Thursday, December 12th, 2013
A new study from Dartmouth University researchers has found that kids who grow up in different cities and towns are more or less likely to receive different types of health care such as tonsil removals or CT scans. The research paints a confusing picture of standards of care for young patients, as Reuters reports:
Children in Lebanon, New Hampshire, are more than twice as likely to have their tonsils removed as those in Bangor, Maine. Kids in Lewiston, Maine, are 50 percent more likely to have a CT scan of their head than are kids in Portland, Maine, or Lebanon and Burlington, Vermont.
Lebanon’s children don’t have especially infection-prone tonsils, and Lewiston’s don’t fall on their heads more than kids elsewhere do. Instead, according to a report released on Wednesday, the glaring variation means that in some cases “children are not receiving enough good care,” said pediatrician and health policy analyst Dr David Goodman of the Geisel School of Medicine at Dartmouth University, who led the study for the Dartmouth Atlas Project. But in other cases they “may be receiving unnecessary care that is harmful.”
Similar research from the project has shown that the rate of medical procedures performed on older Americans covered by Medicare varies enormously depending on where they live.
The new report, which focused on northern New England, is the first to show that geographic variability exists in children’s healthcare, too, raising questions about why tens of thousands of kids are not receiving recommended care such as screening for lead poisoning and why tens of thousands of others are subjected to potentially unneeded treatments such as CTs for stomachaches.
The Dartmouth Atlas was able to examine geographic variations in the medical care provided to children in Maine, New Hampshire and Vermont from 2007 to 2010 because those states are among the few that collect data on all health insurance claims, which the researchers analyzed.
“This suggests that there is a significant amount of overuse of medical services in some areas,” said Dr Vikas Saini, a cardiologist and president of the Lown Institute, a healthcare think tank in Boston. “Especially because unneeded care can expose children to harmful side effects, this is very troubling.”
Image: Child having throat exam, via Shutterstock
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Tuesday, September 24th, 2013
Over the past 15 years, the cost of delivering a baby vaginally in a hospital has more than doubled, and the cost of Cesarean sections–which have also increased in frequency–have skyrocketed by 70 percent during that period. More from NBC.com:
Over the last 15 years, the cost of vaginal deliveries has practically doubled in the United States, shooting up from $4,918 to $9,294, while the cost of C-sections has increased 70 percent from an average of $8,268 to $14,055, according to Truven Health Analytics.
By contrast, the average cost for an uncomplicated vaginal delivery last year in Switzerland was $4,039 and the average cost in France was $3,541, according to the International Federation of Health Plans (IFHP). That’s nearly half to a third of what it cost in the U.S.
In fact, the United States is the most expensive place in the world to give birth, according to the IFHP. The reason, experts say, has to do with the way hospitals calculate our bills.
“Every time you walk into the hospital, they look at everything that happens to you and say, ‘Can I bill for that?’” explained Gerard Anderson, director of the Johns Hopkins Center for Hospital Finance and Management.
“So, if you get an aspirin, they’re going to bill for that. If you get seen by a specialist, they’re going to bill for that.”
Even when families do have insurance, their portion of the bill can be staggering.
Image: Pregnant woman in the hospital, via Shutterstock
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Thursday, April 18th, 2013
The new health care rules initially seemed to apply differently to children who were part of the foster care system past the age of 18, but provisions that are coming into effect next year will change that, enabling former foster kids to be covered the same way as other young adults. More from CNN:
While many young adults are now covered by the Affordable Care Act, able to remain on their parents’ insurance until age 26, the rules are different for those like [22-year-old Nathan] Cox-Reed, who grew up in the foster care system.
There are more than 400,000 children in foster care in the United States, the Department of Health and Human Services said last year. All are provided with health care coverage as long as they are wards of the state.
When foster kids turn 18, they age out of the system and instantly lose their coverage.
That’s about to change, when another part of Obamacare takes effect on January 1, 2014. Medicaid coverage will be extended for former foster youth until they reach 26, as long as the individual was in foster care and enrolled in Medicaid until the age of 18.
“I definitely think it would be a big relief, and I would definitely feel more secure as far as my health goes,” Cox-Reed said.
But there’s a catch. Cox-Reed has dreams of traveling across the nation and becoming a filmmaker. A future relocation could jeopardize his medical coverage.
States will only be required to keep former foster children on Medicaid if they continue to reside in the state where they were in foster care originally.
This part of the provision is “an incredibly troubling aspect,” said Washington attorney Brooke Lehmann, who founded the child and family advocacy group Childworks. Young adults can be highly mobile as they move for educational purposes, job opportunities and a host of other reasons, she said.
“You can’t be on a film set if you are uninsured,” Cox-Reed said. “You could get hurt. I definitely think [being uninsured] is limiting and it’s a letdown, because what if I do get a job out of state? I might not be able to take it.”
While “it’s a great provision,” said Joan Alker, co-executive director of the Georgetown Center for Children and Families and a professor at the Georgetown University Health Policy Institute, limiting extended Medicaid enrollment because of relocation could threaten the provision’s effectiveness.
Image: Teenager at doctor’s office, via Shutterstock
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Thursday, April 4th, 2013
As health care costs–and diagnoses of autism spectrum disorders (ASD)–rise, families find themselves faced with mounting costs and not much help as they would like. More from ABC News about how advocates are lobbying states to mandate that insurance companies cover autism therapies and other costs:
Thirty-two states have required state-regulated health insurance plans to cover autism, according to Autism Speaks, an organization that advocates for families.
Autism spectrum disorders are developmental disabilities that can cause significant social, communication and behavioral challenges, according to the Centers for Disease Control and Prevention (CDC). Treatments include behavioral, occupational and speech therapy, and experts say early intervention is critical.
Bills to mandate coverage for care are moving along with success in Hawaii, Minnesota and Nebraska, but Autism Speaks is pushing for a law in all 50 states and calling on Congress to mandate all companies not under state jurisdiction to authorize care.
Many companies who self-insure, like Microsoft and Oracle, have already voluntarily done so, according to Autism Speaks spokesman Rick Remington.
“We are calling on the president for a national plan for autism,” he said. “Prevalence is on the rise, and we are calling out the government to say enough is enough.”
Matt Bengtzen, who works as a manager in local government in Salt Lake City, has two sons with autism, aged 13 and 10.
“The diagnosis was a struggle for us because it was not covered by insurance,” he said. “And I have very good insurance.”
“We actually have been pretty fortunate, because our children are on the more functional side of the autism spectrum,” said Bengtzen, 37. “It’s been difficult, but not devastating.”
Still, the family has spent at least $10,000 out of pocket on each child so far.
Image: Health care costs, via Shutterstock
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Friday, January 11th, 2013
A new analysis by the Institute of Medicine of global health care costs and outcomes has revealed the troubling statistic that the infant mortality rate in the U.S. is more than double the rates in Japan, Sweden, and some other developed countries. America lags behind 16 other countries, despite the fact that infant mortality rates have been steadily dropping over the last decade. From The Washington Post:
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“Although U.S. infant mortality declined by 20 percent between 1990 and 2010,” the report notes, “other high-income countries experienced much steeper declines and halved their infant mortality rates over those two decades.”
As to what explains the high infant mortality rate, the researchers aren’t quite sure. They say it is not explained by ethnic diversity in the United States. While U.S. minorities do tend to have a higher infant mortality rate, non-Hispanic whites in the United States also have worse outcomes than those in peer nations.
Image: Earth, via Shutterstock