Some states are trying to solve the shortage of donor organs by requiring the legal owners of the aforementioned organs to “opt out” if they don’t want to give away thousands of dollars worth of organs for free at time of death.
Hand Holding Cash ca. 1998
Historically hospitals have not really had to worry about collect directly from patients. On average patient cost-sharing is only about 3% when patients enter the hospital. Health care providers generally focus on insurance reimbursement. Maybe that is changing with the growing prevalence of high deductible plans. Now hospital patients can potentially owe several thousand dollars depending on whether they’ve met their deductibles and their cost-sharing arrangements.
Many people believe Obamacare was a conspiracy, with asinine design features intended to cause the program to fail. The primary goal in the minds of conspiracy buffs’ was to usher in a single-payer program of Medicare for All once Obamacare collapsed under adverse selection. The theory goes something like this: with nowhere to turn except the government, Americans would finally throw up their hands and acquiesce to government intervention. Seniors purportedly all love their Medicare, so why not expand the program to cover even more people?
The big news on Thursday was that the Congressional Budget Office (CBO) released its score of the American Health Care Act (AHCA). The CBO claimed 23 million people would lose coverage within a decade under provisions found in the AHCA.
Basically, this is another way of saying 10 million people will decide they’d rather keep their money than have poor-value health coverage. It’s hard to understand how someone can lose something they never actually had?
Technology is a significant driver of high health care spending. For instance, many treatments common today were not available 40 years ago. Yet, treatments and therapies that have been in use for decades are still quite expensive. In typical consumer markets, the quality of technology gets progressively better while the (real) inflation-adjusted prices often fall as older technology is surpassed by newer technology. This is especially true of consumer electronics but also of true of automobiles, appliances and other types of consumer goods. The inflation-adjusted prices of consumer goods have held steady because consumers are price sensitive, rewarding the firms who successfully compete for their business.
A bill has passed its first legislative hurdle to establish a government-run program of universal coverage in California. The California Senate Health Committee passed the measure 5-2. Next it will be debated by the Senate Appropriations Committee. The sticking point is how to fund such an endeavor.
The primary sticking point in health reform is what to do with high -cost individuals who have pre-existing health conditions. People with episodic medical needs are easy to insure, while those with persistent needs are far more difficult unless insurers are allowed to underwrite enrollees’ risk. Republicans have long favored high-risk pools to cover individuals who are otherwise uninsurable. Prior to the Affordable Care Act (ACA) just over two-thirds of states had some type of high-risk pool. Most people turned down prior to the Affordable Care Act could ultimately obtain coverage either at a higher price or after meeting some preconditions. In 2011, high-risk pool enrollment varied from 0.1% in Alabama to a high of 10.2% in Minnesota. By most accounts only about 2% of people are uninsurable. However, one Kaiser Family Foundation study argues the actual rate may be a dozen times higher.
Senator Bernie Sanders and Representative Elijah Cummings — along with a few other liberal Members of Congress — want to change the way Medicare purchases drugs for seniors. It is a popular talking point mainly because many Americans naively assume Medicare does not bargain over the price of drugs. Even President Trump has perpetuated the bogus idea that having the government negotiate the price of drugs would lower Medicare’s drug costs. This may sound appealing to many because drug makers don’t elicit much sympathy these days. Yet, seniors, drugmakers and taxpayers alike have a stake in the outcome because drug therapy is the most convenient and efficient way to care for patients.
Conventional wisdom holds that it is nearly impossible to compare prices for medical care like consumers do in other markets. It’s easier than you realize — my wife and I do it just about every time we see our doctors or fill a prescription. Health plan deductibles have nearly tripled over the past decade. Shopping for medical care is more important than ever.
Hand Holding Cash ca. 1998
The Mayo Clinic has admitted it places Medicaid and Medicare patients in a lower priority than patients with private insurance. This is something that many doctors and hospitals likely do. It is well known that Medicare pays physicians only about 80% of what private insurers reimburse for the same coverage. Medicare reimburses hospitals about 70% of private payers. Medicaid rates are a fraction of Medicare’s rates.
