Unbiased Analysis of Today's Healthcare Issues
Health insurance companies are not spending as much money as expected. While COVID-19-related costs are up, the cost savings from people foregoing or delaying elective care has more than offset the COVID costs. Health insurers are refunding much of that savings to their enrollees. However, this is due to a provision of the ACA that…
A number of states have re-insurance programs to support the Affordable Care Act (i.e., Obamacare) marketplaces in the individual and small group markets. Re-insurance occurs when the state offers to pay a percentage of patient costs if they exceed some threshold. This may lead you to ask a number of reasonable questions. For instance: Why…
When new bills pass in Congress or state legislatures that expand health insurance coverage, most researcher look at the demand side effect. How does the insurance expansion affect the number uninsured? How does it affect access to care? How does it affect out of pocket cost? What is less frequently studied is the supply side…
On this Labor Day, I want to address a fundamental question in the U.S. health care system: should employers provide health insurance to their workers? I won’t take a stand on the issue but I will just list some pros and cons. Wherever you stand on the issue, I recommend you carefully consider the arguments…
Are high deductible health plans a good thing? Republicans typically argue yes as they say that increased cost sharing reduces moral hazard. That is, when people have to pay for medical care out of pocket, they don’t ask for unnecessary care or use care more frugally. Democrats typically argue that increased cost sharing reduces demand…
Step therapy is good in theory, but often not in practice. In step therapy, patients are required to try one drug first–typically a low cost and/or high-value treatment–before moving on to more expensive alternatives. In theory, this is a great idea. The first drug patients should try should be the highest value one. In practice, however,…
The answer is yes and no. According to a study Holahan, Karpman, and Zuckerman (2016), the health insurance exchange plans are good at insuring individuals against financial losses, but not everyone is happy with the care they are receiving. Low- and moderate-income adults with Marketplace coverage are no more likely to report problems paying medical…
How should insurance be regulated? Should insurance plans be able to price premiums based on health conditions? The drawbacks of this approach is that it is not equitable as sicker patients will pay higher premiums. Should all people pay the same cost? Although more equitable, using a single price would incentivize healthy people to avoid…
The most common drug class taken among patients aged 18-44 is an antidepressant. Furhter, these relatively young and healthy patients are likely to be the ones who enroll in healht plans within the health insurance exchanges. The question is, how easily can patients access information about antidepressant coverage? According to a recent RWJ report, the…
The Affordable Care Act requires all individuals to be offered the same premium regardless of health status. Although there are some ratings bands based on age and smoking status, most people who purchase insurance on health insurance exchanges receive the same premium for any given insurance product from any given insurance company. The insurance products…