Fewer company sponsored health require no contribution from employees for their health insurance premium. The number of non-contributory health plans, fell from 27% to 18% from 1998 through 2004. Employers footing the bill for workers' dependent premiums are becoming rare. Family plan enrollment dropped from 19% to 15% over the same time frame. Workers in smaller companies - under 50 employees - were much more likely to have no-contribution plans.

Source: Agency for Healthcare Research and Quality.

Doctors get paid the same when they make mistakes, run unnecessary tests and have to redo their work. Recently, health insurers have been proposing pay for performance programs for providers.

California has pioneered the rating of physician groups and rewards with cash - paying out $145 million since 2003 - for improving their ratings on such benchmarks as offering preventive care or patient satisfaction. California's program is voluntary, with more than 200 medical groups participating. Also, California and five other states will join a Federal pilot project that could lead to national standards that measure physicians' clinical performance. The pilot will study Medicare claims and claims of the largest prihealth insurance companies in California. This will extend the ratings to about 25,000 California physicians.

See full story at Los Angeles Times Online, Rethinking criteria for doctors' pay

Kids with chronic asthma symptoms should use corticosteroid inhalers daily. Yet Only 20% of kids with persistent asthma keep their symptoms under control. Even with inhalers, many kids had persistent symptoms, primarily because they weren't using inhalers daily. The drugs have to be used consistently. Also many of these kids had to deal with secondhand smoke and other triggers which make asthma worse even with inhalers.

A majority of kids with asthma have triggers in their home. The list includes: a wood burning stove or fireplace, cockroachs, dust mites, mold, and pets.

Controlling a child's asthma is not a simple matter, the parents, the child, and the child's doctors have to coordinate their efforts. Parents must first report the asthma symptoms to a doctor. Next the physician creates an tailored treatment plan, including daily use of an inhaler and perhaps oral meds as well, too. Daily use of these drugs is essential. But taking medicine isn't the end of the job.

Asthma is a dynamic disease. Kids' asthma can change and their triggers change. They need to re-evaluate their treatment plans several times a year.

About two thirds of the 9 mil uninsured kids in the U.S., could qualify for state health insurance programs. Texas leads all states with 20.3% uninsured children are Texas. Ohter states with a high proportion of uninsured cchildren are Florida and New Mexico. Among the states with lowest number of uninsured children are Vermont, New Hampshire, and Michigan.

The Childrens Health Insurance Programs (SCHIP) is being reauthorized in congress now. Lawmakers are debating the funding levels for SCHIP. They need enough money for all children currently enrolled and the millions more who remain unenrolled and are eligible. This is a "feel good" issue that most in congress would love to get behind. Unfortunately, the eligibility guidelines are being lowered to the point that people who can afford to insure their children will qualify for SCHIP. The money would be better spent on innovative ways of getting truly needy kids signed up.

Unexpected medical problems cause 1 in 4 American workers to retire early. They had lower-than-expected income due to health problems. In retirement planning, it is not just about money. You have to take health into account as well. Poor health can certainly significantly impact your finances.

See full story at Boston Globe Online, Moving into retirement.

If we fail to deal with the problem of the uninsured, more and more people without insurance will see their health deteriorate from mostly preventable illnesses. This truth was brought home recently by Jack Hadley, Ph.D., of the Urban Institute. He looks at uninsured individuals who have had a health shock - the onset of a chronic illness or injury. Only half of the uninsured studied sought medical care. If the uninsured received care, they were less likely to comply with recommended follow-up care. The uninsured reported incomplete recovery more frequently than insured individuals. The uninsured people studied reported worse health 7 months after the health shock,.

Chronic conditions usually need medical care over a a long time and the uninsured are less able to comply with treatment recommendations .The study's finding at the first follow-up interview that the uninsured frequently report no longer being treated indicates inadequate care. They will depend on emergency room care will make it more likely their care will lack continuity.

From March 14, 2007 issue of JAMA. American Medical Association (AMA)

High-deductible health insurance plans seem to work as intended. In addition to lower premiums, members utilize benefits less. For instance, a new study shows that patients went to the emergency room less frequently for non-emergency conditions. According to a recent study conducted by the Department of Ambulatory Care Prevention and published in the Journal of the American Medical Association, patients with high-deductible health plans attended the emergency department approximately 10% less often than patients with traditional more comprehensive plans.

High-deductible health plans have grown in popularity through making insurance more affordable to individuals and employers alike due to lower premiums. The pay off is that policy holders need to pay for most medical expenses until they reach their deductible which averages $1,000 to $4,000 per annum. ER visits and hospital stays are usually subject to the plan deductible.

Tennessee Gov. Phil Bredesen announced the launch of the CoverTN program. The program provides insurance for low-income employees and is administered by BlueCross BlueShield of Tennessee starting April 1.

The goal of CoverTN is to expand coverage options for uninsured, low-income working adults who are not eligible for Medicaid. Average premiums for CoverTN will be $150 per month, with employers, employees and the state paying equal portions. To be eligible for the program employers must have 25 employees or less, at least 50% of whom have earn less than $41,000 per year. They need to have not offered health benefits for at least six months.

Typical copays for the CoverTN members will not exceed $25 for a physician office visit, $10 for a generic prescription, $100 for an ER visit, $25 for hospital outpatient treatment and $100 for an inpatient treatment. Inpatient hospital benefits are capped at $10,000 per year, with the maximum total benefit being capped at $25,000 per year.

See full story at Memphis Commercial Appeal Online, Tennessee Governor Launches Insurance Program For Low-Income Workers

One reason that the plight of the uninsured has moved swiftly to the top of the domestic political agenda is that the number of uninsured middle class is on the rise. More than 30% of uninsured individuals in the U.S. have annual household incomes in excess of $40,000.

The rising cost of health care could be a significant contributing factor, as well as a drop in manufacturing jobs combined with a migration of workers to the service industries and small businesses alike, both of which are less likely to provide insurance.
Without an employer-provided health plan, an employee must buy an individual plan or go without medical insurance altogether. Both individuals and independent contractors are more likely to put off buying coverage until they need it, which makes the pool of the insured less healthy. And, if the pool is less healthy, the costs associated with insuring them are higher.

Health insurance consumers are looking to comparison shop for medical procedures, which seem to be priced in a frustratingly arbitrary manner. Typically medical procedure costs have been kept under wraps, although the internet has started to make this information more readily available, allowing consumers to compare prices and even evaluate affordable alternatives.

Patients rarely receive information on costs before treatment, and even the insurers themselves do not know what other companies are paying for a given procedure. On average doctors have somewhere between five and 100 different reimbursement rates for the same procedure. Worse, a hospital with multiple geographic locations may have upwards of 150 rates for a single procedure.

Of the 50 states, 32 require that hospitals provide specific pricing information to the public. Consumers do not often find this information useful, however, because the hospital does not have to disclose the discounted rates they contractually provide to insurers, which can vary greatly. In essence patients are less interested in what the hospital charges, and more interested in the bottom line cost to them once the discount has been applied.