Author: Cathy Wentz

So Much Misunderstanding about Health Care

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As I was looking through Twitter yesterday, I came upon a meme that really grabbed me because, unfortunately, I think it accurately describes many people’s uninformed attitudes about the place of health insurance in their lives and how it is best managed. Yet, I don’t totally blame most people because the “health care” systems and insurance companies are putting in a great effort to deceive people and make them feel totally dependent on insurance “coverage.”

This meme showed two conflicting statements:

  • One guy states that a sonogram costs $150 if the payment is in cash.
  • The other guy replies, “I’d rather pay the $800 and get credit toward my deductible.”

How crazy is this?

Unfortunately this is a common attitude in our country today. Such an attitude may be the result of people’s natural fear that, somehow or another, they will incur some huge medical bill, and want to be at least partly paid up on their deductible when that disaster happens. However, what if that disaster does not happen in that same year? What if the sonogram is almost the only medical service one receives in the year outside of possibly the follow-up visit to the doctor for the results of the sonogram and a few other routine visits?

I would argue that if a minimal amount of health care is needed in the year that person paid $800 to have a sonogram go through their insurance “coverage,” they probably paid $650 more than necessary just to have that bill count toward their deductible. Not to mention, every year the deductible is wiped clean and starts at zero for the next year. One exception to that rule would be the situation in which some insurance companies allow deductibles accumulated in the last quarter of the year to apply to the next year. However, eventually, the deductible will be reset back to zero.

Another issue with this mentality is that the $800 sonogram paid toward the insurance deductible was most likely based on a negotiated reimbursement rate between one’s insurance company and the service provider. The trick in this negotiation is that the provider (hospitals are generally guilty of this one) charges some outrageous fee and the insurance company has contracted with that provider to pay a lesser amount that may still be fairly ridiculous. The actual charge to the insurance company for the sonogram that was costing the patient $800 is probably much more, and the $800 is considered a “discount,” but only in the insurer/provider universe.

According to an article by Jed Lipinski in the Times-Picayune entitled, “Can’t bring myself to give them that money: Finding out your $284 blood test costs $34 nearby,” (1) a woman found out how insurance companies operate with health systems, much to her chagrin. She had a blood test, a comprehensive metabolic panel for kidney and liver function, done and received a bill from Tulane University Medical Center for $323. The article reported that this patient’s insurance company determined that she owed $284 of that $323. The real clincher was that the same test was available at a nearby lab called Quest Diagnostics for $34.

Now this woman had not made a deliberate choice to pay a large amount instead of a smaller amount to count toward her deductible and clearly felt blindsided by the bill she received. However, I am guessing from my personal experience, that she probably had the blood drawn conveniently at the medical center where she saw her doctor and then analyzed by whatever lab is contracted by Tulane to perform that service.

Another issue here is that it usually all appears so convenient to have one’s blood drawn at the same location as the doctor’s office and patients can just show their card at the front so the insurance carrier is billed for all services. Of course, nobody at the medical center is going to tell patients they can get a better deal elsewhere.

I think that the mentality that one might as well apply all their medical care to their deductible is prevalent because most people assume that ALL health care services are expensive by nature. So why not? Surely they may end up getting their deductible paid off sooner or later in a year because every time they see a doctor or get a medical test, it is guaranteed to be expensive. I believe that is also the reason the Congressional Budget Office attempts to make people panic about repealing and replacing Obamacare – because all medical care is, by nature, expensive so everyone must be “covered.”

However, as the story I just related demonstrates, that is not necessarily true.

I think it’s time that we all become true health care consumers and not blithely stick out our arm or head to a large medical center’s radiology department when we get test orders from the doctor we just saw there. Besides the option of Direct Primary Care in which many common lab tests are available with the cost of a monthly membership, we can look around if the physician we want to keep doesn’t happen to be a DPC doctor. When we have that lab test or x-ray order in our hot little hands, let’s change our mode of operation and ask ourselves, “Can I get this test less expensively somewhere else?”

