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Carvin's Cornhusker Quandary in King

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On Wednesday, as part of a brief filed by my organization, Constitutional Accountability Center, in King v. Burwell on behalf of state and federal legislators -- including Senate Democratic Leader Harry Reid and House Democratic Leader Nancy Pelosi -- we dropped a bit of a bombshell. In their Supreme Court briefs (as well as in their arguments to lower courts), the petitioners in King, represented by conservative superlawyer Michael Carvin, have asserted that Congress intentionally agreed to withhold tax subsidies from otherwise eligible citizens living in states that refused to set up a state-run health-insurance exchange. According to petitioners, Congress did this -- despite the Affordable Care Act's clearly stated goal of making health insurance affordable for all Americans -- because of politics. Particularly, they say, the ACA would not have passed without the vote of moderate (and now former) Democratic Sen. Ben Nelson, and Nelson, they claim, insisted that tax subsidies be withheld in states refusing to set up their own exchanges. Here's the key passage from pages 3 and 4 of the petitioners' brief:
These inducements for states to establish their own Exchanges were compelled by political realities. The House of Representatives initially enacted a bill under which the federal government would create a national Exchange, though individual states could affirmatively choose to establish their own instead. H.R. 3962, § 308, 111th Cong. (2009). That scheme, however, was unacceptable to the Senate. Halbig v. Sebelius, No. 13-623, 2014 U.S. Dist. LEXIS 4853, at *61 (D.D.C. Jan. 15, 2014) ("[T]hese proposals proved politically untenable and doomed to failure in the Senate ...."). Senator Ben Nelson of Nebraska, whose vote was critical to passage, called a national Exchange a "dealbreaker," expressing concern that such federal involvement would "start us down the road of ... a single-payer plan." Carrie Budoff Brown, Nelson: National Exchange a Dealbreaker, POLITICO, Jan. 25, 2010. For Nelson and some other Senators, it was important to keep the federal government out of the process, and thus insufficient to merely allow states the option to establish Exchanges, as the House bill did. Rather, states had to take the lead role, which, given the constitutional bar on compulsion, required serious incentives to induce such state participation.
Other briefs filed before the Court, one by senators led by John Cornyn, and another by two of the principal architects of the King lawsuit, Jonathan Adler and Michael Cannon, say essentially the same thing on pages 12-13 and 30 and 31 of their briefs, respectively.

So here's the bombshell: In an exchange of letters cited in our brief and published here, Sen. Nelson rejects that assertion unequivocally, stating, "I always believed that tax credits should be available in all 50 states regardless of who built the exchange, and the final law also reflects that belief as well." In other words, one of the key assertions made by the central Supreme Court advocates for King has been called false by the very senator relied upon by these advocates.

Not easily deterred, Mr. Adler responded to Sen. Nelson's letter in a tweet on Thursday morning, dismissing the letter as "post hoc" commentary that the Supreme Court should feel free to ignore.

Adler is right, of course, that post-enactment assertions by legislators about the meaning of legislation are given less weight than contemporaneous ones, but his tweet is nonetheless ridiculous for the following reason: The petitioners' assertion that Sen. Nelson insisted on conditional tax subsidies is itself pure speculation without a shred of support in the record. Look carefully at the briefs filed by the petitioners as well as by Adler and Cannon and the Republican senators, and look at the citations in them. These briefs assert that Sen. Nelson demanded that tax credits not be available on federal exchanges in order to "induce ... state participation," but the press reports they cite support only the far more limited propositions that Sen. Nelson did not want a single federal exchange and wanted states to be able to create their own insurance marketplaces. Petitioners offer no support whatsoever for the proposition they advance in this lawsuit: that Congress intentionally withheld tax subsidies in states that chose to have the federal government operate the exchange in their state.

Thus, while Sen. Nelson's letter is indeed a post-enactment account of his understanding of the law and motivations, it is the only piece of evidence in the record or elsewhere that indicates his particular view on a central allegation in this case, which, according to the former senator, has been completely mischaracterized by King and his supporters. It would be surprising if any member of the Supreme Court would take the petitioners' wholly unsubstantiated assertions about Sen. Nelson's critical role in the passage of the ACA at face value, particularly in light of his direct and explicit contradiction of those assertions.

In argument before the D.C. Circuit, the petitioners' lawyer Carvin effectively admitted that the King case "comes down to Sen. Nelson." If that's the case, petitioners should lose King 9-0. Reported by Huffington Post 16 hours ago.

Martin Luther King Jr. -- Health Care as a Moral Crisis

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On this occasion honoring the anniversary of the birthday of Martin Luther King 86-years-ago, coinciding with the release of the movie Selma, it is fitting to recall his leadership on moral principles toward equity of health care in this country. Among his many classic quotes about health care, he had this to say in 1966 in a speech to the Medical Committee for Human Rights:
Of all the forms of inequality, injustice in health care is the most
shocking and inhumane.

Were he here today, Martin Luther King, Jr. would be appalled to see what Americans are facing, even five years after the passage of the Affordable Care Act.

Here's one patient vignette that puts a human face on the outcomes facing patients unfortunate enough to live in states that opted out of Medicaid expansion, as more than twenty states have done.

Charlene Dill was a 32-year-old mother of three who earned $11,000 a year cleaning houses and babysitting in Florida. That was too much to qualify for Medicaid, and too little to afford health insurance. The ACA would have provided subsidies for health insurance if her income was more than $23,550. When she developed a heart condition, and later, abscess on her legs, she did go to emergency rooms, but couldn't afford those bills or any other care.

This is not an isolated anecdote, but more the rule for many millions of Americans. Access to care has improved for some, especially in states that expanded Medicaid, but there are still more than 30 million uninsured and tens of millions underinsured. Lacking any mechanisms to rein in markets and contain costs or prices, the ACA has unleashed increasing consolidation and control by hospital systems and insurers.

Wall Street is happy, and health care stocks are soaring. Yet one-third of insured Americans cannot afford to pay their medical bills, often leading to bankruptcy. Meanwhile, our safety net continues to deteriorate. We can expect that to worsen in the months and years ahead if Republican governors impose more restrictions on Medicaid, and if the Republican-controlled Congress cuts spending for critical programs.

As Martin Luther King knew full well, health care is a moral issue. Virtually all advanced countries around the world recognized long ago that health care is a human right, not a privilege based on ability to pay. Dr. Edmund Pellegrino, leading medical ethicist for many years at Georgetown University's Center for Clinical Bioethics, summed up the issue this way at the Annual Meeting of Academic Health Centers in 2000:
Access to health care is a moral obligation of a good society.
Yet, as a society, we still seem to have a moral blind spot when it comes to health care. As the income gap widens between rich and poor in America, and as the middle class falls into increasingly dire straits in affording health care, our sense of social solidarity continues to erode. The political process toward reform has been corrupted by money, especially in the wake of Citizens United and the McCutcheon rulings of the U.S. Supreme Court.

We can expect that Martin Luther King would see our present health care "system," despite limited progress from the Affordable Care Act, as a political failure and a moral crisis unnecessarily harming a large and growing part of our population. He would be a leader toward the concept of health care as a human right, not just a commodity for sale on a largely for-profit market. He would speak truth to power and be a beacon of hope if he were on the scene today. He was never one to give up in a fight, and has left us with this perspective:
We must accept finite disappointment, but never lose infinite hope.
We need to carry on his spirit to best honor his legacy. This would address his strong belief that injustice in health care is a major expression of inequality and inhumanity. An answer to health care reform is in plain sight if we just take off our blinders -- single payer national health insurance along the lines of H.R. 676 Improved Medicare for All, the Conyers bill in the House of Representatives. That will assure all Americans full access to necessary care, with full choice of physician and hospital care anywhere in the country. It includes public financing, coupled with a private delivery system, at a cost far less than we are paying today.
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John Geyman, M.D. is professor emeritus of family medicine at the University of Washington School of Medicine in Seattle and past president of Physicians for a National Health Program 2005-2007. Adapted in part from John Geyman, M.D.'s just released book How Obamacare Is Unsustainable: Why We Need a Single Payer Solution for All Americans, Copernicus Healthcare, 2015. Reported by Huffington Post 16 hours ago.

