Tag: health insurance

Blog Posts (62)

January 17, 2017

The Future of Health Insurance May Look A Lot Like Our Past

by Craig Klugman, Ph.D.

This week marks the transition of power from President Obama to President-elect Trump. One issue that has been high on Trump’s list of policy changes is a repeal and replace of the Affordable Care Act (a.k.a.…

December 13, 2016

Imminent Threats To Healthcare and Medical Professionalism: We Must Remain Vigilant

In a previous blog I expressed concerns about the possible direction of politics in our country and the risks it poses to the larger procedural, democratic framework, which I take to be essential to the work of contemporary bioethics. Now that the election is over and a new administration is taking shape, I have many grave concerns about the fundamentally new policy directions our nation will be taking. None concern me more than how the planned changes in our healthcare system in the United States and, if they happen, how our most vulnerable patients will be affected. This is because a top agenda for them on day one will be to repeal the Affordable Care Act (ACA), which has provided healthcare coverage for about 21 million more people since its inception in 2009.

The ACA was an imperfect healthcare plan from the start. But after decades of false starts to reform a system that does not have a close second in terms of excessive costs and inefficiencies among industrialized nations, especially in relation to outcomes, in 2009 it was the best option our country had at that time. In spite of some problems in its implementation, due largely to lack of cooperation and critics setting up obstacles, the ACA has become entrenched into our healthcare system. If it is repealed, there will be widespread suffering and chaos. Just recently the nations’ hospital industry “…warned President-elect Donald Trump and congressional leaders on Tuesday that repealing the Affordable Care Act could cost hospitals $165 billion by the middle of the next decade and trigger “an unprecedented public health crisis.”

 The eagerness of the new administration to gut the ACA was affirmed by the appointment of Tom Price, Representative from Georgia who has been a ferocious and over the top critic of this law from its inception. A prominent orthopedic surgeon prior to running for Congress, Dr. Price seems to advocate for a system that is extricated from government as much as possible and placed in the hands of the private insurance companies. His plan, which provides for individual fixed tax credits and health savings accounts and allows insurance companies to cross state lines, may be helpful for many Americans who are relatively well off and have healthcare to start with. But for most of the sickest patient in lower income brackets, these market-based ideas will do nothing to help them and in fact make them worse off. But real world, harmful consequences are the concerns of an ideologue: All that matters is having in place a policy that accords with an ideal vision of how the world should work.

There is no practical way that a purely market based approached to providing access to healthcare to Americans will accomplish the goals of healthcare that the majority of Americans have, which is to provide some type of basic, quality healthcare to all citizens, at an affordable cost. Price’s approach will leave millions of American citizens, many already with serious health problems without access to health except via the emergency rooms. The predictable consequences will be astronomically increasing costs because healthcare will retreat to its pre-ACA days of inefficiency by focusing more on rescuing patients from acute conditions than preventing them from occurring in the first place; and physicians caring for patients with insurance will be doing more and more procedures for which they will be handsomely paid, without improving quality for patients. Which makes it all the sadder to see the American Medical Association (AMA), as it has done at prior critical historical junctures as it did in standing against the passage of Medicare and Medicaid in 1965, endorsing Price’s nomination.

Though Price’s nomination may be bad for patients, it likely represents good news for physicians in terms of their incomes from reimbursement rates. Which is the reason why the AMA supports him and why, in my judgment, it is an abdication of professional, ethical good judgment and responsibility. Their support violates the basic tenant of professionalism as stated in the American College of Physicians (ACP) Ethics Manual that require its members “…to teach and expand, by a code of ethics and a duty of service that put patient care above self-interest, and by the privilege of self-regulation granted by society. Physicians must individually and collectively fulfill the duties of the profession.”

I am heartened by practicing physicians and physicians-in-training who speak out and refuse to be a part of the AMA and its support of Price’s appointment to be Secretary of HHS.  Most notably a petition has gained over 5,000 physicians’ signatures that make it clear “The AMA Does Not Speak For Us”.  As they state in the petition:

 

“We are practicing physicians who deliver healthcare in hospitals and clinics, in cities and rural towns; we are specialists and generalists, and we care for the poor and the rich, the young and the elderly. We see firsthand the difficulties that Americans face daily in accessing affordable, quality healthcare. We believe that in issuing this statement of support for Dr. Price, the AMA has reneged on a fundamental pledge that we as physicians have taken?—?to protect and advance care for our patients.”

 

Medical professionalism always exists in relationship to the prevailing economic and political order in society. Because economic and political winds can shift, so can medical professionalism that at times can put it at risk of losing its moral compass. We do not know yet just how strong the head winds will be. But medical professionals and all citizens who care about the future of just and quality healthcare should be especially vigilant in the coming days and remain prepared to show resistance when necessary.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

September 22, 2016

Did You Know That Obamacare Causes Diabetes? Here’s Why It Happens And Why It’s A Good Thing

Obamacare is a big, messy law with so many moving parts, it is often hard to tell how well it’s working. People debate whether it is killing jobs or creating them; they argue about whether it is lowering medical expenses … Continue reading

The post Did You Know That Obamacare Causes Diabetes? Here’s Why It Happens And Why It’s A Good Thing appeared first on PeterUbel.com.

