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A Health Consumer Bill of Rights: Assuring Affordability, Access, Autonomy, and Equity

Let’s put “health” back into the U.S. health care system. That’s the mantra coming out of this week’s annual Capitol Conference convened by the National Association of Benefits and Insurance Professionals (NABIP). (FYI you might know of NABIP by its former acronym, NAHU, the National Association of Health Underwriters).         NABIP, whose members represent professionals in the health insurance benefits industry, drafted and adopted a new American Healthcare Consumer Bill of Rights launched at the meeting. While the digital health stakeholder community is convening this week at VIVE in Los Angeles to share innovations in health tech, NABIP

 

Americans Come Together in Worries About Medical Bills, the Cost of Health Care, and Prescription Drug Costs

In the U.S., national news media, Federal statistics, dozens of business leaders  and the Federal Reserve Bank have been talking about an historically positive American economy on a macro level. But among individual residents of the U.S., there is still a negative feeling about the economy in a personal context, revealed in the Kaiser Family Foundation Health Tracking Poll for February 2024.                I’ve selected three figures of data from the KFF’s Poll which make the point that in peoples’ negative feelings about the national economy, their personal feelings about medical costs rank high

 

Inflation and the cost of health care top U.S. voters’ issues for 2024 elections

The cost of living ranks top in U.S. voters’ minds among many issues Americans are feeling and following in late 2023. A close second in line is affordability of health care, as consumers’ household budgets must make room for paying medical bills — with prescription drug costs also very important as a discussion topic for 2024 Presidential candidates, we learn from the latest KFF Health Tracking Poll published 1 December. The monthly study focused on U.S. voters’ top issues and perspectives on the health system and care approaching the new year of 2024. KFF fielded the study among 1,301 U.S.

 

Don’t Mess with Medicare and Medicaid, Washington: They Remain Popular with Americans Across Party ID

A majority of the U.S. public does not want politicians to “up-end” government-funded health programs, according to the Kaiser Family Foundation’s March 2023 Health Tracking Poll.           Social Security, Medicare, and Medicaid all garner most partisans’ support whether identifying as Democrat, Independent, or Republican, KFF found in their monthly poll of U.S. voters ages 18 and over. The survey was conducted online and by telephone among 1,271 U.S. adults between March 14-23, 2023.               Among all the important findings in this well-timed poll, I’ll point to the issue of public

 

The 2022 US Health System Report Card: Pretty Terrific If You Live in Hawaii or Massachusetts

The best U.S. states to live in for health and health care are Hawaii, Massachusetts, Connecticut, Washington, Vermont, Rhode Island, and Maryland…             Those are the top health system rankings in the new 2022 Scorecard on State Health System Performance annual report from the Commonwealth Fund. If you live in Mississippi, Oklahoma, West Virginia, Texas, Missouri, Alabama, Georgia, or Arkansas, your health care and outcomes are less likely to be top-notch, the Fund’s research concluded.                 The Commonwealth Fund has conducted this study since 2006, assessing a range

 

Only in America: Medical Debt Is Most Peoples’ Problem, KHN and NPR Report

When high-deductible health plans became part of health insurance design in America, they were lauded as giving patients “more skin in the game” of health care payments. The theory behind consumer-directed care was that patients-as-consumers would shop around for care, morph into rational consumers of medical services just as they would do purchasing autos or washing machines, and shift the cost-curve of American health care ever downward. That skin-in-the-game has been a risk factor for .some patients to postpone care as well as take on medical debt — the strongest predictor of which is dealing with multiple chronic conditions. “The

 

Doctors’ Offices Morph into Bill Collectors As Patients Face Growing Out-Of-Pocket Costs

In the U.S., patients have assumed the role of health care payors with growing co-payments, coinsurance amounts, and deductibles pushing peoples’ out-of-pocket costs up. This has raised the importance of price transparency, which is based on the hypothesis that if patients had access to personally-relevant price/cost information from doctors and hospitals for medical services, and pharmacies and PBMs for prescription drugs, the patient would behave as a consumer and shop around. That hypothesis has not been well proven-out: even though more health care “sellers” on the supply side have begun to post price information for services, patients still haven’t donned

 

Medical Debt in the U.S. Greater in States That Did Not Expand Medicaid

The level of medical debt in America exceeded debt of other types in 2020. Furthermore, the flow of medical debt was greater among health citizens living in states that did not expand Medicaid as part of the Affordable Care Act, compared with patients who reside in Medicaid expansion states, according to an original research essay, Medical Debt in the US, 2009-2020 published in JAMA on 20 July 2021. The first line chart illustrates the trends in medical debt in collections by state expansion of Medicaid, with the bottom darkest line representing debt in collections in Medicaid expansion states from the

 

One in Two Americans with Work-Based Insurance Worries That Healthcare Costs Could Lead to Bankruptcy

One in two people in the U.S. with employer-sponsored health insurance worry that a major health event in their household could lead to bankruptcy, according to research gathered by West Health and Gallup in Business Speaks: The Future of Employer-Sponsored Insurance. Gallup and West Health presented their study in a webinar earlier this week; in today’s post, I feature a few key data points that particularly resonate as I celebrate/appreciate yesterday’s U.S. Supreme Court’s ruling on the Affordable Care Act (i.e., California v. Texas) combined with a new study published in JAMA Network Open, discussed below the digital fold in

 

The Cost of Health Care for a Family of 4 in America Will Reach $28,256 in 2021

The good news for health care costs for a family of four in America is that they fell, for the first time in like, ever, in 2020. But like a déjà vu all over again, annual health care costs for a family of four enrolled in a PPO will climb to over $28,000 in 2021, based on the latest 2021 Milliman Medical Index (MMI). The first chart shows how health care costs declined in our Year of COVID, 2020, by over $1,000 for that hypothetical U.S. family. But costs rise with a statistical vengeance this year, by nearly $2,200 per family–about

 

The Cost of Healthcare Can Drive Medical Rationing and Crowd Out Other Household Spending

One in five people in the U.S. cannot afford to pay for quality health care — an especially acute challenge for Black and Hispanic Americans, according to a West Health-Gallup poll conducted in March 2021, a year into the COVID-19 pandemic. “The cost of healthcare and its potential ramifications continues to serve as a burdensome part of day-to-day life for millions of Americans,” the study summary observed. Furthermore, “These realities can spill over into other health issues, such as delays in diagnoses of new cancer and associated treatments that are due to forgoing needed care,” the researchers expected. The first table

 

How to Restore Americans’ Confidence in U.S. Health Care: Deal With Access and Cost

With a vaccine supply proliferating in the U.S. and more health citizens getting their first jabs, there’s growing optimism in America looking to the next-normal by, perhaps, July 4th holiday weekend as President Biden reads the pandemic tea leaves. But that won’t mean Americans will be ready to return to pre-pandemic health care visits to hospital and doctor’s offices. Now that hygiene protocols are well-established in health care providers’ settings, at least two other major consumer barriers to seeking care must be addressed: cost and access. The latest (March 2021) Kaiser Family Foundation Tracking Poll learned that at least one

 

Value-Based Health Care Needs All Stakeholders at the Table – Especially the Patient

2021 is the 20th anniversary of the University of Michigan Center for Value-Based Insurance Design (V-BID). On March 10th, V-BID held its annual Summit, celebrating the Center’s 20 years of innovation and scholarship. The Center is led by Dr. Mark Fendrick, and has an active and innovative advisory board. [Note: I may be biased as a University of Michigan graduate of both the School of Public Health and Rackham School of Graduate Studies in Economics].   Some of the most important areas of the Center’s impact include initiatives addressing low-value care, waste in U.S. health care, patient assistance programs, Medicare

