Hi all,
As you've noticed, I have been somewhat lax in my responses, and in my upkeep of this little part of my life. It was not intentional. Over the past period of time, I have been writing extensively, serving on an AAPA council (Leadership and Professional Development), speaking frequently on health policy and reform, conducting 3 different workforce research studies (although, admittedly, two are still in the developmental stage), trying to conceive a mathematical healthcare workforce model accounting for all variables (a request from powers that be), functioning as the guest health policy contributor to "Angry Bear" which is top Wall Street economics blog, and I was recently asked to represent our national Emergency Medicine PA group with respect to legislative affairs.
In short, I've been busy. No disrespect, no excuse. Just an explanation.
(OH, and I've been asked to possibly contribute a chapter to a major economic policy book on health policy this year)
Wednesday, March 30, 2011
New Look
Decided as I will be here far more often now, that the place needed a new look....hope everyone likes it.
Mike
Mike
Medical Malpractice Reform: Truth in Advertising Needed (Part three of three)
Crossposted at AngryBear...
So in the first two articles we have addressed the historic effects of tort reform using Texas as an example, and subsequently we reviewed the effects of tort reform on so called “defensive medicine” practices, looking at both the effect of reform measures on physician/provider ordering patterns, as well as the possible effects on patient outcomes or mortality.
Today, we are going to examine the last party in this carousel. The insurance agencies themselves. For starters, I wanted to examine if there was any sort of a relationship between malpractice premiums, and healthcare spending. So, using historic healthcare expenditure rates from the NHE database (CMS), I calculated the rate of healthcare growth, percentage wise, per year from 1995-2008. I then used an ISO database set to examine the growth in insurance premiums per year.
As we can plainly see, there is no correlation, but out of sense of thoroughness, I even ran a simple regression.
But with an R-Squared of 0.021, there is simply little correlation there.
So what causes these random spikes in medical malpractice premiums? Well, according to the AIR (Americans for Insurance Reform) these are due to the economic cycles of insurers and to drops in investment income.
Lastly, I visited THIS article, which found:
1. Inflation-adjusted payouts per doctor not only failed to increase between 2001 and 2004, a time when doctors’ premiums skyrocketed, but they have been stable or falling throughout this entire decade.
2. Medical malpractice insurance premiums rose much faster in the early years of this decade than was justified by insurance payouts.
3. At no time were recent increases in premiums connected to actual payouts. Rather, they reflected the well-known cyclical phenomenon called a “hard” market. Property/casualty insurance industry “hard” markets have occurred three times in the past 30 years.
4. During this same period, medical malpractice insurers vastly (and unnecessarily) increased reserves (used for future claims) despite no increase in payouts or any trend suggesting large future payouts. The reserve increases in the years 2001 to 2004 could have accounted for 60
percent of the price increases witnessed by doctors during the period.
But the real devil, the real devil is in the loss ratios…I’m assuming that we are all familiar with the MLR discussions that raged over the past two years discussing what should be an allowable loss ratio for health insurance. Malpractice also has it’s loss ratios, and oh boy, are they favorable to the insurance industry. 61.1% is the average, in 2007, for the average loss ratios for malpractice insurance companies. To put this another way as per the article: In 2007, medical malpractice insurer profit based just on insurance transactions, that is,just on the premiums they took in, was 24.6%. This was more than double the amount on insurance transactions for the entire industry (11.0%).
If I were a physician who paid my own malpractice, I would be livid over these figures. It is not as though there is a huge advertising market for medical malpractice insurance. 38.9 cents on every dollar are kept as almost pure profit. Surely, administrative costs cannot account for this. Add to this, this last nugget: Inflation-adjusted payouts per doctor not only failed to increase between 2001 and 2004, a time when doctors’ premiums skyrocketed, but they have been stable or falling throughout this entire decade.
It seems, that right now would be a great time to own a malpractice insurance firm. Too bad, that it isn’t so great for everyone else in healthcare.
So in the first two articles we have addressed the historic effects of tort reform using Texas as an example, and subsequently we reviewed the effects of tort reform on so called “defensive medicine” practices, looking at both the effect of reform measures on physician/provider ordering patterns, as well as the possible effects on patient outcomes or mortality.
Today, we are going to examine the last party in this carousel. The insurance agencies themselves. For starters, I wanted to examine if there was any sort of a relationship between malpractice premiums, and healthcare spending. So, using historic healthcare expenditure rates from the NHE database (CMS), I calculated the rate of healthcare growth, percentage wise, per year from 1995-2008. I then used an ISO database set to examine the growth in insurance premiums per year.
