Tuesday, January 28, 2014

Government Workers' Health Benefits Cost 40 Percent More Than Private Workers'

I recently gave critical treatment to an advocacy piece by an employers’ group, which promoted harmful, government-driven, solutions to price transparency in health care. This entry will argue that private employers are not entirely ineffective.

Private employers certainly do a better job than pubic-sector employers do of keeping health-benefits costs under control.

Read the entire column at The Independent Institute's Beacon blog or John Goodman's Health Policy Blog.

Friday, January 24, 2014

"I Felt Like A Hostage": Towards A Solution For Medical Price Transparency

I recently wrote an article critical of a business group's approach to improving transparency of prices for medical and hospital procedures.

However, we do have a serious problem when it comes to figuring out how much we owe for treatment. Many solutions have been tried, but none have quite worked.

Here is a new attempt to find a solution to the lack of medical price transparency.

Read the entire column at John Goodman's Health Policy Blog or The Independent Institute's Beacon Blog.

Thursday, January 23, 2014

If Obamacare Lost Your Personal Data, Would You Even Know?

David Kennedy is a cybersecurity expert who runs a computer security firm called TrustedSec, LLC. He is in the news because of his expert testimony to Congressional committees on the security of healthcare.gov, the website to which people go to apply for Obamacare health insurance if they are in a state with a federal health-insurance exchange.

Kennedy’s basic message is that there is no effective security of personal data that is submitted to healthcare.gov. He is a so-called “white-hat” hacker: Companies hire him to hack into their computers and then tell them how to fix the entry points he discovers. One can reasonably expect that he knows what he is talking about.

Read the entire column at the Independent Institute's Beacon blog or John Goodman's Health Policy Blog.

Tuesday, January 21, 2014

Will Republicans Repeal Obamacare's Risk Corridors?

This blog’s readers are better informed than most about the (somewhat complicated) question of how health insurers will be compensated for bearing risk in ObamaCare’s health insurance exchanges.

A previous entry explained the basics “risk corridors”, which exists only for three years, 2014 through 2016, and were put in the legislation because health insurers were not confident that they could accurately price premiums in Obamacare’s early years.

On January 9, Humana, a large insurer, reported in a filing to the Securities and Exchange Commission (SEC) that the “risk mix of members enrolling through the health insurance exchanges to be more adverse than previously expected.” Corporations cannot spin filings with the SEC: The CEO and CFO can go to jail if they mislead investors. So, they have to tell us more about what is going on in the exchanges than the Administration does.

Republican politicians believe that shutting down the risk corridors will force health plans to withdraw from exchanges in 2015, contributing to ObamaCare’s ignominious end.

Likely? Not according to Senator Marco Rubio and many other Republicans, who see discouraging health insurers from participating in ObamaCare’s exchanges as a good way to finally chip away important industry support for ObamaCare.

Read the entire article at John Goodman's Health Policy Blog or The Independent Institute's Beacon blog.

Friday, January 17, 2014

Price Transparency: What To Do And What Not To Do

While everyone outside the health sector agrees that more price transparency would be beneficial, others often propose solutions that increase government regulation. One example is a recent report written by the Pacific Business Group on Health (PBGH), a group of large employers in Northern California.

While the recommendations sound reasonable on their face, they invite more government intrusion in health care, with unintended consequences. Let’s examine the major proposals:

Read the entire column at the Independent Institute's Beacon blog or John Goodman's Health Policy Blog.

Least Exciting Research Result Ever: Medicaid Increases ER Use

Medicaid is a welfare program jointly funded by federal and state governments, which claims to provide health insurance to low income people. A few years ago, Oregon expanded Medicaid enrollment by lottery. This created an excellent environment to study the effects of being uninsured versus being enrolled in Medicaid, because it approximated a randomized-controlled trial — the gold standard of medical research, but seldom conducted in the social sciences.

The latest result of the study, published in Science, reported that Medicaid increased use of emergency rooms by 40 percent. This is not really news: It confirms results we have seen for at least forty years in different jurisdictions.

Read the entire column at John Goodman's Health Policy Blog or The Independent Institute's Beacon blog.

Wednesday, January 15, 2014

Contraceptives for Nuns? Government At Its Most Absurd

How absurd can a law be, to force nuns (who have taken vows of both poverty and celibacy) to explain to the state why they don’t want to pay for contraception? That requirement was too much for Supreme Court Associate Justice Sonia Sotomayor, who issued a temporary injunction against ObamaCare’s mandate that health plans must cover contraception.

