Showing posts with label Insurance. Show all posts
Showing posts with label Insurance. Show all posts

June 11, 2018

The Reason for US Life Expectancy To Have Gone Down {Inequality}

This statement should answer any question about the "inequality" on the title:
Who gets the best health care in this country(US or any country)? the ones that have all the money, not the best insurance. Insurance does not pay a Doctor to cure you but only to try not to hurt you and he/she most medicine you. You have to keep coming back to make this system keep going. Along the way, a particular congress paid by Insurance companies and an ignorant president decided the Insurance companies were not making enough money because there were too many people insured; So they even started to kill this system.

Living in the US increasingly looks like a health risk. Average life expectancy here dropped for the second year in a row, according to recent data from the Centers for Disease Control and Prevention. The grim trend stems from a toxic mixture of more drug- and alcohol-related deaths and more heart disease and obesity in many parts of the country. And it puts Americans at a higher risk of early death compared to their counterparts in other wealthy countries.
But what’s often lost in the conversation about the uptick in mortality here is that this trend isn’t affecting all Americans. In fact, there’s one group in the US that’s actually doing better than ever: the rich. While poor and middle-class Americans are dying earlier these days, the wealthiest among us are enjoying unprecedented longevity. 
So when we talk about life expectancy slipping, what we should also talk about is the growing problem of health inequality in America. And it’s an increasingly urgent discussion, health researchers are warning, because of policy changes on the horizon that are poised to make the mortality gap even wider. 
Some of these policies will hamper access to medical care (such as failing to fund CHIP, the health insurance program for low-income children) but others that aren’t even directly related to health care — like tax cuts — may have even more insidious effects on the American mortality gap. 

America’s alarming life expectancy gap 

The rich have long-enjoyed more longevity than the poor, but the gap in life expectancy has been widening in the US over the last few decades, along with other types of social and income inequality here. 
The CDC’s Division of Vital Statistics, which tracks mortality in the US, uses death certificates as the data source and doesn’t collect family income data. But we do have good data on the mortality gap and income from a study published in JAMA in 2016.  A group of researchers, led by Stanford University economist Raj Chetty, analyzed income data for the US population from 1.4 billion tax records between 1999 and 2014. They then compared it with mortality data from Social Security Administration death records. They found that, from 2001 to 2014, the richest Americans gained about five years of longevity, while life expectancy for the poor didn’t budge: 

Changes in race- and ethnicity-adjusted life expectancy by income group, 2001 to 2014.


 They also found that men who were among the top 1 percent of income earners lived 15 years longer than men at the bottom 1 percent. For women at the extremes of the income distribution, life expectancy differed by 10 years. At Vox, we broke their data down by state, and you can see that wealthier Americans are living longer than poorer Americans all across the country. (Here’s the data on men, but the same trends hold for women.)   his life expectancy divide between rich and poor Americans has been growing for decades. A report from the National Academies of Science looked at life expectancy by income groups between 1980 and 2010. In 1980, the richest cohort of middle-aged American men could expect to live until about 83 and the poorest, to 76. By 2010, the richest American males had gained six years in life expectancy, living to 89 on average, while life expectancy for the poorest men hadn’t improved. (The Washington Post has nice visualizations of the data in the report here.)

“Because we have widening income inequality and there’s a bigger gap between the haves and have-nots,” said Steven Woolf, a researcher at Virginia Commonwealth University who has been researching income and mortality. “We are seeing a bigger divide in mortality.” 

