Predictive genetic testing may upend the insurance market

Predictive genetic testing may upend the insurance market, The Economist writes, as insurers about adverse selection and consumers worry about discrimination.

Consumers can now on their own order genetic tests that inform them of their risk of developing certain diseases. Health tests can gauges customer’s chances of developing diseases like Parkinson’s and Alzheimer’s.

Email motherhealth@gmail.com for DNA EXOME test, gut microbiome test, whole blood panel test,  and anti-oxidant level test.

But, consumers who learn they are at genetic risk of a disease like Alzheimer’s are much more likely to buy long-term care insurance than those who don’t know of such risk, as Harvard researchers have reported.

This, Economist says, creates an imbalance in which people who know they are more likely to need such insurance seek it, and drive up rates. But, on the flip side, it adds that people with such higher risk who disclose it could be subject to higher rates or be excluded from coverage.

“Either way, the scientific advances could well disrupt insurance significantly,” it says.

The Economist notes there is a patchwork of regulations around the world, with the Genetic Information Nondiscrimination Act in the US barring health insurers from using genetic testing results, though other types of insurers may rely on such results.

You’re Probably Going to Need Medicaid

You’re Probably Going to Need Medicaid

By DAVID GRABOWSKI, JONATHAN GRUBER and VINCENT MOR

JUNE 13, 2017

Imagine your mother needs to move into a nursing home. It’s going to cost her almost $100,000 a year. Very few people have private insurance to cover this. Your mother will most likely run out her savings until she qualifies for Medicaid.

This is not a rare event. Roughly one in three people now turning 65 will require nursing home care at some point during his or her life. Over three-quarters of long-stay nursing home residents will eventually be covered by Medicaid. Many American voters think Medicaid is only for low-income adults and their children — for people who aren’t “like them.” But Medicaid is not “somebody else’s” insurance. It is insurance for all of our mothers and fathers and, eventually, for ourselves.

The American Health Care Act that passed the House and is now being debated by the Senate would reduce spending on Medicaid by over $800 billion, the largest single reduction in a social insurance program in our nation’s history. The budget released by President Trump last month would up the ante by slashing another $600 billion over 10 years from the program. Whether the Senate adopts cuts of quite this magnitude or not, any legislation that passes the Republican Congress is likely to include the largest cuts to the Medicaid program since its inception.

Much focus has rightly been placed on the enormous damage this would do to lower-income families and youth. But what has been largely missing from public discussion is the radical implications that such cuts would have for older and disabled Americans.

Newsletter Sign UpContinue reading the main story
Sign Up for the Opinion Today Newsletter
Every weekday, get thought-provoking commentary from Op-Ed columnists, the Times editorial board and contributing writers from around the world.

Medicaid is our nation’s largest safety net for low-income people, accounting for one-sixth of all health care spending in the United States. But few people seem to know that nearly two-thirds of that spending is focused on older and disabled adults — primarily through spending on long-term care services such as nursing homes.

 

Indeed, Medicaid pays nearly half of nursing home costs for those who need assistance because of medical conditions like Alzheimer’s or stroke. In some states, overall spending on older and disabled adults amounts to as much as three-quarters of Medicaid spending. As a result, there is no way that the program can shrink by 25 percent (as under the A.H.C.A.) or almost 50 percent (as under the Trump budget), without hurting these people.

A large body of research, some of it by us, has shown that cuts to nursing home reimbursement can have devastating effects on vulnerable patients. Many nursing homes would stop admitting Medicaid recipients and those who don’t have enough assets to ensure that they won’t eventually end up on Medicaid. Older and disabled Medicaid beneficiaries can’t pay out of pocket for services and they do not typically have family members able to care for them. The nursing home is a last resort. Where will they go instead?

