living in the USA for at least 4 years report worse health and are more likely to be obese. The report authors recommend improving language services and educating immigrants about protections that generally prohibit city agencies and employees from asking about immigration status.
The full article may still be available at the Commonwealth Website CLICK HERE
HISPANIC AND AFRICAN AMERICAN WORKING-AGE ADULTS FACE GAPS IN HEALTH INSURANCE COVERAGE, PROBLEMS ACCESSING CARE, AND MEDICAL DEBT AT HIGHER RATES THAN THEIR WHITE COUNTERPARTS
"Health Care Disconnect: Gaps in Coverage and Care for Minority Adults" concludes that 62% of Hispanics ages 19 to 64--an estimated 15 million people--were uninsured at some point during While insurance is crucial to reducing racial and ethnic disparities in access to care, the policies that promote continuity in patients' relationships with health care providers are also needed to improve health care access and quality for minority Americans.
The full article may still be available at the Commonwealth WebsiteCLICK HERE
MOST AMERICANS SEE THE NEED FOR FUNDAMENTAL CHANGES IN THE NATION'S HEALTH CARE SYSTEM
"Public Views on Shaping the Future of the US Health Care System" reports that change is desired in nearly every aspect of health care. 42% of respondents said they had recently received poorly coordinated, inefficient, or unsafe care. The survey also reveals strong public support for efforts to improve care coordination, as well as a shared belief that expanded use of information technology could improve care. Additionally, paying for care is a major concern: about half of adults in middle- and low-income families reported they have experienced serious problems paying for health care and health insurance. Not surprisingly, expanding affordable coverage and controlling costs, they said, should be top priorities for federal action.
The full article may still be available at the Commonwealth WebsiteCLICK HERE
AS EMPLOYERS DROP BENEFITS, WORKING FAMILIES GET "SQUEEZED"
"Squeezed: Why Rising Exposure to Health Care Costs Threatens the Health and Financial Well-Being of American Families" reports people who turn to the individual insurance market after losing their employer group coverage often find they don't qualify for any plans in this market, or simply can't afford their often high cost. In a national survey of working-age adults, an overwhelming proportion--89% --of working-age adults who sought coverage in the individual market during the past three years ended up never buying a plan. A majority of those who sought coverage found it very difficult to find an affordable health plan, while one-fifth were turned down, were charged a higher price because of a preexisting condition, or had a health problem excluded from coverage. Americans with high-deductible health plans--whether through the individual market or through an employer--have higher out-of-pocket costs than people with lower-deductible plans. Many plan enrollees are left with burdensome medical bills because of limits to their insurance coverage.
The full article may still be available at the Commonwealth Website CLICK HERE
USA FALLS FAR SHORT OF WHAT IT COULD ACHIEVE
The "National Scorecard on US Health System Performance" assessed our nation's health care in terms of health outcomes, quality, access, equity, and efficiency, comparing national averages to benchmarks of achieved performance. Out of a possible score of 100, the US averages just 66 across more than three dozen health system indicators. "US Health System Performance: A National Scorecard" discusses that not only does the US often fare poorly when compared with other nations, but performance varies greatly across states and across hospitals and health plans. "What the Scorecard tells us is that there are many pockets of excellence in health care in this country, but overall we are performing far below our national potential". Based on the Commission's findings, if the US improved performance in key areas, it could save an estimated 100,000 to 150,000 lives and $50 BIL to $100 BIL annually.
The full article may still be available at the Commonwealth Website CLICK HERE
AMERICANS SAY US HEALTH CARE NEEDS FUNDAMENTAL CHANGE, OR TOTAL REBUILDING
Three-quarters of all adults said the US health care system needs either fundamental change or complete rebuilding. Expanding insurance and controlling costs, they said, should be top priorities for federal action.
