Check out the video below. It really proves my point that it's all about cost control.
A medical billing advocate shows CNN's Elizabeth Cohen some of the wasteful charges she's seen in bills.
http://cnn.com/video/?/video/health/2010/03/01/cohen.health.care.bills.cnn
Thursday, March 18, 2010
Wednesday, March 17, 2010
Massachusetts' "Reform" Mess
Great article…
Massachusetts’ ‘reform’ mess
By Sally C. Pipes
March 16, 2010
FEDERAL lawmakers pondering how to vote on Obama-Care this week should notice that Massachusetts is back asking Washington for hundreds of millions more to bail out its universal health-coverage system.
When it became law in 2006, the Bay State’s plan was supposed to fix everything — with much the same exact “medicine” as in the current national “reform” bills.
Everyone would have to buy insurance on threat of a $1,116 fine. Meanwhile, bureaucrats would redirect large amounts of federal and state money already sloshing around the state from supporting care for the uninsured to providing subsidized insurance for these same folks. Instead of using money to patch up problems caused by a lack of insurance, the state would use the cash to provide preventive care, saving even more money down the road.
So what happened? The state enrolled 55,000 more people in Medicaid, and folks flooded to the new free insurance and enrolled in their subsidized employer plans — but few bought private insurance.
So the total uninsured rate dropped from 10 percent of the state’s 6.3 million population to just 3 percent — but the savings haven’t materialized.
Of the 176,766 people enrolled in plans under the “Connector” authority set up by the state for individuals and small businesses to buy insurance, 87,838 are paying no premium and another 64,733 are subsidized. A mere 24,195, or 14 percent, are paying full fare.
This new insurance was supposed to be funded not by new federal money, but by redirecting the enormous amounts of money in the state’s uncompensated care pool. Yet the need to subsidize providers of care to uninsured hasn’t gone away — indeed, Massachusetts bureaucrats are seeking more money for the renamed Safety Net Care Pool. They want to keep hard dollar, openended subsidies flowing directly to hospitals and other institutions.
That’s why the state is now begging the feds for $473 million — to fund the safetynet programs that were supposed to be solved by their near-universal insurance.
And this comes on top of vast aid from Washington: The 2006 reform was itself an effort to save $385 million in federal funding.
Last year, Congress granted Massachusetts another $1 billion over three years to fund its system. In all, the feds are kicking in $21.2 billion over three years — more than $3,000 per person in the state.
Yet they’re already back asking for more, barely a year after the ink is dry on the deal that provided the last windfall.
The next step in Massachusetts is to impose global budgets for doctors — that is, to pay a flat fee rather than fees for service. In other words, to turn the entire state into a government-dominated HMO. (And the Bay State wants the feds to fork over another $135 million to help pay for the shift.)
In short, they don’t have a clue. The only thing they know is that they want more federal cash to keep the “reformed” system afloat.
Americans must understand that the Massachusetts mess is what ObamaCare will bring. In his latest request for more money, Gov. Deval Patrick’s administration actually asks for the added funds based on being a national model: “The legislation passed by each house of Congress bears a striking resemblance to the Massachusetts model.”
Be afraid. The only thing Massachusetts has demonstrated is its ability to get billions out of the federal government. But where will the country as a whole go for the extra money? Only two choices: Raise taxes on ourselves today or borrow our children and grandchildren into beggarhood.
Sally C. Pipes is president and CEO of the Pacific Research Institute and author of The Top Ten Myths of American Health Care.
Let me know what you think. -The Health Insurance Guy
Massachusetts’ ‘reform’ mess
By Sally C. Pipes
March 16, 2010
FEDERAL lawmakers pondering how to vote on Obama-Care this week should notice that Massachusetts is back asking Washington for hundreds of millions more to bail out its universal health-coverage system.
When it became law in 2006, the Bay State’s plan was supposed to fix everything — with much the same exact “medicine” as in the current national “reform” bills.
Everyone would have to buy insurance on threat of a $1,116 fine. Meanwhile, bureaucrats would redirect large amounts of federal and state money already sloshing around the state from supporting care for the uninsured to providing subsidized insurance for these same folks. Instead of using money to patch up problems caused by a lack of insurance, the state would use the cash to provide preventive care, saving even more money down the road.
