Posted in Access to healthcare, big government, Economic Issues, Government Spending, Government Stimulus, Health Insurance, Healthcare financing, Medical Costs, Medicare, Organizational structure, Philosophy, Policy Issues, Uncategorized

5 Charts That Explain the Student Debt Crisis – Foundation for Economic Education

The commonality between the insatiable rise in both healthcare costs and college tuition, post 1965, should be obvious:  Massive amounts of other people’s money in the form of government programs, payments, subsidies and loan guarantees; which economists call the 3rd-party payer effect.

As exposited in the FEE article below, the U.S. Higher Education Act introduced “incentives” into the market for higher education, encouraging both the supply side and the demand side to make decisions that they would not be as likely to make under “non-stimulated” market situations.

Similarly, the passage of Medicare in 1965 sent huge surge of money into the healthcare system. The predictable consequence of this massive revenue stream was an incentive for healthcare providers to enter the market and expand services at an unprecedented magnitude and rate.  Essentially, demand was spurred by new source of financing.  Amy Finkelstein, et.al have done excellent work in this area.  Her work indicates that Medicare funding may have allowed hospital to spend 6-fold more than what individual levels of insurance would have predicted.  And that the spread of 3rd party insurance from 1950 – 1990 may explain about 50% of the increase in real per capita spending over that time period. https://economics.mit.edu/files/788

 

 

“As Bernie Sanders tweeted last year, the cost of education, in nominal dollars, has increased by roughly 3,800 percent since the mid 1960s.

What Sanders didn’t mention was that this was when the US Higher Education Act was passed (1965), which directed taxpayer dollars to low-interest loans for students pursuing college. This increased accessibility to higher education, but the flood of federal money also caused a surge in demand and costs.

The problem isn’t unsolvable, but it will require significant changes to universities and the federal loan program. “Free” tuition and student debt forgiveness will only make the problem worse.

Instead, as University of Maryland economist Peter Morici recently argued, market discipline must be brought back to our institutions of higher learning as part of any debt forgiveness.

While policy wonks offer no shortage of proposals for tweaking the federal loan program to improve it, perhaps the best solution would be to get the federal government out of the loan business all together.”

https://fee.org/articles/5-charts-that-explain-the-student-debt-crisis/

Posted in Access to healthcare, Accountable Care Organizations, American Presidents, big government, Doctor-Patient Relationship, Economic Issues, Electronic Health Records, Health Insurance, Medical Costs, medical inflation, Medicare, Patient Safety, Policy Issues, Uncategorized

How Medicare Ruined American Healthcare | Medpage Today

Regarding the King-Anderson bill, the forerunner of Medicare, touted by JFK which eventually was defeated in the Senate…

“Edward Annis, MD, spoke eloquently to an empty Garden and to one of the biggest TV audiences of the times.

He explained directly to viewers: “This is not health care insurance … It will put government smack into your hospitals … deciding who gets in, who gets out, what they get, and what they don’t get. … This King-Anderson Bill is a cruel hoax and a delusion. … It will stand between the patient and his doctor. And it will serve as a forerunner of a different system of medicine for all Americans.”

In the late 1990s I asked Dr. Annis what was in the King-Anderson Bill that enabled him to predict in 1962 the insolvency of Medicare and the coming government takeover of healthcare. He replied with a smile, “Cost-plus financing. It was a license to steal.”

Indeed, Medicare ushered in unbridled spending for two decades before approaching insolvency.

But, as predicted by Dr. Annis, the system became insolvent by the early nineties… Hospitals and many providers became addicted to the easy money and abused the system. Why not? Cost-plus meant guaranteed profit.

Faced with Medicare insolvency, the insurance lobby persuaded Hillary Clinton to have secret meetings, without physician input.

Though Hillarycare never became law, the effort brought a sea change. Patients could no longer choose their doctor. Insurance companies now owned the patients. Participation in HMOs rose from 10% to 50%. Your doctor could no longer refer you to the best hospital or consultants if they were “out of network.” The doctor-patient bond had been successfully severed.

Medicare does not mandate who gets into hospitals, but it forces patients to get out by paying for only a limited number of days.

