Youth Radio - Topic: public option

Senator Harry Reid pushes for Public Option with Opt Out

sfuller — Fri, 30 Oct 2009 22:54:50 -0500

According to the New York Times and NPR, in Washington D.C. on Tuesday Senate Majority leader Harry Reid announced that he was going to push for a public option in the senate’s version of health care reform bill. With a state opt out which would allow individual states to opt out of the public option. Public option would be designed to compete with private insures therefore reducing costs if the bill passes and some states opt out, people in those states would be forced to pay higher premiums also included in the heath care bill is a provision that requires all Americans who don’t get health insurance from an employer to buy heath insurance.

If they don’t the government would fine them. Having the state opt out does not make sense. It was just put in the bill to get blue dog democrats to vote for it. Why any state would opt out. Opting out would hurt the people of that state. The governor and legislature would probably not opt out cause restricting there constituents options and making them pay more for health insurance is horrible politics. It is still up in the air whether Reid can get the vote’s republican senator Olympia Snowe of Maine said she would not vote for any bill with a public option. She knows that if a bill with a public option passes that it will be in most if not all states

Pelosi Announces House Health Care Bill

rpereira — Thu, 29 Oct 2009 14:07:24 -0500

House Speaker Nancy Pelosi unveiled a $894 billion health care bill Thursday. The bill would extend coverage to 36 million Americans through a mix of subsidies, tax incentives and penalties on individuals and small businesses. Under the bill, the government would sell health insurance, in competition with private insurers. Pelosi said the competition would hold down premium costs, but Republicans said the public plan could eventually drive private insurers from the market. The final package from the House does not have the more liberal vision of a public health insurance option.

In the House bill, as in the Senate version, insurers would have to accept all applicants, regardless of pre-existing conditions and they would not be able to charge higher premiums because a person was sick. The House bill includes a provision letting children stay on their parents’ insurance through the age of 26. A bill approved by the Senate health committee offers a similar provision allowing children to stsay on their parents' insurance through age 25.

President Obama welcomed the House bill as “a historic step forward”. He said it meets two of his criteria. “It is fully paid for and will reduce the deficit in the long term,” he said.

Opponents to the bill were quick to respond to Pelosi's announcement. Representative Mike Pence of Indiana, the No. 3 Republican in the House, said the Democrats’ bill “looks like another freight train of big government with more taxes, more mandates and more spending.” That, he said, is “not what the American people want.”

(via The New York Times)

Mom and Dad's Health Insurance May Be Yours

rpereira — Thu, 15 Oct 2009 15:59:09 -0500

By: Emily Beaver

This week, Speaker Nancy Pelosi said that under a health reform bill in the House of Representatives, young adults could stay insured under their parents' plans through age 26.

Members of Y.I. Want Change, a coalition of youth organizations formed by the Young Invincibles health reform advocacy group, and their supporters stood with Pelosi when she made the announcement at a press conference. The reform could be an important victory for young people.

"It's important because as young people graduate from college and are struggling to find jobs in this economy, they need to have coverage and this provides them with an option," said Chrissy Faessen, vice president of communications and marketing for Rock the Vote. The organization is a member of the Y.I. Want Change coalition.

Right now, about 25 states allow young people to stay on their parents' plans into their 20s. But in other states, young adults get dropped from their parents' private health insurance plans, usually between ages 19 and 22. At age 19, most young people no longer qualify for Medicaid, a government health insurance program that provides coverage for very low-income children and parents.

Being able to stay on a parent's insurance plan longer could help more young people get health insurance, especially those who don't receive insurance through an employer. But it won't be a solution for young adults whose parents don't have insurance or whose parents are insured through Medicaid.

Young advocates for health reform are lobbying for more changes that will help young people get access to affordable health care. Members of Y.I. Want Change and their supporters spent Tuesday on Capitol Hill talking to lawmakers' staff members about health care reform. Y.I. Want Change also released six priorities for reform, including more financial help for young people who can't afford insurance premiums and a public option.

Supporting legislation that lets young adults stay insured under their parents' plans should be easy for lawmakers. The measure could encourage more young adults to get insured without costing taxpayers, because parents would pay for their children's premiums.

Pelosi has said she supports the public option, which could provide another option for young adults who can't get health care through a parent or employer. Whether Congress will pass a public option or other reforms that will make health care accessible and affordable to all young people--no matter who their parents are--will be seen in upcoming weeks, as the House and Senate work to finalize health care reform legislation.