New Book Predicts Small Businesses Will Dump Health Insurance - Authors say it’s a good thing for employees

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"The End of Employer Provided Health Insurance" predicts 60 percent of small businesses will cancel health insurance for employees over the next three years.

Salt Lake City, UT (PRWEB) January 30, 2015

In a new book, The End of Employer-Provided Health Insurance, co-authors Rick Lindquist and Paul Zane Pilzer predict 60 percent of small businesses will cancel health insurance for employees over the next three years. The authors go on to argue that this transition is beneficial for both, employers and employees.

“It no longer makes financial, legal, or social sense for any U.S. employer to continue providing health insurance to its employees,” says Rick Lindquist. Since 2000, the percentage of Americans covered by employer-provided health insurance has declined annually.

“But this doesn’t mean that small businesses won’t help employees get health insurance,” adds Lindquist. “Many business owners will replace their group policy with a defined contribution plan that offers a stipend to employees to buy the health insurance that best suits them in the Health Insurance Marketplace. Everyone wins.”

According to 2014 reports, WellPoint, one of the nation's largest health insurance companies, has watched 218,000 members, or 12 percent, of its health plans disappear because small businesses have ended their employer-provided health plans. WellPoint expects this trend to play out over the next two years.

“We think [that the trend of our small business customers ending their group health plans] will be in a more accelerated timeframe over a shorter window of time, meaning this year and next, than over a longer period of time,” said WellPoint Chief Financial Officer Wayne DeVeydt during a July 30 conference call with investors.

“Employees have more choice in the marketplace,” says Lindquist. “They’re no longer forced into a one-size-fits-all policy. And if they lose their job, they can keep their health insurance regardless of employment.”

For more information visit: HealthInsuranceRevolution.org

About the Authors:

Paul Zane Pilzer is The New York Times best-selling author of 11 books, a former professor at NYU, and has served as an economist in two White House administrations. He is also the founder of six companies including the two largest U.S. suppliers of personalized employee health benefits, Extend Health (1999) and Zane Benefits (2006).

Rick Lindquist is president of Zane Benefits, Inc., the U.S. leader in individual health insurance reimbursement for small businesses. Zane Benefits’ software has been featured on the front page of The Wall Street Journal, USA Today, and The New York Times. He is a regular contributor to leading health benefits publications, including ClarifyingHealth.com.

About the Book:

The #1 Amazon best-selling The End of Employer-Provided Health Insurance is a comprehensive guide to utilizing new individual health plans to save 20 to 60 percent on health insurance. Over the next 10 years, 100 million Americans will move from employer-provided to individually purchased health insurance. Written by a world-renowned economist and New York Times best-selling author, this insightful guide explains how individual health insurance offers more to employees than employer-provided plans.

The End of Employer-Provided Health Insurance: Why It’s Good for You, Your Family, and Your Company (Wiley, 2014, ISBN: 978-1-119-01211-5, $25.00) is available at bookstores nationwide, from major online booksellers, and direct from the publisher by calling 800-225-5945. In Canada, call 800-567-4797. For more information, please visit the book’s page on http://www.wiley.com.

Founded in 1807, John Wiley & Sons, Inc., has been a valued source of information and understanding for 200 years, helping people around the world meet their needs and fulfill their aspirations. Wiley’s core business includes scientific, technical, and medical journals; encyclopedias, books, and online products and services; professional and consumer books and subscription services; and educational materials for undergraduate and graduate students and lifelong learners. Wiley’s global headquarters are located in Hoboken, New Jersey, with operations in the U.S., Europe, Asia, Canada, and Australia. The Company’s Web site can be accessed at http://www.wiley.com. The Company is listed on the New York Stock Exchange under the symbols JWa and JWb. Reported by PRWeb 15 hours ago.

Zane Benefits Discusses “Deductible Nightmares”- A Refresher Course for Insurance Shoppers

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Zane Benefits discusses health insurance terms for American consumers.

Salt Lake City, Utah (PRWEB) January 30, 2015

In a recent release, Zane Benefits discussed the reality of deductible nightmares. Under the Affordable Care Act (ACA), Americans are mandated to have health insurance coverage. So this means that Americans must health insurance coverage. For many terms like “deductible” and “out-of-pocket maximum” make your eyes glaze over.

In Zane Benefits’ recent release, they define four common health insurance terms that every consumer should know.

Deductible:
The amount paid for covered care before the insurer begins to pay. For example, a family or individual might have to pay $500 out-of-pocket for a covered service like a hospital procedure before the insurance company pays. After the policyholder has paid $500, the insurance company pays the remainder of the cost for the procedure. This would be a $500 deductible.

Copayment:
A set dollar amount paid to the healthcare provider for a covered service. For example, there may be a $30 copayment for each visit to your general practitioner.

Coinsurance:
The percentage of allowed charges for covered services you are required to pay. For example, if an insurer is responsible for 80 percent of the charges for a service, you would be responsible for the remaining 20 percent.

Out-of-Pocket Maximum:
An out-of-pocket maximum is the maximum amount of money you will pay for covered services during a benefit period (for example, over the course of a year). Let’s start with what your out-of-pocket maximum never includes: your premium, balance-billed charges, or services your health insurance plan doesn’t cover. As for what you’re out-of-pocket maximum does include, that will vary from plan to plan but copayments, deductibles, and coinsurance might be on the list.

According to Zane Benefits, consumer education is key to making the best health insurance decision.

For more information visit: ZaneBenefits.com

About Zane Benefits:
Zane Benefits, the #1 Online Health Benefits Solution, was founded in 2006 to revolutionize the way employers provide employee health benefits in America. We empower employees to take control over their own healthcare, while helping employers recruit and retain the best talent. Our online solutions allow small and medium-sized businesses to successfully transition to a health benefits program that creates happier employees, reduces costs and frees up more time to serve their customers. For more information about ZaneHealth, visit http://www.zanebenefits.com. Reported by PRWeb 15 hours ago.

Health care transparency bill – opposed last year by Premera – gets second chance

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A bill that would require health insurance companies to submit all patient claims to a statewide database and therefore make health care costs more transparent was met with support today at a House committee hearing in Olympia. This is round two for a bill that had almost total support last year, but was opposed by Premera Blue Cross, one of the top three-largest health insurance companies in Washington state. Premera officials last year said that they feared mandating insurance companies to report… Reported by bizjournals 14 hours ago.

Paul Zane Pilzer and Rick Lindquist's New Book Helps You Choose a Health Insurance Policy

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New Book helps consumers choose the best health insurance policy.

Salt Lake City, Utah (PRWEB) January 30, 2015

In a new book, "The End of Employer-Provided Health Insurance: Why It’s Good for You, Your Family, and Your Company", co-authors Rick Lindquist and Paul Zane Pilzer help consumers dodge mistakes in purchasing individual health insurance policies - a common challenge for many of today’s consumers.

The purchase of health insurance can have serious implications for your well-being and your wallet, if approached with a lack of information. In addition, many consumers have shown to be intimidated when it comes to decisions regarding health insurance.

But, according to Lindquist, “Applying for individual health insurance has never been easier. Health insurance shouldn’t be something that consumers are nervous about. The ACA has made it relatively easy for anyone to purchase a plan. The key is determining which approach is best for you and your family.”

Since this is a new experience the authors recommend you ask yourself these three vital questions:

“Can I keep my same doctor?” Each health insurance plan has a network of providers, including hospitals, laboratories, doctors’ offices, imaging centers, and pharmacies.

“Which metallic level is really right for me?” As of 2014, individual health insurance plans are categorized in four standardized levels of coverage. In terms of monthly premium cost, from lowest to highest, they are bronze, silver, gold, and platinum. When you’re evaluating coverage,look both at premiums and out-of-pocket costs.

“What does the policy cover?” Due to the Affordable Care Act (ACA), all individual health insurance policies are required to cover ten essential health benefits:

Emergency services, hospitalization, laboratory tests, maternity and newborn care, mental health and substance abuse treatment, outpatient care, pediatric services (including dental and vision care), prescription drugs, preventive services and management of chronic diseases, rehabilitation services.

“By putting some thought into what your ideal individual health insurance policy should look like, you’ll make the process of shopping on the Marketplace easier and less confusing,” concludes Lindquist. “Moreover, you’ll ensure that you have the coverage you need at a price that fits your budget.

