Drew Altman
Drew Altman
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More than nine years into our longest economic expansion on record, more employers are now using health insurance coverage to attract and keep workers, and are absorbing rising costs rather than passing them on to their employees. But this may change if the economy cools down, and the bigger challenge that still remains is how to help the 44 million Americans who are uninsured despite the robust economy.
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It is low-wage workers who are being hurt the most by the steady drip, drip, drip of coverage draining out of the employer-based health insurance system.
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The American people rejected strict managed care in the late '90s. Government regulation, like the kind in other industrialized countries, is opposed by powerful industry forces and is not in the cards politically. So we're stuck with a bunch of halfway measures.
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The positive drum beat has caught up with the negative one. But on an individual basis, most seniors still can't answer the big question: 'What does it mean for me?
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The point is that when they talk about quality of health care, patients mean something entirely different than experts do. They're not talking about numbers or outcomes but about their own human experience, which is a combination of cost, paperwork and what I'll call the hassle factor, the impersonal nature of the care.
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We may be looking at the start of a fundamental shift in what we mean by health insurance, from a system where we share risks to one where it's up to individuals to make their own deals and bear their own risks.
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Beneficiaries are having a difficult time answering the most important question: 'What does it mean for me?'
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The good news is the rate of increase in health care costs is down, ... The bad news is that's the only good news.
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The good news for the ratings system is that many parents are using the ratings and find them helpful. But they do not always understand the system, and there are changes they'd like to see made.
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There have been temporary successes, but always health care costs have bounced back with a vengeance.
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There are lots of things on the table, but there's nothing that will have a significant impact on the rate of increase of health care costs.
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Seniors still are having a hard time. Seniors still aren't really prepared, and they're going to need a lot of help to make the choices they need to make under the law.
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The widespread dropping of drug benefits that some had feared has been averted so far as business figure out what their long-term response would be.
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This is a slow but perceptible fraying of our employment-based system, ... what I call the drip, drip, drip (of health coverage).