Checking the pulse of Obamacare

first_img Related GAZETTE: What about the insurers who are pulling out of the program? Will that increase costs? BAICKER: The goal of having privately provided insurance through an exchange is that insurers will compete for enrollees by offering higher-quality benefits at a more affordable premium. If you don’t have competition there’s very little advantage to having a marketplace. If insurers drop out to the point that there aren’t enough competitors, that could have real negative consequences in terms of the value of the plans that are being offered. And I think we did see that some of the withdrawals were relatively new insurers with relatively small books of business who came in with low premiums — thinking that they were going to be able to provide a really lean, competitive benefit — but discovered that their premiums were too low, and that they couldn’t continue to participate in the market. That pushes premiums up and competition down. And certainly too much consolidation on either the insurer side or the provider side undermines the competitive pressures that we would like to be driving higher value benefits and lower premiums. So that’s a real concern.GAZETTE: Another critical issue is that too many young people are choosing to pay the penalty instead of signing up in the exchanges. What do you think the fix is there?BAICKER: That’s definitely a related issue. Insurers price their policies based on their guess about who is going to enroll. If young healthy people don’t enroll, then it’s going to be more expensive per enrollee to cover the people who are left, and premiums are going to be higher.What’s the fix? My suspicion is that it may not be clear to people what subsidies they are eligible for, what the advantages of being insured are, what policies are available to them at what net premium. Making sure people are aware of those benefits is necessary but may not be sufficient. Even people who are aware may not be signing up, and maybe the penalties are not high enough. It might be that the benefits of being insured are not clear enough. It’s difficult to perceive the advantages of being insured if you don’t end up using your health insurance benefits in a given year. The financial protection that insurance provides is a pretty abstract thing if you are not sick. That’s really hard for people who are young and healthy to internalize.GAZETTE: Is the public perception of the effectiveness of the ACA a concern? A recent poll by Politico and the Harvard T.H. Chan School of Public Health found that a majority of voters say the law is failing. How will that affect efforts at reform?BAICKER: There are clearly some misconceptions about what’s going on in health care markets. What policies are available and how much people have to pay for them is not very clear from the coverage that you read. Also, there are millions of people who are insured now who weren’t before. So when you asked whether the ACA is working, it depends on what your goals are. Is it working to increase health insurance coverage? Yes. Is it working to slow health care spending growth? Much less clear.GAZETTE: What are some of the things that analysts agree could be improved?BAICKER: Some states have expanded their Medicaid programs and some haven’t. There’s an opportunity for more flexible options in expanding coverage for low-income populations, whether it’s private versions of Medicaid coverage offered through things like exchanges, or other kinds of Medicaid waivers. There’s also an opportunity to improve continuity of coverage for low-income populations with variable income. Having people transition from Medicaid to subsidized exchange plans and back again creates discontinuities in coverage that are both expensive and potentially harmful for health. Those could be addressed. There are also gaps in coverage that I think were not intended by the original law, either because some states didn’t expand Medicaid or because of the specifics of drafting that may not have been intended — for example, defining the affordability of coverage based on a single policy versus a family policy. When you look at any large-scale, complicated new program — whether it’s Social Security or Medicare and Medicaid or the Affordable Care Act — there are inevitably lots and lots of things that need to be refined in the years that follow. There were lots of changes to the Medicare law after it was initially implemented. I think there are parallel changes needed in the Affordable Care Act that would make it work much better than it does now. And if there isn’t willingness to address some of the technical fixes, that’s really problematic for having it function well.Interview was edited for length and clarity. From the very beginning, the Patient Protection and Affordable Care Act (ACA), President Obama’s signature piece of legislation, has been beset with problems: bitter debate among lawmakers, a Supreme Court challenge, and crippling technical difficulties with sign-up site Healthcare.gov, to name a few. More recently, insurers have been pulling out of the law’s insurance exchanges, and just last week the federal government announced that the cost of some health care plans would jump next year by 25 percent. Still, some 20 million more people have health insurance thanks to the ACA, and the new law prohibits insurers from denying coverage to people with pre-existing health conditions. To assess the ACA landscape the Gazette spoke with Katherine Baicker, the