Last week, we talked a bit about the basic health insurance vocabulary you gotta know. This week, we're going to make some use of what we learned to better understand a current economic phenomenon.
One of my favorite concepts in health economics is moral hazard–the idea that someone is more likely to undergo a costly or risky situation if they know they are protected by against the cost/risk because someone else will be footing the bill. Putting this in healthcare terms, if you know you have a great coverage plan, you are more likely to seek medical care, or visit the doctor for a sniffle, or undergo expensive but questionably necessary procedures. This is because the cost to you will be severely reduced from what it otherwise would have been because of your insurance coverage.
Moral hazard is a tricky lil bugger, not because it's particularly hard to understand, but rather because it's hard to overcome. One of the ways insurance companies (or employers) are dealing with the rising American healthcare spending is by raising the out-of-pocket costs, mostly deductibles, for consumers and thus reducing the moral hazard that results from healthcare coverage. Thus, we've seen a reduction in the rate of healthcare spending (finally), which helps reduce the federal deficit. However...
These increasing out-of-pocket costs1 are causing some people to avoid even routine healthcare altogether. They're also having an effect on other markets–Americans are spending less on entertainment, retail, and childcare. 2 This only makes sense. If Joe Schmo's bank account were a pie, when the slice that is his out-of-pocket healthcare spending increases, there is less pie available for other expenses.
Healthcare in the United States is expensive, but necessary. While you may not be able to control an increase in your deductible, you can shop around for a reliable doc, research procedures to determine their necessity, and practice preventative measures (washing your hands regularly, eating well, exercising, sleeping!!!) to keep costs low. To start the New Year right, next week I'll discuss some best practices for staying healthy [thereby avoiding hefty healthcare spending] and happy in 2015. And since I won't see you until then, Happy New Year!
Have a healthcare question you want answered? A topic you want addressed? Email whatthehealthnow@gmail.com!
1. Increased costs of mobile phones are also contributing to the reduced spending in other markets.
2. Knutson, Ryan, and Theo Francis. "Basic Costs Squeeze Families." Wall Street Journal. 1 Dec. 2014. Web. 27 Dec. 2014.
Saturday, December 27, 2014
Sunday, December 21, 2014
on health insurance 101
Not all health insurance plans are alike. And in order to truly pick the plan that is best for you (or to understand your current plan), it's important to know both a.) what each type of plan entails and b.) what else is out there.
There are three main categories of health insurance plans:
Health Maintenance Organization (HMO)
Preferred Provider Organization (PPO)
Health Maintenance Organization (HMO)
Preferred Provider Organization (PPO)
Exclusive Provider Organization (EPO)
PPOs, followed by HMOs, are the most common type of coverage. So how do they differ?
Under an HMO, you first choose a Primary Care Physician (PCP). This PCP is your home base, so to speak. He or she will need to refer you to any specialists you may need within a network of pre-selected providers. So, let's say you have been having terrible foot pain. You'd first see your PCP, who would refer you to a podiatrist within the network. These network providers, i.e. doctors who have opted to participate in the specific plan, are the often the only ones your insurance will cover visits to. Usually, visits to out-of-network providers will not be covered.
PPOs give you a bit more flexibility in that you don't have to go through your PCP and you are welcome to visit service providers outside of your network. However, out-of-network providers will be at a higher cost, such that you will pay more out-of-pocket if you choose to go outside of your network (hence the origin of the "preferred" part of preferred provider organization). Additionally, you will likely have to pay a deductible during your visit.
Okay, let's pause here and go over the vocab of what consumers pay out-of-pocket. I just mentioned a deductible. This is the amount you pay yourself before your insurance coverage. Once you've paid 100% of your deductible, your insurance plan will cover the rest. In the case of a PPO, seeing an out-of-network provider means you will have to pay a higher deductible.
This premium is your periodic payment into the health insurance plan. Generally, your premium and deductible are inversely related: a higher premium means a lower deductible, and vice versa.
In addition to the deductible and premium there is also a copay. This is the flat rate amount you pay during doctors visit or for prescriptions. For example, on my plan, when I go in for my annual physical, I pay $10 copay during my visit.
Last but certainly not least, there is the coinsurance payment. This is the amount you pay after your copay and deductible and after the insurance company has paid their portion. If my coinsurance is 20% of remaining fees after the deductible, I pay the 20% of the bill that is left once my deductible is paid and my insurance pays their 80%.
Okay, let's move on to EPOs.
EPOs are like PPOs in that you usually don't need a PCP referral, but similarly to HMOs, out-of-network providers are not covered, unless in cases of emergencies.
