Is the ACA Helping or Hurting?

The Affordable care act is more popular because of the republican party attempting to repeal it rather than its ability to help provide the american people with quality healthcare. According to a new Bankrate.com survey, a total of 43 percent of people believe the ACA has had a predominantly negative effect on the United States. Another 21 percent feel the ACA has not had much effect on the country at all, while 28 percent of respondents to the survey felt that yes, the ACA has made positive strides in healthcare reform in the United States. In addition, the survey also found that only 11 percent of Americans are lacking health insurance, this is the lowest percentage recorded  since last August when 15 percent claimed to be without insurance. On the other hand, “23 percent of respondents who had employer-sponsored health insurance told Bankrate that they are more likely to retire early or otherwise leave their jobs because of aspects of Obamacare that dilute the advantage of job-linked coverage.” This is a major gap between the 8 percent who said they were less likely to leave their employer as a result of Obamacare. Earlier this year, the Congressional Budget Office predicted that roughly 2.5 million jobs would disappear as a result of people leaving the workforce due to the effects of Obamacare by 2024. Lastly, according to a Bankrate survey from last month 45 percent of respondents  believed Obamacare should be repealed; 44 percent said it should be maintained. It has been a struggle for even the most avid followers of the law to distinguish whether it is working or not due to speculative information and propaganda. At this point it’s clear that we need more time to collect more accurate information before we can start understanding and stop speculating on positive and negative outcomes in respect to the ACA. 

EVERA. Everyone should feel this good about healthcare.

Source: http://www.cnbc.com/id/101707786 

Building a Strong Foundation with Primary Care

You cannot build a house without laying the proper foundation.  The same can be said for the healthcare system. Primary care physicians are on the front line of defense for almost every injury or ailment that occurs. They are responsible for diagnosing and/or treating a wide array of illnesses, from the common cold to mental health issues. These are the people that decide when we need to see a specialist and point us in the direction of the people who are most qualified to help us regain our health. Primary care doctors play an important part in our countries health and well being. They are the ones that lay the foundation for a healthier, wealthier, stronger and happier America.

This being said, the demand for primary care doctors is increasing while the amount of people seeking to become general practitioners is not. Oddly enough, insurance companies are paying primary care doctors about 1% of the premium they receive per patient. A shocking number considering 90% of doctor visits in the U.S. can be filed as a primary care visit. This is not to say that all primary care doctors are struggling to get by, but it does show that they are not being compensated properly for the amount of responsibility they own in regards to the healthcare system as a whole.

The Affordable Care Act has made minor strides in increasing the amount of medicare dollars that are spent on primary care by 10%. Research from The Commonwealth Fund shows that this increase will actually cause a 1.9% decrease in total spending. The savings will stem from a decrease complications, the use of expensive specialists, and people achieving an overall more healthy lifestyle. 

It's clear to see that spending more money on primary care (the foundation) will help us build a more effective healthcare system (the house). There are still 30 million people in the U.S. without any form of health insurance and 11 million undocumented immigrants in the U.S.. In a country as wealthy as ours we should be able to care for everyone and strides need to be made to at the very least make PRIMARY CARE affordable and obtainable to our people.

EVERA. Everyone should feel this good about healthcare.

Sources:

http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2012/Mar/1585_Reschovsky_paying_more_for_primary_care_FINALv2.pdf

http://www.thedailybeast.com/articles/2014/05/13/why-primary-care-physicians-need-a-minimum-wage.html

Transparency Is a Beautiful Thing

Over the past few years, individuals have progressively became responsible for paying more out of pocket for their medical costs. This is due to augmented co-payments and deductibles in their health plans, as well as the scarce network of providers accepting their insurance. The Health Care Cost Institute (HCCI) is working to add transparency to the healthcare marketplace. This new cost transparency will be a "positive" for most consumers because it will allow them to not only shop for the best deal, but also to bargain with providers for a better price. This is increasingly important, because more and more patients have high-deductible plans in order to lower premiums. The HCCI hopes to have this data available to the public in early 2015. As of now, three major health insurers have agreed to share information. Aetna, Humana, and UnitedHealth care are the pioneers in transparency, with other expected to follow. This online "transparency tool" will aggregate pricing data from commercial health plans, as well as Medicare Advantage and Medicaid plans if nonprofits gets individual states to share information. Cost data will be supplemented with information about the quality of care and other data to help consumers "make more informed decisions about health care". This major step forward will help control healthcare costs, which account for 20 percent of the U.S. economy.

