Cost Of Health

An estimated 788,000 Maryland residents lack health insurance of any kind, and it's time the state got serious about addressing the issue. Not just for humanitarian reasons (although that argument is compelling), but because the lack of coverage is simply too costly for most of the other residents of the state, who pay higher insurance premiums to cover the uninsured's emergency room care. It's a horribly inefficient system, and the spiraling cost of health care is, in turn, only fostering more uninsured each year.

THE ERA of the Health Maintenance Organization is coming to an end. No doubt many Americans will cheer, just as they did when the Helen Hunt character in the 1997 film "As Good as It Gets" forcefully denounces the HMO industry.But if HMO coverage is bad, no coverage is worse. And a government takeover of all health care, still the enduring dream of many, would be the worst outcome of all.According to a recent study by the William M. Mercer consulting company, the percentage of workers enrolled in health maintenance organizations and point-of-service plans fell in 1998, after rising steadily for years.

Under prodding yesterday from legislative leaders, the state health department delayed implementation of new payment rates for Medicaid providers while an independent actuary examines about $80 million in overpayments the state made last year.House Speaker Casper R. Taylor Jr. and Senate President Thomas V. Mike Miller informed the state health secretary, Dr. Martin P. Wasserman, that the legislature would be contracting with a nonprofit foundation to examine the state's Medicaid rates."We want to make sure the rates we're promulgating are going to be actuarially sound," Taylor said yesterday.

IS ANYBODY out there concerned about where health care is headed?Advice: You should be more than merely concerned. You should be scared. You should also be angry. No, furious.Let's dispense with I told you so, although the inevitable should have been clear from the start.Health care in the marketplace? The market dictates bottom-line considerations even as they clash with quality, access, etc. In the marketplace, poorer Americans are excluded and neglected by the millions, now approaching 50 million.

SOME OF THE recent Medicare-fraud stories are the kind of stuff that makes satire unnecessary. Like the owners of a home-health-care business who tried to include the BMW driven by their son in college as a cost of doing business.Other reports seem to have escaped from the script of a horror film: A cardiologist who got kickbacks from a pacemaker manufacturer is alleged to have implanted the devices in dozens of patients who didn't need them.Estimates of the overall scale of Medicare fraud run into the tens of billions of dollars.

There are times when the General Assembly's hearing schedule looks more like a medical school curriculum than a legislative agenda.This year, legislators are considering bills about mastectomies and bills about prostate cancer detection. There are bills about osteoporosis, diabetes and blood transfusions. Bills about testicular cancer, catheter insertion and clinical trials.All these bills fall into a class called "mandates." They would require health maintenance organizations and other insurers to do things they don't want to be required to do. Some say insurers must cover a minimum length of hospital stay after surgery or childbirth; others would require insurers to cover medical procedures they otherwise might not pay for.The annual parade of mandate bills has many legislators wondering how 188 politicians in Annapolis ever got into the business of making medical decisions for their constituents.

In an effort to improve county health services, Anne Arundel County health care providers are sending surveys to 2,200 county residents, soliciting their opinions on health care issues.Launched as part of the Atlantic Health Alliance, the project aims to address unmet health care needs. The county's Healthier Communities Coalition is overseeing administration of the survey Anne Arundel.The nine-hospital alliance -- which includes North Arundel Hospital and Anne Arundel Medical Center -- is mailing 10,000 surveys at random to households in the greater Baltimore area.

YOUR EDITORIAL assertion that the Democrats are engaging in demagoguing about Medicare (Oct. 2, "Medi-scare") reflects a serious lack of understanding of health policy alternatives.Yes, Medicare needs to be modified. No, the Republican plan is far from an adequate solution. And neither is managed care an adequate solution to the health care problems of non-seniors. The long-term data is far from clear that managed care will really significantly reduce the cost of health care.A little more than a year ago, the Congressional Budget Office released a study showing that independent-practice HMOs (the most common model)

The cost of health care is actually falling. The expense of employee health benefits declined last year -- by 1.1 percent nationally and 1.5 percent in Maryland.So isn't this the perfect time for our legislators in Annapolis to monkey around with the very programs that have produced these savings?That's what the General Assembly is doing. It's on the verge of restricting the cost-effective quality-control methods of the health-maintenance organizations and managed-care plans that are revolutionizing the American health industry.

WASHINGTON -- Opponents opened a new line of attack yesterday against the Senate version of President Clinton's health care reform proposal, branding it a bureaucratic nightmare that fails to curb skyrocketing medical expenses.The predominantly Republican assault on the second day of debate on the Democratic bill barely mentioned its most controversial provision: that employers may ultimately be askedto pay 50 percent of the cost of health care for their workers.That provision would take effect if voluntary measures and government subsidies didn't achieve 95 percent coverage of Americans by 2000.