Affordability concerns are moving up the income ladder Half of middle-income ($35,000-$49,999 annually) and lower-income (less than $35,000 annually) families said they have had serious problems paying for care in the past two years. With the median US household income at $44,000, the findings indicate that more than half of all US households are experiencing stress when paying for medical care.
Affordability is a now a concern at even higher-income levels. One-third of adults with annual incomes between $50,000 and $74,999 reported serious problems in paying for care.
The full report may still be available at CLICK HERE (ACROBAT)
MOST PHARMACISTS AND PHYSICIANS THINK MEDICARE DRUG LAW IS TOO COMPLICATED AND PATIENTS EXPERIENCING
PROBLEMS - Sept 7, 2006
Some 86% of pharmacists and 71% of physicians believe that the prescription drug law may be helping some people on Medicare save money on their medications. However, more than 90% in both professions believe the law is too complicated and a majority report that Medicare beneficiaries who they see are encountering problems in getting their medications, sometimes with serious consequences.
This includes one in five (19%) pharmacists who say problems in acquisition of need medications have affected "most" of their customers in Medicare drug plans and two in three pharmacists say they had customers leave the pharmacy without a medication because the prescribed drug was not on their drug plan’s formulary, while almost . six in 10 pharmacists said they had customers pay out-of-pocket for their drugs because they could not verify their enrollment in a Medicare drug plan. Nearly half of pharmacists (49%) say they had customers leave without a prescription because they could not afford the co-pay charged under the Medicare drug plan.
The full report may still be available CLICK HERE
HEALTH CARE COVERAGE AND ACCESS FOR HISPANICS: HOW DOES IT DIFFER ACROSS AMERICA? -September 21, 2006
Long-term immigration trends and secondary migration is increasing the share of Hispanic residents in many areas of the country, according to recently released US Census data. While large cities like Miami, Los Angeles, and New York have traditionally had large Hispanic populations, smaller urban and rural areas that previously had relatively few Hispanics are now experiencing rapid growth. These "new growth communities" have less experience providing health care to the Hispanic population. Hispanics are much less likely than other groups to have health coverage (33 percent are uninsured) and may also face language and cultural barriers to care. As the Hispanic population becomes increasingly dispersed, these factors may lead to Hispanics facing greater difficulties accessing needed health care.
The new report, Health Coverage and Access to Care for Hispanics in New Growth Communities and "Major Hispanic Centers" may still be available at CLICK HERE
PUBLIC’S VIEWS OF MEDICAL ERRORS AND QUALITY OF CARE
A survey has been released capturing the public’s views and knowledge of medical errors and their experiences in taking steps aimed at improving the quality of their care over the last six years. These include that only 36% of the public : have seen information comparing the quality of care provided by health plans, hospitals and doctors, while only about one in five say they have seen and used such data to make decisions about their care. Only slightly more than half of Americans say they understand the term "medical error". After being given a common definition of medical errors, more than four in 10 say preventable medical errors occur "very often" or "somewhat often" when people seek care from a health professional.
The full report may still be available at CLICK HERE
HEALTH SAVINGS ACCOUNTS AND HIGH DEDUCTIBLE HEALTH PLANS: ARE THEY AN OPTION FOR LOW-INCOME FAMILIES? - October 2006 By C Hoffman and J Tolbert
Premiums for HSA-qualified health plans may be lower than for traditional insurance, but these plans shift more of the financial risk to individuals and families through higher deductibles and the costs of such plans (premiums, plus out-of-pocket costs) would consume a substantial portion of a low-income family’s budget. Furthermore most low-income individuals and families do not face high enough tax liability to benefit in a significant way from tax deductions associated with HSAs. People with chronic conditions, disabilities, and others with high-cost medical needs may face even greater out-of-pocket costs under HSA-qualified health plans.
Cost-sharing reduces the use of health care, especially primary and preventive services, and low-income individuals and those who are sicker are particularly sensitive to cost-sharing increases. HSA's and HD plans are unlikely to [EINO: They may be little more than a PR gimmick, boosting sales slightly to young and healthy middle-incomed workers.]