EVERA. Everyone should feel this good about healthcare.  

Source: http://www.cnbc.com/id/101672099

Limited Options for Undocumented Immigrants

25 percent of the people who will remain without health insurance once the Affordable Care Act is fully implemented will be undocumented immigrants.
The ACA is meant to expand health care coverage, but undocumented immigrants are excluded from these benefits. There are nearly 12 million of them living in the United States, and under the federal health care law, they are not eligible for assistance. They are excluded from getting federal subsidies to buy health insurance, and they cannot shop for coverage in the health insurance marketplace. The only provision that mandates coverage for undocumented immigrants is under Emergency Medicaid. Healthcare options available to the most needy immigrants are limited, and vary widely from state to state.

Florida is home to the third largest share of undocumented immigrants in the United States. These people account for 4.5% of Florida’s population The GMSIM (A census simulation mechanism) estimates that 68% of the illegal immigrants in Florida will be uninsured in 2012 and that this will increase in years to come.

So what options do undocumented immigrants have? Not many, they turn to community health clinics, nonprofit organization, and by law they must receive treatment in a life threatening situation.
The options listed above for the most part are NOT valuable options. However, in America when people want something and someone can supply it they will. Evera Health offers a low cost, high quality primary and urgent care care subscription. They currently operate in 12 locations surrounding major cities in Florida and plan on expanding their network rapidly over the next 12 months. With Evera's subscription costing $49.99 per month it allows the patient to see a doctor as frequently as they need to with no out-of-pocket cost for treatment as long as it is listed under their wide variety of included services. This service is not designed to treat catastrophic events however, it is a way for people to keep themselves healthier. By having access to premium primary and urgent care a person is able to stop illnesses before other costly complications occur.

EVERA. Everyone should feel this good about healthcare.


Sources:

http://www.theatlantic.com/politics/archive/2013/12/obamacare-bars-illegal-immigrants-and-sticks-hospitals-with-the-bill/282444/

http://www.huffingtonpost.com/2014/01/28/undocumented-immigrants-health-care_n_4679348.html

Is TeleMedicine a No-Brainer?

61% of people in the US have a smartphone, yet we are still using technology from the 80's to communicate with doctors. TeleMedicine is starting to gain some serious traction in the healthcare industry, within the backdrop of the recent healthcare reform. The benefits that come to mind are quite attractive; receiving treatment from the couch versus a waiting room full of sick people.  Coupling the "comfort of one's own home" with receiving faster diagnoses, and more access than ever before to doctors and specialists, makes for a very compelling suite of offerings.

Pros:

Patients:

-Telemedicine will reduce unnecessary admissions and readmissions by consulting with patients from their own home

-Will lift geographical limitations of care for patients by enabling them to consult with specialist anywhere

-Will experience reduced cost due to more efficient use of specialists.

When the patient is not in their home:

-Telehealth will allow staff to gain access to a specialist support network to provide better care for patients while allowing them to remain with their primary doctors in which they feel comfortable with.

-Practices will retain more patients rather than shipping them off to specialist which would cause a loss in revenues and/or cause the patient to receive care at a location that doesn't accept their insurance.

-Practices will also see an immediate increase in the amount of ailments and injuries they will be able to treat through their network of specialists. This would result in an increase in the quality of care across the nation

For Physicians:

-Each physician will be able to care for about 1,000 patients so more people can benefit from each doctors expertise

-Allows doctors to earn "On-call pay"

- Reduce time spent traveling between facilities to treat patients resulting in an increase in productivity and quality of life.

-Implementing Telehealth capabilities will lead to referral patients causing an increase in revenue from new patients.

The Healthcare System as a Whole:

-Helps the increasing number of patients needing care access the decreasing supply of doctors

-Helps lower overall cost of care by increasing access to the right doctors more efficiently as well as decreasing the amount of people that acquire illnesses from within a doctors office or hospital.

