Turdacious wrote:It all really depends on which insurance scheme pays the bulk of those costs. If those costs are primarily paid by Medicare (ex. arthritis), or by Medicaid (ex. diabetes)-- they affect state (Medicaid) and federal (Medicaid and Medicare) budgets, but will have little impact on private sector insurance rates. It's interesting data, but because they don't break it down, it's not particularly useful.
They just focused on diabetes, but pull up a list of what health insurances do pay for, and I bet I can pick off reams of examples of high cost procedures that are covered and that didn't exist to even charge for not long ago. All of the 3D imaging methods, for example. Cancer drugs. Upcoming tailored gene therapies. I don't see anything putting a dent into this trend.
Turdacious wrote:It all really depends on which insurance scheme pays the bulk of those costs. If those costs are primarily paid by Medicare (ex. arthritis), or by Medicaid (ex. diabetes)-- they affect state (Medicaid) and federal (Medicaid and Medicare) budgets, but will have little impact on private sector insurance rates. It's interesting data, but because they don't break it down, it's not particularly useful.
They just focused on diabetes, but pull up a list of what health insurances do pay for, and I bet I can pick off reams of examples of high cost procedures that are covered and that didn't exist to even charge for not long ago. All of the 3D imaging methods, for example. Cancer drugs. Upcoming tailored gene therapies. I don't see anything putting a dent into this trend.
There is simply more medicine to buy.
You have to compare the costs of those treatments to the ones that were previously used, also the effect of rising deductibles.
"Liberalism is arbitrarily selective in its choice of whose dignity to champion." Adrian Vermeule
Turdacious wrote:
You have to compare the costs of those treatments to the ones that were previously used, also the effect of rising deductibles.
Before there were 3D imaging technologies or artificial joints, for example, there were no treatments. They aren't replacing anything. Like organ transplants. People would just die our suffer, but on the cheap.
Turdacious wrote:
You have to compare the costs of those treatments to the ones that were previously used, also the effect of rising deductibles.
Before there were 3D imaging technologies or artificial joints, for example, there were no treatments. They aren't replacing anything. Like organ transplants. People would just die our suffer, but on the cheap.
If you've got evidence that these things are responsible for the recent spike in insurance cost, I'd like to see it. I've seen no evidence that this is a major factor.
"Liberalism is arbitrarily selective in its choice of whose dignity to champion." Adrian Vermeule
Inside the Affordable Care Act is a "health insurance tax" (or HIT) levied on all insurance companies on premiums for policies sold to individuals and small- to medium-sized businesses. Expected to generate $8 billion in revenue in 2014, the HIT will simply be passed on to consumers in the form of higher premiums.
According to the National Federation of Independent Businesses (NFIB), the HIT will add $475 per year to the average individually-purchased family policy -- $5,000 over a 10 year period.
Small businesses are in an even worse position, and employer-provided family policies will see costs rise by $6,800 over a decade.
Most large companies self-insure, so the tax does not hit them. It is the small- and medium-sized businesses that will bear the burden of this tax, many of whom will either raise the portion of premium payments owed by their employees or simply lay off workers.
Private sector employment, according to NFIB, will lose at least 146,000 jobs simply due to the HIT. For a sense of scale, 146,000 is more than the total number of employees working for Costco, Microsoft and Delta.
Fifty-nine percent of this reduced job growth will be in small- and medium-sized businesses, and 26 percent in very small businesses.
It probably doesn't explain the recent spike in premiums, but Amitabh Chandra and coauthors have done good work on health care expenditures and productivity, including this. Essentially, he argues that the US is very bad about paying for expensive procedures, regardless of whether there is reason to believe they work or not. Examples I remember him mentioning are stents in cases where drugs would be just as effective and super-mecha proton prostate zappers.
Part of the "rationing" that goes on in other countries is the refusal to pay for these treatments that have little empirical evidence behind them. When Sarah Palin and other know-nothings start ranting about "Death Panels", they're talking about attempts to restrict the use of taxpayer dollars to exclude these expensive treatments that don't (usually) work. They're attacking what is arguably the most conservative part of the ACA.