 

The Economics of the Pandemic Put Costs at the Top of Americans’ Health Reform Priorities

A major side-effect of the coronavirus pandemic in 2020 was its impact on the national U.S. economy, jobs, and peoples’ household finances — in particular, medical spending. In 2021, patients-as-health-consumers seek lower health care and prescription drug costs coupled with higher quality care, discovered by the patient advocacy coalition, Consumers for Quality Care. This broad-spanning patient coalition includes the AIMED Alliance, Autism Speaks, the Black AIDS Institute, Black Women’s Health Initiative, Center Forward, Consumer Action. Fair Foundation, First Focus, Global Liver Institute, Hydrocephalus Association, LULAC, MANA (a Latina advocacy organization), Myositis Association, National Consumers League, National Health IT Collaborative, National Hispanic

 

Addressing Lives and Livelihoods with a Whole-of-Government Approach – The First Wave of Biden Health Policy

President Biden’s first few days on the job gave us a very clear view on how he sees conquering COVID: through a whole-of-government approach to public policies that bolster directly addressing the virus, along with the many forces shaping how we got here and how to come out of the pandemic era stronger. I cover this first wave of Biden health policy in my latest post for the Medecision Liberation blog titled, “Top Priorities for President Biden: COVID-19, Then Everything Else.” The plotline goes… On the day of inauguration, January 20, 2021, Joseph R. Biden was installed as the 46th

 

The 2021 Health Populi TrendCast – Health Care, Self-Care, and the Rebirth of Love in Public Health

In numerology, the symbolic meaning behind the number “21” is death and re-birth. In tarot cards, 21 is a promise of fulfillment, triumph, and victory. How apropos that feels right now as we say goodbye and good riddance to 2020 and turn the page for a kinder, gentler, healthier New Year. It would be sinful to enter a New Year as challenging as 2021 promises to be without taking the many lessons of our 2020 pandemic life and pain into account. For health care in America, it is a time to re-build and re-imagine a better, more equitable landscape for

 

Voting for Health in 2020

In the 2018 mid-term elections, U.S. voters were driven to polls with health care on their minds. The key issues for health care voters were costs (for care and prescription drugs) and access (read: protecting pre-existing conditions and expanding Medicaid). Issue #2 for 2018 voters was the economy. In 2020, as voting commences in-person tomorrow on 3rd November, U.S. voters have lives and livelihoods on their minds. It’s the pandemic – our physical lives looming largest in the polls – coupled with our fiscal and financial lives. Health is translating across all definitions for U.S. voters in November 2020: for

 

Two in Three Americans Cite the U.S. Presidential Election is a Significant Source of Stress, Even More than the 2016 Race

If you perceive you are more stressed in the COVID-19 pandemic than you were in 2019, you are one in many millions feeling so. If you felt stressed during the 2016 Presidential election season, you were also one in a million. Now, as the 2020 Election converges with the coronavirus crisis, even more Americans are feeling significant stress in a double-whammy impact. Our friends at the American Psychological Association have assessed Stress in America for many years of studies. The latest, published 7 October, finds that the 2020 Presidential election is a source of significant stress for more Americans than

 

In the Past Ten Years, Workers’ Health Insurance Premiums Have Grown Much Faster Than Wages

For a worker in the U.S. who benefits from health insurance at the workplace, the annual family premium will average $21,342 this year, according to the 2020 Employer Health Benefits Survey from the Kaiser Family Foundation. The first chart illustrates the growth of the premium shares split by employer and employee contributions. Over ten years, the premium dollars grew from $13,770 in 2010 to $21K in 2020. The worker’s contribution share was 29% in 2010, and 26% in 2020. Single coverage reached $7,470 in 2020 and was $5,049 in 2010. Roughly the same proportion of companies offered health benefits to

 

Financial Health Is On Americans’ Minds Just Weeks Before the 2020 Elections

Financial health is part of peoples’ overall health. As Americans approach November 3, 2020, the day of the real-time U.S. Presidential and down-ballot elections, personal home economics are front-of-mind. Twenty-seven days before the 2020 elections, 7 in 10 Americans say their financial health will influence their votes this year, according  to the doxoINSIGHTS survey which shows personal financial health as a key voter consideration in the Presidential election. Doxo, a consumer payments company, conducted a survey among 1,568 U.S. bill-paying households in late September 2020. The study has a 2% margin of error. U.S. voters facing this year’s election are

 

The Emergence of Health Citizens – Part of Liberating Health, on the Medecision Blog

I have always appreciated Medecision’s mission as expressed in the company’s tagline: “Liberating,” as in “liberate healthcare.” I began collaborating with Medecision as a client several years ago, a couple of years after I heard Todd Park, then Chief Technology Officer in the White House, joyfully assert the phrase, “Data Liberación!” at an early Health 2.0 Conference. Medecision published my blog about health citizenship this week on the company’s Liberate.Health site. The emergence of health citizens in the U.S. — people re-claiming their health, health care, and control of data — is part of liberating health in America. Please check

 

Only in America: The Loss of Health Insurance as a Toxic Financial Side Effect of the COVID-19 Pandemic

In terms of income, U.S. households entered 2020 in the best financial shape they’d been in years, based on new Census data released earlier this week. However, the U.S. Census Bureau found that the level of health insurance enrollment fell by 1 million people in 2019, with about 30 million Americans not covered by health insurance. In fact, the number of uninsured Americans rose by 2 million people in 2018, and by 1.9 million people in 2017. The coronavirus pandemic has only exacerbated the erosion of the health insured population. What havoc a pandemic can do to minds, bodies, souls, and wallets. By September 2020,

 

50 Days Before the U.S. Elections, Voters Say Health Care Costs and Access Top Their Health Concerns — More than COVID-19

The coronavirus pandemic has revealed deep cracks and inequities in U.S. health care in terms of exposure to COVID-19 and subsequent outcomes, with access to medical care and mortality rates negatively impacting people of color to a greater extent than White Americans. The pandemic has also led to economic decline that, seven weeks before the 2020 elections in America, is top-of-mind for health citizens with the virus-crisis itself receding to second place, according to the Kaiser Family Foundation September 2020 Health Tracking Poll. KFF polled 1,199 U.S. adults 18 years of age and older between August 28 and September 3,

 

How the Coronavirus is Reshaping Consumer Trust – The Edelman Trust Barometer Lens and Health Impacts

U.S. consumers were re-shapen by the 2008 Recession in two key ways: people took on more self-service DIY daily life-flows, seeking self-sufficiency and less dependence on institutions; and, consumers became more value-sensitive both in terms of financial value and personal values. As Americans confront the clinical and fiscal realities of the coronavirus in the U.S., the trust people feel with organizations, brands and information sources is shifting, a special report from Edelman explains. In Brand Trust and the Coronavirus Pandemic, Edelman focuses its trust lens on the pandemic and consumers’ shaken confidence in business and government institutions. These findings have

 

Most Americans Concerned About Coronavirus Impact on Economy & Families, and Not a “Hoax”

