cost of healthcare – R&R – Reachout and Rebuild

AHCA (Trumpcare) Bill is a Disaster

David Posnett — Wed, 22 Mar 2017 20:08:24 +0000

Here is why the American Health Care Act (Trumpcare) is a disaster.

The bill has now been vetted (along with its latest changes). In particular, the Congressional Budget Office has reported on the bill and the Brookings Institution has discussed the primary points which can be summed up in 2 graphs:

This graph clearly shows that if you hold everything constant (the age mix of the insured population & the benefits provided) the average premium will increase by 13% by 2026. The graph has been used by the GOP (and by our Rep. Zeldin) to mislead the public by focusing on the left-hand bar (minus 10%). It has become a GOP talking point given to all representatives to argue with their constituents. Here is why it is misleading. The AHCA (Trumpcare) is going to result in 2 major shifts: 1) more young healthy people vs old sick people signing on for insurance, and 2) lesser coverage of items currently covered through the ACA, like birth control, or preventative procedures (like mammograms for breast cancer screening, or colonoscopy for colon cancer screening). So of course, if the public is buying a lesser insurance coverage (analogy: a cheap untrustworthy car) instead of a better type of insurance (a highly recommended reliable car) expenses are going to be less (the price of the car is going to be less). The bar on the right side of the figure (plus 13%) corrects for the comparison: if you were to buy the same insurance (the same car) under Trumpcare versus Obamacare it would be 13% more expensive by 2026. That is the key number!

Figure 2 from the Brookings report compares the AHCA (Trumpcare) versus ACA (Obamacare, current law) for every age group. Notice how the premiums rise dramatically by 2026 if you are 45 years or older. If you are 65 your premiums will rise on average to about $15,000 with the Obamacare, and to about $22,000 with Trumpcare. The bill will punish older folks. It is that simple.

I have no beef with those people who say they don’t want a good insurance and would rather have a stripped down, bare bones insurance without the quality rules imposed under Obamacare. Just don’t say it is cheaper because it isn’t. We could discuss the value of having yearly mammograms, for example, to both the individual, and to society at large. For the individual, it is a matter of life versus death from cancer. For society, catching a stage I early cancer and curing it by surgery and medical therapy is much cheaper than dealing with the medically expensive treatments for advanced cancer. In the end, those costs are transferred to all of us. That is because hospitals, providers, and insurances will jack up the costs for all of us who can pay, to cover those that can’t or won’t pay and those that have gone bankrupt trying to pay.

Rep. Lee Zeldin, for personal and political reasons, is counting on us being ill informed and unable to decipher the lies promoted by the GOP in the name of trying to pass a disastrous health care bill.

Cancer Patients in Fear of the Ultimate Death Panel

David Posnett — Sun, 26 Feb 2017 06:37:29 +0000

Cancer patients, survivors fear GOP efforts to dismantle the Affordable Care Act, By Laurie McGinley February 23, 2017

Great article in the WaPo, reminds me of my friend Liz. She was young when she was first diagnosed with an aggressive type of lymphoma. In 50% of cases, this type of cancer can be cured with chemotherapy. She had lost her insurance at the time. So she spent about $ 350,000 of her savings and was lucky to get a cure, but she was also broke! Years later she applied for Obamacare on the exchange. She was actually waiting for her insurance card to go back to a physician and deal with some new troubling symptoms. The card did not come in time. She died very suddenly without medical insurance.The new WaPo article describes other cancer patients and how they feel about losing Obamacare. Here is some of their testimony:

Ashley Walton was 25 when a mole on her back turned out to be melanoma. She had it removed, but three years later she discovered a lump in her abdomen. She was then unemployed and uninsured, …. Every company rejected her.

By the time Walton finally sought medical help, the melanoma had spread to her brain, lungs and elsewhere. And she eventually became eligible for California’s Medicaid program, which had been expanded under the Affordable Care Act. Two major surgeries, radiation and immunotherapy did not cure the cancer — but did beat it back.

She credits her survival to the ACA. Without it, “I would likely be dead, and my family would likely be bankrupt from trying to save me,” she said. Her greatest concern is that Republican assaults on the law will imperil that coverage.

