Sample Letter Stating No Health Insurance: Fill & Download for Free

There is one recent study showing that the Obamacare insurance mandate saves lives.BackgroundWhen the US Congress was still debating the Affordable Healthcare Act some conservatives argued that providing health insurance to low-income people may not improve their health. Maybe, for example, low-income people couldn’t afford the sizable co-pays or maybe they aren’t diligent in taking prescriptions.Some of these conservatives might raised these arguments insincerely but the claim isn’t entirely crazy. Many people won’t make the best use of modern medicine if it’s costly.[1][1][1][1] The least expensive family plans under Obamacare have an average out-of-pocket maximum of $15,800.[2][2][2][2] Even with the new law, many Americans skip prescriptions on account of cost, especially low-income people that Obamacare was intended to help.[3][3][3][3] So, there’s a real possibility that Obamacare might not be as effective as it’s advocates wished.There isn’t much hard data showing that giving people health insurance or encouraging them to buy it, enhances health. The Oregon Health insurance study couldn’t detect an effect:[4][4][4][4]We did not detect significant changes in measures of physical health including blood pressure (systolic or diastolic), cholesterol (HDL or total), glycated hemoglobin, or a measure of 10-year cardiovascular risk that combined several of these risk factors. Nor did we detect changes in populations thought to have greater likelihood of changes, such as those with prior diagnoses of high blood pressure of the portion of our population over age 50.A review of the literature on health insurance coverage for prescription drugs concluded that “evidence is insufficient to draw conclusions about the effect of policy interventions on clinical and economic outcomes…”[5][5][5][5]The ideal way to test the effectiveness of a policy is to do an experiment. The US IRS recently conducted an experiment in which people were encouraged to get health insurance.The studyIn 2017, the IRS sent an informational letter to a sample of households telling them about the penalty for not having insurance and providing information about getting insurance. The total population had 4.5 million households (8,897,821 people). These households were randomly assigned to either receive a letter (86%) or not (14%).The experiment was done by mistake. The original intent was to send the letter to all households in the sample but the IRS ran out of money so the control group consists of people the IRS couldn’t send the letters to.ResultsThe effect on insurance coverage was modest. People who got a letter were 1.2% more likely to get insurance coverage in that year compared to the control group mean of 69%. Expressed differently, the letter reduced the share of the sample without any insurance coverage by 2.7%.The investigators looked at cumulative mortality in people 45−64 years old. The effect looks small but that’s because the treatment only increased insurance coverage slightly.If you plot the data as a difference, it’s easy to see that the effect is statistically significant by the end of the study.The authors compared the change in insurance rate to the mortality rate and concluded that “each month of coverage induced by the intervention reduced mortality by approximately 11.9% during our sample period.” That’s a sizable effect.ConclusionsThe authors of the study reached strong conclusions:We found positive effects of the intervention on subsequent coverage enrollment decisions, particularly for taxpayers who were uninsured in the year prior to the intervention. We also found that the intervention reduced mortality among middle-aged adults in the subsequent two years, which we attribute to the additional coverage the intervention induced. Our findings thus provide strong empirical support, and the first experimental evidence, for the hypothesis that health insurance coverage reduces mortality.LimitationsThe study did not show statistically significant effects for people younger than 45 or older than 54. That’s probably because it lacked statistical power to detect effects in other age groups.The problem of deductiblesStill, Obamacare may be inadequate. Deductibles are high in many Obamacare insurance policies. That probably discourages people from getting the care they need. That may be especially true for taking prescription drugs for chronic conditions. More than a third of Americans making less than 40,000 a year report that they find it difficult to afford their prescriptions.[6][6][6][6] Many Americans report postponing needed health care on account of cost.This chart suggests that Obamacare’s passage in 2010 may have stopped the growth in people delaying/going without but the problem is still large.[7][7][7][7]Medicare-for-all is a popular solution but it has large deductibles and only provides very limited prescription drug coverage unless one buys supplemental insurance.