Nevertheless, some of the law’s opponents are engaged in a disproportionate response to the contraceptive mandate.

Read the entire column at The Independent Institute's Beacon blog or John Goodman's Health Policy Blog.

Thursday, January 9, 2014

Hooray! The Medicare "Doc Fix" is Fixed Until March 31!

Once again, Congress pretends to have fixed the unfixable: The way Medicare pays doctors. An earlier blog entry describes how Medicare pays physicians by using a method that puts the old Soviet Gosplan to shame.

However, Congress is not able to correct this, because of the “cake and eat it too” approach of organized medicine’s lobbyists. They want effectively unlimited access to taxpayers’ money without political control.

Read the entire column at John Goodman's Health Policy Blog or the Independent Institute's Beacon blog.

Tuesday, January 7, 2014

Obamacare Has Narrow Networks. But Why Are There Any Networks At All?

According to recent research, about two-thirds of hospital networks on the Obamacare exchanges are “narrow” or “ultra-narrow”; This was defined by surveying 20 urban areas and identifying the 20 biggest hospitals in each area; An insurer with at least 15 hospitals in network have a “broad” network; those with 7 to 14 hospitals have a “narrow” network; and those with 6 or fewer hospitals have an “ultra-narrow” network.

But why do health insurers have networks at all?

Read the entire column at the Independent Institute's Beacon blog or John Goodman's Health Policy Blog.

Monday, January 6, 2014

Private Exchanges: Getting Ready For Individual Health Insurance To Be The Standard

The Holy Grail of free-market health reform is changing the tax code so that individuals can buy individual health insurance on the same tax-advantaged basis as they get employer-based health benefits.

How can we get there, in a world where everyone who promotes the idea will be accused of “taking away” citizens’ employer-based benefits? The ground is being prepared with a relatively recent innovation: Private health-benefit exchanges.

According to a recent survey sponsored by a coalition of employers’ groups, 45 percent of employers have or are considering using private exchanges to offer health benefits to their employees before 2018. A November survey by David Franklin of the independent equity research firm Blueshift reported similarly high interest in private exchanges.

Read the entire column at John Goodman's Health Policy Blog or The Independent Institute's Beacon blog.

Friday, January 3, 2014

Obamacare Will Not Stop Hospitals Overcharging the Uninsured

In two recent posts I discussed out-of-control prices for hospital services, especially emergency-room care. In the first, I argued that sky-high hospital prices are the result of government interference. In the second, I cheered the fact that consumer-driven health plans are inducing hospitals (ever so gradually) to be more upfront with patients (at least, those coming in for scheduled surgeries) about how much they will have to pay out of pocket, and agreeing on payment plans before admission.

Obamacare promises to come to the rescue of uninsured patients who are charged outrageous prices by hospitals. Statutory language purports to limit hospital charges to uninsured patients in the ER to “not more than the lowest amounts charged to individuals who have insurance covering such care.” Hospitals that fail to adhere to this policy risk losing their non-profit status. (The relevant text is on page 739 of the enrolled version of the bill here.)

Hospitals take threats to their non-profit status very seriously. So, since the Affordable Care Act was passed in 2010, you might expect that the overcharging of uninsured patients has long since stopped. You would be wrong. Like everything else in Obamacare, this has malfunctioned.

Read the entire article at The Independent Institute's Beacon blog or John Goodman's Health Policy Blog.

Medical-Device Connectivity to Grow 800 % in 7 Years

Transparency Market Research recently published a report anticipating a 38 percent compound annual growth rate in the market for medical-device connectivity through 2019, from $3.4 billion worldwide in 2012. If this comes to pass, it is good news, because it will cause health costs to drop and quality to increase.

Read the entire article at Forbes.com: The Apothecary.

Thursday, January 2, 2014

California's Consumer Hotline for Obamacare Will Not Fix Its Problems

Nationwide, many (including New York Times columnist Paul Krugman) seem to think that California got Obamacare right. Given the fiasco of the Obamacare launch in other states, that's a low bar. At least, the Covered California website works.

Nevertheless, the relative success of the California exchange cannot compensate for Obamacare's fundamental flaws.

Read my entire article at the Orange County Register.