Health

Americans Say Health Premiums Increased in 2015

Gallup: “Nearly three in four American adults (74%) who pay all or some of their health insurance premiums say the amount they pay has gone up over the past year. This percentage is up marginally from the 67% who last year said their costs increased, but it is generally in line with what Gallup has found in yearly updates since 2003.”

Self-Reports of Cost Changes Among Adults Who Pay All or Some of Their Health Premiums

“Though Americans are still more likely to be satisfied than dissatisfied with their personal healthcare costs, the latest poll indicates they are more likely to be grappling with higher premium costs than in previous years.”

“What Americans pay for their healthcare premiums has not noticeably improved since the ACA’s implementation, and experts have stressed that a rise in premiums will continue for several years. Meanwhile, the White House contends that recent premium increases would have been larger if not for the ACA.”

Health Spending Grew 5.3% to $3 Trillion

Wall Street Journal: “Growth in U.S. health-care spending is accelerating after reaching historic lows … Spending on all health care increased 5.3% in 2014 [to $3 trillion], according to a report Wednesday from actuaries at the Centers for Medicare and Medicaid Services. That compares with the 2.9% growth in 2013, which marked the lowest rate since the government began tracking the gains 55 years ago.”

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L.A. Times: “Experts aren’t predicting a return to double-digit increases in medical spending. But the latest trend underscores how difficult it will be for policymakers, employers and insurers to control healthcare costs going forward.”

“‘Two main factors were responsible for health spending growth in 2014 — coverage expansion associated with the Affordable Care Act and faster growth in prescription drug spending,’ said Anne B. Martin, an economist at the Centers for Medicare and Medicaid Services.”

“Wednesday’s report by government actuaries found that the percentage of Americans with health insurance reached 88.8% in 2014, the highest share since 1987.”

“The Obama administration pointed out that the 5.3% increase in 2014 is still below the 6.9% average growth rate during the decade prior to the 2010 health law being enacted. Officials also predicted the spending increases tied to the coverage expansion will fade in the coming years.”

Is Obamacare Saving Lives?

Jonathan Cohn: “Hospitals have cut down on deadly medical errors, saving around 87,000 lives since 2010, according to a new government report … Many analysts think government initiatives within the Affordable Care Act have played a significant role in the progress so far.”

Bar graph shows total annual and cumulative deaths averted: 2011, 3,527; 2012, 12,300; 2013, 34,530; 2014 (Interim), 36,295; Cumulative (2010 - Interim 2014), 86,669.

On Tuesday, the Agency for Healthcare Research and Quality, “announced its latest findings on these ‘hospital-acquired conditions,’ based on preliminary data from 2014. For every 1,000 patients admitted to and then discharged from a hospital, the agency found, roughy 121 of them developed such a condition. That rate is unchanged from last year, but it is down 17 percent from 2010, when it was about 145 out of every 1,000 patients.”

“Based on the existing research about what happens to patients who get sick in the hospital and what it costs to treat them afterwards, that decline works out to roughly 87,000 lives saved and $19.8 billion not spent on extra medical care, according to the report.”

In the past, “hospitals made money for every new treatment and a patient who got sick in the hospital needed more care, rather than less.”

“A major goal of the Affordable Care Act was to reduce and eventually eliminate these incentives for poor quality care, while rewarding the hospitals that getter better results.”

The GOP Ties to Pharmaceutical Industry Are Strong

STAT: “A STAT analysis of thousands of pages of congressional disclosure forms found that about 30 percent of senators and 20 percent of representatives held assets in biomedical and health-care companies, or in specialty funds set up to invest in those industries, during 2014. The most common investments in the House were Pfizer, Johnson & Johnson, Merck, and Abbott Laboratories. In the Senate, investors favored Johnson & Johnson, Pfizer, and Merck.”

“Members of Congress owned more stock in health-related companies last year than in the defense and construction sectors combined, according to the Center for Responsive Politics. Their investments in the sector topped $68 million.”

“Some of the most aggressive congressional investors in the biomedical sector also sit on key committees, such as the House Judiciary Committee, which has jurisdiction over patent law, or the House Energy and Commerce Committee, which oversees the Food and Drug Administration and works on many issues of critical importance to the industry, including drug regulation, research funding, and taxes on medical devices.”

In addition, Politico reports that “Even as they try to address an issue that polls show is voters’ No. 1 health concern, the candidates are caught in the box of Republican free market orthodoxy — and also, of long-standing relationships with the pharmaceutical industry, a lobbying powerhouse on the Hill. In the 2012 election cycle, more than 60 percent of PhRMA’s spending went toward Republican candidates, compared to 25 percent of contributions to Democrats, according to the Center for Responsive Politics.”

