A California professor published an editorial in The LA Time suggesting that the individual health insurance mandate is really just an economic incentive. Such thinking could be dangerous to consumers who do not consider the more important effect. For the first time in our history, it would be illegal to choose to be without health insurance. The consequences could be far worse than the loss of economic incentive. My response published in the Wall Street Journal is pasted below.
Healthcare reform law: What’s the big deal?
There really is no such thing as an individual health insurance mandate. Let’s stop suggesting otherwise, and start referring to the individual health insurance incentive.
President Obama speaks in the Rose Garden at the White House on Sept. 19.…
October 07, 2011|By William D. Leach
Healthcare reform law: What’s the big deal? – Los Angeles Times
Response by Tony Novak, Freedom Benefits, in Wall Street Journal 10/27/2011
By focusing on the micro-economic issues, I think the author misses the major social and financial impact of the individual insurance mandate. The real impact of the mandate is not the tax penalty but rather the social shift that will result by putting an uninsured person on the wrong side of the law. While our current social health care environment is designed to protect "innocent victims of the system" who incur health expenses while uninsured. That attitude will change quickly in 2014 when (and if) the mandate becomes effective. We are likely to see major reductions in charity care in both public and private organizations. Hospitals across the county have already incorporated the effects of this policy change into their financial projections. Public sentiment will also turn unsympathetic to free-riders who ignore their responsibility to purchase even minimal coverage. We already know that the majority of uninsured are middle income individuals who could afford insurance if they chose to make it a priority but do not take care of that responsibility. After 2014 those individuals who ignore the law are setting themselves up for a dangerous denial of medical care – an consequence far more serious than a tax penalty.
The real work of implementing health care reform was left up to the state governments even though it was clear that the majority of the cost has to be borne by the federal government. A majority of states oppose health reform as passed by the federal government and 27 have taken legal action against the federal government to stop the 2010 law. State governments fear that if the federal government does not come through to financially support the new law, states will be left “holding the bag” without any means of funding the new expensive mandates. Yet as of August 2011 all but three states have initiated new health reform actions in response to the federal Affordable Care Act.
Three states-Alaska, South Dakota and Wyoming-have not taken any action to comply with the new federal law.
Eight states have introduced bills but not passed any health care reform laws. These include Florida, Michigan, New Jersey, Ohio, Pennsylvania, South Carolina, Texas and West Virginia.
The other 39 states and the District of Columbia, including those who are suing the federal government to stop implementation of the health care reform act, have all passed new health reform laws. Part of the reason is to gain access to the hundreds of millions of dollars the federal government is offering to states that implement portions of the law especially the development of state-run health insurance exchanges to sell insurance to individuals and small businesses. States keep the money even if part or all of the health reform bill is repealed.
Meanwhile, other key parts of the federal law were abandoned or scaled-back by the U.S. Department of Health and Human Services this week in recognition that costs were too high or the law, as originally envisioned, is too expensive.
The US Supreme court is expected to rule on another expensive part of the law called the individual mandate. It that part of the law is overturned then the most substantial remaining effects of the law may the the state laws already passed up to that date. It is too soon to know whether the states will reverse their new health care laws if the federal government withdraws financial support but most health care commentators seem to believe that this is inevitable due to the heavy cost of of the newly expanded health care mandates.
More information on the status of specific state mandates is available on the National Conference of State Legislatures Web site.
Mobile phone technology is moving faster than most would have predicted in health care delivery. Yet few if any health insurance providers have incorporated mobile phone technology into their product delivery or customer service platforms.
Consider these two news articles released this week:
Cellphone Monitors vital signs
A researcher has developed a heart monitoring smartphone app that he says is as accurate as standard medical monitors now in clinical use.
Building on the idea of using a smartphone to measure heart rate, and has added other medical monitoring facilities, Worcester Polytechnic Institute (WPI) professor Ki Chon has developed an application that can also measure heart rhythm, respiration rate and blood oxygen saturation using the phone’s built-in video camera.