[8][8][8][8]CommentPresident Trump signed into law, in 2017, a repeal of the Obamacare mandate, so people who do not get insurance coverage do not pay a penalty. If the results of this study are valid, that repeal increased mortality in the US.More to readHere’s a good overview of the study:The I.R.S. Sent a Letter to 3.9 Million People. It Saved Some of Their Lives.The official report is here but behind a paywall:Health Insurance and Mortality: Experimental Evidence from Taxpayer OutreachThere is a free copy here:http://www.academia.edu/download/61534589/w2653320191216-98809-rnbuum.pdfHere’s some data on the affordability of health care in the US:How does cost affect access to care? - Peterson-Kaiser Health System Trackerhttps://ldi.upenn.edu/sites/default/files/pdf/Penn%20LDI%20and%20USofC%20Affordability%20Issue%20Brief_Final.pdfHere’s some good discussions of prescription coverage:The Cost of Not Taking Your MedicineInterventions to Improve Adherence to Self-administered Medications for Chronic Diseases in the United StatesFootnotes[1] Interventions to Improve Adherence to Self-administered Medications for Chronic Diseases in the United States[1] Interventions to Improve Adherence to Self-administered Medications for Chronic Diseases in the United States[1] Interventions to Improve Adherence to Self-administered Medications for Chronic Diseases in the United States[1] Interventions to Improve Adherence to Self-administered Medications for Chronic Diseases in the United States[2] Out-of-pocket maximum/limit - HealthCare.gov Glossary [2] Out-of-pocket maximum/limit - HealthCare.gov Glossary [2] Out-of-pocket maximum/limit - HealthCare.gov Glossary [2] Out-of-pocket maximum/limit - HealthCare.gov Glossary [3] Poll: Nearly 1 in 4 Americans Taking Prescription Drugs Say It’s Difficult to Afford Their Medicines, including Larger Shares Among Those with Health Issues, with Low Incomes and Nearing Medicare Age[3] Poll: Nearly 1 in 4 Americans Taking Prescription Drugs Say It’s Difficult to Afford Their Medicines, including Larger Shares Among Those with Health Issues, with Low Incomes and Nearing Medicare Age[3] Poll: Nearly 1 in 4 Americans Taking Prescription Drugs Say It’s Difficult to Afford Their Medicines, including Larger Shares Among Those with Health Issues, with Low Incomes and Nearing Medicare Age[3] Poll: Nearly 1 in 4 Americans Taking Prescription Drugs Say It’s Difficult to Afford Their Medicines, including Larger Shares Among Those with Health Issues, with Low Incomes and Nearing Medicare Age[4] Oregon Health Study - Results[4] Oregon Health Study - Results[4] Oregon Health Study - Results[4] Oregon Health Study - Results[5] Oregon Health Study - Results[5] Oregon Health Study - Results[5] Oregon Health Study - Results[5] Oregon Health Study - Results[6] Poll: Nearly 1 in 4 Americans Taking Prescription Drugs Say It’s Difficult to Afford Their Medicines, including Larger Shares Among Those with Health Issues, with Low Incomes and Nearing Medicare Age[6] Poll: Nearly 1 in 4 Americans Taking Prescription Drugs Say It’s Difficult to Afford Their Medicines, including Larger Shares Among Those with Health Issues, with Low Incomes and Nearing Medicare Age[6] Poll: Nearly 1 in 4 Americans Taking Prescription Drugs Say It’s Difficult to Afford Their Medicines, including Larger Shares Among Those with Health Issues, with Low Incomes and Nearing Medicare Age[6] Poll: Nearly 1 in 4 Americans Taking Prescription Drugs Say It’s Difficult to Afford Their Medicines, including Larger Shares Among Those with Health Issues, with Low Incomes and Nearing Medicare Age[7] How does cost affect access to care? - Peterson-Kaiser Health System Tracker[7] How does cost affect access to care? - Peterson-Kaiser Health System Tracker[7] How does cost affect access to care? - Peterson-Kaiser Health System Tracker[7] How does cost affect access to care? - Peterson-Kaiser Health System Tracker[8] Prescription Drug Coverage[8] Prescription Drug Coverage[8] Prescription Drug Coverage[8] Prescription Drug Coverage

I get odd threat calls where the message starts in the middle of a sentence. The chances are that it’s a scam. Then there are the ones who call and leave a message that I need to pay them. Oddly, they don’t send collection notices. No notice, no payment. If you are legitimate, it doesn’t take that much money to send out a legitimate notice.At one point, a former doctor of mine waited five or six years past my last appointment to have a collection notice sent to me. She never sent the last bill. Fortunately, I’d paid by credit card, and I’d had a credit card through my financial institution. They found the record of my payment, and I redacted everything that wasn’t pertinent to the payment. I mailed it under cover of a letter to her new manager.I told him that I’d paid her showed the documentation and indicated how dissatisfactory the last appointment was. I told him what her office had told me. Call and complain to her business office. I did that. I never got a bill for the 2 minutes she spent on me. I talked about their crappy and illegal business practices (once the bookkeeper sent every patient a second notice of payment due without sending out a first billing).I had several conversations with the business manager. I told him that for me to pay the money (the difference between what I’d paid initially, and what I hadn’t been billed for), I needed a copy of the bill. He said that it was in storage. I said, “Gee, that’s too bad. Without that bill—the one your office never sent me—I can’t pay you!” He called me back a few days later and said that they’d decided to eat the cost (not his exact words). I requested