Monday, March 27, 2017

ACA/Obamacare: The Alternative Cash-only, No Insurance, Price-displaying Business Model of Health-Care

“How does Clinica Mi Pueblo offer these medial services at the “most affordable prices possible”? Here’s how: the clinic operates on a cash-only basis, with transparent prices that are listed both on the clinic’s website and on the wall at each clinic. Further, the clinic accepts no insurance, and it will not submit insurance claims on patients’ behalf. If patients have insurance, they can easily take the paperwork the clinic provides and file an insurance claim on their own. Reducing the costly, time-consuming mountain of paperwork associated with insurance, Medicare and Medicaid is one of the main reasons that cash-only medical clinics can keep their costs down and prices so low and affordable. That’s the same business model that keeps surgery costs so low/affordable at the Surgery Center of Oklahoma, the “free market-loving, price-displaying, state-of-the-art, AAAHC accredited, doctor owned, multi-specialty surgical facility in central OK” that has been featured on CD many times over the years.

So how does the cash-only, no insurance, price-displaying business model of the Clinica Mi Pueblo compare to medical coverage under Obamacare? Well, deductibles for individuals enrolled in the lowest-priced Obamacare health plans will average more than $6,000 in 2017, and families enrolled in bronze plans will have average deductibles of more than $12,000. Importantly, the deductible is the amount of money patients must personally pay out of pocket for health services before Obamacare insurance policies cover any medical costs. And what about the monthly Obamacare premiums? A 40-year-old unsubsidized bronze Obamacare plan patient will pay slightly more than $350 per month this year for their “health coverage” with a deductible of more than $6,000. And that’s supposed to somehow be “affordable” health care? In contrast, spending $350 per month out-of-pocket at Clinica Mi Pueblo, instead of going toward an Obamacare plan that provides almost no actual medical care, would actually purchase quite a lot of actual medical services.

Bottom Line: For routine medical care (annual physicals, flu shots, routine office visits, X-Rays, ultrasounds, MRIs, blood tests, etc.) most Americans, especially younger, healthier patients, would be much better off with a cash-only medical clinic like Clinica Mi Pueblo than with Obamacare, no? Under Obamacare, a 40-year-old American pays more than $4,200 per year in premiums. The out-of-pocket limit for an Obamacare plan is $7,150 this year but that doesn’t include the monthly premiums, so an individual could pay more than $11,000 out-of-pocket this year before his or her health plan would start to pay 100% of the costs of covered benefits. Only in some fantasy world of Big Government progressives and collectivists would that ever be considered an “affordable” health care system!” - An antidote for Obamacare: Cash only medicine with transparent pricing and no insurance — the future of medicine?, AEI, 03/26/2017

Link to the entire article appears below:

https://www.aei.org/publication/an-antidote-for-obamacare-cash-only-medicine-with-transparent-pricing-and-no-insurance-the-future-of-medicine/


 

Friday, March 3, 2017

ACA/Obamacare: Healthcare Supply-Side and The Story of Telemedicine v. The Angels of Mercy

“The goal of health care reform is to provide better health care to everyone at a lower cost, year after year. The solution is not to provide a better third-party-payer system — e.g., health insurance or government-provided health insurance — but instead to allow technological development and entrepreneurship to improve the current business model through groundbreaking innovations that empower consumers, improve quality and cut prices. We have seen it happen in many industries, such as transportation, room and board, and tech.

Of course, special interests benefiting from the old model do not appreciate being challenged. As a result, rather than make it easier for new models to thrive by ensuring that rules and regulations do not stifle innovation, politicians often choose to protect established industry players at the expense of consumers.”

“Some services strive to do something even more impactful by making health care more affordable and accessible, yet they are held back by outdated rules and hostile competing industries. Take, for example, telemedicine — the use of modern communications technology, such as videoconferencing and using smartphones, to facilitate patient care. It has the potential to help millions of Americans struggling to pay the skyrocketing costs of health care. But instead, some politicians are siding with their campaign contributors in the health care industry and not the constituents they supposedly are in office to serve.”

“The California State Board of Optometry used taxpayer dollars to engage in a public relations campaign against one telemedicine startup. Indiana enacted a law last year to prevent the use of online eye exams. Georgia and South Carolina have also enacted bans, and the Virginia Legislature just sent a bill to the governor's desk that would do the same.

All of this is done not to safeguard patients but to protect older and more expensive business models. This is highly unfortunate. Telemedicine not only can help reduce health care costs but also has the potential to greatly expand access to care — something politicians claim to care about. Yet many states nevertheless prevent doctors licensed in other states from offering telemedicine services to their residents. This makes it more difficult for poorer citizens living in medically underserved areas to achieve the same access to care that their wealthier neighbors can discover by traveling out of state.” - Cronyism Thwarts Telemedicine and Other Innovations, mercatus.org, 02/23/2017

Link to the entire article appears below:

https://www.mercatus.org/commentary/cronyism-thwarts-telemedicine-and-other-innovations


 

 

 


 


Saturday, February 25, 2017

ACA/Obamacare: So You Think ACA is Too Expensive to Maintain…Try Medicare on for Size

"The Trump Administration has promised to deliver to the American people a healthcare plan that is, in President Trump’s own words, “much less expensive and far better” than Obamacare. But While Obamacare is expected to spend over $900 billion from 2018 to 2027, focusing solely on the Obama administration’s signature achievement ignores bigger fiscal challenges; Namely, the Medicare program.

