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Reference Links

Worstpills Independent source for prescription drug information.
Partnership for Prescription Assistance Through this site, the Partnership for Prescription Assistance offers a single point of access to more than 275 public and private patient assistance programs for prescriptions, including more than 150 programs offered by pharmaceutical companies.
Healthcare Coverage Options Database An on-line tool to help make American health care consumers aware of all of the coverage options available to them. The Database contains information about private health insurance coverage, as well as the many public and private programs available to Americans to help them obtain the medical care they need.
StateHealthFacts.org Source of information provided by the Kaiser Family Foundation about state-level health services.
healthinsuranceinfo.net Georgetown University has written a consumer guide about your medical insurance rights for each state and the District of Columbia, each of which is available on this site.
Nieman Watchdog - "Health" Put out by the Nieman Foundation for Journalism at Harvard University. Its aim is to encourage more and better watchdog reporting, and it is targeted at reporters, editors and concerned citizens.
Hospital Compare This tool provides you with information on how well the hospitals in your area care for all their adult patients with certain medical conditions.
Association of Health Care JournalistsAn independent, non-profit organization dedicated to advancing public understanding of health care issues. Its mission is to improve the quality, accuracy and visibility of health care reporting, writing and editing.
patientINFORMA free online service that provides patients and their caregivers access to some of the most up-to-date, reliable and important research available about the diagnosis and treatment of specific diseases.
Health HippoHealth Hippo is a collection of policy and regulatory materials related to health care, with some graphics sprinkled in. It would be wise to confirm anything you intend to rely on with a hardcopy of the reference.
Boston University Health Reform ProgramThe Health Reform Program designs practical solutions to health care problems�solutions that address the needs of all parties.


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Pat Sullivan Blog - Long-time sufferer of Candida, Chronic Insomnia, Mercury-Toxicity, Chronic Fatigue, Irritable Bowel, and Adrenal Fatigue Syndromes. (But doing quite well now!)




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Mon Oct 17, 2005

California Employers Offer Cross-Border Healthcare in Mexico

Southern California employees travel to Mexico, where they receive healthcare that is less expensive and reportedly better, according to the San Diego Union-Tribune.

Posted by: Duncan Kinder on Oct 17, 05 | 3:07 pm

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Tue Oct 11, 2005

Employers and Employees Struggle With Health Care Costs; Rate Hikes Continue to Outpace Inflation and Salary Increases

U.S. companies continue to face significant health care cost increases, but 2005�s is the lowest rate increase in six years, according to global human resources services firm Hewitt Associates (NYSE: HEW). For 2006, Hewitt is projecting a 9.9 percent average increase for employers, following 2005�s 9.2 percent increase.

Employees� contributions for health care have steadily increased, nearly doubling since 2002. Hewitt projects that the average employee contribution1 for 2006 will be $1,612, representing 20 percent of the overall health care premium, and up from $1,444 in 2005.

In addition to significant employee contribution increases, employees also have experienced increased out-of-pocket costs, such as copayments, coinsurance and deductibles. The average employee out-of-pocket costs are expected to increase from $1,366 in 2005 to $1,524 in 2006. Overall, employees� total health care costs -- including employee contribution and out-of-pocket costs -- are projected to be $3,136 in 2006, up 12 percent from $2,810 in 2005.

With relatively flat pay increases -- Hewitt projects salaried exempt employees can expect a base salary increase of 3.6 percent2 in 2006 -- rising health care costs are offsetting salary gains for many workers. For example, an employee making $40,000 today who receives the average salary increase ($1,440) will use 23 percent of that increase to pay for the increase in health care costs next year.

�While it is encouraging to see cost increases stabilizing, the rate of growth remains unsustainable and the magnitude of health care costs continue to be a major concern for employers� bottom lines and employees� wallets,� said Craig Dolezal, national health care practice leader at Hewitt Associates. �These slightly lower cost increases are due to a variety of factors, including increased consumer awareness and financial responsibility, continued consolidation of health plans and providers, and lower overall inflationary demands. However, health care is still growing almost three times faster than wages and general inflation.�

Cost Increases by Major Metropolitan Area

While Hewitt�s data shows a moderation in costs, a few major U.S. markets continued to experience double-digit increases. Hewitt�s 2005 data reveals that the following markets recorded the highest rate increases: Cleveland/Akron (12.2 percent), Boston (11.1 percent), Atlanta (11.1 percent), Houston (10.6 percent), Orlando (10.4 percent), Kansas City (10.4 percent), Orange County (10.4 percent), Sacramento (10.4 percent) and Tampa Bay Area (10.3 percent).

