Health Policy and Reform

A Blue Cross Blue Shield headquarters in Providence, RI.
Photo credit: Jef Nickerson

Is it fair for nonprofit health insurance plans to increase customer rates when they’re hoarding millions in surplus cash?

Health insurance costs continue to rise, hitting consumers with high premiums and co-pays despite the downturn in the economy. Adding insult to injury, a new report from Consumers Union (a Burness client) has found that over the past decade, nonprofit Blue Cross and Blue Shield (BCBS) health insurers accumulated vast amounts of surplus cash. Meanwhile, these same plans haven’t cut rates for customers. In fact, many have continued to increase rates, ratcheting up premiums by as much as 20 percent annually.

Photo credit: Sam Pullara

Everywhere we look, we see stories about high-risk pools, insurance exchanges and the crisis facing the U.S. health system.  But there is another health crisis in America that few are talking about – oral health.

It’s an unfortunate reality: many Americans see oral health as unnecessary or cosmetic.  When money is tight, dental visits are often the first to go.  But oral health is critical to overall health.  Though largely ignored in national health reform, oral health is important, and for some – like 12-year old Deamonte Driver who died from an untreated tooth infection – it’s a matter of life and death. 

Today at the Federal Reserve in Washington, D.C., a unique event is in progress: leaders from the health, finance and community development sectors are coming together to discuss how their collaboration could help build healthier communities.

Hosted by the Federal Reserve Board of Governors, the Federal Reserve Bank of San Francisco and the Robert Wood Johnson Foundation (a Burness client), it's an event that starts from a premise that we've been working with nonprofits to communicate for years: that where we live, learn work and play can have a tremendous effect on our health, and that if we want to make Americans healthier, we've got to look beyond health care to the social factors that affect health - from education, to transportation, to community design and beyond.

We'll be following the event during the day via the live streaming video and Twitter coverage at #fedhealth.   I hope you'll join us there!

A carving of a caduceus on the Howard University campus in Washington, DC. Howard is one of the universities ranked highly in the Fitzhugh Mullan study. (Credit: tacomabibelot).

Click here to listen to lead author Dr. Fitzhugh Mullan and Dr. John Prescott from the AAMC debate the study on WBUR, Boston’s NPR station.

As the U.S. girds for an influx of newly-insured patients under health reform, attention is shifting to whether medical schools are producing doctors that meet the country’s health care needs.  Helping to spark this debate is a recent study that ranks U.S. medical schools in a new, provocative way: on the extent to which they produce doctors who practice primary care, work in underserved areas, and are minorities.

By measuring schools against this “social mission” criteria, Dr. Fitzhugh Mullan of George Washington University and his colleagues (with support from the Josiah Macy Jr. Foundation, a Burness client) have created a new “best medical schools” list that turns traditional rankings on their head. Historically black schools Morehouse School of Medicine, Meharry Medical College and Howard University lead the pack (PDF), while more “prestigious” medical schools such as Vanderbilt, Duke, Stanford and Johns Hopkins fall into the bottom 20.

Deaths from breast cancer are four times higher among some Asian-born women in the United States than among their U.S.-born counterparts. Rates of vaccine-preventable liver and cervical cancer among the Hmong in California are three to four times higher than those of other Asian American groups. Some Pacific Islander-Americans have among the highest rates of pre-term births, with one-in-five mothers delivering pre-term.

These are just a few of the findings included in the May issue of the American Journal of Public Health (AJPH). In this first-ever issue of a major public health journal devoted to Asian American, Native Hawaiian and Pacific Islander populations, an array of new research highlights alarming disparities. 

Secretary Kathleen Sebelius of the U.S. Department of Health and Human Services speaking at last week's Health Affairsevent. Click here for full video from the briefing.

 Now that health reform is the law of the land, a massive challenge remains: how can we deliver primary care to the tens of millions of Americans who will soon gain insurance coverage?

The shortage of primary care providers is well-publicized.  But, as studies in the May issue of the health policy journal Health Affairs (a Burness client) point out, recruiting more primary care doctors, nurse practitioners, and physician's assistants to fill that void is only part of the solution.  That was a message echoed by a number of health care experts at a May 4 Health Affairs briefing in Washington D.C.