Posted in Access to healthcare, American Exceptionalism, Consumer-Driven Health Care, Dependency, Direct-Pay Medicine, Direct-Pay Practice Models, Doctor-Patient Relationship, Economic Issues, Free Society, government incompetence, Government Regulations, Health Insurance, Healthcare financing, Independent Physicians, Medical Costs, Medical Practice Models, News From Washington, DC & Related Shenanigans, Organizational structure, Patient Choice, Patient Safety, Patient-centered Care, Policy Issues, primary care, Quality, Technology, Telemedicine Trends, Third-Party Free Practices, Uncategorized

Shelter In-Place Care: Another “Box Checked” for the Value of Direct Primary Care

HEADLINE:

FCC Unveils COVID-19 Telehealth Program, Updates Connected Care Pilot

The Federal Communications Commission is using $200 million in funding from the CARES Act to launch a new program to help providers access the broadband resources they need to support telehealth programs.

Wow, the government has discovered remote digital technology medical care!  Although, maybe a little late. What would we do without those innovative minds in D.C. ?!?

But there’s a better solution that’s been up and running for more than a decade; private citizens being free to act and chose what services they value.  It is a solution which occurred organically when an innovative supply side acted to solve other people’s problems within a cooperative marketplace driven by mutual benefit.  It is called Direct Primary Care (DPC). And it is only possible because we still have some semblance of healthcare freedom within our society.  No thanks to Washington, D.C.

But step aside, the FCC with money to burn is coming to the rescue after COVID is already in full crisis mode.

The DPC Consumer Guide -- Now Available for office/clinic use and and an educational/marketing resource for your patients.Never mind that Direct Primary Care physicians have routinely integrated remote care technology platforms into their practices for a more than a decade.  And set aside the fact that revenue in a DPC business model doesn’t rely on office visits (the opposite of social distancing) to trigger a billable encounter, the claim against which is paid out of a grossly over-priced pre-paid 3rd party fund that we call health insurance.  Instead, the Direct Primary Care physician is paid to be available to solve problems, answer questions, triage illness/injury, provide treatment and advice via the most appropriate venue for each patient.

And last, no disrespect meant to the media outlet below for featuring this story.  They are just reporting the healthcare news, as is their mission.

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https://mhealthintelligence.com/news/fcc-unveils-covid-19-telehealth-program-updates-connected-care-pilot

Posted in Bailouts, Dependency, Economic Issues, Entrepreneurs, Free Society, Free-Market, government incompetence, Government Regulations, Government Spending, Government Stimulus, Job loss, Keynesian Economics, Liberty, Organizational structure, Philosophy, Policy Issues, Uncategorized, Unemployment

Focus on People During Economic Crises, Not Macro-Statistics – Foundation for Economic Education

By Mark Hornshaw

“Economics studies human choice under scarcity. Humans must act in the present to provide for the future. Informed choice relies on market data in the form of prices—specific prices for specific things, as we assess various different means to satisfy our ends—that is what economics is about.

Macro-statistics such as GDP and CPI, whether they are rising or falling in the aggregate, do not help much with this vital task. These statistics are compilations of vast amounts of data to come up with averages across entire countries and time-periods. It’s a dilution of the data, not an enhancement.

“What a country wants to make it richer, is never consumption, but production. Where there is the latter, we may be sure that there is no want of the former,” said John Stuart Mill, citing Say’s law.

In a tune of rapid change and disruption, we need prices to do their job more than ever so the entrepreneurial process can work. High prices show which industries to move more resources into, and low prices show which ones to move resources out of to free them up for more urgent uses. From the point of view of consumers, high prices show us what we should cut back on, and low prices show where we can pick up bargains.

This process takes time. Interfering with this process just locks in shortages and surpluses.
So-called “stimulus,” just thrown at “the economy” to increase “aggregate demand” in the abstract, cannot work, when there are supply constraints in some industries and prohibitions in others.

Government policy should be on mending holes in the social safety net, compensating those it has forced out of business and jobs, and reducing the tax and regulatory burden it places on businesses, workers and consumers as they try to adjust.