�Health care remains a very local issue driven by demographics, regional health issues, and the market dynamics of the providers and health plans competing for patients and members. The current efforts for more consistent treatment protocols, better health risk management, and price and quality transparency will narrow, not eliminate, these regional differences over time,� said Dolezal.

2006 Cost Increases by Plan Type

On average, Hewitt forecasts that companies will experience 2006 cost increases of 9.5 percent for preferred provider organizations (PPOs), 10 percent for health maintenance organization plans (HMOs), and 10.5 percent for both traditional indemnity and point-of-service (POS) plans.

That means, from 2005 to 2006, the average cost per person for major companies will increase from $7,048 to $7,752 for HMOs; $7,374 to $8,075 for PPOs; $7,322 to $8,091 for indemnity plans; and $7,849 to $8,673 for POS plans.

Employer Reaction to Rate Increases

Companies continue to evaluate and implement substantial changes -- both traditional and leading-edge strategies -- to manage increasing health care costs. Hewitt Associates is currently working with many large employers to develop new strategies to reduce costs and assist employees with managing their heath care decisions and financial responsibilities, including:

* Offering consumer-directed health plans. Hewitt has found that companies with significant enrollment in consumer-directed health plans, such as account based plans and customized �build-your-own� designs that allow employees to tailor a plan based on their individual health and financial needs, are experiencing rate increases well below the national trend or, in some cases, even decreased costs. �To date, Hewitt has helped more than 100 organizations introduce consumer-directed plans and we�re starting to see positive results,� said Dolezal. �We�re continuing to see a lot of interest in these plans and expect even more companies will offer them in the next few years, maybe as many as 25 to 30 percent of all large employers.�

* Contracting with plans that offer specialized or health risk management programs and focus on wellness and prevention. In an effort to enhance or maintain the health of their workforce, more employers are offering specialized or health risk management programs that can help manage employees� chronic health conditions. More companies are offering wellness and health promotion programs, as well as providing financial incentives for employees to participate in these programs. �In the end, we need to continue to help people better manage their health risks and the care they receive if we have any real hope of reducing health care cost increases,� said Dolezal.

* Requiring more quality data and price transparency. Employers have increased their focus on quality. Many are choosing to work only with plans and hospitals that have solid track records in terms of efficiency, quality, outcomes and cost. Quality information is becoming more detailed and widely available, and employers have begun to require greater cost transparency, especially in the area of prescription drugs.

* Changing prescription drug coverage. Prescription drug costs continue to be a major driver behind insurance hikes, and employers are actively evaluating new strategies to contain these costs. For next year, companies are implementing higher copayments and coinsurance models, mandating low-cost substitution provisions and mail-order for certain therapeutic drug classes, and offering generous generic programs and designs.

�The American public will continue to demand the highest level of health care in the world, and the health care industry will continue to strive to deliver that level of service. Our challenge and obligation then is to satisfy those demands in the most efficient manner possible by identifying and promoting consistent quality care at affordable costs for both employers and patients,� said Dolezal.

About Hewitt's Data

Hewitt�s health care cost data is derived from the Hewitt Health Value Initiative, a cost and performance analysis database of more than 2,000 health plans throughout the U.S., including 400 major employers and more than 18 million health plan participants.

Posted by: Duncan Kinder on Oct 11, 05 | 1:08 pm

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Wed Sep 28, 2005

Survey: 2006 Employee Health Care Costs to Raise 8 Percent

According to the 2006 Towers Perrin Health Care Cost Survey, U.S. employers are facing an 8% increase in their 2006 health care costs. Moreover, the cumulative effect of years of double-digit increases has produced a record high for employer-sponsored health care costs in America. In flat dollar terms, next year�s gross health care expenditure is expected to rise by an average of $597 per employee, to an average total cost of $8,424 -- representing a 140% increase over the last 10 years.