HMOs, PPOs, and EPOs are only the most common plans, not the only ones available, and the details of each vary a bit based on your specific insurance provider. What works best for you complete depends on what is available through your employer, what you personally can afford, or your personal necessities. If you are rarely sick or injured, a plan with a low premium and high deductibles may work better for you. If you're really into extreme sports and breaking bones, you should probably look into a higher premium that gives you a lower deductible.
Hopefully, this post has given you a little better understanding of health insurance jargon and the most popular plans available. However, if you're picking a new plan, it is still up to you to research what specific plans are out there (and available to you) and to decide what works best for you.
Alright, that's enough for now. Go get back to your families, enjoy your holidays, and check back in next Sunday for a new post!
Have a healthcare question you want answered? A topic you want addressed? Email whatthehealthnow@gmail.com!
Under an HMO, you first choose a Primary Care Physician (PCP). This PCP is your home base, so to speak. He or she will need to refer you to any specialists you may need within a network of pre-selected providers. So, let's say you have been having terrible foot pain. You'd first see your PCP, who would refer you to a podiatrist within the network. These network providers, i.e. doctors who have opted to participate in the specific plan, are the often the only ones your insurance will cover visits to. Usually, visits to out-of-network providers will not be covered.
PPOs give you a bit more flexibility in that you don't have to go through your PCP and you are welcome to visit service providers outside of your network. However, out-of-network providers will be at a higher cost, such that you will pay more out-of-pocket if you choose to go outside of your network (hence the origin of the "preferred" part of preferred provider organization). Additionally, you will likely have to pay a deductible during your visit.
Okay, let's pause here and go over the vocab of what consumers pay out-of-pocket. I just mentioned a deductible. This is the amount you pay yourself before your insurance coverage. Once you've paid 100% of your deductible, your insurance plan will cover the rest. In the case of a PPO, seeing an out-of-network provider means you will have to pay a higher deductible.
This premium is your periodic payment into the health insurance plan. Generally, your premium and deductible are inversely related: a higher premium means a lower deductible, and vice versa.
In addition to the deductible and premium there is also a copay. This is the flat rate amount you pay during doctors visit or for prescriptions. For example, on my plan, when I go in for my annual physical, I pay $10 copay during my visit.
Last but certainly not least, there is the coinsurance payment. This is the amount you pay after your copay and deductible and after the insurance company has paid their portion. If my coinsurance is 20% of remaining fees after the deductible, I pay the 20% of the bill that is left once my deductible is paid and my insurance pays their 80%.
Okay, let's move on to EPOs.
EPOs are like PPOs in that you usually don't need a PCP referral, but similarly to HMOs, out-of-network providers are not covered, unless in cases of emergencies.
HMOs, PPOs, and EPOs are only the most common plans, not the only ones available, and the details of each vary a bit based on your specific insurance provider. What works best for you complete depends on what is available through your employer, what you personally can afford, or your personal necessities. If you are rarely sick or injured, a plan with a low premium and high deductibles may work better for you. If you're really into extreme sports and breaking bones, you should probably look into a higher premium that gives you a lower deductible.
Hopefully, this post has given you a little better understanding of health insurance jargon and the most popular plans available. However, if you're picking a new plan, it is still up to you to research what specific plans are out there (and available to you) and to decide what works best for you.
Alright, that's enough for now. Go get back to your families, enjoy your holidays, and check back in next Sunday for a new post!
Have a healthcare question you want answered? A topic you want addressed? Email whatthehealthnow@gmail.com!
Thursday, December 18, 2014
on the unveiling of fluff & stuff 2.0!
I had mentioned previously that the blog was going to be receiving a makeover. I'll be kicking off the new era of Fluff & Stuff with this post. But first, a little background on the who, what, and why...
Who: I am two academic quarters away from B.A.s in Biology and Public Policy, but my main focus for the past year or so has been healthcare policy. In addition to my coursework, I have worked closely with doctors and nurses in the hospital setting as well as conducted my own research into the current healthcare system. While I do not have a formal economics background (though my boyfriend does, and will be assisting if/when he's needed) I have taken a significant amount of coursework, including at the graduate level, in healthcare and behavioral economics. And I've now got brand new Wall Street Journal and The Economist subscriptions as well as access to all my university's resources to help ensure I'm keep y'all up to date with the most accurate information.
What: My goal here is to explain, in an easily digestible manner, aspects of the healthcare industry on a behavioral economic level as well as some of the things anyone entering or already in the market should know, such as, what is a PPO? Each week will feature a different story, be it an explanation of a facet of our healthcare industry, a summary of recent breaking news, or a little healthcare history.
Why?: One thing I've realized is that people are generally un- or misinformed of many of the basics of the health industry, even though it is something we constantly come face-to-face with in our daily life. This blog intends to look at all aspects of the industry, from Obamacare, to what all the difference health insurance plans are, to the history and development of those nutrition labels you see on all your food.
