South Africa is mired in a health crisis as the rate of HIV infection reaches 22 percent of adults, including more than one in five pregnant women. The crisis is expensive. Drug treatment costs for AIDS range from $15,000 to $20,000 per year in the U. S., while per capita income in South Africa is only $6,800.
The Internet is the right tool at the right time to allow Americans to manage their own health care. It is changing the entire health care environment for physicians, insurers and patients. The Internet offers the possibility of one-stop shopping – enabling consumers to compare and price health plans, choose their doctors, apply for insurance coverage, check on the status of claims submitted, and pay premiums online.
In the history of social thought, advocates of a more equal distribution of income have made many arguments to support their cause. Egalitarians are now advancing a new argument: inequality of income leads to poorer health.
The Medical Savings Account (MSA) pilot program expires at the end of this year unless Congress acts soon to extend it.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) allowed small employers and the self-employed to set up a tax-favored savings account to pay for routine medical expenses, provided they also have an insurance plan that meets some very specific requirements.
While managed care was rather successful at holding down health care inflation in the 1990s, it did so at the price of growing dissatisfaction among workers, their doctors and ultimately politicians. The various proposals in Congress for a "Patient Bill of Rights" are an indication of this dissatisfaction. So too are the dozens of new "anti-managed care" state laws.
In South Africa, MSA plans have competed against other forms of insurance on a level playing field. The result has been remarkable. In a few short years, MSA plans have become increasingly popular, and they already have captured about half the market. By contrast, HMO-type managed care has made only small inroads.
Some Americans faced with the rising costs of prescription drugs have begun looking longingly at Canada, where prescription drugs appear to cost less than in the United States. Some seniors are taking bus trips from New York and New England to Quebec to buy cheaper drugs.
The growth of the Internet and the vast amount of information it makes available are dramatically changing health care and medicine. As many as 100 million people in the United States now have access to the Internet, and that number is expected to grow by 50 percent over the next few years. Health information is some of the most popular content on the Internet.
Medical Savings Accounts (MSAs) are usually associated with large deductibles. For example, under a federal pilot program, in order for employers and their employees to make tax-free deposits to MSA accounts, patients must incur $1,550 or more in expenses before the insurance kicks in. All the expenses below the deductible are to be paid from the MSA or directly out of pocket. Once the deductible is satisfied, the insurance acts like any other health plan.
Medical Savings Accounts (MSAs) give patients direct ownership of and control over a portion of their health care dollars. They have two main advantages. First, when people spend their own health care dollars, they become more careful and prudent consumers of care than when they spend other people's dollars. The result is lower health care costs and better value for the money spent. Second, when patients pay the bills, doctors and other providers are more likely to act as the patients' agents rather than as agents of a third-party payer. The result is care that better meets the patients' needs.
President Clinton and some on Capitol Hill are proposing a costly prescription drug benefit for the elderly that could create huge new burdens for taxpayers. Fortunately, there is a way to solve the problem without costing taxpayers a single dime.
About 65 percent of the people on Medicare also have some kind of prescription drug coverage. Some obtain it from a former employer. Some buy private supplemental (Medigap) insurance. Others are covered through Medicaid. But about 12 million have no coverage. Sens. Olympia Snowe (R-Maine) and Ron Wyden (D-Ore.) have proposed a new federal program, the Seniors Prescription Insurance Coverage Equity (SPICE) Act, to subsidize prescription drugs for all Medicare beneficiaries.
Almost everyone agrees that the elderly need insurance coverage for prescription drugs. However, a growing number of health policy analysts believe that solving the problem of prescription drugs requires wholesale reform of Medicare. And fundamental Medicare reform may take a year or more to complete.
This Backgrounder discusses the proposal for Medicare reform that was developed by a bipartisan and bicameral group of members on the Medicare Commission.
We have analyzed a distinct new health care delivery and financing system for the Medicare aged population (excluding institutional and Medicaid individuals). The new alternative, referred to as the Medicare Defined Contribution Alternative (MDCA), allows an individual the choice between Medicare as it currently exists and a defined contribution from Medicare that must be used to purchase a plan that includes at least catastrophic insurance.
At President Clinton's direction, the Department of Labor has published a proposed regulation that would allow states to pay unemployment insurance (UI) benefits to fathers and mothers who take time off for the birth or adoption of a child.
If the United States were to adopt the Canadian single–payer system of financing health care as some advocate, the change would not solve many of the problems attributed to the present system. Rather, it would replace one set of problems with another. According to a survey sponsored by the Harvard School of Public Health, which measured public opinion toward health care in five English–speaking countries, people in all five countries had roughly the same level of discontent with their system.
As everyone "knows," the Patients' Bill of Rights that recently passed the House of Representatives would allow members of Health Maintenance Organizations to sue their plans. What most people probably don't know is that members already can sue their HMOs under current law. So what's going on?
Vice President Al Gore's new health care reform plan proposes a major step toward eliminating severe inequities in the tax law and giving needed relief to the millions of people who must buy their own health insurance or go without.
Critics complain that prescription drugs have contributed to a massive increase in health care spending in the United States. Some critics contend that drug prices are too high and propose lowering them through price controls. Many complaints about price, and the laws those complaints spawn, are based on a misunderstanding of how the prescription drug market works.
President Clinton has proposed a new prescription drug entitlement for people on Medicare, the program covering 39 million seniors and the disabled. However, the plan has significant problems.
In 1996 Congress passed "mental health parity" legislation that required employers who had more than 50 employees and who included mental health coverage in their health insurance benefits to offer the same annual and lifetime benefits for mental health care as for standard health care such as surgery and physician visits. The law went into effect in 1998.
President Clinton has outlined a new prescription drug entitlement for people on Medicare, the federal health insurance program covering 39 million seniors and the disabled.
In 1996 Congress created a demonstration project permitting small employers and the self-employed to establish tax-free Medical Savings Accounts (MSAs). However, congressional lawmakers imposed strict limits on who can purchase MSAs and undermined their ability to work properly.
Unwise government policies are largely responsible for the fact that the number of Americans without health insurance is 43 million and rising. Unwise government policies also are responsible for the fact that people who have health insurance are turning over an ever-larger share of their health care dollars to managed care bureaucracies that limit patient choices and sometimes give providers perverse incentives to deny care.