Why Does an MRI Cost $2,500 Here and $250 in Finland?

 

JPen and money on CT-scan flim.ust had dinner with an old friend from Finland. He’s a physician so, of course, the talk turned to health care and the differences between our countries. I asked him how much an MRI cost in Finland. With a few clicks on his phone he had the answer: about $250. Not to be outdone, I pulled out my own phone. The average price of an MRI here? About $2,500.

And therein lies the problem. The US spends more per capita on health care than any other industrialized country in the world. The spending is driven by our high use of technology and the cost of health care. And before you say we have the best healthcare system in the world, let me tell you that we don’t.

Our country ranks last or near the bottom on nearly every health-related outcome compared to other high-income countries. In fact, life expectancy has actually dropped in the past couple of years for the first time in decades, with death rates rising for eight of the top 10 leading causes … Continue Reading

Labels:
Affordable Care Act blog health insurance healthcare costs high-deductible health plan

Replacing the ACA: Selling Across State Lines

A United States map with a stethoscope across it, symbolizing national health care policy and wellness of the population

A cornerstone of every Republican plan to replace the Affordable Care Act (ACA), including the president’s plan, is to allow health insurance companies to sell their products across state lines. The Republicans claim this will increase competition and drive down costs.

Health policy experts, including the National Association of Insurance Commissioners and the Center for Insurance Policy and Research, say it will do exactly the opposite: Drive up costs and reduce choice, particularly for those with medical conditions.

State Regulations on Health Insurance

First, a bit of background. States regulate all small group and individual health insurance policies through their insurance commissioner, although the federal government sets certain minimum requirements that plans must offer, like the 10 essential benefits required under the ACA.

States can mandate that their licensed insurers add certain benefits, like infertility coverage. They also determine how much older people can be charged for premiums on the individual market and how much money insurers must have available to pay claims.

… Continue Reading

Labels:
ACA Affordable Care Act blog health insurance healthcare system; Obamacare

Replacing the ACA: Will Health Savings Accounts Work?

Desktop with calculator, cash, notepad with the phrase healthcare reform, high-deductible plan, health savings accountsThe problems with high-deductible plans and health savings accounts

Note: I am beginning a series of posts examining various approaches the Republicans are touting as replacements for the ACA. Sorry, but no alternative facts here.

Several years ago (ie, pre-ACA), I needed to buy health insurance on the open market. The cost of an individual policy and the deductible was atmospheric because I had a pre-existing condition. And, of course, the policy didn’t cover costs related to my pre-existing condition.

Luckily, I had just incorporated my business. Since I had two employees (my husband and I) I could get a small business policy. Still expensive but manageable with decent coverage since employer-provided plans can’t discriminate based on pre-existing conditions.

I chose the cheapest plan, which came with a very high deductible. This plan also allowed me to create a health savings account (HSA). Money deposited into an HSA is not subject to federal taxes, grows tax-free, and is not taxed when used for qualified medical expenses (but … Continue Reading

Labels:
ACA Affordable Care Act blog health savings accounts healthcare reform high-deductible health plan Obamacare

Goodbye 2016, Hello 2017

Bright beach with 2016 written in sand

Looking Back on the Year in Health Care: There Were Some Bright Spots

I don’t know about you, but I personally hate end-of-year columns. I had to write far too many when I was a newspaper reporter (back in the day when you got ink on your hands while reading a newspaper).

So why am I writing one, you ask?

Sigh. Blame it on the young lady who handles my social media. She’s making me.

So here goes.

2016 Highlights in Health Care

There’s a lot of moaning on social media about 2016 and what a terrible year it was. And yes, it did suck for many reasons, none of which I’m going to go into here. Instead, I’m going to talk about a few positives on the health care side for which I’m thankful.

Fewer Uninsured Americans Twenty million previously uninsured Americans now have health insurance. Put another way, the uninsured rate in this country has never been lower. Gains Under the Affordable Care Act Many aspects of the Affordable Care Act (aka Obamacare) … Continue Reading

Labels:
21st Century Cures Act Affordable Care Act blog healthcare reform Obamacare

Memo to Health Insurers: Pay Attention to Us

Young woman looking stressed with a "help" cardboard sign

The text came from our 20 year old. His girlfriend had gone to her doctor to get the implantable birth control, Nexplanon, which (as every parent of a teenager might be happy to know) is nearly foolproof for 3 years. Needless to say, we were thrilled.

The problem?

It cost $1,500 and insurance wasn’t paying.

