policy

Trumpcare is Bad for Women’s Health

The American Health Care Act (AHCA), or Trumpcare, doesn’t seem to care for women’s health. The bill—which was narrowly passed by the House of Representatives on May 4th—allows states to withdraw from providing essential health benefits, which includes maternity and preventive care. Under Obamacare, all insurance plans are required to provide ten essential health benefits. This provision protects patients—it mandates insurance companies to cover the costs of important care, while also preventing them from selling barebones coverage to consumers. However, as the AHCA/Trumpcare permits states to waive coverage of essential health benefits, the cost of care will shift from insurance company to the patient. And, patients will be forced to pick up a huge tab out of pocket. This will disproportionately affect women who, without coverage, will have to pay high prices for treatment that’s vital to their health, including birth control, cancer screenings, and routine vaccines. Fortunately, the AHCA/Trumpcare isn’t the law yet. But imagine just how much women will potentially have to pay under its provisions! Amino, a healthcare transparency company, looked through their database of nine billion health insurance claims to uncover the astronomically high prices women patients may have to pay under the AHCA. Here’s a summary: About $1,000 for an intrauterine device (IUD). IUDs provide long-lasting birth control. Depending on the type, they need to be replaced every three to 10 years. $4,000 for...

Before You Board That Plane – Have You Had Your Measles Vaccination?

The  Measles, Mumps and Rubella (MMR) shot is one of the many immunizations recommended by the CDC for healthcare workers and it is on the immunization schedule for children as early as 12 months. However, small outbreaks of Measles continue to occur in the US, with the vast majority of these infections coming from travelers returning from overseas trips. A highly contagious virus, Measles symptoms include high fever, cough and runny nose, followed by a red rash. In about 30% of cases there are serious complications, such as brain inflammation, blindness and pneumonia. Before immunization became common in the United States there were 3-4 million cases of measles each year, but as of 2016, the WHO declared that Measles was no longer endemic in the Americas. A new study from the Annals of Internal Medicine takes a closer look at pre-travel health consultations and the missed opportunities to establish measles immunity in adults travelling overseas. In association with the CDC’s Global TravEpiNet, researchers utilized data from 24 sites where adults born after 1957 filled out a survey regarding their pre-travel medical consultations. From an initial pool of 40,810 travelers, 6,612 travelers were deemed eligible to receive the MMR vaccination at the time of the consultation, meaning that they were in good health and did not report already having the MMR vaccination. Despite their eligibility, over 53% of patients did not go...

The Literal Price of Health Care

With all the dialogue on Obamacare, Trumpcare, the ACA, and the AHCA, Dr. Fizzy briefly reflects on the cost of health care.  Recently my daughter sprained her ankle. Because she’s a bit of a drama queen, I took her to urgent care after she refused to put weight on it for a day. The x-ray didn’t show a fracture and they gave her a crutch and an Aircast, which she used for exactly one day before she was better. A couple of months later, I got a bill for $150 for the crutch and Aircast that we barely used. Because of large deductibles and other reasons, we end up paying a lot of our outpatient healthcare expenses out of pocket. But the problem with that is that you have no idea what you’re going to pay until the bill actually arrives. If they had told me it was going to be $150 for that stuff, I never would’ve taken it. Think about how crazy it is. You would never go to a furniture store, buy a sofa, and just wait a few months until the bill comes to see how much you ended up paying for it. But that’s what I’m constantly doing with my healthcare bills. I can give multiple other examples. Recently, my own doctor ordered a lab test which I didn’t think was entirely necessary, but...

The American Health Care Act and its Effects on Healthcare

Repeal and replace has been the ongoing motto of the current administration with regards to the Affordable Care Act. Repealing has remained the easy task, but replacing is the hard part, the one filled with frustration of a system that is can swallow you whole.   While the Affordable Care Act is not without its shortcomings, it was a success in several ways. Mark Hall, JD, one of the leading scholars in the areas of health care law and public policy at Wake Forest University, made three clear points about the ACA at a town hall in Winter 2017: 1) it was never written to provide universal coverage; 2) most Americans have no idea that the uninsured rate is the lowest in decades; 3) the insurance laws were changed so that no one was uninsurable.   However, the American Health Care Act (AHCA), the replacement for the ACA, seems less likely a repeal and replace, and more like a repeal with no clear strategies to on improvement. And when it comes to health and lives of millions of Americans, an inadequate replacement is not good enough. The House Energy and Commerce and Ways and Means committees initially introduced the AHCA in March 2017, where it failed to pass. This bill as it stood in March would have repealed tax penalties for those without insurance, reduced Medicaid spending, incentivized states...

