Medicare Procedures Become More Technical

The overall population of the US knows that the current medical insurance system has significant problems. For upper-middle and upper class, the dangers do not seem so drastic, but for the lower income families, serious consideration is taken before consulting a hospital. This reason is because of all the hidden charges, certain insurance coverages, and being behind on payments. The current conflict is about a patient's status as either 'observational' or an 'inpatient'. What seems like just words to an everyday person, actually means millions of dollars in medicare payments if not specified.

Medicare officials are weighing changes to the admissions policy and sent letters to hospital associations in July soliciting suggestions. Among the options are requiring hospitals to notify patients that their stay is considered observation, setting a strict time limit for observation care and changing how the agency pays hospitals for such care, Blum says.

Now I am not saying that the US medicine is terrible and needs complete remodeling, but it is a harsh reality for patients that are discharged early on their road to recovery, simply because their plan doesn't cover the remaining time. Hospitals are forced to make do with what they are given.

The trend is emerging as hospitals cope with increasing constraints from Medicare, which is under pressure to control costs while serving more beneficiaries. In addition to more stringent criteria for inpatient admissions, hospitals face more pressure to end over-treatment, fraud and waste.

It is more and more evident that health insurance companies have one goal, make a profit. Hospitals can no longer make the right calls if Medicare is the ominous shadow watching through the glass. Although a tad dramatic, the sentiment is clear for all who find themselves in need of severe medical attention, and cannot receive it.

Maine Receives a Health Care Waiver?

On a previous CS blog, I discussed some Republican states that had reprieve from the new Obamacare laws. On Tuesday, Maine was the first state to receive a waiver from the health care overhaul. Maine received the waiver in fear that the overhaul would destabilize the state's market because of individual health insurance companies.

Maine's individual insurance market has been volatile, with big premium increases attributed in part to the small number of enrollees and lack of competition. There have been fears the market could collapse altogether.

Relying solely on a few companies for financial stability, has proved disastrous in the US's economic history. It seems that the HMO's are buying time to get all they can from their customers.

 The Affordable Care Act allows states to petition to delay the federal standard until 2014 on how much money from premiums must go to medical care for the individual market. Administrative costs tend to be higher on those plans than on insurance plans provided through employers.The federal law envisions that by 2014 there will be health insurance exchanges to provide individuals with new, affordable options for health care options.

 Trusting the insurance companies to keep their word is a large leap of faith by the government, but it seems that there isn't another option other than to introduce the new plan slowly.

Health Insurance Falls Short to Other Countries

Recent surveys have revealed how Americans really feel about the current state of health insurance. Compared to other countries, citizens are hesitant because of monetary challenges.

In the United States, 33 percent of adults went without recommended care or drugs because of the expense, compared with 5 percent in the Netherlands and 6 percent in the United Kingdom, according to the report.
In addition, 20 percent of U.S. adults had problems paying medical bills, compared with 9 percent in France, 2 percent in the United Kingdom, 3 percent in Germany and 4 percent in the Netherlands.

Although much of Europe provides healthcare for its citizens, the Single Payer system would not work in America due to the grip that HMO companies have on the US government. It is important that new laws like Obamacare continue to adapt and pass, because the current system isn't working.

Retirement Health Care Benefits Dwindling



Ken Allen, a union official in Portland, Ore.,

says workers sacrificed to keep fully paid health care.



Although elderly citizens have bought their way into health insurance throught payments over the years, the rising debt is bigger than just one generation. If we are to stay afloat among the billions of dollars of debt, then there must be radical change. One alternative that states have created is to extend the age requirement to receive full benefits. One of the biggest surprises that I found interesting was,



Richard O’Gara, Omaha’s director of human resources, put the numbers in perspective. “We’re going to reach a point where in five years, retiree health care will cost us more than employee health care,” he said, adding that was partly because the city was shrinking its work force and partly because retirees used far more medical services than active workers.

The expensive payments are becoming 'astronomical' and without a cap or restriction laws, new generations will suffer from the debt and retirement plans will be cut altogether.

Richard Johnson, national public sector health practice director at the Segal consulting firm, said cutting retirees’ health coverage raised moral and legal issues. “It’s a tough group to deal with,” he said. “You have to remember that state and local governments have routinely catered to them and often promised them being able to retire with full benefits. Those are huge promises.”

On a personal level, I want my parents to retire as soon as they can, but as a statistical value, it would not be practical. The current longevity of senior citizens will only increase, and at this rate, so will the debt.