Archive for the 'Reform' 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

Historic Milestone Reached! Bill Needs Improvement…

Published on December 24, 2009 in Debra Ness, Health Care, Reform and Reproductive Health. 1 Comment
Debra Ness

Debra Ness

Today, the Senate took a historic step to fix our nation’s broken health care system by passing comprehensive reform that will cover 31 million more people, prohibit insurance practices that undermine meaningful, affordable coverage, help contain costs, and put us on track to improve the quality and coordination of care.

But this flawed bill must be improved. The anti-choice provisions in the Senate and House bills are bad and worse, and represent a step the nation simply should not take.

It is a sad day when the price of reform is undermining access to a basic health service that America’s women need.

Those of us who spend our lives working to improve women’s health have been deeply shaken as lawmakers allowed reproductive health services to become a political bargaining chip, and as opponents of choice used reform to advance their extreme agenda.

Both the Senate and House bills contain anti-choice provisions that betray the promise of reform for women and would, in practical terms, cost millions of women coverage for basic reproductive health care. This should not stand.

We will work tirelessly to improve the final bill, including by urging conferees to provide more support to the low- and moderate-income families that will now have to purchase coverage.

We must strengthen the final bill by maintaining strong delivery and payment reforms, ensuring greater affordability and meaningful benefits, and guaranteeing effective market reforms that prohibit the discriminatory practices that have put affordable, quality health coverage out of reach for millions of women and families.

We see today’s vote, and the eventual enactment of this bill, as a beginning rather than an end.

The true test of reform’s success will depend on whether it delivers on the promise to expand access to high quality, affordable care; dramatically improves quality and care coordination; gives us better value for our health dollars; and puts us on track to get costs under control. We see implementation as key, and making our health care system work for the most vulnerable patients is essential.

And we look forward to the day when women’s health is no longer bargained away.

Our elected leaders’ work will not be done until those goals are achieved. And we will count on you to stand by our side.

It’s a resolution for the new year that we must all keep!

Health Care Reform Matters to Older Women

Published on December 7, 2009 in Campaign for Better Care, Debra Ness, Health Care and Reform. 0 Comments
Debra Ness

Debra Ness

Let’s be clear. As both caregivers and patients, women bear the brunt of shortcomings in our health care system – high costs, poor quality, and fragmented, uncoordinated care. 

That’s because women are the primary users of health care, and we continue to use more health services as we age.

It’s also because, in most cases, we are primary caregivers for our families.  We coordinate care for our spouses, parents and children, and often, at great cost to ourselves, we fill in the gaps when the system fails and care is poor quality or uncoordinated.

With the finish line in sight on health reform, everyone needs to take a close look at what the House and Senate bills will do, not only to expand coverage and contain costs but also to improve the way care is delivered.  We should look particularly closely at whether these bills will provide higher quality care for older women, who are more than half of Medicare beneficiaries and 70 percent of those aged 85 and older.

The good news is that the House and Senate bills both contain a number of measures that will improve the way we pay for and deliver health care.  These quality improvement measures are vital to preserving and protecting programs like Medicare for the long term, and containing costs and improving efficiencies overall.

For example, both bills move us toward a system that links payment to better quality and better coordinated care.  This means we can start paying for health care based on value and better health outcomes, rather than paying based on the number of services or tests performed. This is good news for anyone who has a loved one struggling with illness or health problems. People who navigate the health system know that their loved one needs the right test or treatment at the right time – not an abundance of repeat or erroneous services that don’t provide answers or make them better.

Earlier this year, we talked to caregivers around the country about their concerns with our health care system.  Poor care coordination and a lack of communication among doctors were foremost on their minds.  That’s because they’ve seen first-hand how these problems lead to dangers and waste from bad drug interactions, repeat tests, misdiagnoses, and more.

Both the Senate and House bills also introduce new models of delivering health care that are specifically designed to improve coordination and reduce events like preventable hospitalizations and readmissions, which are all too common now.

Because passing legislation only begins the work to fix our broken health care system, these bills allow us to test new models over time so we can find out what works best and continuously build on our success.

Recently a distinguished group of consumer advocates, economists and analysts issued a letter praising the Senate’s Patient Protection and Affordable Care Act for its payment and delivery reforms.  I was proud to coordinate and sign that letter.

Older women have a huge stake in turning our health care system around, and ensuring that it serves them and other vulnerable populations better.  If we can make the system work for them, we can make it work for everyone.

We’re closer than ever to the reforms we need, but victory is not assured.  We need to be certain the final legislation includes the key provisions that will improve care coordination and put patients first.  

Balancing the need for change with ensuring that we do change right is the key to sustainable reform.  As the Senate debates the specifics of reform, we must all fight for policies that will provide higher quality, better coordinated, and more affordable care for everyone.