Majority of Uninsured American Will Buy Insurance

In a recent report from Gallup Healthcare by Frank Newport and Kyley McGeeney, it was found that 65% of uninsured Americans plan to buy insurance as directed by the Affordable Care Act (ACA) while 25% plan not to buy insurance but to pay the associated fine. Less than half of uninsured Americans (48%) say that they will seek insurance in health insurance exchange programs offered by either their state government or the federal government while 36% of the uninsured said that they will make their insurance purchase through one of the government programs. 

In this round, the Gallup Daily Tracking Survey asked Americans about their awareness of provisions in the the ACA, which goes into effect on January 1, 2014. and how they plan to respond to those provisions. Gallup surveyed a nationally representative sample of 5,099 insured and uninsured American adults via landline and cell phone from September 17, 2013 through September 26, 2013.


Read more:
http://www.gallup.com/home.aspx
http://www.gallup.com/tag/Healthcare.aspx
http://www.gallup.com/poll/164696/two-three-uninsured-americans-plan-buy-insurance.aspx

Medicaid Recipients Most Likely to Suffer from Preventable Illnesses

A survey conducted by The Gallup-Healthways Well-Being Index shows that those who rely primarily on Medicaid are far more likely to have preventable chronic illnesses than those who receive insurance from their employer, union, as part of a military or veteran's benefit package, and those who are uninsured. More than 1 in 3 recipients of Medicaid are obese compared to 27% of those who receive insurance from their employer or union. Those on Medicaid are also three times more likely to suffer from depression than those who receive their primary insurance from their union or employer, with 22% of the former suffering from depression compared to only 7% of the latter. Also concerning is the fact that 16% of Medicaid recipients suffer from asthma, compared to only 6% of those who receive insurance from an employer or union.
       Although these numbers are certainly cause for concern, it should be noted that recipients of Medicaid are usually living in poverty or are disabled, hence why they receive Medicaid. As Gallup notes, there is a strong correlation between poverty and suffering from poor health. Thus, these findings do not necessarily indicate that those on Medicaid are receiving poor quality care, but perhaps they are simply more likely to suffer from these conditions as a result of their poor socioeconomic status.

“Behind a cancer-treatment firm’s rosy survival claims”

In a recent post on the blog, Statistical Modeling, Causal Inference, and Social Science, the following was reported:

Brett Keller points to a recent news article by Sharon Begley and Robin Respaut:

A lot of doctors, hospitals and other healthcare providers in the United States decline to treat people who can’t pay, or have inadequate insurance, among other reasons. What sets CTCA [Cancer Treatment Centers of America] apart is that rejecting certain patients and, even more, culling some of its patients from its survival data lets the company tout in ads and post on its website patient outcomes that look dramatically better than they would if the company treated all comers. These are the rosy survival numbers . . .

Details:

CTCA reports on its website that the percentage of its patients who are alive after six months, a year, 18 months and longer regularly tops national figures. For instance, 60 percent of its non-small-cell lung cancer patients are alive at six months, CTCA says, compared to 38 percent nationally. And 64 percent of its prostate cancer patients are alive at three years, versus 38 percent nationally.

Such claims are misleading, according to nine experts in cancer and medical statistics whom Reuters asked to review CTCA’s survival numbers and its statistical methodology.

The experts were unanimous that CTCA’s patients are different from the patients the company compares them to, in a way that skews their survival data. It has relatively few elderly patients, even though cancer is a disease of the aged. It has almost none who are uninsured or covered by Medicaid – patients who tend to die sooner if they develop cancer and who are comparatively numerous in national statistics. . . . Accepting only selected patients and calculating survival outcomes from only some of them “is a huge bias and gives an enormous advantage to CTCA,” said biostatistician Donald Berry . . .

What I really like about this article is how it combines quantitative information with qualitative interviews:

Carolyn Holmes, a former CTCA oncology information specialist in Tulsa, Oklahoma, said she and others routinely tried to turn away people who “were the wrong demographic” because they were less likely to have an insurance policy that CTCA preferred. Holmes said she would try to “let those people down easy.” . . .

The ads also challenge viewers to “compare our treatment results to national averages.” Doing so, on the company’s website, shows that CTCA’s reported survival outcomes regularly beat those averages.

Experts in medical data who reviewed CTCA’s claims for Reuters say those claims are suspect because of what they called deviations from best practices in statistics – in particular, comparing its carefully selected patients to those nationwide.

