Smart. Sharp. Funny. Fearless.

Monday, December 09, 2019 {{ new Date().getDay() }}


Your Guide to the Difficulties of American Healthcare

The current United States healthcare system is a heavily debated topic as the 2020 election comes into full swing. Some are proclaiming a transition to Medicare for all and others are pushing for a public option that allows individuals to choose their plans, including government-provided options. To help you better understand the difficulties facing the healthcare system, as well as the challenges of navigating it, let’s explore in-depth just how the system works and what can be done to mitigate the stress of accessing care.

The Financial and Legal Challenges of Navigating Healthcare

Over 44 million Americans are uninsured with another 38 million having inadequate insurance. The lack of insurance or appropriate coverage is one of the biggest hurdles facing Americans when it comes to accessing healthcare services. Without necessary coverage, millions of Americans face crushing medical debt or the possibility of forgoing needed treatment to avoid debt they cannot pay.

These facts have been thrown to the forefront of the 2020 political debates, with each candidate putting forth their solutions to help lift this burden off the shoulders of the people. However, regardless of who enters into office, the difficulties facing Americans now and those already struggling with medical debt is something that must also be taken into consideration.

Already it costs over $250 billion to process the 30 billion healthcare transactions that occur every year. Adding to that are the 20,000 malpractice claims which are filed by patients and family members each year. The problem here comprises both how the medical industry is structured and how lower rates of coverage result in underinsured Americans receiving a lower standard of care. Studies indicate that uninsured or underinsured individuals are less likely to receive preventative care or services for both major health issues and chronic conditions that would otherwise be treatable.

Arguments against Medicare for all and healthcare reform insist that a higher influx of patients now able to seek affordable treatment will result in even higher rates of malpractice, though many counter-argue that adequate reform will reduce the number of claims due to more readily accessible superior care programs. To understand the truth, let’s look that the top reasons people file malpractice claims as reported in a study published in J Law Med Ethics.

  • 33 percent of respondents answered that they were advised to sue from someone outside of their immediate family, 56% of which were advised by someone in the medical field.
  • 24 percent of respondents said that they sued for malpractice because they needed money for long-term care.
  • Another 24 percent said that they were intentionally misled by a healthcare provider.
  • 20 percent of respondents said they sued because their child wouldn’t be able to have a future.
  • Another 20 percent said they filed a claim to get more information that they felt had been withheld from them.
  • 19 percent of respondents filed because they wanted to prevent future errors or get justice for their malpractice injury.

As this study shows, out of 127 families surveyed, a majority of malpractice cases were filed at the advice of a medical professional or because a family either needed money or felt they had been misled intentionally. Though the survey conducted was only on a small group, it shows that one of the top concerns facing Americans is the high cost of care which leads to legal entanglement in the hopes of mitigating the burden.

Power of Attorney

Another legal issue that many Americans face is obtaining acceptance as powers of attorney. About 63 percent of those surveyed by the Joint Editorial Board of Uniform Trust reported that they had occasional difficulty, with another 17 percent saying they had frequent difficulty. Having the power of attorney over healthcare is important if an individual is incapacitated and unable to make healthcare decisions for themselves. When family members have difficulty being accepted in this role, it can lead to unnecessary stress, especially if the problems are occurring in the middle of a medical emergency. If the power of attorney is rejected, it’s often up to the family to seek out a lawyer to help them get approval. These difficulties, coupled with the challenges of haggling with insurance companies or navigating healthcare costs upfront, contributes to the growing frustration and outright avoidance of medical intervention for potentially treatable issues and concerns.

The Debate in 2020

As we’ve discussed, healthcare is one of the foremost debate topics of the 2020 election, but voters need to understand the differences in the plans that are being put forth. Universal coverage, for instance, would attempt to provide insurance for all American residents. In other countries that have this system implemented, these services are paid for by either public or private programs, sometimes a combination of both. Alternatively, a single-payer healthcare system utilizes one entity — not necessarily the government — which pays for all healthcare services. Contrary to popular belief this is not a form of socialized medicine, which would instead consist of government ownership over all medical facilities, professionals, and payment plans.

That said, a majority of Americans are also split on how healthcare should be reformed, with most being concerned about the overall cost they are paying, as opposed to the system used to insure them. As of 2016, the United States has been spending twice as much as other Western nations on healthcare, with the U.S. spending 25 percent more than the second-highest spending nation, Switzerland. And a recent survey of voters in Iowa, South Carolina, and New Hampshire show that voters there are more concerned about out of pocket costs and not the insurance coverage itself.

Different Ideas

Both parties have various solutions on how to fix the rising costs of healthcare, though even along party lines there are not concrete agreed on solutions. Most in the Democratic party wish to see the government play a larger role in healthcare, while Republicans are rallying for less government interference and more free-market programs. Both solutions bear weight, though unless a solution can be agreed upon, healthcare will likely remain a hot debate topic for decades of elections to come.

