Report Links Health Insurance Status With Cancer Care

In Memory of Tina

The difference between having health insurance and not being covered can mean the difference between life and death according to a new study out from the American Cancer Society. The report, posted on line, says that uninsured Americans are less likely to get screened for cancer, more likely to be diagnosed with an advanced stage of the disease, and less likely to survive that diagnosis than their privately insured counterparts.

This report, which is sure to fuel the fire of those advocating a single-payer health care system, found that for all cancers combined, uninsured patients were 1.6 times as likely to die within 5 years compared to individuals with private insurance. More specifically, 35 percent of uninsured patients had died at the end of five years, compared with 23 percent of privately insured patients.

In 2007, the American Cancer Society launched the Access to Care campaign, a national initiative dedicated to raising awareness about the plight of uninsured and underinsured people in the United States. The campaign encourages Americans to get involved in finding ways to fix the problem and make access to care a national priority.

I can think of no more powerful way to dramatize the plight of the uninsured and underinsured than to tie it to the real people represented in these figures. As an insured person currently undergoing treatment for cancer, I can tell you that I like the improved odds that having health insurance has given me, and my heart goes out to those who truly do not have the means to seek treatment. I hope that the publicity that this study will generate will stimulate a national discussion about how to solve the problem, and not a headlong rush to a national health care system.

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AHIP Offers Individal Health Proposals

This was an interesting news day. First, I saw an article on about a report from America‘s Health Insurance Plans (AHIP) that said the insurance industry trade group had found that health care coverage is more accessible and affordable than is widely known. The survey they conducted was said to have found that premiums are affordable, most who applied were offered coverage, and that consumers have access to a wide variety of benefit options to meet their individual needs.

OK, I thought, this is some good news for all those people who are looking for individual health coverage and for the industry. Now maybe there is no need for states to pass legislation to require carriers to issue policies to anyone who applies potentially creating another layer of bureaucracy like Massachusetts has created, and the potential for reduced competition because many carriers may simply choose not to do business in those states.

Then the second article hit my in box. Again it involved AHIP. This one appeared in the New York Times with the lead: “Acknowledging that too many people simply cannot obtain health insurance on their own, the insurance industry plans on Wednesday to propose a series of steps the companies say would let more individuals, even those who have health problems, obtain coverage.”

What? I thought I had just read that everything was OK and that most everyone who wanted insurance was able to buy it. What is going on here?

It seems that the AHIP is trying to get out in front of this issue by developing proposals that would make it harder for insurers to cancel policies or deny coverage to people with pre-existing medical conditions. They also say that they want to limit the premiums that could be charged for such people. In turn, the trade group called on states to provide individual coverage for people who were likely to incur very high medical bills.

This is all apparently geared toward taking the wind out of the sails of politicians who are happy to vilify the insurance industry making them the culprits for the fact that some 47 million American do not have health insurance coverage.

Not a bad approach AHIP. While I am still confused by the mixed messages you sent today, I do think that it was the right move to acknowledge that there are problems inherent in the current individual health insurance market and to ask for the state’s to help jointly develop a solution with the industry rather than provoke an adversarial situation.

Could an a Medicare Advantage type program for non-Medicare individuals be in the future?

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The Health Care Scoop: Social Networking Comes to Health Care

Here is an innovative health care idea that has come out of Blue Cross Blue Shield of Minnesota. It is a website called and it is social networking, health 2.0-type website where everyday people can post thoughts about their health care experiences. It is designed to be a place where consumers can post their thoughts about the care they have received from local medical providers.

On my recent visit to the site, I was somewhat surprised to find that most of the posts were in fact positive in nature. Some of the headlines I saw included: “Great ER care at St. Francis!” and “Awesome Pediatrician!”

Of course, not all the posts were so complimentary, but that is OK, because the idea is to provide people with learning from other people’s experiences so they can make their own “best fit” choices. The site acknowledges that what’s best for one person may not be the best for someone else, and maintains that information about all aspects of health care should be easy to find, easy to understand, and easy to navigate. The Healthcare Scoop is about making health care information available to everyone, all the time, and at no cost.

If you can go on line and find out what people are saying about your plumber, why not be able to get similar information about your doctor?