So what happened? The state enrolled 55,000 more people in Medicaid, and folks flooded to the new free insurance and enrolled in their subsidized employer plans — but few bought private insurance.
So the total uninsured rate dropped from 10 percent of the state’s 6.3 million population to just 3 percent — but the savings haven’t materialized.
Of the 176,766 people enrolled in plans under the “Connector” authority set up by the state for individuals and small businesses to buy insurance, 87,838 are paying no premium and another 64,733 are subsidized. A mere 24,195, or 14 percent, are paying full fare.
This new insurance was supposed to be funded not by new federal money, but by redirecting the enormous amounts of money in the state’s uncompensated care pool. Yet the need to subsidize providers of care to uninsured hasn’t gone away — indeed, Massachusetts bureaucrats are seeking more money for the renamed Safety Net Care Pool. They want to keep hard dollar, openended subsidies flowing directly to hospitals and other institutions.
That’s why the state is now begging the feds for $473 million — to fund the safetynet programs that were supposed to be solved by their near-universal insurance.
And this comes on top of vast aid from Washington: The 2006 reform was itself an effort to save $385 million in federal funding.
Last year, Congress granted Massachusetts another $1 billion over three years to fund its system. In all, the feds are kicking in $21.2 billion over three years — more than $3,000 per person in the state.
Yet they’re already back asking for more, barely a year after the ink is dry on the deal that provided the last windfall.
The next step in Massachusetts is to impose global budgets for doctors — that is, to pay a flat fee rather than fees for service. In other words, to turn the entire state into a government-dominated HMO. (And the Bay State wants the feds to fork over another $135 million to help pay for the shift.)
In short, they don’t have a clue. The only thing they know is that they want more federal cash to keep the “reformed” system afloat.
Americans must understand that the Massachusetts mess is what ObamaCare will bring. In his latest request for more money, Gov. Deval Patrick’s administration actually asks for the added funds based on being a national model: “The legislation passed by each house of Congress bears a striking resemblance to the Massachusetts model.”
Be afraid. The only thing Massachusetts has demonstrated is its ability to get billions out of the federal government. But where will the country as a whole go for the extra money? Only two choices: Raise taxes on ourselves today or borrow our children and grandchildren into beggarhood.
Sally C. Pipes is president and CEO of the Pacific Research Institute and author of The Top Ten Myths of American Health Care.
Let me know what you think. -The Health Insurance Guy
Friday, February 12, 2010
Free Clinics
It is interesting to hear the prognostications of economists when it comes to health insurance. They often talk about the cost of care as a compared to Gross Domestic Product. They say the country will go bankrupt if we do not get cost under control. Our legislature in Washington tried to attack this issue with a 2000+ page bill to control about 20% of the nation's economy. The people shut this bill down. Currently, about 90% of Americans have individual or group insurance and, for the most part, are happy with their coverage, but unhappy with the expensive premiums. Are these expensive premiums the result of how much it actually costs to buy insurance, or are these premiums more expensive in order to cover the cost of the inefficient Federal and State programs?
The cost of “health care” drives the cost of health insurance. If the cost of care was less expensive, the cost of insurance would be less expensive. This being said, the private sector reacts to the price of health insurance and health care. When cost increase, the public market reacts, by limiting coverage and raising deductibles. The problem is that government-sponsored programs, like Medicaid and a host of other State and Federal programs, are unaffected by higher deductibles. So a privately insured individual moving to a higher deductible plan has a point of diminishing return when the savings are being gobbled up by government plans and the social welfare network. The government does not pay claims at market rates. These artificially low rates create an imbalance, and the health care providers increase the cost to the private payers in order to make up for the low reimbursements they receive from the government plans.
The State and Federal plans need to get their costs under control. Government programs need to create local clinics where they can control cost. Some will complain this type of change will create a two-tier system of health care delivery. Perhaps it will, but is that so bad? At least we will have a good clinic system that takes care of the folks who cannot afford health insurance with fixed cost. A national clinic program will lower the cost of government-run programs, which will lower the cost of private plans because the fee for service system will be replaced by a cost controlled State and Federal clinic program.