Trumpcare Is Bad For Mental Health Coverage

On May 4, the House of Representatives narrowly passed the Republican regime’s new health plan, known as the American Health Care Act (AHCA), or Trumpcare. This is a win for Republicans, many of whom promised their constituents that they would finally repeal Obamacare. The AHCA is different from Obamacare in many ways, and NPR does a great job of breaking down the main provisions of the new health care bill. One of the ways the AHCA is so different from Obamacare is by how it addresses mental health.   One of the provisions of the AHCA permits states to apply for waivers that allow insurers in their state to eliminate Obamacare-required “essential health benefits” from their plans. The removal of required essential health benefits, which include mental health and addiction services, will likely lead to cheaper, and therefore more affordable, health plans. But, of course, it comes at a cost—while these cheaper plans seem like a good deal for consumers, they actually provide barebones coverage that excludes mental health care. The sad thing is that many consumers aren’t fully aware of the barebones coverage their more ‘affordable’ plan provides. This isn’t necessarily the consumer’s fault, considering how complicated insurance language is….but, that’s a story for another day. The exclusion of behavioral health care is crippling, considering 1 in 5 adults experience mental illness within a given year. The loss of...

Medicine’s Gender Pay Gap is Huge

  A new survey conducted by Doximity, a social media site for physicians, shows that female physicians make an average of 26.5% (or $91,000) less than male doctors. The self-reported data—which was gathered from 36,000 licensed physicians and controlled for factors such as hours worked—shows that the pay gap exists in all medical specialties and in every U.S. city.   The largest wage gap is in neurosurgery, where female neurosurgeons are paid, on average, $93,000 less than males. One of the smallest pay gaps is in preventive medicine, where females still make $35,000 less on average. Meanwhile, in terms of geography, the largest wage gap exists in Mississippi, where female physicians make, on average, $118,000 less than males. The smallest gap is in Hawaii, where women make $45,000 less.   Medicine’s gender pay gap is especially concerning considering many medical specialties rely greatly on female physicians. For instance, specialties such as Pediatrics and Obstetrics & Gynecology are predominantly female, but male physicians in these specialties still make an average of 21% more than their female counterparts. These specialties, among others, will likely see more females in coming years as close to half of the graduates from U.S. medical schools are women. In fact, female graduates outnumbered males in states such as Pennsylvania, Illinois, and Washington. Furthermore, research suggests that female doctors perform better than males—a recent Harvard study showed...

An Update on Healthcare Reform

In March, Republicans failed to repeal Obamacare and replace it with the American Health Care Act (AHCA). It was a troubling moment for a new Republican regime that, for years, had promised to repeal Obamacare.   The AHCA was a flawed bill. It attempted to appease varied conservative interests, but it ended up being a convoluted mess that only alienated hard-line and moderate Republicans. Far-right conservatives thought the bill was Obamacare-lite, while moderates were concerned the bill failed to protect the interests of both their lower-income and sicker constituents.   According to Politico, Republicans have come to a tentative agreement that would appease the conflicting interests of their party. The conservative Republicans have agreed to reinstate Obamacare’s Essential Health Benefits, which was stricken from the original AHCA. According to this provision, all health plans must provide health benefits such as mental health and addiction treatment, preventive services, ambulatory care, and more—all with no limit. This appeases moderate Republicans who were worried about their constituents, as the provision prevents insurers from providing bare-bones coverage. In exchange for this, moderate Republicans have agreed to permit states to opt out of Obamacare’s community rating provision—this means that insurance companies can charge higher premiums to individuals with pre-existing conditions. This is a win for fiscally conservative Republicans because it’ll theoretically lower health insurance prices, at least for healthy individuals.   The compromise does...

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