Who: I am two academic quarters away from B.A.s in Biology and Public Policy, but my main focus for the past year or so has been healthcare policy. In addition to my coursework, I have worked closely with doctors and nurses in the hospital setting as well as conducted my own research into the current healthcare system. While I do not have a formal economics background (though my boyfriend does, and will be assisting if/when he's needed) I have taken a significant amount of coursework, including at the graduate level, in healthcare and behavioral economics. And I've now got brand new Wall Street Journal and The Economist subscriptions as well as access to all my university's resources to help ensure I'm keep y'all up to date with the most accurate information.
What: My goal here is to explain, in an easily digestible manner, aspects of the healthcare industry on a behavioral economic level as well as some of the things anyone entering or already in the market should know, such as, what is a PPO? Each week will feature a different story, be it an explanation of a facet of our healthcare industry, a summary of recent breaking news, or a little healthcare history.
Why?: One thing I've realized is that people are generally un- or misinformed of many of the basics of the health industry, even though it is something we constantly come face-to-face with in our daily life. This blog intends to look at all aspects of the industry, from Obamacare, to what all the difference health insurance plans are, to the history and development of those nutrition labels you see on all your food.
Wednesday, December 17, 2014
on bad journalism: part II
I have realized recently that very few people understand how to source check. Facebook has become (among other things) a cesspool for ignorant debates of ridiculously biased or misinformed articles.
I don't wish to use this post to spew judgment, but rather want to raise awareness that there is a lot of bad journalism out there and that it is very important, whether posting an article on Facebook or using it in an academic paper, to check your sources.
It's important to note that all journalism is biased. News sources get to choose the articles they run, which facts they convey, the language they use. However, reputable journalism is based on well-checked facts and is held to a high standard of ethics.
PewResearch conducted the Journalism Project to help define the 9 Core Principles of Journalism:
Where I see most of these sensational news sources, such as The Conservative Times, fail is in 1, 3, 8, and perhaps an over-use of 9. These sources have an obligation only towards a truth which serves their political purpose. They do not wholly embrace a system of verification. In fact, their fact checking is near non-existent. These sources pass opinion off as fact on readers who don't know any better or who don't wish to know any better, which is their freedom of speech. As a result, misinformed or intolerant readers stick to these sources that only confirm their pre-existing beliefs. In this way, the sources contribute to an ugly cycle of an ignorant public.
NPR has an Ethics Handbook which perhaps covers the bases of journalistic accuracy in a more digestible way, that can be utilized by readers as well:
I don't wish to use this post to spew judgment, but rather want to raise awareness that there is a lot of bad journalism out there and that it is very important, whether posting an article on Facebook or using it in an academic paper, to check your sources.
 |
| Just one of the Facebook posts that inspired this entry. |
PewResearch conducted the Journalism Project to help define the 9 Core Principles of Journalism:
1. Journalism's first obligation is to the truth.
2. Its first loyalty is to its citizens.
3. Its essence is a discipline of verification.
4. Its practitioners must maintain an independence from those they cover.
5. It must serve as an independent monitor of power.
6. It must provide a forum for public criticism and compromise.
7. It must strive to make the significant interesting and relevant.
8. It must keep the news comprehensive and proportional.
9. Its practitioners must be allowed to exercise their personal conscience.
Pew Research. Principles of Journalism. Accessed from: http://www.journalism.org/resources/principles-of-journalism/.
Pew Research. Principles of Journalism. Accessed from: http://www.journalism.org/resources/principles-of-journalism/.
Where I see most of these sensational news sources, such as The Conservative Times, fail is in 1, 3, 8, and perhaps an over-use of 9. These sources have an obligation only towards a truth which serves their political purpose. They do not wholly embrace a system of verification. In fact, their fact checking is near non-existent. These sources pass opinion off as fact on readers who don't know any better or who don't wish to know any better, which is their freedom of speech. As a result, misinformed or intolerant readers stick to these sources that only confirm their pre-existing beliefs. In this way, the sources contribute to an ugly cycle of an ignorant public.
NPR has an Ethics Handbook which perhaps covers the bases of journalistic accuracy in a more digestible way, that can be utilized by readers as well:
Selected Excerpts from NPR's Accuracy Guidelines
Edit like a prosecutor.
Good editors should test, probe, and challenge reporters, always with the goal of making NPR's stories as good (and therefore as accurate) as possible.
Take special care with news that might cause grief or damage reputations.
Guard against subjective errors.
When quoting or paraphrasing anyone - whether in a blog post, an online story or in an on-air “actuality” – consider whether the source would agree with the interpretation, keeping in mind that sources may sometimes parse their words even though we accurately capture their meaning. An actuality from someone we interview or a speaker at an event should reflect accurately what that person was asked, was responding to or was addressing.Be able to identify the source of each fact you report.
Give preference to primary sources.