The cost of “health care” drives the cost of health insurance. If the cost of care was less expensive, the cost of insurance would be less expensive. This being said, the private sector reacts to the price of health insurance and health care. When cost increase, the public market reacts, by limiting coverage and raising deductibles. The problem is that government-sponsored programs, like Medicaid and a host of other State and Federal programs, are unaffected by higher deductibles. So a privately insured individual moving to a higher deductible plan has a point of diminishing return when the savings are being gobbled up by government plans and the social welfare network. The government does not pay claims at market rates. These artificially low rates create an imbalance, and the health care providers increase the cost to the private payers in order to make up for the low reimbursements they receive from the government plans.
The State and Federal plans need to get their costs under control. Government programs need to create local clinics where they can control cost. Some will complain this type of change will create a two-tier system of health care delivery. Perhaps it will, but is that so bad? At least we will have a good clinic system that takes care of the folks who cannot afford health insurance with fixed cost. A national clinic program will lower the cost of government-run programs, which will lower the cost of private plans because the fee for service system will be replaced by a cost controlled State and Federal clinic program.
Thursday, January 28, 2010
The Perfect Prescription for Fixing Health Care
Now that the debate has been sidelined with a loud message delivered by the people of Massachusetts and heard across the United States, it is time to get back to basics on health insurance and health care. There are certain facts about life that after raising four kids, and being married for 33 years, I have learned whether I wanted to or not. The first is that in the end, most people’s success in life comes down to personal responsibility, self discipline, and hard work. No matter what I have attempted, there does not seem to be a substitute for these three character building attributes. This applies to diet, exercise, saving or just plain hard work, it’s what makes the world go round.
When the economy is growing and there is lots of money to go around society will put up with certain behavior. When things get tight these behaviors are not accepted. This seems to be where we are now in the health insurance debate. Society is expecting people to be responsible. Society expects reform that is based on controlling cost and has a prescribed dose of personal responsibility in it, something that if we could bottle it up and sell it would be the perfect prescription for fixing health care.
The Health Insurance Guy
When the economy is growing and there is lots of money to go around society will put up with certain behavior. When things get tight these behaviors are not accepted. This seems to be where we are now in the health insurance debate. Society is expecting people to be responsible. Society expects reform that is based on controlling cost and has a prescribed dose of personal responsibility in it, something that if we could bottle it up and sell it would be the perfect prescription for fixing health care.
The Health Insurance Guy
Monday, January 18, 2010
Great Interview, Steve Poizner Talks to KMPH’s Rob Johnson
I wanted to share with you California Insurance Commissioner, Steve Poizner’s interview with KMPH’s Rob Johnson because I respect his ideas, opinions, and feel his past experiences make him a really great candidate.
Republican candidate for Governor Steve Poizner spoke with Modesto's Rob Johnson of KMPH this morning to discuss his campaign for governor of California. In the interview, Steve discusses his budget proposal for California and Meg Whitman’s refusal to debate the issues, among other topics. To listen to the entire interview with Rob Johnson, copy and paste the link below.
http://www.youtube.com/watch?v=4sLDmhgcoJE&tr=y&auid=5806558
[Partial Transcript – Starting at 3:22]
ROB JOHNSON: I surely have to agree with you that one of Meg Whitman’s weaknesses is her openness to go into public debate and the interview that we did with her here on this program was pre-recorded from the afternoon before. And I think she’s a little concerned because she doesn’t have any political experience and I think she’s concerned, probably, about having to get out and answer tough questions and work quick on her feet when she’s standing in front of potential voters, and that’s got to say something too about her performance as governor if, on the campaign so far, that’s her behavior.
STEVE POIZNER: Well, these campaigns are tough, they’re grueling, and they need to be that way, and voters are watching carefully and they’re looking for the personal characteristics and the backbone and the vision and the stamina to actually be governor of this great state. And the fact is, Meg Whitman has a very interesting background and lots of great experiences in marketing positions at Disney and Hasbro and so forth, but the fact is, being in politics is just a different business. The fact is, being successful and effective in politics requires a different skill set. It’s not like being a CEO in a boardroom where you’re in command, barking out orders, hiring and firing people at will. Being effective in Sacramento requires cajoling skills and arm twisting skills and the ability to put together winning coalitions. In my case, the reason why I think I have such an interesting value proposition so to speak for voters right now is I’m the only one running that has 20 years of experience at starting companies from scratch. And that important entrepreneurial experience is very distinctive as compared to running big companies. And then in addition to my ability to bring jobs back to California and my 20 years of experience at running companies, I now have eight years of success in politics and public sector service. A year in the White House during the 9-11 crisis building a new homeland security plan, time in the classroom teaching kids in a low income area, running successfully statewide, being Insurance Commissioner now for three years, and downsizing my operating budget by 15% and creating a huge surplus at the Department of Insurance. This track record of success, both in the private sector and the public sector, will distinguish me in this race, and that’s what voters are looking for right now. They’ve had it with career politicians, and they also are not ready to turn the state over to a rookie either. So I’m ready to step forward here as a problem solver, really hit these problems head-on and get this great state back on track. ...