Harris offers wrong fix for health system Dr. Andy Harris has made a misdiagnosis of the underlying problem in U.S. health care, and his suggestions for treatment are off ("Reform, not overreach," Oct. 6). He's shared a misconception that competition among insurers would bring down the cost of health care insurance. That was the original concept before the industry went to a for-profit model. Since that time, the annual cost of care for individuals and families has risen steadily. The 2009 Kaiser Family Foundation's annual survey of health benefits notes that despite these hard economic times and the focus on health insurance costs, the average annual premiums for employer-sponsored health insurance are $4,824 for single coverage and $13,375 for family coverage - a 5 percent increase from last year alone.

The health-care reform bills making their way through Congress have focused on improving access to care for millions of uninsured Americans while slowing rapidly rising health-care costs. But there is another side to the health-care crisis that has been mostly neglected. A study that we performed for the Joint Center for Political and Economic Studies, a Washington-based think tank, found that, between 2003 and 2006, 30.6 percent of medical care expenditures for African-Americans, Asians and Hispanics were excess costs that were the result of inequities in the health of these groups.

Brian England was still so excited the morning after spending a Wednesday evening in the White House, shaking hands and speaking to President Barack Obama, that he had trouble remembering his own age. The long-established Columbia businessman finally settled on 63, as he related the details of his and his wife Jennifer's adventure as two of 164 people invited to a televised town hall meeting on health care reform organized by ABC news. "She was extremely nervous," England said about his wife, but he said after spending hours, first waiting in the hot sun to enter, enduring the security screening, and finally for the show to begin, "the adrenaline wore off and you just feel numb."

Adrienne Summers left a job this month to focus on running her floral shop full time in Frederick County. But the decision meant losing health insurance for her and her two children. Seeking affordable options, Summers stumbled onto an attractive offer: A new state program that would help provide coverage for employees and their families at small businesses, like hers, that don't provide insurance. Under the Health Insurance Partnership, a business that has fewer than nine full-time employees with an average wage below $50,000 is eligible for subsidies to cover up to 50 percent of premiums.

As its costs continue to spiral upward, most people now agree that America's health care system is broken. And as the race for the White House heats up, politicians on both sides of the aisle are clamoring to propose ideas that rein in health spending. Unfortunately, the policies offered thus far are misguided. As counterintuitive as it may sound, the answer to America's health care woes won't be found by harping over the price of care. Consider prescription drugs. Americans now take more drugs - and spend more on them - than ever before.

An estimated 788,000 Maryland residents lack health insurance of any kind, and it's time the state got serious about addressing the issue. Not just for humanitarian reasons (although that argument is compelling), but because the lack of coverage is simply too costly for most of the other residents of the state, who pay higher insurance premiums to cover the uninsured's emergency room care. It's a horribly inefficient system, and the spiraling cost of health care is, in turn, only fostering more uninsured each year.

Sign up family members for your employer's health insurance during open enrollment, and you might hear this from the company: "Prove it." You might be asked to produce birth certificates, adoption papers or college transcripts to show that a child is eligible for your health plan. Or you might have to dig up a marriage license to confirm a spouse. These "dependent audits" have been around for a long time, but started taking off recently as employers have wrestled to keep health care costs down.

America's quest to find a successful formula for universal health insurance took a giant leap forward this week in Massachusetts. With overwhelming support from all quarters, the legislature adopted a plan that requires individuals and employers to share with taxpayers the burden of health care costs. The Bay State plan doubtless contains many flaws, and is certainly not yet the perfect solution to one of the country's most vexing problems. Yet this product of painstaking negotiations between the state's Republican governor and mostly Democratic legislature represents the first substantial progress - after decades of attempts - in marrying the concerns of the business community with those of health care advocates.

I work for a company with about 100 employees. Health insurance is a contentious issue because of the high costs and few options. The company offers two plans, which cost the same. (One bills $200 per employee weekly, the other $800 a month.) The company pays one-third of the amount, and we pay the rest. I pay the equivalent of one-quarter of my take-home pay under either plan. Do we, as employees, have any rights here, or are we stuck with the high cost of health care? When you begin with the fact that employers don't have to offer health insurance, it's easy to understand that they have a wide latitude in choosing what to offer and how much to charge you for it. "There is no requirement that the contributions required from employees be reasonable or affordable," said New York employment attorney Richard Kass.

WASHINGTON -- Wal-Mart Stores Inc., under growing pressure in many states to improve health care benefits, said yesterday that it will expand coverage for its employees and build more than 50 in-store health clinics. At the same time, the nation's No. 1 private employer said in a news release that government and business must "work together to solve this challenge" of rising health care costs. The company said that on Sunday, at the annual winter meeting here of the National Governors Association, chief executive H. Lee Scott Jr. will call on state lawmakers to work with companies.