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Category Archives: Medicine

An Introduction to Health Insurance: What Should a Consumer Know?

CRS – An Introduction to Health Insurance: What Should a Consumer Know? Carol Rapaport, Analyst in Health Care Financing. April 30, 2015.
“Congress has seen a renewed interest in the market for private health insurance since the passage of the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended). This report provides an overview of private-sector (as opposed to government-provided) health insurance. It serves as an introduction to health insurance from the point of view of many consumers under the age of 65. No background in health insurance is assumed, and all terms are defined in the body of the report. A consumer may find the purchase of health care inherently different from some other purchases. Health care can be expensive, and many relevant details concerning future health care may not be known when the consumer is choosing an insurance plan, including when over the course of a year (if at all) health care will be purchased, which services will be needed, and the costs of those services. These characteristics of purchasing health care decrease the consumer’s ability to plan financially and increase the consumer’s exposure to financial risk. The purchase of health insurance reduces the risks and unpredictability inherent in paying for health services. An employed consumer may obtain health insurance from his or her employer if health insurance is offered by the employer (known as employer-sponsored insurance, or ESI) as a fringe benefit. All consumers may purchase health insurance directly (perhaps through an insurance agent or broker) from private insurance firms. In addition, all consumers may obtain health insurance through insurance exchanges, or marketplaces. Exchanges facilitate transactions between buyers and sellers of insurance but are not insurers. Health insurance plans can differ across many dimensions, including coverage, costs, flexibility in choosing providers, special features, and generosity. Two specific health insurance plan types that may be of interest to Congress are consumer-directed health care (CDHC) and value-based insurance design (VBID). Both these plan types have the potential to lower aggregate health care (however measured) by providing incentives for consumers to seek less care, or less expensive care. Which particular health insurance plan a consumer chooses depends on a number of factors, including the expected health of those covered by the plan, the price of the plan and of the medical services it provides, the consumer’s income, and the prices of the other goods and services the consumer wishes to purchase. In addition, because some health insurance plans are tied to employment, the consumer’s status as an employee also influences (and is influenced by) his or her choice of health insurance.”

New GAO Reports – Defense Transportation, Federal Veterinarians, U.S. Postal Service

Defense Transportation: Air Force’s Airlift Study Met Mandate Requirements, GAO-15-457R: Published: May 26, 2015. Publicly Released: May 26, 2015. Federal Veterinarians: Efforts Needed to Improve Workforce Planning, GAO-15-495: Published: May 26, 2015. Publicly Released: May 26, 2015. U.S. Postal Service: Improved Management Procedures Needed for Parcel Select Contracts, GAO-15-408: Published: Apr 23, 2015. Publicly Released:Continue Reading

New GAO Reports – Federal Home Loan Banks, Medicare

Federal Home Loan Banks: Collateral Requirements Discourage Some Community Development Financial Institutions from Seeking Membership, GAO-15-352: Published: Apr 23, 2015. Publicly Released: May 22, 2015: “Collateral requirements rather than membership requirements discouraged some nondepository community development financial institutions (CDFI)—loan or venture capital funds—from seeking membership in the Federal Home Loan Bank (FHLBank) System. CDFIs areContinue Reading

New GAO Reports – Federal Vehicle Fleets, Medicare Physician Payment Rates, Nuclear Weapons Council, Telecommunications, Unemployment Insurance

Federal Vehicle Fleets: Leading Practices for Managing Fleet Operations, GAO-15-644T: Published: May 21, 2015. Publicly Released: May 21, 2015. Medicare Physician Payment Rates: Better Data and Greater Transparency Could Improve Accuracy, GAO-15-434: Published: May 21, 2015. Publicly Released: May 21, 2015. Nuclear Weapons Council: Enhancing Interagency Collaboration Could Help with Implementation of Expanded Responsibilities, GAO-15-446:Continue Reading

New GAO Reports – Aviation Security, Border Security, Indian Affairs, Medicaid Demonstrations, North Korea Sanctions