C. Boyden Gray Professor of Health Economics at the Harvard T.H. Chan School of Public Health.GAZETTE: Do you think the Affordable Care Act has worked? Has it achieved the goals that the president and Congress set out for it?BAICKER: I think there were two goals, broadly speaking. The first was to get more people covered with affordable health insurance and the second was to slow the rate of health care spending growth.I think a lot of progress has been made toward the first goal, if not covering everyone. The number of uninsured people has been reduced through expansion of Medicaid and subsidized health insurance plans through the health insurance exchanges. That in some ways is the easier goal, even though it’s expensive and is perhaps is more expensive than some people had hoped — we fundamentally know how to get people health insurance. You have to make affordable plans available, and you have to suitably encourage people to be enrolled in those plans.The much harder goal is slowing the growth of health care spending. And really, the goal shouldn’t be to spend less on health care, the goal should be to get high value for what we are spending. We frequently talk about spending less, which is shorthand for having spending grow less quickly. And what we really mean is spending less for every unit of health we are getting. So the shorthand can sometimes be misleading about what the real goals are — improving value in the health care system. And that’s a much harder nut to crack. How do you discourage spending on care that’s of low value, while ensuring that there’s really good access to care that’s of high value, particularly for low-income populations? A number of strategies have been deployed, but they have had mixed success. It’s also much harder to know the effects of those levers — to assess what trends in health care spending can be attributed to the ACA versus not.GAZETTE: What are the main drivers of medical costs and what if anything can be done to reduce the rate of growth?BAICKER: First of all, the main driver of health insurance premiums is health care utilization. We use a lot more health care resources in the U.S. than some other countries do. We use a lot more resources in some parts of the country than we do in others. And all of that is evidence that we could be getting better value out of the system. There are pockets of the U.S. where people are getting really high-quality care at a lower cost with better outcomes. And those are models for parts of the country where we seem to be spending a lot more money and not achieving the health outcomes that we could. Part of it is the disconnect between the people who pay for health care and the people who make the decisions about the health care that’s used. And that can be about insurance and what it covers with what co-payment; it can be about providers’ decision-making; and it can be about patients not having the information they need to decide what care is really right for them.GAZETTE: Data released by the federal government indicates some premiums will rise 25 percent in 2017. In addition, a number of insurers have pulled out of the program. What do those factors mean for the ACA moving forward?BAICKER: It’s important to realize that the premium increases people are talking about are for a very specific subset of of health insurance policies: those sold on the health insurance exchanges, the non-group market. It’s not about the premiums people are paying for employer plans. It’s not about people who are covered by Medicare or Medicaid. It’s a pretty narrow slice of the population we are talking about. That doesn’t mean it’s not important — it’s just that sometimes people think that means everybody’s health care costs are going up by 25 percent and that’s just not what’s happening.Most of the people who get health insurance through the exchanges are heavily subsidized, with premium and cost-sharing subsidies. So individuals’ costs are not going up as much as the total premiums are going up. That means it’s going to be more expensive for the federal government as the subsidies are going up commensurately with premium increases.GAZETTE: So that cost falls to the taxpayers.BAICKER: Yes, more expensive for the government equals more expensive for the taxpayer — either today or tomorrow, depending on whether it’s financed through deficits or current taxes.GAZETTE: So why are these premiums going up?BAICKER: Some of it is about general rise in health care spending, but some of it is really specific to the way the health insurance exchanges were implemented and phased in. For example, because it was a new market, because insurers were entering an exchange that didn’t exist to cover a population that hadn’t been covered, there was a lot of uncertainty about how much it would really cost to deliver health insurance to that population. So the law had subsidies to protect insurers against unexpectedly high costs: reinsurance. As those subsidies phase out, premiums will necessarily go up because the cost of that insurance for very high-risk people is being transferred from the federal government to the insurance plans. Another part of it was that some insurers might have priced their premiums too low in the beginning, making guesses about who was going to be covered and how much those people were going to cost. The costs of inequality: Money = quality health care = longer life Federal insurance has helped many, but system’s holes limit gains, Harvard analysts say last_img read more