that they put it in writing. I hand-delivered a copy of the letter that stated that I owed nothing to the collection agency. The matter was settled.When possible, pay with plastic. Keep the receipt. Someone who claims that they sent you a bill should have to prove it, especially if their bookkeeper has pulled illegal stunts in the past. In my state, you can’t record a conversation without the consent of all parties. Make notes and keep documentation.It’s one thing if you owe money and haven’t paid it. It’s a different matter if someone claims that they sent don’t fall for you a bill that you never received. There was something suspicious about the whole thing.I don’t take threats well and have contacted my attorney general about some issues, the state insurance commissioner about illegal auto insurance practices, the FTC about some matters.I’ve had two hospitals try to commit fraud against me. In one case, I decided not to pay them. They had changed my records so that it looked like they were done taking a tissue sample before the anesthesia wore off. Then they tried to keep me from getting a second opinion at a closer hospital.In the other case, a billing employee lied about getting a check and was trying to make me pay the bill in full. My health insurance helped with that one.Don’t accept someone else’s word that you owe money if they are unwilling to provide you with documentation that you owe them money.Incidentally, if you get a call or email purportedly from the IRS, the Social Security Administration or the FBI warning you to be home at a certain time on a certain day so that they can arrest you, it is a scam! No LEO (law enforcement agency) is going to invite you to stay home at a certain time on a certain day so that they can come put you in handcuffs! Don’t fall for it!!

The top 13 technologies with the biggest promise for 20171) A new era in diabetes careIn 2016, the US Food and Drug Administration approved the world’s first artificial pancreas. The device monitors blood sugar and supplies insulin automatically. It basically replicates what a healthy version of the organ does on its own; and it enables diabetes patients to live an easier life in a sustainable way. It is the biggest step towards a new are in diabetes management in yearsThe breakthrough happened years after the #wearenotwaiting movement started to campaign for the introduction of such artificial pancreas on the market. One of the leading figures of the movement, Dana Lewis also told me how an artificial pancreas eases everyday life. In 2017, this new way of diabetes management will spread around; and it will become a life-changing milestone in many patients’ lives when they first start to use the device.The development of diabetes care does not end there. Google patented a digital contact lens that can measure blood glucose levels from tears as an added benefit. Google launched a partnership with the pharmaceutical company Novartis; and while there is rather silence around the state of the developments, there are rumors about it becoming available for trials in 2017.2) Precision medicine in oncologyDigital technology will start the transformation of available cancer care methods on the market. Personalized oncology is becoming available through start-ups and companies such as Foundation Medicine and SmartPatients.Foundation Medicine aims to bring cancer genomics to cancer care. It provides information about patient-specific cancer treatments based on DNA-tests. SmartPatients tries to change cancer care with patient empowerment through an online community.There are significant advances in immunotherapy which might launch a new era of treating cancer. Liquid biopsy was the big thing in 2016 and now it’s becoming more accessible for patients worldwide. The technology has limitations, but it’s getting better. For example, the blood sample should be obtained before a chemotherapy and it’s hard to detect cancer cells. Precision medicine is changing the old model of treating cancer: instead of canons, we start using sniper rifles.3) Narrow artificial intelligence in US clinicsIBM Watson, the company’s advanced artificial intelligence program is transforming healthcare into a quantifiable service where every bit of information is available. By using it, physicians only have to go through their personalized reports instead of reading through dozens of papers for every patient’s case. It has been used in oncology and radiology (Medical Sieve project) so far. Although recent news about IBM making Watson available widely at US clinics could boost the whole idea of physicians needing help from algorithms. The so-called Watson for Genomics helps advance precision medicine by combining cognitive computing with genomic tumour sequencing.We need to prepare for IBM Watson’s broader use in 2017. Although it does not answer medical questions, but based on patients’ data it comes up with the most relevant and likely medical outcomes. However, physicians will make the final call. Computer assistance can only facilitate the work of physicians, it will definitely not replace it.4) Driverless trucks or cars will include health sensorsIn 2017, we have to prepare for the spread of cars with more and more automated functions. In September, Uber started offering rides in self-driving cars in Pittsburgh, a notoriously