Medicaid spending will come under intense scrutiny in the next decade Continue reading →
The recent political debate over health insurance coverage does not take into account actually getting medical care. Continue reading →
Via The Washington Times –
The National Institutes of Health is dedicating $3 million to fast-track the development of drugs to treat marijuana addiction — an estimated 4.2 million Americans are hooked on cannabis — even as the president encourages its legalization and more states look to enact laws for its recreational use. Continue reading →
Walmart is now opening clinics to compete in the ever changing healthcare landscape. This from Marketwatch:
Wal-Mart Stores Inc. pushed down prices for some generic prescription drugs to just $4 eight years ago, setting a new industry standard. Now it is trying to do the same for seeing a doctor.
On Friday, a Walmart Care Clinic opened in Dalton, Ga., six months after Walmart U.S., the retailer’s biggest unit, entered the business of providing primary health care. It now operates a dozen clinics in rural Texas, South Carolina and Georgia and has increased its target for openings this year to 17.
Here is a list of pricing for services offered:
An office visit costs $40, which Walmart U.S. says is about half the industry standard, and just $4 for Walmart U.S. employees and family members with the company’s insurance. A pregnancy test costs just $3, and a cholesterol test $8. A typical retail clinic offers acute care only. But a Walmart Care Clinic also treats chronic conditions such as diabetes. (Walmart U.S. also leases space in its stores to 94 clinics owned by others that set their own pricing.)
Ran across this piece at Economic Policy Journal. Disturbing how bogged down our doctors will get in the future.
Dr. Mark Sklar writes:
The push to use electronic medical records has had more than financial costs. Although it is convenient to have patient records accessible on the Internet, the data processing involved has been extremely time consuming—a sentiment echoed by most of my colleagues. To save time, I was advised by a consultant to enter data into the electronic record during the office visit. When I tried this I found that typing in the data was disruptive to the patient visit. My eyes were focused on the keyboard and the lack of direct contact kept patients from opening up and discussing their medical and personal problems. I soon returned to my old method of dictating notes and pasting a print-out of the dictation into the electronic record.
Yet to avoid future financial penalties from Medicare, I must demonstrate “meaningful use” of the electronic record. This involves documenting that I covered a checklist of items during the office visit, so I spend 90 minutes each day entering mostly meaningless data. This is time better spent calling patients to answer questions or keeping updated with the medical literature…
To prevent physicians from prescribing more costly medications and tests on patients, insurers are increasingly requiring physicians to obtain pre-authorizations. This involves calling a telephone number, often being rerouted several times and then waiting on hold for a representative. The process is demeaning and can take 30-45 minutes…
To avoid Medicare penalties, I also must participate in the Physician Quality Reporting System program. Initially, this involved choosing three codes during the patient visit to reflect quality of care, such as blood pressure or blood-sugar control, and reporting them to Medicare. In 2015, the requirement will increase to nine codes.
Coming down the pike, but thankfully postponed from the October 2014 deadline, is something called ICD-10. This is a newer system that will contain about 70,000 medical diagnostic codes used for billing insurance. The present ICD-9 system has about 15,000 codes. The Physician Quality Reporting System and ICD-10 requirements are intended to benefit population research, but the effect is to turn physicians into adjuncts of the Census Bureau who spend time searching for codes—and to further decrease the amount of direct contact with patients.
The practice of medicine in the current environment is unsustainable. The multiple bureaucratic distractions in my day consume so much time that I have to give up what little personal time I have in the morning, evening and on weekends if I want to continue to provide excellent care during office hours.
Prescription drugs, new federal rules and insurer fees will help drive up healthcare premium costs related to Obamacare “Silver Plans” in Indiana by 16%. Bloomberg Business fills a rather short article with lots of good financial nuggets for readers to absorb. Bloomberg broke down the pricing.
How insurers set prices: Cost of claims, benefit changes, rising prices, risk pools, provider networks, geography, reinsurance, taxes and fees, profit and risk load.
With all that calculated, this is what they got for various states:
When Congress passed another healthcare plan designed to “help” the American people it had widespread implications. The bill has thousands of pages of not just law, but also regulations written after the bill was passed.
One of the programs within the bill for the HHS(Health & Human Services) agency to begin implementing right away was a “High Risk Pool” for people with already pre-existing conditions. I have been following this program for awhile now in the press. Here is the short version of what the program was created to do. Five Billion dollars was set aside to assist people with already pre-existing conditions until the full bill was implemented. Projections were to sign up anywhere from 350,000-500,000 people. Now the stats are out and should give many pause in seeing how costs of the total health care program will affect the United States government overall spending of this bill down the road.
Investors.com reported on April 10,2013:
ObamaCare funded the PCIP with $5 billion to cover patients with pre-existing conditions from 2010 to 2014. Less than a third of the people HHS projected would enroll in the plan actually signed up for the coverage. Yet despite the low enrollment, the plan is broke. In fact, it started running out of money at the beginning of this year, which means it busted its budget a full year ahead of projections. In a 2012 report, HHS conceded that it had miscalculated (though not until page 11 of its 15-page report): “On average, the PCIP program has experienced claims costs 2.5 times higher than anticipated.”
So what were the estimated numbers in 2010 for this one small program within the bigger healthcare plan? Here is a breakdown from the Heritage Foundation:
In 2010, the Obama Administration estimated that 375,000 people would enroll in the PCIP. But as of January 2013, over two-and-a-half years since the plan began, only 107,139 were enrolled—less than 29 percent of original projections.
Not only did costs skyrocket, but major changes to the program recipients as well:
In addition to suspending enrollment, CMS made major benefit adjustments in an effort to control program costs—mainly by increasing enrollee cost-sharing requirements. These changes included the consolidation of three plan options into one, increased co-insurance, and increased maximums for out-of-pocket costs (a 56 percent increase for in-network services and a 42 percent increase for out-of-network services).
This is not unexpected. History is filled with facts to teach us present day Americans about the fallacy of “Government Healthcare Programs” but we always choose the divine providence of “The Government” when it comes to social experiments. In the same article quoted above, they also had this historical data to show us the coming cost explosion from previous healthcare experiments:
In 1965, the Johnson administration figured Medicare would cost $12 billion by 1990. Its actual cost was $110 billion. Now it’s almost $600 billion and climbing.
Washingtontimes.com had these historical numbers on November 18,2009:
In 1965, the House Ways and Means Committee estimated that the hospital insurance program of Medicare – the federal health care program for the elderly and disabled – would cost $9 billion by 1990. The actual cost that year was $67 billion. In 1967, the House Ways and Means Committee said the entire Medicare program would cost $12 billion in 1990. The actual cost in 1990 was $98 billion.
Once 2014 kicks in which is full implementation of the law itself, we unfortunately will be on the side of waiting to see costs explode. Not only that aspect, but HHS will probably start changing rules once people have signed contracts for health insurance. Constantly changing rules is part of having “Centrally Planned” programs by the government.
Like I said, we unfortunately will have to wait and see.