Aviation Security: TSA Has Taken Steps to Improve Oversight of Key Programs, but Additional Actions Are Needed, GAO-15-559T: Published: May 13, 2015. Publicly Released: May 13, 2015. Border Security: Progress and Challenges in DHS’s Efforts to Implement and Assess Infrastructure and Technology, GAO-15-595T: Published: May 13, 2015. Publicly Released: May 13, 2015. Indian Affairs: FurtherContinue Reading

New GAO reports – Forest Restoration, Medicaid

Forest Restoration: Adjusting Agencies’ Information-Sharing Strategies Could Benefit Landscape-Scale Projects, GAO-15-398: Published: Apr 9, 2015. Publicly Released: May 11, 2015: “Agencies GAO reviewed—the Forest Service in the Department of Agriculture and the Bureau of Indian Affairs (BIA), Bureau of Land Management (BLM), Fish and Wildlife Service (FWS), and National Park Service (NPS) in the DepartmentContinue Reading

New GAO Reports – Medicaid, Telecommunications Relay Service

Medicaid: A Small Share of Enrollees Consistently Accounted for a Large Share of Expenditures, GAO-15-460: Published: May 8, 2015. Publicly Released: May 8, 2015: “A small percentage of Medicaid-only enrollees—that is, those who were not also eligible for Medicare—consistently accounted for a large percentage of total Medicaid expenditures for Medicaid-only enrollees. In each fiscal yearContinue Reading

Antibacterial Drug Shortages From 2001 to 2013

Antibacterial Drug Shortages From 2001 to 2013: Implications for Clinical Practice. Clin Infect Dis. (2015) doi: 10.1093/cid/civ201 First published online: April 22, 2015 “Background. Previous studies have described drug shortages; however, there has been no comprehensive evaluation focusing on US antibacterial shortages. Methods. Drug shortage data from the University of Utah Drug Information Service database were analyzed,Continue Reading

New GAO Reports – Drug Discount Program, Homeland Security, James Webb Space Telescope, NASA, Unmanned Aerial Systems

Drug Discount Program: Status of GAO Recommendations to Improve 340B Drug Pricing Program Oversight, GAO-15-455T: Published: Mar 24, 2015. Publicly Released: Mar 24, 2015. Homeland Security: Action Needed to Better Assess Cost-Effectiveness of Security Enhancements at Federal Facilities, GAO-15-444: Published: Mar 24, 2015. Publicly Released: Mar 24, 2015 James Webb Space Telescope: Project Facing IncreasedContinue Reading

New GAO Reports – Border Security, DOJ Budget, Medicare, National Nuclear Security Administration, Nuclear Waste, Private Health Insurance

Border Security: Additional Efforts Needed to Address Persistent Challenges in Achieving Radio Interoperability, GAO-15-201: Published: Mar 23, 2015. Publicly Released: Mar 23, 2015. Department of Justice: Alternative Sources of Funding Are a Key Source of Budgetary Resources and Could Be Better Managed, GAO-15-48: Published: Feb 19, 2015. Publicly Released: Mar 23, 2015. Medicare: Payment MethodsContinue Reading

Two out of 3 people with invasive cancer are surviving 5 years or more

CDC press release: “Two out of 3 people diagnosed with cancer survive five years or more, according to a CDC study published in today’s Morbidity and Mortality Weekly Report. The report found that the most common cancer sites continue to be cancers of the prostate (128 cases per 100,000 men), female breast (122 cases perContinue Reading

CRS – Genetic Testing: Background and Policy Issues

Genetic Testing: Background and Policy Issues. Amanda K. Sarata, Specialist in Health Policy. March 2, 2015. “Congress has considered, at various points in time, numerous pieces of legislation that relate to genetic and genomic technology and testing. These include bills addressing genetic discrimination in health insurance and employment; precision medicine; the patenting of genetic material;Continue Reading