A blog covering the health/care ecosystem and people.

So much for America’s ability to manage health care costs without health reform: health costs will increase in the double-digits this year, according to Buck Consultants‘ 21st National Health Care Trend Survey. This annual survey monitors medical trend — the factors that drive cost increases. These include inflation, service utilization, technology, adding new programs, changes in service mix, and benefit mandates. The chart illustrates that medical trend varies across plans — but not my much. High-deductible consumer-driven health plans expect growth of 10.4%: hardly a significantly lower rate of growth than for the most open, rich plans (PPO, POS). Buck

Where you live is a determining factor in whether you have health insurance. The darker green on the map illustrates states with the highest percentage penetration of people with private health insurance among people under 65. Note the concentration in the Upper Midwest, scattered Midwest, and bits of the northeast. It’s also helpful to live in Utah when it comes to health insurance coverage. The lowest proportions of privately insured Americans are in much of the south, from Florida west to Texas and into southern New Mexico, Arizona and much of California. The Urban Institute has studied health insurance coverage

$16,771 is roughly the cost of health care for an American family of four in 2009, according to the Milliman Medical Index. If the median family income in 2008 was about $67,000, then health care costs represent about 25% of the annual household paycheck (remember, that’s gross, not net, income). As the chart illustrates, 1 in 3 health care dollars goes to physicians, with another third paid to inpatient services. Outpatient services and prescription drugs consume 15-17 cents on the health dollar in 2009. The greatest increase in cost trends in 2008-9 is with hospital outpatient services, which grew more

Nearly 100% of Wal-Mart’s staff is covered by health insurance, either through the company itself or through another source. Covered “associates” reached a total of 94.5% this month, compared with 92.7% last year.   The total proportion of Wal-Mart employees covered by Wal-Mart’s plans at the end of open enrollment was 51.8%. Uninsured Wal-Mart employees fell to 5.5%, a 40% drop from 2007 to 2009.   The most recently gauged national uninsured rate for employed Americans was 16.8%.   Wal-Mart’s role in health care is growing both in terms of its approach to employee health benefits within the company, and

The most important elements of the economic stimulus package for health would be investing in health information technology, providing COBRA funding assistance for recently laid-off workers, and allowing unemployed Americans access to a public health insurance program. In the longer-run, getting to universal coverage while controlling costs and improving quality and efficiency should be the health care reform priorities for President Obama, according to 2 in 3 opinion leaders. These are the results of the 17th Commonwealth Fund/Modern Healthcare Health Care Opinoin Leaders Survey, conducted by Harris Interactive. The poll was conducted among 194 health care opinion leaders culled from

Anxiety about health care costs tops American citizens’ concerns about health care in the U.S. Rich, poor, insured or un-, 2 in 3 Americans worry about the affordability of health care in America.   So it follows, then, that among those without health insurance, 57% blame their uninsured state on the fact that they simply cannot afford it, as shown in the table on the right. Beyond this group, 30% of the uninsured cite the employer’s role in health insurance: 14% aren’t employed, 9% have employers who don’t offer coverage, and 7% are “between jobs.”   These findings come from

We’re in a recession; actually, we’ve been in one for the past year, but no official agency decided to tell us. Perhaps “they” wanted to wait until after the November ’08 Presidential election?   The declaration of recession is the official news from The National Bureau of Economic Research (NBER), whose mind-numbingly-titled press release, Determination of the December 2007 Peak in Economic Activity, provides the following important details:   The Business Cycle Dating Committee of NBER met by conference call on 11/28 to discuss whether the U.S. economy was in recession. The group figured out that the U.S. economy “peaked”

The U.S. employer sponsored health system is experiencing some bipolar behavior: there is a cadre of large employers who want to continue sponsoring health benefits as part of overall compensation. But, for at least one in 3 employers, most would not be willing to pay $50 per member per month to cover health for an employee.   According to Mercer‘s survey of employers released October 21st, 2008, What Price Universal Health Coverage?, the rejoinder is: any price is too high.   4 in 10 employers say the main reason they do not offer health coverage is simply that they cannot

In this season’s Health System Idol contest, the U.S. loses to most other developed countries. One in three Americans would like to “completely rebuild” the U.S. health system, according to The Harris Poll conducted in ten nations.   And another 50% believe that, “fundamental changes are needed to make it work better.”   Harris also measured ‘unpopularity’ with another metric: asking whether, “the system works pretty well and only minor changes are necessary.” Adding this yin to the other yang, the mash-up is still the same: the U.S. plays last fiddle to the rest of the world’s health system orchestra.

Growth in spending on Medicare and Medicaid is a function of (1) the aging of the population and (2) trends in the cost of health care. The Congressional Budget Office (CBO) has published an issue brief, Accounting for Sources of Projected Growth in Federal Spending on Medicare and Medicaid, which finds that health care cost growth per beneficiary relative to GDP growth will be a greater driver of health spending than the aging of the population.   The bottom-line: over half of the growth in federal spending on Medicare and Medicaid is attributable to health care costs per person growing

An outstanding commentary in this week’s Journal of the American Medical Association succinctly traces the history of U.S. health care in the context of “market justice.” Peter Budetti, MD, PhD, who teaches health policy at the University of Oklahoma, observes, “Fragmented and struggling to come to terms with externally imposed pressures, medicine is losing both its political force and moral compass.” Those so-called externally imposed pressures come from stakeholders behaving according to their own self-interest in the health market: employers, physicians, hospitals, suppliers, insurers, public officials, and of course, consumers. Dr. Budetti concludes that, “Market justice may have outlived its

A strong FDA is crucial for the health of our country. The benefits of a robust, progressive Agency are enormous; the risks of a debilitated, under-performing organizaiton are incalculable.   These are the findings of the latest critical analysis of the Subcommittee on Science and Technology prepared for the FDA Science Board, FDA Science and Mission at Risk. FDA Commissioner von Eschenbach requested a hard look at the FDA one year ago, and this report is the sobering culmination of that effort. The Subcommittee included leading members of the scientific community familiar with emerging science, the external marketplace, and the

There is more money spent on health care for each citizen of Massachusetts and Pennsylvania than for a citizen in Utah, Arizona or Nevada. In fact, per capita health spending was 59% lower in Utah than Massachusetts in 2004. The latest state-by-state spending variations are highlighted in Health Affairs’ web-exclusive feature. Welcome to the statistical phenomenon in health care known as “regional variation.” The guru-researcher of regional variation is John Wennberg, who has detailed these trends in fhe Dartmouth Atlas.   New regional health spending data were published in Health Affairs, which we health economists and policy wonks eagerly anticipate