Seven in 10 Americans are concerned about the coronavirus outbreak’s impact on the economy, and 6 in 10 people worried about someone they love getting sick from COVID-19. But most Americans also get the politicized nature of the coronavirus and say they’re less likely to vote for President Trump in November based on his handling of the public health threat, according to a just-released survey from Protect Our Care fielded by Public Policy Polling. Some of the data points which demonstrate that Americans are taking the emerging coronavirus pandemic quite seriously are that: 53% disagree that President Trump and his

 

Americans’ Top 2 Priorities for President Trump and Congress Are To Lower Health Care and Rx Costs

Health care pocketbook issues rank first and second place for Americans in these months leading up to the 2020 Presidential election, according to research from POLITICO and the Harvard Chan School of Public Health published on 19th February 2020. This poll underscores that whether Democrat or Republican, these are the top two domestic priorities among Americans above all other issues polled including immigration, trade agreements, infrastructure and regulations. The point that Robert Blendon, Harvard’s long-time health care pollster, notes is that, “Even among Democrats, the top issues…(are) not the big system reform debates…They’re worried about their own lives, their own

 

The Ill Health of Rural Hospitals in Four Charts

There are 1,844 rural hospitals operating in the U.S. That number is down by 19 in the 2019 calendar year, the worst year of rural hospital closings seen in the past decade. That hockey-stick growth of closures is shown in the first chart, where 34 rural hospitals shut down in the past 2 years. Rural U.S. hospitals are in poor fiscal health. “The accelerated rate at which rural hospitals are closing continues to unsettle the rural healthcare community and demands a more nuanced investigation into rural hospital performance,” threatening the stability of the rural health safety net, according to the

 

USA Today Finds Hidden Common Ground Among Americans For Health Care

“We need to demand our health citizenship. That means our nation must approach medical treatment and data privacy as civil rights that protect everyone.” This is the start of my column, Americans, let’s claim our health care rights, published by USA Today today. USA Today is publishing a 10-part series called “Hidden Common Ground” addressing key issues where Americans can come together. Thus far, the series has covered climate change, and this month health care. Going forward, we’ll see analyses on jobs, gun rights and violence, and immigration through May’s publishing schedule. In their study conducted in December 2020, USA Today

 

Come Together – A Health Policy Prescription from the Bipartisan Policy Center

Among all Americans, the most popular approach for improving the health care in the U.S. isn’t repealing or replacing the Affordable Care Act or moving to a Medicare-for-All government-provided plan. It would be to improve the current health care system, according to the Bipartisan Policy Center’s research reported in a Bipartisan Rx for America’s Health Care. The BPC is a truly bipartisan organization, co-founded by Former Democratic Senate Majority Leaders Tom Daschle and George Mitchell, and Former Republican Senate Majority Leaders Howard Baker and Bob Dole. While this political week in America has revealed deep chasms between the Dems and

 

What’s Causing Fewer Primary Care Visits in the US?

Americans who have commercial health insurance (say, through an employer or union) are rarely thought to face barriers to receiving health care — in particular, primary care, that front line provider and on-ramp to the health care system. But in a new study published in the Annals of Internal Medicine, commercially-insured adults were found to have visited primary care providers (PCPs) less often, and 1 in 2 had no PCP visits in one year. In Declining Use of Primary Care Among Commercially Insured Adults in the United States, 2008-2016, the researchers analyzed data from a national sample of adult health

 

A Uniting Issue in the United States is Lowering Prescription Drug Costs

Health care continues to be the top-ranked voting issue in the U.S. looking to the November 2020 Presidential and Congressional elections. The Kaiser Family Foundation conducts the monthly poll which gauges U.S. adults’ perspectives on health care, and this month’s January 2020 Kaiser Health Tracking Poll explores Americans’ views on broad healthcare reform plans and specific medical policy issues. Overall, Americans point to prescription drug costs and the preservation of the Affordable Care Act’s protections for people with pre-existing conditions, the first chart tells us. Third and fourth on voters’ minds are protecting patients from surprise medical bills and better

 

Out-of-Pocket and Prescription Drug Costs – Connecting Digital Health Dots at CES 2020

The top two health care concerns facing Americans are out-of-pocket costs and prescriptions drug costs, according to a poll published today in Morning Consult. Apropos to my title of this post, the survey was sponsored by the Bipartisan Policy Center, whose mission is to promote, cross-party affiliations, “health, security and opportunity for all Americans.” Health care is the top issue driving voters’ choices in the 2020 elections for most Americans. The economy follows second with 44% of voters, then immigration with 33% of Americans keen on the issue. For overall healthcare reform, the plurality of Americans prefer improving the current system

 

More Evidence of Self-Rationing as Patients Morph into Healthcare Payors

Several new studies reveal that more patients are feeling and living out their role as health care payors as medical spending vies with other household line items. This role of patient-as-the-payor crosses consumers’ ages and demographics, and is heating up health care as the top political issue for the 2020 elections at both Federal and State levels. In research from HealthPocket, 2 in 5 Americans said they needed to reduce other household expenses to be able to afford their monthly insurance premiums. Four in ten consumers said their monthly health insurance premiums were increasing. One in four people in the

 

Thinking About Health Care One Year From the 2020 Presidential Election

Today is 4th November 2019, exactly one year to the day that Americans can express their political will and cast their vote for President of the United States. Health care will be a key issue driving people to their local polling places, so it’s an opportune moment to take the temperature on U.S. voters’ perspectives on healthcare reform. This post looks at three current polls to gauge how Americans are feeling about health care reform 365 days before the 2020 election, and one day before tomorrow’s 2019 municipal and state elections. Today’s Financial Times features a poll that found two-thirds

 

Americans’ Top Sources of Stress are Money, Money, Money and Family

ABBA sang the song “Money Money Money” back in 1976. The lyrics feel, sadly, spot-on when thinking about health care costs, job-lock and Americans’ home economics in 2019. “Work all night, I work all day, to pay the bills I have to pay Ain’t it sad And still there never seems to be a single penny left for me That’s too bad… Money, money, money must be funny In the rich man’s world.” That year, ’76, wasn’t just the U.S. bicentennial — it was a year when the U.S. allocated 8.6% of the nation’s Gross Domestic Product for health care.

 

Wasted: $1 of Every $4 Spent on Health Care In America

A study in JAMA published this week analyzed research reports that have measured waste in the U.S. health care system, calculating that 25% of medical spending in America is wasted. If spending is gauged at $3.8 trillion, waste amounts to nearly $1 trillion. If spending is 18% of the American gross domestic product (GDP), then some 4.5% of the U.S. economy is wasted spending by the health care system and its stakeholders. In “Waste in the US Health Care System,” a team from Humana and the Univrsity of Pittsburgh recalibrated the previous finding of 30% of wasted spending to the 25%,

 

Most U.S. Voters Support Building on the ACA, Not Medicare For All, As Fewer Americans Have Insurance Coverage

The vast majority of Americans favor lowering the cost of prescriptions, keeping the Affordable Care Act’s provisions to cover pre-existing conditions, lower overall medical costs, and protect people from surprise medical bills, according to the KFF Health Tracking Poll – September 2019: Health Care Policy In Congress And On The Campaign Trail. The big headline in this poll following last night’s third Democratic Presidential debate is that 55% of Democrats and Democrat-leaning Independent voters prefer a candidate that will build on the Affordable Care Act (ACA) versus a President that would replace the ACA with a Medicare For All plan (M4A).

 

Growing Support for Medicare for All – But Do People Really Understand What It Means?

