One approach to determine how much life insurance one should carry is to analyze the various needs of the family in the event of the death of a wage earner. Life insurance satisfies a number of these needs by providing a fund that can be used to:
- Pay off an individual’s last debts such as medical bills and funeral expenses
- Meet estate taxes and other expenses in settling an estate
- Provide life income for the spouse
- Pay off a mortgage
- Pay for the children’s education
- Provide funds for retirement
- Provide an income for the policyholder’s spouse to give the family time to readjust to a new standard of living
- Draw interest to provide funds for some special purpose
- Provide a monthly income until the children are grown and out of school
Calculate the total amount you think you will need to meet tomorrow's needs and obtain a policy for that amount.
Sunday, October 19, 2008
Doctors Aren't Using Electronic Health Records
A government-sponsored survey of the use of computerized patient records by doctors points to two seemingly contradictory conclusions, and a health care system at odds with itself.
The report, published online found that doctors who use electronic health records say overwhelmingly that such records have helped improve the quality and timeliness of care. Yet fewer than one in five of the nation's doctors has started using such records.
Bringing patient records into the computer age, experts say, is crucial to improving care, reducing errors and containing costs in the American health care system. The slow adoption of the technology is mainly economic. Most doctors in private practice, especially those in small practices, lack the financial incentive to invest in computerized records.
The national survey found that electronic records were used in less than 9 percent of small offices with one to three doctors, where nearly half of the country's doctors practice medicine.
The initial cost of upgrading the office's personal computers, buying new software and obtaining technical support to make the shift would be $15,000 to $20,000 a doctor. Then, during the time-consuming conversion from paper to computer records, practices would be able to see far fewer patients, perhaps doubling the cost.
Private and government insurers and hospitals can save money as a result of less paper handling, lower administration expenses and fewer unnecessary lab tests when they are connected to electronic health records in doctors' offices. Still, it is mainly doctors who bear the burden making the initial investment.
We have a broken market for electronic health record adoption because the people who gain financially are not the people who pay. To fix the market government must play a role in providing incentives or subsidies to speed the use of computerized patient records in the United States, whose adoption rate trails most developed nations.
The government took a step in that direction recently, announcing a $150 million Medicare project that will offer doctors incentives to move from paper to electronic patient records. The program is intended to help up to 1,200 small practices in 12 cities and states make the conversion.
Individual doctors will be offered up to $58,000 over the five-year span of the project, which is intended to test the impact of incentives on the spread of electronic health records. Further programs across the country are planned.
The report published in the journal also found that electronic health records were used by 51 percent of larger practices, with 50 or more doctors.
Indeed, electronic health records are pervasive in the largest integrated medical groups like Kaiser Permanente, the Mayo Clinic, the Cleveland Clinic, University of Pittsburgh Medical Center and others. These integrated groups not only have deep pockets. By combining doctors, clinics, hospitals and often some insurance they can also capture the financial savings from electronic health records.
The findings of the study broadly echo previous research on the adoption of electronic health records. Large medical groups have long been the early adopters, and small practices have struggled.
But the new study is based on a large sampling - more than 2,600 doctors across the country - and a detailed survey, making it more definitive than past research, experts say. The results, they say, also show a strong endorsement of electronic health records by doctors who have them, especially for what the report termed "fully functional" records, which include reminders of care guidelines, based on a patient's age, gender or medical history.
For example, 82 percent of those using such electronic records said they improved the quality of clinical decisions, 86 percent said they helped in avoiding medication errors and 85 percent said they improved the delivery of preventative care.
The report, published online found that doctors who use electronic health records say overwhelmingly that such records have helped improve the quality and timeliness of care. Yet fewer than one in five of the nation's doctors has started using such records.
Bringing patient records into the computer age, experts say, is crucial to improving care, reducing errors and containing costs in the American health care system. The slow adoption of the technology is mainly economic. Most doctors in private practice, especially those in small practices, lack the financial incentive to invest in computerized records.
The national survey found that electronic records were used in less than 9 percent of small offices with one to three doctors, where nearly half of the country's doctors practice medicine.
The initial cost of upgrading the office's personal computers, buying new software and obtaining technical support to make the shift would be $15,000 to $20,000 a doctor. Then, during the time-consuming conversion from paper to computer records, practices would be able to see far fewer patients, perhaps doubling the cost.
Private and government insurers and hospitals can save money as a result of less paper handling, lower administration expenses and fewer unnecessary lab tests when they are connected to electronic health records in doctors' offices. Still, it is mainly doctors who bear the burden making the initial investment.