As we can plainly see, there is no correlation, but out of sense of thoroughness, I even ran a simple regression.
But with an R-Squared of 0.021, there is simply little correlation there.
So what causes these random spikes in medical malpractice premiums? Well, according to the AIR (Americans for Insurance Reform) these are due to the economic cycles of insurers and to drops in investment income.
Lastly, I visited THIS article, which found:
1. Inflation-adjusted payouts per doctor not only failed to increase between 2001 and 2004, a time when doctors’ premiums skyrocketed, but they have been stable or falling throughout this entire decade.
2. Medical malpractice insurance premiums rose much faster in the early years of this decade than was justified by insurance payouts.
3. At no time were recent increases in premiums connected to actual payouts. Rather, they reflected the well-known cyclical phenomenon called a “hard” market. Property/casualty insurance industry “hard” markets have occurred three times in the past 30 years.
4. During this same period, medical malpractice insurers vastly (and unnecessarily) increased reserves (used for future claims) despite no increase in payouts or any trend suggesting large future payouts. The reserve increases in the years 2001 to 2004 could have accounted for 60
percent of the price increases witnessed by doctors during the period.
But the real devil, the real devil is in the loss ratios…I’m assuming that we are all familiar with the MLR discussions that raged over the past two years discussing what should be an allowable loss ratio for health insurance. Malpractice also has it’s loss ratios, and oh boy, are they favorable to the insurance industry. 61.1% is the average, in 2007, for the average loss ratios for malpractice insurance companies. To put this another way as per the article: In 2007, medical malpractice insurer profit based just on insurance transactions, that is,just on the premiums they took in, was 24.6%. This was more than double the amount on insurance transactions for the entire industry (11.0%).
If I were a physician who paid my own malpractice, I would be livid over these figures. It is not as though there is a huge advertising market for medical malpractice insurance. 38.9 cents on every dollar are kept as almost pure profit. Surely, administrative costs cannot account for this. Add to this, this last nugget: Inflation-adjusted payouts per doctor not only failed to increase between 2001 and 2004, a time when doctors’ premiums skyrocketed, but they have been stable or falling throughout this entire decade.
It seems, that right now would be a great time to own a malpractice insurance firm. Too bad, that it isn’t so great for everyone else in healthcare.
Wednesday, February 23, 2011
Medical Malpractice Reform: Truth in Advertising Needed (Part TWO of three)
(Cross posted at Angry Bear and Clinician One)
ALSO, picked up by Business Insider, HERE
So in the first article, we discussed the historical implications of tort reform by examining Texas. The take home message being that tort reform failed to curb health care spending, and/or control costs (outside of malpractice premiums which did fall). Proponents of tort reform claim that by enacting aggressive tort reform measures, so called defensive medicine practices could be reigned in. Estimates about the costs of defensive medicine vary, and I have seen estimates in the literature as low as 4%, and as high as 14% of total health care spending. As with most things, the truth is probably somewhere in the middle, with a realistic estimate of 8-9% likely being the real integer. Recently, several studies have attempted to assess two of the most important questions about this topic:
A: Does a reduction in defensive medicine practices occur with the implementation of tort reform measures?
And
B: If it does cause a reduction in defensive medicine practices, will this affect patient outcomes or mortality?
Three more recent studies are likely the most pertinent, and we will briefly review those. To start with, Currie and MacLeod (go ahead, I had the Highlander flashback too) (2006) reviewed national data on childbirths to examine whether or not a cap on non economic damages would change the types of procedures performed at childbirth. They found that nationally, in those states with tort reform, the rate of C-Sections increased, and the rate of preventable complications secondary to childbirth increased by 6%. They also found, that a change in the “deep pockets rule”, actually decreased them. The paper is HERE: (gated article).