Previously:

No Health Insurance? That'll be $950.

rpereira — Wed, 30 Sep 2009 12:35:32 -0500

By: Emily Beaver

For many young people, health insurance is unaffordable. But under some plans to reform health care, going without health insurance will be expensive, too.

Senator Max Baucus recently introduced a health care reform plan that requires everyone to get insurance. Anyone who doesn't have insurance would be fined up to $950 a year, depending on income.

Making sure everyone gets health insurance is an important goal of many of the plans to reform health care. For some, the principle that everyone should have health care is behind the "individual mandate" requiring everyone to get health insurance. But there's another reason lawmakers want to get everyone insured--to lower the government's cost of making health insurance affordable.

All forms of insurance, including health insurance, work by spreading costs among a pool of people. Since young people generally spend less on medical care, their insurance premiums help to subsidize the cost of care for older, sicker people. When young people don't buy insurance, costs go up for those who are insured. So making sure everyone contributes to health insurance is important to lowering costs overall.

Senator Baucus' reform bill does offer a few benefits for young people. His plan would allow some low-income young people to get insurance under the government's Medicaid program, which has been closed to young adults who don't have children.

The bill would also create a "young invincibles" health care plan available to Americans age 25 and younger, which would cover emergency medical and preventive care only.

While the "young invincible" plan could help young people get access to insurance, it doesn't necessarily give them access to quality health care--only catastrophic emergencies and preventative care would be covered. Young people with chronic health problems like asthma and diabetes wouldn't have adequate coverage.

Senator Baucus' reform bill doesn't include a public option, a government-run health insurance program. Without a public option, private insurers have little incentive to create better, more affordable health insurance plans that young people would want to buy.

And since few health plans available to young people cost less than $950 a year (which would break down to about $80 a month), paying the fine for being uninsured could still cost less.

Some critics have complained that Senator Baucus' bill caters to young people. But Senator Baucus' bill actually offers little for people--young or old--who don't get health insurance through an employer. Most will be forced to choose between spending money for health insurance that won't necessarily cover quality care or paying a fine.

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Can Obama Get Youth 'Fired Up' Over Health Care?

rpereira — Tue, 22 Sep 2009 16:51:31 -0500

By: Emily Beaver

President Obama recently brought the health care reform debate to a youth audience at the University of Maryland. The rally was the president's first youth event since his campaign and the atmosphere was similar to a campaign rally. At the end of the rally, Obama pumped up an enthusiastic crowd of 15,000 people with his "fired up, ready to go" chant.

In contrast to the festive atmosphere, the rally opened with a young-- and sobering--perspective on health care reform. Before introducing the president, 20-year-old University of Maryland junior Rachel Peck spoke about surviving papillary thyroid cancer during her freshman year. Peck was covered under her parents' health insurance, but said she worried about being able to pay for treatment if her cancer returns. She told the crowd to do something about health care now.

Obama's speech was similar to the one he delivered to Congress earlier this month, although he focused on the importance of health reform for young people. One in three young adults live without insurance and are "one accident or illness away from bankruptcy," Obama said.

So how would health care reform change young people's lives? Everyone would be required to have health insurance, Obama said. Young people could stay insured under their parents' plans until age 26, he said. This change could have a big impact on the young population, since only 25 states have passed laws allowing young people to be insured under their parents' plans until age 24 or older.

Young people who can't get health insurance through a parent would be able to buy affordable health insurance through an exchange, or a marketplace for individuals and small businesses to purchase affordable health insurance, Obama said. One of the options in the exchange should be the public option, a government health insurance program, he said. Although the president has mentioned the public option in speeches, it's not certain whether health care reform will include a public option. Last week, Senator Max Baucus released a health reform plan that does not have a public option.

By speaking at the youth rally, President Obama emphasized the importance of getting young people insured and involved in the health care debate. Although young adults are one of the largest and fastest growing segments of the population without insurance, they've often been left out of the debate.

Young people need to have access to affordable health care, regardless of where they work or if their parents have health insurance. But without a public option, it's hard to see how health care reform will change the situation of young adults who struggle to get insurance through work or on the private insurance market.

Talking to young people about health care reform is a good first step, but the real test will be whether President Obama can pass health care reform that offers a real change for youth.

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Young Docs Talk Health Reform

rpereira — Thu, 17 Sep 2009 15:50:59 -0500

By: Emily Beaver

Youth Radio reached out to young doctors and medical students around the country to get them to weigh in on the health care debate. They talked about how health insurance impacts patients’ care, “socialized medicine,” and more. Will they agree more than members of Congress? Does being a health care professional change the way they think about health care debate?

Take a look at their responses after the jump.

