US Healthcare Spending to hit $3.8 Trillion in 2014

Dan Munro wrote that annual U.S. healthcare spending will hit $3.8 trillion this year (~21% of GDP).

11/20/2015: Spending actually has stayed mostly flat at about $3 trillion.

There’s good info in his Forbes article and the referenced Deloitte report, but it should not be taken politically one way or another. Centers for Medicare & Medicaid Services (CMS) data shows a slow bending of the cost curve, where the increases in health care expenditures are slowing slightly, the increase is slower than the economy, and it’s slightly slower than in previous years. Still, many of us hope to see costs decline outright, and by a lot.

Total Health Care Expenditures Grew 19% from 2006 to 2010.

The past four years have seen a gradual slowing in health care expenditure annual growth rate. The percentage change from the previous year slowed between 2007 and 2010: 5.9 percent in 2007, 4.7 percent in 2008, and 3.7 percent in 2009 and 2010.

To me, the real value is recognizing that there are hidden costs not captured in the official 2012 estimate of $2.8 trillion/year. Read More …

Multi-generation Homes & Communities

Multi-generation HomesMulti-generational homes were common during the Great Depression but declined once people rebounded economically. Now, as John Graham, coauthor of Together Again: A Creative Guide to Successful Multigenerational Living, observes, the recent recession has prompted a move back from valuing independence to interdependence.

Some 51 million Americans (16.7% of the population) live in a house with at least two adult generations, or a grandparent with at least one other generation, under one roof, according to a Pew Research Center analysis of the latest U.S. Census Bureau data. The Pew analysis also reported a 10.5% increase in multi-generation households from 2007 to 2009. Now builders are responding with homes designed specifically for multi-generation homes, or that can be modified to support that option later.

Could this trend be a utopia of built-in child care, elder care, three square meals, and shared costs? Could it avoid isolation in old age? Read More …

Saving while Helping your Kids & Parents

Click to view original photo

Flickr photo credit: geoffreyrockwell

By Lucy Stewart, a financial counselor
for families looking to get out of debt

Forty-eight percent of middle-age adults provided support to their adult children in 2012, which is up from 42 percent in 2005, according to PewSocialTrends.org. Also up is the financial support they provide their aging parents: 21 percent said they provided some financial support to a parent age 65 or older in 2012, up from 19 percent seven years earlier.

Offering financial support to your adult children and 65+ parents does not mean that you give up your own financial plans and dreams. Family is family, but sacrificing your personal well-being won’t benefit anyone. Look for ways to cut expenses and create streams of income, and don’t assume you have to do this alone. Read More …

The Elephant in the Room – Retirement Planning

The Elephant In The Room When It Comes To Family And Retirement

Elephant in the RoomThis is the first of a two-part series by Ken Dychtwald Ph.D. (Gerontologist, psychologist, author, entrepreneur and public speaker)

For most of us, our families make our lives — and life in retirement — richer and far more enjoyable. However, retirement planning has traditionally centered on just dollars and cents — and largely on the financial needs of an individual or a couple. With more and more of our lives impacted by family ties as well as family tensions, perhaps it’s time to rethink retirement planning from a more holistic perspective.

You may have already begun to notice in your own life that the hopes and dreams of today’s pre-retirees and retirees are increasingly complicated by three converging family-related trends: Read More …

Help Seniors Live Safely & Comfortably.

Portrait of a beautiful senior woman smiling at home

Help Seniors Live Safely & Comfortably
by Eliminating Safety Hazards at Home

Guest article by Anna Graves, a freelance writer
who lives on a farm in upstate New York.

Researchers from Colorado State University reported what most of us long suspected—the number one reason seniors fall in their home is tripping over something they didn’t see on the floor. The dangers don’t stop at the front door, either; uneven sidewalks, poor lighting and steep inclines present challenges for seniors. While you can’t remove every risk of a fall, you can explore your options to ensure your home (or the home of an elderly parent or friend) is safe.

