Healthy World, Healthy Nation, Healthy You

Finance and Health Care Reform

Finance and Health Care Reform

shutterstock_107202491Value, Quality and Access to Services
We Need to Design a System that Provides Better Quality for Less Cost


Uninsured. Nearly 44 million Americans who currently do not have health insurance are projected to be covered under new health care law. Other coverage milestones include better preventive care, women’s health services, better care for seniors and expanded coverage of our nation’s poorest. New reforms include letting young adults stay on their parents plan until 26, eliminating pre-existing conditions and preventing insurance companies from dropping you when sick. All of this comes at a cost as citizen’s are experiencing changes in insurance coverage, employers are moving away from providing coverage for employees, and out of pocket co-pays are expected to rise.


We are Breaking the Bank. America’s health care system has become too complex and costly to continue business as usual. We spend more than $8,000/person in the US for care, yet we rank # 22 in health outcomes as compared with the rest of the world. Spending less on health care is a national mandate otherwise, we cannot continue to bear the cost either individually or as a nation. The reasons why our health care cost so much than the rest of the world has to be explored and remedied.

Investing in Health vs. Illness~ A National Mandate

Rising health care costs continue to dominate the American health policy agenda.


Health spending in the U.S. reached an estimated $2.9 trillion in 2013 while overall growth remains low. For 2012, the figure was $2.8 trillion and 2011 it was $2.7 trillion, according to the federal actuary analysis released in Health Affairs in January 2013. The rate of growth nationwide in both 2010 and 2011 was 3.9 percent, and only 0.1 percentage point higher than the 2009 growth rate of 3.8 percent. National health spending averaged $8,680 per person in 2011. Health care accounted for 17.9 percent of the gross domestic product in both 2010 and 2011.

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The Patient Protection and Affordable Care Act reforms the way we buy health insurance requiring that all Americans, purchase a private health care plan, get an exemption or pay a 1% – 2.5% of their taxable income or a set amount (it’s a tax, not a mandate). Americans who cannot afford health insurance will most likely either qualify for Medicare, Medicaid, CHIP or get assistance in the form of tax credits or assistance with up-front costs through their State’s Health Insurance Exchanges (HIX). Going on the open market to purchase health insurance will allow many to “customize” insurance for their particular needs. This will require that individuals and families project what they think they will need in the year ahead in order to cover health expenditures.

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Employer Trends. Many Americans will keep their employer-based or current insurance while low-to-middle income Americans will be able to purchase federally regulated and subsidized insurance through online health insurance exchanges.

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The trend appears that many employers will continue to subsidize insurance for employees, but will no longer offer employer sponsored plans. Each employee will receive money from an employer and with this sum, will go out in the open market and purchase their own plan.

Investing in Primary Care and Population Health is Key. In addition to insurance coverage and the cost of health care, issues such as access to services, especially primary care services, will become a major policy issue as so many more people attempt to find a primary care provider in a system that has a much lower number of providers/person than other countries who work through primary care practices to keep the population well. We have invested in a high tech system that fixes people when they are sick. Finding providers to provide the care once citizens have insurance cards will be a challenge for us to address.


Medicaid. Expanded coverage to provide health coverage to 17 million uninsured Americans who are falling in between the cracks of being able to afford insurance and qualifying for Medicaid. The ACA overhauls Medicare as well adding new benefits, expanding c overage, fighting fraud, cutting costs, and improving care for patients.

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Planning for Your Estate and Your Life~ Combining Financial and Advanced Care Planning in Meeting Your Security Goals

Karl  M Ahlswede, MD

Director of Pain and Palliative at Bryn MAwr Hospital, Bryn Mawr, PA and Medical Director for the Pain and Palliative Care Program for Main Line Health System, Bryn Mawr, PA.

Robert J. Sims, CFP®, MSFS, CLU, ChFC.

Bob is currently the Chairman of Sims Financial Services LLC, located in Wayne, Pennsylvania.  The firm’s focus is on developing, implementing, and monitoring personalized financial plans for individuals and businesses.

Continue reading Planning for Your Estate and Your Life~ Combining Financial and Advanced Care Planning in Meeting Your Security Goals

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