That's Why They Call It An Emergency

Without insurance, people have more to worry about than covering a co-pay or a deductible. They have to pay for all of their procedures, tests, drugs and physician fees. If someone without insurance needs a procedure done, they now have a few online resources that may help them choose where to have that procedure done. I searched around the web for comparison sites, found a few, but the one that was the most comprehensive and user-friendly is Vimo.com (http://www.vimo.com/)

At Vimo.com patients can search for prices by procedure (even with or without complications), by hospital, doctor, and can also find competitive prices for drugs, dental work, and quotes for personal/group medical insurance or health savings account. Not only that, but they have an informational subset to their site where people can inform themselves on health care issues.

I decided to take Vimo.com for a test run. I wanted to find the facts for what an uninsured 20-something would pay if they had to have an emergency appendectomy. Mayo Clinic’s website says that appendicitis is an inflammation of the appendix; the appendix often becomes infected and requires surgery. Before or during surgery an appendix may burst and cause peritonitis, a serious infection. Vimo.com allows patients to get price estimates for surgeries that have no complications, mild complications or serious complications. I searched for a surgery with no complications and here are the results:

Average price for an appendectomy nationwide: $18,500
Number of hospitals in this average: 2,063

Spectrum Health Hospital in Grand Rapids, Michigan offers the lowest cost on average for an appendectomy at $7,800.

Spectrum Health performs about 14 procedures a year.

However, if the doctor at Spectrum Health found it difficult to diagnose the patient’s condition AND there were surgery complications during the appendectomy the total cost would skyrocket- it would cost about $24,800.

Now lets compare that to if the uninsured patient went Fairview University Medical Center, the ER of choice for many students at the University of Minnesota.

At Fairview, a patient can expect to pay about $18,000 for a general appendectomy and $38,200 for an appendectomy with a tough appendicitis diagnosis and surgical complications.

There is no reasoning for the price variations and Vimo.com didn’t break down what is included in the price they quote. Does it include anesthesia, doctor’s fee, Emergency room costs, antibiotics, pain medications? That is something that I, as a patient, would want to know before I gave the estimates any more credibility.

Of course, I wanted to see who was behind Vimo.com. Here is their “About Us” segment from their website.

“[Vimo.com was] Founded in 2005 by Internet industry veterans from WebMD and Valicert, Vimo is funded by Bessemer Venture Partners, Trinity Ventures, and Partech International. Vimo operates out of headquarters in Mountain View, California.”

I found that Bessemer Venture Partners has a hand in Sirtris Pharmaceuticals, Restore Medical, Endonetics, Circe BioMedical, Epic Therapeutics and CHD Meridian Healthcare among others. Unsure, but this may cause some conflict of interest issues.

Vimo.com could be used as a good tool for patients to gauge medical costs but should not be used as a definitive decision making tool . Still it is very important that uninsured people at any age understand how expensive an emergency medical procedure can be- and that’s why they are emergencies- unplanned and unfunded. Could you imagine spending somewhere behind $8,000-$38,000 tomorrow?

- Alex Harkness

Mike Huckabee's Health Care Ideas

Huckabee also takes a very different approach to health care. He argues the private sector should compete and bring down the cost of care. He disagrees with universal health care, though he concedes the current health care system is broken. He does argue for consumer-based health care rather than the focus on employer:

"The health care system in this country is irrevocably broken, in part because it is only a "health care" system, not a "health" system. We don't need universal health care mandated by federal edict. We do need to get serious about preventive health care. I advocate policies that will encourage the private sector to seek innovative ways to bring down costs.

I value the states' role as laboratories for new market-based approaches.
When I'm President, Americans will have more control of their health care options, not less.
As President, I will work with the private sector, Congress, health care providers, and other concerned parties to lead a complete overhaul of our health care system.
Our health care system is making our businesses non-competitive in the global economy. It is time to recognize that jobs don't need health care, people do, and move from employer-based to consumer-based health care."

See the link at the right for more information.
-Randi

John McCain's Health Care Plan

McCain has strikingly different view than both Obama and Clinton. He focuses more on making insurance affordable to everyone (isn't that what we are supposedly doing now?). He also emphasizes the importance of personal responsibility to one's own health, as well as promotion of competition among insurers to make health coverage affordable. He believes the fundamental problem with the American Health Care system has much more to do with the "rapidly rising cost of U.S. health care."

"John McCain is willing to address the fundamental problem: the rapidly rising cost of U.S. health care. Bringing costs under control is the only way to stop the erosion of affordable health insurance, save Medicare and Medicaid, protect private health benefits for retirees, and allow our companies to effectively compete around the world.

Families should be in charge of their health care dollars and have more control over their care. We can improve health and spend less, while promoting competition on the cost and quality of care, taking better care of our citizens with chronic illness, and promoting prevention that will keep millions of others from ever developing deadly and debilitating disease.
While we reform the system and maintain quality, we can and must provide access to health care for all our citizens - whether temporarily or chronically uninsured, whether living in rural areas with limited services, or whether residing in inner cities where access to physicians is often limited.

John McCain believes that insurance reforms should increase the variety and affordability of insurance coverage available to American families by fostering competition and innovation.
Reform the tax code to eliminate the bias toward employer-sponsored health insurance, and provide all individuals with a $2,500 tax credit ($5,000 for families) to increase incentives for insurance coverage. Individuals owning innovative multi-year policies that cost less than the full credit can deposit remainder in expanded health savings accounts.

