Posted in Access to healthcare, CPT billing, DC & Related Shenanigans, Economic Issues, government incompetence, Government Regulations, Healthcare financing, Leadership, Medical Costs, Medicare, News From Washington, Reforming Medicare, Uncategorized

Judge tosses CMS’ site-neutral pay policy | Modern Healthcare

Forum for Healthcare Freedom writes:

When central planners interfere with markets, as happened in 1965 and which continues to this day, the toxic distortions on pricing mechanisms weave their way extensively through the entire industry. The long term damage is insidious. It clouds our view of reality and tricks us into thinking the abnormal is normal; what is unjust is legal; what seems unfair is rationalized away.

So even when we try to undo the damage, even in a small way, the complexities of labyrinth often render us incapable of reversing course. When government gets too big & powerful, only the big & powerful (AHA) can manipulate it.

The judge in this case is probably correct from a technical/legal/legislative/regulatory standpoint, but alas, our problem of price disparities favor the status quo and continuation of a non-transparent billing protocol, which ironically has been codified by HHS/CMS…the same department that is now attempting payment reform. You can’t make this stuff up!

https://www.modernhealthcare.com/payment/judge-tosses-cms-site-neutral-pay-policy

 

Posted in Access to healthcare, DC & Related Shenanigans, Economic Issues, Education, government incompetence, Government Regulations, Health Insurance, Healthcare financing, Influence peddling, Medical Costs, medical inflation, Medicare, News From Washington, Organizational structure, Policy Issues, Reforming Medicaid, Reforming Medicare, Tax Policy, Uncategorized

The History Of U.S. Health Policy Is A History Of Political Exploitation

Greg Scandlen

By Greg Scandlen

It all began with a concept known as “Roemer’s Law.” If you ask anyone who has studied health economics or health policy in the last 50 years, “What is Roemer’s Law?” each will be able to tell you in an instant: “That means a built bed is a filled bed.”

Milton Roemer, MD, was a researcher and professor, mostly at the University of California-Los Angeles, who spent a lifetime (he died in 2001) advocating for national health systems around the world. He was involved in creating the World Health Organization in 1951 and Saskatchewan’s provincial single-payer system in 1953.  His “law” was based on a single study he did in 1959 that found a correlation between the number of hospital beds per person and the rate of hospital days used per person. That’s it. That is the whole basis for “Roemer’s Law.”

“A built bed is a filled bed.” This little bumper sticker slogan has been the foundation of American health policy for 60 years. Hundreds of laws, massive programs, thousands of regulations at the federal, state, and local levels of government, all have been based on this slogan. It is the source of such concepts as “provider-induced demand,” and has resulted in centralized health planning, Certificate of Need regulations, managed care, and everything else currently on the table. Yet this “law” is both verifiably untrue and illogical.

There is a kernel of truth to it. When third-party payers pick up the tab, the usual tension between buyer and seller doesn’t exist. The buyer has no reason to resist excessive prices if someone else pays the bill.

But the believers in Roemer’s Law take that core idea to Alice-In-Wonderland proportions. They argue that, therefore, whenever a health-care provider wants to make more money, it simply has to sell more — more capacity equals more sales without end. So, the only way to reduce this endless consumption is to limit the capacity — place strict controls on the availability of services. But the notion fails for several reasons:

Source: The History Of U.S. Health Policy Is A History Of Political Exploitation

Posted in Crony Capitalism, DC & Related Shenanigans, Economic Issues, Government Regulations, Government Spending, Organizational structure, outcomes, outcomes measurement, Policy Issues, Poverty, Progressivism, Uncategorized, Wealth

Homelessness and the Failure of Urban Renewal | Mises Wire

In the department of economy, an act, a habit, an institution, a law, gives birth not only to an effect, but to a series of effects. Of these effects, the first only is immediate; it manifests itself simultaneously with its cause—it is seen. The others unfold in succession—they are not seen: it is well for us, if they are foreseen. Between a good and a bad economist this constitutes the whole difference—the one takes account of the visible effect; the other takes account both of the effects which are seen, and also of those which it is necessary to foresee. Now this difference is enormous, for it almost always happens that when the immediate consequence is favorable, the ultimate consequences are fatal, and the converse.  ~Frederic Bastiat