For more information visit: HealthInsuranceRevolution.org

About the Authors:

Paul Zane Pilzer is The New York Times best-selling author of 11 books, a former professor at NYU, and has served as an economist in two White House administrations. He is also the founder of six companies including the two largest U.S. suppliers of personalized employee health benefits, Extend Health (1999) and Zane Benefits (2006).

Rick Lindquist is president of Zane Benefits, Inc., the U.S. leader in individual health insurance reimbursement for small businesses. Zane Benefits’ software has been featured on the front page of The Wall Street Journal, USA Today, and The New York Times. He is a regular contributor to leading health benefits publications, including ClarifyingHealth.com.

About the Book:

The #1 Amazon best-selling The End of Employer-Provided Health Insurance is a comprehensive guide to utilizing new individual health plans to save 20 to 60 percent on health insurance. Over the next 10 years, 100 million Americans will move from employer-provided to individually purchased health insurance. Written by a world-renowned economist and New York Times best-selling author, this insightful guide explains how individual health insurance offers more to employees than employer-provided plans.

The End of Employer-Provided Health Insurance: Why It’s Good for You, Your Family, and Your Company (Wiley, 2014, ISBN: 978-1-119-01211-5, $25.00) is available at bookstores nationwide, from major online booksellers, and direct from the publisher by calling 800-225-5945. In Canada, call 800-567-4797. For more information, please visit the book’s page on http://www.wiley.com.

Founded in 1807, John Wiley & Sons, Inc., has been a valued source of information and understanding for 200 years, helping people around the world meet their needs and fulfill their aspirations. Wiley’s core business includes scientific, technical, and medical journals; encyclopedias, books, and online products and services; professional and consumer books and subscription services; and educational materials for undergraduate and graduate students and lifelong learners. Wiley’s global headquarters are located in Hoboken, New Jersey, with operations in the U.S., Europe, Asia, Canada, and Australia. The Company’s Web site can be accessed at http://www.wiley.com. The Company is listed on the New York Stock Exchange under the symbols JWa and JWb. Reported by PRWeb 15 hours ago.

3 Health Care Resolutions for Democrats in 2015

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2015 promises a lot of political activity in health care. Recent wins in Congress, along with increased power at the state level mean that Republicans can influence our health care system in ways they could not before. This could have a huge impact on health care consumers nationwide, and Democrats need to be ready. Following are three New Year's Resolutions that Democrats would do well to heed.

*1. Prepare for an adverse King v. Burwell ruling.*
This is mostly for state-level Democrats. The Supreme Court is set to hear this case in March and a ruling could come down as early as June. If the plaintiffs win, millions of Americans who purchased their health insurance on a federal health insurance exchange would lose the subsidies that helped them pay for it. Because those subsidies trigger the employer penalty, it would also mean that employers could avoid the penalties associated with not offering coverage.

Generally, Democrats would view this as a negative development. Why? If the subsidies go away for policies purchased on a federal exchange, it is likely that millions of Americans would drop their coverage and become uninsured again. This would make the insurance pools smaller and most likely sicker, threatening the solvency of a program closely associated with their party.

To avoid this, state-level Democrats in the 27 states that refused to set up a state exchange should push hard to get one set up. They should argue that relying on the federal government's exchange is costing the state's citizens billions in federal subsidies. Republicans will argue that it is saving the state's employers in penalties. Democrats need to be ready for that, and to have a concrete plan for getting a state exchange set up in time for 2016's open enrollment.

*2. Position the lack of Medicaid expansion as hurting the state's economy.*
Both federal and state-level Democrats can have an impact here. Many Republican-led states did not expand Medicaid when first given the opportunity under health care reform. This was partly due to an expectation that states would have more negotiating power with the federal government in future years to design their expansion the way the state wanted, rather than the way the federal government wanted.

Recent announcements in Tennessee indicate that the federal government is indeed getting more flexible. As such, Democrats should step up their messaging that it is long past time for all states to expand Medicaid.

In doing so, Democrats should shift the focus of their messaging from the plight of the uninsured to the harm that Republican leaders are doing to their state's economies by not expanding Medicaid.

Why is that? Well, citizens of every state pay federal tax dollars for Medicaid. If one's state doesn't expand Medicaid, that state doesn't get the federal money. Other states that do expand Medicaid, though, do get the federal money. As a result, when Texas refuses to expand Medicaid, it is sending its citizens' federal tax dollars to Massachusetts and California. Expanding Medicaid, on the other hand, would mean billions of federal dollars coming back into Texas.

State-level Democrats should elevate this angle of the argument when pushing for their states to expand Medicaid. Let state-level Republicans explain why they are okay with their citizens' federal tax dollars flowing to the blue states.

*3. Have a plan for the renewal of CHIP funding.*
This is for federal-level Democrats. "CHIP" stands for the "Children's Health Insurance Program." This is a federal "block grant" program that provides coverage for children. It is due for congressional renewal this summer. Republicans often argue that it provides a better model than Medicaid, in that it is funded with "block grants" to the states rather than being "open-ended" in nature. Because federal funding for CHIP is not "open-ended," states are allowed to freeze enrollment in it when costs get out of line or an economic downturn hurts a state's ability to pay for the program. While this is used as an argument against "block grants," it also means that the program is more sustainable financially.

The bottom line here is that the vote to renew CHIP funding is another opportunity for Republicans to influence the U.S. health care system in 2015. Democrats need to have a plan to secure a renewal of the CHIP program "as is" without sacrificing priorities in other areas.

The degree to which Democrats are prepared and proactive in these areas will have a big impact on what the options are for health care consumers nationwide. Reported by Huffington Post 13 hours ago.

India Network Announces AXA Visitor Travel Assistance Services for All US Bound Visitor Health Insurance Policy Holders

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Visitor Health Insurance administrator India Network continues to provide various services to policy holders. AXA Travel Assist Services and Nurse line are accessible to India Network members 24 hours, 7 days a week worldwide.

Orlando, FL (PRWEB) January 31, 2015

India Network Foundation, a non-profit organization in the United States sponsors various health insurance plans for visitors, students, temporary workers, and their families. India Network visitor health insurance plans are well known in the Asian Indian community for their excellence in coverage with innovative consumer oriented designs. India Network members and visitors covered under the ACE Accident & Sickness policy are eligible for services during the policy term offered by AXA Travel assistance services. Emergency Travel Services are available only if a covered person is traveling at least 100 miles away from his or her legal residence or outside of his or her home country. Access to the ACE Travel Assistance Website and Pre-trip information services are available at any time. Security assistance services are available if a covered person is traveling outside of his or her home country.

India Network policy holders can reach the multilingual response center to confirm coverage and obtain access to available services by calling toll-free or direct dial or by e- mail 24 hours a day, 365 days a year. India Network recommends all international visitors to take in its ACE Comprehensive Insurance Plan or Premier plan before leaving home to avail benefits of Travel assistance services in case of any unforeseen problems during travel.

Travel Assistance Services will provide payment guaranteed to cover on-site medical and hospital expenses during medical emergencies for India Network Visitors Health Insurance covered person anywhere in the world. In addition, Assistance Services will also work with India Network Health Insurance policy holder or the covered person’s family to guarantee any amount required in excess of policy limits. Other travel assistance services include medical evacuation, repatriation and accidental death benefits are provided on need basis to policy holders.

Dr. KV Rao, President and Founder, India Network Foundation said that ACE Travel Assistance services will enhance emergency services delivery to all India Network Visitor Health Insurance policy holders 24 x 7 worldwide in case of need. All members should contact the ACE Travel assistance services in case of death of insured to assist them with repatriation benefits, etc. All India Network members are encouraged to take advantage of 24 x7 Nurse hotline for minor medical questions."

About India Network Foundation

India Network Foundation, established as a US non-profit organization, has been helping the Asian Indian community in North America with programs and travel grants to academics from India for more than two decades. India Network Foundation sponsors visitor health insurance to tourists, students, temporary workers (H1 visa holders) and their families. All insurance products are administered by India Network Services in the United States.

For more information, visit http://www.indianetwork.org.