Employers continue to shoulder the majority of the burden. Employees on average will pay $155 more in 2006, representing a 10% increase from the year before. Employers, on the other hand, will see an increase of $442 per employee, absorbing 74% of the total cost increase. Overall, employers will pay 80% of premium costs and employees will pay 20%.

Notably, while the average cost of health care coverage will increase by $597 per employee in 2006, this figure would have been close to $750 were it not for employer efforts to aggressively manage program performance through vendor selection and performance management, prescription drug expenditures, care management, employee engagement and other initiatives.

These observations are drawn from top-line results of the annual survey, now in its 17th year, conducted by Towers Perrin�s HR Services Business. This year�s survey includes data on the health benefit programs provided by more than 200 of the nation�s largest employers, covering over five million U.S. employees, retirees and dependents.

�The health care cost crisis has become a chronic problem for U.S. employers and employees alike,� said David Guilmette, Managing Director of Health and Welfare for Towers Perrin. �There is a fundamental tension between managing costs and managing people that constrains how much of the cost can be shifted to employees. Given the huge cost base built up over the years and continuing inflation at rates well above CPI, employers simply have to take a longer-term view. With this perspective as a platform, some employers are moving toward a model that increases employees� responsibility and accountability -- engaging them in a long-term solution to a problem that is not going away. And these companies are beginning to see positive outcomes and a significant difference in program performance.�

A Crisis Turns Chronic
A historical view highlights the magnitude of the health care cost problem and why cost inflation -- whether at single- or double-digit rates -- now produces significant additional burdens for both employers and employees. Employees are paying 64% more in health care costs today than they spent five years ago. Employers, meanwhile, are paying 78% more in health care costs today than five years ago.

Employers continue to bear the lion�s share of the cost, and although cost-shifting in past years has increased employees� relative share, the 2006 survey suggests that employers recognize the need to look beyond stopgap �fixes� that simply shift costs and may have negative consequences for effective workforce management over the longer term.

For example, this year�s survey shows that the average employee share of premium costs will increase 10% in 2006, while the employer share will increase by 7%. In the 2005 survey, the cost increases experienced by employees and employers were 12% and 8%, respectively. In the 2006 survey, the bulk of the increase in the dollar amounts contributed by employees is due to inflation on their share of the premium, with less impact coming from cost shifting (increasing the employees� percentage of the cost).

Active Employee and Retiree Medical Costs Continue to Climb
The average reported 2006 cost of medical coverage for all types of health plans combined is $355 per month ($4,260 annually) for active employee-only coverage; $715 per month ($8,580 annually) for employee-plus-one-dependent coverage and $1,033 per month ($12,396 annually) for family coverage.

The total cost for retirees under age 65 is the highest in our survey -- $562 per month for retiree-only coverage ($6,744 annually) and more for coverage that includes dependents. Notably, the rate of cost increase for this group is higher than for active employees -- 10% versus 8% for active employees -- a trend that has persisted in employer-sponsored plans since 1999. This is of particular concern for employers who have large postretirement medical obligations.

Meanwhile, the Medicare Modernization Act is changing the landscape for employer-sponsored retiree medical programs. With a 2006 effective date for Medicare Part D on the horizon, the vast majority (83%) of the survey respondents who offer retiree medical say they will provide prescription drug coverage at least as rich as Medicare�s new program and take the federal subsidy offered to employers who provide this benefit.

For many companies, however, the 2006 approach could be an interim step toward a new strategy for the longer term as the impact of rising costs, changing demographics and the new Medicare law combine. Notably, over half (53%) of responding companies offering retiree medical say the Medicare changes will prompt them to rethink their commitments to all retirement programs, including both medical and retirement income benefits.

Employees Have More at Stake
Despite what appears to be a slowdown in costshifting, the data suggest that the trend toward greater sharing of costs between employers and employees is still under way. And in flat dollar terms, the employee share represents a significant cost by any standard. Employees will contribute 18% of the premium cost for employee-only coverage and 21% for dependent coverage (20% overall) -- an average of $63 a month ($756 annually) for employee-only coverage and $217 a month ($2,604 annually) for family coverage in 2006.

Retirees, meanwhile, will contribute approximately 43% of the total cost of their coverage. Retirees under 65 will pay an average of $244 a month ($2,928 annually) for retiree-only coverage, while retirees age 65 and older will pay an average of $108 a month ($1,296 annually) for retiree-only coverage.