The parallels are numerous, and highly revealing, between our attempts to control prices in healthcare over the past 50 years and that of government attempts to solve “urban blight” and improve inner city living conditions.  In his book Myth Busters: Why Healthcare Reform Always Goes Awry, Greg Scandlen does a fantastic job of laying out the case for the negative unintended consequences of central planning in healthcare. https://www.goodreads.com/book/show/34942619-myth-busters

homeless“…Since the Progressive Era, government agencies — from the federal level on down — have been front and center in subsidizing, regulating, and planning city development in ways that have made housing in city centers more sparse and more expensive for households who aren’t part of the hipster-millionaire demographic that so many urban planners and politicians are working hard to attract.

While rising demand for housing in a fixed number of square miles will indeed increase the price of land and housing, various types of government intervention makes housing more expensive than it would otherwise be. And sometimes, through zoning ordinances and other regulations, cities largely outlaw just the sorts of housing that are most needed by low-income residents…

City planners were happy to show off the shiny new projects they had used government money to redevelop. But unseen were the households who simply could not afford units in the new buildings.

After all, the poor that lived in the slums lived there precisely because it was cheap, low-rent housing. Reformers admitted there were no “pat answers” to explain what would become of the displaced families. But few reformers seemed much troubled by it. Then, as now, it may have been what really mattered to reformers was to be able to claim they were doing something.

It turned out that the federal government’s grand plan of leveling flophouses and residential hotels in the name of “beautifying” cities, mostly just resulted in destroying the only housing the very-low-income population could afford. Deprived of their units in the slums, these people ended up living in tent cities and cardboard boxes instead.

Today, little has changed for those with the lowest incomes. The options once available to them in the pre-1950s world are gone, and were never replaced.

Thanks to the persistence of the Progressive mindset in cities, zoning, “redevelopment” and a centralized control of new construction remains the norm. “Density” is the new “congestion” and the attitude of city planners remains the same. They bemoan the lack of affordable housing while also blocking efforts to build more housing. Meanwhile, they tighten controls on modern-day boarding houses and other private-sector attempts to provide low-cost housing…

…Tax Increment Financing (TIF) legislation is geared not toward low-cost housing, but toward new commercial development. Often, that development is built where “unsightly” (but affordable) housing once existed. Its destruction is encouraged by government policy…

Yet, city centers remain the most practical place for very-low-income housing to be built and sustained. This is because the lowest-income households need to be close to the densest areas that sustain mass transit and access to employment. By destroying the urban ecosystem of very-low-income housing, though, governments have left many of these people few options other than living in cars, alleyways, and sidewalks…

…We continue to live with the wreckage of failed urban renewal, and the evidence can be seen in the tent cities and makeshift latrines we now see in public spaces.”

Source: Homelessness and the Failure of Urban Renewal | Mises Wire

Posted in Access to healthcare, big government, DC & Related Shenanigans, Economic Issues, Government Regulations, Government Spending, Health Insurance, Healthcare financing, Independent Physicians, Liberty, Medicaid, Medical Costs, Medical Practice Models, Medicare, News From Washington, Organizational structure, Patient Choice, Patient Safety, Policy Issues, Reforming Medicaid, Reforming Medicare, Subsidies, Tax Policy, third-party payments, Uncategorized

Are You Sure You Want Medicare for All? – Reason.com

A big part of the problem, as Cato’s Tanner pointed out earlier this year is that “Americans want widely contradictory things from health-care reform. They want the highest-quality care for everyone, with no wait, from the doctor of their choice. And they want it as cheap as possible, preferably for free.” Promising, as Sanders and Warren do, to give everybody high-quality health care without regard for ability to pay will always find an enthusiastic audience. But delivering on that promise is likely to give us not the illusion of Medicare for All, but rather its awful, unsustainable reality.