After reading all of these benefits that would result in the implementation of Telemedicine you're probably wondering why isn't this the way we normally receive treatment.  Unfortunately, good things take time.

Setbacks:

State Licensing and Proscribing Laws:

The problem here is that different states have different protocol when it comes to treatment and prescriptions. In 2009 a doctor in Colorado was convicted for prescribing a patient anti-depressant medication to a patient in California that later committed suicide. If telemedicine were to experience significant growth you can see how problems like this would become the norm.

Lack of Highly Developed Protocols and Guidelines:

The American Telemedicine Association is currently working on a set of guidelines to help overcome skepticism of regulators and payers. They claim physicians and organizations need to step in to get the ball rolling. The CEO of the ATA surprisingly stated that the Government is the "Lagging Partner" in the move to Telehealth. They must be busy making to sure the ACA rolls out perfectly. That must be more important than reforming the system...

HIPAA  Privacy and Security:

This is the biggest threat to the future of Telehealth. Since the services revolve completely around technology. It makes records more accessible and harder to secure. Steps have to be made in order keep patient records in the hands of the right people before we can move forward with Telemedicine.

EVERA. Everyone should feel this good about healthcare.

The Nanny Plan

Sooo you have have a nanny.

You are unsure whether or not you should provide or contribute to some sort of healthcare option for your nanny. Most people will automatically assume that it is going to be too expensive or it is unimportant. However, when you have someone that is consistently around you and your family it's important for that person to be healthy. Providing or contributing to your nanny's healthcare is most likely less expensive and more beneficial than you think.

First, there are many different options to choose from. If you want to give your nanny traditional insurance in the past it would cost you about 300 per month. Not bad, but now with the ACA and steep increases in premiums that is just not possible. Any contribution made toward a healthcare benefit for your employee is considered to be a form of non-taxable compensation. So you catch a little bit of a break on your taxes but this option is still very steep.

What if I told you there was an option that cost somewhere between 49.99-149.99 per month that would allow your nanny to see a doctor as many times as she/he needed? No copays, deductibles, or exclusions due to pre-existing conditions. Well, what I'm describing is the new, more attractive version of the Direct Primary Care Model.

For those of you who don't know, direct primary care focuses on keeping people healthy and reducing further complications. So in theory if direct primary care is used correctly less people would get sick, and the overall cost of care would be lowered. The other cost saving aspect of this model is the lack administrative costs associated with care because it's a monthly subscription.

The third option we can call a hybrid option. This would be when a you purchase a high deductible, low premium plan and pair it with a direct primary care subscription. This is a way for people to save on out-of-pocket expenses or at least put a cap on them.

EVERA. Everyone should feel this good about their healthcare.

P.S.- Evera offers DPC plans

Th(E) Cig

If you are surprised when you see someone puffing on some sort of high-tech pen or flashlight looking object you need to get out more. E-Cigarettes or E.C.'s are taking the tobacco market by storm. Currently, an almost 3 billion dollar industry that's growing faster than it ever has before, and nobody really knows the long term effects of inhaling vaporized nicotine.

Advertisement for Blow
(E-Cig & Hookah Company)

One thing we can be pretty sure about, is that it's considerably less harmful than traditional cigarettes. There is no tar, burning, or combustion happening. A battery heats liquid nicotine into a vapor which is then inhaled by the user. This is true for most E.C.'s that you will find in a gas stations but this industry is so new with very few regulations people are buying e-cigs overseas or from small companies that offer different features. Some if which give the user the ability to choose how much vaporized nicotine is inhaled. This is called "Dripping" many of the devices that allow you to do this can get hot enough to create combustion resulting in the inhalation of the carcinogen formaldehyde. A carcinogen is found in traditional cigarettes. This being said cigarettes have over 400 chemicals and more than 60 carcinogens. So the E-cig "should" be considerably less harmful but how do we gauge the monetary difference between Non-Smokers, E-Cig Smokers, and actual Smokers when it comes to healthcare?