First Things First

Every room in the home has potential dangers. Take a tour of the home with a friend or relative and look for hidden risks of a fall. Read More …

Every Patient is Unique

Lowering Health Care Costs Is Hard Because Every Patient Is Unique — That’s Bull $hit.

Drug MoneyBelow is my scathing response to this recent article in The Atlantic, by Dr. David A. Shaywitx, director of strategic and commercial planning at a San Francisco based biopharmaceutical company.

COMMENT:

I’m not surprised that this article was written by someone representing a biopharmaceutical company who sees every cure as a new drug and has a profit motive to find ways to justify high costs – in this case the “complexity of patients.”

This is exactly what’s wrong with our health care system – it’s actually a sick care or disease management system that has nothing to do with keeping people well and healthy and that treats symptoms to keep patients alive but coming back as paying customers. Read More …

Middle Generation: Rising Cost of Care for America’s Elderly

Middle Generation LadiesBy Caroline Montague

With an aging population and a generation of young adults struggling to achieve financial independence, the burdens and responsibilities of middle-aged Americans are increasing. Nearly half (47 percent) of these adults have a parent age 65 or older and are either raising a young child or financially supporting a grown child (age 18 or older). In addition, about one in seven middle-aged adults (15 percent) are providing financial support to both an aging parent and a child.

Adult children, worried about costs and the loss of their parents’ independence, must make difficult decisions about the best options for care for their loved ones. Assisted living communities, such as Emeritus assisted living, allow individuals to remain independent as long as possible in an environment that maximizes the person’s autonomy, dignity, privacy and safety. These types of communities also encourage family and resident involvement. (Editor: Emeritus is one of the largest and most well known, but you can also compare facilities in your area by zip code.)  Read More …

Long-term Care – 11 Myths and Facts

Long-term Care Myths & FactsMost people over 65 will need some kind of help with the activities of daily living such as bathing, dressing, or moving around. The need for such help can stem from a chronic illness or the natural decline of eyesight, hearing, strength, balance, and mobility that comes with aging. It’s never too early, or too late, to start planning for long-term care.

Many people think the phrase “long-term care” refers to an insurance policy. While insurance may be part of your strategy, long-term care encompasses many other decisions. You will need to decide where you will live, how you will navigate the myriad of legal, family, and social dynamics along the way, and the many options for paying for everyday help. Though a number of government programs may help pay for some long-term care services, many people are faced with significant out-of-pocket costs.

In partnership with LongTermCare.gov, Huffington Post took a look at eleven myths that may be keeping some from planning for long-term care, and ways you and your loved ones can prepare for the future.

Myth 1: I won’t need it

About 70 percent of Americans over 65 will need some kind of help with the activities of daily living for months or years as they age. It may be due to an illness, chronic disease, or disability. But often, the care is required because of the natural decline due to aging of one’s eyesight, hearing, strength, balance, or mobility. Read More …

What is a Fair Price for your health care needs?

Hospital Charges can vary widelyAccording to a new report from the centers for Medicare and Medicaid services, there are vast differences in how much you will pay depending on which hospital you use. Where one might charge $7,000 for a procedure, another just down the road may charge $100,000 or more for the same care quality. (see Secret Hospital Charges)

Now there are ways to find the Fair Price on your own. One is like the Kelly Blue Book of healthcare, and it’s appropriately called Healthcare Blue Book. If you’re dealing with some major healthcare procedures, it’s certainly worth checking out. It never hurts to get informed when it comes to dealing with health care providers.

Read More …

Secret Hospital Charges Now Revealed, Wide Disparities

High Healthcare CostsHospital Prices No Longer Secret As New Data Reveals Bewildering System, Staggering Cost Differences

By Jeffrey Young and Chris Kirkham

When a patient arrives at Bayonne Hospital Center in New Jersey requiring treatment for the respiratory ailment known as COPD, or chronic obstructive pulmonary disease, she faces an official price tag of $99,690.

