3 Goals: Healthcare Changes to the American Families Plan Could Create Affordable Healthcare

3 Goals: Healthcare Changes to the American Families Plan & Health Savings Plans Could Make Medical Expenses More Affordable.

The new administration, like all of them, has plans for Americans and their healthcare. On this edition of the podcast Dr. Steven Goldstein, who founded the Houston Healthcare Initiative, will get us all better acquainted with what those proposals are and explore other possible ways for how healthcare can be fixed. The Biden administration has three goals.

3 Healthcare Changes are Goals for the Biden Administration.
There are three healthcare priorities for the Biden administration plus one more that Dr. Steven Goldstein suggests.

To listen to the podcast, click this link: https://soundcloud.com/harold-nicoll/three-biden-administration-healthcare-goals-plus-one-not-included. 

The Covid 19 Response

Of the three goals, first is the Covid-19 pandemic response. Part of the goal is to prevent over capacity of limited hospital beds and critical care space during spikes in the virus outbreak, like those occurring now. Others include the ability to establish temporary hospitals and better ways to track Covid surges via technology. Making telehealth options more widely available, tasking all relevant federal agencies to set up temporary hospitals and getting the Center for Disease Control (CDC) to develop real-time tracking dashboards to better predict when surges will happen, where they are and other details needed to better inform healthcare professionals about the evolution of the pandemic.

The Affordable Care Act

The second of the three priorities has to do with the Affordable Care Act, or as it is more popularly known, ObamaCare.

The idea is to reduce medical costs for the American public. As part of a separate pandemic relief bill, there is $34 billion to help Americans who buy insurance from the health plan marketplaces that were created by Obama Care now through 2022.  Those who know about it state that this would help lower and middle-income Americans who have fallen through the cracks of the government’s eligibility requirements for ObamaCare subsidies. It would also help people who choose policies with lower premiums and higher deductibles. There is also assistance for the unemployed.

Medicare Reform

One of the more visible proposals is to increase the age of people who are eligible for Medicare from the current 65 to 60 years of age.

“While we can think of these as beneficial to society, there is a considerable cost that comes along with it,” Dr. Goldstein told his listeners. “Instead of transferring more money to people, there are other ways to use existing healthcare payment strategies that will benefit everyone.” So why not fund Health Savings Accounts (HSA’s) with this same amount of money?  It is tax-advantaged when received, if the money earns interest while in the health savings account the account owner can keep it and be prepared to pay cash for more health-related expenses. So what is a health savings plan?

Prescription Drugs

The Trump Administration launched a “Transparency in Coverage” ruling in December of 2020 that required health insurers to disclose current drug prices and provide patients with personalized cost estimates. The Biden Administration hopes to increase these efforts by repealing existing laws that prevent Medicare from negotiating lower prices with drug corporations. “Plenty of people believe that the government already uses its mass buying power with Medicare to negotiate better rates,” Dr. Goldstein said. “That is not the case.”

Health Savings Accounts

The Health Savings Account. or HSA, is a type of savings account that is used for medical expenses. HSA’s were established for those with high deductible health insurance coverage. HSAs and high-deductible health plans were created to help control health care costs. The idea is that people will spend their health care dollars more wisely if they’re using their own money. The money deposited by individuals into their HSA account is not taxed.

Further, HSAs feature a triple-tax benefit: money you contribute to your HSA can be written off on your taxes and thus reduce your income tax bill; money in your HSA grows and compounds assuming investments rise. All is tax-free over time; and when HSA money is withdrawn for qualified medical expenses, no tax is paid on the withdrawal. It is owned by the individual so that he or she can pay their healthcare costs. These include everything from doctor visits to blood tests, paid for with cash from the health savings accounts.

As always, information about this and more than 50 other podcasts can be heard and read about at the website, www.houstonhealthcareinitiative.org.

About The Houston Healthcare Initiative

The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To learn more about the Houston Healthcare Initiative please visit www.houstonhealthcareinitiative.org.

Did The Covid-19 Pandemic Cost You Your Job and Health Insurance?

In a time when so many lost their jobs because of the Covid-19 Pandemic….

