Saturday, April 18, 2009
Guest Authors
Our guest authors include Matthew (patient), Brittany (worker), Scott (student) and Coach Showen (worker). Coach Showen's opinion can be viewed in various "comments" sections throughout our blog.
Thank you.
Monday, April 13, 2009
Medicaid & Access to Dental Services
As a BadgerCare Plus Outreach Specialist, I witness firsthand how healthcare reform could greatly benefit members I work with everyday. Imagine telling a single working mother that the only way she is able to obtain regular dental care is by driving over two hours one way to receive care, or listening to a member describe how his oral health pain became so severe that he extracted his own tooth with everyday tools laying around his house, all without anesthesia. While the Medicaid program in Wisconsin has been touted as one of the best, there are also many gaps, sadly due to financial issues. Members of BadgerCare Plus receive two cards once they have been enrolled in the program: one is their HMO card stating which HMO they are a part of and the other is the ForwardHealth card which is what members use for prescriptions, chiropractic care and dental services. However, when BadgerCare Plus members call the long list of dentists in their community, they hear a repetition of “no, we do not accept the ForwardHealth card,” leaving many Medicaid members without regular dental care for extended periods of time until emergency services are demanded due to pain, infections and reduced quality of life. Oral health care is extremely important for children, pregnant women and adults alike, all across the life span for many reasons. According to the National Maternal and Child Oral Health Resource Center, individuals from low income families face a twelve times higher rate of missing school or work due to dental problems compared to those from families with higher incomes. Early tooth loss caused by tooth decay may result in impaired speech development, absence from and difficulty concentrating in school, and decreased mental and social well being at school all of which in turn negatively affects the child’s self esteem and success later in life. In addition, a child who is experiencing dental pain or missing teeth may have to limit their food choices due to chewing problems which can result in nutritionally inadequate diets. It is also extremely necessary for pregnant women to receive regular dental care as pregnant women experience increased hormone levels making them more susceptible to oral infections which may result in pregnancy complications. There are several dental issues that pregnant women are more prone to develop including periodontal disease, pregnancy tumors, and pregnancy gingivitis.
The goal of BadgerCare Plus was to guarantee 98% of Wisconsin children health insurance, however if the oral healthcare needs are being unmet by a large number of Medicaid members, has the state of Wisconsin really fulfilled that need? Serious healthcare reform must take place in order to solve this dental access issue for BadgerCare Plus members. While it is true that some communities have attempted to combat the issue by establishing free or reduced price dental clinics, those clinics are forced to install parameters stating they will see only children under the age of 12 or emergency dental issues only otherwise the clinics would be flooded with individuals. One solution to the problem would be to increase the Medicaid payout to dentists. Currently the Medicaid rate for dental health care is 34 cents to the dollar, the reason dentists refuse Medicaid patients. Dentists do not want to perform a service for which they are underpaid compared to commercial HMO members. However, with the state of Wisconsin’s budget, finding extra money to dole over is not a very likely happenstance. Another solution would be for the state to mandate that every practicing dentist in the state has to see at least 10 Medicaid patients – that would greatly help to solve the problem.
The need for oral health care is the most prevalent unmet need among children and adolescents. A state Medicaid program targeting children and their caregivers that cannot guarantee dental services provides grossly inadequate services to its members.
Let's Minimize the Profit in Healthcare
On the other side, however, are the right-wing zealots who scare citizens into believing that any government-initiated remedy to our broken, needlessly expensive, and anti-democratic health care system would mean less access, less choice, and a lower standard of care.
Apparently, many people trust that their insurance company, the faceless financial behemoth that collects the premium money from them and their employers, will take better care of them than their government will.
Given the deregulation of the corporate and financial world over the past 30 years and the booms and busts that have left a wake of economic decay and demoralization for the majority of Americans, I don't think it's wise to entrust life and death decisions of health care to corporate boardrooms and Wall Street traders. For example, when I learn from 60 minutes that health corporations grant bonuses for denials of service to patients who pay their hefty premiums on time, that is the clearest evidence that this system is beyond reform. Such appalling corporate conduct is the best argument for removing private insurance companies from health care.