Two new data points converge that beg the question in the title of this post. These two surveys are: The Morning Consult’s poll published today finding growing support among Democratic voters for Medicare for All as the centerpiece for health reform in America; and, A recent study from Eligibility.com on “Medicare Myths Explained,” with the tagline, “How much do you know about Medicare?” Not so very much, Eligibility.com found out. Let’s start with the Morning Consult poll results, which compare support for Medicare for All from January 2019 and August 2019. The headline number from this poll is seen in

 

Love ACA Provisions, Not the ACA – KFF Poll Reveals American Voters’ Views on Health Care Reform

Today is the bridge day between The Battle of the Democratic Primary Candidates Debate #2 Part 1 and tonight, Part 2. So it’s a good time to take stock of U.S. voters’ views on health care, through the lens of the Kaiser Family Foundation’s Health Tracking Poll for July 2019 published yesterday. Health care is the top issue Democrats want to hear about in the debates, well ahead of climate change, women’s issues, immigration and gun policy. Let’s start with an overall context statistic from this poll: that is that 86% of insured U.S. adults like their health insurance plan

 

Finances Are the Top Cause of Stress, and HSAs Aren’t Helping So Much…Yet

If you heed the mass media headlines and President Trump’s tweets, the U.S. has achieved “the best economy” ever in mid-July 2019. But if you’re working full time in that economy, you tend to feel much less positive about your personal prospects and fiscal fitness. Nearly nine in 10 working Americans believe that medical costs will rise in the next few years as they pondering potential changes to the Affordable Care Act. The bottom line is that one-half of working people are more concerned about how they will save for future health care expenses. That’s the over-arching theme in PwC’s

 

Americans’ Financial Anxiety Ties to Personal Cash Flow and Health Care

“The Dow Jones Industrial Average was on the brink of claiming a thousand-point milestone for the first time since January 2018, ending the longest period without crossing such a psychologically significant level since the blue-chip benchmark crossed the 19,000 threshold three weeks after Donald Trump was elected president in November 2016,” Mark DeCambre of MarketWatch wrote yesterday morning. He noted that President Trump, “tweeted a simple call-out to the intraday record: ‘Dow just hit 27,000 for first time EVER!'” clipped here from Twitter. Indeed, the U.S. macro-economy has nearly full employment and the stock market hit a high mark this

 

Health Care and the Democratic Debates – Round 2 – Battle Royale for M4All vs Medicare for All Who Want It – What It Means for Industry

Looking at this photo of the 2020 Democratic Party Presidential candidate debater line-up might give you a déjà vu feeling, a repeat of the night-before debate. But this was Round 2 of the debate, with ten more White House aspirants sharing views — sometimes sparring — on issues of immigration, economic justice, climate change, and once again health care playing a starring role from the start of the two-hour event. The line-up from left to write included: Marianne Williamson. author and spiritual advisor John Hickenlooper, former Governor of Colorado Andrew Yang. tech company executive Pete Buttigieg, Mayor of South Bend,

 

Health Care and the Democratic Debates – Part 1 – Medicare For All, Rx Prices, Guns and Mental Health

Twenty Democratic Presidential candidates each have a handful of minutes to make their case for scoring the 2020 nomination, “debating” last night and tonight on major issues facing the United States. I watched every minute, iPad at the ready, taking detailed notes during the 120 minutes of political discourse conducted at breakneck speed. Lester Holt, Savannah Guthrie, and Jose Diaz-Balart asked the ten candidates questions covering guns, butter (the economy), immigration, climate change, and of course, health care — what I’m focusing on in this post, the first of two-debate-days-in-a-row. The first ten of twenty candidates in this debate were,

 

The 3 A’s That Millennials Want From Healthcare: Affordability, Accessibility, Availability

With lower expectations of and satisfaction with health care, Millennials in America seek three things: available, accessible, and affordable services, research from the Transamerica Center for Health Studies has found. Far and away the top reason for not obtaining health insurance in 2018 was that it was simply too expensive, cited by 60% of Millennials. Following that, 26% of Millennials noted that paying the tax penalty plus personal medical expenses were, together, less expensive than available health options. While Millennials were least likely to visit a doctor’s office in the past year, they had the most likelihood of making a

 

Will Health Consumers Morph Into Health Citizens? HealthConsuming Explains, Part 5

The last chapter (8) of HealthConsuming considers whether Americans can become “health citizens.” “Citizens” in this sense goes back to the Ancient Greeks: I return to Hippocrates, whose name is, of course, the root of The Hippocratic Oath that physicians take. Greece was the birthplace of Democracy with a capital “D.” Hippocrates’ book The Corpus is thought to be one of the first medical textbooks. The text covered social, physical, and nutritional influences, and the concept of “place” for health and well-being. Here, the discussion detailed the roles of air and water for health. The Hippocratic texts also coached doctors to

 

Having Health Insurance Is A Social Determinant of Health

Health insurance was on the collective minds of American voters in the 2018 midterm elections. Health care, broadly defined, drove many people to the polls voting with feet and ballots to protect their access to a health plan covering a pre-existing condition or to protest the cost of expensive prescription drugs. These were the two top health care issues among voters in late 2018, a Kaiser Family Foundation poll at the time assessed. Yesterday, President Trump verbally re-branded the Republican Party as “the party of healthcare.” That Presidential pronouncement was tied to a letter written on U.S. Department of Justice

 

Medical Issues Are Still The #1 Contributor to Bankruptcy in the U.S., An AJPH Study Asserts

Medical costs in America are still the top contributor to personal bankruptcy in the U.S., a risk factor in two-thirds of bankruptcies filed between 2013 and 2016. That’s a sad fiscal fact, especially as more Americans gained access to health insurance under the Affordable Care Act, according to a study published this month in the American Journal of Public Health (AJPA). Between 2013 and 2016, about 530,000 bankruptcies were filed among U.S. families each year associated with medical reasons, illustrated in Table 1 from the study. The report, Medical Bankruptcy: Still Common Despite the Affordable Care Act, updates research from 2007 which

 

Patients, Health Consumers, People, Citizens: Who Are We In America?

“Patients as Consumers” is the theme of the Health Affairs issue for March 2019. Research published in this trustworthy health policy publication covers a wide range of perspectives, including the promise of patients’ engagement with data to drive health outcomes, citizen science and participatory research where patients crowdsource cures, the results of financial incentives in value-based plans to drive health care “shopping” and decision making, and ultimately, whether the concept of patients-as-consumers is useful or even appropriate. Health care consumerism is a central focus in my work, and so it’s no surprise that I’ve consumed every bit of this publication. [In

 

Americans Are Warming to Universal Health Care, Kaiser Poll Finds

Most Americans like the idea of universal health care as a guaranteed right, Kaiser Family Foundation learned in this month’s Health Tracking Poll. This finding reinforces the voter turnout for the 2018 mid-term elections which was largely driven by peoples’ concerns for losing health access for pre-existing conditions. The first chart notes important nuances under the majority support for a national health plan which, in this case, asked whether people favored a plan “sometimes called ‘Medicare for all.'” I note that note all national health plan designs would need to be tied to Medicare. There are many ways to deliver

 

Healthcare Is Local: Channeling Tip O’Neill in the 2018 Midterm Election Results

As Tip O’Neill’s mantra goes, “All politics is local.” In the U.S. 2018 midterm elections, healthcare voting seems to have translated as a local issue, falling into O’Neill’s axiom. In this election, healthcare was the most important voting issue for consumers, PwC found, ranking above the economy, national security, and education. On this morning after 2018 midterm election results are (mostly) out, it looks like healthcare was a local and state issue for U.S. 2018 midterm voters. The Democrats flipped more than 23 seats in the U.S. House of Representatives to gain control of that chamber. The Senate is up

