REPOST: Obamacare triggers massive drop in Americans without health insurance

After Obamacare was signed into law, the number of Americans without health insurance fell to 16.4 million from five years ago, which is considered to be  the largest drop in four decades. This report has additional details.

Obamacare supporters at the supreme court. | Image Source: theguardian.com

The proportion of Americans without health insurance has fallen by more than a third since the start of the Affordable Care Act, according to new government estimates that are likely to strengthen efforts to prevent Barack Obama’s flagship domestic reforms being rolled back by political opponents.

A total of 14.1 million adults are thought to have gained insurance since the act – known as Obamacare – went into full effect in October 2013, with a further 2.3 million younger adults benefitting from new rules that allow those aged 19-25 to remain on their parents’ insurance plans.

Together these net gains have reduced the national uninsured rate from 20.3% to 13.2%, or a total of 16.4 million people, based on government analysis of recent survey data.

Though tentative, the statistics may help the White House argue that its reforms are too well entrenched for future administrations to unpick – something many leading Republicans in Congress have called for due to their fierce opposition to the compulsory elements of the scheme.

The supreme court is also currently considering a legal challenge sponsored by Obamacare’s opponents that could reverse a vital subsidy included in the reforms after a dispute over the wording of the original legislation.

Though critics remain sceptical about many aspects of the reforms, both the supreme court justices and Republican candidates for president in 2016 will now have to consider the political consequences of unravelling a package that has brought health insurance to a nationwide group almost as large as the total population of New England.

But the figures also show how many more Americans are still without insurance despite the reforms, which compel adults to buy insurance or employers to offer it only in certain circumstances. Some 26.3 million adults remain without insurance of their own.

Officials say they expect the growth trend among those insured to continue, though they acknowledge they know little about the millions of Americans who are still without coverage.

“We are entering new territory here,” Richard Frank, the assistant secretary for planning and evaluation at the Department of Health and Human Services, told reporters on a conference call.

“We are just starting to understand more completely who we have really brought in and also who is left uncovered.”

The department’s analysis also shows a clear difference between states that have allowed an extension of Medicaid, a program which covers many poorer families, and those that have resisted it.

The 29 mostly Democratic-controlled Medicaid expansion states saw their uninsured rates fall by 7.4% over the period, while those who have refused to accept the federal funding to expand the scheme saw a 6.9% fall.

Nevertheless, the largest source of the rise in insurance cover has been new individuals signing up through so-called healthcare exchanges, which are available in all states, either through locally run systems or via the federal exchange.

This federal exchange in particular had an extremely rocky start due to computer glitches and delays to associated tax reforms, but figures released last week showed 11.7 million people had now signed up or renewed their insurance by 22 February.

Dr. George Northrop of Danbury is a clinical practice management specialist.Follow this Twitter account for more news and updates on the healthcare industry.

REPOST: The stark North-South divide in health insurance

According to a new study from Gallup, the highest percentage of uninsured Americans are mostly in Southern states, where opposition is strong to the health law's option to expand the program for low-income residents. This article has the details.

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When it comes to health care coverage, America is becoming a land of geographically based haves and have-nots.

States with the lowest uninsured rates are clustered in the Northeast and upper Midwest, while those with the highest rates of uninsured Americans are mostly in Southern states such as Georgia and Louisiana, according to a new study from Gallup. One reason is that many Southern states opted out of expanding Medicaid coverage under Obamacare.

On the other hand, the states that both expanded Medicaid and set up their own state exchanges saw a bigger drop in uninsured residents than did states that opted out, the study found. In the 21 states that adopted both measures, the uninsured rate fell 4.8 points, while states that shunned one or both options saw a 2.7 point decline.

"Consequently, the gap in uninsured rates that existed between these two groups in 2013 nearly doubled in 2014," Gallup said in its report.

With almost a quarter of its residents lacking health insurance, Texas has the highest uninsured rate among the 50 states, although that's still lower than state's 27 percent uninsured rate in 2013, Gallup found.

The state with the lowest uninsured rate is Massachusetts, where only 4.6 percent of its residents lack insurance.

"Massachusetts' plan is based on the 'Romneycare' model, from which certain aspects of the Affordable Care Act were drawn," Gallup said. "The Massachusetts healthcare law, originally passed in 2006, has undergone modifications to accommodate details of the federal law, but maintains its core element mandating that nearly all residents must obtain a minimum level of insurance coverage."