Job & Health Insurance Loss Come and Go Together; How To Find Affordable Coverage

March 2, 2021 — In December 2020, 66% of Americans who answered a survey said they fear they won’t be able to afford health care this year. Of the 41% of respondents who are very or moderately concerned about health-care costs, 53% are parents with children. The amount of people who were and remain unemployed because of the Covid-19 pandemic remains high. Since most individuals get their health insurance with their jobs, those same folks are also in need of medical coverage.

On his regular podcast, Houston based neurologist and founder of the Houston Healthcare Initiative Dr. Steven Goldstein has immediate and affordable medical insurance solutions for those who need coverage. To hear the podcast visit: Apple Podcasts, Radio.com, iHeartRadio, SoundCloud, and the Houston Healthcare Initiative web site. Job & Health Insurance Loss Come and Go Together.

Use the Obama Care National Marketplace

People who lost their jobs due to the pandemic have the burden of finding work and paying for healthcare. As most people’s healthcare is tied to their jobs. “There are alternatives for people who lost both their jobs and accompanying health insurance,” Dr. Goldstein told his audience. “The key for those people to get covered is to act quickly.”

One reason for this is that job loss qualifies Americans for a special enrollment period in the health insurance marketplace regulated by the U.S. government, but it only lasts 60 days. “Normally the enrollment period for this is in the month of November, but job loss allows an exception. Just remember the 60-day deadline,” Dr. Goldstein said.

Private Health Insurance

Private health insurance will sometimes offer more flexibility than standard coverage. For example, short-term policies lasting up to one year are available in many states. There are differences between health insurance and private health insurance. People buy private health insurance many times because their place of employment does not offer it. In the case of people who lost their employer provided health insurance, purchasing it like this is an option. Private health insurance is often an option for those who work part time, are self-employed, or own a small business.

Health Co-Ops

Health insurance co-ops are private health insurance plans that serve a small group of people and are owned and operated by the members of that group. The health co-operative or co-op is a member owned not for profit corporation. They are run democratically by the members.

The real benefit of health insurance co-ops are they are significantly cheaper than regular health insurance. “The monthly fees are called membership fees, not premiums, Dr. Goldstein said. “The average cost of a co-op membership is about $40 to $90. To put that into perspective, regular COBRA insurance premiums can cost as much as $650 per month.”

Job loss is unnerving enough at any time. Losing health coverage during a pandemic makes that level of anxiety even higher. Because no one wants to be without medical insurance when a previously unseen virus is spreading.  It could make you or a loved one sick at the worst possible time. Fortunately there are reasons to be optimistic about getting health insurance that is affordable and obtainable if action is taken sooner than later.

The amount of information about this and other similar issues grows ever higher at the Houston Healthcare Initiative web site and its social media sites. To learn more about the Houston Healthcare Initiative go to www.houstonhealthcareinitiative.org.

Job & Health Insurance Loss Come and Go Together.

With Haven in the rearview mirror… Failures to Reform U.S. Healthcare System Are Because the System Is the Problem

Haven Failure
In spite of the high tech ability and deep pockets of the joint venture partners, Haven went out of business on January 31, 2021.

Big fail. Haven, a joint venture between Amazon, JPMorgan-Chase, and Berkshire Hathaway, booted the chance to reform their collective employee health insurance, in part, by not working on the correct challenge, according to respected neurologist Dr. Steven Goldstein.  Dr. Goldstein hosts the Houston Healthcare Initiative podcast with a focus on reforming the highest priced healthcare system in the world. Haven is the most recent, but likely not the last, story of corporate good intentions not delivering what was hoped. So, what’s the right challenge?

The System Is the Problem

“Our current healthcare system is focused on treating sick people, not preventing illness,” Dr. Goldstein told his audience, and he gave an example. “The more people there are in hospital beds, the more money is made by the hospitals, doctors and everyone else involved in patient care.” The U.S. healthcare industry is a volume-based scheme of reimbursement for getting paid. Better patient health is not part of the current equation.

More of the Same

The business system Haven tried to disrupt offers no tie to healthier outcomes for patients or incentives for those same people to take better care of themselves. “It’s just more of the same,” Dr. Goldstein said. “Haven failed at reforming their collective employee health insurance in part by not working on the correct challenge but instead ‘worked on the fringes’ of a non-competitive business.”

