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SingleCare Industry News Round-up 6/24: Infant Insurance, Marketing to Prescribers, and Expensive Healthcare

By | June 24, 2016

This week in healthcare news, read about the difficulties of getting health insurance for infants and rising prescription drug and health insurance prices.

First, a story that highlights how difficult it can be to get a newborn insured for the first few months of its life. The author, Ester Bloom, recounts the obstacles she encountered as she attempted to obtain health insurance for her infant son.

  • The Atlantic | The Unconscionable Difficulty of Getting Health Insurance for a Newborn | Ester Bloom, June 20, 2016

    Even as a reasonably well-educated person with hard-won knowledge of the limitations of America’s health-care system, I was unprepared for this level of dysfunction. For 40-some weeks, I had been pregnant on a plan purchased on an Obamacare exchange: first bronze and then, when the year changed and my delivery loomed, platinum. My pregnancy on that plan transformed me into a far savvier medical consumer, and a far more jaundiced one. Still, when my son was born, and I went through what I had been told would be the straightforward process of getting him signed up for insurance, I was stymied. […] Not 12 hours after bringing a new human being into the world, before I had slept or showered or gone more than a few feet from my bed in the maternity ward, I was on the phone with the New York State of Health. I answered all of the rep’s questions, and she assured me she could sign my son up for Child Health Plus. Because he had been born after the 15th of March, his coverage would start in six weeks.

Young doctor examining baby boy with otoscope
[Image credit: KatarzynaBialasiewicz]
Next, read an article that explores studies which have found that doctors are significantly more likely to prescribe expensive name-brand drugs rather than cheaper alternatives if drug companies offer perks.

  • STAT | After drug makers fed doctors, they prescribed more of their pills | Ed Silverman, June 20, 2016

    A study published last month found that, among 12 physician specialties, payments given to doctors were associated with greater prescribing costs per patient. And another recent study of 2,444 Massachusetts physicians found that for every $1,000 received from industry for any drug, the prescribing rate for brand-name statins increased by 0.1 percent. […] ‘This study should be another nail in the coffin of the argument that there is no association between industry marketing to physicians – even meals worth as little as $20 – and wasteful physician prescribing practices,’ said Dr. Aaron Kesselheim, an associate professor of medicine at Harvard Medical School and a faculty member at Brigham and Women’s Hospital in Boston, who has studied the payments issue.”

Last, read an analysis on why health care costs are rising faster than overall inflation.

  • Forbes | Here’s Why You’ll Likely Pay More for Your Employer-Sponsored Health Insurance | Laura Lorenzetti, June 21, 2016

    Insurers and employers can keep medical cost growth more manageable through various tactics, which often includes some form of cost sharing with plan holders. While costs are expected to go up by 6.5% next year, employers anticipate that they will only have to swallow a nearly 4% cost gain thanks to some realignments, says Gniewek. This can include moves like higher deductibles, switching to high-performing providers, narrower drug options, or higher co-pays. That means that more and more of rising health care costs are going to be shouldered by everyday workers. Another PwC report finds that more employers are switching to high deductible health plans (HDHPs). A quarter of surveyed employers already offer only high-deductible health plans, while another 39% are considering making the move to HDHP-only strategy in the next three years.