"The biggest problems that we’re facing right now have to do with George Bush trying to bring more and more power into the executive branch and not go through Congress at all."
Pinky wrote:It probably doesn't explain the recent spike in premiums, but Amitabh Chandra and coauthors have done good work on health care expenditures and productivity, including this. Essentially, he argues that the US is very bad about paying for expensive procedures, regardless of whether there is reason to believe they work or not. Examples I remember him mentioning are stents in cases where drugs would be just as effective and super-mecha proton prostate zappers.
Part of the "rationing" that goes on in other countries is the refusal to pay for these treatments that have little empirical evidence behind them. When Sarah Palin and other know-nothings start ranting about "Death Panels", they're talking about attempts to restrict the use of taxpayer dollars to exclude these expensive treatments that don't (usually) work. They're attacking what is arguably the most conservative part of the ACA.
While that's certainly part of it, that type of analysis needs to be done in other areas. Malcolm Sparrow argues for it here, focusing on fraud control and overbilling. Another tool that's been often used at the state level successfully is reference pricing.
Fraud control was tried by the Clinton administration (the advisers familiar with those efforts, like David Cutler, were forced out of the Obama administration). Reference pricing has been used by states to control Medicare costs. Implementing these 'rationing' techniques don't require limiting end of life care (ie. death panels), and would do a tremendous amount to reduce costs.
Another big one, possibly the biggest of all for the health care system as a whole, is to provide legal clarity on risk. If providers and insurers know what actions effectively reduce lawsuit risk, and can calculate the risk/reward ratio of implementing these measures, it's likely to change the ways that providers do business.
"Liberalism is arbitrarily selective in its choice of whose dignity to champion." Adrian Vermeule
Pinky wrote:Part of the "rationing" that goes on in other countries is the refusal to pay for these treatments that have little empirical evidence behind them. When Sarah Palin and other know-nothings start ranting about "Death Panels", they're talking about attempts to restrict the use of taxpayer dollars to exclude these expensive treatments that don't (usually) work. They're attacking what is arguably the most conservative part of the ACA.
Perhaps thats one thing that makes America unique, and shouldn't be disturbed by Washington D.C.
Kathleen Sebelius, the health and human services secretary, is resigning, ending a stormy five-year tenure marred by the disastrous rollout of President Obama’s signature legislative achievement, the Affordable Care Act.
Mr. Obama accepted Ms. Sebelius’s resignation this week, and on Friday morning he will nominate Sylvia Mathews Burwell, the director of the Office of Management and Budget, to replace her, officials said.
Sylvia Mary Mathews Burwell (born June 1965) is the Director of the White House Office of Management and Budget. She has been in that position since April 2013. Prior to that, she was president of the Walmart Foundation, having assumed that post in January 2012,[1] and was previously the president of the Global Development Program of the Bill and Melinda Gates Foundation. While at the Bill and Melinda Gates Foundation, her program focused on combating world poverty through agricultural development, financial services for the poor, and global libraries. She was Chief Operating Officer and Executive Director of the Foundation prior to its reorganization in 2006. She came to the Foundation in 2001, after serving as Deputy Director of the Office of Management and Budget in Washington, D.C., since 1998. She is expected to be nominated by President Obama on April 11, 2014, to be the next Secretary of Health and Human Services after the resignation of Kathleen Sebelius.
Pinky wrote:It probably doesn't explain the recent spike in premiums, but Amitabh Chandra and coauthors have done good work on health care expenditures and productivity, including this. Essentially, he argues that the US is very bad about paying for expensive procedures, regardless of whether there is reason to believe they work or not. Examples I remember him mentioning are stents in cases where drugs would be just as effective and super-mecha proton prostate zappers.
