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Health Insurance News
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 A sad story in Miami, Florida regarding health insurance was recently brought to my attention. It highlights the flaws inherent in both public and private health insurance plans, and is an example of why healthcare reform is so important. A friend of mine has an ailing grandfather, named Benito Jimenez. Benito's daughter, Maria Conroy cares for him 24/7, and has taken charge of navigating the complexities of his insurance coverage. Her 85-year-old father has Medicare, but also has a Medicare Advantage administered by Humana. This would seem like an ideal compromise of the government and corporations, which would allow them to provide the best healthcare possible. Instead, it's only brought Maria and her family one frustration after another.
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Healthcare Reform
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Nancy Pelosi has finally released the House of Representatives' version of the mammoth healthcare reform bill, which costs almost $900 billion. While this is by no means the end of the debate (the bill still has to be reconciled with the Senate's differing proposal), some of the dust has now settled. Who looks to benefit from Pelosi's proposals, and who will be hurt by them? As expected, the bill includes a public option and forbids the denial of coverage to people with pre-existing conditions. The uninsured win (even more so than in the Senate's bill, which allows states to opt out of the public option), and health insurance companies lose. Medicare Advantage will see some budget cuts, so many senior citizens will lose; but the new insurance exchange market (including both for-profit insurers and the federal government) will lead to lower premiums, a boon to individuals and small businesses in search of affordable health insurance on the open market. Most of these results are obvious, but there are some unusual beneficiaries and also-rans in the House's bill.
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Health Insurance News
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 A recent survey by U.S. News and World Report ranks the top hospitals in the United States. The 2009 rankings are based on several factors, including the hospital's mortality index: How good are they at keeping their patients alive? Obviously, patients are very interested in that statistic; but health insurers also want to know when they are determining which hospitals to include in their network. Hospitals included in major health insurance companies' plans will see more customers and revenue than those out-of-network. A positive reputation among doctors is greatly coveted and also plays a large role in a hospital's rank, since medical professionals are presumably more knowledgeable and better able to judge their quality. Other elements of a high-quality hospital are the availability of advanced medical technology, its experience in certain specialties, the quality and ratio of nursing staff, and other patient services. Finally, top hospitals take great care to keep their patients as safe as possible. After all, nobody--especially an insurer--wants to pay to fix another hospital's mistakes.
So which hospitals are the best in America, and why?
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Health Insurance News
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Diabetes Drug Might Be Weight Loss Solution; Will Insurance Cover It?
 A recent study gives some hope to the millions of people struggling with maintaining a healthy weight. Although few health insurers directly base their coverage decisions on a person's weight, obesity often leads to other health problems that will cause premiums to skyrocket. Sometimes, these ailments will prevent someone from being able to buy health coverage altogether. Diabetes, specifically the type-2 variety, is one of the illnesses that can result in excess weight and higher costs for everyone (because everyone subsidizes part of diabetics' treatment). It appears that a drug developed to treat diabetics can also result in weight loss; but will insurance companies pay for it? More importantly, does it even work? |
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Healthcare Reform
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Th ere has been much speculation over the possible inclusion of a public option in the healthcare reform bill. Despite the controversy, Senate Majority Leader Harry Reid plans to ensure that a government-run health insurance program, intended to compete with private health insurance plans, is included--but there's a catch. The new provision allows states to pass legislation that excludes them from the public option. With this strategy, Democrats in both chambers of Congress are forgoing support from any of the Republicans--although only one, Maine Senator Olympia Snowe, expressed willingness to vote for any version of health care reform with some type of public option (albeit one that first had to be "triggered"). However, it will probably secure the votes of some conservative and moderate Democrats who have been unsure of the public option. However, does this version of the public option defeat the purpose of the public option, and will it meet the goals of its liberal supporters?
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