demanding urban environment. The company teamed up with Volvo to fulfil Uber’s objective to replace its more than 1 million human drivers with robots – as quickly as possible. There are already significant results: Volvo trucks have gone through Europe already without drivers – how amazing is that!Parallel with striving for the introduction of driverless cars as soon as possible, companies are equipping cars with tons of sensors. As we will spend more passive time in 2017 in these vehicles, Uber, Volvo or Tesla will start implementing health sensors into the driver’s seat. I believe that the car itself is going to operate as a point-of-care in the future.5) New service in nutrigenomicsIn 2014, the FDA clamped down the marketing activities of the biggest provider of genetic tests, 23andMe due to its precautionary concerns. Despite the precedent set by 23andMe, several companies continue to offer and market genetic testing and interpretive analysis without submitting to premarket review by the FDA. Since November 2015, the FDA has sent five “it has come to our attention” letters to such companies. While the FDA cannot stop companies offering genetic-based services to patients forever, the next “big deal”, namely nutrigenomics, is already knocking on the door. It is going to become a hit in 2017.Nutrigenomics is a brand-new cross-field combining genetics and nutrition science. The basic idea behind nutrigenomics is that our genome reveals valuable information about our organism’s needs. We should map out this data and utilize in order to lead a long and healthy life. After having your DNA sequenced (perhaps already at home), a smart app could let you know which food you should eat and what you should avoid at all cost. There is already a California-based start-up dealing with nutrigenomics. The inventive company, Habitplans to use genetic markers to identify the ideal meal for each of its customers, and send that meal directly to their doors.6) SpaceX and NASA will realize they need a digital health masterplan to reach MarsIn September, Elon Musk, CEO of the SpaceX rocket company aroused hope in astronautics again for the greatest pleasure of the fans of space flights. He promised no less than to take humanity to Mars. I followed Musk’s brilliant and inspiring speech online and I got really excited about his vision. His words rang in my head for the next couple of days, and I started to think about the realities of the mission to Mars.I think the biggest obstacle in reaching the Red Planet and installing the conditions of life there is the current state of healthcare. 2017 will be the year when NASA and SpaceX will realize that they not only need a masterplan for revolutionizing the transportation industry and space travel, but also one in digital health.7) The genome editing method CRISPR in clinical trialsEvery decade or so, there are only a few new ideas that show the potentials of revolutionizing the whole industry of healthcare and pharma. The amazing genome editing method, CRISPR has this potential.Researchers have already used gene-editing to create mosquitoes that are almost entirely resistant to the parasite that causes malaria. Some scientists also believe that we will have the chance to edit our cells in our immune systems with CRISPR to improve them against cancer cells and to help them kill these malevolent entities in time. This year, experiments also showed how scientists were able to treat mice with Duchenne’s muscular dystrophy through gene editing. I believe that in 2017, we have a great chance for launching the first clinical trials to test the real power of CRISPR in changing devastating diseases.8) A big tech company will step into healthYes, I know, you are right, Google, Apple, Microsoft, IBM, they all showed interest in medicine and healthcare. However, they should step up their efforts. Google has made steps forward in healthcare with Calico. They look for possible “cures” for ageing and for basically everything which might lead to death. It works together with pharma giant Abbvie to accelerate the discovery, development and commercialization of new therapies.Human Longevity Inc. joined forces with Cleveland Clinic for a human genomics collaboration aimed at disease discovery and making ageing a chronic condition. IBM has been developing its artificial intelligence program, Watson and puts it to use in cardiology and cancer care. There is a harsh race among companies in terms of digital technological development; and its effects are already tangible in medicine and healthcare as well.The race will not tone down in 2017, rather on the contrary. A tech giant will announce next year that it will devote significant resources to changing healthcare, a quite undiscovered industry for them.9) An insurance company launches a wearable sensor package2017 will be the year when the behemoth system of health insurance will start to change with data provided by patients. The hipster insurance company, Oscar Health made the first steps already. It has built upon the idea that without quantifying health, insurance is the riskiest business of all. With the help of Oscar Health, insured people can submit their Fitbit data; and if they reach their fitness goals, they get $1 every day. It helps keep people healthy and motivated with a simple but quantifiable