Archive for the 'Quality' Category

Setting the Record Straight: Best Kept Secrets about Health Reform

Published on February 24, 2010 in Campaign for Better Care, Christine Monahan, Health Care, Quality and Reform. 0 Comments
Christine Monahan, Health Program Assistant

Christine Monahan, Health Program Assistant

Between President Obama issuing a new proposal on health insurance reform on Monday and the White House Health Care Summit Thursday, the beat marches on around this debate in Washington.

But people around the country are wondering how health reform will help them.  I think you’ll agree that the amount of misinformation and scare tactics spread by opponents over the past several months has confused just about everyone about what the health bills in Congress would really accomplish.

It’s time to set the record straight.

The National Partnership for Women & Families created a list of the top 10 best kept secrets about health reform, because people across the country need to know how meaningful reform will benefit them and their families.  That, after all, is the most important question to answer in this debate.

Here’s a look at some of the things opponents don’t want you to know about the legislation Congress has passed.

  • Better Benefits – women and families will be guaranteed coverage for the care they need, from the doctors they need.
  • Better Care – finally we will invest in innovative new ways to provide health care that will support better communication and coordination among health care providers – and between doctors and patients (and their families) – to prevent errors and duplication that disrupt your care.
  • Free Preventive Care – both private health plans and Medicare will cover the full costs of a range of preventive services and immunizations, so women and families can stay healthy without worrying about the expensive co-payments or deductibles that now often keep them from getting the care they need.
  • Coverage for Young Adults – recent high school and college graduates won’t be left without coverage as they struggle to find work and start their careers. The new legislation will let young adults stay on their parents’ insurance plans until they are 26 years old.

There’s more too.

Women and families are counting on lawmakers to get health care reform done and done right. We can’t let anyone stand in the way, or mislead the public about meaningful reform. Check out the full list: The Top Ten Best Kept Secrets about Health Insurance Reform and Why Congress Should Pass It Without Delay.

Are Workplace Wellness Programs Really as Innocuous as They Seem?

Published on January 15, 2010 in Health Care, Quality, Reform and Sabrina Corlette. 1 Comment
Sabrina Corlette

Sabrina Corlette, Director of Health Policy Programs

So, what’s wrong with the workplace wellness programs included in the Senate’s health care reform bill?  That’s a fair question, and one you may have asked yourself if you saw some of the recent coverage of the issue.

To be clear, many workplace wellness programs are innovative, effective, and help employees and their families get and stay healthy, which benefits employees and employers alike.  These workplace wellness programs should be implemented, studied, and then the best of them should be replicated (as the House health reform bill proposes.)

Unfortunately, in the name of “workplace wellness” the Senate bill creates a loophole that would allow employers and insurance companies to discriminate against people based on their health status.

Some may say, “What’s wrong with wellness? How can you be against that?”  As usual, the devil is in the details, and the language in the Senate bill is so nuanced that answering the question “what’s the problem” can stump even the top policy wonk or the most informed journalist.

Here’s my attempt at a plain English explanation.  To start, there are two important things to know in order to understand why the Senate bill would create a loophole that would allow insurance companies to continue to discriminate based on pre-existing conditions.

First, under current law employers are allowed to do some cost-shifting.   Did you think corporations would take money from their own profits to help motivate people to get healthy? Yeah, right.  No, what’s happening is that employers raise everyone’s insurance premium, and then give a “reduction” to those who meet certain health targets and call it a reward.   Those who can’t meet the health targets — for whatever reason — get charged more than their healthier co-workers.

Second, current law says a reward or penalty to an employee under these programs cannot exceed 20 percent of the cost of their health plan.  The Senate bill ups the ante and could eventually allow employers to charge an employee up to 50 percent of their health plan.   With the cost of insurance soaring – an average family policy could cost $20,000 by 2016.  This means people could be charged as much as $10,000 more for their insurance than their co-workers, simply because they have high cholesterol, high blood pressure, or weigh more than they should.   If this sounds like discrimination based on health status (something lawmakers have promised health reform would fix in our current system), that’s because it is!