 

Vote As If Your Health Depended Upon It; Learning from Governor Kasich on Voting Day 2018

…because it does. “Citizens scare politicians,” I heard Governor John Kasich say to Nicole Wallace on her show Deadline: White House yesterday, just hours from today’s U.S. 2018 midterm elections. Governor Kasich has led the Buckeye State since 2011, and his second and final term ends in January 2019. The Governor expanded Medicaid under the Affordable Care Act in the State of Ohio, discussed in this insightful Washington Post article. “I am my brothers’ and sisters’ keeper,” Kasich told Wallace. The Governor asserted this in the context of the role of protecting his fellow citizens for health and well-being, for

 

Healthcare and the F-Word: Health Politics Rank High on November 6, 2018

“Let’s get this thing f-ing done,” Martha McSally passionately asserted on May 4, 2017. Paul Ryan said, on the floor of the U.S. House of Representatives without cursing, “A lot of us have waited seven years to cast this vote.” McSally, who represents Tucson, Arizona, in the U.S. Congress, is running to replace retiring Senator Jeff Flake. McSally was one of the 217 Republicans in the House who voted to repeal the Affordable Care Act, subsequently celebrating a victory in the Rose Garden of the White House with jubilant peers. The final vote was 217-213. Here’s the final roll call

 

Healthcare Costs Stress Out U.S. Voters One Week Ahead of 2018 Mid-Term Elections

With seven days until voters go to the polls for what some call the most momentous U.S. election in decades, most Americans say that healthcare costs are a major stress, second only to money. So warns the Sixth Annual Nationwide TCHS Consumers Healthcare Survey, with the tagline: “Stressed Out: Americans and Healthcare.” Perhaps this is why healthcare has become a top voting issue for the 2018 mid-term elections that will be held on November 6 one week from today. The first chart illustrates that healthcare costs, the economy, and family responsibilities all closely cluster as sources of stress for a

 

The Top Pain Point in the Healthcare Consumer Experience is Money

Beyond the physical and emotional pain that people experience when they become a patient, in the U.S. that person becomes a consumer bearing expenses and financial pain, as well. 98% of Americans rank paying their medical bills is an important pain point in their patient journey, according to Embracing consumerism: Driving customer engagement in the healthcare financial journey, from Experian Health. Experian is best known as the consumer credit reporting agency; Experian Health works with healthcare providers on revenue cycle management, patient identity, and care management, so the company has experience with patient finance and medical expense sticker shock. In the

 

Pre-Existing Conditions: A Trans-Party, National Health Priority

Pre-existing conditions impact Americans north, south, east and west, the Kaiser Family Foundation maps. But those maladies aren’t evenly distributed across the U.S.: the highest incidences of people with pre-existing conditions are generally dotted in the eastern half of the U.S., in diverse metropolitan areas. This study looks at non-elderly adults, people between 18 and 64 years of age. That is, working-age U.S. adults who would be prospects for private health insurance coverage, whether through employers or on the individual insurance market. A striking aspect of this map is that one metro that has a higher rate of people with

 

More U.S. Companies Offering Health Insurance After 8 Years of Decline

After eight years of decline, more U.S. employers offered health insurance to workers in 2017, EBRI reports in its latest Issue Brief. In 2017, 46.9% of U.S. companies offered health insurance to their employees, up by 1.6 percentage points from a low of 45.3% in 2016. For perspective, ten years earlier in 2008, 56.4% of employers offered health insurance, shown in the first bar chart (Figure 1 from the EBRI report). The largest percentage point increase in health plan offer-rates came from the smallest companies, those with less than 10 employees: while 21.7% of those companies offered health insurance in

 

Healthcare, and Especially Covering Pre-Existing Conditions, Ranks High for Voters in 2018

President Trump and his administrative have been trying to make the ACA fail, claim most U.S. adults. Thus, the public holds the POTUS and the Republican party responsible for moving the Affordable Care Act forward….or not, according to the July 2018 Kaiser Health Tracking Poll conducted by the Kaiser Family Foundation (KFF). Health care will be a key issue in the 2018 mid-term elections that will be held in November. Among U.S. voters’ key health care concerns in 2018, one ranks “most” or “very important” for two-thirds of Americans: that is continuing to protect people with pre-existing health conditions. Other issues

 

Consumers Consider Cost When They Think About Medical Innovation

While the vast majority of Americans say that science has made life easier for most people, and especially for health care, people are split in questioning the financial cost and value of medical treatments, the Pew Research Center has found. The first chart illustrates the percent of Americans identifying various aspects of medical treatments as “big problems.” If you add in people who see these as “small problems,” 9 in 10 Americans say that all of these line items are “problems.” In the sample, two-thirds of respondents had seen a health care provider for an illness or medical condition in

 

Healthcare Policies We Can Agree On: Pre-Existing Conditions, Drug Prices, and PillPack – the June 2018 KFF Health Tracking Poll

There are countless chasms in the U.S. this moment in social, political, and economic perspectives. but one issue is on the mind of most American voters where there is evidence of some agreements: health care, as evidenced in the June 2018 Health Tracking Poll from Kaiser Family Foundation. Top-line, health care is one of the most important issues that voters want addressed in the 2018 mid-term elections, tied with the economy. Immigration, gun policy, and foreign policy follow. While health care is most important to voters registered as Democrats, Republicans rank it very important. Among various specific health care factors, protecting

 

The True Costs of Diabetes Go Well Beyond the Wallet

The daily life of a person managing diabetes feels many costs: at work, on relationships, at play, during sleep, on time, on mental health, and to be sure, on personal finances. The True Cost of Diabetes report from Upwell details the many tolls on the person with diabetes. The first-order impact for a patient engaging in self-care to manage diabetes is time that the many tasks in a day borrow from work, sleep, home-keeping, and relationships. Seventy percent of PwD (people with diabetes) checks blood sugar at least once a day (41% one to two times, 29% three to five

 

Guns, Jobs, or Health Care? In 2018, Voters Split as to Top Issue

It’s a fairly even split between voting first on gun policy, jobs, or healthcare for the 2018 mid-term elections, ac cording to the May 2018 Kaiser Family Foundation Health Tracking Poll. Arguably, gun policy can cut in two ways: in light of the Stoneman Douglas High School shootings and wake-up call for #NeverAgain among both students and the public-at-large, vis-a-vis Second Amendment issue voters. And, as a growing public health issue, “guns” could also be adjacent to health. “If it isn’t a health problem, then why are all these people dying from it?” rhetorically asked Dr. Garen Wintemute, professor of emergency

 

Having Health Insurance Is a Social Determinant of Health: the implications of growing uninsured in the U.S.