We have a broken market for electronic health record adoption because the people who gain financially are not the people who pay. To fix the market government must play a role in providing incentives or subsidies to speed the use of computerized patient records in the United States, whose adoption rate trails most developed nations.
The government took a step in that direction recently, announcing a $150 million Medicare project that will offer doctors incentives to move from paper to electronic patient records. The program is intended to help up to 1,200 small practices in 12 cities and states make the conversion.
Individual doctors will be offered up to $58,000 over the five-year span of the project, which is intended to test the impact of incentives on the spread of electronic health records. Further programs across the country are planned.
The report published in the journal also found that electronic health records were used by 51 percent of larger practices, with 50 or more doctors.
Indeed, electronic health records are pervasive in the largest integrated medical groups like Kaiser Permanente, the Mayo Clinic, the Cleveland Clinic, University of Pittsburgh Medical Center and others. These integrated groups not only have deep pockets. By combining doctors, clinics, hospitals and often some insurance they can also capture the financial savings from electronic health records.
The findings of the study broadly echo previous research on the adoption of electronic health records. Large medical groups have long been the early adopters, and small practices have struggled.
But the new study is based on a large sampling - more than 2,600 doctors across the country - and a detailed survey, making it more definitive than past research, experts say. The results, they say, also show a strong endorsement of electronic health records by doctors who have them, especially for what the report termed "fully functional" records, which include reminders of care guidelines, based on a patient's age, gender or medical history.
For example, 82 percent of those using such electronic records said they improved the quality of clinical decisions, 86 percent said they helped in avoiding medication errors and 85 percent said they improved the delivery of preventative care.
Controlling Your Health Insurance Premiums
Health insurance costs are rising much faster than inflation. But what can manufacturers do about it? One idea that seems to be working is giving employees "ownership" in their health plans. A big problem is that employees are disconnected from the cost of healthcare. For instance, when asked in surveys, a surprising number of people think the doctor only receives their health plan's co-pay amount, $10 or $20!
This misperception leads employees to think, "I've already paid for my health care via these premiums, so I want to get the most I can out of the plan." The result of this thinking leads to wasteful use of healthcare services and rapidly escalating costs.
But durable medical equipment, such as crutches, wheelchairs and the like, has averaged less than 5% inflation over the last 20 years. In October, the Department of Labor announced that the inflation rate for prescription drugs had dropped to 1%.
Not coincidentally, in both categories consumers pay a larger share of costs than in other healthcare expenses. Durable medical equipment benefit is usually limited to some relatively small amount ($750-$1,500 maximum benefit) with the insured paying the rest. And often the insured shares in the initial cost, too.
Prescription cost-sharing has changed in the last ten years. Not long ago most drug plans required only a $5 or $10 co-pay for all drugs. And drug inflation reflected that disconnect, reaching a high of 22% per year. But in the last half dozen years most health plans have changed to a three-tier drug co-pay plan: $10 for generic drugs, $25 for "approved" brand-name drugs and $45 for non-approved drugs.
To break the disconnect, smart employers are using supplemental plans: Flexible Spending Accounts (FSAs), Health Reimbursement Arrangements (HRAs) and Health Savings Accounts (HSAs). Each offers tax breaks to employer and employee alike, and each gives employees ownership of the results of their spending decisions. Frugality reduces costs; profligacy increases them!
This misperception leads employees to think, "I've already paid for my health care via these premiums, so I want to get the most I can out of the plan." The result of this thinking leads to wasteful use of healthcare services and rapidly escalating costs.
But durable medical equipment, such as crutches, wheelchairs and the like, has averaged less than 5% inflation over the last 20 years. In October, the Department of Labor announced that the inflation rate for prescription drugs had dropped to 1%.
Not coincidentally, in both categories consumers pay a larger share of costs than in other healthcare expenses. Durable medical equipment benefit is usually limited to some relatively small amount ($750-$1,500 maximum benefit) with the insured paying the rest. And often the insured shares in the initial cost, too.
Prescription cost-sharing has changed in the last ten years. Not long ago most drug plans required only a $5 or $10 co-pay for all drugs. And drug inflation reflected that disconnect, reaching a high of 22% per year. But in the last half dozen years most health plans have changed to a three-tier drug co-pay plan: $10 for generic drugs, $25 for "approved" brand-name drugs and $45 for non-approved drugs.
To break the disconnect, smart employers are using supplemental plans: Flexible Spending Accounts (FSAs), Health Reimbursement Arrangements (HRAs) and Health Savings Accounts (HSAs). Each offers tax breaks to employer and employee alike, and each gives employees ownership of the results of their spending decisions. Frugality reduces costs; profligacy increases them!
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