Be Well: Must Reads On Medical Costs, Affordable Care Act

Discovering the Affordable Care Act's many nuances: Health Law's Impact Has Only Begun

After talking to people across the country, the Wall Street Journal published a project in February with examples of doctors, insurance executives, patients and others who are affected by the Affordable Care Act.

The article "Health Law's Impact Has Only Begun," includes an interactive graphic and videos with individual profiles.

John Lavey, a 60-year-old living in southern California, talks carefully about how his insurer sent him a cancellation notice last year. His family's plan didn't meet new coverage requirements under the law. And new policy would cost more than twice as much as his old with a price tag of more than $1,000 a month.

"Once I got that it really hit home. And frankly, I was outraged,"
Lavey says in the Wall Street Journal video.

The federal law requires all plans to cover what it calls essential benefits. For some, like Lavey, that has meant an increase in premiums for insurance they buy on the individual market.

Why? Lavey and his family are healthy and rarely use the doctor. In addition, his income is such that he doesn't qualify for a subsidy. So, his prices are going up, according to the article and videos.

The package includes other stories as well, including ones that show the positive side of this law. For example, there's a profile of a woman in Missouri who is has a bleeding disorder called hemophilia and lacked health insurance before the law.

Saving money when you die: The Town That Loves Death
SARAH: Glad you asked. There are a lot of stories out there focused on cost, but I'd like to point our listeners to one that aired over the weekend on National Public Radio.

Planet Money aired a show over the weekend about LaCross, Wisconsin, where 96 percent of the people who die have completed paperwork called "advanced directives" that explain what level of health care they want when they are dying.

In contrast, while nearly everyone in LaCross has an advanced directive, across the country only about 30 percent of adults do some sort of end-of-life planning, according to the story.

It all began when a medical ethicist at one of the hospitals in this small town took action. He was charged with talking to family members when a loved one faced dire medical news. And, he says, the conversations were always predictable. So, he wanted to help the families avoid the anguish of not knowing what to do by getting paperwork up front.

While also saving the family from painful and often dissatisfying decisions, the town also spends less on health care than any other place in the country, according to the story and research at Dartmouth. A report on this is available at the National Bureau of Economic Research here.)

One-quarter of health care spending is during the last year of life when there's very little or no chance of recovery, according to the Planet Money story. The directives help avoid that spending while also helping the family know exactly what their family members wants.

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