Monday, April 6, 2009
Reform Proposal 4
Reform Proposal 4-Quality
Molly Teska-Maroon Group-Finance
For the most part, Americans receive high quality health care services everyday, but there is always that risk that someone will not receive the best quality in their healthcare services (medical errors, patients receive care that they don’t need; patients receive wrong type of care). The truth is Quality of healthcare services depends on where you live, who you are, and how much is known about treating your condition. Some believe that we as Americans are not receiving the quality we should be for as much as we are paying. The
http://www.wsbtv.com/health/18991527/detail.html
http://www.whitehouse.gov/search/?keywords=health%20care%20quality
Monday, March 30, 2009
Reform Proposal 3- Access
Reform Proposal 3- Access
Maroon-Finance, Written by Jessica Wysocki
The Obama administration has many plans to change the health care system so every citizen has access to the care they need. The key points are to expand the Medicaid program, mandate coverage for all children, create a “National Health Insurance Exchange” plan, provide subsidies to lower-income individuals and small businesses to help lower the costs of purchasing insurance, and taxing larger firms that will not provide their employees with health insurance coverage. Obama plans to create a system that will cover everyone, opposed to a system run by the government because some Americans still approve of their private insurance plans, and changing to a single government-run plan is such a drastic change that some Americas are not ready for.
By expanding the Medicaid program, or by creating a program similar to the current Medicaid program, it would be available to individuals who do no have access to an employer insurance plan or for those who do not qualify for existing government programs. By expanding/creating this program, it will allow more citizens who are not currently eligible for Medicaid to receive health care coverage. In addition, all children who do not qualify for the State Children’s Health Insurance Program (SCHIP), will also be covered.
As for insurance companies, they will be required to cover pre-existing conditions so that all Americans can receive coverage regardless of their health status. By doing this insurance companies cannot pick and choose whom they will cover based on health conditions, thus everyone has the opportunity for coverage. Part of the plan is to also prevent insurers from overcharging doctors for their malpractice insurance and invest in strategies to lower preventable medical errors. The “National Health Insurance Exchange” is a government run organization that would sell insurance plans directly to those who do not have an employer plan or public coverage. This would also require employers to either provide health insurance to their employees or contribute funds towards the cost of a public plan.
To finance these changes, money will come from the changes to Medicare, an expected $316 billion in the next decade, combined with $318 billion that will be generated from a tax increase on families earning more than $200,000 or more, equaling $634 billion allowed for the expansion of health coverage to all of the uninsured Americans. Money will also come from a program that will help small businesses to provide affordable health insurance to their employees, by requiring large employers that do not offer coverage to their employees to contribute a percentage of payroll toward the costs of their employee’s health care. The Obama campaign is attempting to change to United States Health Care system so that every citizen can have access to affordable and equitable health coverage. By expanding or creating a new Medicaid program, making companies that do not offer health insurance coverage to their employees pay money to support a public health plan, and creating a “National Health Insurance Exchange”, are all steps towards creating changes in the current health care system.
Sources:
http://www.barackobama.com/issues/healthcare/
http://www.forbes.com/2008/11/05/obama-healthcare-plan-forbeslife-cx_rr_1105health.html
http://www.forbes.com/2009/03/03/obama-health-plan-lifestyle-health_obama_health_budget.html
http://www.thehealthcareblog.com/the_health_care_blog/2008/03/a-detailed-anal.html
Saturday, March 28, 2009
Arnst, Cathy. "Health-Care Reform: McCain vs. Obama." Business Week. 13 Oct. 2008. 14 Mar. 2009
BOROSAGE, ROBERT L. "Comes the Change." Nation 288.11 (23 Mar. 2009): 3-4. Academic Search Premier. EBSCO. Oregon Public Library, Oregon, WI. 16 Mar. 2009
"Dr. Obama's Waiting Room." New Republic 240.4 (18 Mar. 2009): 1-1. Academic Search Premier. EBSCO. Oregon Public Library, Oregon, WI. 14 Mar. 2009
"Healthcare Heats Up." Nation 30 Mar. 2009: 3+. Academic Search Premier. EBSCO. Oregon Public Library, Oregon, WI. 14 Mar. 2009
"Mr. President, Here's Another Thing to Change." Advocate (Apr. 2009): 22-22. Academic Search Premier. EBSCO. Oregon Public Library, Oregon WI. 14 Mar. 2009
Thursday, February 26, 2009
Reform Proposal 1
There are a number of things which will be changed by this legislation, including changing the uninsured status of millions of citizens as well the overall amount of expenditures in the health care arena annually. Because the dollars to fund health insurance are received, primarily, from the government and employers, they are considered the main financiers of the health services delivery. It is quite obvious, with the economy in a tragic state, that the financial aspect of a health care reform plan is a bar above any others. How exactly will the new financing system work? First off, the expansion of the Medicaid program will extend eligibility to millions of Americans, as well as eliminate the disparities between which sick children are allowed to see a doctor and which aren’t by mandating that all children be covered. In turn, lower income families and small businesses would be provided subsidies to help control costs. Also, medium to large size companies who refuse to insure employers will face a slight tax increase. In line with this, any consumer who is currently content with their own coverage status would face no changes. These marginal changes in the spending of money will, hopefully, help shift the escalating cost of medical services away from the individual, and also help contribute to a national exchange.