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Health Savings Accounts for Poor Tested

The popularity of health savings accounts for the poor will be put to the test in Indiana under a program approved Friday by the Bush administration. This according to a story published by The Associated Press and carried on Under the plan, someone making $20,000 a year could get health coverage for about $19 a week.

According to the report, under the Indiana program, eligible residents can pay up to 5 percent of their incomes into state-subsidized “Personal Wellness and Responsibility Accounts” that cover their initial medical expenses up to $1,100. Once that deductible is reached, private insurance purchased by the state kicks in.

The story reported that eligibility is limited to adults with incomes below twice the federal poverty level. The poverty level is now $10,210 for an individual and $20,650 for a family of four.

Obviously, the Health Plan Innovation Blog and other will be watching closely the results of this program and the implications it might have for providing health insurance coverage for the poor.

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Global Public Health “Wish List”

While U.S. politicians wrangle over who is offering the best plan to provide health coverage to all Americans, a Gallup poll released early this fall offered a dozen separate ways to expand health insurance coverage and each suggestion garnered majority support. We said we wanted it all: tax breaks for small businesses, large companies to be required to offer health coverage and federal subsidies for the poor. That certainly narrows it down.

In the midst of this debate and in the spirit of the season, it is worth noting a report issued today by the Kaiser Family Foundation and the Pew Global Attitudes Project that surveyed 47 countries to examine global perceptions of health problems, priorities and donors.

According to the report, here are the top items on the public health “wish lists” from around the world:

Public Health Priorities in Low and Middle Income Countries: Preventing and treating HIV/AIDS is the top-rated health priority in the countries surveyed in sub-Saharan Africa and Asia. Fighting hunger and malnutrition is the top priority among countries surveyed in Latin America and the Middle East. Crime is the top issue among countries surveyed in Latin America and Asia. Political corruption leads in Central Europe, while terrorism is number one in the Middle East. Among countries in Western Europe, pollution ranks highest top priority in Central/Eastern Europe.

While reviewing this list does not solve the real health issues we face in this country it does help to put some perspective on the matter.

The entire report can be downloaded here: A Global Look at Public Perceptions of Health Problems, Priorities, and Donors: The Kaiser/Pew Global Health Survey.

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Health 2.0: What is It?


If you are like me, you have probably been seeing a lot of references lately to something called Health 2.0. And, if you are like me, you probably are not too sure about what it means. Joseph Conn attempts to explain this phenomenon in a article published on Modern Healthcare Online.

In the first paragraph, Mr. Conn assures us that if we are curious about Health 2.0, we are not alone. He says that on a given day “Health 2.0” is generating more than 130,000 hits on Google, outstripping “consumer-directed healthcare” at about 44,400 hits, but lagging “personal health record” at 294,000.

Conn then traces the roots of the term back to the phrase Web 2.0 (I’ve still been trying to figure out what that means.) and quotes some of the thought leaders in Health 2.0 such as Matthew Holt, Indu Subai, and Scott Shreeve.

This is only Part 1 of a two part series, but if you are interested in being able to impress the boss with you knowledge of the latest buzz phrase, it will be worth the read. Click here.


W00t is Word of the Year!

This is not really health care related, but I just had to laugh when I learned that W00t was selected as Merriam-Webster’s word of 2007. W00t! Read More.

Will U.S. Health Plans Encourage Medical Tourism?

An article in today’s The Kansas City Star reports that growing legions of American patients – by one estimate, 150,000 last year – are traveling to countries such as India, Thailand, Brazil and Mexico for medical care.

To illustrate this growing trend, the paper tells the story of a local couple who ventured to Brazil where they underwent obesity surgeries that were not covered by their health insurance policies. Their total tab, including medical costs, drugs, airfare and hotel bills: $24,000. If they would have had the surgeries in this country, the combined medical costs alone would have totaled at least $140,000. Apparently these price differences are not just for the types of surgeries not covered by insurance plans. The article noted that the typical cost of a coronary bypass in the United States ranged from $55,000 to $86,000, compared with $7,000 to $7,500 in India and $15,612 to $16,913 in Thailand.

