Do High-Deductible Health Plans Cut Costs Now, But Backfire in Long Run?

(Getty Images)

(Getty Images)

By Jay Hancock, Kaiser Health News

Got a high-deductible health plan? The kind that doesn’t pay most medical bills until they exceed several thousand dollars? You’re a foot soldier who’s been drafted in the war against high health costs.

People with high deductible plans are foot soldiers in the war against high health costs.  

Companies that switch workers into high-deductible plans can reap enormous savings, consultants will tell you — and not just by making employees pay more. Total costs paid by everybody — employer, employee and insurance company — tend to fall in the first year or rise more slowly when consumers have more at stake at the health-care checkout counter whether or not they’re making medically wise choices.

Consumers with high deductibles sometimes skip procedures, think harder about getting treatment and shop for lower prices when they do seek care.

What nobody knows is whether such plans, also sold to individuals and families through the health law’s online exchanges, will backfire. If people choose not to have important preventive care and end up needing an expensive hospital stay years later as a result, everybody is worse off. Continue reading

Posthumous Brittany Maynard Video Supports Calif. ‘Death with Dignity’ Bill

State senators heard testimony today on a proposed bill that would allow doctors to prescribe lethal medication to terminally ill patients who request it. The testimony included a video from Brittany Maynard recorded 19 days before she took life-ending drugs.

 

In the video, Maynard implored California lawmakers to legalize “aid in dying.” Maynard, who had been diagnosed with terminal brain cancer, took lethal medication last year in Oregon, where the practice is legal.

“The decision about how I end my dying process should be up to me and my family under a doctor’s care. How dare the government make decisions or limit options for terminally ill people like me. Unfortunately, California law prevented me from getting the end-of life-option I deserved,” said Maynard, who died Nov. 1 at age 29. Continue reading

Frontline ‘Vaccine War’ Live Chat; Wednesday 3/25, Noon PT

A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)

A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)

Frontline aired an updated version of its 2008 documentary The Vaccine War on Tuesday night. The film dives deep into the debate over vaccines. While the overwhelming majority of parents vaccinate their children, a small but growing minority either under-vaccinate their children or refuse vaccines altogether.

The debate has taken a new turn in the wake of the measles outbreak which started in Disneyland in December. Public health officials believe a still-unknown person infected with measles visited the park and spread it to others. As the outbreak took hold, a new front in the debate grew: that of people who are immune-compromised.

State of Health first told the story of Carl Krawitt the father of 7-year-old Rhett who was diagnosed with leukemia when he was two and a half. Because of the treatments Rhett underwent to fight his disease, prior vaccine protection was wiped out, and he had to wait until he had been in remission for a year before his vaccines could begin again. The Krawitt family has been arguing that those unvaccinated by choice should not be able to attend public school.

Frontline producers told the story of Rhett’s family in The Vaccine War.

Now, it’s your turn. On Wednesday (March 25) at noon PT, Frontline is hosting a live chat, and I’m honored to be the moderator. ‘Vaccine War’ producer and director Kate McMahon will take your questions, along with Carl Krawitt, and Dr. Arthur Reingold, Head of Epidemiology at the UC Berkeley School of Public Health.

Feel free to leave a question now and please join us at noon for the chat!

On Medi-Cal Now, Lose Your House Later?

(Erik Soderstrom via Flickr)

(Erik Soderstrom via Flickr)

Catherine Jarett ran into a nasty surprise after she sent a form to Medi-Cal on behalf of her clients. An estate attorney, Jarett was hired by the sons of an elderly Vallejo woman who had died. The woman had been enrolled in Medi-Cal, the state’s insurance program for the poor, for more than 20 years.

Many on Medi-Cal learning that the state can file a claim against their estate after they die.

After Jarett filed the form with Medi-Cal — a death notice as required — the state sent a bill for a hefty $76,349. Jarett was stunned. It was for the cost of “health insurance, vision insurance, dental insurance,” she said.

The bill was part of Medi-Cal’s “estate recovery program.” Under a federal law not widely known to consumers, states can seize assets of Medi-Cal beneficiaries after they die. “I was never aware of this wrinkle that they could recover for health insurance,” Jarett said. Continue reading

Millions Need to Be On Alert for Medi-Cal Renewal

(Screen shot of California's Department of Health Care Services website)

(Screen shot of California’s Department of Health Care Services website)

By Emily Bazar, CHCF Center for Health Reporting

I spend the majority of my time (and space) writing about the new state health insurance exchange, Covered California.

But the behemoth in California’s Affordable Care Act implementation is Medi-Cal, the state’s decades-old version of the federal Medicaid program, which provides publicly funded insurance to low-income residents.

About 12 million Californians are in Medi-Cal now. That’s roughly one in three state residents. By comparison, about 1.4 million Californians are enrolled in Covered California.