About India Network Visitor Health Insurance

India Network Services administers visitor health insurance to help visiting parents, transient residents, tourists, students, temporary workers and their families. Cashless Visitor health insurance plans are offered for all age groups with network based comprehensive coverage and with pre-existing condition coverage.
For more information, visit http://www.kvrao.org or reach our operators at 855-428-3425. Reported by PRWeb 2 hours ago.

The Future of Medicine? Forget Private Doctor Appointments, Group Medical Visits are Coming

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The Future of Medicine? Forget Private Doctor Appointments, Group Medical Visits are Coming Submitted by Mike Krieger via Liberty Blitzkrieg blog,



*According to the American Academy of Family Physicians, around 10 percent of family doctors already offer shared medical appointments, sessions that bring together a dozen or more patients with similar medical conditions to meet with a doctor for 90 minutes. With pressure from the government and insurers to bring down the cost of care while treating the increasing number of people with health insurance, patients can expect group visits to become more common. “It’s efficient. It’s economical.*"

 

– From the Bloomberg article: Your Next Doctor’s Visit Could Get Crowded



Get ready, this is coming. While this trend was already happening before the passage of Obamacare, it’s not hard to imagine that private medical consultations could soon be a thing of the past for your average American serf.

Somehow I doubt members of Congress will be having group visits any time soon…

From Bloomberg:



In a typical doctor’s visit, you wait around for a while, get your vitals checked, and spend a few minutes alone in a room with a physician. It’s private and short. Some doctors, frustrated by a relentless schedule of 15-minute, one-on-one visits, are experimenting with appointments that are neither.

 

According to the American Academy of Family Physicians, around 10 percent of family doctors already offer shared medical appointments, sessions that bring together a dozen or more patients with similar medical conditions to meet with a doctor for 90 minutes. With pressure from the government and insurers to bring down the cost of care while treating the increasing number of people with health insurance, patients can expect group visits to become more common. “It’s efficient. It’s economical. It’s high-quality care when it’s done right,” says Edward Noffsinger, a California psychologist who created the model in the 1990s at Kaiser Permanente, the state’s largest health maintenance organization (HMO).

 

*In a group visit, exams and tests are still conducted privately, but patients discuss their ailments in front of the group.* The theory is that each patient can learn from the others’ experience, and doctors get to have a longer, more relaxed discussion instead of hopscotching to three or four exam rooms in an hour. “You have one appointment with 10 observers,” says Marianne Sumego, an internist at the Cleveland Clinic.* “Patients are really getting the equivalent of 10 visits.”*



They’ve already started with the hedonics. Incredible.



*Here’s what is clear: Seeing several patients at once can be good for harried doctors’ finances.* *In 90 minutes, a physician might be able to complete five or six one-on-one visits.* A group visit could allow doctors to see double that number or more in the same time, and medical assistants or nurses can take care routine aspects of care—checking patients in, taking vital signs, writing refills of medication.



Finally, the real reason for groups visits is revealed.



Often it takes a fair amount of promotion by doctors to get patients interested in exploring group appointments, which require them to sign privacy agreements. “Patients have a lifetime of expecting a one-on-one visit,” says Noffsinger. “*We’re asking them to do something entirely different.”*



Yeah they’re “asking” you now, but I suspect they’ll be “telling” you faster than you can say free healthcare.

*Never forget, group doctors visits are what happens to a society with an increased standard of living. Keep telling yourself that.*

*  *  *

For other healthcare related articles, see:

Yep, You Guessed It – Obamacare Website Funneling Private Consumer Info to Private Companies

Video of the Day – Obamacare Architect Credits “Lack of Transparency” and “Stupidity of the American People” for Passage of Healthcare Law

ObamaFraud: GAO Study Finds Almost All Fake Applicants are Approved for Subsidized ObamaCare

Computer Security Expert Claims he Hacked the ObamaCare Website in 4 Minutes Reported by Zero Hedge 20 hours ago.

Six Million May Owe Health-Insurance Penalty

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Fine is $95 per adult or 1% of family income, whichever is greater. Reported by Wall Street Journal 8 hours ago.

Zane Benefits Named Gold Level Sponsor of StartSLC - National Firm Invests in Local Community

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Zane Benefits has been named a gold sponsor of StartSLC event.

Salt Lake City, Utah (PRWEB) January 31, 2015

Zane Benefits, the leader in individual health insurance reimbursement for small businesses, has been named a gold sponsor of the inaugural StartSLC event, which is expected to be Utah’s largest startup and technology festival in history.

According to Zane Benefits CEO and President Rick Lindquist, “Zane Benefits is honored to contribute to this year’s StartSLC event.” All attendees will receive a free copy of his latest book, “The End of Employer-Provided Health Insurance: Why It’s Good for You, Your Family and Your Company" published by John Wiley & Sons, Inc.

“We are excited about this opportunity to support and help Utah-based technology leaders and entrepreneurs,” says Lindquist.

According to its website, StartSLC is the largest startup and technology festival to ever be held in Utah. Hosted by Beehive Startups, Grow Utah, Zions Bank, and numerous friends and leaders within Utah's startup community, this three-day event will bring together entrepreneurs, hackers, designers, marketers, musicians, filmmakers, bloggers, makers, thought leaders, and foodies to have fun, learn from one another, and create lasting connections.

For more information visit: ZaneBenefits.com and StartSLC.com.

EDITORS NOTE: Rick Lindquist is available for questions from the media through Zane Benefits. Contact Leah Bergersen at 435-659-2921 or leah.bergersen(at)zanebenefits(dot)com

###

About Zane Benefits:
Zane Benefits is the leader in individual health insurance reimbursement for small businesses. Since 2006, Zane Benefits has been on a mission to bring the benefits of individual health insurance to business owners and their employees.

Zane Benefits' software helps businesses reimburse employees for individual health insurance plans for annual savings of 20 to 60 percent compared with traditional employer-provided health insurance. Today, over 20,000 customers use Zane Benefits' software, services, and support to reimburse individual health insurance plans purchased independent of employment. For more information visit http://www.zanebenefits.com.

About the Book:
The #1 Amazon best-selling The End of Employer-Provided Health Insurance is a comprehensive guide to utilizing new individual health plans to save 20 to 60 percent on health insurance. Over the next 10 years, 100 million Americans will move from employer-provided to individually purchased health insurance. Written by a world-renowned economist and New York Times best-selling author, this insightful guide explains how individual health insurance offers more to employees than employer-provided plans.

"The End of Employer-Provided Health Insurance: Why It’s Good for You, Your Family, and Your Company" (Wiley, 2014, ISBN: 978-1-119-01211-5, $25.00) is available at bookstores nationwide, from major online booksellers, and direct from the publisher by calling 800-225-5945. In Canada, call 800-567-4797. For more information, please visit the book’s page on http://www.wiley.com. Reported by PRWeb 11 hours ago.

Zane Benefits Named Gold Deluxe Sponsor of ICMG - All Attendees to Receive Copies of 'The End of Employer-Provided Health Insurance'

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Zane Benefits named Gold Deluxe Sponsor of ICMG Conference.

Salt Lake City, Utah (PRWEB) January 31, 2015

Zane Benefits, the leader in individual health insurance reimbursement for small businesses, has been named Gold Deluxe Sponsor of the 31st Annual ICMG Conference. The event will be held February 3-5, 2015, at the Omni Orlando Resort in Champions Gate, Florida.

According to its website, the Inter-Company Marketing Group (ICMG) is the leading trade association devoted to fostering strategic alliances in the insurance and financial services market.

According to Zane Benefits CEO and President Rick Lindquist, “Zane Benefits is honored to contribute to this year’s ICMG event. We will be handing out free copies of our latest book, "The End of Employer-Provided Health Insurance," published by John Wiley & Sons, Inc.

Attendees interested in meeting Lindquist and receiving a copy of the book should visit the Zane Benefits’ exhibit.

“We are excited about this opportunity to sponsor ICMG and help brokers leverage our expertise and solutions to profit from the Affordable Care Act and related healthcare reforms,” says Lindquist. “Over the next three years, 60 percent of small businesses will stop offering employer-provided health insurance in favor of defined contribution for employees. Brokers' roles have never been more valuable.”

ICMG’s 31st Annual Conference takes place February 3-5, 2015, at the Omni Orlando Resort at Champions Gate.

