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
Showing posts with label health insurance. Show all posts
Showing posts with label health insurance. Show all posts
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.
Monday, January 11, 2010
Mandate-Light Coverage
Sacramento and Washington D.C. are full of lobbyists whose job it is to represent the industry who is paying their salary. You can imagine how important it is for certain industries like Chiropractic, Acupuncture, Alcoholism and Drug Addiction, Mental parity and others to get mandates that health insurance must cover their particular area. Over the years the lobbyists have been successful and these mandates increase the cost of insurance. Most people simply want coverage for illness and accident. So these mandates are coverage they do not need. Cal-Basic would be a “mandate light” individual health insurance plan that would be available to people who lost their jobs in addition to COBRA. The insurers are fine with this concept. The premiums would be much lower for the laid-off employee while they looked for another job.
Cal Basic would be available on the open market as the lowest level plan an insurer could sell. Insurers have already done the actuarial analysis on this type of program. It would cost about $60 to 75 dollars per month for someone under age 30. The guaranteed issue rate for the age group under age 30 would be about $544 per month.
A plan like this would lower the ranks of the uninsured by lowering the cost of purchasing catastrophic insurance and open markets for consumers with pre-existing conditions.
The Health Insurance Guy
Cal Basic would be available on the open market as the lowest level plan an insurer could sell. Insurers have already done the actuarial analysis on this type of program. It would cost about $60 to 75 dollars per month for someone under age 30. The guaranteed issue rate for the age group under age 30 would be about $544 per month.
A plan like this would lower the ranks of the uninsured by lowering the cost of purchasing catastrophic insurance and open markets for consumers with pre-existing conditions.
The Health Insurance Guy
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