Worthy Goal but Poor Execution

At Haven, the published goal was improving healthcare services and lower costs for the three companies’ employees. With a heavy reliance on ‘big data’ and the ability to analyze patient information in big amounts, Haven promised to make primary care easier to access, prescription drugs more affordable and render insurance benefits easier to understand. While essentially getting nowhere but costing a lot of money to get there, Haven shut down without affecting the healthcare industry at all.

Healthcare as a Commodity?

The best way to ensure an adequate supply of anything at the lowest possible price is to permit the laws of supply and demand to work. “But as we also know, that is not what we have and not the way costs are assigned or managed by insurance companies, hospitals and pharmaceutical companies that assign prices,” Dr. Goldstein said.

Employee & Patient Voices Heard for a Change?

The public has little to say about how pricing is determined but could have a great deal to say with the right type of organization. The correct method available to everyone is via the non-profit, employee-owned healthcare cooperative.

The cooperative or ‘co-op’, can replace traditional health insurance for qualified individuals and families. Co-ops can also provide incentives for members to adopt healthier lifestyle habits. Financial incentives based on lifestyle would result in lower healthcare costs by decreasing utilization. Ownership of the cooperative would pass the savings from the cooperative to the employees. Co-ops can allow employees to remain members even if they leave the company. By transferring ownership of the cooperative to the employees, companies are no longer responsible for healthcare and can concentrate on their core business.

How Co-ops Work

Co-ops provide affordable medical coverage through a combination of negotiated rates, low monthly payments, personal accountability and lifestyle incentives. “By organizing their workers and families, businesses of any size can overcome this less than efficient way of doing things,” Dr. Goldstein said. “For example, financial incentives based on choices about diet and exercise will result in lower healthcare costs by decreasing utilization. The ownership of the cooperative will pass the savings from the cooperative to the employees. But there are other benefits that will make those employees healthier.”

About the Houston Healthcare Initiative

The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To learn more about the Houston Healthcare Initiative please visit www.houstonhealthcareinitiative.org.

What a New Administration May Mean for Healthcare Reform

Biden Healthcare Reform 2021
The incoming Biden administration will face a shrinking workforce and growing number of Medicare enrollees through 2028. 

In the New Year What a New Administration May Mean for Healthcare Reform

 December 2, 2020 – The incoming Biden administration could force mandates for private firms and their employees to provide for and buy health insurance. This according to Dr. Steven Goldstein on his regular podcast. The respected neurosurgeon and founder of the Houston Healthcare Initiative discussed the possibilities for healthcare reform in the coming year on his regular podcast. The Houston Healthcare Initiative podcast can be heard on: on SoundCloudGoogle PlayLibsyn FeedStitcheriHeartRadioSpotify, and the Houston Healthcare Initiative web site.

Mandates Could Eliminate Opting Out

The Affordable Care Act, also known as Obama Care, made more choices for insurance available and penalized people who did not purchase health insurance. While not ideal, it was a way to get more people covered by private insurance than before. And it offered subsidies for people who could not afford insurance. But there was a downside.

The financial penalties were unpopular and made Obama Care an easy target for those who were against it. Without the specter of financial penalties, many employees chose to go without health insurance and keep the part of their pay that would normally go to help fund it. “One economic rationale for employer mandates is that the cost of care for these uninsured workers is often passed along to the insured through higher insurance premiums, taxes and other mechanisms,” Dr. Goldstein said. “Employer mandates are, in part, an attempt to eliminate those who opt out of available coverage. By adding more payers, health insurance is more affordable at the individual level. At least in theory.”

Do Less for More Or just Pay More

According to the Centers for Medicare and Medicaid, national health spending will grow at an average annual rate of 5.4 percent for the years 2019-28 and reach $6.2 trillion by 2028. Among major payers, Medicare is expected to experience the fastest spending growth of 7.6 percent per year from 2019-to 2028, largely as a result of the highest projected enrollment growth. “National health expenditures will grow 1.1 percentage points faster than the gross domestic product every year on average from now through 2028, said Dr. Goldstein. “The health share of the economy is projected to rise over a full percentage point by 2028. In other words, the costs are growing faster than the income. So, we have to do less of something or boost the gross national product.”

