The most important health-care document released this week was not Sen. Max Baucus's Healthy Future Act. It was the Kaiser Family Foundation's 2009 Employer Benefits Survey.
While the proposal by Baucus, chairman of the Senate Finance Committee, outlines a direction for policy, the survey, which polls employers about health benefits to assemble a detailed look at the actual cost of health care, fits it squarely in our pocketbooks.
The truth is we all pay, and much more than we recognize, for health care.
For many, it's among the largest investments we'll make, on par, even, with the money we spend on a house or tuck away for retirement. But while it's easy to track our stock portfolios as they tank along with the market, our outlay for health care is less obvious. Employers pay some, and so do individuals, and taxpayers. And some even hides behind the deficit. As such, few of us see the full picture. But to make sense of the proposals for reform, getting a grasp of the cost is critical.
The average health-care coverage for the average family now costs $13,375, according to Kaiser. Over the past decade, premiums have increased by 138 percent. And if the trend continues, by 2019 the average family plan will cost $30,083.
Three years of slightly above-average health insurance will cost a solid six figures.
Those are numbers to marvel at. Those are numbers to fear. But they are not the numbers that loom in the minds of most Americans. And therein lies the problem for health-care reform.
About 160 million Americans receive health coverage through their employers. In general, the employer picks up 73 percent of the tab. This seems like a good deal. In reality, that money comes out of wages.
As Ezekiel Emanuel, who advises Office of Management and Budget Director Peter Orszag on health-care policy, has pointed out, health-care premiums have risen by 300 percent over the past 30 years (and that's after adjusting for inflation). Corporate profit per employee has soared by 200 percent. Hourly earnings for workers, adjusted for inflation, have fallen. The wage increases have been consumed by health-care costs.
Another 80 million Americans are on public plans, mainly Medicare and Medicaid. Those costs are paid by taxpayers. And about 46 million Americans are uninsured. The costs for their care are shifted to the insured: This raises premiums for the average family by $1,100 each year, according to an analysis by Ben Furnas and Peter Harbage of the Center for American Progress.
Imagine if people who touched a hot stove felt only a small fraction of the pain from the burn. That's pretty much what's happening in our health-care system. It hurts enough that we would prefer it to stop, but the urgency is lost. Read it all at the Washington Post.
Employers struggling with the steady rise of health insurance costs – which in 2009 increased 5 percent to an average of $13,375 for family coverage -- are passing on more of the expense to their workers through higher deductibles and co-payments, according to survey released today. Since 1999, health insurance premiums have soared 131 percent -- more than triple the rise in workers' wages and four times the overall inflation rate, the report said.
Paul Fronstin, senior research associate at the Employee Benefit Research Institute, said that "employers see raising deductibles as the easiest way to control costs." The higher deductibles are one reason why premiums have been going up more slowly in recent years. "It’s a crude instrument, but it does the job," he said. Read it all at Kaiser Health News
Physicians’ Views on a New Public Insurance Option and Medicare Expansion
63% overall support public option and 10% support single payer = 73% support public plan.
The voices of physicians in the current debate have emanated almost exclusively from national physicians’ groups and societies. Like any special-interest group, these organizations claim to represent their members (and often nonmembers as well). The result is a well-established understanding of the interests of physicians’ societies but little, if any, understanding of views among physicians in general. Faced with this absence of empirical data, we conducted a national survey of physicians to inform federal policymakers about physicians’ views of proposed expansions of health care coverage. Survey respondents were asked to indicate which of three options for expanding health insurance coverage they would most strongly support: public and private options, providing people younger than 65 years of age the choice of enrolling in a new public health insurance plan (like Medicare) or in private plans; private options only, providing people with tax credits or subsidies, if they have low income, to buy private insurance coverage, without creating a new public plan; or a public option only, eliminating private insurance and covering everyone through a single public plan like Medicare. We also assessed the level of physician support for a proposal that would enable adults between the ages of 55 and 64 years to buy into the current Medicare program — a strategy that the Senate Finance Committee has proposed. Overall, a majority of physicians (62.9%) supported public and private options (see Panel A of graph). Only 27.3% supported offering private options only. Respondents — across all demographic subgroups, specialties, practice locations, and practice types — showed majority support (>57.4%) for the inclusion of a public option (see Table 1). Primary care providers were the most likely to support a public option (65.2%); among the other specialty groups, the “other” physicians — those in fields that generally have less regular direct contact with patients, such as radiology, anesthesiology, and nuclear medicine — were the least likely to support a public option, though 57.4% did so. Physicians in every census region showed majority support for a public option, with percentages in favor ranging from 58.9% in the South to 69.7% in the Northeast. Practice owners were less likely than nonowners to support a public option (59.7% vs. 67.1%, P<0.001), but a majority still supported it. Finally, there was also majority support for a public option among AMA members (62.2%).  Panel A shows the proportion of survey respondents who favored public options only, those who favored both public and private options, and those who favored private options only. Panel B shows the proportions of respondents (according to their medical specialty) who supported, opposed, or were undecided about the expansion of Medicare to include adults between the ages of 55 and 64 years. The proportion of support was consistent across all four specialty groups (P=0.08).
Read it all in the New England Journal of Medicine
Rising health care costs are the single biggest economic concern facing American businesses, according to a survey of business leaders released today by Business Forward.
Nearly 90% of those polled cite health care costs as a major concern, more than cite taxes, government regulation, labor costs or energy costs.
Without reform, 86% of those polled believe that health care costs will continue to rise in the next five years, and 55% believe it will go up "a lot." If costs continue to rise as expected, nearly 9 out of 10 business leaders expect to raise their employees' deductibles and copayments. Nearly 8 out of 10 expect to cut benefits. And nearly one in three expects to lay off employees. The survey also indicates that the surge in interest among business leaders during the 2008 campaigns is likely to continue -- and it could have a big impact on Washington. One in three business leaders became more involved in the 2008 campaign than in previous campaigns, and nearly nine out of ten of those leaders expect to be even more involved in future campaigns.
Business Forward is a new organization dedicated to building business support for policies that promote America's economic competitiveness, particularly those that relate to health care, energy, the environment and education. Business Forward briefs business leaders on key issues, holds conferences and press events, issues policy briefings and engages in other public advocacy initiatives. Read it all
Americans at Risk: "To find out how many people are affected by being uninsured, Families USA commissioned The Lewin Group to analyze data from the Census Bureau’s Current Population Survey (CPS) and its Survey of Income and Program Participation (SIPP), as well as from the Medical Expenditure Panel Survey (MEPS), which is conducted by the Agency for Healthcare Research and Quality. This analysis found that 86.7 million people—one out of every three Americans under the age of 65—was uninsured for some period of time during 2007 and 2008. These Americans have had to pay for medical care out of their own pockets, or they have had to delay needed care altogether.
Who are these uninsured Americans? No one is protected from the risk of uninsurance. People in all age groups, of every race and ethnicity, and across all income ranges are affected. While most of us have health insurance through our jobs, four out of five uninsured Americans are from working families. Many of these working families are at great risk today as more and more workers get laid off and lose their ability to retain health coverage.
This report offers a closer look at the number of uninsured Americans, who they are, and how long they are uninsured. We also discuss the major underlying reasons for the growth in the number of uninsured."
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