Maybe we can, maybe we can’t, but why not ask the question?

Better pricing is often available if we shop around, and let’s certainly re-examine our attitudes about paying higher prices just to work toward a deductible. Who knows? If enough people made a habit of shopping around for procedures, the big bad health systems and their crony insurance partners just might think twice about their ridiculous charges and charge something more in line with reality.

I wouldn’t hold my breath on that one though.

Sources for further reading:

  1. http://www.nola.com/health/index.ssf/2017/05/blood_tests_new_orleans.html

 

Photo courtesy of canstockphoto.com


Where is Obamacare Repeal Going?

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There seems to be a temporary lull, as far as I have been hearing, regarding the progress of the American Health Care Act. This is mainly because a whole host of scandals are swirling around Washington, D.C. regarding a Russian connection to the Trump campaign, the firing of FBI Director Jim Comey, and one about whether President Donald Trump gave away some classified information to Russian officials during a meeting.

I think Senate Majority Leader Mitch McConnell is right in saying that less drama from the White House would help the Senate to concentrate on matters that affect the everyday lives of American people.

One of those issues would be health care in the United States and how to repair this very broken system that has become far too dependent on insurance coverage and government intervention. Although the talk in the media for the last week and a half has discussed the scandal du jour ad nauseam, it looks like there is a little bit of work regarding the nation’s health care policies going on in the background. Once again, it seems like some kind of “deadline” looms that is making Senate Republicans think that they may have to do something before June 21.

Why?

According to an article in the online publication Axios (1), this is the date by which insurers have to make a final decision regarding whether or not they will sell insurance  for 2018 on the federal Obamacare exchanges. I am not sure if the states with their own exchanges have alternate deadlines.

So, if the Senate can ignore the White House drama and plug away at the American Health Care Act that is now before it, they have a tough choice to make because they are faced with either passing a short-term stabilization bill of some kind to make sure that there actually insurers on most of the exchanges or try to work on the larger package of health care reform in a way that it could be passed and signed into law in time for that deadline. With all the deep division between the two major parties, as well as between different positions within the Republican party, I am not placing any bets on passing a larger package of sensible free market reforms that could be signed into law by the president in time for the June 21 decision crunch.

So what’s the Senate to do?

According to the Axios article, the Senate has the following options to consider:

  • Go ahead and fund the subsidies so the few remaining exchange insurers would know what they are dealing with in 2018 and would remain on the exchanges, at least for the coming year. (Hopefully such an action would only be considered temporary to provide a “bridge,” so to speak, as the Senate gives more in-depth consideration concerning the best way to repeal and replace Obamacare.)
  • Pass a bill by Senators Lamar Alexander and Bob Corker that would allow people to use premium subsidies to buy health care insurance not offered on the exchanges, which looks like it would only be available in areas where there are no insurance companies on the exchanges. (Once again, I hope this would only be a band-aid solution while the Senate mulls over the best way forward for a free market in health care.)
  • They could always just take their time to put out a bill, regardless of insurance decision deadlines, that allows a free market in health care that can really make health care and insurance affordable for the average person. (There is a great risk of widespread chaos in this scenario, but then maybe it is time for many people to have the government pacifier yanked out of their mouths; they may cry a lot for a while, but then those who know better could direct the ones being broken of their dependency into health care options that are so much better than what we have now.)
  • There may also be another option because Axios also reported that Senator Claire McCaskill has indicated she is planning to introduce a bill as well, but has not revealed anything about it.

Maybe I was at least partially wrong in one of my earlier blogs, when I said Congress needs to take their time to get health care reform right. On the other hand, the Senate cannot slap something together that can get passed and claim they have done the job for the American people. When that happens, I fear that people will just get used to the “new normal” and expect to always be able to buy insurance whenever and wherever they want with a subsidy from the government, which could be just as destructive as Obamacare.

The Senate prospects also look difficult because Republicans only have a narrow majority, so there will be very intense division in trying to repeal a law that Democrats doggedly defend.

