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, Economic Issues, Government Regulations, Health Insurance, Healthcare financing, Medicaid, Medical Costs, medical inflation, Medicare, out-of-pocket costs, Policy Issues, Uncategorized

The Pernicious Impact of Government Intervention in Healthcare, Captured in a Chart

AdministratorGrowthVS.PhysiciansAs Dan Mitchell mentions in his post, much of the dysfunction we witness in healthcare are simply symptoms of the distortions that arise when we rely on a third-party payer system, with heavy government involvement, and all its perverse incentives which distort decision making for all participants. And so often the proposed “fixes” are aimed at mitigating symptoms caused by the third-party effect, rather than peeling back the layers to get to the root cause. Is it any wonder things aren’t improving despite billions and billions of subsidies, massive intervention, regulations and various forms of scrutiny!

International Liberty

America’s healthcare system is a mess, largely because government intervention (Medicare, Medicaid, Obamacare, and the tax code’s healthcare exclusion) have produced a system where consumers almost never directly pay for their medical services.

This “third-party payer” system basically means market forces are absent. Consumers have very little reason to focus on cost, after all, if taxpayers or insurance companies are picking up the tab for nearly 90 percent of expenses.

As a result, we get ever-higher prices.

But we also get a lot of featherbedding and inefficiency because providers want to take advantage of this system.

Athenahealth offered some sobering analysis on the system last year.

The number of physicians in the United States grew 150 percent between 1975 and 2010, roughly in keeping with population growth, while the number of healthcare administrators increased 3,200 percent for the same time period.

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Employers saving thousands on medical bills due to up-front pricing | KFOR.com

sco-building-full-980x360Yet there are still many among us who refuse to believe that price honesty in an open market can “bend the healthcare cost curve” – let alone that it is essential for affordable healthcare. Not only does it work, but is less expensive for participants and also begets higher quality, being intrinsic to the proposition of a mutually beneficial exchange of value between buyers and sellers.

Source: Employers saving thousands on medical bills due to up-front pricing | KFOR.com

Posted in Access to healthcare, advance-pricing, Affordable Care Act (ObamaCare), Consumer-Driven Health Care, CPT billing, Direct-Pay Medicine, Economic Issues, Employee Benefits, Employer-Sponsored Health Plans, Government Regulations, Health Insurance, Health Savings Accounts (HSA's), Healthcare financing, Individual Mandate, Individual Market, Individual ObamaCare Market, Individual Underwriting Standards, Insurance subsidies, Large group insurance market, Medicaid, medical inflation, Medical Practice Models, Patient Choice, Policy Issues, Portable Insurance, Pre-existing Conditions, Private Exchanges, Quality, Subsidies, Tax Policy, Uncategorized

A Path Towards a Viable Interstate Health Insurance Market | Robert Nelson, MD | Pulse | LinkedIn

Alternatives to our current over-priced and dysfunctional health insurance market are often biased, and thus limited, by our current operational and regulatory structure. These structures are so entrenched in our healthcare psyche that it makes it difficult sometimes to set these aside in our minds while entertaining how another approach might work.

If we view all alternative plans to replace the Affordable Care Act from the vantage point of “what is”, then there is little room for anything other than attempts at further regulating the problems away. If one presupposes that the current regulatory framework remains unchanged, indeed the same framework has served to suppress the very market we wish create, then of course that market will not be created.

The dilemma facing alternative healthcare plans being considered to replace the ACA is particularly evident when it comes to the issue of selling health insurance across state lines. A brief on this subject published by the American Academy of Actuaries in February of 2017 speaks to the the main challenges facing the advent of a viable interstate market for the sale of health insurance.

Source: A Path Towards a Viable Interstate Health Insurance Market | Robert Nelson, MD | Pulse | LinkedIn

Posted in Affordable Care Act (ObamaCare), Consumer-Driven Health Care, Economic Issues, Medicaid, Medicaid Expansion, Medical Costs, Medicare, News From Washington, News From Washington, DC & Related Shenanigans, Patient-centered Care, Policy Issues, Reforming Medicare, Uncategorized

National Health Spending Slowdown Underwhelms; Obamacare Hurting Middle Class | Health Policy Blog | NCPA.org

Dollar-under-magnifying-glass-1024x910While it is literally true that last year’s increase was the lowest since 1960, growth in 2009 was only 3.8 percent, after 4.8 percent in 2008. You do not need a PhD in economics to conclude that the recession was likely the largest factor. It is hard to detect much more than noise in the annual changes since the recession hit. This is corroborated by the fact that 17.4 percent of Gross Domestic Product is accounted by health care ― exactly the same percentage as in 2009 and every year since.

Nevertheless, CMS’ actuaries allege that Obamacare’s provisions kept a lid on costs, citing:productivity adjustments for Medicare fee-for-service payments;reduced Medicare Advantage base payment rates;increased Medicaid prescription drug rebates; and the medical loss ratio requirement for private insurers.

Yes, Medicare spending dropped from 4.0 percent in 2012 to 3.4 percent in 2013. However, Medicare’s enrollment growth also slowed, and the Republican-driven sequestration also held back spending. Medicare spending per enrollee actually rose at the same rate as in 2012. It is hard to see Obamacare’s technocratic cost savings in these figures.

Medicaid spending exploded 6.1 percent. Although government wrangled more discounts from drug makers, this did not compensate for increased Medicaid enrollment and higher fees for providers. The best performance was by private insurers, for whom spending growth dropped from 4.0 percent in 2012 to 2.8 percent in 2013. Medicare regulates health insurers’ medical loss ratio (MLR), which is the ratio of medical claims to total premium (actually, a more complex calculation than it appears). CMS’ actuaries credit this regulation with lowering the growth of private insurers’ spending.

via National Health Spending Slowdown Underwhelms; Obamacare Hurting Middle Class | Health Policy Blog | NCPA.org.