For more information, visit: ZaneBenefits.com

EDITORS NOTE: Rick Lindquist is available for questions from the media through Zane Benefits. Contact Leah Bergersen at 435-659-2921 or leah(dot)bergersen(at)zanebenefits(dot)com

###
About Zane Benefits:
Zane Benefits is the leader in individual health insurance reimbursement for small businesses. Since 2006, Zane Benefits has been on a mission to bring the benefits of individual health insurance to business owners and their employees.

Zane Benefits' software helps businesses reimburse employees for individual health insurance plans for annual savings of 20 to 60 percent compared with traditional employer-provided health insurance. Today, over 20,000 customers use Zane Benefits' software, services, and support to reimburse individual health insurance plans purchased independent of employment. For more information, visit http://www.zanebenefits.com.

About the Authors:

Paul Zane Pilzer is a New York Times best-selling author of 11 books, former professor at NYU, and has served as an economist in two White House administrations. He is also the founder of six companies, including the two largest U.S. suppliers of personalized employee health benefits, Extend Health (1999) and Zane Benefits (2006).

Rick Lindquist is CEO and President of Zane Benefits, Inc., the U.S. leader in individual health insurance reimbursement for small businesses. Zane Benefits’ software has been featured on the front page of The Wall Street Journal, USA Today, and The New York Times. He is a regular contributor to leading health benefits publications, including ClarifyingHealth.com.

About the Book:
The #1 Amazon best-selling "The End of Employer-Provided Health Insurance" is a comprehensive guide to utilizing new individual health plans to save 20 to 60 percent on health insurance. Over the next 10 years, 100 million Americans will move from employer-provided to individually purchased health insurance. Written by a world-renowned economist and New York Times best-selling author, this insightful guide explains how individual health insurance offers more to employees than employer-provided plans.

"The End of Employer-Provided Health Insurance: Why It’s Good for You, Your Family, and Your Company" (Wiley, 2014, ISBN: 978-1-119-01211-5, $25.00) is available at bookstores nationwide, from major online booksellers and direct from the publisher, by calling 800-225-5945. In Canada, call 800-567-4797. For more information, please visit the book’s page on http://www.wiley.com. Reported by PRWeb 10 hours ago.

Disruptor and Entrepreneur Rick Lindquist Advises Employers to Cancel Group Health Insurance - Businesses Encouraged to Give Employees Money to Buy Own Policies

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Zane Benefits CEO advises employers to cancel group health insurance.

Salt Lake City, Utah (PRWEB) January 31, 2015

Zane Benefits CEO and co-author of “The End of Employer-Provided Health Insurance” Rick Lindquist, has one piece of advice for small businesses: cancel your employer-provided health insurance.

According to Lindquist, “employer-provided health insurance is the greatest challenge facing U.S. employers, small and large, when it comes to recruiting and retaining top-quality employees."

"Due to the significant cost advantage for business owners and their employees in the individual market, we predict 60 percent of businesses will eliminate traditional employer-provided health insurance in favor of defined contribution healthcare and individual health plans over the next three years.”

New defined contribution healthcare solutions allow employers to reimburse employees for individual health insurance costs in lieu of offering traditional employer-provided health insurance. According to Lindquist, “defined contribution solutions save businesses and their employees 20 to 60 percent on health insurance costs annually.”

For more information visit: ZaneBenefits.com/Book

EDITORS NOTE: Rick Lindquist is available for questions from the media through Zane Benefits. Contact Leah Bergersen at 435-659-2921 or leah(dot)bergersen(at)zanebenefits(dot)com

###
About the Authors:

Paul Zane Pilzer is The New York Times best-selling author of 11 books, a former professor at NYU, and has served as an economist in two White House administrations. He is also the founder of six companies including the two largest U.S. suppliers of personalized employee health benefits, Extend Health (1999) and Zane Benefits (2006).

Rick Lindquist is CEO and President of Zane Benefits, Inc., the U.S. leader in individual health insurance reimbursement for small businesses. Zane Benefits’ software has been featured on the front page of The Wall Street Journal, USA Today, and The New York Times. He is a regular contributor to leading health benefits publications, including ClarifyingHealth.com.

About the Book:

The #1 Amazon best-selling The End of Employer-Provided Health Insurance is a comprehensive guide to utilizing new individual health plans to save 20 to 60 percent on health insurance. Over the next 10 years, 100 million Americans will move from employer-provided to individually purchased health insurance. Written by a world-renowned economist and New York Times best-selling author, this insightful guide explains how individual health insurance offers more to employees than employer-provided plans.

The End of Employer-Provided Health Insurance: Why It’s Good for You, Your Family, and Your Company (Wiley, 2014, ISBN: 978-1-119-01211-5, $25.00) is available at bookstores nationwide, from major online booksellers, and direct from the publisher by calling 800-225-5945. In Canada, call 800-567-4797. For more information, please visit the book’s page on http://www.wiley.com.

About Zane Benefits:

Zane Benefits is the leader in individual health insurance reimbursement for small businesses. Since 2006, Zane Benefits has been on a mission to bring the benefits of individual health insurance to business owners and their employees.

Zane Benefits' software helps businesses reimburse employees for individual health insurance plans for annual savings of 20 to 60 percent compared with traditional employer-provided health insurance. Today, over 20,000 customers use Zane Benefits' software, services, and support to reimburse individual health insurance plans purchased independent of employment. For more information visit http://www.zanebenefits.com. Reported by PRWeb 10 hours ago.

"The End of Employer-Provided Health Insurance" Featured on 5th Avenue in New York City

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Paul Zane Pilzer and Rick Lindquist's new book "The End of Employer Provided Health Insurance" is featured on 5th Avenue in New York City.

Salt Lake City, Utah (PRWEB) January 31, 2015

The new book “The End of Employer-Provided Health Insurance: Why It’s Good for You, Your Family, and Your Company” is co-authored by Paul Zane Pilzer and Rick Lindquist featured in Barnes and Noble on 5th Avenue in New York City.

In a new book, Lindquist and Pilzer predict more than 100 million Americans will move from employer-provided to individually purchased health insurance over the next 10 years. The book focuses on this shift, which Lindquist and Pilzer believe will be led by small businesses.

“We are at the beginning of a paradigm shift in the way businesses offer employee health benefits and the way Americans get health insurance—a shift from an employer-driven defined benefit model to an individual-driven defined contribution model,” says Lindquist. “This parallels a similar shift in employer-provided retirement benefits that took place two to three decades ago from defined benefit to defined contribution retirement plans.”

“Due to the significant cost advantage for business owners and their employees in the individual market, we predict 60 percent of businesses will eliminate traditional employer-provided health insurance in favor of defined contribution healthcare and individual health plans over the next three years.”

For more information visit: ZaneBenefits.com

EDITORS NOTE: Rick Lindquist is available for questions from the media through Zane Benefits. Contact Leah Bergersen at 435-659-2921 or leah(dot)bergersen(at)zanebenefits(dot)com

###
About the Authors:

Paul Zane Pilzer is The New York Times best-selling author of 11 books, a former professor at NYU, and has served as an economist in two White House administrations. He is also the founder of six companies including the two largest U.S. suppliers of personalized employee health benefits, Extend Health (1999) and Zane Benefits (2006).

Rick Lindquist is CEO and President of Zane Benefits, Inc., the U.S. leader in individual health insurance reimbursement for small businesses. Zane Benefits’ software has been featured on the front page of The Wall Street Journal, USA Today, and The New York Times. He is a regular contributor to leading health benefits publications, including ClarifyingHealth.com.

About the Book:

The #1 Amazon best-selling The End of Employer-Provided Health Insurance is a comprehensive guide to utilizing new individual health plans to save 20 to 60 percent on health insurance. Over the next 10 years, 100 million Americans will move from employer-provided to individually purchased health insurance. Written by a world-renowned economist and New York Times best-selling author, this insightful guide explains how individual health insurance offers more to employees than employer-provided plans.

The End of Employer-Provided Health Insurance: Why It’s Good for You, Your Family, and Your Company (Wiley, 2014, ISBN: 978-1-119-01211-5, $25.00) is available at bookstores nationwide, from major online booksellers, and direct from the publisher by calling 800-225-5945. In Canada, call 800-567-4797. For more information, please visit the book’s page on http://www.wiley.com.