For my part, I am going to try my best to communicate with my Utah senators, as well as other key senators, to impress upon them the necessity of getting health care reform right, and familiarizing them with some free market innovations they may not know about that can drive down health care costs without the involvement of insurance.

Source:

  1. https://www.axios.com/senate-grapples-with-looming-health-care-deadline-2411779537.html

Photo Attribution:

<a rel=”license” href=”http://creativecommons.org/licenses/by-sa/4.0/”><img alt=”Creative Commons License” style=”border-width:0″ src=”https://i.creativecommons.org/l/by-sa/4.0/88×31.png” /></a><br />This work is licensed under a <a rel=”license” href=”http://creativecommons.org/licenses/by-sa/4.0/”>Creative Commons Attribution-ShareAlike 4.0 International License</a>.

 


Almost Everybody is Missing the Point

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Every day the American Health Care Act is discussed in the media, most of the dialogue I hear is about how many people will lose their “coverage” or have their “health care” literally ripped away from them if the AHCA is successfully passed by both houses of Congress and signed into law by President Donald Trump. That’s quite a picture!

Such discussion only hammers home one major truth to me – most people have become so accustomed to having the availability of health care defined as whether or nor we have insurance coverage with supposedly convenient copays. It seems that the conventional “wisdom,” if you could all it that, is those without health insurance coverage do not have health care.  After all, health care itself is WAY to expensive to pay for it ourselves. Right?

This impression becomes further entrenched when patients inquiring about what a medical or surgical procedure might cost them generally get a non-answer like, “Well that depends on your insurance plan.”  Let’s say that I am either unfortunate, or fortunate, enough not to have health insurance in the current environment of narrow networks and “non-profit health care” systems that are raking up huge surpluses (i.e. profits). What if I first tell someone at a typical hospital I am not covered by any insurance and then ask how much a procedure will cost? It’s a toss-up as to whether they will quote me the “Chargemaster” price (think grossly inflated) or whether they will say, “We have discounts for our cash-paying patients.” (Fat chance of that.) I am betting that they would quote me the grossly inflated price first. Then, when I balk in horror, and ask if I can get a discount for paying cash, they will quote me something much more doable.

I just saw (and actually retweeted) a tweet this week that was actually a short snipped of the movie, “The Matrix,” a movie I have generally said I did not like (amid gasps of horror from my husband and son). I am thinking I may have to give that movie another chance. But I digress. In this little snippet, Laurence Fishburne’s character (Morpheus) says, “You have to understand that most of these people are not ready to be unplugged, and many of them are so inured, so hopelessly dependent on the system, that they will fight to protect it.”

That is what I see happening as the efforts to repeal and replace Obamacare go forward … people protesting in the streets, pleading to keep their “health care” in town hall meetings, and Democrat representatives and senators howling about mostly “guestimates” from the Congressional Budget Office that as many as 24 million people (a very suspect statistic) could lose health “coverage.”

What if basic health care was so inexpensive for the average person that the only occasion for which the average person would need insurance coverage would be situations like a cancer or other horrible diagnosis or accident? Yes, those things can happen to anyone at anytime, and it is nice to feel that we could have some protection from the curve balls of life that we cannot control.

However, there is so much routine care that should not even require insurance to pay for it – the annual check up, a cold or flu visit, even diabetes management – the issues for which we usually see a primary care practitioner.

There is a type of medical practice that is continuing to gain popularity as primary care doctors get burned out and tired of the same old song and dance from Medicare, Medicaid, and commercial insurance. Many primary care physicians are ditching third party payers entirely and establishing Direct Primary Care practices. These practices are third-party free, which means they do not bill or accept payment from Medicare, Medicaid, or commercial insurers. Instead, they have very reasonable pricing for the services they offer, well below the standard Obamacare premiums and deductibles. Most of them offer a wide array of services for a low monthly membership.

