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Researchers Use Income Of Three Times Poverty Level As Affordability Threshold; Alternative Measures Show Coverage Out Of Reach For Even More Uninsured People

Bethesda, MD -- More than half of the nation's uninsured residents are ineligible for public programs such as Medicaid but do not have enough resources to purchase coverage themselves, researchers from the Urban Institute report in a Health Affairs Web Exclusive published today. The report was funded by the Robert Wood Johnson Foundation.

Of the 44.6 million uninsured Americans, 56 percent are ineligible for public programs and have insufficient incomes to afford coverage on their own, the researchers report. Another 25 percent of the uninsured are eligible for public programs, and the remaining 20 percent have incomes high enough to afford coverage.

"Sometimes you hear arguments that all but a small minority of the uninsured could either purchase coverage or are already eligible for assistance," said lead author Lisa Dubay, now a research scientist at the Johns Hopkins Bloomberg School of Public Health. "But our study shows that the affordability problem is far more serious than that."

Continue reading More Than Half Of Uninsured Americans Cannot Afford Coverage And Are Not Eligible For Public Programs


The New York Times is reporting that the health insurance industry is proposing an expansion of Medicaid and new tax breaks to expand coverage to virtually everyone within 10 years.

More than few people would argue that Medicaid is barely functional now. Witness that many physicians and hospitals refuse to take these patients because the government does not reimburse enough to even cover the cost of health care. So, without new funding mechanisms, isn't this proposal simply a way to quietly shift the cost to providers who in turn will pass it on to private insurers who in turn, will pass it to, yep, the employees paying for health insurance. What will happen then? Higher co-pays, higher deductibles, more $$ paid by working individuals. In name, we will achieve universal coverage, but will it help the U.S. achieve what should be the real goal? Universal HEALTH?

Continue reading Disingenuous? Ya think?


By Curious George

I’m new to this field as a professional working in health care. Up ‘till now, I’ve only been its victim of its explosive costs; albeit one who has been brilliantly cured, helped and mended many times.

Before daring to make any suggestion about reform, however, I’d love to hear from others to see if I understand the problem. I’m a little confused. Do I have the following view of the situation right?

The United States is the last industrial nation that can’t seem to take care of the health needs of about a quarter of its population without squawking and sacrifice.

Despite this, we have a de facto health education system that ensures a constant undersupply of trained professionals in such a way as to guarantee constant demand and a large reading audience for such waiting-room pillars of culture like People and Us magazines.

Despite this undersupply, we’ve constructed a health care education system that guarantees the vast majority of graduates are so far in debt that their only choice is to become workaholic slaves to health care plantations. Of course, with steady work and a diligent effort they can clear themselves of this debt in time to realize that their only remaining choice is to stay in the system, make more money, and pledge that no one rocks the boat.

And setting the national health agenda, we have two giant industries whose only concern is our well-being: insurance and drugs. With record-breaking profits from an otherwise dysfunctional system, these two industries spread their wealth with obscene management salaries and much-needed gifts, contributions, golf and travel for our poor, over-worked elected leaders.

So, perhaps you can understand why I’m confused. Where’s the problem?

Continue reading Help!


By Mónica Arce

I have found it very interesting that there is a lot of talk about reducing costs, and that our health care system's survival depends on it.  I would like to know what percentage of the expenses of the Oregon Health Plan and federal health programs pay for maternity care, including prenatal care, labor and delivery and postpartum.  The use of nurse-midwives has been shown in several studies to reduce the amount of interventions during labor and delivery.  Midwives have outcomes that are the same or better than Ob/Gyn doctors.  I would like to see more talk about the money-saving advantages of hiring and using more midwives in our hospitals and community health care centers.

Homebirths have also been shown to be as safe as hospital birth and use less interventions in birth, keeping costs down.  Several countries around the world with better mortality/morbidity rates than the United States use midwives as their primary care providers for pregnant women, and only have Ob/Gyn doctors when a pregnancy becomes complicated or high risk.  I would like to see more conversation around this issue.

Continue reading Midwives: cheaper and better?



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