(i.e. information directly from a first-hand account, such as a witness, rather than a second-hand source who heard from someone or third-hand source who heard from someone who heard from someone...and so on.)
Don't just spread information. Be careful and skeptical.
Be vigilant about presenting data accurately.
It’s easy to represent data inaccurately or misleadingly, especially in charts and infographics. Double-check your numbers and the way you portray them to make sure you’re imparting the proper information.
Source: NPR. Accuracy. NPR Ethics Handbook. Accessed from: http://ethics.npr.org/category/a1-accuracy/.
Again, no journalism is unbiased. However, some journalism is more accurate than others. When reading articles or preparing to site sources, make sure you are being a critical reader and judging the articles by the same guidelines news sources should be judging themselves. Is it fair? Are they using primary sources who are accurate cited? Are they clearly injecting opinion that is not supported by reputable facts, i.e. primary sources?
A little education can teach readers tune a critical eye for good, or bad, sources. I don't mean to harp on NPR, but their thorough and publicly available Ethics Handbook makes it an excellent starting point for learning how to read critically. For example, they even list case studies of when they went wrong, including how they went wrong. Studying these examples can give some insight into what a reader should be looking for.
As always, the key takeaway is this: question everything. No single news source has all the information and can give you the entire story. Accurately informing oneself requires thorough investigation of multiple sources with different political viewpoints and perspectives to truly be well-informed.
Think about it. If you were to, say, get in a fight with your younger sister, would you want Mom or Dad to only ask your sister what happened? Would you even want them to only ask your young brother, who had been standing by? Or, if this hypothetical situation is lost on your because you don't have siblings or have never fought with them because you're part god, imagine if you were accused of a crime. Would you only want the judge or jury to listen to the plaintiff?
Be smart out there, people!
Tuesday, December 2, 2014
on time management
With finals season right on the horizon, I thought this post would be particularly fitting. I currently have to prepare a presentation for a client due at the end of the calendar year, have a final on Saturday morning, have a final Tuesday morning, have to submit my final BA thesis proposal before the end of the quarter, am wrapping up my term as my sorority's President, am finishing up a write-up of my research for a fellowship grant due at the end of the calendar year, have to complete the patient interviews for a health policy study I'm assisting on, and I'm applying to jobs for after graduation.
I have never missed an assignment. I have never even turned one in late without obtaining professor approval first. But I have had a lot of stressful days and nights where I'm struggling to get it all done at the expense of my sleep schedule, social life, or sanity.
This obviously is unideal. Poor time management jeopardizes the quality of work produced and burns you out, affecting the effort you have left to give to other assignments. So here are some of my best practices for staying organized and managing your precious time well.
1.) Set daily goals.
Every morning, I wake up and write down 5-10 goals I have for the day. These can be simple little things like "Drop off dry cleaning" or "Email Joann about ______." They can also be much larger, such as "Study physics for 4 hours" or "Finish fellowship proposal." I try to limit myself to 3 big projects a day. I then set these as "Tasks" on my Google Calendar. Then I get to check off each goal as you complete it. I like the app Wunderlist as well.
2.) Limit distractions.
If you are working on something that doesn't require being plugged in, do not plug yourself in. Disable Wifi, put on Airplane mode. I am always surprised by how much I accomplish as soon as I stop texting/Facebooking/e-mailing and start working.
3.) Take Breaks
Ah now this is a tricky one, that can be easily abused. Let me clarify. If you are stuck on a, let's say, physics concept and you have now spent a good 45 minutes on it, close your book, stand up, walk around a little bit. I like to do a lap around the 1st floor of the library, say hi to a few friends, and get some coffee before I return to it. Sometimes I'll go complete another assignment or task. Usually, taking that time to clear my head means I come back stronger and suddenly, something clicks. This also works for me with video games.
4.) Spend less time worrying, more time doing
A common inflicting my friends and I tend to have (and perhaps the entirety of my college) is to spend a huge portion of time fretting over the amount of work we have to complete. Don't do this. Make your list in the morning, add to it as necessary, and get 'er done. The more time spent worrying, the more you SHOULD worry. It takes up time, it affects your work quality...Very bad negative feedback loop.
5.) Reflect upon your day
Before bed (yes you heard me, go to bed!!), review your day. Admire what you've accomplished, drag tasks you didn't complete onto the next day so you can do them first thing in the morning, and assess what went well or not-so well so you can learn from your mistakes. This is so important, and so rarely done. Self-assessment can be the difference between improvement and stagnation. And it doesn't need to be an official type deal where you sit across a desk from yourself. Hell, do it on the toilet. But do it!
With regard to the last one, some self-reflection has revealed that this blog is going to need a major revamping post finals. COMING SOON: fluff & stuff & more stuff 2.0.
Subscribe to:
Posts (Atom)