For example, one doctor that I am interviewing for an article I am working on now has monthly service fees of $55 for adults 19-69 years of age, $35 per child 18 years of age and younger, and $75 for seniors aged 70 years and older. Additionally, families of four (2 parents and two dependent children 25 years of age or younger) can have a monthly membership for $130.

What do patients get for this pricing?

  • Communications (phone, text, emails) with doctor and nurse.
  • Clinic visits (regular hours) when necessary
  • Yearly wellness and prevention planning
  • Some routine labs and tests
  • Medical equipment lease (crutches, etc.)
  • Annual flu shot
  • Access to discounted wholesale pricing on other services (labs, medications, procedures, etc.)

Another DPC practice has prices in the same range, more or less – $50/month for adults 20-45 years old; $10/month for each child with at least one parent as a member; $75/month for adults 45-64 years of age; and $100/month for seniors aged 65 years and older. Benefits in terms of access to care are somewhat similar, especially in terms of free office visits, after-hours communications with the doctor, wholesale medication and lab costs.

One person on a Twitter feed I frequent reported that their family premium is $1,600 per month with an annual deductible of $8,000. That family most likely has copays or coinsurance in addition to the frightfully high premium, so it is easy to see that access is much less expensive and available in a DPC practice.

So while many people fuss and whine about “losing their health care” and the Democrats go practically apoplectic over the AHCA, the real solution to health care access and costs is sitting right under our noses.

I would like everyone who reads this post to contact their senator (since that is where the bill is now) and tell them that the AHCA needs to be at least changed to allow free market access and cost solutions like Direct Primary Care. Please educate yourselves about Direct Primary Care, and other free market medical care solutions like ambulatory surgery centers with transparent pricing, because they can solve so many of our nation’s health care problems.

Photo Attribution:

<a rel=”license” href=”http://creativecommons.org/licenses/by-sa/4.0/”><img alt=”Creative Commons License” style=”border-width:0″ src=”https://i.creativecommons.org/l/by-sa/4.0/88×31.png” /></a><br />This work is licensed under a <a rel=”license” href=”http://creativecommons.org/licenses/by-sa/4.0/”>Creative Commons Attribution-ShareAlike 4.0 International License</a>.

 


It’s Half-Done Anyway, but Hopefully Not Half-Baked

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Close up of female African American doctor holding patient’s hand

For those who have been struggling under the intolerable burdens of the Patient Protection and Affordable Care Act of 2010 (affectionately or less affectionately known as Obamacare), this has been an encouraging day. Why? The United States House of Representatives passed the newest version of the American Health Care Act with the purpose of repealing and replacing Obamacare.

This is definitely a hurdle jumped, especially since the House was not able to pass the original version of the AHCA. Apparently there were too many problems with it in the eyes of the House Freedom caucus, the more conservative wing of the Republican party. So some celebration is in order. However, this bill still has a tough road ahead as it makes its way through the Senate.

I really was not sure what would happen. I honestly was concerned that the Republicans would blow their chance to get rid of what I consider a law that’s hated by many people and only lauded by a few. Even the Democrats talked about “improving” Obamacare, although ironically their solution would be to make our health care system worse because it would involve even more strong-arm government control.

I learned, through the last episode in March, not to try to go through an entire bill and try to explain it while trying to translate governmentese without a translator. However, I am well aware of one of the most difficult sticking points in the bill – the issue of how our nation addresses the problem of pre-existing conditions.

Pre-existing conditions are a tough issue because I personally believe that the vast majority of Americans, myself included, want everyone to have access to medical care, whether they are already sick or not. However, some Economics 101 comes into play here. How do we take care of those of us who are less fortunate while allowing much more freedom of choice to the healthier members of our society and not forcing them to pay for someone else’s health problems unless they personally choose to do that?

When Obamacare became the law of the land, guaranteed issue became mandatory that, in effect, required insurance companies to cover citizens whether or not they had pre-existing conditions. Then the “community rating” scheme required that insurance companies not charge those with pre-existing conditions any higher premiums than any one else. As a result, everyone paid the high costs of covering people who already had some kind of illness. This caused premiums to continue soaring year after year after the implementation of Obamacare because insurance companies continued to lose money covering very sick people.

