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July 16, 2007 -- Miami, Florida

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Diabetes is a disease that is largely self-managed. In order to stay healthy, a person with diabetes needs access to supplies like test strips, meters and insulin. Usually, people are able to get these medications and supplies covered through their health insurancae policies.

For a person with diabetes, obtaining and keeping health insurance and life insurance can be very difficult or -- sadly -- impossible to do. However, there may be other options available. To learn about your options, please select the category below that best represents your current situation.

American Diabetes Association a Proud Supporter of Cover the Uninsured Week (PDF) As the nation’s leading health non-profit organization supporting diabetes research, information, and advocacy, the American Diabetes Association will join various health associations, organizations, and supporters during “Cover the Uninsured Week” (April 23-29).

Nearly 21 million American children and adults have diabetes, but many are uninsured and cannot access the supplies, medications, and education necessary to successfully manage the disease and prevent diabetes-related complications such as heart disease, stroke, kidney failure, blindness, and lower-limb amputation.

Research on Health Insurance and Diabetes

On February 8, 2005, the American Diabetes Association -- in conjunction with the Georgetown University Health Policy Institute -- released "Falling Through the Cracks: Stories of How Health Insurance Can Fail People with Diabetes" This report provides a critically important window into the health insurance coverage problems faced by Americans with diabetes, and highlights the need for accessible, affordable, and adequate health insurance. Find out more from this Florida health insurance provider.

Florida Insurance Problems Continue

More bad news for Floridians. Florida lawmakers have hit a wall on the new health insurance measure for kids. According to insurance consultant Morgan Moran, the session will likely ignore the new health insurance plans all together, since they cannot decide who will run the new Florida health care program.

Florida lawmakers are supposed to discuss changes to (KidCare), the state's version of SCHIP, (health insurance) during the special legislative session that began last week, says Morgan Moran, a Florida health insurance consultant. Gov. Charlie Crist, a Republican (R), and other legislative leaders said a bipartisan group of lawmakers this year "introduced a proposal to streamline KidCare" but could not reach an agreement before the legislative session ended last month.

The central disagreement on the insurance bill, was over whether the Department of Health, or the Agency for Health Care Administration should run the new Florida health insurance program. Supporters of the legislation, like Moran, say the "serious differences have been resolved and lawmakers should approve the bill now" rather than wait until the fall, when the Legislature might hold an additional special session.

Health Insurance is one of the main topics for the 2008 presidential campaigns. One says he has a plan to "fix the broken down health insurance industry", and to provide coverage not only for children and the poor, but every American citizen. Presidential Candidate John Edwards' health care plan, "includes coverage for all American's" as well as a drug patent process overhaul. Edward's said "his proposal would cost $90 billion to $120 billion annually and that he would fund the plan through the elimination of tax cuts proposed by President Bush".

Florida health insurance consultant Morgan Moran of www.FloridaHealthInsuranceWeb.com said Edwards' proposal also would "require employers to provide health insurance for workers" or contribute 6% of their payrolls to a fund that would help individuals purchase coverage. More on the story is available at the Florida Health Insurance web site: Florida Health Insurance

Thanks to Michael Moore's movie SiCKO the health care debate is now front and center. While I have not seen the movie -- I firmly agree with the need to create some type of national health insurance. There are three primary reasons for this.

While I will almost always advocate for a market based economic approach to allocating resources, health care is not an area where the profit motive should dominate decision making. Simply put, the end product is a patient's health. Private health insurance has a conflict of interest between the insurance company and the insured which will be resolved in favor of the insurance company a majority of the time.

Let me paint a hypothetical picture to illustrate this point. Insured makes a claim with the insurance company, which is a publicly traded company. Because the insurance company is publicly traded they must turn a profit and increase their profits to maintain their share price. In order to make a profit they have every incentive to either

1. Deny the insured's claim, or
2. Delay payment to increase the possibility the insured will drop his claim

There are numerous stories about an insured making a routine claim only to be inundated with paperwork, or being told the policy doesn't cover that procedure, or being told the insurance company has to look into the claim to see if the insurance company can make a payment. In any of these situations the central idea of insurance -- to provide some safety for the insured at a specific cost -- is compromised.