The Explanation of Benefits that Was Anything But

Impossible, I said (after all, there’s not much I know about but health insurance and the Affordable Care Act [ACA] are two). The ACA requires that most health insurers/employers provide all FDA-approved contraception with no out-of-pocket cost.

It took several back and forths between the girlfriend, her father, and me, including copies of the statement from the insurance company, before I figured it out. She was only seeing the insurance company statement, called an explanation of benefits (EOB), showing what was billed and what was paid. She didn’t owe a thing.

And therein likes one of the many problems with health insurance today. It’s unnecessarily complicated and confusing. After all, … Continue Reading

Labels:
blog health insurance healthcare system; patient-centered care

From CrossFit to StorySLAM: The Value of Taking Risks

Woman leaping over rocks

In honor of Thanksgiving and the start of the holiday season, I’m taking a break from my rants about the election and health care. Instead, I want to talk about taking risks.

I’ve never been a risk taker. I don’t gamble. I’m extremely financially conservative. I would never go on vacation without a hotel reservation. The biggest risk I’ve taken in the past 20 years was starting my own business.

But as I move through my 50s (I turn 54 November 30) I’m also moving out of my comfort zone and starting to take more risks. It began two years ago when I started CrossFit, the uber exercise program that combines strength training with cardio with gymnastics. To understand how unlike me this was, you should know that I hated exercising and did the bare minimum required so I could drink as much wine as I wanted and still fit into my clothes.

Then came an hour of daily torture that often left me close to tears and literally on … Continue Reading

Labels:
blog work/life balance

The Election and the ACA: Why I’m Sad, and Will Be For A Long Time

Ballot box with national flag on background - United States of America

I’ve been writing this blog on and off for about eight years. And in all that time, I’ve tried to keep it as apolitical as possible. But, at my core, I am a writer. It’s all I’ve ever done for 30 years. And when writers can’t make sense of the world, or don’t know what to do with their feelings, well, they write.

So, spoiler alert, I am devastated by Tuesday night’s results for so many reasons. For an end to women’s reproductive rights. For an end to what I thought was a decent, inclusive country. For an end to a free press. For an end to LGBT rights. For an end to the respect we once had from the rest of the world.

And for the horrific overt racism and homophobia that has been unleashed in this country in just the past few days.

But, since I earn my living as a healthcare writer, the one I’m going to focus on here has to do with the almost-certain death … Continue Reading

Labels:
ACA Affordable Care Act blog federal budget Obamacare politics

Is The ACA As Big A Mess As Everyone Says?

 

Affordable Care Act – Image of pills and coinsMaybe. But many of the problems the Affordable Care Act (ACA) is now encountering – insurance companies on the exchanges pulling out, large premium increases in some states – are not unexpected given the design of the program.

Major problem? The Patient Protection and Affordable Care Act bill set the penalties for not having insurance too low. Far lower than the cost of the insurance to begin with. So there is little incentive for healthy people to enroll. Without healthy people enrolling, it was only a matter of time before the death spiral began.

It’s a simple equation: Sick people + no preexisting condition restriction – healthy people = high spending that outstrips existing premiums.

To add insult to injury the government was too lenient in allowing people to sign up outside of open enrollment, ie, when they got sick and needed the insurance. Plus, as The New York Times explained in a recent editorial, insurers set premiums too low in the beginning in order to attract enrollees.

Is the ACA … Continue Reading

Labels:
ACA Affordable Care Act blog health insurance healthcare reform

Who’s In Charge? You or Your Doctor?

babyshowerSunday was the first baby shower I’d been to since. . . well, let’s just say that my youngest kid turned 19 a few days ago. There were the mandatory sherbet-colored decorations; a watermelon fruit bowl designed to look like a sleeping infant (complete with pacifier); infused water; chattering ladies; a table piled high with gifts. Only one thing was missing: the guest of honor. For even as everyone arrived for the shower, she was already in labor. And, ever the obliging young woman, she delivered a healthy baby boy before the shower ended.

I’m assuming she had great care in the hospital. Most women who have babies do. But far from the cozy, wood-floored, prettily painted maternity suites lies the healthcare system the rest of us have to deal with. Like another young woman at the shower, 26-year-old Mary.

I happened to overhear her talking to someone else and caught the words “migraine,” and “doctor,” and “frustrated.” Manna to my ears. “What’s up?” I asked.

Turns out she’d been having horrific, daily migraines and vertigo for months. The urgent care doctor told her … Continue Reading

Labels:
blog healthcare reform healthcare system; patient-centered healthcare