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, 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, Affordable Care Act (ObamaCare), Consumer-Driven Health Care, Deductibles, Defined Contribution Benefit Plans, Direct-Pay Medicine, Economic Issues, Employee Benefits, Employer-Sponsored Health Plans, Essential Benefits under the ACA, Federal Exchanges, Free-Market, Government Spending, Health Insurance, Health Reimbursement Arrangement (HRA), Health Savings Accounts (HSA's), Healthcare financing, Independent Physicians, Individual Mandate, Individual Market, Individual ObamaCare Market, Individual Underwriting Standards, Insurance subsidies, Liberty, Medicaid, medical inflation, Patient Choice, Patient-centered Care, Policy Issues, Pre-existing Conditions, Price Tansparency, Private Exchanges, Quality, Reforming Medicaid, Self-Insured Companies, Self-Insured Plans, State-Run Insurance Exchanges, Subsidies, Tax Policy, Uncategorized, Uninsured

All the Problems plaguing ObamaCare are Solved by These 12 Bold Ideas

The Sessions – Cassidy bill:

Source: Summary | Goodman Institute for Public Policy Research

Posted in Access to healthcare, Affordable Care Act (ObamaCare), CPT billing, Direct-Pay Medicine, Direct-Pay Practice Models, Economic Issues, Employer-Sponsored Health Plans, Essential Benefits under the ACA, Free-Market, Government Regulations, Health Insurance, Healthcare financing, Medical Costs, medical inflation, Medical Practice Models, Network Discounts, Policy Issues, Third-Party Free Practices, third-party payments, Uncategorized

Irrational Healthcare Payment System Drives Costs And Why Payers Go Along With It | Robert Nelson, MD | LinkedIn


Our third-party payer system, by the nature of how coding & billing is contractually mandated, promotes increased health spending on aggregate – and the economic design of the system includes a perverse incentive to keep the spending going. 

real-health-care-expenditures-and-third-party-largerThis occurs in large part due to price insensitivity on the consumer-patient side due to the low marginal cost of entry compared to the inflated CPT billed charges which serve as a pivot point for network discounts. i.e. ~ once a co-pay is paid, patients don’t have any incentive to know or care what is done or how much it costs. 

 

These perverse motivations are what keeps premiums going up and up… Without utilization (claims), there is no other way to grow the pie because payers are not free to make a higher profit margin beyond the mandated cap, even if they do things to lower aggregate utilization which might lower premiums for everyone.  In other words, payers are not rewarded for efficiency, they reap financial reward to the extent that utilization, thus costs, continue to rise. 

Source: Irrational Healthcare Payment System Drives Costs And Why Payers Go Along With It | Robert Nelson, MD | LinkedIn

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Economic Issues, Federal Exchanges, Health Insurance, Insurance subsidies, State-Run Insurance Exchanges, Subsidies

SCOTUS Rulings: a twitter poll would be quicker and just as meaningful | Robert Nelson, MD | LinkedIn

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Robert Nelson, MD

As noted by Justice Antonin Scalia in a scathing dissent, the Court rules that the term “established by the State,” which appears seven times in the statute, can also mean “not established by the State.”

For those of us opposed to the economic catastrophe that is PPACA, this ruling may be a blessing in disguise.  More tomorrow on the intended and unintended consequences of the SCOTUS ruling.

But for starters, here is something to think about. We now know (per Gruber and many others) the portion of the law that ties subsidies to formation of State Exchange was intentional and DEFINITELY NOT an oversight as Judge Roberts as other apologists for PPACA would have us believe – leaving him “no choice” but to intervene in order to prevent chaos…. as if there was no other financial option besides the subsidies as prescribed and ineptly administered by the ObamaCare mandate.

via SCOTUS Rulings: a twitter poll would be quicker and just as meaningful | Robert Nelson, MD | LinkedIn.

Posted in Access to healthcare, Affordable Care Act (ObamaCare), DC & Related Shenanigans, Economic Issues, Government Regulations, Government Spending, Health Insurance, Medicaid, Medical Costs, Medicare, News From Washington, Organizational structure, Policy Issues, Reforming Medicaid, Reforming Medicare, Subsidies, Tax Policy, Uninsured

Government Math and Healthcare | Anthony Wunsh | LinkedIn

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Anthony Wunsh

I have been reviewing some Census Data and trying to make sense of what we have created relative to what it costs us versus what it could cost us as a nation, more on the public side to provide and receive healthcare. And the more I look at it the more convinced I am that the people we are sending to government must have failed all their math and statistical classes. In fact it may be why they went into government in the first place.

So some basic information to build context for my thoughts is needed.

via Government Math and Healthcare | Anthony Wunsh | LinkedIn.

Posted in Affordable Care Act (ObamaCare), Liberty, News From Washington, DC & Related Shenanigans, Uncategorized

Obama’s Obamcare Fix is His Most Illegal Power Grab Yet: Conn Carroll | Nov 15, 2013

http://townhall.com/tipsheet/conncarroll/2013/30/15/obamas-obamcare-fix-is-his-most-illegal-power-grab-yet-n1747326?utm_source=thdaily&utm_medium=email&utm_campaign=nl