Most Southern states have poverty rates that are higher than the U.S. average, according to the Journal of American Medical Association. About 28 percent of residents in Louisiana and Mississippi live in poverty, compared with 21 percent for the U.S. on average. About 4 million poor, uninsured adults in Southern states that didn't expand Medicaid fall into a coverage gap, which also disproportionately affects people of color, JAMA said last year.

States that have rejected Medicaid expansion, such as Texas, cited concerns about long-term costs because states are on the hook for paying a portion of those Medicaid expansion costs starting in 2017.

To be sure, some Southern states opted to expand Medicaid, and Gallup cited two of those as having the sharpest reductions in uninsured rates. In 2013, 22.5 percent of Arkansas residents were uninsured, but that dropped to 11.4 percent in 2014. Kentucky saw the second-biggest decline as its uninsured rate fell from 20.4 percent in 2013 to just under 10 percent last year.

While Obamacare remains unpopular with a majority of Americans, it has had a positive impact in reducing the ranks of the uninsured, Gallup noted. Across the country, the uninsured rate slipped 3.5 percent to 13.8 percent in 2014. That's the lowest rate in the seven years Gallup has been tracking it.


Dr. George Northrop of Danbury has years of experience in managing hospitals. Follow this Twitter account for more updates on the healthcare industry.

Big changes in store for US healthcare

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Late in 2014, experts were already predicting big changes ahead for the US healthcare system, especially in the areas of insurance, medical services, payments, supplies, and pharmaceuticals. Early in 2015, it appears that Republicans are making moves to speed up the process of change.

However, healthcare executives revealed that the 2010 law aimed at providing health coverage for millions of uninsured Americans is unlikely to be repealed. It may yet undergo many amendments but it is already well-established and it cannot be removed entirely.

For a time, US healthcare policy was centered on individuals getting insurance through their employers. An emerging trend, however, has shown that Americans with a health insurance policy from their job could become a minority. Surveys from the past few years have shown a steady decline in the number of Americans below 65 years old who have health insurance from their employer. In 2009, the figure was at 59.2 percent and in 2013 it was at 57.1 percent.

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The number of people who are still on employer-based insurance has been on a steady decline for most age groups. However, young adults remain the exception to this trend. Most of them are still on their parents’ plan until they reach age of 26 because of an Obamacare provision.

Big changes are coming to US healthcare, albeit slowly. At the moment, it is unclear whether these changes will lead to better options for Americans. However, with the shift in power in the healthcare, consumers may gain greater control over the care that they receive.

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Dr. George Northrop of Danbury is a board-certified physician, medical law expert, and healthcare executive. For more articles about the healthcare industry, visit this Facebook page.

Vaccine refusal raises fears of disease outbreaks in the medical community

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According to the Centers for Disease Control and Prevention, the number of measles cases more than tripled in 2014. From just under 200 in 2013, there were 603 reported cases and 20 outbreaks in the first 11 months of 2014. And the majority of the people who contracted measles were not vaccinated.


While the rate of vaccination remains high in the United States, a new and troubling trend -- vaccine refusal -- is raising fears in the medical community. Vaccine-preventable diseases are popping up all over the country. In June 2014, California was declared a hotbed for whooping cough, with more than 10,000 reported cases. Reports call the California epidemic the worst in 55 years, with the disease spreading to other states. Public health officials maintain that vaccine refusal played a role in the epidemic. California is one of the states that allow parents to refuse vaccines for philosophical reasons. 


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Parents are refusing to get their children immunized for a variety of reasons. Some parents are afraid of the much-disproved link between autism and the MMR vaccine, while some believe that the toxins in vaccines cause harm to the body. 


The pediatric community is responding to this trend by stepping up its efforts at parent education. Numerous medical organizations and journals such as the Immunization Action Coalition (IAC,) the Journal of the American Academy of Pediatrics, the CDC, and the World Health Organization (WHO) have made available through their websites various resources to assist medical professionals in vaccine education and parent counselling. 


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Misinformation on vaccine safety and efficacy abounds on the Internet. While there is no way to prevent unfounded rumors from spreading in today's age of lightning-fast communication, physicians can do their part to ensure the safety of the majority through meaningful patient education. 


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CDC reacts to Dallas Ebola case, updates its healthcare worker guidelines

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The Centers for Disease Control and Prevention (CDC) have released stricter guidelines in the treatment and management of Ebola-infected patients.

The change comes in the wake of the events at Texas Health Presbyterian Hospital in Dallas, in which several nurses stated having been sent to care for Thomas Eric Duncan, the first patient diagnosed with Ebola in the U.S., unprepared and under-protected. Two nurses were infected, and the CDC cleared an infected nurse for air travel.