Less than 30 miles away in the Bronx, N.Y., the Lincoln Medical and Mental Health Center charges only $7,044 for the same treatment, according to a massive federal database of national health care costs made public on Wednesday. Read More …

Why High Medical Bills Are Killing Us

TIME magazine coverIn his 38-page TIME magazine special report, “Bitter Pill: Why Medical Bills are Killing Us,” Steven Brill dives into our health care system to understand why things cost so much, avoiding the more traditional question of who pays for what. What he found was both disturbing and telling. (His 3:38 min video introduction is at the end.)

His first story starts with the MD Anderson Cancer Center in Houston, a nonprofit facility of the University of Texas, as he follows a patient who had to prepay $48,900 for six days of testing just to determine his cancer treatment regimen, which could easily run half a million dollars. An analysis of the itemized list of confusing charges showed that they were inflated as much as 100 times over retail prices, even before the hospital’s leveraged buying power. Those costs were also way higher than what Medicare would pay for the same tests, procedures and drugs.

MD Anderson, with its 19,000 employees, is one of the city’s top-10 employers, and its CEO last year was paid $1,845,000. Four other hospitals in the 1,300-acre Texas Medical Center are also in the top-10. Clearly, healthcare is a big business, but who’s making the money if it’s not doctors, nurses and technicians? It’s the hospitals, insurance companies, drug companies, equipment providers, and testing companies. Read More …

Unpaid Caregiving in America

Image showing The economic cost of unpaid caregiving is over $480 billion per year.According to AARP, 43.5 million Americans are caregivers, and although they do it out of love and obligation, caring for a loved one takes a personal and financial toll.

The economic impact is surprisingly high. It was over $480B/year in 2009, a figure that includes lost worker productivity, reduced earning capacity & retirement income, and increases in their own physical & emotional health and related costs. That’s about 3.2% of the U.S. GDP ($14.1 trillion in 2009). It’s more than the $361B in Medicaid spending. And it’s nearly as much as the $509B in 2009 Medicare spending. It’s also more than half of what we spend on defense. The burden is even worse for long-distance caregivers.

The infographic below details caregiving in the U.S. Read More …

Health Care Waste: What $750 billion could buy.

What could $750 billion buy?According to the prestigious Institute of Medicine (IOM), “Thirty cents of every dollar spent on U.S. health care – a total of $750 billion – was wasted in 2009 on unnecessary services, excessive administrative costs, fraud and other problems.”

There are many ways to portray healthcare inefficiencies. One way is to ridicule the industry by reflecting its waste onto other industries, as listed below. Another is to explore what the $750 billion in wasted money could buy, as Allison McCartney did in her infographic (below). We could also examine what’s possible if healthcare were to adopt best practices from other industries, including the computer industry.

Read More …

Senior Living Options & Costs Infographic

As seniors age, they may need help with daily tasks. Helping them decide on appropriate living arrangements is critical to staying safe and healthy. Investing in home modifications and some sort of medical alert system is a cost effective way for seniors to feel safe and secure while living an independent lifestyle, as this infographic suggests. Read More …

The Waiting Room, a feature length documentary

 

The Waiting Room - Title Text

Certified Nurse Assistant Cynthia Y. Johnson at Highland Hospital in The Waiting Room

Certified Nurse Assistant Cynthia Y. Johnson at Highland Hospital in The Waiting Room

The Waiting Room is like a punch to the gut for people cast off and left out of our U.S. medical care system, what some call the best in the world. When Democrats and Republicans vie for your votes and debate healthcare reform, remember that these are not the people they are talking about. Most don’t even notice the plight of those at the bottom — this ugly underside. But our politicians, and the billionaires who set their agenda, should be made to watch this documentary, because these are the 47 percent they talk about — the people left out of the American Dream. They’re real people.

This character-driven documentary film uses unprecedented access to go behind the doors of Oakland’s Highland Hospital, a safety-net hospital fighting for survival while weathering the storm of a persistent economic downturn. Stretched to the breaking point, Highland is the primary care facility for 250,000 patients of nearly every nationality, race, and religion, with 250 patients – most of them uninsured – crowding its emergency room every day. Using a blend of cinema verité and characters’ voiceover, the film offers a raw, intimate, and often uplifting look at how patients, staff and caregivers cope with disease, bureaucracy, frustration, hope and hard choices during one typically hectic day.