“This gives a patient the ability to carry an accurate physiological monitor anywhere, without additional hardware beyond what’s already included in many consumer mobile phones,” he says.
from Health IT Daily
Smartphones, medical apps used by 80 percent of docs
Four out of five practicing physicians use smartphones, computer tablets, various mobile devices and numerous apps in their medical practice, according to a new report from Jackson & Coker.
“Tech-savvy physicians, especially recent graduates, increasingly rely on digital and Internet-based tools to communicate with patients and improve the medical outcomes of the care they provide,” said Sandra Garrett, president of Jackson & Coker.
The report cites recent studies that pointed out the practical value of integrating the latest digital hardware and software into healthcare delivery. It’s not surprising that so many practitioners are relying on iPhones, iPads and other computer tablets – as well as downloading a myriad of apps – given the growing movement toward “digitizing as much of the health care process as possible,” the report notes.
from Healthcare IT News
We see an increasing number of reports in this same theme and the pace of mobile health care technology development is certainly likely to increase. Recently we posted an article in another media company asking whether the next generation is more likely to think of their health plan as a mobile phone app rather than a commercial contract.
Freedom Benefits made a first experimental step into mobile delivery with the re-launch of www.OnlineAdviser.org Web site early in 2011. It was the first of our Web services to be released in HTM5 format that allows it to display and function properly in most types of mobile browsers. Although this is primarily an email and telephone service, it does allow us the ability to record some health insurance enrollments by telephone for the first time.
We anticipate partnering with other technology firms to make the mobile service delivery more robust over the next few years.
This article reported by Reuters is about Spain but I’m afraid it is only a matter of time until this becomes the case in the US as well. In two years the headline could easily substitute “California” or “Texas” in place of Spain. Government-paid health care systems simply can not keep afloat under current conditions. The correction is painful in any scenario.
Medical suppliers haven’t been paid for as much as two years, emergency rooms have been shut down and doctors in Catalonia have been told to accept a pay cut or 1,500 medical residents will lose their jobs.
WSJ Professional Article – WSJ.com
Based on initial reports of the Florida health insurance exchange, Freedom Benefits insurance exchange decided to not pursue media coverage or provide Navigator support to the exchange users. While the decision is not permanent and may be reviewed at a later date, the decision is based primarily on reports that:
- Florida’s exchange is open only to small employers, not to individuals.
- The federal law provides subsidies to help lower-income individuals buy coverage through the exchange, and tax credits to some small businesses that cover their workers. Florida does not.
- The federal law requires health plans to offer certain “essential health benefits.” Florida does not.
Freedom Benefits is dedicated to provide enrollment support to individuals in the most affordable insurance options. Group plans are generally more expensive than individual insurance, especially individual basic insurance. The Florida exchange model noes not appear committed to serve either of these primary purposes.
Florida to launch its own health exchange | BenefitsPro
ATLANTA, Georgia – September 14, 2011 – The National Association of Dental Plans (NADP) held its annual CONVERGE 2011 Conference & Exhibition this week in Atlanta.
The annual CONVERGE conference is designed for leaders of the dental benefits community as a professional development event and features a variety of learning formats – interactive roundtables, panels, discussions, exhibits and networking opportunities. The conference allows dental plan professionals to gather to voice challenges with colleagues and gain insight from industry leaders through a series of scheduled, informative sessions.
A key session at this week’s conference was CONVERGE Session Spotlight, “An Open Discussion on the Future of Discount Products.” This panel discussion featured four panelists, each with a unique focus on the session’s topic. Stewart Sweda, Chief Sales and Marketing Officer for Careington International Corporation, spoke specifically on the prevalence of the discount dental plan in today’s market, the adaptability of a discount dental program, and the direction of the discount industry as a whole.
“Discounts probably won’t replace traditional insurance plans, but they have become a viable alternative,” said Sweda of the future of the discount dental model. “We now have a prominent place on the shelf we didn’t have before.”
NADP Press Releases > Careington Executive Serves as Panelist at National Dental Conference
It seems clear that dental discount plans will play a greater role for individuals who pay for their own benefits than those covered by employer-sponsored dental plans. Based on the media coverage, it is not clear that this came out as a conclusion of the conference.