Make A Bad System Less Bad

If the current healthcare system remains unchanged, there will be less in the way of medical resources for the public. But according to Dr. Goldstein, that is unlikely. The overall insurance industry and its approach to paying for healthcare are very flawed in fundamental ways but unlikely to realize any dramatic reform.  Working around the edges to make a bad system work somewhat better is what he believes will happen. As Dr. Goldstein told his audience, “we can spend time and money to make a bad system work better and that is probably what will happen in the near term.”

Another Possibility, Pay Cash

According to Dr. Goldstein, cash payments are accepted for most if not all medical charges and prescription drugs. But that comes with a caveat for those who do have insurance, especially catastrophic health insurance. “Do not try to get the ‘insured’ rate to put against your deductible,” he counselled. “Paying cash is much less desirable when put against the insured rate, it will cost you more but not buy any more benefit.”

Most people with catastrophic coverage will never reach their deductible amount. Better to put that money directly into care, at a much-discounted price. This arrangement is the best value for people under the current system. So, while at the doctors’ office show them your insurance card but tell them you are paying cash.

About Houston Healthcare Initiative

The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To learn more about the Houston Healthcare Initiative please visit www.houstonhealthcareinitiative.org.

Job Losses Equal Employer Funded Health Insurance Loss

Closed for Coronavirus

Here Are Some Resources

Even with fewer jobs lost in May than anticipated Americans now experience an unemployment rate of 13.3% or 21 million people out of work due to the coronavirus/covid-19 pandemic. On top of lost income, loss of employer provided health insurance makes the cost even higher for those who through no fault of their own find themselves in a very challenging situation. On his podcast this week, Dr. Steven Goldstein describes how job losses equal employer funded health insurance loss and some available and often free resources for those who need health insurance. To listen to the podcast go to: Soundcloud, iHeart, Spotify, or iTunes. Or click here to listen:

 

Double Loss; Job and Health Insurance

Most Americans rely on their employers to provide health insurance for them and their families and when those jobs disappear so does the coverage. “It is extremely important that people get some type of coverage when they have lost their health insurance,” Dr. Goldstein told his listeners. “The available things to look into are COBRA, spouse insurance, faith-based cooperatives, enrollment on the insurance exchange (Obama Care), Medicaid and CHIP.”

COBRA Coverage

COBRA allows employees (and their families) who would otherwise lose their group health coverage due to certain life events to continue their same group health coverage. The former employee generally pays the full monthly rate and not the discounted one for their health insurance. Under COBRA, group health plans must also provide covered employees and their families with certain notices explaining their COBRA rights. The revised model notices provide additional information to address COBRA’s interaction with Medicare. The model notices explain that there may be advantages to enrolling in Medicare before, or instead of, electing COBRA.

State Insurance Exchange

While typically only available during certain months of the year, the state insurance exchange can open for those who experience a ‘life changing’ event. One such event is the loss of a job and employer sponsored health insurance. “You can shop for health plans through your state’s insurance marketplace,” Dr. Goldstein said. “But don’t wait around, there are 30 to 60 days to sign up after a qualifying life event before the end of that special enrollment period.”

Spouse Insurance

In households where a spouse’ employer offers health insurance; those benefits may be available. “It is easy enough to find out if a spouse’s job offers health insurance and sign on for that,” Dr. Goldstein said.

Faith Based Health Cooperatives

Faith based plans most often share expenses among members. Each member pays a monthly premium. When one of the members becomes ill or needs treatment for an injury, his or her contributions cover the expenses, in conjunction with the collective input of fellow members. “As such, the premiums are lower in comparison to those of traditional health care,” Dr. Goldstein said. “These operate with exemptions to the mandates of the Affordable Care Act, also known as Obama Care.”

Medicare

Eligibility for Medicare is based on income and the size of family. Medicaid provides health coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities in all fifty states.  In some states the program covers all low-income adults below a certain income level. “But do not assume that you do or do not qualify,” said Dr. Goldstein. “There are online resources available from the U.S. Department of Health and Human Services along with state references to help guide you.”

