By Jan Greene
Wasn't that some culture's curse — may you live in interesting times? Well, in healthcare we're smack in the middle of interesting times, and they don't want to let up.
I've been busy with work (a good thing for a freelance writer! A bad thing for a blogger!) so I've been remiss in posting. Meanwhile, lots of action to be noted:
–AHIP, the trade association for health plans, is meeting just across the bay from me this coming weekend, and proponents of single payer (government-sponsored) health coverage will be outside promoting their cause. That should be interesting…a little street theater at San Francisco's Moscone Center usually jazzes up a slow summer news day. And maybe that's the kind of energy it will take to get some kind of reform happening somewhere, somehow.
–Yet another Commonwealth Fund report following the experiences of the underinsured finds that their ranks have grown from 16 million to 25 million since 2003 — a 60 percent increase! This is interesting because people with inadequate health insurance tend to get ignored in policy discussions focused on covering more people with no insurance at all. But these folks are often employed, maybe work for themselves, are paying an insurer for "coverage" and yet face big out-of-pocket expenses anyway. The Commonwealth Fund found that 45 percent of these people have an outstanding medical debt and 53 percent of them went without needed care because of costs.
The other interesting piece of this study is its mention of the various ways that health plans are being winnowed away and not just with high deductibles (the dollars you pay before coverage kicks in). Health plan designers are finding creative ways to cut costs, and in ways that the average consumer might not notice until she trips on them — limiting the total amount the plan will pay for medical care, limiting the number of physician visits.
–The wordplay around "consumer-directed" continues to be an interesting topic of discussion. It's the flavor of the month in the healthcare industry but some consumer advocates believe the term is a palatable-sounding shield for making individuals pay more out of pocket for their care. Writing on the Health Affairs blog, Ron Cunningham, an editor at the journal, makes the the point nicely:
But the policy community understands, and pardons with an ironic wink,
the gamesmanship involved in labeling as “consumer-directed health
care” those recent insurance benefit redesigns that increase
deductibles and patient cost sharing. When did consumers ever stand up
and demand that they be allowed to pay more when they are sick?
Meanwhile, back at the ranch (we'll see how many of you young'uns catch that reference), I'm checking out a redesigned medical price information service provided by an outfit called change:healthcare. Its Medstimate is supposed to be new and improved and based on a wide variety of sources. We'll see if it measures up and I'll report back next time.