�As health care costs continue to rise faster than the rate of general inflation, it�s more important than ever for employees to actively participate in controlling the overall spend and realize that increasing costs will affect them in both direct and indirect ways,� said Guilmette. �Clearly, as the company�s health care costs increase, the employee�s cost goes up as well. Continuing high inflation rates mean that employees� out-of-pocket health care expenses will also rise. And, at the end of the day, employees need to recognize that a larger piece of the total compensation pie is being taken up by health care costs.�

�The money has to come from somewhere, and increasingly we�re seeing it come from resources set aside to reward employee performance,� adds Ron Fontanetta, Principal in the Towers Perrin Health and Welfare practice. �Health care has become a tremendous financial burden on employers, and unless health care cost increases moderate, the funds available for compensation and rewards will be reduced. Moreover, as employees plan for retirement, they need to factor in health care premium costs because future retirees will often have to pay the entire amount.�

Beyond the Averages: Creative Actions Can Drive Positive Results
The survey data overall tell a sobering story, but the averages don�t give the complete picture -- i.e., the data also show significant variations in both the flat dollar and percentage cost increases experienced by U.S. companies and their employees. And the survey results suggest that companies with lower-than-average costs are doing some creative things -- notably, taking a comprehensive, longer-term approach to cost management and actively engaging employees in the process.

To better understand the factors that contribute to lower costs, the Towers Perrin analysis divides the survey group into three categories -- low-cost companies (companies in the lower third, with the lowest premium level per employee), average cost (the middle third) and high cost (the upper third, experiencing the highest cost per employee).

The cost variation across these groups is significant, with companies in the upper third facing a total cost of $10,022 per employee in 2006, against a $6,866 per employee cost for companies in the lower third. The rate of cost increases for the two groups -- 9% versus 6%, respectively -- is also notable. �While some variations in health care costs can be explained by differences in geography or employee demographics, many companies are experiencing better cost containment as a direct result of proactive steps they have taken,� said Guilmette.

Looking more closely at what distinguishes these groups, a number of key findings come to light. First, the low-cost companies seem to be looking at all aspects of their vendor relationships for quality of care, efficiency and cost-saving opportunities. For example, these companies are more likely than their high-cost counterparts to have consolidated vendors or implemented enhanced vendor performance standards/service levels. They are also much more likely to have implemented processes to monitor the results of their care management initiatives.

Aggressive vendor management does appear to yield results that go beyond the impact of geographic and demographic differences. And, while the average increase for HMOs in this year�s survey is 9% (compared with 7% for other plans overall), for the �low cost� companies, the average HMO increase is only 7%. �Smart employers are managing their HMOs using tactics that have been successful with PPOs, such as terminating poor-performing vendors and using self-insured arrangements,� noted Fontanetta.

�The gains achieved through aggressive program management allow these employers to minimize any cost shift to employees, as shown in the contrast between the rate of cost increases for employees at high-cost versus low-cost companies,� added Fontanetta.

Relief from cost shifting does not mean, however, reduced responsibility for employees at the low-cost companies. In fact, companies with the lowest health care costs are more likely to be sharing more of the costs as a percentage of the total with employees -- i.e., employees at low-cost companies pay on average 22% of the total, while employees at high-cost companies pay 17%.

The companies with lower costs are also more likely to have put other cost-sharing elements into place that encourage employees to take responsibility for their decisions at the point of care. For example, the differential between the copay amount for brand-name drugs compared with that for generic drugs is greater for employees at low-cost companies than for those at high-cost companies, creating a stronger incentive to use the less expensive alternative. Other incentives aimed at increasing employee accountability include meaningful differentials between primary care and specialist copays, along with a move away from copays altogether to coinsurance -- a trend much more prevalent among the low-cost companies.

Perhaps most important, companies with the lowest costs are not only requiring employees to take more responsibility for their health care decisions, but are also equipping them to do just that by communicating more effectively about health care costs, providing decision support tools and encouraging them to understand and manage their health risks.

�Most of the companies in the survey say they see their role and responsibility as employers continuing as it is or even growing over the next five years,� said Guilmette. �In other words, they see themselves in the game for the foreseeable future. But it�s interesting to note that companies with lower costs also seem to have more of a long-term philosophy and are taking actions that minimize the need to shift costs to employees.