Under this reform proposal lowering costs, improving access, and ensuring quality seem to be an equal three-legged stool. Costs will be lowered as a shift to preventative medicine helps in early diagnoses and a strengthening of public health will increase the knowledge of consumers on health care issues. Reducing administrative costs by preventing errors will be another key component to this proposal. Access will be improved greatly, as millions more Americans will potentially have access to the system. The voluntary system of health care, which results in a vicious cycle, will be no more. Raising the bar on quality will force competition between hospitals, and the care facilities which can produce better outcomes shall prevail. Quality will then be ensured through availability of providers and standards of medicinal practices.
Written by Jessica Showen
Citations:
Shi, Leiyu, and Douglas A. Singh. Delivering Health Care in America. 4th ed. Boston: Jones and Bartlett Publishers, 2008.
Laszewski, Robert. "A Detailed Analysis of Barack Obama's Health Care Reform Plan." The Health Care Blog. 26 Feb. 2009 http://www.thehealthcareblog.com/the_health_care_blog/2008/03/a-detailed-anal.html.
Ruiz, Rebecca. "What Obama's Health Care Plan Means For You - Forbes.com." Business News and Financial News at Forbes.com. 26 Feb. 2009 http://www.forbes.com/2008/11/05/obama-healthcare-plan-forbeslife-cx_rr_1105health.html.
"Barack Obama and Joe Biden: The Change We Need Health Care." Welcome to Obama for America. 26 Feb. 2009 http://www.barackobama.com/issues/healthcare/.
"Healthcare Platform Highlights: Barack Obama." Who Will Save Health Care? 26 Feb. 2009
Friday, February 20, 2009
There are multiple ways to describe the finances of Health Care. In using a dollar amount to measure this topic, take into account that in 2005, 2 trillion dollars was spent in this nation on health care, equaling $6,997 per capita. Also, Health Care makes up 16% of the nations GDP today. However, this rate is projected to grow to 20% by 2015. Lastly, in the 4th quarter of 2008, the GDP shrunk by 3.8% while medical spending continues to rise. In relation to finance and access, we must consider that 1/6 people do not have insurance in the United States. This relates to the finances, because the level of one’s insurance greatly affects their access and outcomes in regards to care. Another important factor of this issue is the quality of services which due to financial problems, may be late and in turn, further complicate pre-existing health concerns in the first place.
Year , Amount (in billions) , Percentage of GDP , Amount per Capita
1960, 26.9, 5.1, 141
1965, 41.1, 5.7, 202
1970, 73.2, 7.1, 341
1975, 130.7, 8, 582
1980, 247.3, 8.9, 1052
1985, 428.7, 10.3, 1735
1990, 717.3, 12.4, 2821
1995, 1,020.4, 13.8, 3762
2000, 1,358.5, 13.8, 4729
2005, 1,987.7, 16, 6697
Source: Centers for Medicare and Medicaid Services, Office of the
Actuary, National Health Statistics Group.