The full report may still be available at CLICK HERE
ANALYSIS OF HEALTH COVERAGE AND APPROACHES FOR LOW-INCOME AMERICANS - September 2006
This includes the primer and two papers. The primer provides the key facts, statistics, and policy points to understand health coverage trends and the nation’s uninsured population.
The paper, "Why Did the Number of Uninsured Continue to Increase in 2005?," based on the latest US Census data, finds that despite the improving economy, the percentage of the population with employer-sponsored insurance continued to decline resulting in a 1.3 million increase in the uninsured from 2004. In 2005, the Medicaid and State Children’s Health Insurance Program were no longer growing to fill the gap left by declining employer coverage resulting in the first increase in the number of uninsured children in recent years.
The second paper, "Changes in Employees’ Health Insurance Coverage, 2001-2005," examines the underlying reasons behind the decline in employer- sponsored coverage among employees. Almost half of the decline in employer- sponsored coverage from 2001-05 was due to a loss of employer sponsorship with another quarter of the decline due to lost eligibility for benefits or lost access as a dependent of another employee. The remaining quarter of the decline was due to an increase in employees not participating in the offer of coverage. The paper also finds that two-thirds of newly uninsured employees between 2001 and 2005 were from low-income families.
The reports may still be available at CLICK HERE
HEALTH CARE COSTS FOR INDIVIDUAL AND GROUP INSURANCE - November 10, 2006
The Kaiser Family Foundation today released two new reports providing insights into variations in health care costs across insurance products and their implications for policy initiatives. The reports are part of the Foundation’s online series, Snapshots: Health Care Costs.
The first Snapshot examines the differences in costs associated with individual, nongroup insurance and employer-sponsored insurance. Premiums for nongroup health insurance available from online brokers or reported by insurance industry surveys are much lower than premiums observed for employer-sponsored coverage. This is surprising to some because nongroup healh insurance has higher administrative costs. The paper uses data from the Medical Expenditure Panel Survey and finds that people covered by individual insurance have much lower health care spending on average than people who have employer-sponsored insurance, but pay a greater share of that spending out-of-pocket. It also shows that those with individual insurance are significantly more likely than those with employer-sponsored insurance to report that they are in excellent physical and mental health. These findings may help explain why premiums for individual coverage are actually lower than group coverage. The analysis suggests that proposals to extend coverage to lower income people through lower cost nongroup health insurance need to account for the higher out-of-pocket costs associated with these policies.
The full report may still be available at CLICK HERE
POTENTIAL IMPACT OF RISK SELECTION IN HIGH DEDUCTIBLE PLANS - November 10, 2006
The second Snapshot examines the sensitivity of health insurance premiums to enrollment shifts by high cost enrollees - a process often referred to as adverse selection. The introduction of high-deductible, consumer directed health plans has raised concern about their potential to attract younger and healthier people away from more traditional insurance plans, which could increase the costs of those plans. The public discussions of this possibility are often phrased in rather extreme terms - for example, that consumer directed health plans attract primarily the young and healthy. The new report shows that extreme selection behavior is not needed to produce real premium differences between insurance pools, and that the shift of even a small percentage of high spenders from one risk pool to another can have a dramatic impact on average costs - and, therefore, premiums - in the pools.
The full report may still be available at CLICK HERE
BACKGROUND FOR US CENSUS DATA ON UNINSURED
The US Census Bureau released its annual update on health insurance coverage and the number of uninsured Americans on August 29, 2006. Here are some key statistics and facts, based on data from prior years which may be helpful as background: Over 80 % of uninsured individuals are from working families; almost two-thirds of the uninsured are from families earning less than 200% of the Federal Poverty Level (roughly $38,000 for a family of four). About half of the uninsured are white and half are racial and ethnic minorities; and the large majority of the uninsured (80%) are American citizens. The offering of employer-sponsored health coverage has declined from 69 % in 2000 to 60 % in 2005. Most adults without dependent children - regardless how poor - remain ineligible for Medicaid.
