Tuesday, May 20, 2008

Health

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On Health and Money Blog -- U.S. News & World Report

Avoiding a Disabling Mistake

May 15, 2008 05:58 PM ET | Michelle Andrews | Permanent Link

And now for something completely different: a tax code change that actually makes life easier for people, in this case husbands and wives who run small businesses together and want financial protection if they become disabled.

Of course, everyone faces this risk. It gets higher the older we get as brittle bones, heart disease, and all the rest make unwelcome inroads into our otherwise able-bodied, never-miss-a-day-of-work selves. A 20-year-old worker has a 30 percent chance of becoming disabled before retirement, according to the Social Security Administration. "To the extent that husbands and wives go into business together, and if they stay in business together, there's a very good chance someone will become disabled," says Andrew Imparato, president and CEO of the American Association for People with Disabilities.

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Tags: health insurance | insurance | taxes | marriage

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Healthcare Reform, by the Commonwealth Fund

May 13, 2008 02:47 PM ET | Michelle Andrews | Permanent Link

Imagine this: a healthcare system that provides coverage for nearly everyone and lowers insurance costs for individuals and small businesses by 30 percent. Sound too good to be true? It may well be. But let's take a look at it anyway. The new plan, developed by the Commonwealth Fund and published today in the journal Health Affairs, is similar in many particulars to the proposals put forward by the Democratic presidential candidates. But unlike the candidates' plans, this one offers specifics about costs to individuals and businesses. The numbers can certainly be disputed—that 30 percent cost savings seems awfully optimistic—but given our regular diet of lofty but not always satisfying campaign rhetoric, this provides food for thought.

Like the Democrats' plans, the Commonwealth Fund proposal would create a new national "connector" through which small businesses and individuals could buy insurance, either a souped-up "Medicare Extra" plan through the federal government or private insurance. Everyone would be required to have coverage, but insurers couldn't turn anyone away or charge people an arm and a leg because they're sick. The program would expand Medicaid and SCHIP coverage for low-income adults and children to all those earning less than 150 percent of the poverty level (about $15,000) and provide tax credits for everyone to make premiums more affordable. Employers would be required to either provide health insurance or contribute to a pool to help pay for coverage.

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Tags: Democrats | healthcare | health insurance | Medicare | presidential election 2008 | reform

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An Experiment With Concierge Medical Care

May 08, 2008 02:39 PM ET | Michelle Andrews | Permanent Link

You'd expect to find a concierge medical practice in Palm Beach, Fla. These high-touch, personalized practices that give patients 24/7 access to doctors who keep close tabs on their care generally cost a few thousand dollars a year. That's more than many people who are already struggling just to cover their healthcare premiums and copayments can afford.

So I was surprised to learn of a Florida concierge practice that's offering its 24-karat care free to a select group of 25 people with incomes at 200 percent of the poverty level or less ($42,400 for a family of four). It's all happening under the auspices of the Palm Beach County Medical Society's Project Access, which provides nonemergency medical care to hundreds of residents in this mostly rural county, people who don't show up in the society pages and aren't well to do.

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Tags: Florida | doctors | healthcare | charity

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HSAs, Favored by McCain, Grow in Number—Slowly

May 01, 2008 03:58 PM ET | Michelle Andrews | Permanent Link

They may have grown 35 percent in the past year, but the fact is that health savings account (HSA) plans—which are high-deductible health plans that can be linked to tax-advantaged health savings accounts—are still pretty thin on the ground. In 2007, the number of Americans covered by these plans grew to 6.1 million, up from 4.5 million the year before, according to a new survey by America's Health Insurance Plans, a trade group. With total private insurance coverage topping 170 million, however, that's small potatoes indeed.

In case you haven't come across them, these plans (also sometimes described as consumer-driven health plans, though that phrase can also refer to other plans) must have a deductible of at least $2,200 for families and $1,100 for individuals in 2008, among other criteria. An HSA that links to the plan allows people to accumulate money tax free to pay for medical expenses.

...continue reading.

Tags: healthcare | health insurance | John McCain

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Marriage, in Sickness and for Health Insurance

April 29, 2008 12:14 PM ET | Michelle Andrews | Permanent Link

After 12 years of unwedded bliss, two friends of mine recently got married. The reason: Her job offers health insurance benefits to married couples but not unhitched cohabiting ones. Now it turns out these two may have been at the leading edge of a trend. According to a new poll, 7 percent of respondents said they or someone they lived with decided to get married in the last year in order either to have access to health insurance benefits or to give their new spouse access.

And they say romance is dead. At a time when the typical family health plan costs upwards of $12,000 a year, sharing a group policy number is more than a token way to say "I love you." It's a hefty commitment, giving new meaning to "in sickness and in health."

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Tags: healthcare | health insurance | marriage

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Wealth Lowers Stroke Risk, No Surprise

April 24, 2008 04:13 PM ET | Michelle Andrews | Permanent Link

Money can't buy you love or happiness, but it may protect you from having a stroke. That's the takeaway from a new study in the journal Stroke, released today. Researchers found that the least wealthy were three times more likely to have a stroke between ages 50 and 64 compared with those who were in the top 75th to 89th percentile in wealth (the very wealthiest outliers were excluded). Once people hit 65, however, all bets were off, and wealth no longer afforded them protection.

The study examined the effect of education, income (annual earnings), and wealth (all housing and financial assets) on nearly 20,000 participants in the ongoing University of Michigan Health and Retirement Study. It's the first study to find that wealth predicts stroke incidence independently of income and education, according to Mauricio Avendano, a research fellow in public health at the Erasmus Medical Center in Rotterdam and coauthor of the study, in a press release announcing the findings.

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Tags: American Heart Association | income | money | stroke

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Find Medicare Part D Confusing? You're Not Alone

April 22, 2008 04:49 PM ET | Michelle Andrews | Permanent Link

As anyone who's ever tried to decipher the Part D Medicare drug benefit knows, user friendly it's not. Seniors typically have dozens of plans to choose from, all with different moving parts—deductibles, copayments, coinsurance, covered drugs—not to mention that mother of all confounders, the so-called doughnut hole into which seniors fall after they've accrued a few thousand in drug costs. Until they reach a certain threshold and catastrophic coverage kicks in, they're responsible for paying the full freight.

Now the Journal of the American Medical Association has released a pair of studies that examine seniors' understanding of their costs under Part D, and how those costs affect "adherence" to their prescription drug regimens. One study found that—surprise!—60 percent of a random sample of seniors enrolled in a plan through Kaiser Permanente didn't know that it had a doughnut hole. Just over a third of these seniors reported that drug costs had affected their behavior, causing them to switch to a cheaper drug or not fill a prescription, for example. The other JAMA study found that seniors were less likely to report problems sticking to their drug regimens because of costs after the Medicare drug benefit began in 2006. But the sickest patients didn't see the same improvement.

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Tags: healthcare | Medicare | prescription drugs

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