Why Do We Pay More for Prescription Drugs?

The Wall Street Journal reports its findings on its study on “international drug-cost differences and what lies behind them.”

In the case of Norway, “U.S. prices were higher for 93% of 40 top branded drugs available in both countries in the third quarter. Similar patterns appeared when U.S. prices were compared with those in England and Canada’s Ontario province. Throughout the developed world, branded prescription drugs are generally cheaper than in the U.S.”

“The upshot is Americans fund much of the global drug industry’s earnings, and its efforts to find new medicines. ‘The U.S. is responsible for the majority of profits for most large pharmaceutical companies,’ said Richard Evans, a health-care analyst at SSR LLC.”

“The government systems also are the only large drug buyers in most of these countries, giving them substantial negotiating power.”

“Medicare, the largest single U.S. payer for prescription drugs, is by law unable to negotiate pricing. For Medicare Part B, companies report the average price at which they sell medicines to doctors’ offices or to distributors that sell to doctors. By law, Medicare adds 6% to these prices before reimbursing the doctors. Beneficiaries are responsible for 20% of the cost.”

“The arrangement means Medicare is essentially forfeiting its buying power, leaving bargaining to doctors’ offices that have little negotiating heft.”

Healthcare Costs Still a Concern for Americans

Gallup: “Slightly fewer than one in three Americans (31%) say that they or a family member have put off any sort of medical treatment in the past year because of the cost. This is essentially unchanged from the 33% who said this in 2014, and the figure has remained steady for the past decade. The majority of Americans (68%) say they did not have to put off care because of the cost.”

Trend: Percentage of Americans Putting Off Medical Treatment Because of Cost

Obamacare has “provisions that are designed to limit the cost of healthcare services, but despite all these measures, a consistent third of the country say that in the past year, they or their family has had to delay medical treatment. The ACA has achieved objectives considered important by the policymakers who crafted the law — most notably, ensuring that a greater a number of Americans have medical insurance — but on this cost-related metric, its influence has not been felt.”

Despite Glitches, Obamacare is Still a Success

Paul Krugman acknowledges that “Obamacare has hit a few rough patches lately. But they’re much less significant than a lot of the reporting, let alone the right-wing reaction, would have you believe. Health reform is still a huge success story.”

“First, premiums are going up for next year, because insurers are finding that their risk pool is somewhat sicker and hence more expensive than they expected … That’s a slight disappointment, but it’s not shocking, given both the good news of the previous two years and the long-term tendency of insurance premiums to rise 5-10 percent a year.”

“Second, some Americans who bought low-cost insurance plans have been unpleasantly surprised by high deductibles. This is a real issue, but it shouldn’t be exaggerated. All allowed plans cover preventive services without a deductible, and many plans cover other health services as well. Furthermore, additional financial aid is available to lower-income families to help cover such gaps.”

“Oh, and official projections now say that fewer people will enroll in those exchanges than previously predicted. But the main reason is that surprisingly few employers are dropping coverage; overall projections for the number of uninsured Americans still look pretty good.”

“Without question, the run of unexpectedly good news for Obamacare has come to an end, as all such runs must. And look, we’re talking about a brand-new system in which everyone is still learning how to function. There were bound to be some bobbles along the way.”

The Painkiller Epidemic Grows

The Washington Post got an early look at a Kaiser Family Foundation survey which shows 40% of Americans know someone who has been addicted to prescription painkillers, including 25% who say it was a close friend or family member and 2% who acknowledge their own addiction.

More from the survey:

  • 16% say they know someone who has died from an overdose of prescription painkillers, including 9% who say that person was a family member or close friend.
  • 56% of the public say they have some personal connection to the issue.
  • Prescription painkiller abuse is most common among whites (63%) and the affluent (63% among people with incomes of $90,000 or more).

John Bel Edwards Victory is Victory for Medicaid Expansion

Times Picayune: “Governor-elect John Bel Edwards called expanding Medicaid ‘among the highest priorities’ of his new administration, though he said Sunday (Nov. 22) he may not be able to approve an expanded program on Day One.”

Edwards: “‘The expansion of health care coverage for working families is among the highest priorities. It’s something I’ve been working on for three years, and I never once during this campaign shied away from that particular issue,’ Edwards said during a news conference with reporters in New Orleans. ‘So we are going to expand the Medicaid program in Louisiana. We’re going to do it as soon as we possibly can and as responsibly as we possibly can.'”

With Edwards’ victory, “supporters of ObamaCare are increasingly hopeful that Medicaid expansion could sweep through the deep-red South,” according to The Hill.

“More recently, there was surprising news out of Alabama, as a commission appointed by Republican governor Robert Bentley recommended expansion. Bentley said earlier this month that he is ‘looking’ at the possibility of broadening Medicaid.”