Part of the "rationing" that goes on in other countries is the refusal to pay for these treatments that have little empirical evidence behind them. When Sarah Palin and other know-nothings start ranting about "Death Panels", they're talking about attempts to restrict the use of taxpayer dollars to exclude these expensive treatments that don't (usually) work. They're attacking what is arguably the most conservative part of the ACA.
While that's certainly part of it, that type of analysis needs to be done in other areas. Malcolm Sparrow argues for it here, focusing on fraud control and overbilling. Another tool that's been often used at the state level successfully is reference pricing.
Fraud control was tried by the Clinton administration (the advisers familiar with those efforts, like David Cutler, were forced out of the Obama administration). Reference pricing has been used by states to control Medicare costs. Implementing these 'rationing' techniques don't require limiting end of life care (ie. death panels), and would do a tremendous amount to reduce costs.
Another big one, possibly the biggest of all for the health care system as a whole, is to provide legal clarity on risk. If providers and insurers know what actions effectively reduce lawsuit risk, and can calculate the risk/reward ratio of implementing these measures, it's likely to change the ways that providers do business.
The 40% spike, fraud control, and risk controls all drive costs up or down around some median baseline. That baseline is driven by the care needed versus the care available, with a never-ending supply of new and more expensive cares arising all the time, so that baseline and its growth is the problem. My opinion, YMMV.
Pinky wrote:Part of the "rationing" that goes on in other countries is the refusal to pay for these treatments that have little empirical evidence behind them. When Sarah Palin and other know-nothings start ranting about "Death Panels", they're talking about attempts to restrict the use of taxpayer dollars to exclude these expensive treatments that don't (usually) work. They're attacking what is arguably the most conservative part of the ACA.
Perhaps thats one thing that makes America unique, and shouldn't be disturbed by Washington D.C.
As a proud new beneficiary of the Affordable Health Care Act, I’d like to report that I am doctorless. Ninety-six. Ninety-six is the number of soul crushing rejections that greeted me as I attempted to find one. It’s the number of physicians whose secretaries feigned empathy while rehearsing the “I’m so sorry” line before curtly hanging up. You see, when the rush of the formerly uninsured came knocking, doctors in my New Jersey town began closing their doors and promptly telling insurance companies that they had no room for new patients.
My shiny, never used Horizon health card is as effective as a dollar bill during the Great Depression. In fact, an expert tells CNN, “I think of (Obamacare) as giving everyone an ATM card in a town where there are no ATM machines.” According to a study 33% of doctors are NOT accepting Medicaid. Here in Jersey, one has a dismal 40 percent chance of finding a doctor who accepts Medicaid – the lowest in the country.
For those blaming President Obama for the newly insured remaining unseen by primary healthcare physicians, the government has provided monetary incentives for doctors to accept new Medicaid patients---a 30% increase in most states (and a 50% increase in New Jersey.) Despite the government’s valiant attempts to give the nations the unemployed and underemployed adequate health care, many doctors are still unwilling to take on Medicaid patients. The arguments as to why physicians are not jumping at the chance vary, but the undeniable truth is that too many of us are insured in name only. According to Whitehouse.gov, “21 percent of African Americans were uninsured in 2009, and more about 20 percent of African Americans did not have a regular doctor, compared with less than 16 percent of White Americans.” Statistics prove that in some Black communities preventive doctors’ visits are scarce because health insurance is not an option. Prior to ACA, African Americans were 55 percent more likely to be uninsured than White ones.
However, physicians say they are rejecting Medicaid patients with good reason. One doctor explains, “the state reimburses… only about $23.50 for a basic office visit [of those insured by Medicaid], less than half of what from Medicare or private insurers.” The argument of physicians is essentially that they aren’t being paid enough to treat the ill, which finds poor and “at risk” populations in danger---as usual.
1. LOL Ebony
2. A lack of article bio or any info on Google seems to suggest "Danielle Kimberly" is a nom de bullshit.
3. You found that article persuasive? "Statistics prove"?
One of the downsides of the Internet is that it allows like-minded people to form communities, and sometimes those communities are stupid.