In addition to access to care, there are also different ideas about types of care. Long-term care, mental health services, and addiction rehabilitation have also become hot button issues that hopeful candidates are talking about this election season. Once again at the heart of these problems lies the cost of care and accessibility. Mental health and addiction services, in particular, are areas in which the healthcare system is severely lacking. Even as though some candidates have put forth plans for reform in these areas, only a few have devised plans regarding Americans in rural areas and those living with disabilities.

What Can Be Done to Mitigate Difficulty in Accessing Care?

First and foremost the healthcare system needs to be reformed to match the current needs of American citizens and it needs to be done in a way that the common public can understand. This means removing unnecessary jargon and instead laying out healthcare plans in a way that doesn’t exclude individuals without a medical degree. Often families have the most difficulty when it comes to trying to understand exactly what their insurance plans cover and what all they are being charged for. This confusion can lead to people being overcharged for services and paying more simply because they cannot understand the ins and outs of the current medical system.

Furthermore, there needs to be a collective move to bring down the price of necessary treatments and drugs to ensure that they are both accessible and affordable for every American. Because cost is the number one concern of voters in this election, this issue is likely to be the one talked about and targeted the most. Until healthcare costs can be reigned in, we will likely continue to see the same aversion to care and the denial of treatment in fear of debt accumulation that we have seen for the past decade.

While these changes are likely to not be seen immediately, what we can do now is not hesitate to ask questions and demand answers to all of our healthcare concerns. If you don’t understand your current policy and feel that you are underinsured, speak to your insurance company and ask them to explain your policy in full.

If you’re currently without insurance and need care, you can call doctors, hospitals, and urgent care centers in your area and ask for prices. Often urgent care centers offer faster and more affordable care than hospitals or doctor’s offices. You can also ask your doctor to prescribe a generic version of a prescription you need or use a discount app to save on the cost.

The healthcare system is tricky at best to navigate, but if people continue to speak up about their difficulties, it’s likely that soon there will be a solution reached that can better benefit the American people.

Is America’s Healthcare Ready For The Silver Tsunami?

With the Baby Boomer generation aging and gradually having advanced healthcare needs, America seems like it’s going to have a hard time keeping up. The so-called “silver tsunami” isn’t a natural disaster that causes flooding, but rather a test of the United States’ healthcare capacities. This tsunami carries a hefty amount of power just like its natural namesake, as it could potentially force change in the U.S over time. Already, the impacts of generational population sizes are beginning to show where the weak points are in the nation’s care options.

Baby Boomers Aging

Every generation has some natural fluctuations in numbers, but the Baby Boomer generation has been notoriously large. Because of this, many current systems in place are unequipped to deal with the generation’s large numbers. Now, as the generation ages and the Silver Tsunami approaches, more members of the generation will require additional medical intervention.

Many of these medical needs are fairly commonplace, such as hearing aids and similar assistive devices. More than 10 million people in the U.S. use hearing aids. However, with more strain being put on the nation’s healthcare system, some Boomers are falling through the cracks. This neglect can have a major impact on the health of Boomers, especially in the face breakouts of diseases. The common cold may be easy enough for an older American to overcome since the average person makes a full recovery in about 10 days, but viruses like influenza and measles pose a serious danger. If at-risk seniors don’t have access to the vaccines and care they need to fight afflictions like these, they could lose their lives.

Cracks In System Exposed

With more people relying on healthcare and even assisted living, more problems with the systems currently in place are being exposed. In some cases, this can take the form of highly costly procedures that are necessary for comfortable aging. This is particularly true of complicated interventions, such as cardiopulmonary bypass. Gibbon developed the cardiopulmonary bypass in 1953, and it’s still often a necessary measure in healthcare. The high cost, unfortunately, leads many individuals to not receive the care they need to live longer, healthier lives.

Cost isn’t the only harmful element of the current American healthcare system. When it comes to treating the elderly, malpractice and even abuse occur at alarmingly high rates. Elderly patients often lack necessary representation and advocacy when it comes to their care. A recent study estimated that only one in 14 cases of elder abuse are ever reported to authorities. With an aging population, the United States will be in need of better, more reliable care for the elderly.

Preparing Future Healthcare

Luckily, some are taking steps to begin preparing for the Silver Tsunami today. Improving the nation’s healthcare system will take time, and as the next presidential election approaches, healthcare will continue to be a subject of debate. However, some areas across the nation have already begun training additional medical care staff in order to prepare for the needs of an older demographic of patients. With improved training and changes to healthcare, it’s possible that medical treatment across the board will become more affordable. This could even extend into procedures often seen as aesthetic in nature; today, some four million Americans are wearing braces, according to the American Association of Orthodontists. With potentially drastic measures needed to make healthcare affordable enough for the vast aging population, it’s possible that healthcare could gradually become more affordable.

With the Baby Boomer population aging rapidly, adaptations in healthcare must be created in order to accommodate the increased demands. Currently, the healthcare system will struggle to care for everyone reaching their elderly years. In the years to come, the United States will need to adapt in order to care for all of its elderly citizens effectively and affordably.

Ron Johnson’s Obamacare Lawsuit Is Becoming Messy — For Him And The Far Right

As Republicans slowly retreat from their war on the Affordable Care Act, ultra-conservative Wisconsin senator Ron Johnson’s Obamacare lawsuit is threatening to turn into one more headache they would prefer to forget.