�For employees who work at these more proactive companies, there is a quid pro quo. They must actively share responsibility, understand and accept the financial consequences of their decisions, and protect and invest in their own health,� added Guilmette. �Overall, we call this a culture of health -- employers and employees together managing the money, managing the vendors and providers, and sharing a commitment to the value of employee health.�

About the Survey
The Towers Perrin 2006 Health Care Cost Survey was conducted during August and September 2005. Participants were asked to report their 2006 per capita premium costs for insured health and dental plans, and premium equivalents (i.e., estimated benefit and administrative costs) for self-insured plans. Survey respondents represent primarily Fortune 1000 companies with operations in numerous locations nationwide. Health benefits for the 204 participating companies cost more than $24 billion annually.

Posted by: Duncan Kinder on Sep 28, 05 | 8:01 pm

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Thu Sep 15, 2005

Survey: The Percentage of Businesses Offering Health Insurance to Their Workers Has Declined Steadily Over the Last Five Years

The percentage of businesses offering health insurance to their workers has declined steadily over the last five years as the cost of providing coverage continues to outpace inflation and wage growth, according to the 2005 Annual Employer Health Benefits Survey released by the Kaiser Family Foundation and Health Research and Educational Trust.

The survey found that three in five firms (60%) offered coverage to workers in 2005, down significantly from 69% in 2000 and 66% in 2003. The drop stems almost entirely from fewer small businesses offering health benefits, as nearly all businesses (98%) with 200 or more workers offer such benefits.

�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,� Kaiser Family Foundation President and CEO Drew E. Altman, Ph.D., said.

Premiums increased an average of 9.2% in 2005, down from the 11.2% average found in 2004. The 2005 increase ended four consecutive years of double-digit increases, but the rate of growth is still more than three times the growth in workers� earnings (2.7%) and two-and-a-half times the rate of inflation (3.5%). Since 2000, premiums have gone up 73%.

The annual premiums for family coverage reached $10,880 in 2005, eclipsing the gross earnings for a full-time minimum-wage worker ($10,712). The average worker paid $2,713 toward premiums for family coverage in 2005 or 26% of the total health premium. While workers� share of their premium has been relatively stable over the past few years, they are now paying on average $1,094 more in premiums for family coverage than they did in 2000.
�While premium increases slowed this year, they continue to rise much faster than inflation and other economic indicators. As a result, workers and businesses alike are finding it harder to afford health coverage,� said Health Research and Educational Trust President Mary A. Pittman, Dr. P.H.

High-deductible health plans

The survey found that 20% of employers who offer health insurance now provide a high-deductible health plan option. Jumbo firms � those with 5,000 or more workers � are significantly more likely than smaller firms to offer a high-deductible plan option, with 33% offering one in 2005. The survey defines high-deductible health plans as those with at least a $1,000 deductible for single coverage or at least a $2,000 deductible for family coverage.

Among employers who offer a high-deductible plan, relatively few (19.5%, or 3.9% of all offering employers) also make a contribution to a health reimbursement arrangement (HRA), offer a plan that would permit an enrollee to establish a health savings account (HSA), or do both. HRAs and HSAs are tax-favored accounts that employees can use to pay for medical expenses. Such arrangements are often described as consumer-driven because patients pay for a greater share of their health care directly, rather than through insurers, and therefore may have a financial incentive to reduce their health-care spending.

Despite the growing availability of high-deductible plans, relatively few workers are enrolled in consumer-driven arrangements. The survey estimates that this year about 2.3% of non-federal covered workers, or 1.6 million people, are enrolled in high-deductible health plans with an HRA, and about 1.2%, or 810,000 people, are enrolled in plans that are eligible for use with an HSA.

�Consumer-driven plans are proving attractive to some, but with just a couple million people now enrolled, it's too early to know whether they'll have a meaningful effect on the health system,� said Gary Claxton, a Kaiser Family Foundation vice president and co-author of the study. �The jury is still out on whether employees feel that these arrangements work for them, particularly when they get sick, and on whether employers feel that they have a real impact on costs.�

The survey also provides a detailed look at the features of high-deductible health plans, including premiums, deductibles, use of spending accounts, and employer and worker contributions. Such plans can cost less than other forms of employer-sponsored health coverage, but also leave workers exposed to greater potential out-of-pocket costs.

