Saturday, June 27, 2009

Why New Mexico Needs Health Reform

From a HHS:
With each passing year, Americans are paying more for health care coverage. Employer-sponsored health insurance premiums have nearly doubled since 2000, a rate three times faster than wages.(1) In 2008, the average premium for a family plan purchased through an employer was $12,680, nearly the annual earnings of a full-time minimum wage job.(2) Americans pay more than ever for health insurance, but get less coverage.

THE HEALTH CARE STATUS QUO:

Congress and the President are (supposedly. W) working to enact health care reform legislation that (purportedly. W) protects what (reputedly. W) works about health care and (allegedly. W) fixes what is broken. New Mexicans know that inaction is not an option. Sky-rocketing health care costs are hurting families, forcing businesses to cut or drop health benefits, and straining state budgets. New Mexicans are paying more for less. Families and businesses in New Mexico deserve better.
(So, then, why is Obama/HSS supporting measures that won't do what they are promising they will do, and opposing and rejecting the only alternative that wou.ld fix the problems??? W.)
NEW MEXICANS CAN’T AFFORD THE STATUS QUO

* Roughly 933,000 people in New Mexico get health insurance on the job(1), where family premiums average $13,050, about the annual earning of a full-time minimum wage job.(2)
* Since 2000 alone, average family premiums have increased by 110 percent in New Mexico.3
* Household budgets are strained by high costs: 21 percent of middle-income New Mexico families spend more than 10 percent of their income on health care.(4)
* High costs block access to care: 16 percent of people in New Mexico report not visiting a doctor due to high costs.(5)
* New Mexico businesses and families shoulder a hidden health tax of roughly $2,300 per year on premiums as a direct result of subsidizing the costs of the uninsured.(6)

AFFORDABLE HEALTH COVERAGE IS INCREASINGLY OUT OF REACH IN NEW MEXICO

* 23 percent of people in New Mexico are uninsured, and 70 percent of them are in families with at least one full-time worker.(7)
* The percent of New Mexicans with employer coverage is declining: from 51 to 48 percent between 2000 and 2007.(8)
* Much of the decline is among workers in small businesses. While small businesses make up 73 percent of New Mexico businesses,(9) only 35 percent of them offered health coverage benefits in 2006 -- down 4 percent since 2000.(10)
* Choice of health insurance is limited in New Mexico. HCSC (Blue Cross Blue Shield) alone constitutes 35 percent of the health insurance market share in New Mexico, with the top two insurance providers accounting for 65 percent. (11)
* Choice is even more limited for people with pre-existing conditions. In New Mexico, premiums can vary, within limits, based on demographic factors and health status, and coverage can exclude pre-existing conditions or even be denied completely.
To reiterate: So, then, why is Obama/HSS supporting measures that won't do what they are promising they will do, and opposing and rejecting the only alternative that would fix the problems??? W.
NEW MEXICANS NEED HIGHER QUALITY, GREATER VALUE, AND MORE PREVENTATIVE CARE

* The overall quality of care in New Mexico is rated as “Weak.” (12)
* Preventative measures that could keep New Mexicans healthier and out of the hospital are deficient, leading to problems across the age spectrum:
o 16 percent of children in New Mexico are obese.(13)
o 26 percent of women over the age of 50 in New Mexico have not received a mammogram in the past two years.
o 44 percent of men over the age of 50 in New Mexico have never had a colorectal cancer screening.
o 70 percent of adults over the age of 65 in New Mexico have received a flu vaccine in the past year. (14)