The ER waiting room serves as the grounding point for the film, capturing in vivid detail what it means for millions of Americans to live without health insurance. Young victims of gun violence take their turn alongside artists and uninsured small business owners. Steel workers, cab drivers and international asylum seekers crowd the halls. (movie trailer follows)

Read More …

A Disease-Creation Economy

Money, Politics and Health Care: A Disease-Creation Economy

By Mark Hyman, MD, practicing physician (original on Huffington Post)

“There is nothing more difficult to carry out, nor more doubtful of success, nor more dangerous to handle, than to initiate a new order of things. For the reformer has enemies in all those who profit by the old order, and only lukewarm defenders in all those who would profit by the new order.” —Niccolò Machiavelli, The Prince and The Discourses

Medical Economics - follow the MoneyMoney in politics is making our nation sicker, threatening our national security, and ultimately destroying the very economic prosperity the “money in politics” seeks to achieve. It is undermining our capacity to care for our citizens and threatening our global economic competitiveness in invisible, insidious ways. The links, connections and patterns that promote obesity and chronic disease are clear, though. The economic and social impacts are evident. As health care consumes an increasingly large percentage of our federal budget, the negative impacts of money in politics have become too alarming too ignore, and never more obvious than in this election cycle of 2012.

Read More …

Now the Real Work of Healthcare Reform Begins

Roberts Saves Obamacare: Now the Real Work of Reform BeginsArianna Huffington
By Arianna Huffington

The narrow survival of the Affordable Care Act last week was certainly cause for celebration. But as the jubilation subsides, it’s important to realize that having avoided what would have been a giant step backward doesn’t mean we’ve taken a giant step forward. Because the law as it now stands is only the first step toward health care reform.

On Sunday’s This Week, Vicki Kennedy (Ted Kennedy’s widow) spoke movingly of how “health care reform was the cause” of her husband’s life. “He believed that it was a moral issue,” she said, “that it defined the character of who we were as a society, who we were as a country, and that decent, quality, affordable health care should be a fundamental right and not a privilege.” She went on to say, “Families can go to sleep relaxed and happy knowing that their children who have asthma or diabetes or allergies are covered by insurance and aren’t barred because they have a pre-existing condition.” Read More …

How will you pay your lifetime $4 million healthcare bill?

Your $4 Million Bill and The Anatomy of Health InsuranceThe following infographic shows that a typical 22 year old worker and his employer can expect to pay over $4,000,000 in his lifetime for healthcare and health insurance. That number seemed awfully high, so I created a spreadsheet model to see if I could match it. I did, and here are my assumptions.

  • Starting salary at age 22 = $53,000 ($870,000/year by age 70)
  • Annual salary increase = 6% compounded
  • Percent of income for healthcare = 18%, increasing by 0.3% per year

I assumed a modest salary that increased at 6% compounded each year, but that’s a simplistic view since raises are larger earlier in a career and generally taper off (or even go negative) as you get older. I calculated to age 70 to account for longer lifespans and the likelihood that young people will continue working that long by then.

Read More …

CAPABLE means Home, not Nursing Homes, for Seniors

Source: Newswise (6/26/2012) — Nursing homes do not have to be inevitable destinations for frail older adults. Many—even those with long-term health problems—can remain at home and be independent. All it takes is a little help to change “disability” to “capability”.

A handyman with a few nails to fix a wobbly bannister can make the difference between staying at home and a nursing home stay. Visits from a nurse or occupational therapist can help simplify a bewildering medication regimen or improve the ability to get around the house and neighborhood. Simple, inexpensive steps may change the equation for thousands of seniors, but in reality, services like these are rarely available for many at greatest need—the poorest and sickest older adults receiving Medicare and Medicaid.

CAPABLE, short for “Community Aging in Place, Advancing Better Living for Elders,” and a $4 million Health Care Innovation Award from the U.S. Department of Health and Human Services Center for Medicare and Medicaid Services, is about to change that reality. Read More …