Drugs costs might be higher for some
I was reading in the New York Times today about yet another delay of an Obamacare mandate.
This latest delay is regarding the new out-of-pocket(OOP) limits that insurers can charge consumers. In 2014, all plans are supposed to cap OOP costs, including the deductible, at $6,350 for an individual and $12,700 for a family.
Certain group health plans that carry separate policies for prescription drugs have been granted a one-year delay on these OOP caps (have they really not had enough time to make this work?). Such plans will have two separate… Continue reading
Obamacare kicks catastrophic plans to the curb
I read on Kaiser Health News this morning that when
ehealthinsurance.com began notifying people in non-grandfathered [catastrophic] plans that they would have to change policies next January, they got so many calls that they shut down the planned week-long email campaign after one day.
“The people that received the email were not happy at all,” says Carrie McLean, the website’s director of customer care.
Yes! I thought. That is my situation and I’m not happy, either.
Traditionally, insurance companies have offered catastrophic plans to individuals that are relatively healthy and use little health … Continue reading
As someone who advocates for less medical care, I’m always thrilled to see physicians and others in the health care industry step forward to protest over-testing, over-screening, over-diagnosing, over-treating and over-charging.
Here are some of my favorite health care blog posts and news articles from the last week.
Dr. Lamberts is embracing the newest trend in primary care: the direct-pay model. He does not accept health insurance, but rather charges a modest (age-based) monthly fee per patient. Booting the insurance companies not only lowers his overhead costs considerably, but frees him from so many … Continue reading
Shining a light on the physician-Big Pharma relationship
One of the little-known laws buried in the Affordable Care Act (ACA) is the Physician Payments Sunshine Act, which takes effect today.
I understand the impetus of this law, but I am less sure of its positive effect.
The Sunshine Act (the drafters no doubt had a mental image of exposing something slimy to the light) seeks to illuminate the financial relationships between doctors/teaching hospitals and drug companies/medical device manufacturers.
Conflicts of interest and questionable ethics have been problems for years as public funding has decreased and private industry money has … Continue reading
Physicians have a role in lowering health care costs
The Mayo Clinic has been busy this month.
Last week researchers published a report in the Journal of the American Medical Association (JAMA) titled “Views of US Physicians About Controlling Health Care Costs.”
Also last week, Mayo Clinic Proceedings published its conclusion that nearly 40% of current medical practices are of no net benefit and needlessly contribute to high health care costs.
The first study surveyed physicians’ attitudes about their role in reducing health care costs. Do they believe they can and should help rein in the cost of health … Continue reading
Dental health is important, isn’t it?
Starting in 2014, the Affordable Care Act (ACA) mandates that all insurance plans cover “essential health benefits,” including vision and dental benefits for children.
Obviously pediatric eye and dental health are important to the crafters of the ACA; but what about adults? We have eyes and teeth, too!
Even though many preventive services, such as annual exams, mammograms, and even breast pumps are covered, routine eye and dental exams are not.
I posted a few months ago that I thought it a shame that preventive vision care had received so little support in health … Continue reading
How much does good health cost? Apparently less than we are spending…
Once again, a study has shown that although Americans far outspend other countries on health care, our health is poor in comparison.
The healthiest citizens, no surprise, are in the wealthier cities and states, and vice versa. And it’s not because they can afford better health insurance. Other studies have linked education and income level to better lifestyle choices – diet and exercise – rather than access to health care.
In my opinion, we should be spending tax-payer dollars on all levels of education (Congress, what about … Continue reading
That’s a good question!
H. Gilbert Welch, MD, the author of Overdiagnosed: Making People Sick in the Pursuit of Health, wrote a recent op-ed in the New York Times in which he wonders at what point will the high costs—and profits—of medical care in America be considered “a crime”?
Medical care is intended to help people, not enrich providers. But the way prices are rising, it’s beginning to look less like help than like highway robbery. And the providers — hospitals, doctors, universities, pharmaceutical companies and device manufacturers — are the ones benefiting.
The crime of perverse incentives
Although … Continue reading
Baby boomers get another screening test
I was annoyed when the US Preventive Services Task Force (USPSTF) announced last week that baby boomers, those born between 1945 and 1965 (myself included), should be tested for the liver infection hepatitis C (HCV) regardless of risk factors.
I think my age group is already subjected to too many screening tests of questionable value.
Related reading: Check and check again
Just last November the USPSTF issued a statement that only people at an increased risk of HCV—mostly IV drug users and anyone who received a blood transfusion before 1992—should be tested. Anyone … Continue reading
Last week the American Medical Association voted to recognize obesity as a disease, as opposed to just a symptom of an unhealthy lifestyle or sluggish metabolism.
Obesity is a huge (no pun intended) problem in the US; over 60% of adults and 30% of children are considered overweight or obese. Proponents of the decision argue that accepting obesity as a disease will focus more attention on the problem and allow physicians and patients greater access to and reimbursement of weight loss counseling, drugs and surgeries. Sounds good, right?
So why does this decision trouble me? Three reasons come … Continue reading