Our insurance program for the elderly and disabled – Medicare – is expected to cost $900 billion in 2024 alone. From 2018 to 2027, this comes to a whopping $8.5 trillion—an order of magnitude larger than the cost of the ACA. Beyond the topline price tag are a number of endangered programs.

Medicare’s hospital insurance trust fund, commonly known as Part A, is expected to run out of money in the next 10 years. This would mean an immediate reduction in benefits when the money runs out—2028, according to the program’s actuaries. Meanwhile, the funds that Medicare uses to pay for physician services (Part B) and prescription drug benefits (Part D) are consistently growing as a share of revenue". - Repeal & Replace: Missing the Medicare Forest for the Obamacare Trees, realclearhealth.com, 02/24/2017

Link to the entire article appears below:

http://www.realclearhealth.com/articles/2017/02/24/repeal__replace_missing_the_medicare_forest_for_the_obamacare_trees_110464.html?utm_source=RCP+Morning+Note&utm_campaign=8da8cfe47f-EMAIL_CAMPAIGN_2016_11_11&utm_medium=email&utm_term=0_a4db5f2336-8da8cfe47f-84790497

 


 


ACA/Obamacare: What Does a Replacement Plan for Obamacare Plan Look Like?

"We believe the American health care system is desperately in need of reform. The Affordable Care Act has failed to achieve its goal of affordable, universal coverage. Instead it has forced people, especially those in middle-income households, to choose from insurance plans with deductibles that are unreasonably high and provider networks that are too narrow to adequately help many afflicted with serious health problems.

The following proposals would vastly improve coverage by making health insurance affordable for all and by ensuring access to reliable medical care. They are incorporated in bicameral legislation introduced in the House and the Senate by Rep. Pete Sessions and Sen. Bill Cassidy and in the Patient Freedom Act, sponsored by Sen. Cassidy". - Replacing Obamacare and Insuring the Uninsured, The Independent Institute, 02/13/2017

Some highlights are:

(1) uniform tax credit for people buying their own health insurance coverage,

(2) tax credit can be used toward coverage in the individual market or the credit is transferable to an employer willing to purchase group health insurance for the individual,

(3) portability between individual and group health insurance coverage,

(4) integrate Medicaid and private insurance for seamless coverage,

(5) remove incentives for dumpling plans onto the individual market via “health status risk adjustments”,

(6) removal of mandate and the use of Medicare type penalty rates (higher premiums) for those not signing up for coverage when first eligible.

Note: At the link below one can download the “Executive Summary”.

http://www.independent.org/publications/article.asp?id=8994


Note (B): A more detailed discussion appears at this link:

http://www.independent.org/newsroom/article.asp?id=8979

ACA/Obamacare: Goodbye Humana, Hello Accelerating Death Spiral

“Health insurance company Humana announced Tuesday that it would leave the ObamaCare market in 2018. The insurer said it would offer plans through 2017, but that the market has not stabilized enough to participate next year. Humana said it was losing money from taking on too many sick people without enough healthy people to balance the pools. The decision came after Humana scaled back participation and raised premiums, among other changes. "All of these actions were taken with the expectation that the company’s Individual Commercial business would stabilize to the point where the company could continue to participate in the program," the company said in a statement. "However, based on its initial analysis of data associated with the company’s healthcare exchange membership following the 2017 open enrollment period, Humana is seeing further signs of an unbalanced risk pool." - Death Spiral: Humana Completely Abandoning Obamacare Marketplaces After 2017, townhall.com, 02/15/2017

Link to the entire article appears below:

https://townhall.com/tipsheet/guybenson/2017/02/15/death-spiral-humana-completely-abandoning-obamacare-marketplaces-after-2017-n2286358

Tuesday, January 31, 2017

ACA/Obamacare: A Scheme Consolidating Other Schemes

“Unwise public policies have allowed this market [ACA] to become a dumping ground for people who are older and sicker than average. The states were allowed to end their high-risk pools and send their enrollees to the exchanges. The federal government did the same thing with the (Obamacare) risk pool (the Pre-Existing Condition Insurance Plan). Cities and counties are ending their post-retirement health care programs (which are almost always unfunded) and sending people to the exchanges, where they pay premiums that are well below the cost of their care thanks to limited age rating. That includes, for example, 8,000 former employees of the city of Detroit.” - How We Can Repeal the ACA and Still Insure the Uninsured, Independent Institute, 01/20/2017

Link to the entire article appears below:

http://www.independent.org/newsroom/article.asp?id=8979