In addition, insurance companies will seek to minimize the amount of money they would have to pay to the insured. Again, remember the product here is the patient's health. Supposed the insured has a disease where the cure is expensive but a cheaper alternative exists. However, the cheaper alternative would moderately or seriously compromise the insured's quality of life. Because the insurance company is profit-driven, it will probably opt for the cheaper treatment that compromises the insured's quality of life.

Secondly, private health care is more expensive the public health care. Here are three charts compiled from the Organization for Economic Cooperation and Development. The figures are from 2004.

First, the US spends the least amount of public money on health care. However, the US spends the most on health care as a percentage of GDP and on a per capita basis.

Notice the partially inverse relationship between public expenditures and total amount spent on health care. In short, publicly available health care is cheaper.

Finally there is the issue of competitiveness. I'll let General Motors of Canada make the argument for me.

"The Canadian plan has been a significant advantage for investing in Canada," says GM Canada spokesman David Patterson, noting that in the United States, GM spends $1,400 per car on health benefits. Indeed, with the provinces sharing 75 percent of the cost of Canadian healthcare, it's no surprise that GM, Ford and Chrysler have all been shifting car production across the border at such a rate that the name "Motor City" should belong to Windsor, not Detroit. Just two years ago, GM Canada's CEO Michael Grimaldi sent a letter co-signed by Canadian Autoworkers Union president Buzz Hargrave to a Crown Commission considering reforms of Canada's 35-year-old national health program that said, "The public healthcare system significantly reduces total labour costs for automobile manufacturing firms, compared to their cost of equivalent private insurance services purchased by U.S.-based automakers."

That letter also said it was "vitally important that the publicly funded healthcare system be preserved and renewed, on the existing principles of universality, accessibility, portability, comprehensiveness and public administration," and went on to call not just for preservation but for an "updated range of services." CEOs of the Canadian units of Ford and DaimlerChrysler wrote similar encomiums endorsing the national health system.

Health care costs are killing American business. Our international competitors don't have to deal with these costs. As a result, private health care is making US business less competitive.

So, public health eliminates a conflict of interest that compromises individual health, is cheaper and makes the US more competitive. And we don't have a public health system because?

Here are a few facts: Health Insurance Premiums Rose 11.2% in two years - Premiums Increased at Five Times The Rate of Growth in Workers’ Earnings and Inflation -- About Five Million Fewer Workers Covered By Their Own Employer’s Health Insurance Since 2001. In Washington, DC – Employer-sponsored health insurance premiums increased an average of 11.2% in 2004 -- less than last year’s 13.9% increase, but still the fourth consecutive year of double-digit growth, according to the 2004 Annual Employer Health Benefits Survey released by the Kaiser Family Foundation and Health Research and Educational Trust (HRET). Premiums for employer-sponsored health insurance rose at about five times the rate of inflation (2.3%) and workers’ earnings (2.2%).

In 2004, premiums reached an average of $9,950 annually for family coverage ($829 per month) and $3,695 ($308 per month) for single coverage, according to the new survey. Family premiums for PPOs, which cover most workers, rose to $10,217 annually ($851 per month) in 2004, up significantly from $9,317 annually ($776 per month) in 2003. Since 2000, premiums for family coverage have risen 59%.

The survey also found that the percentage of all workers receiving health coverage from their employer in 2004 is 61%, about the same as in 2003 (62%) but down significantly from the recent peak of 65% in 2001. As a consequence, there are at least 5 million fewer jobs providing health insurance in 2004 than 2001. A likely contributing factor is a decline in the percentage of small employers (three to 199 workers) offering health insurance over this period. In 2004, 63% of all small firms offer health benefits to their workers, down from 68% in 2001.

“The cost of family health insurance is rapidly approaching the gross earnings of a full-time minimum wage worker,” said Drew Altman, President and CEO of the Kaiser Family Foundation. “If these trends continue, workers and employers will find it increasingly difficult to pay for family health coverage and every year the share of Americans who have employer-sponsored health coverage will fall.”

