In a well designed study done in Oregon, researchers have demonstrated that having health insurance improves health, economics, and peace of mind. It’s hardly a surprise, but the study had never been done before. Read this summary in the New York Times: Study Finds Benefits in Providing Health Insurance to the Poor.
“The non-profit insurers have large reserves and the for-profit insurers report larger than necessary reserves as well: Colorado’s for-profit health insurers also are doing well, and the state is required to take their profits into account when approving rate increases. UnitedHealthcare reported a capital reserve of 413 percent at the end of 2009, Anthem had 449 percent of the minimum, and HMO Colorado had 578 percent. Health Care for America Now, a pro-reform group in Washington, said the five biggest commercial insurers saw profits climb 17 percent in 2010 to $11.7 billion.”
So how do we interpret these facts?
How can this be? Blue Shield’s cumulative rate hikes could reach 86.5%
“People are justifiably concerned when they get a significant rate increase. We wish that we didn’t have to do that,” [Tom] Epstein [company spokesperson] said. “When people are getting increases like that and we’re still losing money, something is seriously wrong.”
The Decision Tree: Taking Control of Your Health in the New Era of Personalized Medicine by Thomas Goetz (2010) is a compelling call to action on behalf of one’s health. Goetz describes how we are generally passive regarding decision-making for our own health. We are inclined to allow our health care providers to make choices for us rather than consider our alternatives–even the ones not offered by our doctors–and decide ourselves. As he describes, we are often more likely to investigate the purchase of a car or technicalogical gizmo more than a suggested medical treatment. And yet, the information age makes it much easier to manage our health, so why are we generally willing to hand over our lives, and our health, to others?
Focusing on “health” care rather than “illness” care, the stories and experiences related in the book encourage each of us to have a plan to manage our health and to take an active role in making choices that affect our lives. While the model of “decision trees” isn’t explained as a process, it is descriptive in showing where we make choices. And each choice gives us options to become more (or less) involved.
Goetz shows how medicine today gives us glimpses of the future by not only diagnosing illnesses but by measuring risk factors that might lead to diseases. In a particularly revealing and somewhat sobering chapter, he describes how the risk factors have come to be recognized–and treated–by the health care field (including insurers) as illnesses themselves even though they are only increase the probability of a diagnosis. Similarly, the field of genetics is coming ever closer to predicting one’s medical future.
The options for technology to support us in leading healthier lives are discussed. If apps are good for directions, social media, and games, why not use them to help us to eat better, exercise more and reduce stress?
It’s an interesting book. My biggest question after completing it is about the vulnerable populations; how can decision trees and technology help those who have few resources and no homes to lead healthier lives? Not every book needs to address this question, but it seems like the issues presented are relevant to all of us…not just those with computers and cell phones.
On Friday, the HHS of the federal government announced that it will cut premiums for health insurance for the high risk pool. The lower rates will start in 2011 in a program that will last until 2014 when it be phased out because at that time (because of the reforms) insurance companies will no longer be able to deny coverage based on preexisting conditions.
There are some requirements for this coverage; you can read more about it.
But, this sounds like it’s going in the right direction, don’t you agree?
An article in the LA Times this morning has a striking headline: WellPoint and Aetna post higher profit in 3rd quarter: The insurers say reduced healthcare costs helped boost their earnings. The story explains that Aetna’s net profits are up 53% over the same period last year.
So this is why so many are working diligently to reduce the costs of health care? I thought it was to pass the savings on to those who use the health care system, people who are ill or trying to prevent illness. But no, cost saving measures are used to increase profits.
Does that seem right?
“Over the last two years in an emergency situation we worked with the process instead of to transform the process,” President Barack Obama talking with Jon Stewart about change in policies on The Daily Show on 27 October 2010.
And I respectfully ask: When do emergencies allow us a more radical approach to change? When will we consider our health care system in an “emergency situation”? Can we transform health care so that…
…everyone has all and only the health care they need?
…we work on health and not just illness?
…health is not a “big money” business?