September 9, 2016

Americans Love Their Healthcare But Hate Their Healthcare System — Here’s Why

There’s lots to love about American healthcare. We have some of the best clinicians in the world, as evidenced by the huge number of people who come to the U.S. from other countries when they are sick. Yet the American … Continue reading

The post Americans Love Their Healthcare But Hate Their Healthcare System — Here’s Why appeared first on PeterUbel.com.

August 15, 2016

If You Don’t Have Employer Insurance, You Probably Have a High Deductible

Most people in the United States get health insurance either through their employer or through government programs like Medicare and Medicaid. But some people have to find other ways to get healthcare insurance, with an increasing number of people doing … Continue reading

The post If You Don’t Have Employer Insurance, You Probably Have a High Deductible appeared first on PeterUbel.com.

August 12, 2016

Your Physician Can’t See You Yet – She’s Busy Filling Out Paperwork!

Left to our own devices, most of us physicians try our best to provide high quality care to our patients. But almost none of us provide perfect care to all of our patients all of the time. In fact, many … Continue reading

The post Your Physician Can’t See You Yet – She’s Busy Filling Out Paperwork! appeared first on PeterUbel.com.

July 27, 2016

New WHO diagnostic labels perpetuate transgender stigma

The movement of the World Health Organization (WHO) to declassify transgender identity as a mental disorder is simultaneously a step forward in affirming the personhood of gender minority individuals, and a step backward in diagnoses that adequately reflect their health … Continue reading
April 13, 2016

Inflation Crawls While Deductibles Sprint Ahead

With increasing frequency, Americans are purchasing health insurance plans that require high out-of-pocket costs. Chief among those costs are deductibles, the amount of money a person or family must spend out-of-pocket on medical care in a year before their health … Continue reading

The post Inflation Crawls While Deductibles Sprint Ahead appeared first on PeterUbel.com.

March 29, 2016

Where Your Paycheck Is Going

If you are wondering why your hourly wage or your salary aren’t rising as quickly as you like, or why your bank account at the end of the year hasn’t grown as much as you intended, don’t forget to take … Continue reading

The post Where Your Paycheck Is Going appeared first on PeterUbel.com.

March 4, 2016

Rumors of the Obamacare Death Spiral Have Been Greatly Exaggerated

For a while last fall, it looked like the Obamacare health insurance exchanges were spinning towards a death spiral. Enrollment in the health insurance exchanges was not growing as rapidly as many people had hoped. United Healthcare, one of the … Continue reading

The post Rumors of the Obamacare Death Spiral Have Been Greatly Exaggerated appeared first on PeterUbel.com.

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News (63)

January 20, 2015 7:16 pm

Fight threatens thousands of Californians' health coverage

A contract dispute between health insurance provider Blue Shield of California and the Sutter Health network of doctors and hospitals is threatening to force nearly 280,000 consumers in Northern and Central California to find new doctors.

November 10, 2014 6:49 pm

Medicare proposes covering lung cancer scans for heavy smokers

The U.S. Medicare program is proposing to add lung cancer screening tests for beneficiaries with a history of heavy smoking, the federal government announced on Monday.

October 8, 2014 2:14 pm

Wal-Mart raises healthcare costs, cuts benefits for some part-timers

Taking away access to healthcare, even though many of my co-workers couldn’t afford it anyway, is just another example of Walmart manipulating the system to keep workers in a state of financial crisis.

September 24, 2014 4:50 pm

HHS: Health law will lead to big drop in free hospital care

The Affordable Care Act will lead to $5.7 billion in savings in uncompensated hospital care costs this year, the Obama Administration said Wednesday, reducing one of the biggest financial challenges hospitals face.

September 8, 2014 6:47 pm

Top U.S. health adviser wants end to partisan fighting over Obamacare

President Barack Obama’s top health adviser on Monday called for an end to partisan bickering over Obamacare, saying the public and businesses are sending a clear message to Washington that it is time to move on with implementing the law.

July 30, 2014 5:14 pm

Teen Cancer Survivor Needs New Teeth, Insurance Company Refuses to Pay

His insurance paid to have the dead teeth removed, but won’t pay for new ones. [The insurance] said it wasn’t a medical issue and of course it’s from a medical issue.

July 23, 2014 6:21 pm

Abuse of U.S. generic-drug rules costs billions -report

U.S. rules that ensure prescription medicines are not misused have been manipulated by brand-name drug companies to fight off generic competitors, costing consumers billions of dollars, according to a report released on Wednesday.

July 9, 2014 2:05 pm

NY insurer to pay up to $31 million for denied mental health claims

A New York-based health insurance company has agreed to reimburse members up to $31 million for previously denied mental health and substance abuse claims, the state attorney general said on Wednesday.

July 8, 2014 5:15 pm

U.S. Democrats aim to turn contraception into campaign drive

U.S. Democrats hope to turn their legal setback on Obamacare and contraception into a winning autumn campaign issue by pushing legislation requiring employers to include birth control in healthcare coverage.

June 2, 2014 8:04 pm

Insured young cancer patients fare better, live longer: study

Young adults with cancer are far more likely to recover or live longer if they have health insurance, a new study on the potential impact of the Affordable Care Act shows.

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