Tax reform and other Trump-era policies are expected to make the gap worse

This growing gap should be “a dramatic reminder of what actually affects our health,” Woolf added. 
We often think about health status in terms of access to doctors, hospitals, and medicines. But access to health care only accounts for about 10 to 20 percent of our health outcomes. Far more influential on our health is our socioeconomic status and certain health behaviors, like smoking, eating healthfully, and getting exercise.  
In Chetty’s study, for example, the researchers found that life expectancy among the poorest individuals was “significantly correlated” with health behaviors like smoking, obesity, and exercise. Poorer people are more likely to be overweight, smoke, and drink compared to their wealthier counterparts. Interestingly, these effects seemed to be mitigated in places that had enacted policies to curb poor health behaviors — such as anti-smoking laws or trans fat bans in cities. 
Right now, there are several policies on the horizon that are not only expected to hamper health care access but exacerbate income inequality — and widen the life expectancy disparity, David Blumenthal, president of the Commonwealth Fund, says. Blumenthal has written about the potential effects of the tax bill, which passed through the Senate in December, on low- and middle-income Americans in particular, and how it’ll disproportionately ding them while rich Americans and corporations will enjoy tax breaks:
Blumenthal told Vox, “We can expect ... to see the gap in life expectancy and health care outcomes between low- and high-income Americans grow in coming years if gaps in income increase.” 
Vox’s Dylan Scott and Alvin Chang have also argued that the tax bill — because of its tax breaks for the rich — “takes the wheel of America’s already-dramatic income inequality and presses the accelerator.” It’ll also repeal Obamacare’s individual mandate, resulting in an estimated 13 million fewer Americans with health insurance. That’s not to mention Congress’s failure to fund CHIP and its proposed cuts to Medicaid — health insurance programs for low-income American children and adults — both moves that have been endorsed by the Trump administration, 
So instead of just focusing on the overall decline in life expectancy, we need to start talking about these links between policy, and worsening income inequality and its relationship to the growing mortality gap. If we don’t, Woolf warned, we’ll fail to see the solutions to America’s early death problem.

August 5, 2017

In NY Insurance Has Denied HIV Med To a Gay Man Because His 'High Risk of Homosexual Behavior'

A patient applied for Truvada, FDA's only approved drug to prevent HIV infection, in July

The New York man received a denial letter citing his 'high risk homosexual behavior' as the reason
However, Truvada criteria state the drug should be covered for adults 'at high risk of sexually acquiring HIV-1'

HIV activism groups claim this is hardly the first case of a baseless denial
They also slam the language of the letter and 'down right discrimination'

United Healthcare has overturned the decision amid uproar over the letter
Dr Anthony Fauci, head of HIV at the NIH, told Daily Mail Online 'it seems like an inherent contradiction: PrEP was approved to prevent HIV for people at risk' 

An insurance company refused to cover a gay man's HIV-prevention drug because he 'engages in High risk homosexual behavior'.

The man, who lives in New York, applied for Truvada's PrEP in July to protect himself from the life-threatening disease. The drug is the only FDA-approved antiretroviral treatment to block HIV from infecting cells. 

But days later he received a denial letter from United Healthcare, which stated: 'The information sent in shows you are using this medicine for High risk homosexual behavior'.

The company claimed health plans only cover Truvada for patients who have HIV or have been exposed to the virus, adding that his request for coverage 'is not medically necessary under New York State Law'.

However, the letter also includes a list of United Healthcare Truvada criteria, which state that the drug - which costs $1,450 a month wholesale - should be covered for adults 'at high risk of sexually acquiring HIV-1'.

HIV activism groups have slammed the denial as illegal, and the phrasing of the letter as 'homophobic and discriminatory'.

Dr Anthony Fauci, director of the HIV/AIDS department at the National Institutes of Health, told Daily Mail Online: 'It seems like an inherent contradiction.

'PrEP is made for people who are actually at risk for HIV infection, not for people who are not at risk. 
'It has been proven that PrEP is a highly effective way of preventing HIV infection. That is the reason Truvada was approved.'

After receiving the letter on July 11, the patient, who remains anonymous, went to HIV activism groups for support to appeal the decision.

He sent the document to Jeremiah Johnson, of Treatment Action Group (TAG), who has led calls against the insurance company and the state health department to acknowledge the denial as a violation of guidelines.

'At best, it's gross incompetence of the insurer to carry out their own policy,' Johnson told Daily Mail Online. 'At worst, it's down right discrimination and it's illegal. 
'The patient was shocked by the language, as we all are.

'The words they use were stigmatizing terms on their own, but when you send that on UHC letterhead, saying "you're being denied this essential medication because you're homosexual"... We were just horrified.