“For cancer survivors, we literally live and die by insurance,” Walton said.

“People are scared out of their minds,” said 34-year-old Erin Price-Schabert, who seven years ago was treated for breast cancer. She frets whether that history would make her “uninsurable” in the individual market if she were to leave her job.

Indeed, many people described a kind of existential dread that matches their fear of cancer.

House Republicans have called for major changes in federal subsidies, which have helped the vast majority of people with ACA policies afford their plans. They want state high-risk health insurance pools for people with big medical bills.

Herbert Malamut of Southampton, N.J., is on edge. He remembers the old insurance pools, … “Those pools were poorly funded and had high premiums and skimpy benefits,” said Malamut, 61, who was diagnosed with non-Hodgkin’s lymphoma in 2012. “I don’t know why we would go back to them.”

“Some people will fall through the cracks,” said Larry Levitt, senior vice president at the Kaiser Family Foundation.

Elizabeth Alcorn, 56, and her husband say “We are too young for Medicare.” He’s dealing with prostate cancer that just recurred after several years. “I have had good security with [the ACA],” Gerry Corridon said, “and now we don’t know how this is going to end up.”

In Thousand Oaks, Calif., the law’s bleak future is weighing heavily on 61-year-old Maryann Hammers, too. Diagnosed with ovarian cancer three years ago, the freelance writer underwent surgery and chemotherapy and often couldn’t work. The disease recurred seven months later, and now blood tests suggest that it’s back yet again.

“I know what’s coming next,” she said. “And it’s a friggin’ nightmare.”

Hammers has been covered by an ACA health plan. She’s “completely panicked” about the Republicans’ plan to repeal the law and what that could do to her coverage next year.“Without coverage, I don’t get care, and without care, I die,” she said. “So, to me, the people trying to do away with the ACA are the ultimate death panel.”

Wake up, Rep Lee Zeldin! There are about 9000 cases of cancer (invasive malignant tumors) annually in Suffolk county. Most of these people are your constituents. They depend on you. Without affordable health care coverage, they die!

Medicine for the One Percent

David Posnett — Mon, 21 Apr 2014 13:27:56 +0000

We always suspected this: a new study clearly shows that the richer you are, the longer you live in the US of America (Wall Street Journal). This is no small difference! The top 10% (richest) people live on average 10 years longer than the bottom 10% (poorest). Wow! And this is WITH medicare and medicaid, which the political right would have us get rid of all together.

What I would like to see are 2 things.

(1) A comparison with a similar study in civilized “1st world” countries (Canada, UK, Germany, France, Switzerland, Netherlands, etc.) with better health care coverage that covers the entire population.

(2) A historical comparison: an analysis of life expectancy relative to individual wealth 100 , 50, 20 and 10 years ago in the US. I would like to know whether we have made any progress, and whether (as I suspect) progress has been halted or even reversed.

It will take at least 10-50 years for the effects of Obamacare to show up in such a population wide analysis which measures death rates over many years. At present, only a comparison with other countries can tell us something.

Here is a partial response to my question (2) from the article itself which looks at least at 2 different historical time points: 1920 versus 1940. For men there has been an improvement in longevity (5.9% for the richest men and 1.7% for the poorest men). For women the change in longevity is 3.1% for the richest women. But the poorest women actually live less long -2.1%. This means that if you are a poor woman, you actually would have been better off being born in 1920 rather than in 1940! That is a stunning fact. It is the reverse of progress.

Soaring Costs of Prescription Drugs in the US

David Posnett — Sun, 06 Apr 2014 15:09:35 +0000

Great article about the soaring costs of prescription drugs in the US. The very same drugs are offered in other countries like Germany and the UK etc, at a small fraction of what we are asked to pay. Who benefits? The drug companies. Since most countries have government limits on the costs of drugs, the drug companies make less of a profit in those countries (but still enough to continue selling there). To make up for what they view as insufficient margins, they go crazy with the prices in the US, where there are no government limits. The free market just doesn’t work when it comes to life saving medicines. Unless you decide that only the lives of the rich are worth saving.