Sunday, January 31, 2016
Media Attacking Single-Payer Are Getting Paid Under Current Health System — FAIR
Media Attacking Single-Payer Are Getting Paid Under Current Health System — FAIR
This is worth considering. I know I have seen a preponderance of anti-health care reform articles listed on news sites like MSN.com and YAHOO.com. Sometimes the numbers of such articles listed makes me feel like I'm watching all the drug ads during the 5:30 national news.
This is worth considering. I know I have seen a preponderance of anti-health care reform articles listed on news sites like MSN.com and YAHOO.com. Sometimes the numbers of such articles listed makes me feel like I'm watching all the drug ads during the 5:30 national news.
Saturday, January 30, 2016
FIXIT_COMPLETE FILM_01 on Vimeo
FIXIT_COMPLETE FILM_01 on Vimeo
Watch "Fix it" & Be Empowered!
Here's the link & a password, so you can enjoy this 54-minute documentary for free: https://vimeo.com/143233923
Password is: FIXIT
Employer Sponsored Insurance: Unfair and Unaffordable | THCB
Employer Sponsored Insurance: Unfair and Unaffordable | THCB
I don't agree with his suggestions for solutions but I do really appreciate his points, often forgotten or not mentioned, about the unfairness of employer based insurance. My cost should be based on my income (from all sources) and my coverage should NOT be based on what job I have.
I don't agree with his suggestions for solutions but I do really appreciate his points, often forgotten or not mentioned, about the unfairness of employer based insurance. My cost should be based on my income (from all sources) and my coverage should NOT be based on what job I have.
Does Medicaid pay enough for common surgeries? | Reuters
Does Medicaid pay enough for common surgeries? | Reuters
Providers would love to have a simpler, fairer, more uniform payment rates. Government is by far the biggest single payment source but they can't even get on the same page.
Providers would love to have a simpler, fairer, more uniform payment rates. Government is by far the biggest single payment source but they can't even get on the same page.
Friday, January 29, 2016
Thursday, January 28, 2016
Retirement Giant Fidelity Now Wants Workers' Health Insurance - Bloomberg Business
Retirement Giant Fidelity Now Wants Workers' Health Insurance - Bloomberg Business
Comment by Don McCanne
Although
a majority of Americans favor a national health program, many in the
policy and political communities express a preference for incrementally
building on the existing multi-payer system, as modified by the
Affordable Care Act (ACA). Although 64 percent of our heath system is
already funded through our taxes, our government gives control of much
of our total spending to the private sector, such as the private
insurance companies. Thus the private sector is the source of much of
the incremental changes that are taking place. Now that Fidelity
Investments is entering the scene, what incremental change are they
offering that will benefit patients?
a majority of Americans favor a national health program, many in the
policy and political communities express a preference for incrementally
building on the existing multi-payer system, as modified by the
Affordable Care Act (ACA). Although 64 percent of our heath system is
already funded through our taxes, our government gives control of much
of our total spending to the private sector, such as the private
insurance companies. Thus the private sector is the source of much of
the incremental changes that are taking place. Now that Fidelity
Investments is entering the scene, what incremental change are they
offering that will benefit patients?
* They
are introducing Fidelity Health Marketplace - similar to the government
insurance exchanges under ACA except that they are privately owned and
operated. Since they are targeted at small businesses, they are an
additional intermediary that increases administrative complexity and
expenses. That adds to the cost of the insurance, so that does not
benefit the patient.
are introducing Fidelity Health Marketplace - similar to the government
insurance exchanges under ACA except that they are privately owned and
operated. Since they are targeted at small businesses, they are an
additional intermediary that increases administrative complexity and
expenses. That adds to the cost of the insurance, so that does not
benefit the patient.
* The plans will be
purchased with a defined contribution from the employer. Because the
contribution is fixed, more of the premium costs are shifted to the
employee, especially over time. Either the employee must contribute more
to the premium, or choose a plan with fewer benefits, which then
increases financial exposure in the event of medical need. That does not
benefit the patient.
purchased with a defined contribution from the employer. Because the
contribution is fixed, more of the premium costs are shifted to the
employee, especially over time. Either the employee must contribute more
to the premium, or choose a plan with fewer benefits, which then
increases financial exposure in the event of medical need. That does not
benefit the patient.