About Zane Benefits:

Zane Benefits is the leader in individual health insurance reimbursement for small businesses. Since 2006, Zane Benefits has been on a mission to bring the benefits of individual health insurance to business owners and their employees.

Zane Benefits' software helps businesses reimburse employees for individual health insurance plans for annual savings of 20 to 60 percent compared with traditional employer-provided health insurance. Today, over 20,000 customers use Zane Benefits' software, services, and support to reimburse individual health insurance plans purchased independent of employment. For more information visit http://www.zanebenefits.com. Reported by PRWeb 10 hours ago.

Will Obamacare ruin your tax refund?

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According to H&R Block, as many as 3.4 million people who received subsidies for health insurance will have reduced tax refunds this year due to underestimating their income.

 
 
 
 
 
 
  Reported by USATODAY.com 8 hours ago.

Tax returns need full disclosure on health coverage

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Accountants are happy, but you may have a look of dread on your face. Tax season is here, and for the first time, folks will have to reveal their health care status to Uncle Sam when they file. Did they comply with the Affordable Care Act's requirement to have health insurance, or did they ignore it? It's truth-telling time. Reported by Newsday 2 hours ago.

Reproductive Justice Matters

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"I thought you worked on abortions so how can you also believe Black Lives Matter?" That was the question I was asked when, on the anniversary of Roe v. Wade, I posted remarks, via social media, on the importance of honoring this anniversary and all the women who labored and even lost their lives so that future generations of women would be able to make their own decisions about their bodies. On the same day, I posted an article related to an organizing effort centered on Black Lives Matter, and on that same day I received that message.

I direct a Reproductive Justice organization and we do work to ensure that abortions remain legal and safe and that women have the human right to access an abortion when needed regardless of a woman's locality, economic or immigration status. But Reproductive Justice is not just about abortions any more than equal rights for women are not just about the right to vote.

Reproductive Justice is the term created by black women in 1994 to bridge the gap between reproductive rights and other social justice movements. Reproductive Justice, the human right to not have children, to have children, to parent the children one has in healthy environments and the human right to bodily autonomy and to express one's sexuality freely, insists that we see abortion and reproductive health in the larger context of the overall health and wellness of women, our families and our communities.

For example, demanding that that our health insurance pay for birth control pills and abortions means that we must also address the reality that many people still can't afford insurance or don't have access to get to a doctor.

Although this notion of a more integrated approach to our movement work sounds great in theory, there seems to be this belief that the more attention we put on gender, sexuality, reproduction and violence against women, the more distracted we become from the bigger issues that Black people face that seem to focus around safety, protection and equality for our Black men and boys.

I found myself re-reading the question from my inbox over and over again. "I thought you worked on abortions so how can you also believe Black Lives Matter?"

The truth of the matter is all of life intersects and we do not live single-issue lives. We can feel the pressure and discrimination. We see the violence inflicted upon us on a news loop 24 hours a day. But do we also know that Black women are dying at a rate four times higher than their white counterparts in childbirth? Do we know that Black women still make less than their male counterparts? Do we know that Mississippi is down to one last abortion clinic for the entire state? Do we know that pregnant women in Tennessee are being criminalized for substance abuse issues as opposed to being rehabilitated? Do we know that federal funds cannot be used to assist women in getting an abortion due to the Hyde Amendment?

Black women have always been at the forefront of our movements. It was the organizing efforts of Black women that stated the Reproductive Justice movement twenty years ago and Black queer women that started the Black Lives matter movement, yet we still have to constantly reaffirm that black women and girls' lives are equally as important to the lives of Black men and boys.

Black women have always marched on the front lines for justice and we did so sometimes with menstruation pains, we did so having to remember to take our birth control, we did so pregnant or caring for children, we did so dealing with non-consensual touch or harassment and we did so sometimes with the picture of our slain child, or husband or father or brother or sister on our shirt as a memory.

As I look to the future, I envision a world where our reproductive rights aren't seen as a separate issue that fall squarely on our shoulders alone. To separate reproductive health and rights from the fight for Black liberation would only further our opponents ability to use wedge issues as a strategy to divide us and diminish our collective force that we have yet to fully exercise.

I never responded to the person who sent me the message, but hopefully they will read this article and understand that I have to advocate for abortion access and support efforts like Black Lives Matter because my Blackness and my womanhood are inextricably linked, and I choose all of me. I believe our future depends on all of us bringing our full selves to the fight for freedom, and I believe that Reproductive Justice is the framework that will carry us there.

This post is part of the "Black Future Month" series produced by The Huffington Post and Black Lives Matter for Black History Month. Each day in February, this series will look at one of 28 different cultural and political issues affecting Black lives, from education to criminal-justice reform. To follow the conversation on Twitter, view #BlackFutureMonth -- and to see all the posts as part of our Black History Month coverage, read here. Reported by Huffington Post 20 hours ago.

‘I didn’t have healthcare before’: Tucker Carlson’s anti-Obamacare interview goes off the rails

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A Fox News interview that was presumably intended to bash President Barack Obama’s healthcare reform law took a left turn on Sunday when the guest admitted that he could only afford insurance for the first time thanks to Obamacare. KUSA reported last week that around 3,600 health insurance pol... Reported by Raw Story 18 hours ago.

What it's like when you're an American using Britain's NHS

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I've spent half my life in the US and half of it in the UK, so I'm used to both countries' healthcare systems. I recently returned to London after 20 years in America, and after a few doctors' appointments I've come to see the NHS through American eyes.

The National Health Service is, as all Americans know and fear, a completely public "socialized medicine" system. It's dramatically different from the US's patchwork system of private providers and insurance companies.

My story isn't representative, of course. Healthcare delivery is different in the UK depending on where you live and which doctors and hospitals you use — just as it is in the US. But I've now used both systems for about two decades each, so I feel I have a pretty good handle on the main contrasts.

-'THIS ROLLS ROYCE ISN'T MOVING FAST ENOUGH!'-

The context here is that the NHS just released its most recent stats on accident and emergency room waiting times. The headline number is that 84% of patients are seen within four hours. In the UK, this is regarded as a huge failure — the standard the NHS is supposed to meet is 95% of patients in four hours. The UK media went into a fury about it, and some hospitals have begun postponing and rescheduling some non-emergency procedures in order to get those waiting times down.

In the US, having sat in many an ER waiting room for hours at a stretch, the idea of a hospital seeing nearly 9 out of 10 patients in four hours would be regarded as a miracle. Bear in mind that within that four-hour period the NHS doctors are triaging patients: If you get hit by a bus, you're going to see someone instantly. If you broke a finger because you fell over while drunk at the pub, you're probably going to wait at the back of the line. It's not like people are literally bleeding to death while they wait for attention (although the British media loves it when it finds individual cases where that has happened).

So my overall impression is that currently, the Brits' complaints that the NHS isn't hitting that 95% mark is akin to saying, "This Rolls Royce isn't moving fast enough!"

-SHOW UP WHEN YOU'RE TOLD TO - OR ELSE-

The first major difference from the patient's point of view is what happens when you call your doctor for a routine appointment. My specific health issue was that I thought I was going slightly deaf, and wanted it checked out.

I'm a dual US/UK citizen, so I qualify for NHS treatment. Here's what happened to me.

*
In America, you call your doctor and request an appointment when it's convenient for you.* They might ask you what's wrong with you, presumably to make sure it's not something that requires immediate treatment. But basically, it's first come, first served, regardless of how important it is. Usually, you can pick an appointment time that's convenient for you if it is not an emergency.

*In the UK, I was given an appointment whether I liked it or not.* I called and leave a message. Within an hour or two a nurse practitioner called me back and asked me a few questions about my problem over the phone. (You've got to take the call in a private place if you don't want your office mates to hear.) Then they said: Come in at 9am on Thursday. There was no choice over appointment times — the assumption is that if you're ill, you're going to come to the doctor when they say.

At first I found this jarring. In America, I get to choose when I see the doctor! In Britain, I better show up when I'm told. But the appointment came quickly, as the local health authority in London has targets it needs to meet. Ultimately, I saw the logic of it: This is a public health system. It needs to manage its costs and services. If you're really sick, you'll show up. If you only want to show up when it's convenient for your schedule, then how sick are you, really?