The rolls of the uninsured are growing in America, the latest Gallup-Sharecare Poll indicates. The U.S. uninsurance rate rose to 12.2% by the fourth quarter of 2017, up 1.3 percentage points from the year before. 2017 reversed advancements in health insurance coverage increases since the advent of the Affordable Care Act, and for the first time since 2014 no states’ uninsured rates fell. The 17 states with declines in insurance rates were Arizona, Colorado, Florida, Hawaii, Illinois, Indiana, Iowa, Missouri, New Mexico, New York, North Carolina, South Carolina, Texas, Utah, Washington, West Virginia, Wisconsin, and Wyoming. Among these, the greatest

 

Universal Health Care and Financial Inclusion – Two Sides of the Wellness Coin

Two weeks in a row, The Economist, the news magazine headquartered in London, included two special reports stapled into the middle of the magazines. Universal health care was covered in a section on 28 April 2018, and coverage on financial inclusion was bundled into the 5th May edition. While The Economist’s editors may not have intended for these two reports to reinforce each other, my lens on health and healthcare immediately, and appreciatively, connected the dots between healthcare coverage and financial wellness. The Economist, not known for left-leaning political tendencies whatsoever, lays its bias down on the cover of the section here: universal healthcare

 

Americans’ Trust in the Healthcare System Low Compared to Rest-of-World’s Health Citizens

In the U.S., trust in the healthcare industry declined by 9 percentage points in just one year, declining from 62% of people trusting — that’s roughly two-thirds of Americans — down to 53% — closer to one-half of the population. I covered the launch of the 2018 Edelman Trust Barometer across all industries here in Health Populi in January 2018, when this year’s annual report was presented at the World Economic Forum in Davos as it is each year. The Edelman team shared this detailed data on the healthcare sector with me this week, for which I am grateful. Check

 

Healthcare Access and Cost Top Americans’ Concerns in Latest Gallup Poll

Healthcare — availability and affordability — is a more intense worry for Americans in March 2018 than crime and violence, Federal spending, guns, drug use, and hunger and homelessness. The Gallup Poll, fielded in the first week of March 2018, found that peoples’ overall economic and employment concerns are on the decline since 2010, at the height of the Great Recession which began in 2008. While 70% of Americans were worried about economic matters in 2010, only 34% of people in the U.S. were worried about the economy, and 23% about unemployment, in March 2018. Gallup has asked this “worry”

 

How We Spend Versus What We Get: America’s Healthcare Spending Makes for Poor Health

The U.S. spent nearly twice as much as other wealthy countries on healthcare, mostly due to higher prices for both labor and products (especially prescription drugs). And, America spends more on administrative costs compared to other high-income countries. What do U.S. taxpayers get in return for that spending? Lower life spans, higher maternal and infant mortality, and the highest level of obesity and overweight among our OECD peer nations. These sobering statistics were published in Health Care Spending in the United States and Other High-Income Countries this week in JAMA, the Journal of the American Medical Association. The study analyzes

 

More Working Americans Enrolled in High-Deductible Health Plans in 2017

Over four in 10 U.S. workers were enrolled in a high-deductible health plan in the first 9 months of 2017, according to the latest research published by the National Center for Health Statistics, part of the Centers for Disease Control in the U.S. Department of Health and Human Services. The report details Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January-September 2017. About 28 million people were uninsured in the U.S. in 2017, about the same proportion as in 2016 — but nearly 20 million fewer than in 2010, as the line chart illustrates. The

 

A Tale of Two States: Idaho, Limiting Health Plan Benefits; and Oregon, Moving Toward Universal Health Care

The United States don’t feel very united these days on a whole range of issues. But today, I’m struck by a 180-degree-apart chasm between Idaho and Oregon. While the centers of these two states only lie 290 miles from each other, they are worlds apart when it comes to their views on their residents as health citizens. Idaho. First, let’s travel to Idaho, aka the Gem State due to its rich endowment of natural resources. Health insurers in the state are now allowed to offer plans with limited benefits, escaping the rules for plans in the Affordable Care Act that

 

U.S. Workers Say Health Care is the Most Critical Issue Facing the Nation

Health care ranks highest among working Americans as the top critical issue facing the country, well above terrorism, the role of the Federal government, unemployment and jobs, education, immigration and taxes. Over half of American workers also rate the country’s healthcare system as “poor” or “fair,” based on the results of the EBRI/Greenwald & Associates Health and Workplace Benefits Survey. Workers dissatisfaction with U.S. healthcare is based largely on cost: one-half of workers experienced an increase in health care costs in the past year. Furthermore, only 22% are satisfied with the cost of their health insurance plan, 18% are satisfied

 

Most Americans Say Healthcare is #1 Policy Issue Entering 2018

Concerns about health care are, by a large margin, the top domestic policy issue U.S. voters identified as they enter 2018. The proportion of Americans citing healthcare as the top public agenda priority grew by 50% since 2016, from 31% two years ago to 48%. Taxes rank #2 this year, garnering 31% of Americans’ concerned, followed by immigration, which has remained flat cited by about one-in-four Americans. The Associated Press (AP)-NORC Center for Public Affairs Research polled 1,444 U.S. adults 18 and over between November 30 and December 4, 2017 for this survey. While one-half of Americans would like the

 

Support for the Affordable Care Act the Highest Since Passage

Americans’ approval of the Affordable Care Act reached its apex in December 2017, the Pew Research Center found. The proportion of people approving the ACA has been growing since the middle of 2016, now at 56% of the public. The timing of this survey, conducted at the end of November and first few days of December 2017, coincides with Congress’s arm-wrestling a tax bill that would eliminate the individual mandate for health insurance which is an ACA building block for universal coverage in the United States. Most people in the U.S. also believe that the ACA has had a positive

 

U.S. Healthcare Spending & Outcomes in Five Charts: #EpicFail in the 2017 OECD Statistics

“Spend more. Get less.” If a retailer advertised using these four words, how many consumers would buy that product or service? This is the American reality of healthcare spending in 2016, told in the OECD report, Health at a Glance 2017. I present five charts from the study in this post, which together take the current snapshot health-economic lesson for the U.S. First, look at health expenditures as a share of gross domestic product: the U.S. is number one above Switzerland, France, and the UK, and about two times the OECD average. Note, too, the proportion of out-of-pocket and so-called

 

Health Care Is 2.5 More Expensive Than Food for the Average U.S. Family

The math is straightforward. Assume “A” equals $59.039, the median household income in 2016. Assume “B” is $18,142, the mean employer-sponsored family insurance premium last year. B divided by A equals 30.7%, which is the percent of the average U.S. family’s income represented by the premium cost of health insurance. Compare that to what American households spent on food: just over $7,000, including groceries and eating out (which is garnering a larger share of U.S. eating opportunities, a topic for another post). Thus, health care represents, via the home’s health insurance premium, represents 2.5 times more than food for the

 

Most Americans Are Concerned About Healthcare Policy, and Costs Top the List of Concerns

4 in 5 Americans are aware of potential changes to healthcare policy brewing in Washington, DC. 92% of them are concerned about those changes, according to Healthcare Consumers in a Time of Uncertainty, the fifth annual survey from Transamerica Center for Health Studies. Peoples’ most-shared fears are losing their coverage for pre-existing conditions, out-of-pocket spending, and a ban on lifetime limits. That boils down to one thing: cost. That is, cost, for having to spend money on services not-covered by their health insurance plan; cost for out-of-pocket items under-insured, denied, or requiring coinsurance or co-payments; and, catastrophic costs that rise beyond

 

What Patients Feel About Technology, Healthcare Costs and Social Determinants

U.S. consumers feel positive about the roles of technology and social determinants in improving healthcare, but are concerned about costs, according to the 2017 Patient Survey Report conducted for The Physicians Foundation. The survey gauged patients’ perspectives across four issues: the physician-patient relationship, the cost of healthcare, social determinants of health, and lifestyle choices. Two key threads in the research explain how Americans feel about healthcare in the U.S. at this moment: the role of technology and the cost of health care. First, the vast majority of consumers view technology, broadly defined, as important for their health care. 85% of people

 

The Patient As Payor – Americans Bundle Financial Wellness and Healthcare Costs

Healthcare and the economy tied for US voters’ top issue last week, as the prospects for repealing the Affordable Care Act faded by the weekend. This Morning Consult poll was published 28th September 2017, as it became clear that the Graham-Cassidy health reform bill would lose at least three key votes the legislation needed for passage: from Rand Paul, Susan Collins, and John McCain. Liz Hamel, who directs the Kaiser Family Foundation’s survey research, told Morning Consult that, “when people say ‘health care,’ they often are actually talking about the economic issue of health care.”          