The money lost by insurance companies has continued to grow to such levels that over the last couple of years, several big insurers have withdrawn from the Obamacare exchanges where people needing to buy insurance in the individual market have had fewer and fewer choices.

As the House Republicans celebrated their victory in passing the controversial bill in the White House Rose Garden, Representative Paul Ryan said that it is very important that the AHCA not only pass the House but pass the Senate as well.

“The problems facing American families are real, and the problems facing American families as a result of Obamacare are just too dire and too urgent,” Ryan said. “Just this week we learned of another state, Iowa, where the last remaining health care plan is pulling out of 94 of their 99 counties, leaving most of their citizens with no plans on the Obamacare market at all.  What kind of protection is Obamacare if there are no plans to choose from?”(1)

House Majority Leader Kevin McCarthy also made the point that it is difficult to care for people with pre-existing conditions when there is no care at all. Now the point he was making was that there were areas where there would be no chance for people with pre-existing conditions to have their care covered by insurance plans if there were no insurance plans. Of course, while his point is valid that one cannot get their pre-existing conditions covered by insurance if there are simply no insurance plans to cover them, I would like to point out that it doesn’t mean these people could not actually get care. The question is how would that care get paid for? This is a question for another day.

Although I certainly appreciate the sentiment that insurance coverage for people who are already sick would be very helpful, there are other ways – free market ways – for these people to receive excellent care at a low cost. It’s called Direct Primary Care, which I will discuss at length in my next post.

 


Let’s Restore Common Sense to Medical Care Charges!

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As I was doing my usual scoping of Twitter posts the other day, and I came across one person I follow on Twitter (@StikNtheMud) whose Twitter feed has generally been dedicated to people expressing their disdain for their Obamacare insurance policies. I had actually not been on her Twitter feed for some time, so I figured it was high time to hang out there awhile.

There I found a veritable bevy of comments about the ravages of Obamacare on the average person. Here are a couple of quotes from commenters on this Twitter feed. The names have been withheld to protect the innocent victims of Obamacare.

  • “I don’t want Obama Care. It sucks for me. I lost my doctors, the cost for health care with it is so high. I don’t even go to the doctor anymore.”
  • “In Anchorage, premiums for a silver ACA (Affordable Care Act) plan for a 64-year-old couple making $82K a year =  $50,930 a year. That’s not a misprint.”

Believe me, these are only a couple of the many, many posts decrying the miseries of Obamacare.

So once again, I am beating the drum about so called “coverage” not equaling access to health care.

Wasn’t Obamacare enacted to make health care more affordable?

In the first post mentioned, the person wrote that health care costs are so high that she doesn’t even see a doctor now. Also, in looking closely at the second comment, this 64-year-old couple’s insurance premiums cost more than half their annual income. Clearly, with this annual income, this couple did not qualify for any premium subsidies, and they most likely have a deductible and co-insurance to pay in addition to that annual premium. A mortgage should not even be that much of a percentage of one’s income, much less health care costs.

The ultimate irony here is the name of the law that was supposed to bend down the cost curve for health care is the “Affordable Care Act.”

Posts like the ones above are a strong indication that our current health care environment remains generally Unaffordable, and has become even more Unaffordable each year since the implementation of Obamacare. I do understand that there are those who embraced Obamacare and its subsidies to reduce their premiums. However, if they have deductibles of $5,000 or more, how much use are those plans if they are not the kind of people who see the doctor more than once or twice each year?

Many people have been deceived into believing that if they are in a narrow Preferred Provider network, the contractual agreements between their health care providers and the insurance companies that “cover” them will result in less health care costs for them. NOT!

