People saving for retirement have not flinched

Ethan Wolff-Mann, Senior Writer

Despite severe market volatility last year, investors saving for retirement are not panicking, according to a new report from Fidelity.

In its fourth quarter retirement trends update, average balances of 401(k)s had been hit hard by the market’s swings, and were down about 10% to an average balance of $95,600. This also tanked the number of 401(k) millionaires to 133,800 – from187,400 at the end of Q3.

Despite the drop, Fidelity reports that “very few” people decided to make changes to their investments during the tumultuous fourth quarter, in which the S&P 500 lost 14%. Fidelity said 5.6% of its users sold or made adjustments in the heat of the moment, and two-thirds of those customers only made a single change. Over 98% of Fidelity’s 401(k) savers are still contributing.

Few sign up for new ‘association’ health insurance

Mike Faher / VTDigger

A newly expanded – and frequently controversial – type of health insurance has gotten off to a slow start in Vermont.

Only about 5,000 people are enrolled in the latest version of “association” health coverage, which is marketed as a way for small businesses to save money in an increasingly expensive insurance market.

But the relatively low number of customers hasn’t stopped a tug-of-war over the future of association health coverage in Vermont. Some are pushing lawmakers for further regulation of association plans, while those who have begun offering such plans don’t want the rug pulled out from under them so soon.

“We invested a significant amount of time, a significant amount of staff and a significant amount of money standing up this (program), making sure that we were in compliance with both federal and state law,” said Betsy Bishop, president of the Vermont Chamber of Commerce.

Direct Primary Care

Dr. Alex Lickerman / Chicago Now

Direct primary care began as a movement in the mid 2000s as a way to provide medical care to people with no health insurance. Since then, it’s become a way for all individuals and employers—regardless of their health insurance status—to obtain better access to medical care and better quality of care, all while lowering overall healthcare costs.

The main way direct primary care achieves this “triple aim” is by providing physicians more time to spend with patients. Patients pay a low monthly subscription fee for unlimited access to their own physician via in-person visits, telephone calls, and texts. Bypassing insurance and charging a flat monthly fee directly to patients enables direct primary care medical practices to cut out anywhere between 30 to 40 percent of their overhead (billing, coding, insurance reimbursement, and so on).

This enables direct primary care physicians to reduce the number of patients for whom they care, typically down to no more than 600. In contrast, primary care physicians practicing in the traditional fee-for-service model usually care for 2,500 to 4,000 patients, seeing 20 – 22 of them per day. (Insurance reimbursement rates for primary care visits are low and the cost of running a primary care practice is high so the only way fee-for-service primary care physicians can survive financially is by piling scores of patients into their practices.)

What is ‘Medicare for All’?

Gregory Krieg and Tami Luhby / CNN

The fight to preserve Obamacare kept ambitious Democrats in near lockstep during the first two years of Donald Trump’s presidency. But as the party begins the process of selecting a 2020 nominee, the future of health care in America has emerged as an early flashpoint.

At the center of the early debate is whether Medicare for all — a national, government-run system — should be a centerpiece of the party’s platform. Beyond that, there is a more vexing question, given broad public support for the concept: how to both define what Medicare for all means and sketch out a realistic path to enacting it.

The ensuing disputes have frayed Democratic solidarity over health care, kicking off the first meaningful policy scrap of the 2020 primary contest. What had recently been passed off as minor or, given the Republicans’ grip on government, academic differences, are now opening up like seismic rifts — offering insights for voters not only into the candidates’ visions for health care, but on how they might act as president.