The need for reform in New Mexico and across the country is clear. New Mexico families simply can’t afford the status quo and deserve better. President Obama (says he) is committed to working with Congress to pass health reform this year that reduces costs for families, businesses and government; protects people’s choice of doctors, hospitals and health plans; and assures affordable, quality health care for all Americans.
I repeat: So, then, why is Obama/HSS supporting measures that won't do what they are promising they will do, and opposing and rejecting the only alternative that would fix the problems??? Now, if someone who knows how all this misery and misfeasance can be corrected by the "Obama Plan," or anything like it, send up a fucking flare?
Endnotes:
1 U.S. Census Bureau, Current Population Survey. HIA-4 Health Insurance Coverage Status and Type of Coverage by State--All Persons: 1999 to 2007, 2007.
2 Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2006, Table X.D.
Projected 2009 premiums based on Centers for Medicare and Medicaid Services, "National Health Expenditure Data," available at http://www.cms.hhs.gov/nationalhealthexpenddata/.
3 Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2000, Table II.D.1.
Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2006, Table X.D.
Projected 2009 premiums based on Centers for Medicare and Medicaid Services, "National Health Expenditure Data," available at http://www.cms.hhs.gov/nationalhealthexpenddata/.
4 Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2006.
5 Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2007.
6 Furnas, B., Harbage, P. (2009). "The Cost Shift from the Uninsured." Center for American Progress.
7 U.S. Census Bureau, Current Population Survey. Annual Social and Economic Supplements, March 2007 and 2008.
8 U.S. Census Bureau, Current Population Survey. HIA-4 Health Insurance Coverage Status and Type of Coverage by State--All Persons: 1999 to 2007, 2007.
9 Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2006, Table II.A.1a.
10 Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2001, 2006, Table II.A.2.
11 Health Care for America Now. (2009). "Premiums Soaring in Consolidated Health Insurance Market." Health Care for America Now.
12 Agency for Health Care Research and Quality. 2007 State Snapshots. Available http://statesnapshots.ahrq.gov/snaps07/index.jsp.
13 Child and Adolescent Health Measurement Initiative. 2007 National Survey of Children's Health, Data Resource Center for Child and Adolescent Health.
14 Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2007.
"Calling Martin Heinrich!" Martin Heinrich! Martin Heinrich? Please answer The Red courtesy phone? Mr. Heinrich! Please Answer Your Citizen/ (as opposed to your Corporat) Constituents:

Why the fuck haven't you signed on to HR 676?

1 comment:

mikeoli said...

I advise on several health insurance boards such as http://www.benefitsmanager.net , http://www.bcbstx.info , and http://www.healthinsurancesource.net. I often quote the Switzerland health care system as an example of tough questions that we as a nation will have to answer someday, if we go down the path of nationalized government health care plan. We’ll have to at some point draw the line in the sand and refuse further care for patients receiving critical illness treatments, intensive care unit, trauma care, acute management services, disease management, neonatal intensive-care unit for newborns and seniors in extended care treatment nearing hospice stage . Did you know that premature babies are not resuscitated upon birth if they cannot draw breath in Switzerland? Did you also know that holds true with “senior care” experiencing system failure or multiple organ failures requiring support? Another example, they don't extend the life of a senior via medical equipment such as intubation or respiration for multiple organ failures. Not to be morbid….they are unplugged and allowed to pass. Anyone in the business of paying claims knows that the single most expensive bill in what carriers call “shock loss” is within NICU for newborns and seniors in acute / intensive care / hospital in the last three months of life.
The Swiss apparently made decisions made based upon cost vs. quality outcome. Are we as a nation prepared to make that type of decision or to define when to incubate, resuscitate a newborn or a senior? Are we ready to define the conditions and rules of medical procedures with organ failure? With a litigious society I think not. This is why we need TORT REFORM. Without TORT REFORM medical provider costs will never drop. Liability costs with medical providers are nearly half of operating expenses. Humana health plans state that their costs of medical liability and defensive medicine accounts for nearly 10 cents out of every premium dollar collected. Compare that to Humana’s reported pharmaceutical claims of 15 cents out of every premium dollar collected. Or better yet, 21 cents out of every premium dollar collected is paid back to physicians for physician treatments. The cost of litigation is only obvious with Humana health plans. I sit on the board with several other health insurance carriers. Their books all show similar costs. They basically insure a shrinking populace that is mostly made up of people that only buy insurance because they need it. So is mandatory participation such a bad idea?
I don't think we are hearing about TORT REFORM because most of the house and senate on the federal level are lawyers and have practicing law firm interest’s. In the healthcare system there is no total innocence. We hear about insurance executives with bonuses, doctors overbilling, hospitals overbilling because the street gang thug got dropped at their ER door with no insurance. The lawyers are there to stir the pot and promise lavish fortune at the end of the PERCEIVED misery chain. Am I saying we don’t need them? No, but I am saying there is clear and documented abuse of the legal system that awards outlandish claims in the millions for a questionable mistake. Are ambulance chasers not sociably recognized as being the most abusive? What about those that educate their clients on defraud and then use the legal system to pirate insurers?
I sure wouldn’t want to be on the receiving end of these serious decisions that we will have to make. My senator claims that the government would be held blameless but what about the medical provider that has to make the call? What about the insurance payer that has to deny continued care for an infant that will not survive? Without serious TORT REFORM we aren’t going to get costs down or have good people make headway.