As a proud new beneficiary of the Affordable Health Care Act, I’d like to report that I am doctorless. Ninety-six. Ninety-six is the number of soul crushing rejections that greeted me as I attempted to find one. It’s the number of physicians whose secretaries feigned empathy while rehearsing the “I’m so sorry” line before curtly hanging up. You see, when the rush of the formerly uninsured came knocking, doctors in my New Jersey town began closing their doors and promptly telling insurance companies that they had no room for new patients.
My shiny, never used Horizon health card is as effective as a dollar bill during the Great Depression. In fact, an expert tells CNN, “I think of (Obamacare) as giving everyone an ATM card in a town where there are no ATM machines.” According to a study 33% of doctors are NOT accepting Medicaid. Here in Jersey, one has a dismal 40 percent chance of finding a doctor who accepts Medicaid – the lowest in the country.
For those blaming President Obama for the newly insured remaining unseen by primary healthcare physicians, the government has provided monetary incentives for doctors to accept new Medicaid patients---a 30% increase in most states (and a 50% increase in New Jersey.) Despite the government’s valiant attempts to give the nations the unemployed and underemployed adequate health care, many doctors are still unwilling to take on Medicaid patients. The arguments as to why physicians are not jumping at the chance vary, but the undeniable truth is that too many of us are insured in name only. According to Whitehouse.gov, “21 percent of African Americans were uninsured in 2009, and more about 20 percent of African Americans did not have a regular doctor, compared with less than 16 percent of White Americans.” Statistics prove that in some Black communities preventive doctors’ visits are scarce because health insurance is not an option. Prior to ACA, African Americans were 55 percent more likely to be uninsured than White ones.
However, physicians say they are rejecting Medicaid patients with good reason. One doctor explains, “the state reimburses… only about $23.50 for a basic office visit [of those insured by Medicaid], less than half of what from Medicare or private insurers.” The argument of physicians is essentially that they aren’t being paid enough to treat the ill, which finds poor and “at risk” populations in danger---as usual.
Sounds like a business opportunity to me. Get a bunch of PAs and Nurse Practitioners, and start collecting $23.50 a pop to take their vitals and then tell them to stop drinking sugary drinks and lose 50 LBs.
1. LOL Ebony
2. A lack of article bio or any info on Google seems to suggest "Danielle Kimberly" is a nom de bullshit.
3. You found that article persuasive? "Statistics prove"?
STOP YOUR PROTO. THERE ARE HYPERLINKS TO SOURCES IN THE ARTICLE!!!!!
"Liberalism is arbitrarily selective in its choice of whose dignity to champion." Adrian Vermeule
"The biggest problems that we’re facing right now have to do with George Bush trying to bring more and more power into the executive branch and not go through Congress at all."
Why the CBO has updated their Obamacare projections:
The projected labor force participation rate among people younger than age 65 is lower throughout the next decade than it was in the forecast CBO published in 2013. In 2020, for example, CBO now anticipates that this participation rate will be 75.9 percent, compared with the 76.5 percent it projected previously.
Wages and salaries also are projected to be lower through most of the next decade than they were in CBO’s previous forecast—by between 4 percent and 5 percent, for example, from 2018 through 2023.
A crucial factor in the current revision was an analysis of the characteristics of plans offered through the exchanges in 2014. Previously, CBO and JTC had expected that those plans’ characteristics would closely resemble the characteristics of employment-based plans throughout the projection period. However, the plans being offered through the exchanges this year appear to have, in general, lower payment rates for providers, narrower networks of providers, and tighter management of their subscribers’ use of health care than employment-based plans do.
How Being a Doctor Became the Most Miserable Profession
by Daniela DrakeApr 14, 2014 5:45 am EDT
Nine of 10 doctors discourage others from joining the profession, and 300 physicians commit suicide every year. When did it get this bad?