For the past two decades, hospitals have aggressively been buying up medical practices. The goal is to establish accountable care organizations (ACOs). Private practitioners are being elbowed out slowly but surely. General practitioners (GPs) cannot admit a patient to the hospital without “hospitalists” taking over. Hospital surgeons cannot refer to private surgeons, etc. Even the concierge model will be wiped out.

The Medicare approach to ACOs requires three things: 1) electronic medical records, 2) a “Quality Care Protocol,” and 3) a “Protocol for the Elimination of Non-Compliant Physicians.”

This is the ideal rationing system.

The computer will eventually dictate all allowed testing and treatments according to a “quality,” or more likely “cheapest way to do it,” protocol. Providers will ration according to the computer or they will fall into the “protocol for elimination of non-compliant physicians.”

In the new system, no one has a doctor. Doctors have a shift. The doctor you see on the morning shift has absolutely no responsibility for you when his/her shift is over or on a day off. A nurse practitioner takes the patient history and physical, further fractionating care. A system like this requires that all doctors are created equal. They are not.

Politicians and bean counters have never understood healthcare delivery. It was used and abused as a political tool.

No one listened to the warning of Dr. Annis. The AMA is often demonized by historians for opposition to Medicare, but it understood healthcare delivery and the destructive nature of cost-plus financing. I blossomed in the Golden Age of Medicine and bear witness to the fall.

Source: How Medicare Ruined American Healthcare | Medpage Today

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, Direct-Pay Medicine, Direct-Pay Practice Models, Doctor-Patient Relationship, Economic Issues, government incompetence, Government Regulations, Healthcare financing, Medical Costs, Medical Practice Models, Medicare, News From Washington, Organizational structure, Patient Choice, Patient-centered Care, Policy Issues, primary care, Quality, Reforming Medicare, Third-Party Free Practices, Uncategorized

Is CMS “DPC” model headed wrong direction?

The RFI goes on to explain the CMS vision of, “direct provider contracting (DPC), through which CMS would directly contract with Medicare providers.” Obviously this interpretation of “DPC” turns the true meaning of Direct Patient Care on its head.

https://mailchi.mp/aapsonline/cms-dpc-model?e=7be491a5e2

Posted in Access to healthcare, Accountable Care Organizations, Economic Issues, government incompetence, Government Regulations, Government Spending, Healthcare financing, Medical Costs, News From Washington, News From Washington, DC & Related Shenanigans, Organizational structure, Policy Issues, primary care, Protocols, Quality, Reforming Medicare, The Triple Aim, third-party payments, Uncategorized

Pay-for-performance program failures raise doubts about future success of MIPS | FierceHealthcare

Medicare’s Value-Based Payment Modifier Program, which was designed to improve value by paying doctors who perform better on measures of quality and spending, was a failure, and, in fact, likely exacerbated disparities in delivery, according to the study published in the Annals of Internal Medicine.

The payment system inadvertently shifted money away from doctors who treated sicker, poorer patients to pay bonuses that rewarded practices that treated richer, healthier patients, the study said.

https://www.fiercehealthcare.com/practices/study-pay-for-performance-program-fails-mips-macra-harvard

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, big government, DC & Related Shenanigans, Economic Issues, Government Regulations, Government Spending, Health Insurance, Healthcare financing, Independent Physicians, Liberty, Medicaid, Medical Costs, Medical Practice Models, Medicare, News From Washington, Organizational structure, Patient Choice, Patient Safety, Policy Issues, Reforming Medicaid, Reforming Medicare, Subsidies, Tax Policy, third-party payments, Uncategorized

Are You Sure You Want Medicare for All? – Reason.com

A big part of the problem, as Cato’s Tanner pointed out earlier this year is that “Americans want widely contradictory things from health-care reform. They want the highest-quality care for everyone, with no wait, from the doctor of their choice. And they want it as cheap as possible, preferably for free.” Promising, as Sanders and Warren do, to give everybody high-quality health care without regard for ability to pay will always find an enthusiastic audience. But delivering on that promise is likely to give us not the illusion of Medicare for All, but rather its awful, unsustainable reality.

Source: Are You Sure You Want Medicare for All? – Reason.com