Junior battles cancer, researches disease

first_imgJunior Courtney Rauch is a student researcher. For the past two years, she was also a breast cancer patient. Rauch works with Dr. Steven Buechler, the chair of the Department of Applied Mathematics and Statistics, to compile and organize data about breast cancer treatment. “He’s doing research where he’s not really finding a cure for cancer, but he’s finding out ways to group breast cancer patients so you know which treatment … they would respond to,” Rauch said. “The way it is now, a lot of people get chemo when they don’t actually need chemo. The chemo isn’t necessarily the best treatment to help them.” Rauch spent the last two years splitting her time between surgery and student life. She is now cancer-free. ND Minute spent some time with Rauch to learn about her “let’s fix it” attitude, her love of math and her experience with breast cancer. “It’s kind of given me the mentality that you don’t wait for things,” Rauch said. “I try to make the most out of everything that I do here. Coming in, I knew I only have four years here and I have to make the most of college, but the fact that I had to miss school and occasionally I thought I would have to stay home an entire semester … I dedicate myself to everything I do as much as I can.”last_img read more

Alex Jennings to Play Willy Wonka in the West End

first_img View Comments Jennings is the only performer to have won an Olivier Award in the Drama, Musical and Comedy categories, winning Best Actor for Peer Gynt, Best Actor in a Musical for My Fair Lady and Best Comedy Performance for Too Clever By Half. His other stage credits include Untold Stories, The Habit of Art, Stuff Happens, The Winter’s Tale, The Relapse, Hamlet, A Midsummer Night’s Dream, The Liar, The Wild Duck, The Importance of Being Earnest, and The Country Wife. Based on Roald Dahl’s dark tale of young Charlie Bucket and the mysterious confectioner Willy Wonka, the musical centers on what happens when Charlie wins a golden ticket to the weird and wonderful Wonka Chocolate Factory. Beyond the gates astonishment awaits, though the five lucky winners discover not everything is as sweet as it seems. Charlie and the Chocolate Factory features a book by David Greig and music and lyrics by Tony winners Marc Shaiman and Scott Wittman. Douglas Hodgecenter_img Three-time Olivier winner Alex Jennings will replace Douglas Hodge as Willy Wonka in the West End’s Charlie and the Chocolate Factory. Hodge has played the role of Wonka, the strange owner of a sweet factory, since the musical adaptation opened in June 2013. Jennings is set to begin performances on May 19. Directed by Sam Mendes, Charlie and the Chocolate Factory continues its record-breaking run at London’s Theatre Royal Drury Lane. Star Fileslast_img read more

Compostable products company settles deceptive packaging claims

first_imgAttorney General, September 27, 2011 Penley Corporation, based in West Paris, Maine, has agreed to settle claims by Vermont Attorney General William H. Sorrell that the company violated the state’s Consumer Fraud Act by misrepresenting the availability of local composting options for its Full Circle line of ‘compostable’ cutlery. The settlement requires Penley to pay $10,000 to the State of Vermont in penalties and costs, and another $10,000 to the Northeast Organic Farming Association of Vermont (NOFA Vermont) to support its Harvest Health Coupon Program.Commenting on the settlement, Attorney General Sorrell said that Vermonters care about responsible disposal, including the compostability, of consumer products, and need to be able to rely on sellers’ claims about how those products may be disposed of. ‘If most Vermonters can’t compost an item in the state, then advertising the item as ‘compostable’ is deceptive,’ he said.Starting in June 2007, Penley marketed a ‘Full Circle’ line of cutlery that was capable of being composted in a professionally managed municipal or commercial facility. The Full Circle packaging bore prominent references to compostability, including the term ‘compostable!’ in sizable red type in two places, and a boxed Biodegradable Plastics Institute/US Composting Council logo next to a third, capitalized, ‘COMPOSTABLE.’In fact, there are few municipal or commercial facilities in Vermont that accept compostable cutlery, and most Vermonters have not had, and do not have, practical access to such facilities. And while the Full Circle cutlery packaging did state that municipal or commercial composting facilities ‘may not exist in your community. Check to see if they do.,’ this disclosure was printed in an almost unreadably small five-point typeface on the back of the package.It is estimated that retail sales of Full Circle cutlery in Vermont totaled between 7,920 and 13,776 boxes, for which local consumers paid a total of between $10,216 and $17,771. Penley’s settlement with the Attorney General’s Office prohibits the company from representing to the public, directly or by implication, the compostability of any products sold in or into Vermont unless (a) there are municipal or commercial facilities reasonably and practically available to a substantial majority of Vermont consumers, which facilities accept those products for composting; or (b) there is a prominent disclosure on the product packaging of the absence of such facilities that is proximate to the compostability claim and is no smaller or less visible than the claim itself.Penley’s payment to NOFA Vermont will support a program that offers matching coupons as an incentive to 3SquaresVT (formerly Food Stamp) recipients to buy healthy, farm-fresh foods at over 30 local farmers’ markets. last_img read more

