Showing posts with label health. Show all posts
Showing posts with label health. Show all posts

Saturday, July 14

Small business gives health ruling thumbs up

Tammy Krings doesn’t understand what the fuss is all about.

The small business owner from New Albany, Ohio thinks the Affordable Care Act the U.S. Supreme Court upheld Thursday will help lower the cost of providing health care to the 160 employees at her corporate travel agency, TS24.

“I was very happy about it,” Krings said after the court's decision. ”It will be positive for our organization.”

That puts her in stark contrast to small business advocacy groups, which argue that it will raise costs, add uncertainty to their businesses and put a damper on job creation.

Not so, says Krings. She said her company’s health insurance premiums will rise much more slowly than the 30 percent a year increases she’s been paying in recent years. By prodding younger, healthier workers to sign up for coverage, she said, the law will help offset the cost of covering older workers who consume more care.

“We don’t have the balance of healthy people on our program,” she said. “Our little business is, I think, a very micro example of what the country faces at large.“

Business groups reacted viscerally to the news that the high court upheld the law.

“Small-business owners are going to face an onslaught of taxes and mandates, resulting in job loss and closed businesses,” according to Dan Danner, President and CEO of the National Federation of Independent Business, one of the plaintiffs in the suit, which sought to strike down the law.

“Left unchanged, (the law) will cost many Americans their employer-based health insurance, undermine job creation, and raise health care costs for all," said U.S. Chamber of Commerce President and CEO Thomas J. Donohue.

“This law will have a dramatic, negative impact on every employer and employee in the United States and further constrain job creation and economic growth,” according to Matthew Shay, CEO of the National Retail Federation.

With Thursday’s ruling, the 2010 health care law will continue to be phased in over the next five years. When fully implemented, it’s expected to provide health coverage to about 30 million currently uninsured people, extending coverage to more than 9 in 10 eligible Americans.

Some provisions are already in effect. Young adults can stay on their parents' insurance up to age 26. Insurers can't limit how much a policy pays to each person over a lifetime. Co-payments for preventive care have been eliminated.

For months, small business groups have complained that uncertainty about the health care law had produced a chilling effect on job growth, as employers postponed hiring decisions until the law’s legal foundation was settled.

To be sure, some uncertainty remains. Various specific regulations, for example, have yet to be written by the Department of Health and Human Services.

GOP vows to press for repeal
Republicans have vowed to continue to press for the law’s repeal, a prospect that will depend heavily on the outcome of the November election. Even if they fail in that effort, the sweeping scope of the law makes it likely that Congress will make changes in the next few years as its wider impact is felt.

"There have to be some tweaks,” said Mike McAllister, CEO of Humana, one of the country’s largest health insurers. “This is a big bill and in these cases there are things that have to be done in the next handful of years to make it better.”

One of those “tweaks” will likely center on the tax breaks the bill provides for the smallest businesses, who have complained loudly about the $2,000 per worker penalty that the law imposes on companies that don’t provide health coverage. That fee is partially offset by a tax credit for companies with 25 or fewer workers.

Some opponents of the bill have argued the tax credit provision could prompt very small companies to stop hiring once they reach 25 employees, or even fire workers to take advantage of the credit.

Under the health car law, all businesses with 50 or more employees must provide health care benefits to those employees by 2014. MSNBC"s JJ Ramberg joins NewsNation to discuss.

Krings said that argument doesn’t make much sense. “Maybe I’m just not as smart as these other guys,” she said. “But the fact is when I need people I hire them regardless of a tax credit or a tax break. A tax itself does not dictate how I manage my business.”

Newly created insurance markets are expected to make it easier for individuals and small businesses to buy affordable coverage.

The law also includes provisions to shift some of the cost of health care from employers to their employees, who will spend more of their own money when they seek medical care. The goal is to prompt patients to shop around for care rather than consume health products and services without regard for cost.

“People will have cost sharing, which they will manage out-of-pocket,” said Robert Kocher, a guest scholar at the Brookings Institution. “That’s going to lead to market-based competition and tools coming on the market that show you the price that you'll pay for different providers. Those will vary by as much as 300 to 400 percent. That allows consumers to move towards the lower-priced, better-quality providers.”

Krings said she expects that cost sharing will help contain the overall cost of care and save money for companies like hers.

