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Whats holding undocumented immigrants back from seeking health care?

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Photo by Joe Raedle/ Getty Images

More than 8 million people have enrolled for health care under the Affordable Care Act, far exceeding original goals. But the countrys nearly 12 million undocumented immigrants are largely without health care and dont qualify to apply for it at HealthCare.gov. Their needs are caught between health care policy and immigration reform, two deeply partisan issues.

Some critics of the law argue that it further excludes undocumented immigrants one of the fastest growing populations in the country while others say opening access to this population would put an undue financial burden on public and government institutions, especially hospitals.

A new study published by the journal Health Affairs examines how often undocumented immigrants in California used health services to see if these conservative talking points held true.

We looked at emergency rooms, because some say that emergency rooms are over or misused by some groups versus others, said the studys primary author, Nadereh Pourat, director of research at the UCLA Center for Health Policy Research.

PBS NewsHour spoke with Pourat last week about her research.

NEWSHOUR: How do undocumented immigrants in California use health care?

Photo by Rick Brian/UCLA Health

And we found that uninsured undocumented (populations) use fewer services than other uninsured populations. Even undocumented immigrants who were in insured surprisingly dont use services more or as much as insured documented groups. Youre looking at a systematic lower level of use. And when you see theyre using lower levels of care, you have to ask yourself, Why is that? Why would that be? We speculate that lower levels of utilization have to do with other unmeasured barriers. There are other issues going on that keep undocumented immigrants from using health care.

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Whats holding undocumented immigrants back from seeking health care?

Rising treatment costs drive up health care spending

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PUBLIC RELEASE DATE:

5-May-2014

Contact: Rebecca Basu basu@american.edu 202-885-5978 American University

It's a well-known fact that spending on health care has consistently grown faster than the rest of the U.S. economy. What's behind this trend is less certain. Economists point to two causes: the prevalence of diseases and conditions afflicting the U.S. population, or the rising costs of treating diseases. New research from American University Associate Professor Martha Starr and Virginia Tech Research Professor Ana Aizcorbe shows it is the latter, with higher prices for treatment accounting for 70 percent of growth in health care spending.

"Rising costs of treatment have had a much greater impact on driving up average spending than increased disease prevalence," Starr said. "To tackle the problem of health care spending from a policy perspective, solutions need to focus on slowing growth of spending on procedures, treatments, and drugs used to treat given diseases and conditions. Of course, slowing or reversing the rise of chronic conditions would be beneficial for the health and well-being of the U.S. population, but by itself it won't put much of a dent in health care spending growth."

The research findings appear in the May issue of Health Affairs. The researchers examined data from four nationally representative surveys from 1980 to 2006. They analyzed how shares of the U.S. population afflicted with different diseases and conditions and the costs and services used to treat them contributed to growth in average spending on health care, adjusting for inflation.

"In contrast to earlier studies on health care spending, we analyzed data that covered a longer time period and the full range of health care cases," Aizcorbe said.

Over the whole period, rising disease prevalence boosted spending by 0.5 percentage point per year compared to a contribution of 2.5 percentage points from rising cost per case, the researchers found. Costs of treatment have increased due to both rising prices of health care services and more intensive use of services to treat diseases. Robust growth in cost per case occurred for musculoskeletal conditions and circulatory and respiratory disorders. Particularly hefty growth was associated with rising average costs of routine care, which more than doubled over the period to $602 per person per year in 2006. Increased cases of chronic conditions such as diabetes, heart conditions, high cholesterol, and mental disorders boosted health care spending as well, but in a much more modest way.

When examining rising health care spending, economists look at population aging and shifts in insurance coverage. Starr and Aizcorbe found these played minor roles over the 26-year period. And even though rising disease prevalence from 1997 to 2006 stood out, it still accounted for only one-third of average spending growth. The researchers also noted that had there not been a steady shift away from the use of hospital services, the rate of spending growth would have been well above 3.5 percent per year.

Finally, the researchers warn that even while shifts from hospital-based care to office-based care and prescription medicines for diseases and conditions may lower health care costs, intensified use of these services and the use of more expensive items, such as brand-name instead of generic medications, risk driving up costs.

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Rising treatment costs drive up health care spending

Despite sluggish hospital hiring, health care reports job growth

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Health care continued to add jobs last month, but the industrys employment growth occurred largely outside of hospitals, which until recently were a steady source of payroll gains.

Health care added 18,700 jobs in March, an increase of 0.1 percent to total 14.7 million, although hiring by hospitals was stagnant, according to preliminary seasonally adjusted figures from the U.S. Bureau of Labor Statistics. Overall U.S. employment increased by 288,000 jobs last month, and the unemployment rate fell to 6.3 percent.

Last months health care job growth was slightly slower than the 0.2 percent the same month last year. For the 12 months that ended in March, health care added 198,200 jobs, an increase of 1.4 percent compared with growth of 1.7 percent the prior year.