“It makes their data look better than it is,” said Robert Strawderman, professor and chairman of biostatistics at the University of Rochester. “So the comparisons used to suggest that CTCA has better survival rates are pretty meaningless.”

Income, Poverty and Health Insurance Coverage

On Wednesday, the Census released its yearly report on "Income, Poverty, and Health Insurance Coverage in the United States: 2011."  Median household income fell for the fourth straight year to $50,054.  Men still earn more than women; the median income for men was over $11,000 more than for women.  Looking at various ethnicities, Asians possess the highest median household income at $65,129, followed by Whites with $55,412, Hispanics at $38,624, then and Blacks with $32,229. 

The recession's impacts on income were wide-ranging, and as a result poverty increased drastically.  While the poverty rate fell, it did so only slightly, dropping from 15.1% in 2010 to 15.0% in 2011.  Since 1965, the poverty rate jumped above 15.0% for just five years – 1982, 1983, 1993, 2010 and 2011. 

Lastly, health insurance coverage improved slightly from 2010; however, over 48 million continue to forego coverage.  15.7% of the population lacks health insurance.  This lackluster rate finds its roots in companies' inability to provide employer-based coverage, and in Americans’ inability to simply find a job.  With an unemployment rate that has doubled since the start of the recession and businesses around the country struggling to remain profitable while still providing health benefits, 11 million less Americans received health insurance through their jobs in 2011 than in 2000.  On the other hand, the number of people relying on government health insurance programs, such as Medicare and Medicaid, has shot upwards more than 31 million in that same timeframe.  

Health Spending Represents 17.9% of GDP

The California Health Care Foundation recently released its 2012 report on health care costs.  The report illustrates how America pays for its health care, as well as how these costs have evolved over the past half-century.  In 1960, health spending represented just 5.2% of GDP.  By 2010, that proportion ballooned to 17.9%.  Per capita spending has experienced an even more dramatic increase.  In 2000, health spending per capita was $4,878, but after just a decade, that figure rose to $8,402.  Compared to other countries, the U.S. spends far more on health care both per capita and as a percentage of its GDP.  Switzerland’s $5,270 spent on health care per capita makes the nation a distant second to the U.S. in health spending.

Over the past 50 years, the question of who foots the health care bill has constantly changed.  In 1960, the bulk of health care funds came from out-of-pocket spending. Today, however, government programs like Medicare and Medicaid along with private insurance cover the majority of costs, and hospital care, physician and clinical services, and prescription drugs all necessitate far less out-of-pocket spending.  For instance, in 1960, nearly all of the money for prescription drug costs (96%) came from the consumers’ pockets.  In 2010, out-of-pocket spending accounted for just 19% of the expenditures. 

Number of Uninsured Americans on the Rise

More Americans are now uninsured in 2011 than in 2008, according to a recent Gallup poll. The declining number of Americans who have health insurance has been evident in most population groups, with the exception of younger adults and seniors whose decline rate was within the margin of error. For those who are fortunate enough to have insurance, fewer of them are receiving it from their employer, likely because the employer can not afford to provide insurance or because the employee can not afford to purchase insurance.  Many factors are likely at play in the steady increase of the uninsured. As Gallup reports, while the unemployment rate may be lower in 2011 than in 2008, many more Americans still remain underemployed and thus unable to afford insurance. Health care costs are also continuing to rise with no end in sight, indicating that this trend is likely to continue.

Rising Health Care Costs Felt by Employers

A recent Wall Street Journal article discusses the results of a survey conducted by the Kaiser Family Foundation and Health and Research Educational Trust, which found that the average cost of family health-insurance coverage has exceeded $15,000 for the first time. The survey was conducted between January and May 2011 and included 3,184 randomly selected companies. According to the survey, the average annual family premium for this year, $15,073, is a 9% increase from last year's $13,770. Most of the burden of the cost increase is being felt by employers, as employees' average premium contribution is only up 3% from 2010. This is illustrated in the chart from the article (below), which indicates the average annual premiums for family coverage from 2000 to 2011 and the portion contributed by employers and by employees. While the chief executive of Kaiser Family Foundation said that the cause of the increase in employers' premiums was unclear, the article quotes Goldman Sachs analyst Matthew Borsch, who speculates that the increases may have been due to the fact that insurers "have been conservative in their pricing, so they have overshot to some degree."