These are all microeconomic responses to relieve suffering and remove impediments.”

https://fee.org/articles/focus-on-people-during-economic-crises-not-macro-statistics/

Posted in Bailouts, Currency Manipulation, Dependency, Economic Issues, Federal Reserve, Government Regulations, Government Spending, Interest on the Debt, Keynesian Economics, Policy Issues, Tax Policy, Uncategorized

Economic Lessons from Coronavirus: Government-Subsidized Private Debt Creates Macro Vulnerability | International Liberty

Little more than a decade after consumers binged on inexpensive mortgages that helped bring on a global financial crisis, a new debt surge — this time by major corporations — threatens to unleash fresh turmoil.

The root cause of the debt boom is the decision by the Federal Reserve and other key central banks to cut interest rates to zero in the wake of the financial crisis and to hold them at historic lows for years.

https://danieljmitchell.wordpress.com/2020/03/20/economic-lessons-from-coronavirus-government-subsidized-private-debt-creates-macro-vulnerability/

Posted in Dependency, Economic Issues, Education, Free Society, Liberty, outcomes, outcomes measurement, Philosophy, Policy Issues, Uncategorized

If Only Economics Was as Easy as Rocket Science – Foundation for Economic Education

Gary M. Galles is a professor of economics at Pepperdine University. His recent books include Faulty Premises, Faulty Policies (2014) and Apostle of Peace (2013). He is a member of the FEE Faculty Network.

However, as America’s founders attested so vehemently, rights are at the core of social interactions and government, violations of which can justify revolution. And unlike the physical sciences, where the goal of language is precision, in the social sciences, the language (and thus analysis) is often quite vague and inconsistent (e.g., current versions of “social justice” are inconsistent with the traditional meaning of “justice”), making clear communication, much less clear analysis, far harder.

What is the upshot of all this? Economics is not like physical sciences, and reasoning and analogies based on them are often misleading in economics. Further, they can be dangerous to society, particularly in the mouths of those who wish to subject others to their command and control. That is why Friedrich Hayek wrote,

“The curious task of economics is to demonstrate to men how little they really know about what they imagine they can design.”

In other words, economics is a science whose principles and logic tell us why we cannot know enough to control people, even if we do know enough to control rockets.

https://fee.org/articles/if-only-economics-was-as-easy-as-rocket-science/

Posted in Access to healthcare, advance-pricing, Affordable Care Act (ObamaCare), CPT billing, Deductibles, Dependency, Direct-Pay Medicine, Direct-Pay Practice Models, Economic Issues, Employee Benefits, Health Insurance, Healthcare financing, Individual Market, Medical Costs, medical inflation, Medical Practice Models, Organizational structure, outcomes measurement, Patient Choice, Policy Issues, Price Tansparency, Self-Insured Companies, Self-Insured Plans, The Triple Aim, Uncategorized

U.S. Healthcare: A Case Study of What Happens When “Insurance” Supplants Price-Transparent Markets

By Robert Nelson, MD

Our health insurance-based third-party payer protocols have pernicious and nefarious economic consequences on the cost of medical care; and in many ways has diminished access due to regulatory complexities that accompany these interventions.

The undeniable result continues to be a rampant increase in healthcare prices, which is catalyzed by the economic distortions of the 3rd party payer effect and perpetuated by the price-obscuring distortions of the CPT billing cycle.

We have taken the concept of insurance, designed to pay out rare higher-priced claims on unpredictable events, and turned it into a product whose design promotes an incentive for everyone to use it as often as possible.

Insurance is sustainable only when the financial risks of individually rare events are spread over a large population. When it also becomes a funding source for anticipated and affordable events, combined with a perverse incentive to utilize it to the margin, the result is the creation of a perpetual payout fund.

The costs of sustaining this model are never satisfied, being squeezed by patients who are chasing the benefits and providers who chase the billing codes to achieve maximal reimbursement.

As evidence for the negative consequence of misusing insurance as a pass-through system for virtually every healthcare expense (accelerated by passage of the ACA), we can examine the employer-sponsored group market premiums.