-AMERICA IS WORSE AT ON-THE-DAY CARE-

*
In America, I've always had a long wait to see my doctor.* I have read many a back issue of Newsweek in my primary care / general practitioner (GP) doctor's office. I've sat there for an hour playing with my phone while the doc sees patients in the order they were booked.

*In the UK, I showed up at 9am and was seen instantly*, at the Waterloo Health Centre. For an American, this was bizarre: My butt barely touched the seat in the waiting room before my name was called. Turns out my doc and her staff are serious about patient scheduling.

This was one reason I became convinced that the NHS way of scheduling is superior: You might not get the time or date that you want, but once you're in, you get seen super-quick.

-THE NHS ACTIVELY DISCOURAGES SOME PATIENTS - FOR GOOD REASON-

*The NHS actively discourages some types of patients:* Interestingly, NHS offices and hospitals have posters up all over the place warning you not to show up at the emergency room if you have a cold or the flu. They're actively discouraging patients with minor ailments from seeking emergency treatment, and trying to get them to see their regular doctors instead. It's sensible — everyone knows that a vast amount of hospital time and money is wasted treating people who are not an emergency. And hospitals and doctor's surgery waiting rooms are a hotbed of germs. But still, it's a culture shock to see a medical institution put up signs that basically say, "go home, you idiot!" in every waiting room.

*The US never discourages patients from doing anything.* I've never seen any kind of public campaign to persuade patients to apply some common sense before dropping themselves off at an emergency room. The entire US pharmaceutical industry is also dedicated to running ads encouraging people to "go see your doctor" for even the most trivial of conditions.

*
The treatment from my primary care GP was the same in the UK as it was in the US.* I've had great care from 95% of doctors I've ever seen in both the US and the UK. Doctors are doctors. They're mostly really nice and good at what they do. The system that pays them doesn't seem to make them better or worse.

-THERE IS BASICALLY NO PAPERWORK WITH THE NHS-

*There is a load of paperwork for patients in the US.* This is easily the worst aspect of US healthcare — the billing paperwork. If you've ever had any health issue that required more than a simple doctor visit, you will know that it precipitates a seemingly never-ending series of forms, bills, and letters. You can be paying bills months, years later. And it's almost impossible to correct a billing error. It's stressful. I developed an intense hatred for health insurance companies in the US because of this.

*There was close to zero paperwork in the NHS.* I filled in a form telling my doc who I was and where I lived, and that was pretty much it. The only other paperwork I got was a letter in the mail reminding me of my next appointment. They sent me a text reminder, too, which no American doc has ever done. It was incredibly refreshing.

-THE STANDARD OF CARE IS THE SAME-

So, was I going deaf? Maybe. Maybe not. I'd lost my sense of balance in summer 2014, which an American doctor had diagnosed as Benign Paroxysmal Positional Vertigo. It's a condition of the inner ear. It made my body feel slightly drunk and clumsy even though I am completely sober.

*The US doc told me there is no treatment and it goes away on its own,* mostly. A lot of people get it, apparently. I was managing fine and it doesn't bother me, anyway.

*The UK doc told me the same thing, but also suggested I might have Meniere's Disease,* and wanted to send me to a specialist to get it checked out. Meniere's isn't really a disease, it's just a collection of symptoms: dizziness, hearing loss and a ringing in the ears. Again, there is no treatment. But it's rare.

This freaked me out a little bit. I was used to the US system which is heavily "defensive." Doctors tend to over-treat patients because they get sued if they miss something. They also get paid more money for doing more work. Yet it was the NHS doctor that suggested extra treatment.

It was going to be free — so I said yes!

-A LONG WAIT FOR NHS TREATMENT ...-

I then made an appointment with a specialist at the Guy's and St Thomas' Hospital in London.

*
In the US, I've always been able to see a specialist within a few days.* Score one for America.

*In the UK, they said "we'll see you in January."* It was late November, six weeks or more away. This was a shock. I was going deaf now — not in six weeks! What the hell?!

NHS waiting times are a real thing, it turns out. I comforted myself with the assumption that the staff had made a decision that my condition was likely not life- or health-threatening, and had moved me to the back of the line. It was frustrating. Ultimately, I also needed to change my appointment because I had to leave the country on business, and this was quite difficult to do. I had to call a few times, basically to catch the hospital booking staff at the right time of day, in order to do it. I wished Guy's and St. Thomas' had an online system for this, but they don't — just a bunch of people answering phones, most of whom don't have access to the right appointment schedule.

It was that appointment system again: You're booked in according to their priority, not yours. The big lesson with the NHS is, it's a lot easier to just show up when you're told.

-OLD PEOPLE IN BRITAIN ARE REALLY RUDE-

*In the US, I expect to wait up to an hour in the specialist's waiting room* on the day of my appointment. I often wonder if Time and Newsweek were such big magazines in the US because they're needed for bored patients in American doctors' waiting rooms. Nothing ever happens promptly on the day in US healthcare, as far as I can tell.

*In the NHS, again, I waited only a couple of minutes.* Credit to the staff at St. Thomas, they are cranking through their patients.

On two occasions I noticed old people complaining angrily (and rudely) to the office staff that they had been made to wait 15 or 20 minutes to see their doctor. As an American, I almost laughed out loud. Fifteen minutes to see a free doctor! This Rolls Royce isn't moving fast enough! I asked a British friend — someone who has ongoing health issues and sees a lot of doctors — if old people complaining like this was common. Turns out, it is. Old British people love to complain to NHS staff if they wait more than 1o minutes. Everyone just expects their appointments to be exactly on time.

Again, the NHS care was great. I saw two different doctors within an hour, one for testing and one for diagnosing. A third admin staffer was coordinating the lists so there was no doctor downtime. It was like being in a highly efficient factory. It looked like hard work. I could tell that one of my doctors was not interested in chatting. She treated me, and wanted me out the door. There was a bunch of patients behind me, after all. In America, docs seem to be happy to chat as long as you want — and you can tell that extra couple of minutes with each patient creates long delays as the day wears on.

*The good news: I am not going deaf!* I have great hearing, it turns out. They even showed me a chart of it. But the tinnitus — ringing in my ears that started years ago because I used to go to a lot of punk rock gigs in my youth — has gotten worse, making me feel more deaf.

The UK NHS specialist said she was 99% sure there was nothing wrong with me, or at least nothing that could be treated, but she recommended an MRI to see what the condition of my inner ears is like. This was reassuring. In no way was my treatment rationed or denied, the way Americans fear. It was just the same as in the US, with the same number of docs and the same level of high-tech equipment.

-THE COST TO THE PATIENT IS MUCH CHEAPER IN THE UK, OBVIOUSLY-

So how much did all this NHS care cost me? £0. Nothing. Zero. I paid not a penny for some top-notch healthcare. There is no such thing as a "free," of course, but the per-capita cost of healthcare in the UK (paid by the government via tax collections) is generally lower than the US, according to the World Health Organization. Americans spend $8,362  per capita on healthcare annually, the Brits spend $3,480. Here is a breakdown:

*NHS prices*

· Doctor visit: £0
· Specialist: £0
· Diagnostic test: £0
· MRI: £0
· Total: £0

*Typical US prices**

· Doctor visit: $100
· Specialist: $150
· Hearing test: $72
· MRI: $1,000
· Total: $1,372 (Total payable by the patient in cash, or typically 90% from insurance and 10% as a patient copay. Prices taken from Healthcare Bluebook.)

-SORRY AMERICA, BUT NHS TREATMENT REALLY IS BETTER OVER ALL-

*The bottom line: I prefer the NHS* to the American private system. It's a little more inconvenient in terms of appointment times, but due to the fact that it is free, has no paperwork, and the treatment on the day is super-fast, the NHS wins. That Rolls Royce is moving at a pretty decent clip.

And, of course, there is the small matter of the fact that the NHS covers everyone equally, whereas Americans get care based on their ability to pay, leaving tens of millions with only minimal access to care. (Obamacare is changing that, but it's leagues behind the NHS if you're comparing them by the standard of universal full-service coverage.)

Americans think they have the best healthcare in the world. Take it from me, a fellow American: They don't.

