Health Policy Briefs
Compiled by Benita M. Dodd
ObamaCare sticker shock: Atlanta insurers were included in a six-market survey released this month on how much the multiple mandates in the federal health law will cost ordinary Americans. “The findings highlight the sticker shock in health care premiums that awaits the relatively young and healthy in both the small group and individual markets as the [Affordable Care Act] is fully implemented. The survey finds the cost of premiums for this group will increase by an average of 169 percent,” the report said. The other insurers were in Chicago, Phoenix, Milwaukee, Austin, Texas, and Albany, N.Y. For younger and healthier individuals and small businesses, Atlanta predictions are for a 167 percent increase in premiums in 2014.
Accuracy and speed: The U.S. Food and Drug Administration has approved a drug from Denmark’s Dako that will reduce the turnaround for cancer diagnosis from two days to 3-1/2 hours. Company executives say the new technology will ease the waiting time and associated anxiety for the patient and allow physicians to more quickly initiate targeted cancer treatments.
What would you do? If you had late-stage cancer that isn’t responding to other therapies, would you risk a new drug that could kill you? The U.S. Food and Drug Administration has approved a new drug made by Swiss drugmaker Roche Holding. Kadcyla, also known as ado-trastuzumab emtansine, will be for late-stage breast cancer patients whose cancer cells contain increased amounts of a protein known as HER2. The drug’s label will carry a boxed warning, the most serious possible, of the Kadcyla’s potential to cause liver and heart damage or even death. The drug can also cause life-threatening birth defects. Still, fewer patients in a clinical trial experienced severe side effects than those who received standard therapy.
Did you know? Breast cancer is the second leading cause of cancer-related death among women. An estimated 232,340 women will be diagnosed with breast cancer, and 39,620 will die from the disease in 2013, according to the National Cancer Institute. It is rare, but men get breast cancer, too: The NCI estimates there will 2,240 cases of men diagnosed with breast cancer, with 410 deaths.
If you use more should you pay more? The federal Patient Protection and Affordable Care Act largely prohibits insurers who sell individual and small-group health policies from charging women higher premiums than men for the same coverage. But the same doesn’t go for long-term care insurance, and the country’s largest provider of such coverage has announced it will begin setting its prices based on sex this spring – meaning premium increases for women of 20-40 percent. Genworth Financial says the new pricing reflects the fact that women receive two of every three claims dollars. The change will affect only women who buy new individual policies, or about 10 percent of all purchasers, according to the company. The new rates won’t be applied to existing policyholders or those who apply as a couple with their husbands. (IMHO, if men saw the doctor as much as they needed to, perhaps they’d live as long as women do!) Source: Kaiser Health News
More on long-term care: The California Public Employees’ Retirement System (CalPERS) has informed its 110,000 policyholders that an 85 percent increase in premiums for long-term care insurance premiums will take effect in 2015. CalPERS said the hefty rate hikes are needed to keep the $3.6-billion insurance fund intact for future claims. Like other plans sold by private insurers, the program has been plagued by higher-than-expected claims, lower investment returns and poor pricing.
Insurance can’t hike premiums for age: Young and healthy or older and ailing, the federal government maintains that insurers will not be allowed to charge older people more than three times the amount they charge younger people starting in 2014. Insurers have been pushing to change the law to allow them to vary premiums by as much as a 5:1 ratio, and had hoped the administration would write the rules in a way that phased in the change. “The new restrictions on age rating will result in an overnight increase in health care costs for people in their 20s, 30s and early 40s,” said Karen Ignagni, president of America’s Health Insurance Plans, an insurance trade association. She added, “This increases the likelihood that younger, healthier people forgo purchasing insurance until they are sick or injured. When this happens, costs go up for everyone, young and old.” Source: Reuters
But states can cut pay to physicians: The Obama administration said Monday that states could cut Medicaid payments to many doctors and other health care providers to hold down costs in the program, which insures 60 million low-income people and will soon cover many more under the new health care law. (Good luck finding physicians who will work for less.) Source: New York Times
States leaving it to the feds: The Obama administration will be running new health insurance marketplaces in at least 26 states, including Georgia. The federal government had hoped more states this week would agree to form a partnership exchange by the deadline of February 15, but the offer was largely rebuffed. New Jersey, Ohio and Florida, several of the biggest states that had not declared their intentions, officially said no late in the week. Last week, Florida Gov. Rick Scott announced that he would back expanding Medicaid for three years, the amount of time the federal government picks up the whole cost. The Republican governor still must get the Legislature to go along.
Medicaid expansion: better or worse? Manhattan Institute Senior Fellow Avik Roy notes a report from The University of Virginia found, “Medicaid patients were almost twice as likely to die as those with private insurance; their hospital stays were 4 percent longer, and cost 26 percent more. Compared to those without health insurance, Medicaid patients were 13 percent more likely to die, stayed in the hospital for 50 percent longer, and cost 20 percent more.”
R.I.P. America’s Doctor: Dr. C. Everett Koop, who was widely regarded as the most influential surgeon general in American history and played a crucial role in changing public attitudes about smoking, died on Monday at his home in Hanover, N.H. He was 96. He was nominated by President Ronald Reagan, and the confirmation of the controversial physician took eight months. He was Surgeon General from 1981-1989. Source: Washington Post
Quotes of Note
“There was a May 1993 article in The Wall Street Journal. They quoted an economist named James Ukockis and accurately quoted him as saying you can’t sufficiently suspend the laws of economics to control both price and quantity at the same time. And when I look at health care reform, the goals are high-quality health care at a low cost and access for all. Everybody wants that, but the problem is that violates the laws of economics. You can’t control price and quantity at the same time.” – Pat McConnell, CFO of West Park Hospital in Cody, Wyo.
“State lawmakers must recognize that states are not mere agents of the federal government. They are not powerless, and there is nothing that requires them to assist in implementing this new, misguided federal health care agenda. They should assert their rightful authority, and represent and protect their citizens by resisting the disruptions entailed in ObamaCare – taking actions that pressure the next Congress to scrap or redesign this harmful federal legislation.” – Edmund F. Haislmaier and Brian C. Blasé, “Obamacare: Impact on States,” July 1, 2010
“Time and health are two precious assets that we don’t recognize and appreciate until they have been depleted.” – Denis Waitley