Among the surprises nestled in last week's release of Medicare payment data was this head-scratcher: Of the 50 physicians who got the most Medicare money in 2012, almost half were ophthalmologists. Some of that may come from questionable billings. But it also results from Medicare doctors' perverse incentive to choose more expensive drugs than necessary.
Here's how the system works: When a doctor administers a drug in his or her office, Medicare pays 106 percent of its average selling price. The doctor keeps the extra as compensation for administering the injection.
What has this got to do with eye doctors? The drug Lucentis, used to treat macular degeneration, cost Medicare almost $2,000 a shot in 2012. Another drug, Avastin, which works just as well, costs about $50. If you were the doctor, faced with a system that pays you 6 percent of the drug's cost, which would you choose? That Medicare spent a total of about $1 billion on Lucentis in 2012 suggests most ophthalmologists went with the more expensive one.
The Centers for Medicare & Medicaid Services, the agency that runs Medicare, says it’s required to pay for treatment that a doctor deems medically necessary, and it lacks the authority to direct treatment based on cost. All Medicare can do to control costs is tell doctors the price of what they’re prescribing, as well as the alternatives. Which is to say, almost nothing.
Additional Funding to Fight fraud, Waste and Abuse.
Health reform increases funding for the Health Care Fraud and Abuse Control Fund by $250 million over the next decade.
In August 2011, federal agents swept across the Detroit area, arresting doctors, pharmacists and other health professionals accused of running a massive scheme to defraud Medicare.
The following month, several of those arrested —including psychiatrist Mark Greenbain and podiatrist Anmy Tran — were suspended from billing the state's Medicaid program for the poor.
"Health care fraud steals funds from programs designed to benefit patients, and we all pay for it," U.S. Attorney Barbara McQuade said in a press release at the time of the arrests. "We hope that the strength of our efforts will have a deterrent effect."
But the indictment and Medicaid suspensions didn't deter Medicare from continuing to allow the doctors to treat elderly and disabled patients — and billing taxpayers for their services.
In 2012, Medicare paid Greenbain more than $862,000, according to newly released data on Medicare payments to physicians. Tran received $155,000.
While open enrollment for coverage under the Affordable Care Act is closed, many of the newly insured are finding they can’t find doctors, landing them into a state described as “medical homelessness.”
Rotacare, a free clinic for the uninsured in Mountain View, is dealing with the problem firsthand.
Mirella Nguyen works at the clinic said staffers dutifully helped uninsured clients sign up for Obamacare so they would no longer need the free clinic.
But months later, the clinic’s former patients are coming back to the clinic begging for help. “They’re coming back to us now and saying I can’t find a doctor, “said Nguyen.
Thinn Ong was thrilled to qualify for a subsidy on the health care exchange. She is paying $200 a month in premiums. But the single mother of two is asking, what for?
FOR THOSE OF YOU WHO DON'T KNOW, MOUNTAIN VIEW HAS A POVERTY RATE THAT IS ABOUT HALF THE CALIFORNIA STATE AVERAGE. THIS STORY MUST BE MADE UP, THIS IS CLEARLY.
"Liberalism is arbitrarily selective in its choice of whose dignity to champion." Adrian Vermeule
The administration has failed to meet 44 statutory deadlines required under Obamacare, according to a new report by the Congressional Research Service (CRS).
The report, released on Monday, documents every provision with a specific deadline within the health care law and the administration’s actions taken as of April 15, 2014. The Department of Health and Human Services (HHS) has missed more than half of the 83 deadlines mandated since March 2011.
nafod wrote:Get a bunch of PAs and Nurse Practitioners, and start collecting $23.50 a pop to take their vitals and then tell them to stop drinking sugary drinks and lose 50 LBs.
Disempower the MD Monopoly on medicine, and let the Free Market work.
That would also mean consumers would have some skin in the game…enough to shop for better prices. Medical Savings Accounts might do that.
The best lack all conviction, while the worst
Are full of passionate intensity.