'It's a clear violation of policy, it's unethical and it's malicious to deny people who are vulnerable.' 
The patient appealed to overturn the decision through his doctor, and has now been issued PrEP.
However, activism collectives have launched a petition to New York State Health Department to condemn United Healthcare's denial letter.

James Krellenstein, of ACT UP NYC which is behind the letter and petition, said this is hardly the first case of a baseless denial.

'We are hearing story after story of patients being denied Truvada coverage despite being fully in compliance with CDC, federal and state guidelines,' he told Daily Mail Online. 
'Often you can appeal the decision and get approved, but studies show these kinds of denials deter people and led to lower overall coverage.

'The language in this letter shows that this case is a black and white case of discrimination based on the patient's sexual orientation.'
Krellenstein pointed out that last year the New York City Health Department issued guidelines to doctors, highlighting gay men as candidates for PrEP.

And federal guidelines from the National Institutes of Health say the LGBT community is one of the most vulnerable populations to HIV infection, and therefore should receive PrEP. 
'United Healthcare endangered a patient's health because of his sexual orientation,' Krellenstein said.
'Every time this happens, insurance companies are endangering the health and well-being of the entire LGBT community.'

United Healthcare has not responded to Daily Mail Online's request for a comment.
The CDC last year said that 1.5 million Americans could benefit from taking PrEP to lower their risk of contracting HIV sexually or through intravenous drug use.

Contradiction: The letter included Truvada's criteria, which states that the drug is meant for adults at high risk of sexually acquiring HIV. It is the only FDA-approved drug for that purpose
Currently, figures suggest just over 100,000 people take the drug.
Krellenstein urged insurance companies to make contact with HIV activism groups to discuss coverage, criteria, and costs.

'We are interested in solving this problem, we're willing to sit down with UHC or any insurance company to work this out,' he said.

'But we are not going to remain silent while they endanger the health and well-being of our community.'

Johnson urges people who have been denied PrEP to visit the National Coalition for LGBT Health, which allows patients to anonymously share their stories and get support to appeal the decision if necessary.

'Don't shame yourself if you were denied,' Johnson adds.

'This is a stigmatized medication, like the contraception pill was years ago. Anyone taking a stigmatized medication needs to be very persistent.

'Work with your doctor to keep appealing the decision, and do what you can to make HIV activists aware if you were denied.'

