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<p>“Today, there are 6.6 people on disability for every
100 people actively working. That’s double the ratio from
20 years ago, and almost three times what it was in 1972”</p>
<p>What happens to these people when they hit 65? Do they just transition to medicare?</p>
<p>Forbes claims it is currently at 200 billion per year.</p>
<p>yes they go over to medicare when age eligible.</p>
<p>This offers some perspective for 65+ still covered by an employer: [Medicare</a> Interactive - Should I enroll in Medicare if I have health insurance from my (or my spouse’s) current employer?](<a href=“http://www.medicareinteractive.org/page2.php?topic=counselor&page=script&slide_id=121]Medicare”>http://www.medicareinteractive.org/page2.php?topic=counselor&page=script&slide_id=121)</p>
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<p>People who have been on Social Security Disability become eligible for Medicare after receiving payments for 2 years. I don’t know how many actually go on Medicare, or how many have other coverage. For the disabled on Medicare prior to age 65, they just continue with Medicare.</p>
<p>wow, I was just reading an article in our local paper that was published in the NY Times 3 weeks ago (so discussion is probably buried back in the thread) about the high cost of maternity care. I had no idea that so many plans did not cover maternity care, so even folks with health insurance get stuck with super high bills for maternity. And the ACA will require plans to cover maternity care, so that will add a huge cost to health insurance.</p>
<p>But they do say, confer with HR. Medicare.gov also explains some. [How</a> Medicare works with other insurance | Medicare.gov](<a href=“http://www.medicare.gov/supplement-other-insurance/how-medicare-works-with-other-insurance/how-medicare-works-with-other-insurance.html]How”>http://www.medicare.gov/supplement-other-insurance/how-medicare-works-with-other-insurance/how-medicare-works-with-other-insurance.html)</p>
<p>If anyone is still reading this, I have a question about what other states are offering with regard to mental health services. On another thread, the issue of in patient hospitalization was raised, and touched on indications for admission, and length of stay. </p>
<p>Where I practice, in patient hospitals are closing, especially those for kids, and admission is generally limited to patients who are a danger to themselves and others. Average length of stay is about 7 days. This is managed particularly aggresively for our Medicaid patients. </p>
<p>I am not finding anything specific under “Covered California”. </p>
<p>On the other thread, mention was made that in other communities, children can be admitted for “evaluation”, rather than acute treatment, stay 7 days, maybe even twice, and “treatment” stays may be even longer. </p>
<p>I understand that parity laws for companies larger than 50 may not restrict mental health benefits for “biologically based mental health disorders”, but parity laws and that “treatment” must be "medically neccesary. </p>
<p>Given that in patient stays of 7 days for a mood sdisorder can cost $7k to provide, how would this play out if the number of folks with this kind of coverage expands dramatically? I imagine at first, that only those who have it now, will continue to have it.</p>
<p>The ACA does include “mental health and substance abuse disorder services, including behavioral health treatment” under the “Essential Health Benefits” that must be covered by all plans – and such coverage must be “consistent with the Federal Mental Health Parity and Addiction Equity Act.”</p>
<p>In legal terms it means that all plans must include mental health coverage that is comparable to the coverage for bodily disease. In practical terms, I don’t have a clue what it means – I assume that it is still subject to copays, deductibles, and the insurance company’s determination of UCR – plus the whole in-network/ out-of-network distinctions. </p>
<p>I don’t know whether that is just telling you what you already know.</p>
<p>So right now, companies with fewer than 50 employees don’t have to go by parity laws, but the exchanges will? I don’t assume that means 7 days inpatient for “evaluation”, but even if it only covers treatment, around here, there is no way there will be enough hospital beds for all the folks covered by parity laws, and having new mental health benefits.</p>
<p>Yes – here’s the link with my source: [California</a> Health Benefit Exchange - Covered California - Health Insurance - BenefitsCafe.com](<a href=“http://www.benefitscafe.com/health-exchange/]California”>Covered California for Small Business - Benefits Cafe)</p>
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<p>Wow. I have some kids with “Healthy Families” who will become MediCal as of August 1st, and still don’t know who they can see, as there are no psychiatrists outside of the county and Kaiser that take MediCal.</p>
<p>Can they use Pop 63 funds?</p>
<p><a href=“http://www.californiahealthline.org/articles/2013/7/23/state-to-release-audit-on-mental-health-spending-under-prop-63[/url]”>http://www.californiahealthline.org/articles/2013/7/23/state-to-release-audit-on-mental-health-spending-under-prop-63</a></p>
<p>This may have been discussed already
“Issue Brief May 2013
Private Coverage Under California’s Affordable Care Act:
Benefit and Cost-Sharing Requirements Affecting
Children and Adolescents with Special Health Care Needs”</p>
<p><a href=“http://cshcn.wpengine.netdna-cdn.com/wp-content/uploads/2013/06/Private-Coverage-Under-ACA-7-8-131.pdf[/url]”>http://cshcn.wpengine.netdna-cdn.com/wp-content/uploads/2013/06/Private-Coverage-Under-ACA-7-8-131.pdf</a></p>
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<p>Prenatal care is one of the smartest things we can do, if saving money is the goal. Premature and low birth weight babies are very expensive.</p>
<p>[More</a> Doctors Steer Clear of Medicare - Yahoo! Finance](<a href=“http://finance.yahoo.com/news/more-doctors-steer-clear-medicare-030500979.html]More”>http://finance.yahoo.com/news/more-doctors-steer-clear-medicare-030500979.html)</p>
<p>Do you think this is going to happen with the ACA plans? I do.</p>
<p>H’s firm just sent out the word. All new administrative personnel will be held to fewer than 30 hours to avoid the ACA mandate.</p>
<p>Yet another reason why we need a single payer system. </p>
<p>It’s really ****ty that companies (especially the grossly over-profiting companies) can get away with that.</p>
<p>TatinG, that doesnt make sense.</p>
<p>There isnt a mandate for small employers this year. If large employers are already paying for healthcare, and 96 percent are, How is ACA going to affect the larger firms?</p>
<p>And that 30 hour limit may not fly…</p>
<p>Here’s an interesting article from Bloomberg about heart surgery in India and the drive to cut its cost so it becomes more accessible. [url=<a href=“Bloomberg - Are you a robot?”>Bloomberg - Are you a robot?]Here[/url</a>]. And the grabber part is they’ve cut the cost of:</p>
<p>“artery-clearing coronary bypass surgery to 95,000 rupees ($1,583), half of what it was 20 years ago, and wants to get the price down to $800 within a decade. The same procedure costs $106,385 at Ohio’s Cleveland Clinic, according to data from the U.S. Centers for Medicare & Medicaid Services.”</p>
<p>Allowing for lower cost of living in India, that is a 100fold difference. All because the private insurance system feeds through employers - who deduct their costs - so the spread of costs generates higher costs as well. Note I’m not talking profits, just costs.</p>
<p>It is a larger employer and I suppose they see that insurance is becoming more, not less expensive, while the job market is still soft and they can get administrative staff willing to work without benefits.</p>
<p>The bottom line is always the answer.</p>
<p>Yeah… That is what Milton Friedman used to say…</p>
<p>So why is the ACA to blame? Insurance costs rise, the job market is soft, the corporation wants to cut costs- oh if we do it this way we can blame someone else and do what we want anyway.</p>