Posted in Affordable Care Act (ObamaCare), Economic Issues, Health Insurance, Healthcare financing, Medical Costs, News From Washington, DC & Related Shenanigans, Policy Issues, Risk Adjustment, Risk Corridors, Rule of Law, Uncategorized

Justices grapple with multibillion-dollar ObamaCare case | TheHill

Several of the arguments in this case have credence on their face for different reasons.

There is the idea of an agreement or contract: “I do this, if you do that.” One should not break a contract carelessly.

Or, the “fairness” argument where one side seems to want to change the rules after the game started; that doesn’t seem right.

And, then there’s the constitutional rule of law argument: Congress holds the power of the purse when it comes to public monies. Enough said.

Bottom line…and in a different case, Qliance found this out the hard way…when you get in bed with the gov’t, expect to get screwed!

Forum for Healthcare Freedom

https://thehill.com/regulation/court-battles/473895-justices-grapple-with-multibillion-dollar-obamacare-case

Posted in Access to healthcare, Accountable Care Organizations, Affordable Care Act (ObamaCare), CPT billing, Economic Issues, Health Insurance, Healthcare financing, Independent Physicians, Influence peddling, Medical Costs, Medicare, Patient Choice, Patient Safety, Policy Issues, Price Tansparency, Uncategorized

Wax: Making a Killing in American Health Care, a Step-by-Step Guide

Master this how-to guide and you’ll be on your way.

https://www.breitbart.com/politics/2019/12/03/craig-m-wax-do-making-a-killing-in-american-healthcare-a-step-by-step-guide/

Posted in Access to healthcare, advance-pricing, Affordable Care Act (ObamaCare), CPT billing, Deductibles, Economic Issues, Employer-Sponsored Health Plans, Government Regulations, Health Insurance, Healthcare financing, Medical Costs, medical inflation, out-of-pocket costs, Patient Choice, Policy Issues, Uncategorized

On the Importance of Price Transparency

Dollar-under-magnifying-glass-1024x910On the importance of transparency… may I present exhibit A: https://www.medpagetoday.com/publichealthpolicy/ethics/83459

Pay particular attention to the content of the last paragraph!!! 

“The Affordable Care Act mandates that health insurers cover all federally recommended vaccines…at no charge to patients,…

Kaiser Health News looked at what its own insurance carrier, Cigna, paid for those free flu shots. At the high end, it shelled out $85 for a flu shot given at a Sacramento, California, doctor’s office that was affiliated with Sutter Health, one of the largest hospital chains in the state. Further south, in Long Beach, Cigna paid $48 for a shot.

Prices in the Washington, D.C., area went even lower, to $40 per shot at a CVS in Rockville, Maryland, and to $32 per shot at a CVS in downtown Washington that’s less than 10 miles away from the Rockville location.

Picture1.pngOne expert told KHN that the variation has nothing to do with the cost of the drug, but stems from secret negotiations between health plans and providers. While patients are expected not to care since the shot is free to them, these costs come back to bite in the form of higher premiums — which is one of the major complaints about the ACA.”

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, Affordable Care Act (ObamaCare), Direct-Pay Medicine, Direct-Pay Practice Models, Economic Issues, Health Insurance, Healthcare financing, Individual Market, Insurance subsidies, Medicaid, Medicaid Expansion, Medical Costs, News From Washington, Patient Safety, Policy Issues, Reforming Medicaid, Subsidies, Uncategorized

Options Will Increase, Sky Will Not Fall, If ACA Ends

For example, the AMA complains that hundreds of millions would be at risk of losing “coverage.” In fact, only a net 1.7 million people gained private coverageunder ACA, after subtracting the nearly 6 million who lost it, at a shocking cost of $341 billion or $200,000 per newly insured person. Most of the claimed increased coverage came from expanding Medicaid to childless, able-bodied adults. This reduced access to services by the sickest patients, and at least 21,904 patients died on Medicaid waiting lists according to a 2018 report.

Without ACA and its unaffordable requirements, Americans would have many more options to buy affordable insurance. Instead of paying as much as a mortgage payment for “coverage” they are unlikely to use, they might join a DPC (direct primary care) practice and get preventive care and routine medical treatment for at as little as $50/month. They might buy catastrophes-only major medical insurance that ACA outlaws for persons over 30 years of age. Congress might enact Health Freedom Accounts as proposed by Rep. Chip Roy (R-Tex.) and liberalize Health Reimbursement Accounts.

https://mailchi.mp/aapsonline/aca-standing-639035?e=f50410ece3

Posted in Affordable Care Act (ObamaCare), Economic Issues, Employee Benefits, Employer Mandate, Employer-Sponsored Health Plans, Health Insurance, Individual Mandate, Large group insurance market, Medical Costs, Small group market, Subsidies, Uncategorized

The Current Status of the ACA Employer Mandate: 2019 – Integrity Data

Caution Employers!

With all the focus on Transparency mandates and HRA executive orders, much of the ACA remains in force (unfortunately). Even though the individual mandate penalty (uh…tax) will not be enforced beyond 2018, the employer mandate is still in effect, with all the coverage provisions!

https://www.integrity-data.com/current-status-of-aca-employer-mandate-2019/

Posted in Access to healthcare, Crony Capitalism, Economic Issues, Government Regulations, Health Insurance, Healthcare financing, Influence peddling, Medical Costs, medical inflation, Medicare, Network Discounts, Organizational structure, outcomes, Patient Choice, Patient Safety, Policy Issues, Price Tansparency, Quality, third-party payments, Uncategorized

Improving Hospital Competition: A Key to Affordable Health Care

Avek Roy

In 2011, James Robinson of the University of California reviewedhospital prices charged to commercial insurers for six common procedures: angioplasty, pacemaker insertion, knee replacement, hip replacement, lumbar fusion, and cervical fusion. He found that, on average, procedures cost 44 percent more in hospital markets with an above-average degree of consolidation.

It is problematic enough that regional hospital monopolies have the power to demand high prices. But on top of this, many hospitals engage in additional anticompetitive practices. Anna Wilde Mathews of the Wall Street Journal obtained secret contracts between insurers and hospitals revealing that these contracts often barred insurers from sending patients to “less-expensive or higher-quality health care providers.” Other hospitals precluded insurers from excluding some of the system’s hospitals from the insurer’s networks. Some contract provisions, including those from New York-Presbyterian Hospital and BJC HealthCare of St. Louis, prevented insurers from disclosing a hospital’s prices to patients.

https://freopp.org/improving-hospital-competition-a-key-to-affordable-medicine-343e9b5c70f