By Mia De Graaf For 

November 13, 2012

A Sandy Insurance Nightmare in Staten Island,NYC

When Roman and Marianna Bediner's Staten Island, N.Y., home was clobbered by Superstorm Sandy they took some comfort in knowing that it was insured. But a few days later, when they learned that their coverage would pay for only a fraction of the $75,000 to $100,000 needed to put the house back together again, that feeling evaporated.
During the storm, Roman said the waters of Lower New York Bay rose by close to 11 feet, destroying all the walls, floors and ceilings -- not to mention the furniture and carpets -- on the first floor of his home. When the area flooded, the sewers backed up, filling the Bediners' ground floor with water that contained raw sewage and contaminating the home.
The Bediner's Staten Island, N.Y., home as the floodwaters started to subside post-Superstorm Sandy.
The Bediners carry both homeowners and flood insurance, which is issued by FEMA's National Flood Insurance Program (NFIP) and required of homeowners in flood-prone areas. In theory, it's a lot of protection. But in practice, it can be very little.
His homeowner's insurance policy from Liberty Mutual doesn't cover flooding, just damage caused by high winds. Two days ago, the adjuster came by to inspect the home. The offer: A mere $5,045 for wind damage to the stucco exterior and garage door.
Bediner's meeting with the flood insurance adjuster was even worse: Most of the repairs -- the walls, ceilings, floors and the ruined office equipment in his downstairs office -- would be not be covered by his flood insurance policy. The adjuster said he won't be able to give him an exact figure for a couple of weeks but told him not to anticipate much. 
"Shocked is an understatement," he said. "You pay your premiums and, when something happens, you're basically screwed."
A big part of the problem for Bediner and other victims of Superstorm Sandy is that NFIP's flood insurance does not cover any upgrades done to basements. Any finished walls, floors and ceilings or personal belongings that get destroyed while in a basement won't be covered.
The only claims the policy will honor for basement damage are for things required to run the household, like furnaces, as well as structural elements, like stairways and the foundation.
"The adjuster said we would not get a penny for the ground floor except [to repair] the heating and AC," said Bediner.
Bediner said he didn't realize that his policy was so limited in its coverage. "That doesn't mean it isn't in the policy documents, though," he said. "It's one of those things that no one tells you and you don't know.” 
Making matters even more frustrating for Bediner is the fact that he's never considered his ground floor a basement.
Like many other recently built houses in his neighborhood, the Bediners' has a ground level garage on the bottom floor that has an extra room right behind it containing the home office. The rest of the living spaces are on the upper floors. The NFIP treats enclosed ground floor spaces like these the same way they treat basements.
Liberty Mutual, which the Bediners also purchased their flood insurance through, said it was referring the flood claim to FEMA for review. The NFIP wouldn't comment on individual's claims except to point to its guidelines. 
In the meantime, Bediner has already paid a contractor $6,000 to secure, clean up and decontaminate the house, merely a fraction of the estimated $75,000 to $100,000 needed to repair the home.
While Bediner, a 32-year-old vice president for technical services at a tech company, and his wife, who is a paralegal, are doing well financially, the parents of two young children don't have that kind of money.
And Bediner is far from alone. Tens of thousands of houses were damaged in the area. New York officials have said that 20,000 to 40,000 New Yorkers may have been left homeless by the storm.
"It's not just me," he said. "There are hundreds of families going through the same thing." 

December 15, 2011

Obama’s Health Law More Than Double The People Insured } 2.5 Million More


(Reuters) - U.S. healthcare reforms have enabled 2.5 million young adults to join or remain in their parents' health insurance plans, the U.S. government said on Wednesday, up from 1 million reported earlier this year.

Federal officials fully credited the gains to the Affordable Care Act, legislation championed by President Barack Obama that took effect last year and is deemed the biggest overhaul of the U.S. healthcare system in nearly 50 years.

The law aims broadly to eventually provide medical insurance to more than 30 million uninsured Americans, and in September last year allowed young adults to stay on their parents' private insurance plans through age 26. The provision is perhaps the single most popular element of the highly-divisive law and the announcement on Wednesday elicited little reaction from congressional Republicans.

That age group previously recorded the highest uninsured rate but the new report showed they no longer do. Now 26- to 35-year-olds have that dubious distinction by a narrow margin, according to a survey conducted by the Centers for Disease Control and Prevention.

The jump to 2.5 million young adults reported on Wednesday came as many graduated from high school and college in May and June and otherwise would have lost coverage, health officials said.

Since the policy helping young adults took effect in September 2010, the percentage of adults ages 19 to 25 covered by a private health insurance plan has increased to 73 percent in June from 64 percent, the Department of Health and Human Services said.

Over that time no change was observed in the insurance rate of adults age 26 to 35, 72 percent of whom are insured.

"Young adults were twice as likely to go without insurance... they were taking real risks," Health and Human Services Secretary Kathleen Sebelius told reporters.

"Today, 2.5 million more young Americans are no longer living with that fear. Mothers and fathers can breathe a little easier."

Federal officials said data from the first three months of 2011 showed that 1 million more young adults had coverage compared with a year ago. The U.S. Census Bureau's report earlier this year showed that about half a million more Americans age 18 to 24 received health care coverage last year.

Dozens of states and a field of contenders for the Republican presidential nomination have attacked the Affordable Care Act, sometimes dubbed "Obamacare." They hope to repeal the legislation, saying it is a symbol of intrusive government seeking to raise taxes and burden businesses with new regulation.

The U.S. Supreme Court is preparing to review the reforms, as a sharply divided public watches from the sidelines.

(Reporting by Ransdell Pierson in New York and Alina Selyukh in Washington, editing by Matthew Lewis and Carol Bishopric)

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