�Premium increases have slowed somewhat, but there's little confidence out there that we have an answer to health care cost growth,� said Jon Gabel, co-author of the study. �In the mid-1990s, premium hikes dropped to less than 1%, and we're still far away from that right now.�

Other highlights from the 2005 survey include:

* Reasons for not offering coverage. Firms that do not offer health benefits to their workers � the overwhelming majority of whom are small firms � were most likely to cite cost as a key factor, with nearly three in four (73%) saying high premiums were �very important� to their decision. In comparison, just over half (52%) said their firm�s small size and one in three (33%) said the fact that their workers had access to other coverage were very important to their decision.

* Type of insurance. In 2005, PPO plans were more common than ever, with 61% of all employees with health coverage enrolling in a PPO (up from 55% in 2004). Enrollment in HMOs, which generally cost less than PPOs, fell to 21% in 2005 from 25% in 2004. Conventional, or indemnity, benefit plans have all but disappeared, covering just 3% of covered workers.

* Future plans. Looking toward the future, more than 40% of large firms (200 or more workers) offering health benefits say they are �very likely� to ask employees to pay more in premiums next year, while just 15% of smaller firms say they plan to do so. Across all firms offering coverage, relatively few say that they are �very likely� in the next year to raise deductibles (8%), raise office visit cost-sharing (7%) or raise prescription drug copayments (7%). About 1% of firms say they are �very likely� to drop health coverage entirely in the near future.

* Utilization and disease management. About eight in 10 covered workers (81%) are in a health plan that uses case management for high-cost claims. Most covered workers also must get prior certification for inpatient services (75%) and outpatient surgery (55%). More than half (56%) of covered workers are enrolled in a plan with at least one disease management program. Among workers in these plans, virtually all (99%) are in a plan that provides management for diabetes. Large majorities are also in plans that provide management for asthma (86%), hypertension (82%), and high cholesterol (66%).

* Confidence in cost-containment strategies. Few employers have a lot of confidence in strategies to contain rising health-care costs. For example, 16% of employers say consumer-driven health plans are �very� effective at controlling costs, while another 45% say they are �somewhat� effective. Nearly as many view higher employer cost-sharing as very (12%) or somewhat (46%) effective, and view disease management as very (14%) or somewhat (38%) effective. Fewer see tighter managed-care networks as very (7%) or somewhat (37%) effective.

The 2005 Employer Health Benefits Survey was conducted between January and May of 2005 and included 2,995 randomly selected, non-federal public and private firms with three or more employees (2,013 of which responded to the full survey and 982 of which responded to an additional question about offering coverage).

The full survey is available online.

The survey is a joint project of the Kaiser Family Foundation and the Health Research and Educational Trust. A research team at Kaiser and HRET conducted and analyzed the survey, led by Gary Claxton, Vice President and Director of the Health Care Marketplace Project at Kaiser, and Jon Gabel, formerly of HRET and now Vice President of the Center for Studying Health System Change.

Posted by: Duncan Kinder on Sep 15, 05 | 12:26 am

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Wed Sep 14, 2005

Survey: Health Care Costs Rise More Slowly For Employers As They Shift Costs to Employees

The health care benefit cost trend continues to move in the right direction for employers, but only because they continue to cut benefits and take other steps to manage cost. According to a survey of 1,883 employers released today by Mercer Human Resource Consulting and Marsh Benefits, if employers simply renewed their current medical plans, making no changes, their average cost increase would be nearly 10% � about three times the rate of general inflation. For many employers, an increase of that size just isn�t manageable.

When asked what their actual cost increase for 2006 will be � after making plan design changes � employers predicted an average increase of 6.4%. The tactic many will use to hold down their cost increase is cost-shifting.

