Have you ever felt that going to see your physician or going to the hospital is like stepping onto an assembly line?
Well, the metaphor of being a car (or a hamburger) is a pretty accurate one. Two articles I read this week discuss how health care leaders have been turning to the big manufacturers—Toyota, for example—to increase efficiency, production and profits.
Kaiser Health News (KHN) puts a positive spin on this trend:
As public hospitals…try to cut costs and make patients happier, administrators have turned to an unlikely ally: Toyota. They are adapting the car maker’s production system to
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Two big health insurance mergers are in the works: Aetna plans to buy Humana for $33 billion, and Anthem will take over Cigna for a whopping $54.2 billion.
The number of major health insurers in the US will soon be three, down from five.
So much for more competition, huh?
What’s happening in the health care delivery system mirrors the insurance industry. The biggest health care corporations are furiously buying up smaller hospitals and physicians’ groups.
From their points of view, it makes sense: Each side believes being bigger will give them the upper hand in reimbursement negotiations (that is, … Continue reading
“Cover-your-ass health care” or “save-my-ass medicine” are terms used to describe all the extra diagnostic tests (blood tests, CT scans, MRIs, etc.) ordered by physicians to rule out possible (but unlikely) life-threatening conditions.
Such as going to the emergency department with a headache and getting a CT scan to rule out an aneurysm or a brain tumor.
Or, as in this video example, being worked up for a heart attack when the most likely diagnosis is a simple case of heartburn. (Warning: video contains some bad language!)
The ER physician in the video is certainly … Continue reading
Two recent stories from Kaiser Health News caught my attention because they underscore the burden placed on patients to understand exactly what services their health insurance does or doesn’t cover.
Of course everyone should know their health plan’s benefits, but with so many different types of plans, and the hair-pulling-out frustrations of narrow networks, it can be really difficult. Unfortunately, the financial consequences of making a mistake are heavier than ever.
The first story tells of a … Continue reading
This week the National Kidney Foundation (NKF) started a public health campaign called “Everybody Pees.”
The highlight is a short video featuring a catchy song and colorful South Park-esque kidneys peeing in all sorts of places—parks, swimming pools, on top of a car, etc.
OK, it’s cute, kind of. But here’s my problem with this video (other than the it’s a cartoon more appropriate for six-year-olds): a routine urinalysis is NOT recommended to screen for kidney disease.
But that’s what the song seems to tell us to do:
The smartest place to pee
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High drugs costs are one of the leading causes of higher health care costs overall. Not only are more people taking prescription drugs than ever before, the drugs are getting more and more expensive.
That’s why it’s so infuriating to read about drug companies using “devious” tactics to make sure their profitable blockbuster drugs can evade competition from the less expensive generics (although even many generic drugs are skyrocketing in price). And it’s equally gratifying to know that sometimes they don’t get away with it!
A few days ago the New York Times ran a good editorial on a … Continue reading
One of the premises of Obamacare was that if patients were expected to pay more towards their health care—have more “skin in the game”—they would shop around for the best prices and spend less.
I posted about how difficult, if not impossible, it is for patients to shop for health care. Prices are not as transparent as some policy makers would like to think.
Related post: Researching health care costs
A recent article in Kaiser Health News confirms this:
Douglas White knew high-deductible insurance is supposed to make patients feel the pain of medical prices and turn them
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Here we go again!
Every May, health insurance companies file their requests for premium increases for next year’s plans.
I’ve been watching my state’s website for the Office of the Insurance Commissioner. Rate increases for all health plans—group, small business, and individual (both on and off the health exchange)—are posted for public review and comment.
The insurance commissioner has until late summer to either approve, disapprove or modify the increase. Insurance companies are required to give their subscribers a 90-day notice of any premium increases.
My insurance company is asking for a 9.6% rate hike. Our family’s premium will go … Continue reading
More and more frequently I come across stories of patients who have inadvertently received care from “out-of-network” providers. And it can be a costly mistake.
When you are billed for the costs that your insurance company has denied, that’s called “balance billing.”
My insurance company doubles the deductible for out-of-network care; instead of $10,000, our deductible becomes $20,000. But insurance companies aren’t required by law to put a limit on a patient’s out-of-pocket spending when it comes to out-of-network care. In theory, you could get hit with tens of thousands of dollars in medical bills even though you have insurance.… Continue reading
Take time to read Elizabeth Rosenthal’s latest installment of her “Paying Till it Hurts” series in The New York Times: Insured, but not Covered.
If you are like many Americans struggling with high-deductible, narrow-network health plans, you might relate to the families she writes about.
The Affordable Care Act has ushered in an era of complex new health insurance products featuring legions of out-of-pocket coinsurance fees, high deductibles and narrow provider networks. Though commercial insurers had already begun to shift toward such policies, the health care law gave them added legitimacy and has vastly accelerated the trend, experts say.
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