Secretary of Health and Human Services Sylvia Burwell: “What is going to happen is that support for Medicaid expansion will continue to build … You hear the Alabama governor. You’ve heard conversations in Louisiana.”

“Supporters of Medicaid expansion hope that if they can get a foothold in the South, other states will follow … One option is the Arkansas model, where the expansion enrolls people in private health insurance plans instead of government-run Medicaid.”

Most Americans Say Government Should Ensure Healthcare Coverage

Politico: The government should ensure the health care coverage of all Americans, 51 percent of adults said in a new Gallup survey released Monday. That is slightly more than the 47 percent of Americans who said it is not the government’s responsibility, though the difference is still within the poll’s margin of error.

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The 51 percent is the highest share of American sentiment in that direction since 2006, when nearly seven in 10 (69 percent) said government is responsible and just 28 percent did not. In the years following, only in 2011 did Americans have a more positive view of the role in government in health care than negative.

Though at its lowest level in recent years, 55 percent to 41 percent expressed support for a health care system based on private insurance rather than one run by the government. In 2014, 61 percent to 35 percent felt the same way.

Americans Concerned About Health Care Costs

Gallup: Americans continue to name the cost of (22%) and access to (20%) healthcare as the most urgent health problems facing the U.S. Obesity and cancer are next on the list, cited by 15% and 14%, respectively. No other issue receives more than 2% of mentions from Americans.

Trend: Cost and Access Remain Most Commonly Named as Urgent Health Problems

The Obama administration has made a major effort to address healthcare cost and access by passing the Affordable Care Act. Since its major provisions went into effect, there has been a drop in the percentage of Americans who lack health insurance. But the law probably did not affect the healthcare situation for the large majority of Americans, most of whom get health insurance through an employer or Medicare. The percentages mentioning both cost and access are down from the later years of George W. Bush’s administration, even though they remain the top overall issues.

Fewer Employers Choosing to Terminate Coverage Due to Obamacare

Forbes: “The likelihood that small employers will terminate health coverage for their workers due to the Affordable Care Act is far less likely than the ‘early days of the health reform debate,’ according to a new analysis.”

“Employee benefits consultancy Mercer … said just 7% of employers with 50 to 499 employees now say they are ‘very likely’ or ‘likely’ to terminate coverage for their workers within the next five years.”

“This is in sharp contrast to the early days of the health reform debate when employers worried the law would ad layers of bureaucracy and higher costs from various new rules and mandates. In 2013, one in five small employers, or 21%, said they were ‘very likely’ or ‘likely’ to terminate their health plans, the Mercer annual employer health survey shows. And in 2014, the likelihood of employers dropping coverage fell to 15% of these smaller employers.”

Few employers now say they will drop coverage due to issues related to the Affordable Care Act. Source: Mercer’s National Survey of Employer-Sponsored Health Plans

What Are Americans’ Most Urgent Health Problems?

Gallup: “Americans continue to name the cost of (22%) and access to (20%) healthcare as the most urgent health problems facing the U.S. Obesity and cancer are next on the list, cited by 15% and 14%, respectively. No other issue receives more than 2% of mentions from Americans.”

Trend: Cost and Access Remain Most Commonly Named as Urgent Health Problems

“The percentages mentioning both cost and access are down from the later years of George W. Bush’s administration, even though they remain the top overall issues.”

Despite Successes, Americans’ View of Obamacare Tilts Negative

Wall Street Journal: “By now, supporters and opponents of the Affordable Care Act often divide along ‘glass half full or half empty’ lines over similar facts, and each perspective was on display at the Wall Street Journal CEO Council on Tuesday.”

“’We believe coverage in general has been improved’ by the 2010 law, said Health and Human Services senior counselor Leslie Dach. ‘That’s an important beginning.’”

“His agency has estimated that the law has extended coverage to 17.6 million people, between its provision requiring plans to cover young adult dependents to their 26th birthdays, the expansion of Medicaid, and the availability of subsidized private coverage to everyone through HealthCare.gov and state equivalents. The law also imposes new requirements on insurance plans on what they must cover, and says they must price coverage equally regardless of people’s medical history, and these affect everyone who gets insurance on their own.”

Despite the progress, Americans views on Obamacare have tilted negative, according to a recent Gallup poll.

Americans' Views of the Affordable Care Act

Gallup: “The law’s continued survival and its empirical success in lowering the uninsured rate has not made much difference in how Americans feel about the law. As such, it seems doubtful that the law will be broadly accepted in the U.S. political system in the near future. It will likely remain the target of efforts to repeal or significantly modify it, which could finally prevail if Americans elect a wholly Republican federal government in 2016.”