Download 2006 census report CLICK HERE(ACROBAT)
TRACKING HEALTH CARE COSTS: SPENDING GROWTH REMAINS STABLE AT HIGH RATE IN 2005
Health care spending per privately insured American increased 7.4% in 2005. In 2005, health spending growth continued to outpace overall economic growth, despite a robust 5.4% increase in the overall US economy as measured by per capita gross domestic product.
Two key factors will tend to drive cost trends higher. One is the rapid expansion of specialty facilities, including hospital inpatient and outpatient facilities, freestanding centers and additional ancillary service capability in physician offices. The combination of supply creating demand and the effects of increased physician self-referral could mean that these expansions will increase spending. It has been estimated that 27% of real per capita growth in spending from 1987 to 2001 is attributable to increasing rates of obesity.
The most likely outcome over the next few years is costs continuing to outpace incomes and private health insurance becoming increasingly unaffordable for more people.
See this report at the Center for Studying Health System Change, October 2006 CLICK HERE
US RESIDENTS LESS HEALTHY, LESS ABLE TO ACCESS HEALTH CARE THAN CANADIANS
A study published in the July, 2006 issue of the American Journal of Public Health finds that US residents are less healthy than Canadians. Moreover, despite spending nearly twice as much per capita for health care, US residents experience more problems getting care and more unmet health needs. The study analyzes the Joint Canada-US Survey of Health, the first-ever cross national health survey carried out by the two nations’ official statistics agencies. The authors found that US residents were less healthy than Canadians, with higher rates of nearly every serious chronic disease examined in the survey, including diabetes, arthritis, and chronic lung disease. US residents also had more high blood pressure (18% of US residents versus only 14% for Canadians).
Canadians had better access to most types of medical care. Canadians were 7% more likely to have a regular doctor and 19% less likely to have an unmet health need. US respondents were almost twice as likely to go without a needed medicine due to cost (9.9% of US respondents couldn’t afford medicine vs. 5.1% in Canada). After taking into account income, age, sex, race and immigrant status, Canadians were 33% more likely to have a regular doctor and 27% less likely to have an unmet health need. For each of these measures, the average Canadian did about as well as insured US residents.
Race and income disparities, although present in both countries, were larger in the US. Nonwhites were more likely than whites to have an unmet health need in the US (18.6% vs. 11.1%); while in Canada they were not (10.8% vs. 10.2%). In the US cost was the largest barrier to care. More than seven times as many US residents reported going without needed care due to cost as Canadians (7.0% of US respondents vs. 0.8% of Canadians). Uninsured US residents were particularly vulnerable; 30.4% reported having an unmet health need due to cost. ____
Full Report can be viewed at PNHP website CLICK HERE
DISSATISFACTION WITH HEALTH CARE SYSTEM DOUBLES SINCE 1998
The US public's increasing dissatisfaction with the American health care system appears to be focused primarily on the rising cost of care. Many Americans report that rising costs have hurt their financial well-being and feel that steps should be taken to slow these increases.
More and more, people who experience an increase in health care costs report a negative effect on household finances. Americans are more likely than in previous years to indicate the changes have caused financial difficulties. More than one-third in the 2006 HCS say they have decreased their contributions to retirement plans (36%, up from 25% in 2004), and more than one-half have decreased their contributions to other savings as a result of the cost increases (53 %). Almost 3 in 10 indicate they have had difficulty paying for basic necessities, such as food, heat, and housing (28 %, up from 18 %), while nearly 4 in 10 report difficulty paying other bills (37 %, up from 30 %).
See the Employee Benefit Research Institute's (EBRI) 2006 Health Confidence SurveyCLICK HERE (acrobat)
Continue browsing back through additional
reports from earlier in 2006 |
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