Youth Radio: Have you experienced any situations where a young person not having insurance or adequate coverage meant you couldn't give those patients care?

Adam Green, MD, Chief Resident of Pediatric Medicine at the University of Colorado/ The Children’s Hospital

Green: Working in an academic setting, our hospitals see a large number of uninsured kids as part of their missions. But when kids don't have insurance, it definitely makes it harder to treat them -- we have to jump through a lot of hoops to get them care, especially treatment at home after they're discharged, which is something many of our kids need because they have long-term or chronic illnesses.

YR: How does an emergency situation play out in the ER if a person comes in needing care who doesn't have coverage?

Green: ERs are required by law to treat everyone who comes in, regardless of their insurance coverage, so we treat everyone equally. But this becomes a big problem when families start using the ER as their kids' primary pediatric setting -- ERs get too busy with kids who don't really have emergency problems and can't focus on the real emergencies. We need to get more kids hooked up with primary pediatricians.

YR: Do you see the current health care debate as something that actually has the potential to change the way you do your job?

Green: Yes -- I would be very excited to practice in a system in which we, as providers, worry less about patients' insurance coverage or lack thereof, and more about providing the best care for kids and their families. To get to that point, however, we're going to need to make some deep changes, including putting more emphasis on preventive and primary care medicine so that we can prevent diseases from progressing so far and draining our healthcare resources.

YR: How would you like to see health care coverage run in this country--do you fear the 'socialized medicine' scenario?

Kurtland Ma, an emergency room resident at Jacobi and Montefiore Hospitals in the Bronx, New York

Ma: I would like to see the patients taking much more responsibility for their own health outcomes. Obviously, our health care system is very wasteful, but a great deal of the responsibility can also be blamed on irresponsible patient behavior. Many patients call ambulances and come to the emergency room on a whim, wasting lots of time and money when they could just call their own doctors or do not need any care. Also, they do not fill their prescriptions, do not take care of themselves, and take no responsibility for themselves. This is also a huge waste of resources.

YR: Do you see the current health care debate as something that actually has the potential to change the way you do your job?

Ma: I'm not sure that lack of health care access or lack of coverage is the big problem. Tons of people come to the emergency department every day and are treated regardless [of whether they have coverage]. I think we need to put rational limits on how we distribute the resources we have and make individuals more responsible for their own health--if they do not learn to take care of themselves, then they have to be held accountable.

YR: Do you see the current health care debate as something that actually has the potential to change the way you do your job?

Andrew Rudikoff, an anesthesiologist at University of California Los Angeles Medical Center

Rudikoff: I think so… I think we will have a more systems-based practice rather than more individual-based practices. Health care will be delivered by larger groups, rather than individual clinics. These larger groups will have more standardization and goals for treating the population as a whole—for example, setting glucose [blood sugar] goals for diabetes, making sure patients with coronary artery disease are on the accepted standard litany of medications, and so on.

As an aside, I don't buy this preventative medicine idea. While you can live a healthier lifestyle, you can't really prevent all diseases. Sure, I practice yoga and am a Monday through Friday vegetarian, but I can still get a brain tumor that cannot really be prevented. Sometimes disease just happens and no one is culpable. While we can make tobacco and corn syrup illegal to try to prevent certain diseases like diabetes and cancer, I'm not sure that will curb the costs of health care.

YR: How would you like to see health care coverage run in this country--do you fear the 'socialized medicine' scenario?

Mike Miller, fourth-year medical student in Denver, Colorado

Miller: I would like to see health care run very differently in this country. I think that our current system is shameful, and even criminal in its neglect of our citizens and their right to health. I would like to see a system that is based on existing systems that are successful, rather than on theoretical systems. I believe that it makes sense to take a model of something that works and try to emulate it! I hear, and even support, the call for something "uniquely American." But, we must decide if we are willing to let our pride stand in the way of the lives and the health of our citizens. I would like to see more socialized medicine in this country. This is something that we know will produce better outcomes, as has been demonstrated in our country and many others. One of the biggest difficulties in cost containment (especially in the private sector) is in controlling overhead costs. Medicare has done a remarkable job of eliminating overhead and our country could save billions if the private insurance industry was forced to become as efficient as it's socialized counterpart. The VA [the health care system for veterans], for all of it's shortcomings, which mainly have to do with funding and distribution of available services, provides us with an exceptional example of comprehensive and effective care. Their health outcomes are frequently some of the best in the nation, and this is because their employees are required to practice evidence-based protocols whenever possible.

YR: Have you experienced any situations where a young person not having insurance or adequate coverage meant you couldn't give those patients care?

