Tag: health insurance

Blog Posts (41)

December 4, 2014

Obamacare 2.0—Better than Version 1.0?

Paige Rentz, an excellent reporter at the Fayetteville Observer, recently posted a question and answer piece, exploring some of the pressing issues facing the second round of insurance enrollment, on the Obamacare health insurance exchanges. I suggest you look at … Continue reading
October 10, 2014

Yes, Obamacare is a Success

<p><span style="line-height: 19.0400009155273px;">When the Affordable Care Act, commonly referred to as Obamacare was under consideration there was an unrelenting partisan attack against both the proposed legislation and the president who proposed it. We were told that millions would lose insurance coverage, that the cost of medical care would skyrocket, and that government bureaucrats would be interfering with the health care relationship between us and our physicians. We were told that death panels would be making decisions to end the life of the elderly and infirm. We were told all sorts of things that were so ridiculous that I cannot recall them. The fact is we were told lies. Interestingly and importantly none of these things have occurred. The Affordable Care Act was designed to increase the extent of medical insurance coverage and the corresponding access to health care permitted by insurance coverage. The Affordable Care Act was also designed to slow the growth of health care costs. While it is true that there were initial technical glitches in its rollout, now a year after people could begin to enroll, and still only months after the initiation of most of its provisions it is clearly apparent that it is doing just what it was designed and implemented to do. Yes, the Affordable Care Act, Obamacare, is a success.</span></p> <p><strong style="line-height: 19.0400009155273px; color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px;">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 <a style="text-decoration: underline; color: #000099;" href="/Academic/bioethics/index.cfm">website</a></strong></p>
June 18, 2014

Insurance Woes

A great cartoon from the Kaiser Health News website that pithily captures the “wonders” of the American health insurance system.   (Click here to view comments)
June 15, 2014

Insurance Coverage for Oncofertility: Concerns about Socioeconomic Disparities

<p>In a recent <a href="/BioethicsBlog/post.cfm/the-importance-of-assisted-reproductive-technologies-for-women-in-developing-countries">blog</a>, I asserted that assisted reproductive technology (ART) should be a higher priority for the global South because of the severe health, social, and economic effects infertility can have on women there. The most common response to this claim is that resources should first be devoted to treating and preventing life-threatening conditions, such as malaria and HIV/AIDS, rather than conditions that are perceived as merely social and/or psychological. The same response is often used when people suggest that ART should receive higher priority in the global North. Whereas many global North countries provide national health coverage for ART, the US does not. However, there has been movement toward coverage for ART in the US in the last couple of decades and currently 14 states require health insurance companies to cover ART (though there is a wide range of what is covered and under what circumstances). Unfortunately, oncofertility (fertility preservation for cancer patients) is <a href="http://oncofertility.northwestern.edu/sites/default/files/uploadedfilecontent/basco_et_al._2010.pdf">not covered in any of these state laws</a>.</p> <p>While I understand the argument that limited healthcare resources should be dedicated to the most "pressing" conditions, it is also important to recognize the potential side effects of choosing not to provide coverage for oncofertility and other types of ART. One concern with the lack of coverage for ART is that it reinforces socioeconomic inequalities. The <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1955265/">primary users of ART</a> are white, educated, middle- and upper-class not because this group is the most likely to be infertile, but because they are the most likely to be able to afford the high cost of ART out-of-pocket expenses. Cancer patients from lower socioeconomic backgrounds are unlikely to have the large amount of disposable funds (the <a href="http://www.asrm.org/detail.aspx?id=3023">average cost for one cycle of IVF</a> is around $12,400) for fertility preservation treatment. While “traditional” infertility patients can save their money over a period of time in order to be able to afford ART, cancer patients need to preserve their fertility before their cancer treatment commences and thus they need to be able to immediately provide the cash for fertility preservation treatment in order for it to occur. </p> <p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 20px;">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 <a style="text-decoration: underline; color: #000099;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong></p>
June 10, 2014

The Readmission Problem

<p>No one seems to know what the answer is to keeping costs down in healthcare but grand efforts have been undertaken to find someone to blame. Some of the targets are patients, others are providers, and sometimes the insurers are dragged into the fray as well. The rhetoric is tired and worn on both ends.  Is it the folks with chronic diseases like diabetes? Is it the folks who need dialysis? The smokers? The patients who do not follow the doctors’ advice and stay sick and expensive? The people who want ‘everything done’ at the end of life? Is it the doctors who acquiesce to patient demands or the laws that obligate them to do so? Do doctors order too many expensive tests, bleeding insurance system? Is it the liability insurance that must cover them if they fail to order a test? Maybe it is the insurance companies paying high salaries to executives while handing down ever-shrinking reimbursements pressing institutions to find new ways to eek out enough income to sustain an operating budget. Newer to this menu are penalties for staying in the hospital too long and coming back too soon. This latest addition to the list is perhaps among the most absurd.</p> <p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 20px;">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 <a style="text-decoration: underline; color: #000099;" href="/Academic/bioethics/index.cfm">website</a>.</strong> </p>
April 13, 2014