“Since 2000, the cost of health insurance has risen 59 percent, while workers wages have increased only 12 percent. Since 2001, employee contributions increased 57 percent for single coverage and 49 percent for family coverage, while workers wages have increased only 12 percent. This is why fewer small employers are offering coverage, and why fewer workers are taking-up coverage,” said Jon Gabel, vice president for Health Systems Studies at the Health Research and Educational Trust.

The survey was conducted between January and May of 2004 and included 3,017 randomly selected public and private firms with three or more employees (1,925 of which responded to the full survey and 1,092 of which responded to an additional question about offering coverage). This is the sixth year the joint survey was conducted by Kaiser and HRET, and the 17th year this survey has been conducted overall. Findings appear in the September/October issue of the journal Health Affairs.

Survey highlights include:

• Worker contributions. This year, workers on average contribute $558 of the $3,695 annual premium cost of single coverage and $2,661 of the $9,950 cost of premiums for family coverage. Average employee contributions for single coverage are statistically unchanged from 2003, while average employee contributions for family coverage grew by 10% – a similar rate to the average overall premium increase. The percentage of premiums paid by workers is statistically unchanged over the last several years, at 16% for single coverage and 28% for family coverage.
• Cost-sharing. Cost sharing rose modestly in 2004 compared to the larger increases observed in recent years. Most covered workers are in health plans that require a deductible be met before most plan benefits are provided. In PPO plans, which cover more than half of all workers with health benefits, the average deductible for single coverage is $287 for services from preferred providers and $558 for services from non-preferred providers, about the same as in 2003. In addition, half of covered workers must either pay a separate deductible (average $224) or pay additional co-insurance (averaging 16% of the costs) when they are admitted to the hospital. The proportion of covered workers facing a $20 copayment for an office visit increased to 27% in 2004 from 19% in 2003.
• Consumer-driven plans. While about 10% of all firms offer a high-deductible plan to covered workers this year, only about 3.5% of those firms offer a personal or savings account option along with a high-deductible plan. These accounts permit employers (and sometimes employees) to make pre-tax contributions, which can be used by employees to pay for routine medical care. The survey finds that employers, particularly larger firms, are interested in high-deductible plans (a plan with a deductible of at least $1,000 for single coverage). About 6% of all firms (accounting for 13% of covered workers) say that they are “very likely” to offer such a plan within two years, and another 21% of all firms (accounting for 26% of covered workers) say that they are “somewhat likely” to do so.
• Type of insurance. In 2004, PPOs continue to be the most common form of health coverage, with more than half (55%) of all employees with health coverage enrolling in a PPO. HMOs, which cost significantly less than PPOs, cover about 25% of covered workers. Conventional, or indemnity, benefit plans have all but disappeared, covering just 5% of covered workers. These enrollment shares are statistically unchanged from 2003.

“You have to look over the past several years to really understand why Americans are so worried about health care costs. Just for premium contributions alone, families are paying $1,000 more this year for their health coverage than they paid in 2000,” Dr. Altman said. “More than any other factor, these out-of-pocket cost increases are what's driving voter concern about health.”

Facing continued premium increases, many employers say they looked to make cost-saving changes in the past year. Among firms offering coverage, 56% report that they shopped for a new plan in the past year. Of those firms, 31% (17% overall) report changing insurance carriers in the past year and 34% (19% overall) report changing the type of health plan offered.

When asked about future plans, about half (52%) of large firms (200 or more workers) say they are “very likely” to increase employee contributions in the next year. In contrast, just 15% of small firms (3 to 199 workers) say that they are “very likely” to increase employee contributions next year.

Across all firms offering coverage, relatively low percentages say that they are “very likely” in the next year to raise deductibles (9%), raise office visit cost-sharing (5%), raise prescription drug copayments (5%), introduce tiered networks for physicians or hospitals (2%), or restrict eligibility for benefits (1%). In addition, 3% of firms say they are “very likely” to drop health coverage entirely in the near future.

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