Barbara Melendez, MSIV, fourth-year medical student at the University of Colorado School of Medicine

Melendez: As a third year medical student I did my internal medicine rotation at a local hospital. During this rotation, a 23-year-old female was admitted to our service for hemoptysis [coughing up blood]. During her admission, we diagnosed her with lung carcinoma [cancer], non-small cell. This diagnosis, for patients with limited stage disease, has a reported median survival range from 15 to 20 months, and the reported five-year survival rate is 10 to 13 percent. The treatment consists of chemotherapy and surgery, which has been showed to improve survival. However, neither service would do anything, as she was uninsured. She had to discharge her with no plan for follow-up and the diagnosis of non-small cell lung carcinoma. This is possibly the worst experience I've had in medicine.

YR: How would you like to see health care coverage run in this country—do you fear the 'socialized medicine' scenario?

Melendez: I feel we should have a government-run system. The word socialized, despite the best efforts of some politicians, does not scare me. Access to appropriate health care should be a right, and we need a health care system that protects that right while allowing us to practice evidence based medicine [medical techniques demonstrated effective through research].

YR: How would you like to see health care coverage run in this country--do you fear the 'socialized medicine' scenario?"

Ramnik Dhaliwal, third-year medical student pursuing JD/MD at the University of Colorado Denver Medical School and CU Law School

Dhaliwal: If you look at the statistics right now, the government, whether federal or state, and taxpayers are already one of the largest providers of health care in this country. Programs like Medicare, Medicaid, and CHIP [Children's Health Insurance Program] are all government run and funded. I believe that creating a scenario where the government drives the competition will not only allow more to be covered, but also will help drive prices down as private insurance companies will be forced to decrease costs through streamlining and becoming more innovative to be able to compete with the government programs.

Currently, insurance companies have no incentive to change. They are making billions of dollars in profit with a system that is so inefficient. Health care does not follow the normal economic model of supply and demand where increased demand brings in more players. Because the initial cost of starting an insurance company is so high the big players that have always been there pretty much have a monopoly.

Doctors are unable to really negotiate a great deal because any way they look at it, they must accept the insurance companies' demands since they are the only ones offering the product, which in this case is payment for [medical] services.

Everyone fears such large changes, but without change we will just run further into debt and more Americans will be unable to obtain needed medical care without incurring devastating debt.

If you’re a young medical professional and want to share your perspective on health care reform, contact Youth Radio.

Previously:

Old vs. Young -- the Health Care Tug-Of-War

rpereira — Fri, 11 Sep 2009 15:08:47 -0500

By: Emily Beaver

What’s age got to do with it?

Well, when it comes to what you pay for health insurance -- age is important.

Age-rating, or using age to determine how much someone pays for health insurance, has recently been getting a lot of press. And like much of the health care debate, age-rating is turning into a battle between the older and younger generations.

What’s the fight over? Changing age-rating practices could lead to lower insurance premiums for older adults, but higher premiums for younger adults.

Usually private insurance companies charge older adults more for health insurance than younger adults. As people age, they generally have more health problems and spend more on health care services. The system seems fair—the people who use the most services pay the highest premiums.

Well, not everyone agrees. Some people and groups that advocate for older adults say age-rating isn’t fair because people can’t help aging. And age isn’t the only indicator of health, they say. An active, 52-year-old may be healthier than a 30-year-old who lives on cheese fries, Diet Coke and cigarettes.

Health care reform legislation being considered by Congress could limit how much more insurance companies can charge older Americans. The changes would set a 2:1 ratio on age-rating, which means insurance companies would only be able to charge older adults twice as much as younger ones.

Members of the insurance industry, including the president and CEO of the Blue Cross Blue Shield Association, think insurers should be able to charge older adults up to five times as much, also known as a 5:1 ratio. SHOUTAmerica, a health care reform group for young people, also advocates for a 5:1 ratio. Both the insurance industry and SHOUTAmerica basically have the same reason for wanting to push the ratio to 5:1. Lowering the ratio too much could mean insurance companies have to charge young people more to cover older adults’ health care costs. That could lead to more young people deciding to go without insurance.

Young adults are already one the largest groups of uninsured Americans. While it doesn’t seem fair to penalize anyone because of age, let’s face it—lowering the age-ratio will just cause more young adults to skip coverage.

The reason many young adults are uninsured often comes down to money—they are less likely to have jobs that offer health insurance or pay enough to allow young adults to purchase insurance from the individual insurance market. They may have just lost coverage under their parents’ insurance plans but also can’t afford expensive premiums under COBRA, a government program that allows people who have lost insurance through an employer or parent to continue their insurance coverage.