[9:18]
ROB JOHNSON: You’re not counting on getting any money from the federal government, you’re not counting on $7 billion coming from the federal government to help us.
STEVE POIZNER: No, that’s pretty much fantasy. I mean, I agree with the Governor that the federal government owes us some money. For example, we spend a billion a year covering the costs of illegal immigrants in our prisons. Now the government should pay us for that, but the fact is we’ve been trying to get that money for decades now, so the likelihood that we’re going to get any kind of federal bailout again -- we already got billions and billions in bailout money -- the likelihood is pretty small. And frankly, every time we get bailed out, it just covers over the real problem. It’s time that we balance our own budget. These one-time revenue shots really just procrastinate the inevitable. We’ve got to deal with our own problems here. ...
The Health Insurance Guy
Republican candidate for Governor Steve Poizner spoke with Modesto's Rob Johnson of KMPH this morning to discuss his campaign for governor of California. In the interview, Steve discusses his budget proposal for California and Meg Whitman’s refusal to debate the issues, among other topics. To listen to the entire interview with Rob Johnson, copy and paste the link below.
http://www.youtube.com/watch?v=4sLDmhgcoJE&tr=y&auid=5806558
[Partial Transcript – Starting at 3:22]
ROB JOHNSON: I surely have to agree with you that one of Meg Whitman’s weaknesses is her openness to go into public debate and the interview that we did with her here on this program was pre-recorded from the afternoon before. And I think she’s a little concerned because she doesn’t have any political experience and I think she’s concerned, probably, about having to get out and answer tough questions and work quick on her feet when she’s standing in front of potential voters, and that’s got to say something too about her performance as governor if, on the campaign so far, that’s her behavior.
STEVE POIZNER: Well, these campaigns are tough, they’re grueling, and they need to be that way, and voters are watching carefully and they’re looking for the personal characteristics and the backbone and the vision and the stamina to actually be governor of this great state. And the fact is, Meg Whitman has a very interesting background and lots of great experiences in marketing positions at Disney and Hasbro and so forth, but the fact is, being in politics is just a different business. The fact is, being successful and effective in politics requires a different skill set. It’s not like being a CEO in a boardroom where you’re in command, barking out orders, hiring and firing people at will. Being effective in Sacramento requires cajoling skills and arm twisting skills and the ability to put together winning coalitions. In my case, the reason why I think I have such an interesting value proposition so to speak for voters right now is I’m the only one running that has 20 years of experience at starting companies from scratch. And that important entrepreneurial experience is very distinctive as compared to running big companies. And then in addition to my ability to bring jobs back to California and my 20 years of experience at running companies, I now have eight years of success in politics and public sector service. A year in the White House during the 9-11 crisis building a new homeland security plan, time in the classroom teaching kids in a low income area, running successfully statewide, being Insurance Commissioner now for three years, and downsizing my operating budget by 15% and creating a huge surplus at the Department of Insurance. This track record of success, both in the private sector and the public sector, will distinguish me in this race, and that’s what voters are looking for right now. They’ve had it with career politicians, and they also are not ready to turn the state over to a rookie either. So I’m ready to step forward here as a problem solver, really hit these problems head-on and get this great state back on track. ...
[9:18]
ROB JOHNSON: You’re not counting on getting any money from the federal government, you’re not counting on $7 billion coming from the federal government to help us.