 

Employees Continue To Pick Up More Health Insurance Costs, Even As Their Growth Slows

The average cost of an employer=sponsored health plan for a family reached $18,764 in 2017. While this premium grew overall by a historically relative low of 3.4%, employees covered under that plan faced an increase of 8.3% over what their plan share cost them in 2016, according to the 2017 Employer Health Benefit Survey published today by the Kaiser Family Foundation. [Here’s a link to the 2016 KFF report, which provided the baseline for this 8.3% calculation]. Average family premiums at the workplace rose 19% since 2012, a slowdown from the two previous five-year periods — 30% between 2007 and 2012, and

 

Women’s Access to Health Care Improved Under the Affordable Care Act

    The Affordable Care Act (ACT) was implemented in 2010. Since the inception of the ACA, the proportion of uninsured women in the U.S. fell by nearly one-half, from 19 million in 2010 to 11 million in 2016. The Commonwealth Fund has documented the healthcare gains that American women made since the ACA launch in their issue brief, How the Affordable Care Act Has Helped Women Gain Insurance and Improved Their Ability to Get Health Care, published earlier this month. The first chart talks about insurance: health care plan coverage, which is the prime raison d’être of the ACA. It’s

 

Most Americans, Including Republicans, Want President Trump’s Administration to Make the ACA Work – Not Fail

8 in 10 Americans want President Trump and his administration to do what they can to make the Affordable Care Act work, according to the latest August 2017 health tracking poll from Kaiser Family Foundation (KFF). By political party affiliation, this includes 95% of Democrats, 80% of Independents, and 52% of Republicans (that is, to emphasize the point, just over half, a majority, of Republicans). More Americans are also relieved and happy, versus disappointed and angry, that the ACA repeal did not occur (thus far), the second chart illustrates. To be sure, a majority of Republicans register anger and disappointment,

 

Cost and Personalization Are Key For Health Consumers Who Shop for Health Plans

        Between 2012 and 2017, the number of US consumers who shopped online for health insurance grew by three times, from 14% to 42%, according to a survey from Connecture. Cost first, then “keeping my doctor,” are the two top considerations when shopping for health insurance. 71% of consumers would consider switching their doctor(s) to save on plan costs. Beyond clinician cost, health plans shoppers are also concerned with prescription drug costs in supporting their decisions. 80% of consumers would be willing to talk with their doctors about prescription drug alternatives, looking for a balance between convenience

 

Health Equity Lessons from July 23, 1967, Detroit

On July 23, 1967, I was a little girl wearing a pretty dress, attending my cousin’s wedding at a swanky hotel in mid-town Detroit. Driving home with my parents and sisters after the wedding, the radio news channel warned us of the blazing fires that were burning in a part of the city not far from where we were on a highway leading out to the suburbs. Fifty years and five days later, I am addressing the subject of health equity at a speech over breakfast at the American Hospital Association 25th Annual Health Leadership Summit today. In my talk,

 

Fix the ACA, Most Americans Say

  61% of Americans hold negative views of repealing-and-replacing the Affordable Care Act, according to the July 2017 Health Tracking Poll from the Kaiser Family Foundation. This month’s survey focused on Americans’ views on Republican legislative efforts to repeal and replace the Affordable Care Act (ACA). As of the writing of this post, the majority of the Senate rejected the full repeal of the ACA, but the situation is very fluid. Note that this poll was conducted by phone between July 5-10, 2017, among 1,183 U.S. adults ages 18 and older. The column chart here illustrates that the proportion of people

 

Note to Mooch: The ER is Not Universal Health Care

I quote directly from the Twitter feed of Anthony Scaramucci, @scaramucci: “@dhank2525 agree. We already have Univ Health Care, we made decision long ago to treat everyone that enters an emergency room.” Mr. Scaramucci is President Trump’s Communications Chief, replacing Sean Spicer. Mr. Scaramucci is neither veteran journalist nor healthcare policy wonk. He’s a successful businessman, which I respect for his savvy and ability to build a fund, attract investors, and create a media persona which he has telegenically broadcast on CNBC and elsewhere over the past decade. He’s got a engaging public personality, and goes by the moniker, “Mooch.” But

 

Self-Pay Healthcare Up, Hospital Revenues Down

For every 4.2% increase in a hospital’s self-pay patient population, the institution’s revenues would fall by 2.8% in Medicaid expansion states. This is based on the combination of a repeal of the Affordable Care Act and more consumers moving to high-deductible health plans. That sober metric was calculated by Crowe Horwath, published in its benchmarking report published today with a title warning that, Self-Pay Becomes Ground Zero for Hospital Margins. The “ground zero” for the average U.S. hospital is the convergence of a potential repeal of the Affordable Care Act (ACA), which could increase the number of uninsured Americans by 22 million

 

The Pursuit of Health Equity and the State of U.S. Health Care

Between 2014 and 2015, death rates increased for eight of the ten leading causes; only death rates caused by cancer fell, and mortality rates for influenza and pneumonia stayed flat. The first chart paints this sobering portrait of Americans’ health outcomes, presented in the CDC’s data-rich 488-page primer, Health, United States, 2016. Think of this publication as America’s annual report on health. Every year, it is prepared and submitted to the President and Congress by the Secretary of the Department of Health and Human Services. This year’s report was delivered by DHHS Secretary Tom Price to President Trump and the

 

Costs of Healthcare Top Americans’ Financial Concerns: It’s Financial Health Matters Day

Americans are most worried about healthcare costs among all financial concerns; most people in the U.S. also believe the Federal government should ensure that all people have health coverage. Two polls published in the past week point to the fact that most U.S. health citizens are concerned about health care for themselves and their families, driving a growing proportion of people to favor a single-payer health system. The first line chart illustrates a dramatic trajectory up of the number of American identifying healthcare costs as their #1 financial problem, rising from 10% of people in 2013 to 17% in 2017.