According to an editorial to which I often refer entitled, “Have PPO Networks Perpetrated the Greatest Heist in American History,” author Dave Chase (1) states that hospitals often charge 550 percent of the standard reimbursement by Medicare. Then the BUCA (Blue Cross Anthem, United Healthcare, Cigna, and Aetna) PPOs will discount such charges by about 50 percent. Well, a quick calculation reveals that 50 percent of 550 percent is 275 percent. Those are still very high charges, and I do not believe such charges actually reflect the cost of providing care.

I could not help but wonder why Medicare reimbursement is the benchmark for reasonable payments of medical costs because I often see complaints from doctors about how the low reimbursement rates by Medicare do not cover the costs of care. I do not think that a payment practice by insurers of reimbursing providers 275 percent of Medicare rates (regardless of whether those rates totally cover the cost of care) is reasonable either. Whatever happened to hospitals and other providers determining their costs (I’m sure they have some brains that can figure that out) and charging an amount with a reasonable profit margin over their costs?

In his editorial, Chase’s interviewee Mike Dendy makes the following statement: “A well-run hospital can make money from Medicare payment schedules. The problem is that most hospitals are not financially well managed and have no reason to be when they can pretty much charge for services at will.” So I guess that is the explanation for Chase using Medicare reimbursement as a benchmark for reasonable payment.

There are so many nonsensical factors that go into heath care pricing, mainly by the large health care systems that also try hard to eliminate the competition posed by independent doctors. These doctors generally have reasonable charges for their services,  but large health care systems (including “non-profit” ones) often either employ them or buy them out. My guess for the motivation of the “health care” systems is that they want to continue unfettered with their ridiculous prices for medical services. (Please see my Expert Posts category for more information on this one.)

So what use is “coverage” when all these ridiculous games are being played by “health care” systems and insurance companies? This has to be stopped!

Further reading:

  1. https://www.forbes.com/sites/davechase/2016/09/05/have-ppo-networks-perpetrated-the-greatest-heist-in-american-history/#2e8cfdfa3330

Image courtesy of canstockphoto.com


Expert Post by Dr. Niran Al-Agba

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I follow pediatrician Dr. Niran Al-Agba, pictured here, on Twitter (Twitter handle – MommyDoc, @silverdalepeds), and I also receive email notifications whenever she adds a new post to her blog. I believe that the post I am linking to here on my blog is VERY important for people (and our national leaders) to know because it explains one of several drivers of high costs for health care, so I decided to go ahead and do something that was already suggested to me for my blog – establish an “Expert Posts” category where I will post links to blog posts and articles I feel strongly moved to share outside of the customary source linking I do for my posts.

https://peds-mommydoc.blogspot.com/2017/04/youve-got-facility-fees.html?showComment=1492017458996#c6483269634879565256


Here We Go … Another Round of Numbers!

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I wrote a blog post more than a month ago about the way numbers can be manipulated by government, media, or anyone else who wants to get in on the act to promote a particular point of view, and nowhere has that been more evident than with the Patient Protection and Affordable Care Act of 2010, especially in the midst of efforts by the Republicans to repeal and replace the sputtering law.

In my previous post, I dealt with how many people had been touting the “success” of the ACA because it had supposedly provided insurance coverage for an additional 20 million people, which gave President Barack Obama’s administration the opportunity to pat themselves on the back. However, my post also pointed out that the coverage of  20 million more people was inaccurate, according to most counts, and in fact, no counts on people covered by the ACA reached the 20- million mark as far as I could see. Although one estimate by the Rand Corporation of the people “newly covered” by the law placed the original number at 22.8 million, but then had also calculated that approximately 5.9 million people had also lost their “coverage” as a result of the law. This brought the grand total of newly covered people under Obamacare to approximately 16.9 million, quite a bit under the touted 20 million.

Where is the logic here?

The newest twist in numbers totally mystifies me, but if you read its details it is not as dramatic as one would think.

As Congress and President Donald Trump unsuccessfully attempted to pass the American Health Care Act last month, the Congressional Budget Office, which is supposed to be non-partisan, released some interesting figures regarding the anticipated effects of repealing and replacing Obamacare.