Join the conversation about this story » Reported by Business Insider 16 hours ago.

Medikids: A Proposal to Improve Children's Health Care, Reduce Public Program Non-Benefit Costs and Shrink Adult Health Care Outlays

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*Introduction*Everyone favors eliminating wasteful health care spending. Virtually everyone, polls show, also believes that children should receive the health care they need.We propose to achieve both goals with a proposal that eliminates unnecessary non-benefit costs spent establishing eligibility of children for Medicaid and CHIP (Children's Health Insurance Program), and would make all children eligible for the health care coverage that Americans overwhelmingly believe children should have. It would benefit struggling middle class families, as well as poor families, where 13 percent of low-income children were without insurance in 2012 (most recent data we found).Scrapping complicated, costly, time-consuming eligibility tests would save billions. Substituting a program assuring all children their needed health care with no other eligibility condition than being a kid (that is, below a specified age) would accomplish their coverage. Let's call it Medikids.With that one-two punch, we would spend more money on health care and less on shuffling paper. Facilitating timely care would avert further deterioration and complications, thereby reducing costs and, not least, improving health care outcomes. Healthier children would become a smaller source of infection for other kids and adults, further reducing costs for health care and absenteeism. Such a measure also would trim health care insurance costs for adults in both public and private programs. This arrangement would relieve states of Medicaid expenditures, their largest or second largest budget outlays. That would help them recall large numbers of laid-off state employees, restore vital education and protective services, and fund other essential public services. Most importantly, adequate health care for the nation's children is an investment in all of our futures. Healthier children are likely to be healthier adults. Over the long haul, healthier children will become more productive, more employable and better paid adult workers -- paying higher taxes and contributing to the nation in other important ways.*Wide Support for Assuring Health Care to Children*

Despite tight federal, state, business and personal budgets, numerous polls show widespread support for assuring health care for children. Apparently, misgivings about financial help to adults lessen or disappear with regard to children. Moreover, it costs comparatively little to provide comprehensive health care to infants, children and young people.*Coverage for Children Has Grown Due to Federal-State Programs - But Not Enough*Between 2007 and 2010, the percentage of children without health insurance declined from 10.9 percent to 10 percent. This resulted from the 2009 expansion of CHIP, which provides coverage for children in families with income somewhat higher than those poor enough to qualify for Medicaid. Recession-caused declines in income made more children eligible for those programs. Medicaid covers around 31 million children, while CHIP covers some 5.3 million children. We could cover even more children by eliminating needless costs.*The Key Strategy: Minimize Non-Benefit Costs*

Proposals to reduce health care costs often focus on paring provider services but largely ignore avoidable expenditures, such as what we spend to restrict eligibility to those who meet prescribed income and asset limits. In addition to Medicaid and CHIP, other public programs -- such as well-infant clinics and other publicly-funded health plans -- often impose differing eligibility conditions and provider compensation rates. For example, in the recent past, despite their common purposes, Massachusetts's programs for poor mothers and children had eight different formulae for eligibility and/or benefits. The comparative political power of affected parties and who was dominant in state politics at the times of each program's enactment or extension determined the generosity or tight-fistedness of the eligibility and provider payment provisions selected. Applying such variations to millions of patient claims increases non-benefit costs substantially. Simplification or, better yet, elimination of those variations, or, best yet, elimination of the requirements altogether, would reduce program costs.*Savings Would Be Substantial*

A study published in 2004 found that New York State spent an average of $282 to establish the initial eligibility of each applicant for its CHIP and Medicaid programs for children. In October 2014 -- in the 44 states reporting their numbers -- there were 28,425, 834 children enrolled in Medicaid and Chip. Multiplying that average cost of determining eligibility by the number of children found to be eligible in October 2014 produces a cost of over $8 billion. And that is just for the enrollment of children participating at that particular moment in time! It does not factor in the cost investigating those found not to be eligible. Moreover, CHIP and Medicaid for kids require other expensive administrative tasks -- including, for example, periodic recertification -- but a high percentage do not seek renewal. As a result, many who seek the benefits anew require reprocessing, many of them from scratch. And, the estimate is likely low because inflation and other factors have likely increased processing costs since 2004. (The study looked at the programs New York, where costs, at least in New York City, are generally higher than elsewhere in the country.) Bottom line: Though we are unaware of any study of the cost of determining the eligibility of all children to participate in Medicaid and Chip, it unquestionably involves billions and billions of dollars -- monies that could be devoted to providing actual care.*Like Universal Free Public Education, society-wide Benefits Justify Health Care For All Children Without Eligibility Barriers* *and Costs*

Some will argue that it is more efficient to focus resources on those with demonstrable financial need and leave it to those with adequate resources to bear the responsibility and burden for their own children. This was the critical dispute over free public education two centuries ago. All states embraced the notion that the full development of children goes beyond the children and families immediately affected but benefits all of society and thereby justifies public expenditures.Further, financial capability can change radically and rapidly when it collides with a serious illness or accident. It is desirable to address the need for medical care when it arises without delay. That makes for better treatment, better outcomes, and lower costs.Social Security and Medicare -- two virtually universal programs for working families -- illustrate the greater efficiency of universal programs. Social Security's non-benefit costs -- less than a penny of every dollar collected and spent -- are dramatically lower than those of their private sector counterparts. Similarly, private sector health insurance non-benefit costs are significantly higher than Medicare's even though Medicare covers a higher cost population -- the aged and people with disabilities. The reason for the greater efficiency is not hard to understand. These programs -- like our proposed Medikids -- are insurance, which is most efficient when the risk pool is as broad as possible -- in the case of Social Security and Medicare workers; in the case of Medikids, all children purchasing insurance only when personal risk factors increase -- is impossible. Only the federal government has the ability to determine that all children participate, creating the broadest risk pool possible, with no ability to select adversely. And, in the real world, targeting is likely to be unsuccessful in many cases, in any event. Income tests in the area of health care often are no real constraints because when medical need arises, ability to pay frequently declines.And the savings would go beyond dispensing with verifying eligibility. Such an extensive program could undertake preventative measures like nationwide mass vaccination of all children. Once established, such programs might readily be extended to mothers and babies, very young children and adults, even those without kids. Single dads, too. Convenience and low -- or no -- out-of-pocket cost would encourage adult participation for preventative measures like flu vaccinations. Medicare has been funding mass flu and pneumonia vaccinations. That experience probably can facilitate the initiatives suggested here.We're sure that our grandchildren are typical for being always adorable and frequently infectious. School is where they pick up colds, flu, a variety of communicable ailments and bring them home. Reducing that vector of illness would promote better health for the adults who teach and take care of them, other children with whom they play, their parents, grandparents with whom they visit or sometimes live, strangers on buses, subways, trains and planes -- and so on. We are describing what epidemiologists call the "herd" factor.*Medicare Should Handle Medikids; It Uses Experienced Private Insurers At Low Non-Benefit Cost, Varies Payment Scales By Locale *

For half a century, the Medicare program has been a giant nationwide system that takes account of regional and local variations in cost. It knows the game. Not least, it has proven to be an efficiency champion with non-benefit costs regularly registering in the 2 to 3 percent range.*Private Insurers Administer Medicare- A Plus for Many*

Further, the fact that Medicare uses private insurers to administer its policies should make it more acceptable to those who advocate a substantial role for private enterprise, while avoiding the sometimes costly conflicts of interests that private insurers have vis-à-vis patients.*One Plan for All Children Reduces Costs of Adult Coverage*

Shifting all children into one plan also reduces private plan and state and local employee tabs for both care and administration attributable to covering those youngsters. Further, all public and private programs are on the prowl to fasten liability on some other plan -- for example, workers compensation or the insurers of parties to an accident. Where both parents are employed, insurers of one parent sometimes seek to charge the other parent's plan. Those efforts, whether successful or not, add to non-benefit costs without enlarging the pool of resources. With only one plan for kids, those games and their costs disappear.
*Children: Society's Main Concern, Society's Future*

Our society cherishes children as individuals and for their contributions to society; let's set about maximizing their health -- for the good that will do all of us. As this essay demonstrates, the nation's per capita health care costs can be reduced without eliminating desirable services. Medikids is unquestionably a win not just for children, but for everyone. Reported by Huffington Post 11 hours ago.
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