reward.I believe that in the future, smoking, drinking heavily, eating trashy food and not doing any sports might not only cost people a lot in terms of their expenses and their health on the long run, but it might also heavily burden their health insurance with extra fees.Due to predictions, 245 million wearable devices will be sold in 2019. As more and more accurate data sets about our lifestyle through trackers and wearables become available, it is inevitable insurance companies will try to utilize them. In 2017, a large insurance company (not a start-up!) will launch a package containing wearable sensors and guidance about living a healthy life by measuring data in 2017.10) The surgical robot by Google and Johnson&Johnson will compete with daVinciSurgical robots have the potential to change how surgeons will operate in the future. The industry is about to boom: by 2020, surgical robotics sales are expected to almost double to $6.4 billion.One fine example is the da Vinci Surgical System. It features a magnified 3D high-definition vision system and tiny wristed instruments that bend and rotate far greater than the human hand. With the da Vinci Surgical System, surgeons operate through just a few small incisions. The surgeon is 100% in control of the robotic system at all times; and he or she is able to carry out more precise operations than previously thought possible. Recently, Google has announced that it started working with the pharma giant Johnson&Johnson in creating a new surgical robot system. The tech expertise of Google with the healthcare experience of J&J could prove to be a jackpot combination: daVinci will finally have a real competitor. It will definitely give another boost to the surgical robot industry.11) Vocal biomarkers: the future of diagnostic medicineNot long ago, scientists discovered vocal features in every way imperceptible to humans. They also found that the identification of such distinctive characteristics might have a huge impact on setting up a diagnosis. Researchers labelled these features “vocal biomarkers”. These can serve as a diagnostic tool for your physician to indicate signs of illnesses ranging from stress and depression to cardiovascular diseases. An earlier diagnosis could essentially be the difference between life and death. The Beyond Health Research platform is analysing such biomarkers. An Israeli company, Beyond Verbal is launching a platform solely committed to analysing emotions from vocal intonations.Vocal biomarkers will gain ground in 2017. Instead of focusing only on biomarkers measured in blood or genomic markers analysed by geneticists, vocal biomarkers which are easy to detect, record and analyse will be used more and more for detecting and preventing diseases.12) Pharma will start using massive AI in clinical trials and drug researchClinical trials take a decade and cost billions of dollars. This medical practice has to be changed. The rapid development of artificial intelligence might aid clinical trials. With the help of AI they might require significantly less time and they might be brought closer to the medical institutions and patients themselves. For example the company, Atomwise uses supercomputers that root out therapies from a database of molecular structures. Last year, Atomwise launched a virtual search for safe, existing medicines in order to redesign them to treat the Ebola virus. They found two drugs predicted by the company’s AI technology which may significantly reduce Ebola infectivity. This analysis, which typically would have taken months or years, was completed in less than one day!2017 will be the year when the pharma industry realizes they either use AI in drug research and clinical trials or start-ups will make them suffer. When disruption kicks in through a few new technologies, even the giants will have to change their business models…13) A company will make the 3D printed cast a real choiceImagine a scenario where you have broken or twisted a limb, and need a cast. Previously, a messy process of fitting plaster to your hurting body part would be followed by frequent doctor visits to refit the cast as the inflammation subsides or muscles atrophy. Instead, the doctor just scans your arm, prints out a water-proof, lightweight cast in seconds using a software approved by traumatologists, and you’re free to go home. At the next visit, your caregiver simply pops it open to examine the injury. Cheaper, faster, more convenient for both patient and doctor.The Spanish 3D printing startup Exovite experimented with the technology. Scanning a limb is very simple today. Designing a customized cast is also not rocket science. So what’s the main obstacle for applying the above method? The acceptance from traumatologists. That’s a hard one. But in 2017, a start-up will finally make it happen.It’s important to mention though that none of these will happen without individuals who understand what the technological advances can bring upon as. Those people who discuss the advantages and ethical issues today are the ones who will bring disruption to everyday life tomorrow. Because it’s always more important how we adjust to the changes than what developments will take place next year.I hope 2017 will be the year when we acknowledge that a cultural revolution is on the way only triggered by new technologies