Knowing that, consider the many reasons an employee may not be able to meet a health target and keep in mind that not all those reasons are within the employee’s control.   Scientists have understood for some time that some conditions like high cholesterol are often a function of genetics.  Also, certain ethnic and racial groups face genetic predispositions to conditions such as hypertension and diabetes.  Recent studies have also suggested that, because of the disruption to their body’s natural circadian rhythm, people who work the night shift are more at risk for high blood pressure, high cholesterol, and heart disease.

Women, in particular, stand to lose the most if this back-door discrimination is allowed.

Women want to make healthy lifestyle choices for themselves and their families, yet in practice they often neglect their own health because they put the needs of their children, spouses and aging relatives before their own.  And research shows that women are more likely than men to suffer from chronic conditions, meaning that women could pay disproportionately more for health insurance under these programs than their male colleagues. Such disparities are even more acute for low-income women and women of color.

This potential for discrimination is particularly troubling for the many women with lower incomes who work multiple jobs to support their families. These women often lack access to healthy food choices and have limited time or ability to access safe environments for physical activity. In effect, these programs will make health coverage less affordable to the very people who need it the most.

Employers can help everyone prioritize their health by providing a supportive environment for health and wellness in the workplace.  But, if Congress adopts the language in the Senate’s health reform bill on workplace wellness programs, we’ll see employers and insurance companies using this loophole as a way to discriminate.  That’s not good for anyone, and it undermines the promise of reform.

To learn more about workplace wellness programs under health reform, please see our recent Issue Brief:

Protect Women and Families From Discrimination: Prevent Employer “Wellness” Programs From Unfairly Increasing Health Insurance Premiums

Rx for Health Literacy

Published on October 30, 2009 in Health Care, Jennifer Sweeney and Quality. 0 Comments
Jennifer Sweeney

Jennifer Sweeney

October is health literacy month and, as Congress debates the widespread challenges in health care, we also need to address the problem of low health literacy — an obstacle people face in doctors’ offices across the country everyday and one that has a big impact on health outcomes.

According to the Institute of Medicine (IOM), 90 million people in the United States, nearly half the population, lack the ability to read, understand, and act on health care information. Low health literacy skills are often a result of limited literacy skills, generally. Consider this daunting dose of reality: One out of five American adults reads at the 5th grade level or below, and the average American reads at the 8th to 9th grade level, yet most healthcare materials are written above the 10th grade level. And while low health literacy affects people of all education and income levels, older people, non-whites, immigrants, and those with low incomes are more likely to have trouble reading and understanding health-related information.

Health literacy is defined as the degree to which someone is able to obtain, process, and understand health information in order to make the best health decisions. These are the skills that everyone needs in order to do things like fill out medical and insurance forms, follow medication instructions, and understand the doctor’s orders for before or after surgery.

Schools and hospitals around the country are raising awareness about health literacy month this October because the impact on individuals and families is considerable and, as usual, any stigma linked to a specific struggle will only exacerbate the problem. In this case, many patients are embarrassed to ask their health care providers to explain health information and, as a result, they are less likely to follow prescribed treatment, more likely to experience medication errors, and often don’t seek preventive care. Beyond the impact on individuals and families, low health literacy takes a toll on our health care system too — adding approximately $50 to $73 billion in health care costs, according to the IOM.

The good news is that positive change is within our reach. Health care providers can help by avoiding acronyms and technical medical terminology when possible. And since one of the biggest barriers to addressing the problem is actually identifying patients who are struggling to understand health information — providers should ask every patient questions to determine if they need help.

And (not that we needed another reason besides improving health to invest in tackling this problem) we’re now seeing that improving health literacy rates could also enhance people’s frame of mind. According to a recent study, researchers from the University of Alabama at Birmingham’s Center for Education and Research on Therapeutics (CERT) and the University of Oklahoma have actually found a positive correlation between health literacy and personal levels of happiness. The study revealed that happiness scores increased steadily with higher levels of health literacy even after controlling for demographic variables, poverty levels, and self-reported health.

As we’ve learned during the course of the current health care debate, the solutions we need in order to improve the health and well being of families across the country come in many shapes and sizes. Broad systemic changes, many of which we’ve seen proposed in Congress in the past year, are going to be necessary. But those changes must be underpinned by strategies — like improving health literacy — that can help ensure patients benefit from health reform. To learn more about what you can do to help tackle the problem of low health literacy, please visit the Department of Health and Human Services’ (HHS) Health Literacy Improvement page.