July 2, 2010
Kaiser Foundation's June Update on Health Disparities
The Kaiser Foundation has posted its June Update on Health Disparities which
includes summaries of news articles on efforts to recruit multi-racial donors for the National Marrow Donor Program, cultural factors contributing to disparities in treatment among lung-cancer patients, and a medical-legal partnership that helps patients overcome legal challenges that threaten the care of patients in the Washington, D.C., area. The monthly update synthesizes news coverage from hundreds of print and broadcast news sources related to health and health care issues that affect underserved and racial and ethnic communities as well as providing summaries of relevant journal articles and other research developments in the field.
You can sign up to receive the free report via email by visiting Kaiser's online subscription site and selecting the "Minority Health" topic within the kff.org Kaiser Update section.
June 30, 2010
A New Report Ranks U.S. Last Among 7 Industrialized Countries On Health System Performance
Even though the US health care system is the most expensive, a new Commonwealth Report ranks the US last on measures of health system performance in five areas: quality, efficiency, access to care, equity and the ability to lead long, healthy, productive lives in comparison to Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom. According to a new ScienceDaily Report:
[w]hile there is room for improvement in every country, the U.S. stands out for not getting good value for its health care dollars, ranking last despite spending $7,290 per capita on health care in 2007 compared to the $3,837 spent per capita in the Netherlands, which ranked first overall.
Provisions in the Affordable Care Act that could extend health insurance coverage to 32 million uninsured Americans have the potential to promote improvements to the United States' standing when it comes to access to care and equity, according to Mirror Mirror On The Wall: How the Performance of the U.S. Health Care System Compares Internationally 2010 Update, by Commonwealth Fund researchers Karen Davis, Cathy Schoen, and Kristof Stremikis. The United States' low marks in the quality and efficiency dimensions demonstrate the need to quickly implement provisions in the new health reform law and stimulus legislation that focus on realigning incentives to reward higher quality and greater value, investment in preventive care, and expanding the use of health information technology.
"It is disappointing, but not surprising that, despite our significant investment in health care, the U.S. continues to lag behind other countries," said Commonwealth Fund President and lead author Karen Davis. "With enactment of the Affordable Care Act, however, we have entered a new era in American health care. We will begin strengthening primary care and investing in health information technology and quality improvement, ensuring that all Americans can obtain access to high quality, efficient health care."
Earlier editions of the report, produced in 2004, 2006, and 2007, showed similar results. This year's version incorporates data from patient and physician surveys conducted in seven countries in 2007, 2008, and 2009.
Key findings include:
· On measures of quality the United States ranked 6th out of 7 countries. On two of four measures of quality -- effective care and patient-centered care -- the U.S. ranks in the middle (4th out of 7 countries). However, the U.S. ranks last when it comes to providing safe care, and next to last on coordinated care. U.S. patients with chronic conditions are the most likely to report being given the wrong medication or the wrong dose of their medication, and experiencing delays in being notified about an abnormal test result.
· On measures of efficiency, the U.S ranked last due to low marks when it comes to spending on administrative costs, use of information technology, re-hospitalization, and duplicative medical testing. Nineteen percent of U.S. adults with chronic conditions reported they visited an emergency department for a condition that could have been treated by a regular doctor, had one been available, more than three times the rate of patients in Germany or the Netherlands (6%).
· On measures of access to care, people in the U.S. have the hardest time affording the health care they need -- with the U.S. ranking last on every measure of cost-related access problems. For example, 54 percent of adults with chronic conditions reported problems getting a recommended test, treatment or follow-up care because of cost. In the Netherlands, which ranked first on this measure, only 7 percent of adults with chronic conditions reported this problem.
· On measures of healthy lives, the U.S. does poorly, ranking last when it comes to infant mortality and deaths before age 75 that were potentially preventable with timely access to effective health care, and second to last on healthy life expectancy at age 60.
· On measures of equity, the U.S. ranks last. Among adults with chronic conditions almost half (45%) with below average incomes in the U.S. reported they went without needed care in the past year because of costs, compared with just 4 percent in the Netherlands. Lower-income U.S. adults with chronic conditions were significantly more likely than those in the six other countries surveyed to report not going to the doctor when they're sick, not filling a prescription, or not getting recommended follow-up care because of costs.
June 29, 2010
HHS Launching Health Website For Consumers This Week
Finding health insurance may become as easy as shopping for an airline ticket with a new federal website which will give consumers a list of all private and government health care plans for individuals and small businesses in their areas. The new site is www.healthcare.gov and it is created as the result of a mandate contained in the new health reform law. Starting on July 1, it will initially provide just basic facts, such as the names of companies, health plans and Web links. However, starting in October, it will list detailed cost and benefits information. According to a story prepared jointly by the Kaiser Foundation and USA Today, consumer groups and insurers already are fighting the kind and extent of the information that should be displayed:
"What we are trying to do is create some order in the marketplace," says Karen Pollitz, a top official at the new Office of Consumer Information and Insurance Oversight at the Department of Health and Human Services. She acknowledges the site won't be the Expedia of health care any time soon: "This ain't like buying a plane ticket; it is much more complicated."
For example, unlike the popular travel sites where people can immediately buy an airline ticket, consumers will have to contact insurers directly to sign up.
Insurers including UnitedHealthcare and Aetna say HHS is going too far in planning to list certain data, such as the percent of claims that health plans deny, the rate at which they cancel policies after customers get sick and the number of times patients appeal coverage decisions. They say the data would mislead potential customers. "Let's do what the legislation sets out and not overcomplicate, which will lead to consumer confusion and higher costs," says Aetna spokesman Mohit Ghose.
Consumer groups such as AARP and Families USA counter the data are vital in helping people pick a plan. The site can "be the great equalizer so consumers can have equal access to information and be on the same playing field as insurance companies," says Elisabeth Benjamin, co-founder of Health Care for All New York, a consumer health care coalition. "The government needs to make the information as open as possible …. AARP lobbyist Paul Cotton says “it is a very important first step to give consumers the information they need … so insurers are competing on quality of care and customer service."
HHS has said that in October, when it will begin listing premiums for insurance plans, it will use what Pollitz calls "sticker prices." Actual rates could be significantly higher based on an individual's health status. Until 2014, insurers are allowed to charge sicker people more, and to deny applications altogether. UnitedHealthcare is concerned that consumers could misinterpret even those base prices. The company wants the site to list average prices. Meanwhile, consumer advocates such as Benjamin say consumers should be able to get exact prices from insurers on the site. That could require patients to submit detailed medical histories — at least until 2014.