Then Sloan and Shadle in 2009 examined this same issue, using Medicare payments as an index. Their premise was, that if tort reform truly changed physician practices with regards to additional testing and/or defensive medicine, they would find a reduction in Medicare payment rates per beneficiary. They found that tort reform did not alter defensive medicine practices, with one exception. They did find that so called “indirect” reforms (mandatory periodic payments, Joint and Severability reform, and patient compensation funds) may reduce spending when applied to “any hospitalization”, but inexplicably, these indirect reforms did not affect any of the four diagnoses included in the study. Their paper is HERE:
There have been others, and the final one we will discuss is the NBER report done in 2009 by Darius Lakdawalla and Seth Seabury, Working Paper No. 15383. Found HERE: (gated article). Essentially, Lakdawalla and Seabury found that while targeted reforms may be effective, there could be an associated, and this is key… a 0.2% associated increase in mortality for every 10% reduction in medical malpractice liability costs. Why? Because defensive medicine practices DO FIND things. Any physician who has been in practice for any length of time, and who is being honest with you, will admit that they have done a test presuming it would be negative, and “perhaps the patient doesn’t need it”, only to be surprised by the results. We can argue whether or not 0.2% is a significant number, but even we look at the sickest 5% of Americans who are responsible for 47% of healthcare spending, than this group could have an increase of 30,000 deaths annually with a reduction of 10% spending on medical malpractice. I am not going to pass moral judgment on this fact. I will leave that up to the reader. The reason I bring this up, is that this is an important, and poignant discussion, but we need to be honest about the data that is out there now. Let’s have a discussion, but let it be an honest, and fact based one.
I tend to think that the Sloan and Shadle findings are important in the fact that I don’t think that physician practices are going to “magically” change overnight. The Texas evidence from the last article, would suggest that testing expenditures may actually increase. Yet, in the face of overwhelming evidence, proponents continue to cling to a disproven ideology regarding direct malpractice cost containment, IE; Non economic caps.
ALSO, picked up by Business Insider, HERE
So in the first article, we discussed the historical implications of tort reform by examining Texas. The take home message being that tort reform failed to curb health care spending, and/or control costs (outside of malpractice premiums which did fall). Proponents of tort reform claim that by enacting aggressive tort reform measures, so called defensive medicine practices could be reigned in. Estimates about the costs of defensive medicine vary, and I have seen estimates in the literature as low as 4%, and as high as 14% of total health care spending. As with most things, the truth is probably somewhere in the middle, with a realistic estimate of 8-9% likely being the real integer. Recently, several studies have attempted to assess two of the most important questions about this topic:
A: Does a reduction in defensive medicine practices occur with the implementation of tort reform measures?
And
B: If it does cause a reduction in defensive medicine practices, will this affect patient outcomes or mortality?
Three more recent studies are likely the most pertinent, and we will briefly review those. To start with, Currie and MacLeod (go ahead, I had the Highlander flashback too) (2006) reviewed national data on childbirths to examine whether or not a cap on non economic damages would change the types of procedures performed at childbirth. They found that nationally, in those states with tort reform, the rate of C-Sections increased, and the rate of preventable complications secondary to childbirth increased by 6%. They also found, that a change in the “deep pockets rule”, actually decreased them. The paper is HERE: (gated article).
Then Sloan and Shadle in 2009 examined this same issue, using Medicare payments as an index. Their premise was, that if tort reform truly changed physician practices with regards to additional testing and/or defensive medicine, they would find a reduction in Medicare payment rates per beneficiary. They found that tort reform did not alter defensive medicine practices, with one exception. They did find that so called “indirect” reforms (mandatory periodic payments, Joint and Severability reform, and patient compensation funds) may reduce spending when applied to “any hospitalization”, but inexplicably, these indirect reforms did not affect any of the four diagnoses included in the study. Their paper is HERE:
There have been others, and the final one we will discuss is the NBER report done in 2009 by Darius Lakdawalla and Seth Seabury, Working Paper No. 15383. Found HERE: (gated article). Essentially, Lakdawalla and Seabury found that while targeted reforms may be effective, there could be an associated, and this is key… a 0.2% associated increase in mortality for every 10% reduction in medical malpractice liability costs. Why? Because defensive medicine practices DO FIND things. Any physician who has been in practice for any length of time, and who is being honest with you, will admit that they have done a test presuming it would be negative, and “perhaps the patient doesn’t need it”, only to be surprised by the results. We can argue whether or not 0.2% is a significant number, but even we look at the sickest 5% of Americans who are responsible for 47% of healthcare spending, than this group could have an increase of 30,000 deaths annually with a reduction of 10% spending on medical malpractice. I am not going to pass moral judgment on this fact. I will leave that up to the reader. The reason I bring this up, is that this is an important, and poignant discussion, but we need to be honest about the data that is out there now. Let’s have a discussion, but let it be an honest, and fact based one.