“Once you create that kind of transparency, that’s going to cause the consumer to take pause and say 'Wow: why is this so expensive?'” she said. “That’s part of what is broken. There hasn’t been this transparency. There hasn’t been the personal responsibility to care so much about it."

Tuesday, April 10

Countries that spend the most on health care

Countries that spend the most on health care
Joe Raedle / Getty Images file


The United States spends more than any other country but has the eighth-lowest life expectancy in the Organization for Economic Co-operation and Development survey.

By Michael B. Sauter and Charles B. Stockdale, 24/7 Wall St.

This week, the Supreme Court considered President Obama’s health care reform law. The Patient Protection and Affordable Care Act expands health coverage to millions of uninsured Americans. If the law is overturned, health care costs covered by the federal government would drop substantially.


While government spending on health care could decline, that will not result in lower health care costs. Based on data published by the Organization for Economic Co-operation and Development on global health issues, 24/7 Wall St. identified the countries where health care costs are the highest per person.


Spending a great deal on health care does not result in a healthier population. Of 34 OECD member countries, only three that spent the most per person have citizens that live the longest. The United States spends more than any other country but has the eighth-lowest life expectancy in the OECD. Japan, meanwhile, spends $2,878 per person -- about $5,000 less than the U.S. -- and has the highest life expectancy among developed nations. 


According to the OECD's Matthias Rumpf, health care spending does not result in better treatment. In countries that spend more, he says, people opt for expensive tests and elective procedures that drive up costs. To discourage excess in Germany, for example, citizens are penalized if they see a specialist without first consulting their doctor.


In most of the OECD countries, health care expenses come to more than $2,000 per person each year. In the case of the 10 countries with the highest costs, expenses are roughly twice that. In the U.S., spending on health care per capita comes to nearly $8,000 per person. Many proponents of public health care blame the U.S.’s highly privatized system as the reason for such high costs. But according to Rumpf, a number of factors influence the national spending on care.


How patients use medical services impacts health care expenses. Expensive diagnostic procedures and elective surgeries, like MRI scans and corrective knee surgeries, drive up costs. Conversely, irregular visits to the doctor impair preventative care.


In many of these countries, the source of high costs is drug prices. In four of the countries with the most expensive health care, pharmaceutical expenses come to at least $600 per person per year. In the U.S., those costs are more than $950 per capita.


Another factor that increases cost is poor health-related behavior of the population. Of course, excessive alcohol consumption, tobacco use and poor exercise increase health problems. The incidence of these behaviors is different country to country.


24/7 Wall St.: The 10 most educated countries in the world


Many of the countries that spend the most per capita on health care have highly privatized systems. In the U.S. and Switzerland, which spend the most and third-most on health care, respectively, the government pays less than 65 percent of the total health care costs. In most of the countries in the developed world, public expenditure accounts for at least 70 percent of total costs.


Many of the countries with the highest expenditure per capita on health care also have among the most government-funded health care systems. The governments of Denmark, Austria and Luxembourg pay 84 percent or more of the total health care cost. Total public spending in these countries, without accounting for private health care spending, ranges from 6.5 percent of GDP in Luxembourg to the OECD-high 9.8 percent of GDP in Denmark. In most of the OECD nations, the government foots the majority of the health care bill.


These are the countries that spend the most on health care. 


1. United States

Total expenditure on health per capita: $7,960Expenditure as percent of GDP: 17.4 percent (the most)Annual growth of total health expenditure: +2.2 percent (14th least)Life expectancy: 78.2 years (27th highest)

The U.S. has, by far, the highest total expenditure on health care per capita. America spends approximately $2,600 more per person annually than Norway, the second-highest spender. Only 47.7 percent of this amount is public expenditure -- the third-smallest percentage among developed countries. However, the actual amount of public spending, $3,795, is among the highest. The U.S. also spends the largest amount on pharmaceuticals and other medical nondurables. The country has fairly low rates of doctors and hospital beds relative to its population. It also has the eighth-lowest life expectancy, at 78.2 years.


24/7 Wall St.: America's most miserable states


2. Norway

Total expenditure on health per capita: $5,352Expenditure as percent of GDP: 9.6 percent (16th most)Annual growth of total health expenditure: +8.4 percent (4th most)Life expectancy: 81.0 years (10th highest)

After its neighbor, Denmark, Norway has the most nationalized health care system in the developed world. Of the country’s $5,352 expenditures per person, 84.1 percent are covered by the public sector. Access to health care in the country is high. There are approximately four physicians per 1,000 people, the third most in the OECD. Despite the high percentage of total costs covered by the public, the nation’s residents still pay more than $800 per person on health care.