In January, Johnson filed a lawsuit against an Obamacare measure allowing the federal government to contribute to the premiums of lawmakers and their staff who acquire health plans through the exchanges. Since the filing, The Washington Post reports an additional 38 GOP lawmakers – including Tea Party senators Ted Cruz (R-TX) and Tom Cotton (R-AR) – have joined the suit, which is being represented by the nonprofit Wisconsin Institute for Law & Liberty.

After much speculation concerning just how the lawsuit would be financed, a Milwaukee Journal Sentinel report now reveals a retainer agreement reached between Johnson and the institute. The agreement specifies that Johnson will use campaign funds to pay for the lawsuit once the conservative organization submits its legal bills.

In an amusing twist, however, this arrangement has raised legal troubles for Johnson. According to the Associated Press, the liberal watchdog group One Wisconsin Now claims that the senator failed to file the necessary forms required by state campaign finance laws. The group’s executive director, Scot Ross, now wants Johnson to report the specific details of the agreement reached between his campaign and the Institute. Ross also plans on filing a complaint with the Federal Election Commission, which can easily become a huge nightmare for Johnson if One Wisconsin Now’s allegations are accurate.

Meanwhile, the Justice Department has already asked a federal judge in Wisconsin to dismiss the lawsuit brought by Senator Johnson. As the Department points out, Johnson and other co-signers of the suit – some of whom have purchased their own private health insurance or have obtained coverage through a spouse’s plan – were never “directly injured” by the Obamacare measure and therefore lack legal standing to sue.

Further complicating the lawsuit is the opposition Johnson faces from other members of the Senate Republican caucus who think the lawsuit is frivolous and even potentially damaging to Congress.

With the exception of the lawmakers who joined the suit, the GOP has backed the Affordable Care Act measure that allows members of Congress and their staff to receive employer contributions to their health care plans. The concept behind the provision is certainly not new: Workers in the private and public sectors often receive similar health care subsidies.

From his home state, Representative James Sensenbrenner (R-WI) accuses Johnson – who calls the employer contributions “special treatment” — of dangerously negligence in his decision to file the legal action. “Success in the suit will mean that Congress will lose some of its best staff,” Sensenbrenner warned back in January.

The congressman’s greatest fear is that without employer subsidies, congressional staffers will leave their jobs and force legislators to replace them with “recent college graduates who are still on their parents’ insurance.”

According to The Hill, Johnson recently suggested that Sensenbrenner’s position on the lawsuit has softened. Yet others on the right are remaining mum — another sign that the Republican attitude toward health care reform is more nuanced and careful than a year ago.

Photo via Wikimedia Commons

Want to keep up with the news from Capitol Hill? Sign up for our daily newsletter!

GOP Quietly Backing Off Obamacare Fight

Republicans hardly ever admit defeat, but that doesn’t mean they are always victorious. In their fight against the Affordable Care Act, they are losing and silently retreating.

The right has waged war on President Barack Obama’s health care legislation since well before the reform even took effect. And following the troubled launch in October, the GOP appeared confident that it had won.

In more recent months, however, increased enrollments and reduced numbers of uninsured Americans across the country have signaled a turning point in the fight over covering the uninsured.

As a new CNN/ORC International Survey poll released Sunday finds, even as the public maintains an unfavorable view of Obamacare’s success, an overwhelming 61 percent say they do not want the law repealed. And while 49 percent of those who say they want to keep it admit they would like to see some changes, 51 percent of Americans surveyed believe that the “current problems facing the health care law” will eventually be solved.

The White House shares Americans’ optimism that the law will eventually run more smoothly, touting the 8 million Obamacare enrollments by the end of April. Additionally, recent data released by several insurers finds that most newly insured Americans are, indeed, paying their premiums.

An obvious marker of this progress is, as The Hill notes, the House’s legislative schedule for the coming weeks. According to The Hill, House Republicans have not scheduled a single vote or hearing on Obamacare and not one House Committee has announced plans to continue attacking the law through hearings.

That’s not to say that Obamacare has suddenly found a new ally in the GOP. Republicans will certainly continue their assault ahead of the 2014 midterm elections. But the political barbs are becoming less frequent and less aggressive. Not that the GOP wants to admit it.

“There is absolutely zero evidence that any Republican is talking about Obamacare less,” National Republican Senatorial Committee spokeswoman Brook Hougesen told The Hill.

But the legislative shift makes it hard to deny that conservatives have been increasingly and uncharacteristically mum on the issue. It could be that the GOP has not stopped focusing on Obamacare, but merely has moved on to other issues. Or it could be that Republicans are, as Democratic Senatorial Campaign Committee spokesman Justin Barasky puts it, “beginning to abandon their failed strategy of wasting millions attacking Democrats on Obamacare.”

But fear not: Republican politicos still have plenty of talking points for the rest of 2014. Their current favorite “scandal” — Benghazi — will take over from here.

AFP Photo/Robyn Beck

Want to keep up with the latest Obamacare news? Sign up for our daily email newsletter!