 

Across Party Lines, Few Americans Believe the AHCA Keeps President Trump’s Healthcare Promises

Only 14% of U.S. adults think that the American Healthcare Act (AHCA) fulfills all or most of President Trump’s campaign promises on health care, according to the May 2017 Kaiser Health Tracking Poll, released today. But political party lines surface when people area asked, overall, “given what you know about this proposed new health care plan, do you have a generally favorite or unfavorable opinion of it?” 55% of U.S. adults have an unfavorable view of the AHCA; however, the split across parties is quite clear: 84% of Democrats have an unfavorable view of the AHCA 57% of Independents ahve

 

Americans Say Healthcare is the Nation’s #1 Problem – Tied with Dissatisfaction with Government

Healthcare tops the list of Americans’ concerns, tied with a dissatisfaction for government, this month (May 2017). According to a Gallup poll published 12 May, poor government leadership and healthcare are together the most important problem currently facing the U.S. Immigration, the economy, jobs, and race relations are distance 3rd places in this survey, which was conducted during the first week of May 2017 among 1,011 U.S. adults 18 years and older. The highest percent of Americans citing healthcare as America’s most important problem was 26%, found in August/September 2008 when town hall meetings round the country were protesting healthcare

 

So Far, Food and Nutrition Aren’t Baked Into President Trump’s Health Policies

The FDA is delaying the public posting of calorie counts, a policy that President Obama’s administration had pioneered for public health and wellness. Menu labeling has applied to grocery stores, gas stations, convenience stores, movie theaters and sports stadiums that sell prepared food. “Health and Human Services Secretary Tom Price said the menu labeling requirements would be ‘unwise and unhelpful’ as currently written, and added that the FDA is looking for ways to make the rules ‘more flexible and less burdensome.'” Former FLOTUS Michelle Obama took on the issue of healthy food and fitness for America’s children. Except for keeping her White

 

Women and Children First? What the AHCA Holds for Vulnerable Populations

In accounting, there’s a rule with acronym “LIFO;” this stands for “last in, first out,” which requires taking account of the most recent cost of products being the first ones to be expensed on the ledger. I’m thinking about LIFO when it comes to the American Health Care Act (AHCA) which narrowly passed through Congress yesterday by 4 votes, with a final tally of 217 to 213. Why “LIFO?” Because long-uninsured folks who just recently received access to health insurance as an on-ramp to health care services could lose this benefit, just months after joining the ranks of the insured. Among

 

Most Physicians Say Patients, Doctors and Hospitals Are All Losers Under Trump

“Overall, Council members express pessimism about the health are landscape in the wake of the Trump administration’s proposed plans, citing no clear winners, only losers: patients, clinicians, and provider organizations.” This is the summary of the Leadership Survey report, Anticipating the Trump Administration’s Impact on Health Care, developed by the New England Journal of Medicine‘s NEJM Group. The first chart illustrates the “biggest healthcare losers” finding, detailed on the bottom three bars of patients, clinicians, and provider organizations. The stakeholders that will fare best under a President Trump healthcare agenda would be drug companies, payers, and employers. The biggest loser

 

Financial Stress As A Health Risk Factor Impacts More Americans

A family in Orange County, California, paid a brother’s 1982 hospital bill by selling 50 pieces of their newly-deceased mother’s jewelry. “It’s what she wanted,” the surviving son told a reporter from The Orange County Register. The cache of jewelry fetched enough to pay the $10,000 bill. Patients in the U.S. cobble together various strategies to pay for healthcare, as the first chart drawn from a Kaiser Family Foundation report on medical debt attests. As health care consumers, people cut back on household spending like vacations and household goods. Two-thirds of insured patients use up all or most of their savings

 

Health Care Costs Are A Top Worry for Americans Across Political Parties

Health care costs are out-of-reach for more Americans, among both people who have insurance through the workplace or via health insurance exchanges. The first chart illustrates the growing healthcare affordability challenge for American health consumers, discussed in a data note to the Kaiser Family Foundation Health Tracking Poll in March 2017. In 2017, 43% of consumers found it difficult to meet the health care deductible before insurance would kick in 37% of consumers found it difficult to pay for the cost of health insurance each month 31% said it was difficult to pay for copayments for doctor visits and prescription drugs.

 

Most Americans Favor Some Flavor Of National Health Care Plan

Most US adults favor some kind of national health care plan, based on an Economist/YouGov poll conducted in April 2017. Six in ten people are for expanding so-called “Medicare for All,” where the health plan that currently serves older Americans would extend to all U.S. health citizens. Six in ten people would also favor a Federally-funded health insurance system that would cover all Americans — that is, universal health care. The table details this poll question by political party identification and family income. At least 3 in 4 Democrats would be more likely to favor either of the two healthcare

 

The Fall of the TrumpCare is Retail Health’s Gain in 2017

The non-vote for and withdrawal of The American Health Care Act on March 24, 2017, was a win for the retail health market, at least in the short-run. Before the vote, there had been some pronouncements that the passage of the AHCA would have been a boon to retail health. Here’s one story stating that, “A boom in medical tourism to Mexico predicted if Obamacare ends.” Another article asserts, “Why the American Health Care Act Works for Retailers,” a public policy statement from the National Retail Federation (NRF). But NRF, please don’t fret. Retail health is consumer-driven and will persist beyond the

 

Medical Bill Toxicity: 53% of Americans Say A Big Bill Is As Bad As A Serious Diagnosis

3 in 4 Americans’ health care costs have risen in the past few years. Two-thirds of Americans want to lower their costs, but don’t know how to do that. A survey from Amino released this week, conducted by Ipsos, has found that one in five people could not afford to pay an unexpected medical bill without taking on debt, and another 18% of Americans could only afford up to $100 if presented with an unexpected medical bill. This medical debt side effect more likely impacts women versus men, the less affluent, the unmarried, and those with no college degree. While

 

States That Expanded Medicaid Improved Healthcare Access & Patient Outcomes

States that expanded Medicaid since the start of the Affordable Care Act made greater health system access improvements than those States that did not expand Medicaid, according to Aiming Higher: Results from the Commonwealth Fund Scorecard on State Health System Performance. There’s good news and bad news in this report: on the upside, nearly all states saw health improvements between 2013 and 2015, and in particular, for treatment quality and patient safety. Patient re-admissions to hospitals also fell in many states. But on the downside, premature deaths increased in nearly two-thirds of states, a reversal in the (improving) national mortality

 

Americans Are Not Sold On the American Health Care Act

Most Americans do not believe that TrumpCare, the GOP plan to replace the Affordable Care Act (the ACA, aka  ObamaCare), will make things better for U.S. health citizens when it comes to peoples’ health insurance coverage, the premium costs charged for those health plans, and protections for people with pre-existing medical conditions. The March 2017 Kaiser Family Foundation Health Tracking Poll examined U.S. adults’ initial perceptions of AHCA, the American Health Care Act, which is the GOP’s replacement plan for the ACA. There are deep partisan differences in perceptions about TrumpCare, with more Republicans favorable to the plan — although not

 

Will Republican Healthcare Policy “Make America Sick Again?” Two New Polls Show Growing Support for ACA

Results of two polls published in the past week, from the Kaiser Family Foundation and Pew Research Center, demonstrate growing support for the Affordable Care Act, aka Obamacare. The Kaiser Health Tracking Poll: Future Directions for the ACA and Medicaid was published 24 February 2017. The first line chart illustrates the results, with the blue line for consumers’ “favorable view” on the ACA crossing several points above the “unfavorable” orange line for the first time since the law was signed in 2010. The margins in February 2017 were 48% favorable, 42% unfavorable. While the majority of Republicans continue to be solidly

 

20% of the US Economy Will Be Healthcare Spending in 2025

Price increases and growing use of healthcare services will drive national health spending (NHE) in the U.S. to 20% of the nation’s economy by 2025, according to projections calculated by a team from the Centers for Medicare and Medicaid Services (CMS). Health spending will reach $3.6 trillion dollars this year. These were published in a Web-First article in Health Affairs on 15 February 2017 The caveat on these numbers is that the CMS team used economic models based on “current-law framework:” these make no assumptions about legislative changes that may occur in healthcare reform between 2017 and 2025. While that’s a