3. Switzerland

Total expenditure on health per capita: $5,344Expenditure as percent of GDP: 11.6 percent (5th most)Annual growth of total health expenditure: +2.8 percent (17th most)Life expectancy: 82.3 years (2nd highest)

Switzerland currently spends the third most on health care per capita, or the equivalent of 11.6 percent of the country’s GDP. Switzerland has one of the most privatized health care systems in the world, with 30.9 percent of expenses coming out of pocket. Because of the wealth of country, this comes to $1,650 per person, more than double every country in the developed world except the U.S.


24/7 Wall St.: Highest-paid hosts on late-night TV


4. Netherlands

Total expenditure on health per capita: $4,914Expenditure as percent of GDP: 12 percent (second most)Annual growth of total health expenditure: +16.4 percent (the most)Life expectancy: 80.6 years (14th highest)

Health care costs in the Netherlands amount to $4,914 per person each year. The Dutch health expenditure is equivalent to 12 percent of the nation’s GDP -- the second greatest relative health expenditure of every nation in the OECD except the U.S. Total expenses jumped by 16.4 percent between 2008 and 2009, the most among OECD nations. Despite this increase, total out-of-pocket expenses per capita are just $227 per person, the fourth-lowest in the OECD.


5. Luxembourg

Total expenditure on health per capita: $4,808Expenditure as percent of GDP: 7.8 percent (seventh least)Annual growth of total health expenditure: +8 percent (6th most)Life expectancy: 80.7 years (tied for 12th highest)

Health care expenditure in Luxembourg is $4,808 a year, or 7.8 percent of national GDP. This is the greatest decrease among OECD countries. Of that, public expenditures account for 84 percent of the total, the eighth-highest rate among OECD countries. The country’s system faces some difficult challenges in offsetting unhealthy lifestyle choices. For instance, Luxembourg has the highest annual rate of alcohol consumption at 15.5 liters per capita.

Thursday, March 15

Greek parliament approves health cuts

ATHENS — The Greek parliament approved an extension of pharmacy opening hours and cuts to drugs spending on Thursday as part of a package of healthcare reforms agreed in return for last week's 130 billion euro international bailout deal.


The early morning vote, the final significant element in the package of so-called "prior actions" which Athens had promised before this week's European Union summit, follows Tuesday's approval of 3.2 billion euros in budget cuts and a steep reduction in the minimum wage.


Deputies voted 213 to 58 to approve the package, with 17 abstaining in a result which was generally expected after Greece's two biggest parties backed the package.


Greece has been under heavy pressure to match its repeated reform and savings pledges with concrete action after increasing skepticism about the ability of Prime Minister Lucas Papademos' government to push through unpopular changes.


"The Greek authorities have to deliver," European Commissioner for regional policy Johannes Hahn told Reuters in an interview.


There has been growing concern that the repeated doses of austerity will deepen a recession now in its fifth year and make it impossible to cut a public debt burden amounting to 160 percent of gross domestic product.


As well as extending pharmacy hours, an issue which sparked a revolt among lawmakers who rejected the proposal in January, Wednesday's vote will also limit spending on drugs by state pension funds and mandate generic drugs prescriptions to cut costs.


Greece spends some 25 billion euros a year, roughly 10 percent of its GDP, on health and controlling a bloated public health system, has been a priority.


Resistance to the measures among powerful medical lobbies has been fierce however with posters attacking Health Minister Andreas Loverdos as a "gravedigger" plastered over many pharmacies in recent days.


Cheaper generic drugs account for just 18 percent of the market in Greece, one of the lowest levels in the European Union, compared with 80 percent in Germany.


The latest measures aim to lift the Greek total to 50 percent, in line with the rest of Europe.


Wednesday's vote does not impose the kind of pain on ordinary Greeks that the previous cuts have done but it is intended to attack waste in the frequently corrupt and inefficient public health system.


Popular protests against the austerity measures, which exploded into violence earlier this month, have been muted in recent days with many Greeks still shocked by the images of burning buildings seen during the riots.


A small demonstration in front of the parliament on Wednesday broke up after heavy rain began but a transport strike is set to disrupt trains and buses on Thursday and unions have pledged further action in the coming weeks.


Copyright 2012 Thomson Reuters.

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