I tend to think that the Sloan and Shadle findings are important in the fact that I don’t think that physician practices are going to “magically” change overnight. The Texas evidence from the last article, would suggest that testing expenditures may actually increase. Yet, in the face of overwhelming evidence, proponents continue to cling to a disproven ideology regarding direct malpractice cost containment, IE; Non economic caps.
Tuesday, February 8, 2011
Medical Malpractice Reform: Truth in Advertising Needed
PART ONE OF THREE:
(Crossposted at Angry Bear)
Medical malpractice liability reform (Tort Reform) has been a hotly contested item for years, as the GOP, with physician support, has continued to market this as a health reform measure that can contain costs.
I think to start, we need to examine results in states where tort reform has already been tried. We need look no further than Texas.
Politicians tried to claim that Texas was a success, Rep Bachmann stated ““The state of Texas did a wonderful job of lawsuit reform and actually saw medical costs come down. We know it works.” Others have touted the Texas experiment as a success..but empiric data is a powerful thing, and as we will see, contradicts this sentiment.
In 2003, they passed the most aggressive tort reform measures in the country by placing a 250,000 cap on malpractice awards. It is true that this reform, after 2003, lowered malpractice premiums. But malpractice settlements and awards have dropped even farther than premiums, suggesting that the main benefactors so far, have been insurance companies. (See Table 1).
Also, the same report found that Medicare spending per patient had doubled between 2003 and 2007, in contrast to the decline in Medicare spending that was noted prior to the laws enactment. (See Table 2)
Additionally, one of the strongest arguments that tort reform supporters claim is a reduction in “defensive” medicine expenditures, or unnecessary testing… unfortunately, between 2003 and 2007 testing expenditures per Medicare enrollee grew at 50% greater than the national average…
They also found that Texas has the highest rate of uninsured patients in the country, both prior to the law, and accelerating after the law was passed.
The additional physician presence has only increased because of an increasing population as well, and when it was analyzed, there was only an increase of 0.4 physicians per capita after the law was passed.
These tables and data were all obtained and detailed in this study HERE, and there is much more information at the link. HERE
The short version is that medical malpractice reform should be a topic for discussion, but we need to be honest about this. In this article we reviewed what actually happened in Texas after the most aggressive tort reform measures were created. Costs (outside of settlements, payments, and premiums did NOT go down), and healthcare spending was at best unaffected, and may have even increased.
The next article will focus on the effects of reducing defensive medicine practices on patient mortality. The final article will focus on the association between medical malpractice premiums and healthcare spending.
(Crossposted at Angry Bear)
Medical malpractice liability reform (Tort Reform) has been a hotly contested item for years, as the GOP, with physician support, has continued to market this as a health reform measure that can contain costs.
I think to start, we need to examine results in states where tort reform has already been tried. We need look no further than Texas.
Politicians tried to claim that Texas was a success, Rep Bachmann stated ““The state of Texas did a wonderful job of lawsuit reform and actually saw medical costs come down. We know it works.” Others have touted the Texas experiment as a success..but empiric data is a powerful thing, and as we will see, contradicts this sentiment.
In 2003, they passed the most aggressive tort reform measures in the country by placing a 250,000 cap on malpractice awards. It is true that this reform, after 2003, lowered malpractice premiums. But malpractice settlements and awards have dropped even farther than premiums, suggesting that the main benefactors so far, have been insurance companies. (See Table 1).
Also, the same report found that Medicare spending per patient had doubled between 2003 and 2007, in contrast to the decline in Medicare spending that was noted prior to the laws enactment. (See Table 2)
Additionally, one of the strongest arguments that tort reform supporters claim is a reduction in “defensive” medicine expenditures, or unnecessary testing… unfortunately, between 2003 and 2007 testing expenditures per Medicare enrollee grew at 50% greater than the national average…
They also found that Texas has the highest rate of uninsured patients in the country, both prior to the law, and accelerating after the law was passed.
The additional physician presence has only increased because of an increasing population as well, and when it was analyzed, there was only an increase of 0.4 physicians per capita after the law was passed.
These tables and data were all obtained and detailed in this study HERE, and there is much more information at the link. HERE
The short version is that medical malpractice reform should be a topic for discussion, but we need to be honest about this. In this article we reviewed what actually happened in Texas after the most aggressive tort reform measures were created. Costs (outside of settlements, payments, and premiums did NOT go down), and healthcare spending was at best unaffected, and may have even increased.
The next article will focus on the effects of reducing defensive medicine practices on patient mortality. The final article will focus on the association between medical malpractice premiums and healthcare spending.
