Category Archives: Insurance cost
Brendan Saloner, PhD, is a Robert Wood Johnson Foundation (RWJF) Health & Society Scholar in residence at the University of Pennsylvania and a senior fellow at the Leonard Davis Institute of Health Economics.
In these early days of the Affordable Care Act, the uninsured rate has begun to sharply decrease. One recent estimate suggests 5.4 million adults gained insurance coverage in the first quarter of 2014. The Congressional Budget Office projects that enrollment in Medicaid and the health insurance Marketplaces will increase even more rapidly over the next two years.
The importance of increased health insurance coverage for improved access to health care justifiably receive much of the public’s attention, but the impact of coverage on the financial health of families may be equally important. Subsidized health insurance can increase the disposable income of families by freeing up money that was previously used to pay out-of-pocket for doctor’s visits and prescription drugs. Newly insured individuals also benefit from the risk-protection of health insurance since even people who use little or no health care are at risk of unexpected accidents or newly diagnosed diseases.
A recent study in Oregon that compared adults who received free health insurance through a lottery to those who applied but did not receive the free care found that the “winners” were much less likely to say that they needed to cut back on necessities to pay for health care. They also had much less medical debt and a lower likelihood of receiving a notice from a collection agency.
This is part of a series in which Robert Wood Johnson Foundation (RWJF) leaders, scholars, grantees and alumni offer perspectives on the U.S. Supreme Court rulings on the Affordable Care Act. Michelle Scott recently graduated from Rowan University and is an intern at RWJF, working with The Future of Nursing: Campaign for Action.
I’m 22 and uninsured. I’ve only had health insurance for the four years I went to college, and now that I’ve just graduated, I no longer have that luxury. I survived the first 18 years of my life without it, but thanks to the Affordable Care Act, I don’t have to live without it for the rest of my life.
The day I received my college health insurance card in the mail, that flimsy piece of laminated paper with my name on it, I vividly remember thinking, “Wow. I’m allowed to be sick.” During my time at college I never got sick, nor injured in a serious accident of any kind where I actually needed medical attention. There was a brief period where I thought I smashed my hip and orbital bone in a skateboard incident my senior year of college, but after sitting on the ground at the skate park for a minute, and contemplating whether my family could afford to patch me up, I decided to walk it off. From my very early childhood, that’s how I learned to treat any kind of issue: Walk it off, or rest up until you can walk it off.
A study published in the August 2011 issue of Health Affairs finds that physician practices in the United States spend significantly more time and money interacting with payers than their counterparts in Canada. For nurses and medical assistants, the disparity is huge.
The new study finds “substantial” costs in time and labor to work with multiple insurance plans, especially for small practices with just one or two physicians. Nursing staff and medical assistants in the United States spend nearly ten times more time than their counterparts in Ontario interacting with health plans. Nurses and medical assistants here spend 20.6 hours per physician per week interacting with health plans, compared to 2.5 hours per physician per week spent by Ontario nursing staff.
The study, based on surveys in both countries, estimates that overall, U.S. physician practices spend nearly four times more per physician per year in administrative costs interacting with health plans and payers than physician practices in Ontario. Canada has a single-payer health care system.
“If US physicians had administrative costs similar to those of Ontario physicians, the total savings would be approximately $27.6 billion per year,” the authors write.