An article entitled “The GOP’s Obamacare Replacement Is Going to Disproportionately Affect One Group,” by Lydia Ramsey and Andy Kiersz (1), reported that when the CBO released its report on the effects of the American Health Care Act, the agency estimated that “24 million more people could be uninsured.”

I had an immediate question – 24 million MORE than what? More than the number of people who remain uninsured despite of or because of Obamacare? The article simply does provide any details on that.

Then a CNN report entitled “CBO Report: 24 Million Fewer Insured by 2026 under GOP Health Care Bill.” by M.J. Lee and Tami Luhby (2), stated that there would be 24 million fewer insured people in the United States by the year 2026, which is less than nine years from now. This article also said that as many as 14 million fewer people could be insured by next year if Obamacare is repealed and replaced by the AHCA.

As I mentioned earlier, none of the counts for the number of people who were actually “covered” by insurance under Obamacare ever reached as many as 20 million, much less 24 million. Now this is only the fourth year that Obamacare has been in place, and maybe many more people would have enrolled in the years to come, but maybe NOT because several large insurance companies were pulling out of the exchanges as the result of large losses blamed on the ACA.

There are too many unknown factors to make any real predictions.

One crucial point in all these rather bizarre estimations sticks out in my mind. How can the CBO, or anyone else, accurately predict what may happen in both the individual and employer-sponsored insurance markets over the course of 9-10 years? There are just too many unknown factors. For instance there are several policy areas that could change drastically over that time period that would allow for people to get different insurance plans that fit their needs better.

Here are a few policies that, if enacted, might cause the loss of insurance coverage under our customary insurance models for the last 30 years or so, but may result in a much wider variety of insurance plans being offered, as well as more individualized methods of providing for health care needs such as larger amounts in Health Savings Accounts.

  • The formation of high risk pools in every state that enable the chronically ill to buy insurance for their needs at affordable rates.
  • Making tax credits that have only been available to employers available to all citizens so people can decide whether they want to buy insurance through their employer or buy an insurance policy more suitable to their own needs in the individual market – either way the tax advantages would be roughly the same.
  • The removal of all mandates to buy insurance, including the essential benefit mandates that only served to drive up the costs of premiums for many people because a number of benefits had to be covered. This flexibility could enable people to buy truly catastrophic plans that they feel would meet their needs.
  • Increasing the annual amount allowable, by tax law, to add to health savings accounts as well as not requiring that they be tied to a high-deductible insurance plan.
  • Removing the tax-exempt status of most “non-profit” hospitals. This is one that I have not read or heard about anyone proposing yet, but it would go a long way in making health care providers (especially hospitals) actually have to compete for patients by lowering costs and improving the quality of care with real quality measures rather than useless government-mandated measures.

So while many people wave various and assorted numbers around to catastrophize anything our current national leadership does to restore a functioning health/medical care system, there are opportunities for people to come out of the whole mess with a much better deal than they have now, especially with the continued proliferation of innovative free market practice models designed to lower overall health costs.

Further reading:

  1. http://www.businessinsider.com/cbo-chart-on-how-healthcare-costs-could-change-under-ahca-2017-3
  2. http://www.cnn.com/2017/03/13/politics/cbo-report-health-care/

Perspective From Those in the Trenches

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Introduction

As I have educated myself about a lot of the issues with health care delivery and payment in the course of my employment with Dr. Randy Delcore and my own blogging efforts, I owe a lot of what I have learned to connecting with doctors and health policy experts on several of the social media platforms. I feel that many of those blogs and articles I have come across in that process, especially those written by doctors who work in the trenches of our health care system daily, lend even more insight than I can provide from my perspective as an average non-medical citizen observing the many dysfunctions AND innovative models present in our current health care environment. I will use these “expert posts”  to provide links to those blogs and articles with the purpose of providing an even richer understanding of how to improve the U.S. system of health care delivery with that great American pioneer spirit.