Wednesday, November 3, 2010
Thoughts on Obama, last night, and the GOP
Okay, it was a fascinating evening. From a poly sci standpoint, this was a great election.
Several thoughts come to mind..
#1 The GOP is elated and confused at the same time. Why? Cause now they actually have to do something. Eric Cantor was interviewed by Wolf Blitzer last night who pressed him on WHAT exact cuts he was going to make to government. Cantor kept repeating 100 billion over ten years, but was unable, or unwilling to articulate exactly HOW they are getting to that figure.
John Boehner's tearful moment was the most disingenuous, comical thing of the evening. If you had ever met the man, you would realize within a second that that was staged. In his interviews he has stated many platitudes about the American people, and how they trust him, yada, yada, yada, but, like Cantor, when pressed on what cuts he needs to do, he is unable to answer at this time.
#2 Obama has failed in a more massive way than I thought possible. He was downright indignant in his interview today, and unwilling to concede that perhaps he might have been wrong. This better change, or he will most assuredly be a one term President.
His biggest failure is the one I never saw coming with him....COMMUNICATION. In uncertain financial times, tough times, with people losing their jobs, an economy struggling like a newborn horse to get on it's fight, people are scared. For right or for wrong, people are scared, frightened, and he did nothing to help assure people. In these difficult circumstances, people need comfort, they need re-assurance that things will be okay..
Where were Obama's fireside chats? Where were bi-weekly TV addresses to the nation taking tough questions, and trying to re-assure the populace? Had he done this, I think we might have seen a very different outcome last night, but we'll never know.
#3 The Tea Party has rolled in, they officially have candidates in office. From a poly sci standpoint, it will be interesting to see how they, and more specifically, the TP base reacts when they realize that they simply cannot achieve about 80% of their goals.....
What will they do? What will the elected TP officials do when they run into the machine that is DC? It changes everyone, and is akin to running full speed into a brick wall. It is immovable, and massive. What will happen to the TP candidates when lobbying money begins to come their way? How will the base react? Are they going to vote for the debt increase?
For example, healthcare will not be repealed. Not now, and not in 2012, even with a GOP administration. The bill is polling fairly well.
I DO see some tweaking of the bill, and some amendments to it. Likely interstate insurance sales, tort reform, and possibly an attempt to remove the mandate.
Of course, that will only hasten the collapse of the US healthcare system, so part of me hopes that they do it, but it will be interesting to see.
I'm getting a BIG bowl of popcorn, this is going to be a fascinating 2 years of political history to watch unfold before our eyes
Several thoughts come to mind..
#1 The GOP is elated and confused at the same time. Why? Cause now they actually have to do something. Eric Cantor was interviewed by Wolf Blitzer last night who pressed him on WHAT exact cuts he was going to make to government. Cantor kept repeating 100 billion over ten years, but was unable, or unwilling to articulate exactly HOW they are getting to that figure.
John Boehner's tearful moment was the most disingenuous, comical thing of the evening. If you had ever met the man, you would realize within a second that that was staged. In his interviews he has stated many platitudes about the American people, and how they trust him, yada, yada, yada, but, like Cantor, when pressed on what cuts he needs to do, he is unable to answer at this time.
#2 Obama has failed in a more massive way than I thought possible. He was downright indignant in his interview today, and unwilling to concede that perhaps he might have been wrong. This better change, or he will most assuredly be a one term President.
His biggest failure is the one I never saw coming with him....COMMUNICATION. In uncertain financial times, tough times, with people losing their jobs, an economy struggling like a newborn horse to get on it's fight, people are scared. For right or for wrong, people are scared, frightened, and he did nothing to help assure people. In these difficult circumstances, people need comfort, they need re-assurance that things will be okay..
Where were Obama's fireside chats? Where were bi-weekly TV addresses to the nation taking tough questions, and trying to re-assure the populace? Had he done this, I think we might have seen a very different outcome last night, but we'll never know.
#3 The Tea Party has rolled in, they officially have candidates in office. From a poly sci standpoint, it will be interesting to see how they, and more specifically, the TP base reacts when they realize that they simply cannot achieve about 80% of their goals.....
What will they do? What will the elected TP officials do when they run into the machine that is DC? It changes everyone, and is akin to running full speed into a brick wall. It is immovable, and massive. What will happen to the TP candidates when lobbying money begins to come their way? How will the base react? Are they going to vote for the debt increase?