Anything that causes more young people to go uninsured isn’t good for them or for older adults. Adding more young people to the insured population will lower the cost of insurance for older people. Changing the age-rating system isn’t enough—the cost of health insurance needs to go down so more young adults can sign up. Bottom line: either the government will have to offer subsidies to make insurance available to people who can’t afford it or it has to allow private insurers to offer insurance plans to young people at lower prices -- even if those prices are lower than plans for older adults.

Previously:

Ten Health Care Terms You Need to Know

rpereira — Thu, 20 Aug 2009 19:41:38 -0500

By: Emily Beaver

Maybe you've heard President Obama talking about reforming health care or seen TV news reports about people protesting recent town hall meetings. But if you think health care reform doesn't impact you, it's time to tune into the debate.

One goal of health care reform is making sure that everyone can get health insurance, including young people. About 30% of Americans ages 19-24 don't have insurance, and one in seven teens doesn't have insurance, says Claire Brindis, Director of the Philip R. Lee Institute for Health Policy Studies at University of California, San Francisco.

Many young people aren't covered by their parents' health plans, don't get insurance at work, can't afford to buy insurance or simply don't think they'll get sick. But if you get sick or injured when you're uninsured, you might not get the medical care you need or you may go into debt because of medical bills.

Cutting through the health care jargon isn't easy. Here are ten health reform terms you need to know:

1. Expanding coverage

Expanding health insurance to cover all Americans is a major part of health reform, Brindis says. Other important goals are making sure that people who do have insurance can keep it and lowering the costs of providing health care.

2. The public option

You may have heard debate about whether a "public option" should be included in health reform. The public option is health insurance run by the government, says Melissa Rodgers, Associate Director of the Berkeley Center on Health, Economic and Family Security.

A public health insurance plan would be one option for people who don't have insurance, or don't have insurance that covers their medical needs, Rodgers says. No one would be forced to participate in the public plan.

A public plan can do things the private insurance market can't, like make sure that everyone gets access to affordable healthcare, she says.

3. Medicare/Medicaid

Medicare and Medicaid (which is called Medi-Cal in California) are public health insurance plans the government already runs. Medicare is a national program that provides health insurance for people age 65 and older, and some younger people with disabilities.

Medicaid is a health insurance program for low-income people run by individual states. Each state has different rules about how poor you must be to qualify for Medicaid, Brindis says.

4. Individual Mandate

An individual mandate means that every American would be required to have health insurance. If this mandate was approved, young people could no longer go without health insurance because they can't afford it or don't think they will get sick, says William H. Dow, Associate Professor of healthcare economics at U.C. Berkeley.

If everyone has to be insured, the government will have to help people who can't afford insurance pay for it, Dow says. That could put pressure on the government to find more money to help people pay for health care.

5. Employer-sponsored coverage

Many workplaces, from small businesses like your neighborhood coffee shop to large companies like Starbucks, provide health insurance coverage for employees. People who are self-employed or work part-time usually don't get employer-sponsored coverage.

6. Individual market

The individual health insurance market is currently the main option for people who can't get insurance coverage through a government program like Medicare or Medicaidan or an employer-based plan (or through a parent or spouse's employer-based plan). On the individual market, private insurance companies negotiate prices for health plans with individual people or families rather than large groups of people, such as all the employees at a company.

Employer-sponsored coverage has a different set of rules than the individual market. In the individual market, nothing prevents insurers from denying participants coverage or charging high prices, Rodgers says.

"The individual market is the wild, wild west of insurance," she says.

7. Underinsured

If you have health insurance, but it doesn't cover a service you need, you're underinsured. For example, you're pregnant but your insurance doesn't cover care you need through pregnancy or childbirth.

8. Pre-existing condition

If you have a history of illness or a medical condition that existed before you applied for insurance, private insurance companies may refuse to insure you. Diseases like cancer or diabetes are examples of pre-existing conditions that may make it difficult for a person to be approved for private health care coverage. Insurance companies may also refuse to pay for any care related to a pre-existing condition, Rodgers says.

9. Exchange

An exchange is one way to expand coverage to the uninsured. Anyone who doesn't have access to health care would be placed in a group called an exchange, where they could choose from a variety of private and public health plans, Rodgers says.

10. Electronic medical records

Electronic medical records let doctors and other health care professionals share information about patients across different healthcare settings, like hospitals and doctors' offices. Electronic medical records could prevent doctors from duplicating costly tests that increase the cost of medical care, Brindis says. Lowering what health care costs will be important if the government tries to expand coverage to everyone.

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