Why Health Coaching Helps

<p>A coach <a href="http://www.merriam-webster.com/dictionary/coach">is defined</a> as a person who is tasked with teaching or training others, usually in conjunction with athletic endeavors. When this term is applied to health, we often presume the coach is a personal trainer of sorts, focusing on optimizing fitness and nutrition for those who can afford the fee for this level of personal attention. Over the last few years, however, there has been a growing movement to provide a different kind of health coaching within the medical arena for patients who have difficulty adhering to health related regimens for medication, office visits, and management of chronic medical problems. This endeavor has been found to work for many reasons, but remains in the wings of the contemporary healthcare industry.</p> <p class="MsoNormal">The first time I read about the concept of community based health coaching was via Atul Gwande’s article “The Hot Spotters” published in 2011 in <em><a href="http://www.camdenhealth.org/wp-content/uploads/2011/03/Gawande-Camden-Annals_17.pdf">The New Yorker</a></em> magazine included here in its entirety for interested readers. What resonated for me was the <a href="http://www.newyorker.com/reporting/2011/01/24/110124fa_fact_gawande">comment from one recipient</a> who stated that the coach was effective because of the way the advice and encouragement and nudging was delivered, “Because she talks like my mother” implying that there is understanding, concern, and discipline delivered as the underlying message between coach and patient. I think most good athletic coaching is the same. While success is not measured in trophies, medals, or college scholarships when it comes to medical coaching, the potential for life changing outcomes are very real. And the opportunities for cost savings are very real as well.</p> <p class="MsoNormal"><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 20px;">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 <a style="text-decoration: underline; color: #000099;" href="/Academic/bioethics/index.cfm">website</a>.</strong></p>
February 18, 2014

Health Insurance Execs Watch Patient Battle Cancer

This story from The Onion, which is a parodic source of "news," is really funny.What makes it especially funny is that it's so far-removed from the truth. Really. Far-removed. Really. I swear. Hardly true at all.
February 12, 2014

Sacrifice and Fairness in Healthcare Reform: Lessons from Nature

<p>During a long cold drive home a couple weeks ago, there was a broadcast on NPR about efforts to help promote the survival of the rare northern spotted owl. The controversy has not centered on the importance of saving the spotted owl, but on whether or not it is ethically acceptable to hunt the barred owl which has moved into territory thereby dangerously threatening the spotted owl population. The barred owl is also an “at risk” species, but has been thriving in the northwestern forests where the spotted owls had fed, bred, and nested.  The government faced a “Sophie’s choice” (Shogran 2014, <a href="http://www.npr.org/2014/01/15/262735123/to-save-threatened-owl-another-species-is-shot">NPR</a>),  and reluctantly accepted the morally disturbing decision to kill 3600 barred owls in order to try to help the spotted owl maintain a sustainable population.  This distressing environmental dilemma serves as a unique analogy for responsible business decisions related to healthcare. We can turn to business ethics here, which offers the “precautionary principle” (Weber 2001, 134) whereby avoiding harm and meeting the needs of a community requires that if any deleterious action is going to be taken, the proponents of the activity must establish that safety is the intent and there is no other way to accomplish the task than to inflict some degree of harm. Though the cause of reduced numbers of <a name="_GoBack"></a>spotted owls and the migration of barred owls is related to man’s stripping timber from the natural habitats of each, the solution needs to balance the competing interests in the existing ecosystem. Similarly, people seeking healthcare in the US are not to blame for the economic woes of our system but it seems compromises from everyone will be needed in order to assure a basic level of service for all.</p> <p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 20px;">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 <a style="text-decoration: underline; color: #000099;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong></p>
March 27, 2013

The requirement of health: how companies could discriminate

Gioia Zucchero, M.A.

Recently, the drugstore CVS Caremark implemented a health policy that if an employee would like to be covered through the company’s medical plan, he or she is required to submit information about how much they weigh, their body fat percentage and glucose levels…or else face a monetary penalty each month.…

March 7, 2013

The Boss Is Watching You

Craig Klugman, Ph.D.

Do you smoke? Do you exercise? Do you have a yearly physical with your physician? Your answers to these questions could have an affect on the cost and coverage of your health insurance.…