Source: Are You Sure You Want Medicare for All? – Reason.com

Posted in Access to healthcare, Affordable Care Act (ObamaCare), big government, Crony Capitalism, DC & Related Shenanigans, Economic Issues, Employee Benefits, Employer-Sponsored Health Plans, government incompetence, Government Regulations, Healthcare financing, Individual Market, Medical Costs, Medicare, Network Discounts, Policy Issues, Portable Insurance, Re-Pricing Scams, Tax Policy, Uncategorized

Repeal and Replace? No thanks. | Surgery Center of Oklahoma

Dr. Keith Smith

I’m all about repeal.  But let’s not stop with Obamacare.  Let’s move on to many disastrous legislative interventions brought to us from the other side of the aisle.  How about Medicare Part D, brought to us by a GOP-led executive?  Why didn’t the GOP change the tax code to end the discrimination against individual purchases of health insurance during the time they had all the power?  Hint:  see paragraph one of this blog.  This tax reform isn’t likely as the shift away from employer-purchased plans will gut the scam of PPO repricing, a devastating blow to the big insurance companies.

Source: Repeal and Replace? No thanks. | Surgery Center of Oklahoma

Posted in big government, DC & Related Shenanigans, DC & Related Shenanigans, News From Washington, DC & Related Shenanigans, Uncategorized

Newsgate 2016 | Sharyl Attkisson

Here is just the tip of the iceberg from Attkisson’s story…

It appears the watchdog of the government has a seat at the dinner table!

MSNBC

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“Media Matters staff had the direct line of MSNBC president Phil Griffin, and used it,” a Media Matters source told Daily Caller. “If we published something [negative] about Fox in the morning, [MSNBC would] have it on the air that night verbatim. We were pretty much writing their prime time. But then, virtually all the mainstream media was using our stuff.”

Source: Newsgate 2016 | Sharyl Attkisson

Posted in big government, Caricatures, DC & Related Shenanigans, DC & Related Shenanigans, government incompetence, News From Washington, News From Washington, DC & Related Shenanigans, Unsettled Science

An Attempted Hillary Email Coverup? | The Weekly Standard

A senior State Department official repeatedly pressed the FBI to change the classification of emails stored on Hillary Clinton’s private server, according to FBI interview summaries set to be released in the coming days. Patrick Kennedy, the undersecretary of state for management, discussed providing additional overseas slots for the FBI in exchange for revisions to classifications of the sensitive emails. The 34 summaries, known as FBI 302s, will be released in connection with a Freedom of Information Act request and after pressure from the House Committee on Oversight and Government Reform. Two additional 302s are being withheld because they contain information classified at the Top Secret/SAP level. The summaries, described to THE WEEKLY STANDARD by five intelligence and congressional officials familiar with their contents, are sure to bolster Donald Trump’s criticism of corruption at Clinton’s State Department, the FBI and Washington, D.C., with just more than three weeks until the 2016 presidential election.

Source: An Attempted Hillary Email Coverup? | The Weekly Standard

Posted in Access to healthcare, Affordable Care Act (ObamaCare), DC & Related Shenanigans, Economic Issues, Government Regulations, Government Spending, Healthcare financing, Medical Costs, medical inflation, Medicare, News From Washington, out-of-pocket costs, Policy Issues, Reforming Medicare, Uncategorized

Best Kept Secret In Washington DC: The Future Of Medicare – Forbes

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John C. Goodman

The fact that Medicare has been put on a sound financially footing – for the first time in its history – has never appeared in any official government announcement. Ditto for the fact that the disabled and the elderly may bear a heavy cost along the way.

These facts have not been in the headlines of any major newspaper. They have not been addressed in any news article. To my knowledge they have never been discussed in any opinion editorial. Even more surprising, they are repeatedly ignored by scholars and in scholarly reports at think tanks around the country (other than my own).

Eerie as it may seem, the entire country has been acting as though these incredible public policy changes have never occurred.

Here is a third thing l bet you don’t know. Although Republicans have criticized the “Obama cuts in Medicare spending” as threatening access to care for the elderly, the GOP alternative essentially does exactly the same thing.

What no one bothered to discuss was the much bigger budget story: an enormous reduction in future Medicare spending and its impact on the health and financial well-being of the 54 million people in Medicare.

Here is a bit more detail.

Source: Best Kept Secret In Washington DC: The Future Of Medicare – Forbes