For example, healthcare will not be repealed. Not now, and not in 2012, even with a GOP administration. The bill is polling fairly well.
I DO see some tweaking of the bill, and some amendments to it. Likely interstate insurance sales, tort reform, and possibly an attempt to remove the mandate.
Of course, that will only hasten the collapse of the US healthcare system, so part of me hopes that they do it, but it will be interesting to see.
I'm getting a BIG bowl of popcorn, this is going to be a fascinating 2 years of political history to watch unfold before our eyes
Last Editorial....
Thought some might like to see my latest editorial which was published in JAAPA in September.
See HERE
I also have two clinical articles being published in JAAPA soon.
One on Etomidate and Sepsis and one on the use of Steroids in Spinal Cord Injuries.
See HERE
I also have two clinical articles being published in JAAPA soon.
One on Etomidate and Sepsis and one on the use of Steroids in Spinal Cord Injuries.
Aging.....Not liking it
Okay,
So I am "officially" old now.
I was a friends wedding a couple weeks ago back home, and one day, when I was at my family's farm with my wife and daughter, everyone is hungry, and becoming crabby.
Well, the only real option near the farm is a McDonalds. I go there, and surprise, my 17 year old niece is working. She is very nice to me as I go through the drive thru...apparently, after I left. Her manager came over and asked, "Shaynna, why were you hitting on that old guy". Yeah, that was nice. Of course, my wife had to tell all my friends.
Then I return home, and go to see the eye doctor. I've been getting headaches for about 6 months, and found that I was holding papers farther and farther from my face. Yep...
I needed reading glasses. In fact, I've needed them for some time.
Nice.....I hate getting old.
So I am "officially" old now.
I was a friends wedding a couple weeks ago back home, and one day, when I was at my family's farm with my wife and daughter, everyone is hungry, and becoming crabby.
Well, the only real option near the farm is a McDonalds. I go there, and surprise, my 17 year old niece is working. She is very nice to me as I go through the drive thru...apparently, after I left. Her manager came over and asked, "Shaynna, why were you hitting on that old guy". Yeah, that was nice. Of course, my wife had to tell all my friends.
Then I return home, and go to see the eye doctor. I've been getting headaches for about 6 months, and found that I was holding papers farther and farther from my face. Yep...
I needed reading glasses. In fact, I've needed them for some time.
Nice.....I hate getting old.
Absence...I'm back
Okay,
I've been gone..lax...lazy....out of mind.
Actually, I've been in the grant writing process. Anyone who has done this in the past, will realize quite quickly how painful this is.
I'm also getting my "Assistant Professor of Medicine" rank.
I've been writing, publishing, speaking at various public venues..etc.
BUT, in the immortal words of the drunk pilot in "Independence Day", I'm BAAAACCCKKKKKKKKK!!!!!!
I've been gone..lax...lazy....out of mind.
Actually, I've been in the grant writing process. Anyone who has done this in the past, will realize quite quickly how painful this is.
I'm also getting my "Assistant Professor of Medicine" rank.
I've been writing, publishing, speaking at various public venues..etc.
BUT, in the immortal words of the drunk pilot in "Independence Day", I'm BAAAACCCKKKKKKKKK!!!!!!
Tuesday, September 7, 2010
Health Insurance Premiums passed on to workers this year....
News at 11.
While this years premium increase was lower than in the past (average 10.4% increase per year from 1999-2009)...about 5% higher for single, and 3% higher for family premiums, workers contributions rose to 19% from 17% for single coverage, and 30% from 27% for family coverage.
Interestingly, since 2000, premiums have risen 114%, but the employee contribution has risen 147%.
This is problematic, and is not really addressed in the current legislation. At least not adequately, but only time will tell if the implementation of certain measures will lower preimum increases even further, or stagnate them eventually.
THIS
paper recently done at Kaiser is outstanding, and a must read for those trying to understand this a little better.
While this years premium increase was lower than in the past (average 10.4% increase per year from 1999-2009)...about 5% higher for single, and 3% higher for family premiums, workers contributions rose to 19% from 17% for single coverage, and 30% from 27% for family coverage.
Interestingly, since 2000, premiums have risen 114%, but the employee contribution has risen 147%.
This is problematic, and is not really addressed in the current legislation. At least not adequately, but only time will tell if the implementation of certain measures will lower preimum increases even further, or stagnate them eventually.
THIS
paper recently done at Kaiser is outstanding, and a must read for those trying to understand this a little better.
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