Posted in Access to healthcare, advance-pricing, Economic Issues, Free-Market, Health Insurance, Healthcare financing, Influence peddling, Medical Costs, medical inflation, Medical Practice Models, Policy Issues, Price Tansparency, Reforming Medicaid, Reforming Medicare, Uncategorized

Same Transparent Price to Any Willing Buyer

By Robert Nelson, MD

Within many of the posts regarding the challenges facing healthcare, someone – usually out of frustration – will inevitably pose the following: “So what is the solution?”

Well, the answers won’t be found in repeating partisan talking points. Especially the ones based on economic fallacies and socio-economic myths, so often repeated they have become dogma for the healthcare surrogate we call a “health plan”, despite its sub-par effect on mortality and health when compared to other socio-economic factors. This industrialization of healthcare has been orchestrated to be over-priced by pundits and politicians, on the right and the left, who pander for influence, money and votes. They claim that we need more of it, covering more items for more people. By design, it crowds out more cost-effective alternative sources of funding. It is the ultimate healthcare inflation machine.

The solution is to utilize different financial strategies for different segments of healthcare, using tools to maximize their effectiveness. This begins with the deflationary & stabilizing effect that real prices have when they are known in advance for the vast majority of healthcare services exchanged between buyers and sellers, most of which takes place in a non-emergent scenario.

https://fmma.org/pillars-of-the-fmma/

 

 

 

Posted in Access to healthcare, advance-pricing, CPT billing, Direct-Pay Practice Models, Economic Issues, Free-Market, Healthcare financing, Medical Costs, medical inflation, Medical Practice Models, Organizational structure, Policy Issues, Price Tansparency, Protocols, third-party payments, Uncategorized

Replacing Myths with Markets

images (22)Hardly a week goes by that we don’t hear a defense from the status quo about how different healthcare is from any other services or commodities. The dogma, based on economic fallacies, is pervasive.

We’re asked to believe that advanced pricing is unrealistic, yet the majority of care is scheduled in advance and much of it is elective. We are supposed to believe that value-based reimbursement is the savior and FFS is the root of all evil; yet VBP lacks the very price transparency required to determine value. We are told healthcare is an “essential” service, the implication being that it is rarely a voluntary transaction, therefore it does not respond to market forces; despite voluminous data to the contrary.

There are many essential commodities that are necessary for life, all of which are obtained with advanced transparent pricing. It should not surprise us that these essentials are in abundance with mostly affordable prices and arguably more important to our daily survival than healthcare; largely because these “essentials” are obtainable in an competitive price transparent Market. The idea that Healthcare is “oh so different” and cannot benefit from the discipline of the market, and the price transparency that comes with it, is a myth that should be put to rest.

Posted in Access to healthcare, advance-pricing, Affordable Care Act (ObamaCare), CPT billing, Economic Issues, Health Insurance, Healthcare financing, medical inflation, Medical Practice Models, out-of-pocket costs, Policy Issues, primary care, Uncategorized

Bastiat Society | Nashville

“Healthcare Economics 101: The Bubble is the Trouble” with Dr. Bob Nelson

ADS Security Nashville3001 Armory Dr #100, Nashville, TN 37204, USA map 

Join the Nashville chapter on November 30th at 6:00 pm for their last event of 2017.

Dr. Bob Nelson will give a talk on healthcare. The event is free and open to the public, but you are encouraged to register so that there will be enough refreshments.

About the speaker:

Dr. Robert (Bob) Nelson is the Publisher and editor of The Sovereign Patient, a blog and information resource tool dedicated to Promoting Freedom in Healthcare Using the Power of Free-minds and Free-markets.

Dr. Nelson is a founding member and spokesperson for the Georgia Chapter of the Free Market Medical Association. The FMMA is a non-partisan association that provides resources, support and education to members and to the public about the free market movement and why it is important.

He has authored of over 50 articles and essays focusing on the consequences of unwise tax laws, public policy and pricing failure which have contributed to our healthcare debacle, while proposing free-market solutions to bring down costs and improve access to care.

Dr. Nelson has spoken about healthcare economics and free-market healthcare principles to the Bastiat Society of Charleston, SC. He had the privilege of addressing the 3rd Annual Palmetto Panel at Clemson University about the importance of healthcare economic freedom within our Republic. Dr. Nelson also had the pleasure of speaking to medical students at the Philadelphia College of Medicine campus in Suwanee, Georgia about the role of Direct Primary Care.

He has been a guest on radio shows such as “Your Health Matters” 89.7 WGLS-FM, Doc Talk on WGST 640 in Atlanta and The Vince Coakley show on 103.6 FM in Greenville, SC.

Dr. Nelson received his M.D. degree at the Ohio State University College of Medicine in 1985. He is the Founder and Owner of Encompass Health Direct, in Cumming, GA; providing low-cost primary care for a flat monthly fee.

Bob lives with his wife, Tammy, in Cumming, GA.

Register Now!

Schedule:

6:00 pm Happy Hour
6:30 pm Speaker
7:00 pm Q&A

Continue reading “Bastiat Society | Nashville”

Posted in Access to healthcare, Canadian Health System, Economic Issues, Government Spending, Healthcare financing, Medicaid, Medical Costs, Medical Practice Models, Medicare, News From Washington, News From Washington, DC & Related Shenanigans, Policy Issues, Protocols, Reforming Medicaid, Reforming Medicare, Tax Policy, Uncategorized

Medicaid for All Would ‘Bankrupt the Nation,’ Warns Bernie Sanders—In 1987 – Hit & Run : Reason.com

“Notably absent from Sanders’ proposed single-payer system was a detailed plan to pay for it. The senator said he would lay out the tax hikes necessary to fund his new system in separate legislation.

