Tag: "Health Care Costs"

More Than 1,000 Lab Tests from a Drop of Blood

The secret that hundreds of employees are now refining involves devices that automate and miniaturize more than 1,000 laboratory tests, from routine blood work to advanced genetic analyses. Theranos’s processes are faster, cheaper and more accurate than the conventional methods and require only microscopic blood volumes, not vial after vial of the stuff. The experience will be revelatory to anyone familiar with current practices, which often seem like medicine by Bram Stoker…Theranos is committing to a half-off discount on Medicare fees. “So a test that costs $100 now, we’ll do $50 or less.

Full article worth reading.

Sep 13, 2013 | 13 comments | by

It’s Third-Party Payers, Stupid

How can you write an entire column about waste in health care and never mention why there is waste? Uwe Reinhardt shows he’s up to the task at The New York Times economics blog. Maybe it’s that bottle of champagne he mentioned the other day.

Are there huge administrative costs in the market for cosmetic surgery? Not that I’m aware of. How about Lasik surgery? What about walk in clinics? Domestic medical tourism? I don’t think so.

Even with third-party payers, waste suddenly vanishes if they empower patients and get out of the way. It took all of two years for WellPoint’s cost of joint replacements at out-of-network California hospitals to almost match the in-network cost after WellPoint made patients responsible for the extra payments.

Think about that. WellPoint didn’t have to negotiate a fee with anyone. No arguing or hassling over the charge for an aspirin — or any other charge. Just patients explaining to the admissions office that they only had so much money to spend. (That’s almost as effective as global budgets and price controls without all of the unintended bad consequences!)

Is there waste in the Canadian health care system? Of course there is. It’s in the form of delayed surgeries. Cancelled surgeries. Even unnecessary surgeries. The cost of that kind of waste typically eludes the accountants however. That’s because the cost is born by the patients.

Sep 13, 2013 | 25 comments | by

How to Save $17,000 by Not Using Insurance, and Other Links

Medical-BillsWithout health insurance, a $20,000 bill becomes $3,000.

Even apes suffer midlife crises.

Women are more honest.

Should divorce settlements pay for fertility treatments?

Sep 10, 2013 | 16 comments | by

Headlines I Wish I Hadn’t Seen

121511skynewsiraqflag_512x288Health costs of war.

Robert Reich: Socialize private charity: Parent gifts to their children’s schools should be shared equally with other schools.

Alan Grayson: there’s scant and circumstantial evidence that Assad ordered the attack.

Mississippians are the fattest people in the nation, and also are the most insecure about getting their next meal.

Sep 10, 2013 | 24 comments | by

Medicaid Block Grants Work

In its final days, the Bush Administration granted Rhode Island a block grant — essentially a waiver allowing the state increased flexibility from federal Medicaid regulations in return for a cap on federal expenditures. An analysis by Rhode Island’s former secretary of Health and Human Services illustrates how a block grant reduced yearly spending growth by half other states. In the process medical services delivered to the needy improved.

At the time of the waiver Rhode Island’s Medicaid program was hemorrhaging dollars. [I]ts costs were growing by 7.6% annually, and more than a quarter of the state budget went to pay these medical bills. Since the waiver, the state’s official Medicaid documents show that costs rose an average of only 1.3% a year from 2009-2012 — far below the 4.6% rate in the other 49 states.

Two provisions in particular saved money: reduced use of the emergency room for privacy care and home-care subsidies as an alternative to nursing home care.

Aug 29, 2013 | 15 comments | by

Incentives

The 1,250 employees of Melton Truck Lines have two types of health insurance. The “iCare” policy requires workers and family members to get checked for blood pressure, waistline, cholesterol, triglycerides and blood sugar. The “I Don’t Care” policy requires no screening. It is 50 percent more expensive.

Jim Landers in the Dallas Morning News.

