Tag Archives: health care

Surprise Medical Billing

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The Wall Street Journal recounted one such example and a (partial, I say) solution in Benedic Ippolito’s (of the American Enterprise Institute) Tuesday op-ed.

The example was a man with a broken jaw who was transported, unconscious, to a hospital ER for treatment.  The hospital turned out to be in his medical insurance network, but the treating surgeon turned out not to be.  The latter’s bill was for $8,000, which the insurer refused to pay.  The man was unaware of that fee until after the treatment had been effected.

The solution described by Ippolito (one of three and the one favored by him; the other two were just price fixing in one form or another) is this:

[an] “in-network guarantee,” is a better solution. Hospitals would ensure that all providers treating insured patients are also considered in-network. Some already do this. Doctors at these facilities would have two options: come to an agreement with the insurer (as most already do) or receive payment directly from the hospital. This would eliminate the inflated surprise bills, reduce premiums and federal spending, and leave it to doctors, hospitals, and insurers to work out market prices.

While a good start, this option is incomplete.  All of those prices and fees need to be known to the patient and to the public at large beforehand.  Further, this needs to be the case for all the medical facilities in a region—hospitals, urgent care facilities, clinics.  Such prices and fees easily could be posted on each facility’s Web site, or on the facility’s entrance if it hasn’t joined the 20th century.

The patients and potential patients in the general public need to be in on the working out of market prices.

Medicare for All

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Senator and Progressive-Democratic Party Presidential candidate Bernie Sanders (I [sic], VT) has the canonical version of Medicare for All; the other Progressive-Democrat candidates have only slightly varied versions of it.  Here’s Sanders on his Next Big Idea for health care provision and health care coverage:

You will have a card which has Medicare on it, you’ll go to any doctor that you want, you’ll go to any hospital that you want.

Right.  Been there, done that.  Both claims were straight up lies then, too.  There is a major difference, though, between Sanders’ two lies and ex-President Barack Obama’s (D) two lies: Sanders would make private insurance illegal—both the selling and the possessing.  That, though, only potentiates the power of Sanders’ lies.

As The Wall Street Journal mentioned on the other side of the link,

The point of Medicare for All is to cut reimbursement rates to Medicare levels, which government can now set so low only because private commercial reimbursement rates are so much higher. Cutting reimbursement rates would “probably reduce the amount of care supplied and could also reduce the quality of care,” CBO says.

Not could—would.  Reducing availability cannot help but reduce quality, if only from denying it altogether to many who need it or would merely benefit from it.  But that’s not the only pathway: that reduction in availability will flow, at least in large part, from that reduction in reimbursement rates.  As a result of that, those doctors and hospitals whose talents and skills warrant higher pay will limit their practices to the bare minimum.

That’s not out of personal greed, either: costs of care delivery go up markedly as the number of patients go up.  Absent meeting costs with fees charged, these providers would have no choice but to limit their costs by limiting their services and the numbers of potential patients served.

There’s another cost path, too: the more complex or difficult, or even merely rare, a medical problem, the more expensive it is to provide services for dealing with it.  Capped reimbursements will limit the availability of that care. And—lower reimbursement rates again—lower the quality of those providers willing to provide the care.

Yet Another Veterans Administration Failure

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Here is another failure of the VA to take care of our veterans as they are charged to do, and as the VA’s motto promises they’ll do.  Here is another casual dishonor of that promise [emphasis added].

More than 1,000 Department of Veterans Affairs patients in Kansas didn’t get proper follow-up care after initial colonoscopies last year, a problem that was addressed only after a whistleblower repeatedly reported it, according to a government watchdog.
The watchdog found patients didn’t get follow-up screenings on time and when they did, often didn’t get the results in a timely manner because of [a string of excuses].

Here’s that motto which the VA has so routinely dishonored:

To care for him who shall have borne the battle and for his widow, and his orphan

After all this time, and with VA failure rate continuing unabated, it’s time to get off the dime and get rid of the VA altogether.  As I’ve said many times, commit this Failure Administration’s current and putative future budgets to vouchers for our veterans so they can get the care they need and want from the doctors they choose, the clinics they choose, the hospitals they choose.  It’s time to unshackle our veterans from the VA’s determined resistance to perform.

 

Veteranos Administratio delende est.

A Thought on Medicare for All

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University of Massachusetts-Amherst Economics Professor and Co-Director of the Political Economy Research Institute, Robert Pollin, had a thought on this.

Of course, so do I.

Pollin opened his tract with this:

All Americans would be able to get care from their chosen providers without having to pay premiums, deductibles or copayments.

No, we’ve already seen the lie in this. We experienced the broken, falsely presented promise with the sales job on Obamacare and the oft-repeated lie that if we liked our doctor, we could keep him and the associated lie of lower premiums.

Roughly 30 million people, 9% of the US population, are uninsured. Another 26%, 86 million people, are underinsured…

With millions of those Americans thrown off insurance plans they preferred because Obamacare made them illegal. This “economist” carefully elided that small fact.

We propose that all businesses that currently purchase health insurance for their employees be mandated to pay 92% of what they now spend into Medicare for All—saving 8% of their health-care expenditures.

Thereby throwing even more people off the plans they prefer.

This person also ignores another salient fact: the complete failure that is an existing single-payer plan, the VA.

And one more: even now, folks with surgical needs or prompt-but-expensive care needs or any other non-cookie cutter needs in other nations’ “free for all” health programs come here for those needs’ satisfaction rather than bear the interminable delays in getting that care in their nations’ programs.

Disruption

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And the widening gyre may be dissipating, finally.

Recall that a Federal judge in the 5th Appellate district ruled rump Obamacare unconstitutional because the tax imposed on not having health insurance was rescinded and the law had no severability clause—making the law itself an unconstitutional demand that private citizens buy something they did not want.

An outcome of this is feared by the NLMSM and Progressive-Democrats to be

particular disruption within the industry as no replacement system would be put in place.

It’s certainly true that there will be disruption—but no greater than the disruption from the imposition of Obamacare in the first place, which entailed the Federal government seizing control of the health care provision and health care coverage industries—a full sixth of our economy—and throwing millions of Americans off the health insurance plans they had and wanted to keep by making those plans illegal.

The disruption will be considerably less than the current plans of Progressive-Democratic Party Presidential candidates, whose aim is to make illegal all hints of private health insurance and to seize the rest of those two industries through “Medicare for all” plans, forcing Americans to participate in—and to pay for—yet more programs that they don’t want.

Indeed, both Obamacare and the current Progressive-Democrats’ plans have nothing to do with insurance, health or otherwise; they were and are nothing but Government mandated and privately funded—lately proposed taxpayer funded—welfare programs overlain like a new room on a settler’s prairie house on the existing ramshackle house of welfare programs.

The disruption will be short-lived, too.  The “no replacement system put in place” is only technically true: the Federal government isn’t mandating a particular system (whether by design or by Republican fecklessness).  The resulting newly unfettered health free market will very quickly fill that niche.  The freed-up industries will rapidly produce plans that fit the customers’ needs and wants for their personal health care and true health insurance plans.

The new insurance plans will be based off the plans extant prior to the Obamacare debacle, and then they’ll be tailored to current customer wishes rather than Government one-size-fits-all coverages.  No longer will Americans be required to pay for coverages they don’t need or don’t want, no longer will young and healthy Americans who don’t need or want coverage be required to pay for any sort of it, no longer will grown, adult human beings be treated like children barred from making their own risk-related decisions concerning their own health and the specific insurance coverages they want.