* Fidelity already
offers health savings accounts - savings accounts that are linked with
high deductible health plans and can be used to pay the deductibles and
other cost sharing. Since high deductible plans have lower premiums
which are less likely to exceed the defined contribution, Fidelity will
no doubt heavily market the plans which are linked to their own health
savings accounts. Since employers would use the Fidelity Marketplace to
reduce their own health benefit spending, by offering a defined
contribution, it is likely that employees will have difficulties keeping
their health savings accounts funded. Higher deductibles linked to an
empty savings accounts certainly does not benefit the patient.
offers health savings accounts - savings accounts that are linked with
high deductible health plans and can be used to pay the deductibles and
other cost sharing. Since high deductible plans have lower premiums
which are less likely to exceed the defined contribution, Fidelity will
no doubt heavily market the plans which are linked to their own health
savings accounts. Since employers would use the Fidelity Marketplace to
reduce their own health benefit spending, by offering a defined
contribution, it is likely that employees will have difficulties keeping
their health savings accounts funded. Higher deductibles linked to an
empty savings accounts certainly does not benefit the patient.
*
If an employee or family member has an expensive chronic disorder then
a more comprehensive plan should be selected to mitigate the higher
costs. But with the smaller defined contribution, the portion of the
premium that the employee must pay is significantly greater, and often
unaffordable. That does not benefit the patient.
If an employee or family member has an expensive chronic disorder then
a more comprehensive plan should be selected to mitigate the higher
costs. But with the smaller defined contribution, the portion of the
premium that the employee must pay is significantly greater, and often
unaffordable. That does not benefit the patient.
Private
sector solutions in health care financing, including insurers and other
fiscal intermediaries, are designed primarily to benefit the industry,
usually at a cost to the patient, though often opaque and thus
deceptive. Public sector solutions, such as Medicare and Medicaid, are
designed to benefit the patient. But even there the private sector has
moved in with their private Medicare Advantage plans and their private
Medicaid managed care programs, to the detriment of patients and
taxpayers.
sector solutions in health care financing, including insurers and other
fiscal intermediaries, are designed primarily to benefit the industry,
usually at a cost to the patient, though often opaque and thus
deceptive. Public sector solutions, such as Medicare and Medicaid, are
designed to benefit the patient. But even there the private sector has
moved in with their private Medicare Advantage plans and their private
Medicaid managed care programs, to the detriment of patients and
taxpayers.
How much more of this private
incremental invasion of our already dysfunctional health care financing
system can we take? The next time you hear a politician say that we need
to build on the system we have through incremental steps, do not remain
silent. Say something. Yell, if necessary. Scream, if that’s what it
takes. But do not let them con us out of the national health program
that a clear majority of us want.
incremental invasion of our already dysfunctional health care financing
system can we take? The next time you hear a politician say that we need
to build on the system we have through incremental steps, do not remain
silent. Say something. Yell, if necessary. Scream, if that’s what it
takes. But do not let them con us out of the national health program
that a clear majority of us want.
Wednesday, January 27, 2016
Sunday, January 24, 2016
Saturday, January 23, 2016
Thursday, January 21, 2016
Wednesday, January 20, 2016
Tuesday, January 19, 2016
Sunday, January 17, 2016
The single-payer debate we should be having - Vox
The single-payer debate we should be having - Vox
Comment by Don McCanne
Matthew Yglesias tells us that “the overwhelming preponderance of the cost savings in a Medicare-for-all plan comes from the lower reimbursement rates,” thus “adopting a single-payer structure is neither necessary nor sufficient to achieve the gains.” He then criticizes single-payer proponents for not stating this publicly. What Matt does not seem to understand about PNHP is that we are meticulous with our facts, so we would never state something that is so misleading as to be untrue.