Hospital hiring, meanwhile, was essentially unchanged with 1,700 new jobs in March, continuing a trend in uneven growth and some job losses in recent months. Hospitals hired 6,600 workers in the same month last year, their strongest month for hiring since February 2012. For the year that ended in March, hospitals shed 4,100 jobs, a decline of 0.1 percent compared with growth of 26,900 jobs the prior year, or growth of 0.6 percent.

Hospital employment totaled 4.8 million in March.

Ambulatory-care providers added 12,600 jobs last month, an increase of 0.2 percent, for total employment of 6.6 million. Thats down from employment gains of 21,000 in March 2013. For the year that ended in March, ambulatory care added 174,200 jobs, an increase of 2.7 percent, compared with 179,600 jobs the prior year, for gains of 2.9 percent.

Physician office hiring was up 0.2 percent with 5,600 new jobs in March to total 2.5 million jobs. Thats compared with growth of 7,700 jobs in the same month the prior year. For the year that ended in March, physician office employment increased by 55,300, or 2.3 percent, compared with 50,500 new jobs the prior year, likewise a 2.3 percent gain.

Modern Healthcare is a sister publication to Crains Detroit Business.

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Despite sluggish hospital hiring, health care reports job growth

-Mental health care services are not good enough, says Hie

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Minister of Health Bent Hie admits that health care services for the mentally ill have not been good enough. Meanwhile, those struggling with mentall illness must not be stigmatized - they must not be reluctant to ask for help, Hie says. "The current health care services are not good enough. Therefore I want to make mental health and drug abuse a priority in the time ahead," Hie tells NRK.

According to NRK, 102 persons were murdered by people who suffered from mental illness between 2003 and 2013.

"When 102 out of 228 murders have been committed by persons who suffer from serious mental illness, it is a sign that we are not good enough at preventing severe criminal acts committed by this group. I think and believe that several of these murders could have been prevented if the health care system had taken more responsibility for the mentally ill and offered them better services," says Erik Nadheim, Director of the Council for Crime Prevention (Det kriminalitetsforebyggende rd).

Hie promises that the government wil invest more in mental health.

"We have already started to expand the health care services that are offered in the municipalities." More money will be invested, and the money that has already been allocated to Norwegian hospitals will be re-prioritized, Hie explains.

However, the Minister of Health is worried that too much focus on mental health and its combination with murders and violence can also make matters worse. He warns of the effect it may have on the challenges associated with mental illness.

"Those who are ill must not hesitate to seek help," he says. "It is important to avoid that people who suffer from mental illness are stigmatized. We need openness so that everybody who needs it can seek help at an early stage," Hie tells NRK.

(NRK)

Tuesday, 28 January 2014 21:29

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-Mental health care services are not good enough, says Hie

Dan Walters Daily: Dim prospects for undocumented immigrant health care – Video

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Dan Walters Daily: Dim prospects for undocumented immigrant health care
Though a bill to extend California #39;s health care exchange to undocumented immigrants passed out of policy committee this week, there is no viable plan to fun...

By: The Sacramento Bee

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Dan Walters Daily: Dim prospects for undocumented immigrant health care - Video

AONE Certificate Program in Health Care Finance for Nurse Executives – Jan Phillips – Video

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AONE Certificate Program in Health Care Finance for Nurse Executives - Jan Phillips
Jan Phillips discusses her experience with the AONE Certificate Program in Health Care Finance for Nurse Executives. For more information please visit: http:...

By: AONE Nurse Leaders

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AONE Certificate Program in Health Care Finance for Nurse Executives - Jan Phillips - Video

Obama, Sebelius make fun of health care website failures at WHCD

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The botched health care site, Malaysian Airlines and midterm elections were all fair game Saturday at the 100th annual White House Correspondents Association dinner.

Celebrities and politicians laughed and cheered President Obama and host Joel McHale as they poked fun at everything from the beleaguered launch of the government healthcare site to foreign leaders.

SEE ALSO: Kathleen Sebelius and fierce Obamacare critic, Ted Cruz, sit together at gala

That could have gone better, the president said of the health insurance site launch. In 2008 my slogan was yes we can. In 2013 it was control, alt, delete.

Mr. McHale pointed out it was hard to quantify how terrible a launch the site really had because it serves as the basis for analogies.

The website is now what they use to describe other bad things, Mr. McHale said.

Even former Health and Human Services Secretary Kathleen Sebelius made a brief appearance, stepping on stage to assist the president in restarting a frozen video screen a common problem when the insurance site first launched.

The dinner, where movie and television stars mingle with lawmakers and reporters, was held at the ballroom of the Washington Hilton Hotel.

Prior to the speeches, a video spoof starring Vice President Joseph R. Biden and Julia Louis Dreyfus, who plays one on television, showed the two on a series of adventures, including sneaking ice cream from the White House kitchen and getting tattoos with Nancy Pelosi.

After stepping to the podium, Mr Obama asked for the new set up, in which staff placed two ferns on either side of him a nod to his wildly successful appearance on the online video series Between Two Ferns, with comedian Zach Galifianakis.

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Obama, Sebelius make fun of health care website failures at WHCD


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