Families should be able to purchase health insurance nationwide, across state lines, to maximize their choices, and heighten competition for their business that will eliminate excess overhead, administrative, and excessive compensation costs from the system.

Insurance should be innovative, moving from job to home, job to job, and providing multi-year coverage. Allow individuals to get insurance through any organization or association that they choose: employers, individual purchases, churches, professional association, and so forth. These policies will be available to small businesses and the self-employed, will be portable across all jobs, and will automatically bridge the time between retirement and Medicare eligibility. These plans would have to meet rigorous standards and certification.

We must do more to take care of ourselves to prevent chronic diseases when possible, and do more to adhere to treatment after we are diagnosed with an illness. Childhood obesity, diabetes and high blood pressure are all on the rise. We must again teach our children about health, nutrition and exercise - vital life information. Public health initiatives must be undertaken with all our citizens to stem the growing epidemic of obesity and diabetes, and to deter smoking."

Visit the link on the right for more information
-Randi

Karen Pollitz, Georgetown University Health Policy Institute

My phone interview with Karen, the project director at Georgetown's Health Policy Institute:

Karen's contact infromation:
Karen Pollitz - M.P.P.
Project Director
Georgetown University Health Policy Institute 2233 Wisconsin Avenue, NW, Suite 525 Washington, DC 20007
pollitzk@georgetown.edu

Why should you care?
"We excel in how noninclusive our health care system is."

Karen emphasized how dangerous it is for 20-year-olds to be without health insurance. Health care in the United States is extremely expensive and even something like a broken leg, could cost you a few thousand dollars. She also said 40% of 20-somethings are uninsured and are the group most likely to be uninsured. Why? Because many of them are college graduates in a transition stage. They graduate college $40,000 + in debt and the extra cash for health insurance is defiantly last on the list. This group is no longer eligible under their parents after they graduate college.
Karen also pointed out that right now the federal government isn't doing much to address this problem, " Our Health care system is built with holes in it and we need to fix it. This is not a new problem."
This election year will be critical for that. Some individual states are addressing the problem through COBRA (a program for people who are no longer defined as dependents) or some states are extending the definition of a dependent to 25 years old up to 30 years old.
For information on Minnesota's program go to:
http://www.healthinsuranceinfo.net/
Also, go to
http://www.kff.org/uninsured/index.cfm
or health care statistics.

-Randi

Slipping through the cracks (but at what cost?)

"We do have some people who are uninsured," says Ed Ehlinger, director of Boynton Health Services at the University of Minnesota.

Despite the U's best efforts to mandate that all students who take over 6 credits have health insurance, some people manage to slip through the cracks, usually by providing outdated or falsified insurance information. "Lacking insurance is a huge risk to the investments," Ehlinger says.

While the U requires health insurance, this is not necessarily common practice among colleges and universities. The Minnesota State Colleges and Universities (MNSCU), for instance, has a voluntary insurance plan. In the end, Ehlinger sees this policy as unwise. "We get better rates overall by having a mandatory insurance plan," he says. "You have to weigh individual benefits versus community benefits. It's best for the entire community because we can keep the rates low."

-Jessica

Cracks in the University Health insurance plan

As it was mentioned in a previous post, all U of M students who enroll in classes must either buy the University’s health insurance, which is added to your tuition, or provide proof of insurance from another insurance company. This is done as a way to ensure all students are insured in case of an emergency. However, this is not always the case. Some students have found a way to get around paying for student insurance.
Joy and “Sue” (who both wanted to remain anonymous for fear of having the University find out) do not have any insurance. Joy, a University junior, said last year when enrolling for classes, she didn’t want to have to pay for the U insurance because the tuition was already high, so she opted to provide proof of outside insurance. She said she used an expired insurance card from her last insurance company. Joy said the University never questioned her insurance eligibility because the insurance policy was valid at one point. When asked how she feels about being uninsured, Joy said she feels lucky that she has never needed to go to the doctor in the past year for an emergency or anything. She did say however that next fall when she registers for class, she might end up buying the University insurance just in case she needs it.
“Sue” is an international student in her senior year of college at the University. She said she also used an expired insurance card when she registered for classes in the spring semester. “Sue” said that she doesn’t see the need for University insurance because she has never needed it before. She said that after college, after getting a job, she will then sign up for insurance but with tuition and other college expenses, it doesn’t seem necessary.
According to the University’s OneStop Web site, any student who is registering for six credits or more is required to have insurance and violation of this policy is against the Student Conduct Code. There is a form located in the Web site for students to fill out, which describes the process of signing up for insurance.
“Fill in the name of your insurance company, insurance company phone number, and policy number, and sign the bottom of this form. If you do not provide complete information, you will be charged for the Health Benefit Plan. You may receive a full refund by returning this information to one of the student service centers or by accessing your student record through the Web by the end of the first week of classes. *This information is subject to periodic audits. Providing inaccurate or false information may result in unexpected charges. It is also a violation of the Student Conduct Code*,” as stated on OneStop.
The Student Conduct Code lists various polices that students are required to follow and the actions taken if they are broken. These range in severity starting from a written or oral warning to Expulsion and withholding a degree.
With such a large University, it is impossible to monitor every student to make sure they have valid health insurance. How many more are out there?
-Kelly