A well-designed single payer system includes multiple features that contain health care spending. The most important is the administrative efficiency. Under the Affordable Care Act, the private insurance industry is allowed to keep 15 to 20 percent of the premiums for administrative services and profits. The administrative costs for Medicare are about two percent, and that includes costs of other government programs that support Medicare. Adopting an improved Medicare for all would eliminate much of the excess administrative waste of the private insurers.
On the provider side, our highly inefficient multi-payer system also places a tremendous administrative burden on physicians, hospitals and other providers. In fact, administrative work consumes about one-sixth of U.S. physicians’ time (while eroding their morale, precipitating burnout). U.S. physician practices spend nearly four times as much money interacting with health plans and payers as do their Canadian counterparts.
Administrative costs consume about 31 percent of total U.S. health care spending. That is about twice that of Canada - 16.7 percent. Much of that difference is due to the financing systems - single payer in Canada and a dysfunctional multi-payer system in the U.S. - and thus most of that portion would be recoverable if we switched to single payer.
Yglesias says that we would have to reduce physician payments by 20 percent to achieve the spending goals of a single payer system. But when Canada changed to single payer, not only were physicians’ incomes not harmed, they remain among the top earners in the country.
There are several other policies of a single payer system that control spending. Hospitals are placed on global budgets - a process that works well as demonstrated by public services such as our fire departments. Excess capacity in the delivery system drives up spending, but that can be controlled by regional planning and capital budgets. The prices of pharmaceuticals and medical supplies can be negotiated just as the VA Health system already does so quite successfully. A single payer system incentivizes primary care which has been shown to spend health dollars more efficiently.
The United States and Canada followed the same trajectory in health care inflation until they adopted the Canada Health Act, providing a single payer system in each province. Since then health care inflation has been less in Canada than in the U.S. Likewise, adopting single payer in the U.S. would truly bend the cost curve, putting us on a more sustainable trajectory. Merely cutting prices 20 percent would continue us on a parallel inflationary trajectory.
Of course, there are some other advantages of single payer, besides the cost savings, which would not be achieved merely by cutting prices 20 percent - like truly universal coverage, free choice of physicians and hospitals, removal of financial barriers to care, and better access through capital planning.
We know what we know, but we don’t know what we don’t know. Although Hillary Clinton finds it politically expedient to leave out crucial facts in her critique of single payer, I would assume that Matt Yglesias, as a journalist of high integrity (and for whom I have great respect), would welcome a more thorough understanding of PNHP’s single payer model. We hope he reads this. The we can have that debate that we should be having.
Friday, January 15, 2016
Thursday, January 14, 2016
Tuesday, January 12, 2016
Monday, January 11, 2016
www.urban.org/sites/default/files/alfresco/publication-pdfs/2000559-How-Much-Do-Marketplace-and-Other-Nongroup-Enrollees-Spend-on-Health-Care-Relative-to-Their-Incomes.pdf
www.urban.org/sites/default/files/alfresco/publication-pdfs/2000559-How-Much-Do-Marketplace-and-Other-Nongroup-Enrollees-Spend-on-Health-Care-Relative-to-Their-Incomes.pdf
Comment by Don McCanne
This is just one
more study that shows that far too many individuals who need health care
still face excessive financial burdens in spite of being insured.
Instead of merely trying to tweak our dysfunctional system, we should go
ahead and replace it with one that works - a single payer national
health program.
more study that shows that far too many individuals who need health care
still face excessive financial burdens in spite of being insured.
Instead of merely trying to tweak our dysfunctional system, we should go
ahead and replace it with one that works - a single payer national
health program.
Congress’s $12 billion giveaway to health insurers | New York Post
Congress’s $12 billion giveaway to health insurers | New York Post
We need laws that outlaw, or greatly limit, what can be spent on lobbying.
We need laws that outlaw, or greatly limit, what can be spent on lobbying.
Obama administration's proposed insurance reforms incite industry backlash - Modern Healthcare Modern Healthcare business news, research, data and events
Obama administration's proposed insurance reforms incite industry backlash - Modern Healthcare Modern Healthcare business news, research, data and events
One simple statement shows people where the insurance companies stand -- they
do not like a requirement that "....all plan networks would have to
include hospitals and doctors within certain travel times or distances
from members."