STEVE POIZNER: No, that’s pretty much fantasy. I mean, I agree with the Governor that the federal government owes us some money. For example, we spend a billion a year covering the costs of illegal immigrants in our prisons. Now the government should pay us for that, but the fact is we’ve been trying to get that money for decades now, so the likelihood that we’re going to get any kind of federal bailout again -- we already got billions and billions in bailout money -- the likelihood is pretty small. And frankly, every time we get bailed out, it just covers over the real problem. It’s time that we balance our own budget. These one-time revenue shots really just procrastinate the inevitable. We’ve got to deal with our own problems here. ...
The Health Insurance Guy
Using HSA's to Our Benefit
Individual insurance premiums should be tax deductible both in California and Federally. This would cut the cost if the State let people write off the premium by 10%. I could never figure out why group insurance is tax deductible and individual is not. We want people to be responsible and buy health insurance so let’s make it tax deductible.
There are only two States that do not allow the Health Savings Account deposits to be expensed on the State income tax return. One is California. I think this should be changed right away. The Health Savings Account is the best way to get to where we want to go by making people more aware of the cost of health care. As people save money, the Health Savings Account will lead to more transparency in pricing. People with Health Savings Accounts will also have an incentive to stay healthy so they do not have to spend their savings. Also, I would guess as folks accumulate more money in their accounts, they can go to higher deductible plans and save money on their insurance premiums. This is exactly where the free market wants to go. The State and Federal legislators are against HSA’s because they promote individual responsibility and take control away from the government.
Contributions to Health Savings Accounts should be tax deductible to anyone who wants to help their family member or neighbor out. I would help my friends cover the deductible if they needed it, and I should be able to write it off like I was putting money into an IRA plan. I am sure this is less expensive than sending the money to the State or Federal Government, having them process it, and then having it sent back for claims. Money deposited in a Health Savings Account is the most efficient money of all. There is no commission to the distribution system or profit for the health insurer. The government never touches it and it goes directly to the provider 100%. Someone tell me a more efficient way to go.
The Health Insurance Guy
There are only two States that do not allow the Health Savings Account deposits to be expensed on the State income tax return. One is California. I think this should be changed right away. The Health Savings Account is the best way to get to where we want to go by making people more aware of the cost of health care. As people save money, the Health Savings Account will lead to more transparency in pricing. People with Health Savings Accounts will also have an incentive to stay healthy so they do not have to spend their savings. Also, I would guess as folks accumulate more money in their accounts, they can go to higher deductible plans and save money on their insurance premiums. This is exactly where the free market wants to go. The State and Federal legislators are against HSA’s because they promote individual responsibility and take control away from the government.
Contributions to Health Savings Accounts should be tax deductible to anyone who wants to help their family member or neighbor out. I would help my friends cover the deductible if they needed it, and I should be able to write it off like I was putting money into an IRA plan. I am sure this is less expensive than sending the money to the State or Federal Government, having them process it, and then having it sent back for claims. Money deposited in a Health Savings Account is the most efficient money of all. There is no commission to the distribution system or profit for the health insurer. The government never touches it and it goes directly to the provider 100%. Someone tell me a more efficient way to go.
The Health Insurance Guy
Thursday, January 14, 2010
Good job, New York.
Did you know that while New York has about ½ as many people on Medicaid as California (In California, it is called Medi-Cal), it receives $3 billion more dollars than CA in support from the Federal Government per year? Per capita New York has about $7500 per person per year while CA has about $1850 per person per year.
Get this, California pays about $3 billion more in Federal taxes than New York in total per year. It goes to Washington and then Washington gives this money to New York for their health subsidy.
Are you shocked? Why does this happen? It happens because the subsidy is like a 401k plan. The more the State puts in the more the Federal Government matches it. California contributes about $1250 a year while New York contributes about $5500 per person per year. This costs CA about $3 billion a year. New York has taken advantage of this program. California needs to do a better job. Our legislators are wasting billions.
The Health Insurance Guy
Get this, California pays about $3 billion more in Federal taxes than New York in total per year. It goes to Washington and then Washington gives this money to New York for their health subsidy.
Are you shocked? Why does this happen? It happens because the subsidy is like a 401k plan. The more the State puts in the more the Federal Government matches it. California contributes about $1250 a year while New York contributes about $5500 per person per year. This costs CA about $3 billion a year. New York has taken advantage of this program. California needs to do a better job. Our legislators are wasting billions.
The Health Insurance Guy
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