Given its size, Medi-Cal’s annual renewal process is now one of its greatest challenges. Continue reading

Depression Takes Growing Toll on American Workplace

(Getty Images)

(Getty Images)

By Lisa Gillespie, Kaiser Health News

For every dollar spent on treating depression, nearly five dollars more is spent on related medical conditions like back and chest pain, sleep disorders and migraines. Depression can also lead to lost productivity, placing a greater financial burden on businesses and the health care system, according to new research measuring the economic impact of depression.

Average worker with major depression loses the productivity of 32 days a year.

“The fact that they’re finding such greater costs with all these different [related conditions] underscores how the fragmented system is not helpful for our economy because people with mental illness are not getting the rounded health care they need,” said Lynn Bufka, with the American Psychological Association, who was not affiliated with the study.

The total cost to the U.S. economy of major depressive disorder rose to $210 billion in 2010, up more than 20 percent from $173 billion in 2008. Continue reading

California Needs More Primary Care Docs, But Residency Slots Threatened

Dr. Peter Broderick of  Doctors Medical Center in Modesto examines a patient's x-ray while family practice medical residents look on. (Rebecca Plevin/KVPR)

Dr. Peter Broderick of Doctors Medical Center in Modesto examines a patient’s x-ray while family practice medical residents look on. (Rebecca Plevin/KVPR)

By David Gorn, California Healthline

Today is a huge day for graduating medical students. It’s Match Day — the day they find out where they’re going for residency programs — the training years between medical school and practice.

In California, there are 140 residency slots every year in the family practice specialty. That number may diminish, given the pending loss of four funding sources designed to encourage California medical students to join family-practice residencies, particularly in underserved areas of the state.

According to Del Morris, president of the California Academy of Family Physicians, California faces a loss of $50 million from the end of these four programs: Continue reading

State Lawmakers Investigating High Health Costs

stethoscope and dollar

(Getty Images)

By Rebecca Plevin, KPCC

Last spring, KPCC, KQED and ClearHealthCosts.com teamed up and started a conversation about health costs in California.

We knew a growing number of people wanted to shop around for affordable mammogramsMRI’s and other procedures. But it was nearly impossible to discover the costs. As part of our project, called #PriceCheck, we invited you to share what you paid for certain procedures. In the process, we began building a database of health costs.

On Wednesday, the California State Senate Committee on Health picked up that conversation.

During a hearing at the state Capitol, doctors, researchers and consumers told lawmakers that despite the federal health care law, health costs are still a barrier to care. Continue reading

Why Insulin Is So Expensive in the U.S.

A nurse in 1938 checks the amount of insulin in a needle. For many decades, the only insulin available to people with diabetes came from the pancreases of cattle or pigs. Insulin from animals is still available outside the U.S. — and cheaper than a recombinant DNA version. (Bettmann/Corbis)

A nurse in 1938 checks the amount of insulin in a needle. For many decades, the only insulin available to people with diabetes came from the pancreases of cattle or pigs. Insulin from animals is still available outside the U.S. — and cheaper than a recombinant DNA version. (Bettmann/Corbis)

By Anders Kelto, NPR

Dr. Jeremy Greene sees a lot of patients with diabetes that’s out of control.

More than 90 years after insulin was developed, there are no low-cost options available today.

In fact, he says, sometimes their blood sugar is “so high that you can’t even record the number on their glucometer.”

Greene, a professor of medicine and history of medicine at Johns Hopkins University, started asking patients at his clinic in Baltimore why they had so much trouble keeping their blood sugar stable. He was shocked by their answer: the high cost of insulin.

Greene decided to call some local pharmacies, to ask about low-cost options. He was told no such options existed. Continue reading

State Revokes Blue Shield of California’s Tax-Exempt Status

(Steve Rhodes via Flickr)

(Steve Rhodes via Flickr)

On the Blue Shield of California Web page called “What Does Being a Not-for-Profit Mean to Us?” the health insurer provides an answer:

Operationally, it means we don’t answer to Wall Street – we don’t need to generate returns to shareholders. Philosophically, being a not-for-profit means we’re guided by our mission to ensure all Californians have access to high-quality health care at an affordable price.

Well, the state’s Franchise Tax Board may have found that something in that description does not conform with reality. In a story first reported by the L.A. Times and confirmed by Blue Shield of California to KQED, the board has stripped the company of its tax-exempt status.

Yes the loss of tax exemption is true and we have filed a formal protest of the decision with the FTB,” Blue Shield said in an email. The tax board said the revocation occurred on Aug. 28, 2014, and the Times said the company must now file returns from 2013 on. When asked the reason for the revocation, the board responded that is not considered public information and could not be disclosed.

Whatever the reason, the Times said the move could transfer tens of millions of dollars each year from the company to the state. Calling the action highly unusual, the newspaper said it came on the heels of a state audit investigating the justification for the company’s tax exemption. Continue reading