News & Trends

Marsh study on small-employers dropping health care coverage; Commonwealth Fund report on disability coverage; JAMA report on nation's blood pressure rising




What's one way to battle continuous double-digit increases in health care costs? Just drop the coverage. That's exactly what a number of small employers have been forced to do as of late, according to a new survey by Marsh Inc.

The prevalence of health care coverage dropped from 66 percent to 62 percent in 2002 for employers with 10 - 49 employees, a group battered by 20 percent plus premium increases in 2002 and expecting another double-digit hike this year.

Mid-sized employers (200 - 999 employees) aren't immune either. A 13.5 percent increase last year drove the benefit cost per employee to $5,840. Marsh found them unlikely to drop coverage, however, as that would make it extremely difficult to compete for employees. Short-term solutions are cost-shifting via higher deductibles and copays. For the longer-term, they're implementing disease management and wellness programs.

Uninsured Americans pay an average 72 percent more for medications than the federal government, which uses its market clout to negotiate the lowest market prices, says a new survey by the U.S. Public Interest Research Group. Medicare recipients without supplementary Rx coverage are in the same boat.


More than 1.2 million seriously disabled Americans under 65 are currently on a two-year waiting period for Medicare coverage, the Commonwealth Fund reports, and as many as a third of them have no health insurance in the meantime.

The Wall Street Journal spotlighted their plight in a recent front-page article that profiled long-term employees who'd been set adrift after they became disabled. To demonstrate the extent of the problem, the WSJ cited a 2002 Mercer Human Resource Consulting study that said more than one in four companies dismiss employees as soon as they go on long-term disability, and another quarter set a limit — usually 6 to 12 months — on post-disability employment.). Only 15 percent retain disabled employees with benefits until 65. On their reduced salaries, disabled employees generally can't afford COBRA coverage.

Disabled adults under 65 who qualify must wait five months for Social Security Disability benefits to kick in and another two years for Medicare. The Commonwealth Fund points out that dropping the two-year Medicare wait would help cash-strapped state governments by shifting an estimated $1.8 billion a year in Medicaid costs to the federal government.

The rate of patients screened for colon cancer increased by 20 percent after "Today" show host Katie Couric's on-air colonoscopy in March of 2000. Two years after her husband died of colon cancer, Couric underwent the procedure on the nationally broadcast news show.


Reversing a trend that dated from the 1960s, the number of American adults with high blood pressure is on the rise. Twenty-nine percent of the adult population — more than 58 million people — had hypertension in 2000, compared to 25 percent in 1988, according to a recent report in the Journal of the American Medical Association.

Almost 30 percent of all hypertensive individuals wereunaware of their illness and 42 percent were not being treated. Among those receiving medications,only 53 percent had hypertension controlled to the recommended target.Compared with younger people withhypertension, older individuals have a lowerrate of control despite the availability of universal health insurance in the form of Medicare and an equal likelihood of being treated.

Researchers found that non-Hispanic blacks had the highest rate of incidence at 33.5 percent. Women were more likely than men to have the disease (30 percent vs. 27). And hypertension is most common for patients age 60 and older, afflicting 65.4 percent of them.

This recent jump coincides with a steep increase in the number of overweight or obese Americans, two major contributing factors to hypertension. High blood pressure can lead to heart disease and stroke, the nation's number 1 and 3 killers, respectively. Losing weight, eating healthier and getting plenty of exercise can help keep high blood pressure under control.

Over 27 percent of American employees are telecommuters, according to a new survey by Cox Business Services. Seventy percent of those surveyed (and 66 percent of their managers) feel telecommuting improves productivity, while 52 percent claim a stronger sense of loyalty to their employers.


News & Trends.

Business and Health

Jul. 15, 2003;21.