In an October 15 interview with Forbes Magazine, a public relations staff member at the CDC stated that the Dallas incident led them to update their personal protective equipment (PPE) recommendations and monitoring instructions.

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The new guidelines were released on October 22 and focus on tightening infection control through improved PPE, rigorous training on infection control, and improved supervision through trained monitors who will observe healthcare workers as they put on their PPE, in order to rectify lapses in protocol as soon as they occur.

The CDC has updated its PPE recommendations with the addition of two pairs of protective gloves, fluid-resistant gowns, pants, hoods, shoe coverings, and waterproof aprons; as well as replacement of the previously recommended goggles with disposable full-face shields.

The U.S. Government has also made certain changes to prevent the further spread of Ebola. Despite the repeated demands of the Congress and the American public to ban travel from Ebola-ravaged West Africa, the government has instead required travelers coming from Sierra Leone, Guinea, and Liberia to enter through one of five designated U.S. airports equipped for Ebola screening.

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Dr. George Northrop of Danbury is a licensed physician and healthcare executive. For more health news and updates, subscribe to this blog.

Hospital management seeking ways to protect patient records from cyber threats

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An article published recently in The Boston Globe discussed the medical community’s growing concern regarding data breach from cyber attackers. This comes on the tail of the latest news of 4.5 million patient records from Community Health Systems (CHS) allegedly stolen by Chinese hackers. If proven true, this would be the largest breach of patient data to date. Supposedly, the hackers did not gain access to specific medical information, such as treatment procedures and types of illnesses. Nevertheless, personal information, such as names, addresses, birthdates, phone numbers, and Social Security numbers were accessed. CHS is treating this case as an HIPAA violation.

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Criminals can use the stolen records to file fake insurance claims, get medical prescriptions, or sell Social Security numbers. What’s more, cyber hackers have developed sophisticated systems that bypass traditional security fail-safes. Most businesses have developed strategies to protect themselves from cyber threats, but the health industry has been lagging behind in terms of data security. This, perhaps, can be attributed to the general belief that certain areas are still held sacred by individuals or the fact that most hospitals are more concerned with delivering health care and not operational security. The growing number of theft and breaches nevertheless speak a different story.

To address this, management and administrative staff of health facilities are coming together to create better techniques to protect their records. Criminal intrusions mean not only a financial loss but represent the potential risk of misdiagnosis due to incorrect medical records. Health regulators urge staff members to make these improved procedures higher in their priority list. In the meantime, individuals are recommended to take extra measures to protect their own information and store a separate file of all their medical records.

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Dr. George Northrop, formerly of Danbury Hospital, is the current chief medical officer of the Sheik Khalifa General Hospital in Abu Dhabi. He has decades of experience in hospital management and administration. Like this Facebook page for more news and updates on the medical industry.

Medical malpractice cases: Knowing when to file

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Medical malpractice is when a doctor, healthcare professional, or medical facility causes harm to a patient through gross negligence or omission of pertinent information. Acts that directly result in a misdiagnosis or errors in treatment, aftercare, or management can be labeled as medical malpractice and should be forwarded to a legal firm for proper representation. Nevertheless, it is important to know basic characteristics of a malpractice casebefore proceeding with any legal action. These are as follows:

Violating standard of care. While this may vary from state to state, federal law states that there are certain medical standards that all professionals in this industry must follow. Patients have the right to the best possible care available in the area.

Negligence caused an injury. Patients must prove that they sustained an injury because of the direct actions of a health provider. It is not enough that a doctor or health facility provided an unfavorable outcome.

The injuries resulted in significant damages. Medical malpractice cases are typically very expensive. This is because they require several witnesses to come forward and discuss the actions of the specific doctor or health facility. Furthermore, the case is usually reviewed by other doctors who will state their expert opinion. Patients should provide evidence that the doctor’s specific actions directly caused any disability, impairment, loss of income, or any form of suffering or hardship.

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Chief medical officers of hospitals such as Dr. George Northrop are usually called by legal firms to review malpractice cases and determine their validity. A great number of cases do not proceed because they lack the aforementioned characteristics, which further increases the stress to the injured patient. It is important patients gather all pertinent information regarding their experience so that justice can be served.

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Dr. George Northrop was once Danbury Hospital’s academic hospitalist and Obsidium Group’s medical-legal consultant. Today, he serves as chief medical officer at Sheikh Khalifa General Hospital in Abu Dhabi, United Arab Emirates. For more information about Dr. Northrop career as a physician and hospital executive, visit this LinkedIn page.