More Employees Are Passing On Health Coverage
Increasingly, Americans are choosing to be uninsured even when their employers offer health coverage, according to a new study by the Center for Health Care Policy and Research (CHCPR), an arm of the Department of Health and Human Services. Shedding new light on why the nation's uninsured 41 million Americans are swelling at the rate of one million a year, the study is the first to illustrate how much of that trend is due to voluntary choices made by employees.
The trend emerges at the same time that employers are offering increased coverage options to employees. The study found that the number of people who turned down their employers' health plans more than doubled over the past decade, from 2.6 million in 1987 to 6 million in 1996. The study suggests the reasons are largely economic, highlighting these findings from the last ten years:
- The poorest workers tend to reject coverage. The percentage of workers who earned less than $7 an hour and bought employee-sponsored insurance dropped from 80% to 63%.
- On the other hand, employees who earned $15 an hour and purchased coverage dropped only 5 points, from 91% to 86%.
- Although insurance is being offered to more people overall, those younger than 25, Hispanic and in low-paying jobs have less access to coverage than they did a decade ago. (CHCPR; 202/296-6922)
Investing in Diabetes Care Saves Money; Improves Outcomes
November is National Diabetes Month and diabetes treatment programs that manage the total healthcare needs of patients can reduce healthcare costs more effectively than those that zero in on blood sugar control or special education, according to preliminary results recently released by the Diabetes Treatment Centers of America (DTCA). Its case-in-point is the Diabetes NetCare program. Initial outcomes for 72 participants involved in this comprehensive Diabetes treatment program show significant reductions in healthcare costs, averaging 26%, from $547/month to $406/month.
Stressing the need for high physician involvement, participants experienced significant clinical improvements that include:
- Retinal eye exams - important for preventing blindness - jumped from 28% to more than 80%. (The national average is 37%.)
- Annual foot exams surged from 3% to 99%.
- Inpatient utilization and admissions decreased by 85% and 83%, respectively. Emergency room use dipped by 67%.
These early results are based on data collected from a Diabetes NetCare site that DTCA operates at a large, self-insured employer in the Mid-Atlantic region. The company will report its findings for a population of 10,000 with diabetes, representing all of its sites, in the beginning of 1998. (DTCA, 314/982-9133)
Doctors Urged to Boost Patient Info on Alcohol, Safe Sex
Physicians need to improve how they inform patients about the health risks involved with alcohol and unsafe sex as well as seat belt use, according to a new study by the American Medical Association. Researchers at the New England Medical Center in Boston studied the relationship between patient income, health risk and physician education as they impacted patient behavior. Nineteen percent of the patients felt their doctors did not give them enough advice on key health risks. However, too much physician advice seemed to make a difference on health behavior, according to the study.
Among those who reported receiving too much information:
- 80% of patients reported practicing safer sex;
- 82% reported changing their diet;
- 61% tried to cut down or quit smoking;
- 83% reported trying to reduce stress;
- 76% reported wearing seat belts more often; and
- 48% reported trying to drink less alcohol. (AMA (http://www.ama-assn.org); 312/464-4843)