CHIP

CHIP stands for ‘Children’s Health Insurance Program.’ CHIP offers low-cost health coverage for children from birth through age 18. CHIP is designed for families who earn too much money to qualify for Medicaid but cannot afford to buy private health coverage. This coverage comes through the Medicaid program, which is why they are frequently seen together.

Income Qualification for Medicare

A family of four with an income of $25,750.00 at the poverty level and eligible for Medicaid or CHIP coverage. For an individual the amount was $12,490.00. The amount goes up by $4,420.00 for each additional family member. “The guidelines change every year,” Goldstein said.

The Good News

There are plenty of alternatives available to individuals and families that can be used short or for the longer term that are not all based on a job with insurance. People under age 26, may even be able to join their parents’ employer-based plan. “There are places to go and affordable resources available,” Dr. Goldstein concluded. “Any type of healthcare insurance or coverage will help protect your finances later.”

About Houston Healthcare Initiative And Dr. Steven Goldstein

Dr. Steven Goldstein is a Houston based neurologist. He founded the Houston Healthcare Initiative and is an advocate for common sense solutions to the healthcare crisis that confronts the citizens and residents of the United States of America.

 

Retired But Too Young for Medicare? What Now?

Retired But Too Young for Medicare? What Now?

There are plenty of people who retire before the age of 65, whether this was their choice or had retirement thrust upon them. Regardless of the circumstance, these people need health coverage. And since they are ‘retired’ they likely need low or lower cost coverage without sacrificing their quality of care. There are several options for those people according to Houston based neurologist and founder of the Houston Healthcare Initiative CO-OP, Dr. Steven Goldstein. 

Retired But Too Young for Medicare? What Now?

Fear of Loss

Employees fear losing their company subsidized health insurance and when accepting or choosing retirement, that benefit ceases along with the paycheck. According to Dr. Goldstein, it is a situation worth examining and planning for. “There are several alternatives for people who are not old enough for Medicare,” Dr. Goldstein said. “For one, they can choose an extension of their former employers’ insurance through what is known as COBRA.”

COBRA

COBRA stands for “Consolidated Omnibus Budget Reconciliation Act. “It’s a law that since 1985, provides for continuing group health insurance coverage for employees and family members after what they call ‘job loss’,” Dr. Goldstein said. “But, it only applies at companies with more than 20 employees and to state and local government workers. It does not apply to federal workers, churches, or some church related organizations. What’s more this is a short-term fix because there is an 18-month limit on this option. So for someone who is 60 this will get them to 61.5. But there are those other 3.5 years remaining.” COBRA is also a costly choice. Those choosing it can expect to pay up to 102% of the premiums including the part your employer used to pay. 

Affordable Care Act

Options for the Affordable Care Act or Obama-Care are available on line. While the politics of healthcare mean that future choices may be different or even non-existent, but at the moment the law remains in place. “Here in Texas, everyone is required to have health insurance, but they are not required to purchase it through the government,” Dr. Goldstein said. “There is no longer the threat of a fine from the federal government for not having health insurance but going without is never a good idea.”

Healthcare Co-Ops

People can and probably should consider one of the health sharing cooperatives. There are several from which to choose, not the least of them the Houston Healthcare Initiative CO-OP. But according to Dr. Goldstein, there is more to the Houston Healthcare Initiative CO-OPthan inexpensive health coverage. “Our first priority is to improve our members health first and help pay for ‘sick care’ second,” Dr Goldstein stated. “As people work with us to manage their own health, the cost goes down. When they do get sick, we can provide lists of places to get the best prices on prescription medicine, tests, imaging and hospitalization. But, and I want to really stress this, our approach to managing the cost of healthcare is to find ways to be sick less often. We help people manage their weight, level of fitness and other choices they can consciously make to be healthier. So, if you want to save money on healthcare, find ways to be sick less often.”

To find ways to be sick less often and save on health coverage, then look to the  Houston Healthcare Initiative CO-OP and visit the web site at www.houstonhealthcareinitiative.org.