T
he NSA collects 200 million text messages a day.
Electronic medical records: They don’t save money and they don’t improve quality, but they do allow hospitals to bill more. HT: Jason Shafrin.
Judge rewrites ObamaCare law to allow people to get tax subsidies in the federally run exchanges. See Background posted by Michael Cannon.
Insurance companies had to spend a lot of money adapting to ObamaCare’s botched rollout. And unless the White House intervenes, the law could penalize them for doing it. Problems with HealthCare.gov — and the administration’s work-arounds — saddled insurance companies with unexpected logistical costs. Yet the Affordable Care Act also caps insurers’ administrative spending, forcing them to pay rebates if their overhead is too high. Insurers will ask the White House for some relief from those rules, an industry source said, in light of the unexpected costs they had to shoulder because of HealthCare.gov. The request is still preliminary. Insurers haven’t yet tried to estimate how much the website’s problems cost them, mostly because they’re still focused on trying to get people in the door and to work through the remaining kinks in the system. But the core argument is already there: Insurers don’t think it’s fair to penalize them for expenses they incurred solely because of the government’s broken website or the administration’s last-minute policy changes. (Sam Baker in the Nation Journal)
Fair enough. But should everyone else get relief as well? (Including this woman?)
“
Our results suggest that Medicare’s decisions are far more influential than you may imagine,” said Joshua Gottlieb, an economist at the University of British Columbia. His research shows that a $1 change in the price that Medicare pays yields a $1.30 change in what private insurers pay.
What happens if the government gets those prices wrong? In the past year, a Washington Post investigation has shown that Medicare prices are sometimes based on faulty premises, offer perverse incentives for unnecessary care and provide widely varying amounts for equivalent drugs…
“Our results indicate that the private sector will copy Medicare’s pricing errors,” Gottlieb said. (Washington Post)
Like the ObamaCare exchanges, [Medicare] offerings feature higher premiums and worse benefits, as well as insurers that are competing in fewer markets and shrinking their physician networks.
According to federal data, average consumer premiums are jumping by about 5% above the underlying rise of health costs. Three of every five counties have fewer options than they did this year, most of them in the South and Midwest. A recent Lerrink Swann research note for the nine major publicly traded insurers concludes their premiums are 26% higher and maximum out-of-pocket costs — a proxy measure that is inversely proportional to benefit generosity — have climbed by 22%.
About one of 20 seniors on Advantage had to switch plans because their old coverage was cancelled, but the damage has been particularly acute in a category called special needs plans, or SNPs. More than 1.5 million people were covered by about 500 of these plans in 2013, but the consultants at Avalere Health report that 13% were wiped out.
Liberals want to zero out about 80% of SNPs and allow them only for end-stage renal disease, AIDS and mental disabilities that require patients to be institutionalized. Everyone else is supposed to be shifted into new government-controlled, provider-side “reforms” that were part of ObamaCare. (WSJ)
Two recent posts have discussed out of control prices for hospitals’ services, especially in ERs. The first argued that sky-high hospital prices are the result of government interference. The second cheered the fact that consumer-driven health plans are inducing hospitals (ever so gradually) to be more upfront with patients (at least, those coming in for scheduled surgeries) about how much they will have to pay out of pocket, and agreeing on payment plans before admission.
ObamaCare promises to come to the rescue of uninsured patients who are charged outrageous prices by hospitals. Statutory language purports to limit hospitals’ charge to uninsured patients in the ER to “not more than the lowest amounts charged to individuals who have insurance covering such care”. Hospitals which fail to adhere to this policy risk losing their non-profit status. (The relevant text is on page 739 of the enrolled version of the bill here.)
Hospitals take threats to their non-profit status very seriously. So, since the law was passed in 2010, you might expect that the overcharging of uninsured patients has long since stopped. You would be wrong. Like everything else in ObamaCare, this has malfunctioned.
In Time magazine, Steven Brill reports that hospitals continue to levy exorbitant charges on uninsured patients presenting at ERs, and accuses the Administration of “bungling the easy stuff.” Well, the “stuff” is never “easy” when the federal government gets involved.
A h
igher education riddle: When can a college slash tuition by almost half, without losing revenues? Answer: When nobody much pays full tuition anyway.
When Converse College, a tiny women’s college here, announced that it was “resetting” next year’s tuition at $16,500, down 43 percent from the current year’s published price of $29,000, the talk was about affordability, transparency and a better deal for struggling families.
But of Converse’s 700 undergraduates, only a small number — in the single digits, its president said, paid the full sticker price in recent years. Almost everyone received a tuition discount from the college, along with, in many cases, financial aid from the state and federal governments. (NYT)
But you won’t hear any of the usual suspects in health policy complaining about the universities that pay their salaries.
The feds spend a stunning $125 billion a year on “mental health” via programs ranging from Medicaid to the Social Security Administration. Yet the Murphy committee discovered that most of this cash goes to vague and ineffective services rarely focused on treating the most serious illnesses — schizophrenia, bipolar disorder or severe depression.
The Murphy bill would reorient all of this and create a new HHS assistant secretary for mental health and substance-abuse disorders who would lead federal mental-illness efforts. The secretary would have to be a medical professional and would be responsible for promoting the medically oriented models of care adopted by the National Institute of Mental Health, or NIMH. (WSJ)
More on the WSJ.
Casey M
ulligan explains why 2014 will see a shift to part-time work; and why that means there will be less work.
Acupuncture is not better than fake acupuncture.
Disaster: only 5% to 10% have paid their first month’s premium.
If the new guidelines are fully implemented, close to a third of all Americans will be on a statin.
“It is a conflict of interest for hospitals and drug companies to pay patients’ premiums and cost-sharing for the sole purpose of increasing utilization of their services and products,” said Karen Ignagni, head of America’s Health Insurance Plans, the health-insurance industry’s trade group.
The group’s general counsel, Joseph Miller, said laws regulating tax-exempt organizations could limit activities aimed at enriching themselves or another organization. (WSJ)
