Vol. 23 June 15, 2010 Updates on Health Care Reform and H1N1 Virus

Our health-care system has been a hodge podge for so long that we actually have experience with all kinds of systems…
We’re not going to get perfection. But we can have transformation – which is to say, a health care system that works.
AND THERE ARE WAYS TO GET THERE THAT START FROM WHERE WE ARE.
– Atul Gawande, MD

Per cent of Americans who think that their health care bills will rise under the new Law: 62% (1)

Increase of annual estimated costs for the healthiest people:  + $800 (2)

Decrease of annual estimated costs for families with largest health care costs: –  $2400 (2)

Date that all people will be required to have health insurance (some with subsidies based on income):  2014

Amount of  your “penalty” in 2014 if you do not have health insurance: $95 or 1% of your annual income whichever is greater (unless you are an American Indian, in prison, or claim a religious exemption…then no penalty!)

Per cent of 500 people in a telephone poll that said that their health insurance premiums were “not a burden at all”:  25% (3)

Per cent in same poll that said that the cost of their health insurance premiums was “not a serious problem”: 66%

Health care spending currently represents 17% of our gross domestic product (GDP). Per cent increase of the 2016 GDP due to  health care spending caused by  the new health care reform bill:  0. 1%  (4)

Increase in the number of insured by 2016: 15%

Estimated increase cost per newly insured person in 2019 due to the health care reform bill: $800

Current cost of average single premium health for employer-sponsored health care insurance: $5,000

Per cent of 2130 physicians polled that agreed with the AMA position of opposing expansion of coverage under Medicare and of supporting expansion of coverage through private means only (rather than “the public option”):  12.5%

Per cent of those polled who agreed with the AMA position AND were members of the AMA : 14.2% (5)

Per cent of Massachusetts physicians that were incorrectly labeled as “low-cost” or “not low-cost” by a RAND test of insurance claim data: 25% (6)

  • This so-called “tiering” of physicians by health insurance companies is touted as a cost control measure, but is obviously seriously flawed since these errors occurred in both directions. Some physicians labeled “low-cost” were not, and some “high-cost” physicians were actually “low-cost”. The range of error was from 10% to 67% among different clinical specialities.

Rate of secondary H1N1 flu cases (“attack rate”) in household cases: 8%

Rate of secondary seasonal flu cases (“attack rate”) in household cases: 9%

Estimated reduction of secondary attack rate using simple hand-hygiene procedures: 50%

Per cent of secondary household cases that had serological evidence of H1N1 infection but did not shed virus nor have symptoms: 39%

  • These were silent or invisible cases of the flu who were not contagious, but who develop antibodies against the H1N1 virus.

Chances that both flu viruses would cause 10 days of symptoms and shedding of virus for 5 to 7 days: 100% (7)

  • The conclusion of this study was that in the United States the H1N1 flu and the seasonal flu had similar severities and transmissibility.

Global death rate annually from seasonal flu: 0.1%  (but that is still over 250,00 people each year)

  • Death rate from 1918 pandemic flu was 2%.

Global death rate  from H1N1 in 2009-2010: 0.05% (8)

References:
1. CNN/Opinion Research Corp.;March 2010
2. the Lewin Group as reported in Money Magazine, May 2010
3. Mass Insight reported in Boston Globe, June 8, 2010, Stephen Syre
4.NEJM 362:22, June 3, 2010,J. Gruber
5. NEJM 362:23 June 10,2010, 2230
6. NEJM 362, 1014, March 18, 2010
7. NEJM 362:23, June 10, 2010, 2175
8. Dr. Mark Lipsitch, Harvard University, quoted by Reuters, September 2009

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