This report, published by the West Virginia Partnership to Promote Community Well-Being and funded by the U.S. Office of Juvenile Justice and Delinquency Prevention Block Grant, details the financial burden of substance abuse on the health care system. According to the report, $116 million of the health care budget was spent on substance abuse treatment in 2007 and that figure is projected to increase to $201 million by 2010.

From the report:

This report uses a mix of methodologies from two previous studies that have attempted to estimate the cost of drug and alcohol use. The first, “Shoveling Up: The Impact of Substance Abuse on State Budgets,” was released by the National Center on Addiction and Substance Abuse (CASA) at Columbia University in 2001, and was recently updated in 2009. The second study, titled “Integrated Funding Analysis of Mental Health and Substance Use in West Virginia,” was released by the Public Consulting Group (PCG) in 2007. However, the present study makes some unique contributions to the two reports. First, it provides more recent estimates of the cost of drug and alcohol use to the state. Second, it provides cost trends over the past 8 years and, based on those trends, makes projections for costs in year 2017. Unless otherwise noted, linear trend was assumed for these projections. Third, this report includes certain sectors that are impacted by drugs and alcohol use but were excluded from one or both of the previous two reports. Finally, this report was initiated with the intent of producing annual updates; consequently, only data that are available annually were used.

The West Virginia Partnership to Promote Well-being. (2009). The financial burden of substance abuse in West Virginia: the healthcare system. Shobo, Yetty, Coombs, Wayne & Whisman, Andy

Full report:

http://www.prevnet.org/funding%20study/pdf/2009-10-FS-HealthcareReport.pdf

The Blue Cross Blue Shield Association (BCBS) released a report on October 14 outlining possible effects of health care reform legislation, including estimating that the legislation would increase the price of average annual medical claims for individual policies by 50% in five years.   

From the report:

Insurance reforms alone will substantially increase claims costs in the individual market. The individual market “risk pool” will be less healthy than today and will drive higher insurance premiums. We estimate the average medical claims for the uninsured are 20 percent higher than claims in the current individual market. In addition, certain segments with high medical utilization who are now insured through other arrangements will enter the individual market as a result of guaranteed issue and modified community rating requirements. This includes people enrolled in state high risk pools, people on COBRA through their former employers’ coverage, and other group conversion policies.

Blue Cross Blue Shield. (2009). Insurance reforms must include a strong individual mandate and other key provisions to ensure affordability. Wyman, Oliver.

Full report: http://www.bcbs.com/issues/uninsured/background/Oliver-Wyman-Report-Showing-Impact-of-Healthcare-Reform-on-Premiums-pdf.pdf

A report by the Center for Economic Policy and Research (CEPR) advocates allowing Medicare and Medicaid beneficiaries to move to other countries and buy into their health insurance systems using U.S. vouchers.  The CEPR says the system would reduce U.S. health care costs while improving quality.  Under the proposed system, the government and the beneficiaries would split the savings obtained from using the non-U.S. systems, which spend, on average, nearly half of the $6,714 that the U.S. health care system spends per-person on health care and achieve longer life expectancies.  In addition, the program would give the provider country a premium above their costs to ensure their participation in the program.  The report estimates the cost savings of such a program based on several projected levels of participation.

From the introduction:

There are large differences between the per-person cost of providing health care in the United States and the per-person cost in other countries with comparable health care outcomes. In 2006, the per-person cost of health care in the United States was $6,714, while the average cost in the 26 countries with longer life expectancies was $2,964. This gap suggests the potential for substantial gains from trade.

This paper outlines a mechanism for taking advantage of these potential gains from trade: a globalization of the Medicare and Medicaid programs. Since most of the beneficiaries of Medicare are retirees, as are a substantial portion of the beneficiaries of Medicaid, they need not live near a workplace. Many beneficiaries have family or other ties to other countries. The globalization mechanism proposed in this paper would allow beneficiaries of these programs to have a voucher that would allow them to move to other countries and buy into their health care systems, with the government and the beneficiaries splitting the gains. To provide an inducement for other countries to participate, they would receive a premium (e.g. 10 percent) above their costs to ensure that they benefit from this process as well.

Center for Economic Policy and Research. (2009). Free trade in health care: the gains from globalized Medicare and Medicaid. Dean Baker and Hye Jin Rho.

Full report: http://www.cepr.net/documents/publications/free-trade-hc-2009-09.pdf

A TriNet Group Inc. survey found 71 percent of small business owners worry that health care reform legislation will increase their health care costs and 56 percent believe it will cause “unnecessary complexity”.  Of those respondents who believe that the legislation will increase cost, 44 percent indicated that they would reduce benefits to recoup their costs while 21 percent said they would first look to cut wages and 20 percent said they would reduce staff.

From the introduction:

Full report: http://www.trinet.com/documents/white_papers/TriNet_WP_2009_HRTrends_Q3.pdf

This Commonwealth Fund report presents the results of the 2009 State Scorecard on Health System Performance , assessing states’ performance in health care access, quality, cost, and outcomes.  The report found that states’ performance continues to vary widely; however, all states face rising health care costs and poor care coordination.  The report notes that Vermont, Hawaii, Iowa, Minnesota, Maine, New Hampshire, Massachusetts, Connecticut, North Dakota, Wisconsin, Rhode Island, South Dakota, and Nebraska were the overall highest performers; however, the scorecard does not yet reflect the effects of the recession because of a reporting lag. 

From the report:

Focused on identifying opportunities to improve, The Commonwealth Fund’s State Scorecard on Health System Performance assesses states’ performance on health care relative to achievable benchmarks for 38 indicators of access, quality, costs, and health outcomes. The 2009 State Scorecard paints a picture of health care systems under stress, with deteriorating health insurance coverage for adults and rising health care costs. On a positive note, there were gains in children’s coverage as a result of national reforms, and improvement in some measures of hospital and nursing home care following federal efforts to publicly report quality data. The scorecard highlights persistent wide variation in performance across states and continued evidence of poor care coordination. Increasing cost pressures and deterioration in access across the U.S., together with geographic disparities in performance, underscore the urgent need for comprehensive national reforms to ensure access, change the trajectory of costs, and enhance value.

Full report: http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2009/Oct/1326_McCarthy_state_scorecard_2009_full_report_FINAL.pdf 

The Commonwealth Fund. (2009). Aiming higher: results from a state scorecard on health System performance, 2009. Douglas McCarthy, Sabrina K. H. How, Cathy Schoen, Joel C. Cantor, and Dina Belloff.