     

Under ObamaCare smokers can be charged up to 50% higher than non-smokers and for good reason.  It's pretty hard for someone to truly understand how much smoking actually costs. Purchasing the cigarettes is not even half of what it costs you to smoke. For your entire life you will be paying more for health and life insurance not to mention dying sooner and getting sick more often. I'm getting off topic. What I really want to talk about is how do insurance companies know what to charge people that smoke E.C.'s??? It doesn't seem fair to charge them as much as "Actual cigarette smokers" but you can't charge them as little as someone who doesn't continuously inhale a substance that is deadly if a few teaspoons of it gets consumed (Nicotine).  I have been unable to find any information on the cost relationship between smoking E.C's and health insurance. Can doctors run test to see how much a persons nicotine intake is? Is it easier to lie about smoking E-Cigs? Are more regulations going to be made now that more people are smoking them? There are many unanswered questions about these devices but I am a fan of them. They deter people from smoking and smokers raise the cost of care significantly for everyone. So even though these E-cigs are not perfect I feel comfortable saying they are a step in the right direction.

EVERA. Everyone should feel this good about healthcare.

Numbers Never Lie

The numbers have finally come in, yesterday insurance companies released data showing that 1/3 of the people who signed up for health insurance on the federal exchanged never actually paid their first months premium! This may come as a surprise to some, but if you look back to my previous blogs you can see that I saw this coming from a mile away. I love it when I'm right. Seriously, how could someone not see this coming? The cost of care is too high for EVERY american to afford. Not only that but the amount of young people that signed up for the law was less than expected. In order for this law to be financially sustainable 40% of covered people need to under the age of 35. Right now it's at about 28%. This is going to cause an increase in premiums which in turn will make care unaffordable for more Americans.

So what happens now? Transparency has certainly not been a strong suit for the Obama administration. Ever since the total of 8 million plus sign-ups was released people have been skeptical about how many people actually paid premiums. Obama was using the amount of sign-ups to his advantage when in reality everyone in the country could have signed up for health insurance but if none of them pay the law isn't working. It's disgraceful the amount of promises that have been broken during this rollout. "If your happy with your current insurance you can keep it" Nope. "If you like your doctor you can keep your doctor" Nope. "We will lower premiums by 2,500 per year per family" Nope we're actually going to raise them. " Lastly, the vow of transparency was clearly disregarded in an attempt to get the American people to believe everything was going according to plan.

As i've said before, I want everyone to have healthcare but I think this law is doing more harm than good. It's increasing our country's deficit, making people who had insurance sign-up again and pay more with less option, and the increase in converge in americans is small and uncertain. The system needs to be fixed in order to lower the overall cost of care before we implement a plan like this and expect it to work. 

EVERA. Everyone should feel this good about healthcare.  

Affordable Concierge Medicine

How do we progress? How do we go from driving a Model- T Ford to today's 40 mpg, sleek, GPS in the dashboard Honda Civic. How do get from rotary dial telephones to a smart phone that's just as capable as a desktop computer. We innovate, change, make thing more efficient, and less expensive. It seems as if the healthcare industry is avoiding change. Maybe it's because they are stubborn. Maybe it's because doctors don't want to jeopardize their bottom line. There are so many things in this space that need fixing it's overwhelming to even think about where to start. It's like you have company coming over and your place looks like a bomb went off in your living room (not a good feeling).

This idea of concierge medicine for the masses has so many pros and so few cons it's amazing to me that it hasn't caught fire yet. Everybody wins, as far as models go this is a home run. Doctors make the same if not more revenue from monthly subscribers, they have a very good estimate of what their revenue will be month-to-month, and they get to spend more time with each patient because they have fewer total patients. Doctors and insurance companies both reap the benefits of a DPC model because it cuts paperwork for 90% of all doctor visits in the US filed under the umbrella of primary care each year. Lastly, and most importantly the patients get more quality time with their doctors, convenient appointment times, and more affordable care.

Forbes went on to further explain all of the points I have just made about concierge medicine.

If the above interests you check out our site EveraHealth.com we offer monthly subscriptions for primary care provided by US Healthworks. See if our services are located in your area!

EVERA. Everyone should feel this good about healthcare.