Three reasons not to conduct a marketing audit

first_imgDon’t conduct a marketing audit because you are already happy with your marketing budget. If you already know how well your marketing budget addresses the rapidly-changing financial products and services marketplace and you are content with the amount of your marketing budget, you probably shouldn’t conduct a marketing audit. continue reading » There are plenty of good reasons to conduct a marketing audit (the On The Mark Strategies proprietary method by which your bank or credit union takes an intensive deep-dive look into its marketing strategies and tactics). However, there are also many good reasons not to conduct a marketing audit at your bank or credit union.Here are three:Don’t conduct a marketing audit because you already know what your competition is doing. If you already know what the other banks, credit unions and non-traditional competitors in your area are doing when it comes to consumer engagement, branding, marketing and experiential design, you probably shouldn’t conduct a marketing audit. ShareShareSharePrintMailGooglePinterestDiggRedditStumbleuponDeliciousBufferTumblrlast_img read more

Health center fundraiser offers chance to pocket $3,000

first_imgBATESVILLE, Ind. – Reservations are currently being accepted for the second annual Draw Down Fundraiser, presented by the Ripley County Community Foundation.Proceeds benefit the Southeast Indiana Health Center, an organization that provides local medical care to those who can’t afford it.The fundraiser will be held at the Batesville Knights of Columbus on Saturday, January 10.Ticket cost is $20 and includes entry into the drawing, a chicken dinner, dessert bar and draft beer. A raffle, split-the-pot and pull tabs will also be available. Organizers said there is a chance to win $3,000Purchase tickets by calling (812) 934-5242.last_img

Area High School Basketball Scores

first_imgWRBI Area Basketball Scores.Tuesday (1-20)Girls Scores.Jac-Cen-Del  64     Switz. County  59South Ripley  51     South Dearborn  27North Decatur  49     Milan  36South Decatur  69     Edinburgh  57Lawrenceburg  42     Franklin County  32Greensburg  65     Hauser  59Rising Sun  41     Southwestern  34Shawe Memorial 44  Trinity Lutheran 40Madison  70     Scottsburg  58Boys Scores.Rushville  74     Oldenburg Academy  58Connersville  40     New Castle  37last_img

June 10, 2018 Police Blotter

first_imgJune 10, 2018 Police Blotter 061018 Decatur County EMS Report061018 Decatur County Jail Report061018 Decatur County Fire Report061018 Decatur County Law Report061018 Batesville Police Blotterlast_img

INDOT offers scholarships for aspiring engineers

first_imgIndianapolis, In. — The Indiana Department of Transportation (INDOT) is offering scholarships as well as paid employment during summer breaks and upon graduation to civil engineering students.INDOT’s scholarship program offers students $3,125 per semester or $2,083 per trimester for up to five years of post-secondary civil engineering education. Students can use scholarship funds for education expenses, fees and textbooks. In return, scholarship recipients work for INDOT in full-time, paid positions during their summer breaks and upon graduation.Qualified students must be accepted to or enrolled full time in one of Indiana’s certified civil engineering schools. Eligible schools include Purdue University Fort Wayne, Purdue University, Rose-Hulman Institute of Technology, Trine University, University of Evansville, University of Notre Dame, University of Southern Indiana and Valparaiso University.Applications for the 2019-2020 academic school year must be submitted by Dec. 31, 2018, and can be completed at www.INDOTScholarship.IN.gov.To learn more about INDOT’s Engineering Scholarship program, click here. Parents or students with questions about the process can contact Workforce Development Manager K.D. Thurman at talentmanagement@indot.in.gov or 317-234-8551.last_img read more

Injured Hazard brothers out of Belgium’s Euro 2020 qualifiers for now

first_imgRelatedPosts Chelsea complete signing of German international Dortmund ease past Wolfsburg to stay in title hunt Dortmund explode back into action as Bundesliga restarts Eden Hazard and his brother Thorgan will miss Belgium’s Euro 2020 qualifiers against San Marino and Scotland through injuries, the Belgian football association said on Wednesday. The pair reported to the team camp in Tubize on Tuesday for medical checks which confirmed Eden is suffering from a muscle strain while his younger brother has a rib injury. Eden has yet to make his league debut for Real Madrid since his move to Chelsea because of the injury. No replacements have been named by coach Roberto Martinez. Belgium, who have won their opening four qualifiers in Group I, play in San Marino on Friday and then Scotland at Hampden Park on Monday. Reuters/NAN.Tags: Belgian Football AssociationEden HazardSan MarinoThorgan HazardTubizelast_img read more