Why does health insurance vary state to state

[mykidslovedogs]

This evidence shows that the US ranks average to high (that is, a poor showing) for cancer deaths. Can you please provide a link to where your contrary data come from?

Martha, thanks for collecting those numbers. Did you see anything to confirm my impression that uninsured status is steadily working its way well beyond the indigent population and deep into the middle class sector?

I did post the link on my last post, but you must have missed it:


http://www.cancer.org/docroot/NWS/c...Compares_U_S__and_European_Survival_Rates.asp

 

[Rich_by_the_Bay]

I did post the link on my last post, but you must have missed it:

http://www.cancer.org/docroot/NWS/c...Compares_U_S__and_European_Survival_Rates.asp

Got it. I've seen that study and find it interesting -- it has been discussed at some length. It is a legitimate study.

Not to get technical, but 5 year survival rates are not the same as death rates, so it may be that both surveys are accurate though measuring different phenomena. One explanation is that care in the USA is better (I'd like to think so since it is close to my heart). Another is lead time bias (earlier diagnosis from, for example, excessive use of CT scans, creating a false sense of improved survival whereas in reality you just have a longer time of awareness and worry -- depends on the type of cancer) which the authors acknowledge. Finally, it may be that the survival improvements we achieve here compress death rates toward the end of the expected survival range rather than deaths distributing themselves more evenly year by year; this is generally desirable but not always since the quality of life cost of intensive treatments may not be worth it to all patients.

It is also plausible in the survey I cited that deaths from other causes will lower the apparent death rates from cancer. This situation is not a net "win" of course. Complicated stuff.

Interesting, but none of this is responsive to Martha's excellent post.

 

[Martha]

This evidence shows that the US ranks average to high (that is, a poor showing) for cancer deaths. Can you please provide a link to where your contrary data come from?

Martha, thanks for collecting those numbers. Did you see anything to confirm my impression that uninsured status is steadily working its way well beyond the indigent population and deep into the middle class sector?

From the 2004 Census, it appears that families with incomes between $50,000 and $75,000 is the fastest growing group of uninsured. Also, from the Kaiser 2005 employer health benefits survey, the percentage of employers offering insurance has decreased every year for the past six years, almost entirely in the small group market, with 40% of employers not offering any health insurance. Interestingly, 98% of employers which have 200+ employees offer health insurance. A lot of this is about bargaining power.

Many small to mid size employers I have talked to in the course of my employment would be delighted with national healthcare. The cost to employers in the small group market is becoming unaffordable for many. The employers who do buy insurance pass some of the cost on to employees in the form of higher deductibles, coinsurance and copays. This gets to the affordability issue, with increasing numbers of people forgoing important care due to cost.

 

[Martha]

Sorry, I missed in all my stacks of stuff that the Census Bureau recently revised its insurance figures as follows:

The revised estimates show that, in 2005, 44.8 million people, 15.3 percent of the population, were without health insurance – about 1.8 million fewer than the Census Bureau reported in August 2006. Based on the Current Population Survey, the original 2005 estimate was 46.6 million, or about 15.9 percent of the population .

 

[mykidslovedogs]

I wonder if there is any data available on the effects of community rating vs. rating flexibility in the small group market from state to state? Here is recent report regarding Colorado Legislation allowing rating flexibility in the small group market and how that has impacted losses of small groups in the state of Colorado. Ever since the rating flexibility legislation went into effect in 2003, we have seen a slowing or flattenting in the losses of small groups (this also coincides with a flattening of rates as well), and there has even been a slight uptick in 2006. See figure 9 of attached study:

http://www.dora.state.co.us/insurance/pb/rateflex07.pdf

 

[mykidslovedogs]

Doctors in Canada must elect to (a) join the public system or (b) work exclusively privately. There is no law that prevents me, as a Canadian citizen, from using and paying for the services of a private clinic such as this one if I choose to.

Apparently, not everyone in Canada has the ability or finances to opt out of the public system for private services. If it was that easy, I'm sure this person would have:

http://www.canorth.org/en/about/waiting.asp