One simple statement shows people where the insurance companies stand -- they
do not like a requirement that "....all plan networks would have to
include hospitals and doctors within certain travel times or distances
from members."
Sunday, January 10, 2016
Saturday, January 9, 2016
Plea for Help
Created with NationBuilder, software for leaders. |
Wednesday, January 6, 2016
Tuesday, January 5, 2016
'Critical illness' coverage grows as out-of-pocket health costs jump | Minnesota Public Radio News
'Critical illness' coverage grows as out-of-pocket health costs jump | Minnesota Public Radio News
I quit getting this kind of "extra" cancer coverage years ago when I started to think of it as a rip-off. I remember being bothered by the fact that my employer allowed only the one plan to bug me about buying their policy and having it on my payroll deduction like my normal health insurance.
I quit getting this kind of "extra" cancer coverage years ago when I started to think of it as a rip-off. I remember being bothered by the fact that my employer allowed only the one plan to bug me about buying their policy and having it on my payroll deduction like my normal health insurance.
Sunday, January 3, 2016
Readers Write (Jan. 3): Cabin tax, Affordable Care Act and MNsure - StarTribune.com
Readers Write (Jan. 3): Cabin tax, Affordable Care Act and MNsure - StarTribune.com
Interesting take on how MCOs are ripping us off.
12/31/15 Mpls. Trib.
Interesting take on how MCOs are ripping us off.
12/31/15 Mpls. Trib.
AFFORDABLE CARE ACT AND MNSURE
Commentaries failed to mention our managed care organizations
I was impressed with the two divergent views of the Affordable Care Act on Dec. 27 (“The ACA in action,” Opinion Exchange). One piece by Allison O’Toole extolling the virtues of MNsure (“Trending up: For MNsure, the lights have turned from red to green”) and the other by Stephen Parente (“Trending toward terrible: Expect higher bills, fewer covered”) prophesizing the collapse of the ACA. How could two knowledgeable people look at the same thing and come to such wildly different conclusions? The answer is found in the fact that both of them ignored the single most important issue impacting the future of American health care: the use of private managed care organizations to discharge what is now clearly a government program. Notice I didn’t say “insurance” companies. There is no insurance function in these transactions anymore. The government — state and federal — and self-insured employers pay for the cost of health care, and these managed care organizations act only as disbursement agents, spending other people’s money. This explains why prices keep going up. If you’re paying bills with someone else’s money and there is no oversight or audit, then it’s easy enough to inflate the actual costs and pocket the difference. This is exactly what these managed care organizations have been doing.
Don’t take my word for it. Look at the Segal report that the Dayton administration commissioned. In March 2013, Segal said that the trend methodology that relied solely on managed care organizations’ self-reported data produced “a systemic overstatement of the trend, causing the program to exceed targets over time.”
Still skeptical? Look at a federal case in Michigan in 2014 (Hi-Lex vs. Blue Cross of Michigan). In this case, the courts found that “regardless of the amount [the managed care organization] was required to pay a hospital for a given service, it reported a higher amount that was then paid by the self-insured client.” In other words, the managed care organization inflated its reported costs of health care in order to be paid more money.
We have created a system whereby third-party administrators benefit by inflating their reported costs of health care. The feds think that the state audits this, but the state does not because it regulates only the business of insurance — and this isn’t insurance. Thus, these managed care organizations are free to inflate and misrepresent costs. Furthermore, they are rewarded with subsidies and increased profits for doing so. And we passed a law requiring Americans to buy a useless, overpriced product from these managed care organizations or pay a fine to the IRS. High-deductible plans are useless and overpriced. They provide the illusion of insurance with no meaningful coverage. This explains why costs keep going up and why the ACA in its current structure and administration is unsustainable. Most people inside health care have some understanding of these issues, yet apparently choose to avoid discussing them, lest they offend those abusing the system.
David Feinwachs, St. Paul
The writer is a former lobbyist for the Minnesota Hospital Association.
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