Aug 28, 2013 | 14 comments | by

Issue Settled: The Young Are Worse Off Under ObamaCare Pricing

LifetimePremiums

This is from Chris Conover:

Thus, from the standpoint of the average young adult adversely affected by ObamaCare, I would argue that the figures using a 10% discount rate come much closer to the truth than do the figures using a 3% rate. And you can see from the chart that using that 10% rate, ObamaCare is not a good lifetime deal even for people as old as 30 [and if I had used a much higher discount rate of say, 17%, ObamaCare would turn out to be an even worse deal for young people]. For 18 year olds, ObamaCare essentially is imposing a tax of 18.3% on the premiums they would otherwise pay under the more market-oriented reforms favored by many conservatives and Republicans.

Aug 27, 2013 | 13 comments | by

Why is There Regional Variation in Health Care Spending?

One factor: what doctors believe, including false beliefs:

We find patient demand is relatively unimportant in explaining variations. Physician organizational factors (such as peer effects) matter, but the single most important factor is physician beliefs about treatment: 36 percent of end-of-life spending, and 17 percent of U.S. health care spending, are associated with physician beliefs unsupported by clinical evidence.

NBER paper by Cutler et al. HT: Tyler Cowen.

Aug 27, 2013 | 15 comments | by

Outsource Health Care to Indian Reservations

Writing in Slate, Justin Matis has a novel idea: slash health care costs by letting doctors from India provide low-cost medical care on American Indian reservations. Although his article was meant as satire, Maris inadvertently hit upon a great idea. India is a low cost, high quality medical tourism destination — but it’s far away. American Indian reservations are not subject to the plethora of federal and state laws that restrict the practice of medicine to only physicians licensed by the state. So here is Matis’ proposal:

What if those Indian doctors came to us? Foreign doctors can’t operate on U.S. soil without extensive recertification, but they can work in any country that transfers their qualifications. Doctors from India already work abroad in the Middle East; they treat Qataris and Kuwaitis for a fraction of what these patients would have to pay here. What if some of those doctors set up shop in our nearest semi-autonomous states: Native American reservations, some of which already administer their own health care programs.

In a nutshell, Matis’ solution is domestic medical tourism. Of course not every American lives close enough to an Indian reservation to receive all their medical care at one, but they wouldn’t have to. If health plans began selectively contracting only with facilities that offer package prices and compete on price and quality, it would not be long before other local hospitals began competing for health plan business. The key to fostering competition involves the ability to steer patients to low-cost providers by exposing patients to: 1) better information about prices, and 2) cost-sharing incentives that cannot be ignored. We wrote about how WellPoint, working with CalPERS, used similar incentives to bring down the cost of joint replacement procedures.

Aug 23, 2013 | 13 comments | by

Forget the Annual Physical: It’s a Waste of Your and Your Doctors’ Time

Slate examines the benefit of the annual physical and finds it wanting. Nearly one-in-ten physician visits is for annual checkups ― costing about $8 billion annually.  Otherwise healthy Americans visit their physicians more than 44 million times a year despite having no medical complaint that needs to be addressed. What constitutes an annual physical exam varies form one doctor to the next. Your doctor may just talk to you about your health, check blood pressure and listen to your chest through a stethoscope. Other physicians (or your own physician on a different day) may order preventive medical screenings like mammograms, check for cholesterol. A doctor may even order a battery of laboratory tests. The exact procedures can vary because there are no standardized procedures for what is included in an annual health exam. According to Slate:

The annual health exam is a venerable tradition, stretching back to the late 19th century — those heady days of medicine when doctors overestimated their own ability to cure disease, and badly underestimated their tendency to cause it. We’re now in the evidence-based era of medicine, and there’s little evidence that annual exams provide any benefit. So here’s a free bit of advice: If you’re not sick, don’t go to the doctor.

So what’s the problem? Besides the waste of resources, there’s an elevated chance for false positives and all the accompanying mental anguish and follow up procedures to ascertain there is no (and never was an) actual problem. There is also the tendency to “medicalize” minor ailments, when patients report symptoms they would have ignored. As the result of annual exams, doctors often treat (or over treat) conditions that would have gone away on their own.

Aug 21, 2013 | 16 comments | by
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