side note: Spending more on Cobra expenses and health benefits for laid off workers, the third largest health insurer saw its shares drop 10%. However, it seems that the company’s enrollment in medical plans and its revenue are beating analyst’s estimates. Aetna has affirmed its full year earnings forecast

By Alex Nussbaum
Bloomberg.com

April 29 (Bloomberg) — Aetna Inc., the third-largest U.S. health insurer, slipped the most in two months in New York trading after the company said it was spending more than expected on health benefits for workers who lost their jobs or feared dismissal.

The shares dropped 10 percent, or $2.52, to $21.88 at 4:15 p.m. in New York Stock Exchange composite trading, Aetna’s biggest one-day fall since March 5. The Hartford, Connecticut- based insurer said expenses were pushed higher by dismissed workers who continued buying insurance through the government- subsidized Cobra program, as well as those who ramped up medical treatment as firings loomed.

“I think about this as the recessionary effect,” Chief Executive Officer Ronald Williams said in a conference call with analysts today to discuss first-quarter earnings. “We feel that ‘09 is clearly unlike ‘08 and all the years that have gone before it.”

Enrollment in Aetna’s health plans rose in the quarter, the company said today in reporting profit that beat analysts’ estimates. That occurred even as U.S. unemployment reached 8.5 percent last month, the highest level in 25 years. Earnings were inflated by investment income and share repurchases and offset by the higher costs, said Matthew Borsch, an analyst with Goldman, Sachs & Co. in New York, in a note to clients. (more…)

side note: This has got to be one of the worst healthcare nightmares. A serious illness causes loss of job, total income less then $45,000, 20% of the income goes for healthcare expenses, and the couple makes too much money for state assistance. But this is reality and it doesn’t matter whether the couple is young or old. Healthcare bills, statements, EOB’s, are daunting and confusing. Providers have an obligation to provide clear explanations of medical bills and statements. Patients should make sure they are holding providers to that standard.

By Lesley Alderman
New York Times News Service
Kentucky.com

Kirk Kupka, 48, of Lindstrom, Minn., has multiple sclerosis. He and his wife, Susie, have an annual income of $45,000 — a combination of her salary as an office manager and his disability payments.

More than 20 percent of that income goes for health care. Their annual insurance premiums are $5,400, and Kupka spends $4,000 before he fulfills his policy’s deductible.

In the three years since Kupka was forced to quit his job as a mental health therapist, he has accumulated $12,000 in debt.

“We earn too much to qualify for state and county assistance, but not enough to stay ahead of the bills,” he said.

Medical debt can force people to raid 401(k)s, tap into home equity lines and, in some cases, declare bankruptcy. Surveys by the Commonwealth Fund, a non-profit health care research foundation, found that 41 percent of adults said they struggled to pay their health care bills in 2007, up from 34 percent in 2005. That percentage is almost surely growing.

And as Kupka’s case illustrates, it’s not just uninsured patients who rack up large bills. Nearly two-thirds of those with debt problems, according to Commonwealth, had health insurance.

But insurance covers less and less these days, as employers shift more health care costs to employees and as people resort to lower-cost plans that come with high deductibles or less-generous benefits.

But there are ways to reduce, or at least more effectively manage, medical debt:

Confront, don’t ignore

Procrastinating only leads to trouble. If your bills are turned over to a collection agency, the debt goes on your credit report. So take action — even if that doesn’t mean writing any checks right away. (more…)

side note: This nytimes article sheds light on some basic problems in healthcare. There is an acute shortage of primary care providers in this country. That impacts access to care. One solution in Congress is to increase the level of Medicare reimbursement to primary care providers. However the specialist groups say, don’t mess with our reimbursement, find new dollars. That increases healthcare spending. This is not a problem that is easily solved.

By ROBERT PEAR

WASHINGTON — Obama administration officials, alarmed at doctor shortages, are looking for ways to increase the supply of physicians to meet the needs of an aging population and millions of uninsured people who would gain coverage under legislation championed by the president.

The officials said they were particularly concerned about shortages of primary care providers who are the main source of health care for most Americans.

One proposal — to increase Medicare payments to general practitioners, at the expense of high-paid specialists — has touched off a lobbying fight.

Family doctors and internists are pressing Congress for an increase in their Medicare payments. But medical specialists are lobbying against any change that would cut their reimbursements. Congress, the specialists say, should find additional money to pay for primary care and should not redistribute dollars among doctors — a difficult argument at a time of huge budget deficits.

Some of the proposed solutions, while advancing one of President Obama’s goals, could frustrate others. Increasing the supply of doctors, for example, would increase access to care but could make it more difficult to rein in costs.

The need for more doctors comes up at almost every Congressional hearing and White House forum on health care. “We’re not producing enough primary care physicians,” Mr. Obama said at one forum. “The costs of medical education are so high that people feel that they’ve got to specialize.” New doctors typically owe more than $140,000 in loans when they graduate.

Lawmakers from both parties say the shortage of health care professionals is already having serious consequences. “We don’t have enough doctors in primary care or in any specialty,” said Representative Shelley Berkley, Democrat of Nevada.

Senator Orrin G. Hatch, Republican of Utah, said, “The work force shortage is reaching crisis proportions.”

Even people with insurance have problems finding doctors. (more…)