Tag: "Health Care Access"
A new report from the Pew Charitable Trusts reports that 41 states experienced growth in their correctional health care spending from fiscal 2007-2011, with a median increase of 13%. Further:
…state spending on prisoner health care increased from fiscal 2007 to 2011, but began trending downward from its peak in 2009. Nationwide, prison health care spending totaled $7.7 billion in fiscal 2011, down from a peak of $8.2 billion in fiscal 2009. In a majority of states, correctional health care spending and per-inmate health care spending peaked before fiscal 2011. But a steadily aging prison population is a primary challenge that threatens to drive costs back up. The share of older inmates rose in all but two of the 42 states that submitted prisoner age data. States where older inmates represented a relatively large share of the total prisoner population tended to incur higher per-inmate health care spending.
The Left often attacks Texas as a holding pen of uninsured people. 5.7 million residents do not have health insurance. Yet only 733,757 signed up for Obamacare. And many of them dropped or lost insurance that they had before Obamacare launched. John Davidson of the Texas Public Policy Foundation figures that maybe only three percent of eligible, uninsured Texans signed up for Obamacare. According to Davidson, “The most likely reason is cost. Premiums on the exchange are significantly higher than average pre-ACA premiums on the individual market in Texas. Although subsidies offset these premium costs for some Texans, those earning about 250 percent of the federal poverty limit (FPL), or $29,175 per year, cannot expect their subsidy to significantly reduce premiums.”
In the New Republic, Adam Teicholz and Glenn Cohen discuss insurers whose provider networks run across the border:
Before dawn on a Wednesday in January, Cesar Flores, a 40-year-old employed by a large retail chain, woke up at his home in Chula Vista, California. He got in his car and crossed the border into Tijuana. From there, he headed for a local hospital, where he got lab tests — part of routine follow-up to a kidney stone procedure. He had his blood drawn and left the hospital at 7:30. He arrived home before 10.
But Flores’s situation isn’t medical tourism as we know it. Flores has insurance through his wife’s employer. But his insurer, a small, three-year-old startup H.M.O. called MediExcel, requires Flores to obtain certain medical treatment at a hospital across the border. In part due to cost-pressures generated by the Affordable Care Act, other sorts of plans that require travel have the potential to expand.
Over at Forbes, Bruce Japsen reports that the Affordable Care Act is boosting demand for primary care providers. As we’ve said before, Obamacare does nothing to boost physician supply. The millions of newly insured will increase their demand for medical care — and someone has to provide it. This has caused a Gold Rush of sorts among medical practices and hospitals scrambling for primary care providers.
Physician staffing firm, MerrittHawkins reports primary care providers — family physicians and internists tops the list. The number of requests for nurse practitioners and physicians’ assistants it’s been ask to recruits is up more than three times (i.e. 320 %). Advance practice nurses and physicians’ assistants didn’t even make the top 20 of most recruited medical practitioners three years ago. Here’s the current list.
In many cases, increased use of nurse practitioners and physician assistants can provide high quality care at reduced costs. I have long advocated increasing these professionals’ scope of practice as an important part of innovation in delivering medical care. On the other hand, this should happen as a consequence of increased consumer-direction of healthcare spending, not as a response to increased government control, as imposed by Obamacare.
From the Congressional Budget Office and the Joint Committee on Taxation:
CBO and JCT estimate that 23 million uninsured people in 2016 will qualify for one or more of those exemptions. Of the remaining 7 million uninsured people, CBO and JCT estimate that some will be granted exemptions from the penalty because of hardship or for other reasons.
All told, CBO and JCT estimate that about 4 million people will pay a penalty because they are uninsured in 2016 (a figure that includes uninsured dependents who have the penalty paid on their behalf). An estimated $4 billion will be collected from those who are uninsured in 2016, and, on average, an estimated $5 billion will be collected per year over the 2017–2024 period.
Earlier this month, Colorado governor John Hickenlooper signed the nation’s first “right to try” law. The law allows a patient suffering from a disease, for which no medicine has been approved by the FDA, to try an experimental new medicine before the FDA approves it. The law allows, but does not force, drug-makers to provide their experimental drugs to patients. Other states, such as Louisiana and Missouri, are set to follow.
These patients are in dire straits. They suffer from diseases for which there is no other cure, and have short life expectancies. Most of us cannot imagine being in their position: They are willing to take far greater risks than most would accept, in their search for a cure.
Although the Food and Drug Administration (FDA) has an exemption for “compassionate use”, that exemption requires jumping through too many bureaucratic hoops to be useful. So, scholars at the Goldwater Institute developed the idea of state “right to try” laws that would enable residents to use experimental new drugs without FDA approval.
Many of ObamaCare’s advocates believe that the proportion of a household’s income spent on health care is an appropriate measure of how effective health insurance is at doing its job. If a household spends ten percent or more of income on health care, it is said to be “underinsured” by the Commonwealth Fund or the Kaiser Family Foundation. Five percent is the cut-off for low-income households.
According to that standard, ObamaCare fails miserably at insuring low-income households:
In Washington, one in four individuals in households earning less than 250% of the poverty level signed up for a bronze plan with a deductible of $5,000-$6,350 per person and $10,000-$12,700 per family. Even after premiums, these households could face medical costs ranging from 17% to 40% of income before ObamaCare’s non-preventative-care benefits kick in.
Beyond the premium subsidies that the law provides, households earning up to 250% of the poverty level qualify for cost-sharing assistance. It can greatly reduce the deductible that must be exhausted before benefits kick in and, after that, the co-payments required for medical services and prescription drugs. But those cost-sharing subsidies are available only for those who buy silver-level coverage…
Source:Investor’s Business Daily.