As the cost for care rises due to matters such as growth in technology, aging populations, and administrative costs, the use of these systems continues to increase. Another major factor in the need for increased health care financial support resides on the current economy of citizens and their households. Many of us, have experience with this and battle weighing out the cost of health care to the cost of daily living expenses. Unfortunately the latter usually wins, putting our health and lives at stake due to financial burdens. The financial aspect of history is one that has dictated US Health Care in our world today. For this reason, finances are by far the most important of all others: Workforce, Technology, Outpatient and Primary Care, Inpatient Care, Managed/Integrated Systems, Long Term Care, and Special Populations. In order for all of these to continue their existence, financial costs must be addressed and supported. If not, utilization of these other topics will not occur and the Health Care system as we know it will diminish. Although some people may see this as an unimportant factor for the US Health Care system, if they look back to the origin of any service, it always starts with money. Therefore, even an argument against the importance of finance will be defeated.
Some major years in history that affected the finances of our system include:
1935- Passage of the Social Security Act.
1939- The Federal Security Agency was created, bringing together related federal activities in the fields of health, education and social insurance.
1962- Passage of the Migrant Health Act, providing financial support for clinics serving agricultural workers.
1965- Creation of the Medicare and Medicaid programs, making comprehensive health care available to millions of Americans.
1977- Creation of the Health Care Financing Administration to manage Medicare and Medicaid separately from the Social Security Administration.
1980- Federal funding provided to states for foster care and adoption assistance.
1988- Creation of the JOBS program and federal support for child care. Passage of the McKinney Act to provide health care to the homeless.
1993- The Vaccines for Children Program is established, providing free immunizations to all children in low-income families.
1995- The Social Security Administration became an independent agency.
1996- Enactment of welfare reform under the Personal Responsibility and Work Opportunity Reconciliation Act.
1997- Creation of the State Children's Health Insurance Program (SCHIP), enabling states to extend health coverage to more uninsured children.
1999- The Ticket to Work and Work Incentives Improvement Act of 1999 is signed, making it possible for millions of Americans with disabilities to join the workforce without fear of losing their Medicaid and Medicare coverage. It also modernizes the employment services system for people with disabilities.
2001- The Centers for Medicare & Medicaid is created, replacing the Health Care Financing Administration.
2003- Enactment of the Medicare Prescription Drug Improvement, and Modernization Act of 2003, the most significant expansion of Medicare since its enactment, including a prescription drug benefit.
Sources:
Shi, Leiyu, and Douglas A. Singh. Delivering Health Care in America. 4th ed. Boston: Jones and Bartlett Publishers, 2008.
http://www.hhs.gov/about/hhshist.html
http://www.pbs.org/healthcarecrisis/history.htm
http://www.cms.hhs.gov/HealthCareFinancingReview/01_Overview.asp#TopOfPage
http://www.kaiseredu.org/topics_im.asp?imID=1&parentID=61&ID=358
http://findarticles.com/p/articles/mi_m0795/is_2_27/ai_n16108607
Friday, February 13, 2009
Our Political Stance, Values, and Beliefs Regarding the United States Health Care System
However, even with the recent change of office, millions are still uninsured, have bad debt due to personal medical payments, and several have filed for bankruptcy. We believe it is important to try and change things as soon as possible, without making impulsive decisions, to prevent from things getting worse.
The Obama administration’s believes that the health care system should not be completely market or social justice, but a mixture of both. From this, we are able to get the best of both worlds. The current health care agenda states that the United States needs a “plan that strengthens employer coverage makes insurance companies accountable and ensures patient choice of doctor and care without government interference.” This eliminates having a complete governmentally run system, which would increase taxes, and having the individual have complete responsibility with the insurance companies.
In addition, under the new reform, the plan states that if individuals like their current insurance plan, they will be able to keep it. The only significant change is that these individuals could possibly have a $2,500 decrease in their insurance plan costs. The Obama administration has many different ideas on ways to decrease prices, including lowering drug costs and requiring all hospitals “to collect and report health care cost and quality data.” However, for those who do not have health insurance or would like to switch plans, they will have a choice of a new, affordable option.
Even though we have many values and beliefs regarding the United States health care system, we strongly believe in making sure there is affordable, accessible, and valuable health care for all Americans.
Shi, Leiyu, and Douglas A. Singh. Delivering Health Care in America. 4th ed. Boston: Jones and Bartlett Publishers, 2008.
"The Agenda: Health Care." The White House. 2009. 12 Feb 2009