That may be because enthusiasm for single payer tends to die down pretty quickly once people get a sense of what sort of tax increases would be necessary to fund it. An Urban Institute analysis of a previous version of Sanders’ plan estimated that it would cost $32 trillion over a decade.

It promises huge overall savings along with coverage that would be far more expansive, and far more expensive, than Medicaid for all, with no clear way to pay for it, and no specific strategy for driving costs or spending down.

In 30 years of political advocacy, Sanders has not solved any of the fundamental problems with single payer. He has merely opted to pretend they do not exist.”

[Note: On annualized basis, that would more than double the amount we currently spend annually on healthcare.  And past projections related to the costs of gov’t programs always vastly underestimate the actual costs, as evidenced below. – The Sovereign Patient]

“The House Ways and Means Committee estimated that Medicare would cost only about $12 billion by 1990 (a figure that included an allowance for inflation). This was a supposedly “conservative” estimate. But in 1990 Medicare actually cost $107 billion.” http://reason.com/archives/1993/01/01/the-medicare-monster

Source: Medicaid for All Would ‘Bankrupt the Nation,’ Warns Bernie Sanders—In 1987 – Hit & Run : Reason.com

Posted in Access to healthcare, Economic Issues, Health Insurance, Influence peddling, Medical Costs, out-of-pocket costs, Patient Choice, Patient Safety, Patient-centered Care, Price Tansparency, Quality, Uncategorized

Sworn to Secrecy, Drugstores Stay Silent as Customers Overpay – Bloomberg

You’re Overpaying for Drugs and Your Pharmacist Can’t Tell You

https://www.bloomberg.com/news/articles/2017-02-24/sworn-to-secrecy-drugstores-stay-silent-as-customers-overpay

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Community Underwriting, Economic Issues, Free-Market, government incompetence, Government Regulations, Health Insurance, Healthcare financing, Individual Mandate, Individual Market, Insurance subsidies, Medicaid, Medicaid Expansion, Medical Costs, medical inflation, Medicare, Organizational structure, outcomes, Policy Issues, Uncategorized

Hard Truths about Health Care ‌ by Michael Tanner

Micheal Tanner
Michael Tanner

“Every health-care system in the world rations care in some way, either through bureaucratic fiat (Scandinavia, the U.K.), waiting lists (Canada), or price (that’s us). One can argue about which of these rationing mechanisms is fairest or most efficient, but let’s not pretend that it won’t occur.”

http://www.nationalreview.com/article/446439/health-care-basic-facts-and-hard-truths

Posted in Access to healthcare, advance-pricing, British National Health Service, Consumer-Driven Health Care, CPT billing, Direct-Pay Medicine, Direct-Pay Practice Models, Doctor-Patient Relations, Doctor-Patient Relationship, Economic Issues, Free-Market, Health Insurance, Healthcare financing, Independent Physicians, Medical conditions and illness, Medical Costs, Medical Practice Models, Patient Choice, Patient Safety, Patient-centered Care, Policy Issues, Price Tansparency, primary care, Quality, Third-Party Free Practices, Uncategorized, Wait times to see a doctor

Common Sense Economics: Aligning Incentives with Evidence-based Care | Robert Nelson, MD | LinkedIn

fig2Standard economic theory in healthcare assumes that demand for medical services is inelastic. Simply stated, inelasticity means that demand for certain medical services remains fairly high and constant despite rising prices; whereas with a commodity that is elastic, higher prices will cause demand to fall and vice versa.

While inelastic demand applies to high acuity and critical illness, a large portion of the medical care consumed in this country is habitual and learned based on flawed assumptions about treatments and effectiveness of intervention. Over-utilization is further exacerbated because of our perverse payment and billing model which drives artificially high demand with minimal price considerations beyond a small co-pay.

A peculiarity of our healthcare system that contributes to lumping the vast majority of medical services into the inelastic category is the fact that PPO health plans require virtually all encounters with providers to be billed under the health plan, regardless of how minor or regardless of necessity. This forces analysts and economists to look at aggregate utilization and spend; or average per capita costs and utilization rates based on claims and generally irrespective of medical necessity.

In reality, a significant portion of our medical care consumption in this country is elective, non-emergent and in many cases unnecessary – or at the very least forced into unnecessarily expensive venues such as urgent care or ER. This spans the gamut from colds to constipation and backaches to boo-boos and a whole lot of unnecessary visits in between (like work excuses for mental health days).

Indeed, this same segment of medical care consumption has the potential for much more price elasticity of demand than we have been led to believe. The problem is, our current method of buying and billing for healthcare services has resulted in neutralizing the market forces that would normally allow prices to be affected by demand in these areas.

Nowhere is this more evident than with the millions of annual visits to doctor’s offices, Urgent Care centers and Retail clinics for colds and other upper respiratory illnesses.

Read entire article via Common Sense Economics: Aligning Incentives with Evidence-based Care | Robert Nelson, MD | LinkedIn.