From 2007 – 2017 the average premium for family coverage increased by 55% and employee contribution rate as a share of premium cost increased by 74% over the same 10-year period; while median household income went up by only 3%.

To add financial injury to insult, the percentage of employees with an out-of-pocket maximum of greater than $3,000 doubled, going from 30% to 60% of employees.

“Eighty-one percent of covered workers have a general annual deductible for single coverage that must be met before most services are paid for by the plan. Among covered workers with a general annual deductible, the average deductible amount for single coverage is $1,505.” ~KFF.org

Between 2012 – 2017, the percentage of covered workers with a general annual deductible of $1,000 or more for single coverage has grown substantially, increasing from 34% in 2012 to 51% in 2017. Thirty-seven percent of covered workers in small firms are in a plan with a deductible of at least $2,000, compared to 15% for covered workers in large firms.

In the ACA individual market insurance exchanges, single coverage premiums (unsubsidized) increased by 62% and family coverage premiums increased by 75% just since implementation of ObamaCare!

Our third-party payer system has created a dependency paradox!

The same funding method that contributes to runaway costs also causes us to be more dependent on it for access. This guarantees that Healthcare will cost significantly more than the sum of its individual parts, and will continue to escalate faster than our ability to pay for it.

The costs associated with health plan premiums (aka insurance) have become a surrogate for health-care costs.

Now let that sink in!

In what other market does the cost of an insurance product act as substitute for the aggregate cost of the product or services that it insures?

Now apply a similar scenario to the auto insurance market. It doesn’t take much imagination to extrapolate how that would play out. But if you want some help visualizing the scenario, here’s a brief vignette. https://lnkd.in/eUGeCKv

Self-insured employer health plans are in a unique position to break out of this dependency paradox.

By contracting with a Direct Primary Care practice and re-routing subsequent encounters away from the more expensive insurance-based protocols, Self-insured employers can utilize creative plan designs to cut costs and improve employee satisfaction.

Data from the Qliance experience, and supported by other self-insured employer’s experiences, utilization of efficient primary care via the DPC model reduces unnecessary downstream care by approximately 50%, with the resultant aggregate cost savings of nearly 20%.

The caveat being, as we double the number of primary care visits combined with longer visits to adequately address problems, the need for emergent visits, ER visits and specialty intervention drop significantly.

A similar level of savings for direct-pay lab tests was noted in data published in 2014 by CMT journal comparing lab fees charged to a Direct Pay practice by the lab vs. the CPT billed charges by the lab (assuming patient had no coverage or had not met their deductible). For five common blood tests the savings was 89% by not using insurance, with lab billed charges of approximately $782 compared to a direct pay cost of $80. Plum Health, a direct primary care practice in Detroit, shows similarly impressive lab test savings of 87% on six common blood tests; $811 vs $106.

Many Self-insured companies are beginning to discover the value and savings in this approach, while breaking free of the coverage trap and the myth that health insurance equates to health care; and the realization that so-called “access” to inflated pricing and the phony discounts used to fleece the buyer is no longer a conversation they are willing to have.

Posted in Consumption Inequality, Cost of labor, Dependency, Economic Issues, Education, Free Society, Liberty, Organizational structure, outcomes, Philosophy, Policy Issues, Poverty, Representative Republic vs. Democracy, Rule of Law, Uncategorized, Wealth

Why the Pilgrims Abandoned Common Ownership for Private Property – Foundation for Economic Education

Governor Bradford recorded in his diary that everybody was happy to claim their equal share of production, but production only shrank. Slackers showed up late for work in the fields, and the hard workers resented it. It’s called “human nature.”

The disincentives of the socialist scheme bred impoverishment and conflict until, facing starvation and extinction, Bradford altered the system. He divided common property into private plots, and the new owners could produce what they wanted and then keep or trade it freely.

Communal socialist failure was transformed into private property/capitalist success, something that’s happened so often historically it’s almost monotonous. The “people over profits” mentality produced fewer people until profit—earned as a result of one’s care for his own property and his desire for improvement—saved the people.

https://fee.org/articles/why-the-pilgrims-abandoned-common-ownership-for-private-property/