But what about quality you ask. American patients are said to be drawn to medical tourism by the high-quality reputations of many overseas health providers. Rudy Rupak, president of PlanetHospital, a California company that sets up overseas medical care is quoted in the article as saying, “Ninety percent of the doctors I recommend are U.S.-trained or board-certified, and they’re working in hospitals that are palatial and state of the art.”

Experts attribute those whopping price differentials to lower earnings by most health-care personnel in developing countries. In addition, malpractice insurance premiums are non-existent in most foreign countries, and global health-care product suppliers sell to developing countries at cheaper prices.

What will this global competition mean to the U.S. health care industry? According to this article, some see medical tourism as a positive development. In fact, some U.S. employers are sending their workers overseas for treatment and some U.S. health plans are working with overseas providers.

We have seen it become somewhat commonplace for insurers to use so called Centers of Excellence (COE), regional medical centers that specialize in a particular procedure or disease state, to reduce treatment costs and improve outcomes. Usually, the plan will cover the expenses incurred for the patient and a family member to travel to the COE. If we cannot get onshore costs under control, it may soon become commonplace for health plans to add benefits for Americans to travel off shore for expensive medical procedures.

Employer-based Health Coverage “tipped” with New UAW Contracts

I took a couple of days off this week to travel to attend a memorial service for a family member who had passed away and I made no attempt to keep up with the steady pulse of the news that typically surges though my computer. When I returned my Google Reader was packed with health care related news items from the previous week. Where to start? Which of these stories are important? Which Democratic plan will really cover more people?

Actually, two stories jumped out at me as being related, and as being the most important trends to surface in the news this past week. One was a story had appeared in my local newspaper, The Kansas City Star, and carried the headline “Employer-based health coverage could be near tipping point, report suggests.” This story had shown up in many of the news feeds that I track, telling me that it was widely circulated. The second piece is one I had tagged earlier in the week: “UAW’s retiree health benefits takeover could change the way care is delivered.” This article had not shown up in many of my feeds, but ties quite closely with the “tipping point’ piece.

The “tipping point” article was based on a report issued on Thursday by the Employee Benefit Research Institute which said: “If one larger employer actually did drop its health benefits, others might follow for competitive reasons.”

The article predicted that what would reverberate through national health-care discussions was this finding:

“(Employers) all agree that if one major employer were to drop health benefits, others would immediately begin to assess whether or not they should follow, on the one hand, or take advantage of others dropping the benefits to enhance talent acquisition.”

One employer interviewed said it would be “insane” to be the first large employer to drop health-care benefits.

I would argue that some large employers have already dropped their health care benefits, and that brings me to the second article. On Sept. 26, the United Auto Workers and General Motors Corp. settled on a revolutionary new contract that shifts $46.7 billion worth of retiree health care costs from the company to the union. The UAW worked similar deals this year with Ford Motor Co. and Chrysler LLC, turning the labor union into one of the largest health care consumers in the nation.

In the contracts, GM, Ford and Chrysler agreed to put billions into union-run trusts that will pay bills for all retirees and spouses and for active workers and spouses after they retire. The companies are paying 56 percent to 62 percent of the obligations into the trusts, called voluntary employee beneficiary associations or VEBAs. For the VEBAs to work, experts say the union must invest wisely and make more money than the rate of health care inflation. But they also must control costs.

What the companies have done is institute a defined contribution approach to retiree health care. Their obligation is essentially fixed and it will now be up to unions and their retired members to come up with benefit plans and programs that will make the money last.

Yes, I would argue that the “tipping point” occurred with these paradigm changing union contracts. The shift from defined benefit to defined contribution health care has already happened in the retiree segment. Can it be long before a major employer implements a similar model for active employees?

Top November Posts on the Health Plan Innovation Blog

For the month of November the Top Three posts on the Health Plan Innovation Blog were:

1. Highmark Issues Health Gift Card

2. Yes, we are expensive, but we do poor work

3. Humana Website is a Wiki for Health Care

Continued comments on these and any other posts are always welcome. To receive immediately updated headlines from the Health Innovation Blog, you can grab the blog RSS feed for your reader, or you may syndicate the feed on your Web site.

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