Posted in Access to healthcare, Economic Issues, Government Spending, Healthcare financing, Medical Costs, Medicare, News From Washington, outcomes, Policy Issues, Reforming Medicare, Tax Policy, Uncategorized

Medicare Hypocrisy for All – Foundation for Economic Education

Gary M. Galles
Gary M. Galles
“Medicare is not even close to sustainable in its present form, much less to be leveraged to cover the entire population.”
Saturday, October 5, 2019

“Because of the wealth transfer to early enrollees, as well as from ensuing expansions, Medicare provided many with a great deal. But that deal was the result of dumping an enormous bill on future generations (bigger than the unfunded liabilities for Social Security plus the national debt).

As a result, Medicare was a far worse deal than M4A salesmen and women admit, and it is now decaying at an increasing rate.

With that bill starting to arrive, Medicare is not even close to sustainable in its present form, much less to be leveraged to cover the entire population (although one can understand the vote-buying potential in promising massive new M4A generational transfers).”

https://fee.org/articles/medicare-hypocrisy-for-all/

Posted in Affordable Care Act (ObamaCare), CPT billing, Crony Capitalism, Economic Issues, Free-Market, Government Regulations, Health Insurance, Insurance subsidies, Medical Costs, Medicare, Policy Issues, Reforming Medicare, Tax Policy, Uncategorized

Watch “Milton Friedman – Monopoly” on YouTube

The Healthcare industry, or medical-industrial complex, wears the armor of Government-sponsored protectionism; chinked together by pieces of the tax code, The McCarren-Ferguson Act, Certificate of Need laws, Medicare billing regulations, HIPAA, HITECH, and the ACA.

You would be hard pressed to find a more entrenched, impenetrable cartel.

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, Accountable Care Organizations, Affordable Care Act (ObamaCare), American Presidents, Canadian Health System, Direct-Pay Medicine, Economic Issues, Employer-Sponsored Health Plans, Government Regulations, Government Spending, Health Insurance, Healthcare financing, Independent Physicians, Medicaid, Medical Costs, Medical Practice Models, Medicare, News From Washington, out-of-pocket costs, Patient Choice, Policy Issues, Quality, Reforming Medicare, Uncategorized

What You Need To Know About Medicare For All, Part I

A study by Charles Blahousat the Mercatus Center estimates that Medicare for all would cost $32.6 trillion over the next ten years. Other studies have been in the same ballpark and they imply that we would need a 25% payroll tax. And that assumes that doctors and hospitals provide the same amount of care they provide today, even though they would be paid Medicare rates, which are about 40% below what private insurance has been paying. Without those cuts in provider payments, the needed payroll tax would be closer to 30%.

Of course, there would be savings on the other side of the ledger. People would no longer have to pay private insurance premiums and out-of-pocket fees. In fact, for the country as a whole this would largely be a financial wash – a huge substitution of public payment for private payment.

But remember, in today’s world how much you and your employer spend on health care is up to you and your employer. If the cost is too high, you can choose to jettison benefits of marginal value and be more choosey about the doctors and hospitals in your plan’s network. You could also take advantage of medical tourism (traveling to other cities where the costs are lower and the quality is higher) and phone, email and other telemedical innovations described above. The premiums you pay today are voluntary and (absent Obamacare mandates) what you buy with those premiums is a choice you and your employer are free to make.

With Medicare for all, you would have virtually no say in how costs are controlled other than the fact that you would be one of several hundred million potential voters.

Remember also that there is a reason why Obamacare is such a mess. The Democrats in Congress convened special interests around a figurative table – the drug companies, the insurance companies, the doctors, the hospitals, the device manufacturers, big business, big labor, etc. – and gave each a piece of the Obamacare pie in order to buy their political support.

As we show below, every single issue Obamacare had to contend with would be front and center in any plan to replace Obamacare with Medicare for all. So, the Democrats who gave us the last health care reform would be dealing with the same issues and the same special interests the second time around.

It takes a great deal of faith to believe there would be much improvement.

https://www.forbes.com/sites/johngoodman/2018/09/07/what-you-need-to-know-about-medicare-for-all-part-i/

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 Access to healthcare, Accountable Care Organizations, Affordable Care Act (ObamaCare), Economic Issues, Government Regulations, Healthcare financing, Independent Physicians, Medical Costs, Medical Practice Models, Medicare, News From Washington, DC & Related Shenanigans, Organizational structure, Patient Choice, Patient-centered Care, Policy Issues, Price Tansparency, Reforming Medicare, third-party payments, Uncategorized

How The Trump Administration Is Reforming Medicare | Health Affairs

“This 124-page document challenges a premise behind 50 years of thinking in health policy circles: that our most serious problems in health care arise because of flaws in the private sector. Most problems arise because of government failure, not market failure, the document declares, and it goes into great detail on how to correct the policy errors.

Trump policy toward health care appears to be based on the idea of promoting choice, competition, and the role of market prices. In Medicare, so far that means liberating telemedicine and accountable care organizations (ACOs), ending payment incentives that are driving doctors to become hospital employees, promoting hospital price transparency, reducing regulatory paperwork, and creating more transparency in the market for prescription drugs.”

https://www.healthaffairs.org/do/10.1377/hblog20190501.529581/full/

Posted in Access to healthcare, Economic Issues, Healthcare financing, Medical Costs, out-of-pocket costs, Patient Choice, Policy Issues, Price Tansparency, Reforming Medicare, third-party payments, Uncategorized

Why a patient paid a $285 copay for a $40 drug | PBS NewsHour

Insurance copays are higher than the cost of the drug about 25 percent of the time, according to a study published in March by the University of Southern California’s Schaeffer Center for Health Policy and Economics.

https://www.pbs.org/newshour/health/why-a-patient-paid-a-285-copay-for-a-40-drug

Posted in Access to healthcare, Consumer-Driven Health Care, CPT billing, Direct-Pay Medicine, Direct-Pay Practice Models, Doctor-Patient Relationship, Economic Issues, Employer-Sponsored Health Plans, Government Regulations, Health Reimbursement Arrangement (HRA), Health Savings Accounts (HSA's), Healthcare financing, Individual Market, Large group insurance market, Medicaid, Medical Costs, Medical Practice Models, Medicare, Patient Choice, Patient-centered Care, Policy Issues, Portable Insurance, primary care, Protocols, Reforming Medicaid, Reforming Medicare, Tax Policy, Technology, third-party payments, Uncategorized

Trump’s New Vision for Health Care

Hats off to John C. Goodman again! His work in leading the effort for market-based healthcare reform over the past 4 decades, and highlighting the government’s role in the dysfunctional mess we labor in, is second to none.

This Forbes article lays out a most concise and accurate rendering of what healthcare has become and why…and what to do about it.

If you’re tired of the hearing healthcare pundits wax feverishly about their favorite villains and how more regulations are the answer; or if you’re just a novice starting to explore the Healthcare conundrum, Dr. Goodman’s work is required reading. I recommend starting here and then circling back to some of his earlier work. The book “PRICELESS” is a recommended next step!

https://www.forbes.com/sites/johngoodman/2019/01/14/trumps-new-vision-for-health-care/