Those who are admitted to a nursing home may not fare much better. Lowering Medicaid reimbursement rates lead to reductions in staffing, particularly of nurses. Research by one of us shows that a cut in the reimbursement rate of around 10 percent leads to a functional decline of nursing home residents (that is, a decline in their ability to walk or use the bathroom by themselves) of almost 10 percent. It also raises the odds that they will be in persistent pain by 5 percent, and the odds of getting a bedsore by 2 percent.

Finally, these cuts would just shift costs to the rest of the government. Lower-quality nursing home care leads to more hospitalizations, and for Americans over 65, these are paid for by another government program, Medicare. One-quarter of nursing home residents are hospitalized each year, and the daily cost of caring for them more than quadruples when they move to the hospital. Research shows that a reduction in nursing home reimbursements of around 10 percent leads to a 5 percent rise in the odds that residents will be hospitalized. So care for seniors suffers, and the taxpayer pays.

Mr. Trump and the Republicans would lower spending on the frailest and most vulnerable people in our health care system. They would like most Americans to believe that these cuts will not affect them, only their “undeserving” neighbors. But that hides the truth that draconian cuts to Medicaid affect all of our families. They are a direct attack on our elderly, our disabled and our dignity.

David Grabowski is a professor of health care policy at Harvard Medical School. Jonathan Gruber is a professor of economics at M.I.T. Vincent Mor is a professor of health care policy at Brown.

Turning 50? it is not late to prepare for your retirement savings plan

A senior costs her three homes to pay for 15yrs of staying in a care home facility.She has no retirement savings, long term care or other means of generating income. Her diabetes caused her death after 15 yrs in a care home with not enough exercise and motivation to eat healthy food even when the care home prepares a gourmet meal for her. So if you are planning to retire with sufficient funds, plan early.

Here are a few of her rules of thumb to help you catch up after age 50:

Make savings non-negotiable

People who are not really taking their savings seriously, unfortunately, are going to move themselves into this area of poverty. For someone who has not been saving, take a real hard look at where their money is going and make savings automatic, non-negotiable.

If you make savings a high priority, there’s a lot of opportunity to make a difference. Let me give you a financial example: If a 50-year-old was to take advantage of the 401(k) and save $23,000 for the next 15 years until they’re 65, at a 6% rate of return that money can grow to [about] $570,000. Also take a look at credit card debt because the interest that you’re paying could easily be going to savings.

The 25 Times Rule

You will need 25 times the amount you’ll need to withdraw from your savings to supplement retirement or any other reliable income. So, for instance, if you need $40,000 per year of supplemental income, you will need a million dollars saved at the time of retirement.

The Minus 10 Rule

If you start saving in your 20s, you can save up to 10% and you should have a relatively comfortable retirement. However if you wait until your 30s, you’re going to have to save at least 20%. And then your 40s [save] 30%, and 50s of course 40%. That sounds like a lot of money, but in this country two-thirds of Americans use Social Security as their primary source of income. For a third of Americans, it’s their only source of income. And, unfortunately, the average amount of Social Security is approximately $15,000 [a year].

Are there things that you can cut out? For instance, even life insurance. For a lot of people it’s a waste of money — they don’t have dependents or a small business. Really look at where you can cut money — is it cable television? Do you need that car?

Saving for your health

Keep in mind we’re living longer. In our early retirement days we are going to be active and that’s where our money is going to go. But in our later years, a lot of our money is going to go to health care. A lot of people don’t really think about health care costs and embedding that into their savings.

If you have access to an Index Universal Life policy consider maximizing the funding in it and let it grow over the years so that when you do retire, you have that nest egg.

A lot of people assume that Medicare is paid for and all their medical expenses are going to be paid for, but actually the premium is deducted from your Social Security benefit so Medicare only covers about 60% of your health care costs, so it’s really important to embed health care in your whole retirement savings plan.

———–

Contact Connie Dello Buono CA Life Lic 0G60621 for a investment-retirement-savings plan that will provide a lifetime income, a similar to long term care insurance, with estate plan, life protection and tax-free and risk-free. Best of all it has been growing up to 8% during the last 20yrs.