�We used to think of cost-shifting as something you could do only every so often. But we�re seeing a new willingness on the part of employers � born of desperation � to shift cost in successive years to achieve acceptable cost increases,� says Blaine Bos, Mercer�s Minneapolis office leader for health and group benefits. �At the same time, we�re helping many employers with longer-term initiatives such as health management and consumerism, with encouraging results.�

Last year, according to Mercer�s National Survey of Employer-Sponsored Health Plans 2004 , cost rose 7.5% for all employers. However, large employers (500 or more employees) experienced a much sharper increase (9.0%) than smaller employers (5.5%). Small employers are much more likely to use insured, rather than self-funded, health plans, and an effect called the underwriting cycle brought lower prices in the insured health plan market. In 2006 small employers will again fare better than large, although the difference will not be as marked as in 2004. Large employers predict an average final increase of 6.8% for 2006, compared to 5.8% among small employers.

When asked about the types of changes they would make to reduce their cost increase for 2006, nearly two-thirds of the large employers surveyed (62%) said they would shift cost to employees. Cost-shifting tactics include increasing the percentage of premium paid by the employee (39% of large employers), or raising deductibles, copayments, coinsurance, or out-of-pocket maximums (32%). An additional 17% said they will increase cost-sharing some other way.

With cost rising more slowly for small employers, a smaller percentage of them (35%) said they would shift cost to employees in 2006. �Small employers also have less flexibility to tinker with plan design,� says Mr. Bos. �They�re most likely to shop around for a cheaper plan.�

These are preliminary findings from Mercer�s National Survey of Employer-Sponsored Health Plans 2005 . The survey is still in the field and the complete results, including the actual cost increase for 2005, will be released by the end of the year. The preliminary results discussed above are based on employers who responded by Sept. 7; these results are not weighted and represent only the respondents. Ultimately, close to 3,000 employers will participate in the survey and the final results will be weighted to be nationally projectable. For more information on Mercer�s survey, visit www.mercerhr.com/ushealthplansurvey

Posted by: Duncan Kinder on Sep 14, 05 | 11:43 pm

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Thu Sep 01, 2005

Lost Labor Time Costs U.S. $260 Billion Each Year

Sickness and health problems among working-age Americans and their families carry an estimated price tag of $260 billion in lost productivity each year. This reflects economic losses from adults with chronic disease, disability, or other health problems who are not working; workers who take sick days to care for themselves or sick family members; and workers who show up for work sick or worried about sick relatives, according to a study released today by The Commonwealth Fund.

Approximately 18 million adults, 12 percent of all U.S. adults ages 19 to 64, have a disability, handicap, chronic disease, or other health problem, and are not employed as a result. This lack of labor force participation takes a toll both on families and the overall economy in terms of lost income. Valued at the minimum wage, the loss amounts to $185 billion annually.

In addition, an estimated 69 million workers reported missing days of work due to illness in the past year, for a total of 407 million lost work days in 2003, and $48 billion in lost economic output.

"The health status of workers has significant implications for the economy," said Karen Davis, president of The Commonwealth Fund and lead author of this study. "The main focus of policymakers has been on the cost of providing health insurance to all Americans, but we have neglected to consider the costs sustained by those who are too sick to work or function effectively."

When workers show up for work even though they are not feeling well or are distracted with thoughts of a sick family member or their own health, their reduced productivity can exact a cost in the workplace. Approximately 55 million workers reported a time when they were unable to concentrate at work because of illness or a family member's illness. This amounted to 478 million days per year of reduced productivity, at an estimated cost of $27 billion. There is also increased risk of injury and spreading contagious diseases to co-workers.

"Providing workers with the means to maintain their health�through affordable and comprehensive health insurance coverage, sick leave, and disease management programs�has the potential to enhance the health and productivity of our workforce," said Sara R. Collins, senior program officer at The Commonwealth Fund and a co-author of this report. "Investments in worker health could yield economic payoffs for working families, employers and the economy as a whole."

Adults with children, either single or married, were more likely to report taking any sick days than single or married adults without children. They were also more likely to report inability to fully concentrate at work, according to the report, Health and Productivity Among U.S. Workershttp://www.cmwf.org/publications/publications_show.htm?doc_id=294176, by Fund staff Karen Davis, Sara R. Collins, Michelle M. Doty, Alice Ho, and Alyssa L. Holmgren.

Employer benefits such as paid sick leave or paid time off to see a physician or dentist can make a difference in worker productivity. Workers who are unable to take paid time off to see a doctor during work hours were more likely to miss work or experience one or more days at work in which they were unable to concentrate because of their own illness or that of a family member.

The authors note several strategies that policymakers and business leaders could adopt to help stem economic losses due to illness:

* Research has shown that well-run corporate disease management and health promotion programs can improve workers' health and productivity.
* Providing health insurance coverage for all workers would increase the use of preventive care and help ensure early treatment of acute illnesses and ongoing management of chronic conditions.
* Sick leave and paid time off to see a physician are important benefits to ensure that workers have time to get needed care, recover, or tend to sick family members.

Data come from The Commonwealth Fund Biennial Health Insurance Survey (2003), a national telephone survey conducted September 3, 2003 through January 4, 2004 among a random, nationally representative sample of 4,052 adults (defined as individuals age 19 and older) living in the continental United States, weighted by age, sex, race/ethnicity, education, household size, and geographic region. The analytic sample consists of 1,808 part-time and full-time workers. The survey has an overall margin of sampling error of +/� 2 percentage points at the 95 percent confidence level. The 50 percent survey response rate was calculated consistent with standards of the American Association for Public Opinion Research.

Posted by: Duncan Kinder on Sep 01, 05 | 1:43 pm

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Sat Aug 27, 2005

UAW: No Reduction in Health Benefits without Matching Cuts in Executive Pay

United Auto Workers union President Ron Gettelfinger is demanding General Motors Corp. cut executives and salaried workers' pay if it wants union help in trimming the automaker's $5.6 billion annual health care bill.

In addition, Gettelfinger said Friday he wants Blue Cross Blue Shield of Michigan to slash administrative costs in the union's health care plan. And he said GM's 12-member board of directors also should take a pay cut.

Read the entire story at Mlive.com.

Posted by: Duncan Kinder on Aug 27, 05 | 5:31 pm

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Sat Aug 06, 2005

LA Times: Retiree Health Benefits Challenge California State and Local Governments

According to the Los Angeles Times, new accounting rules are forcing California's state and local governments to face up to mounting obligations to fund their retired employees' health care.

Posted by: Duncan Kinder on Aug 06, 05 | 1:09 am

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Thu Aug 04, 2005

Communication Workers of America Launch Healthcare Website

A new website provides access to the latest information on the state of the health care system and gives working families the opportunity to directly tell their stories.

The site, www.healthcarevoices.org, is a project of the Communications Workers of America. It's a vehicle for workers to speak out about the health care crisis and to tell members of Congress, policy makers, the media and others that despite skyrocketing costs and expenses, the nation's health care system isn't working.

It also serves as a clearinghouse for the latest news and analysis on health care issues, with reports and findings from the National Coalition on Health Care, Families USA, and other organizations working to find a solution to the country's health care crisis.

"CWA is encouraging working families to share their experiences � the hardships they face and the choices they must make to keep health care coverage. Working families deserve a real solution to this crisis, not empty promises and greater cost shifting," said CWA President Morton Bahr.

CWA has endorsed five key principles for national health care reform: universal coverage, comprehensive benefits, affordability, fair financing, and quality care delivery, and has worked to achieve this reform at the bargaining table, in legislative arenas and in communities.

"Our country's health care crisis can't be fixed solely at the bargaining table," said CWA Executive Vice President Larry Cohen. "Our elected officials must face up to the crisis. CWA will continue to work with coalition partners, including some of our employers, to push for just such a solution. CWA remains committed to the goal of maintaining quality, affordable healthcare for our members."

On the website, workers can submit their stories and health care horror stories, search through the latest surveys and other research from organizations fighting for fair health care reform and can donate to CWA-COPE, with funds distributed to candidates for public office who have committed to working for working families, on health care reform and other important issues.

Posted by: Duncan Kinder on Aug 04, 05 | 12:11 am

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Wed Aug 03, 2005

Nebraska Joins Michigan in Using Accelerated Programs to Fight Nursing Shortage

The University of Nebraska Medical Center has begun an accelerated nursing program that compresses two and one-half years of instruction into one year, according to Omaha Channel.com.

The nation faces not only a nursing shortage but a nursing school instructor shortage, which means that training large number of new nurses is no easy trick. Accelerating nursing programs is intended to boost the productivity of those instructors that do exist.

As previously reported, Grand Rapids is also accelerating its nursing instruction program.

Posted by: Duncan Kinder on Aug 03, 05 | 11:42 pm

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