Special interest groups of various political ideologies are holding nothing back in their quest to shift the prime focus on the ‘08 election back to healthcare. In recent weeks, the tenor of both the Obama and McCain campaigns has taken to talk on reforming Big Oil with special emphasis on Iraq. Groups such as the newly formed left-tilting Health Care for America Now and the venerable AARP are spending a combined $60 million to get the word out about the one entity that seems to be driving healthcare in this country — the insurance companies. | LINK
This has all the makings of a classic sports brawl.
Two powerful health trade groups will begin airing dueling ads this week in their fight over Medicare, hoping to influence Congress as lawmakers face pressure to reverse scheduled cuts in doctor fees.
America’s Health Insurance Plans, a trade group of private insurers, is siding with Senate Republicans and the White House in their standoff with Democrats over a measure that would halt the cuts by trimming payments to private insurers. [..] On the other side, the American Medical Association said Tuesday it was airing new television and radio ads in six states through the week that targets a group of senators who blocked action on the proposed legislation. The bill passed the House but stalled in the Senate last week amid a veto threat by President Bush.
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Did you know that more than $200 billion is wasted every single year by health insurance companies in processing claims due to lack of efficiency? Well, you — just like everyone else who hasn’t lived under a rock for the majority of this decade — probably do, even though you may not be aware of the total costs involved.
The AMA, kicking off a PR campaign today, released its first-ever report on the state of healthcare claims processing by Medicare and seven of the nation’s largest private insurers. And the results obtained offer no real surprises, but (in their place) sobering facts.
An analysis of 3 million medical claims over a six-month period beginning in October also found that doctors in the U.S. spend 14% of the fees they receive from insurers and Medicare on the process of collecting those fees, the AMA said in a report issued at its annual meeting in Chicago.
[…]
The report, part of a campaign to reduce inefficiencies in claims payments, was the AMA’s first effort to quantify the red tape and hassle that have sent many physicians into cash-only “concierge” practices or early retirement.
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DTA (direct-to-consumer [drug] advertising) is under the microscope of the Food & Drug Administration. The government agency has already commissioned a two-year study of its effects on everything from physician prescribing patterns to healthcare consumers’ attitudes toward the spots. While good, consumer advocates acknowledge, the pace of the study isn’t fast enough. Many of these groups are urging for swift conclusions with appropriate follow up. The reason? Patients cannot afford to wait. | LINK
Although we haven’t hit the Democratic party’s end of the primary season, its certain nominee, Barack Obama, is already looking toward staking his claims on the designation and the general election in the fall.
This, of course, includes adopting certain positions; today, he has his sights on the Iraq war and its effects on returning veterans — specifically, those returning to our shores with the diagnosis of PTSD.
Obama has written a letter to the VA secretary asking for an investigation of the department’s knowledge of a Texas VA hospital’s treating psychologist’s email asking other treating staff to “refrain from giving a diagnosis of PTSD straight out”. The Bush administration says that it does not condone the practice of underdiagnosing posttraumatic stress disorder to save money.
The government pays out over $2500/month for those vets diagnosed with the disorder. | LINK
What happens to the doctor-patient relationship when its sanctity is tested? Just ask Arnold Schwarzenegger, or Hillary Clinton, or… a bunch of angry doctors. The Blues of California rescinded a plan which would have required physicians to report to the health insurer patients who might have omitted key information in their histories having to do with pre-existing conditions.
In a letter to physicians last week, Blue Cross asked the doctors to “identify members who have failed to disclose medical conditions on their applications that may be considered pre-existing.”
It went on to say that “Blue Cross has the right to cancel a member’s policy back to its effective date for failure to disclose material medical history.”
Is nothing sacred anymore? | LINK 1 | LINK 2
One thing’s for sure, spending on healthcare in this country–as a percentage of the GDP–is still headed north.
Medicare: Medicare spending in 2006 increased to $401.3 billion from $338 billion in 2005, and the prescription drug benefit accounted for $41 billion in Medicare spending in 2006 […], Medicare accounted for 18% of retail prescription drug spending, compared with 2% in 2005…
Direct Consumer Costs: Consumer out-of-pocket health care spending increased by 8% in 2006.
Care Arenas: Spending on hospital care in 2006 increased by 7% to $648 billion; spending on home health care in 2006 increased by 9.9% to $52.7 billion; spending on health care administrative costs in 2006 increased by 8.8%, in large part because of the launch of the Medicare prescription drug benefit.
Look for the drivers for the volume of care to continue to increase in 2008. While spending increases may benefit certain groups in the healthcare sector, such as seniors participating in Medicare D, the growth of healthcare volume in the U.S. is much too rapid to contain costs in the short term.
A local Minnesota glossy has been providing the type of transparency that, for some doctors, no amount of money can buy. Those doctors who benefit say they’re happy to be among the one of some 600 of Minnesota’s “Top Doctors”. Others say that methodology in determining the listing is suspect and amounts to no more than a popularity survey. (Never mind that a former list perennial was recently accused (and later acquitted) of serial patient sexual molestation by the patient’s mother.) I guess consumer acceptance comes down to a rather pithy response quoted in this article: “In the land of the blind, the one-eyed man is king.”
With any hope of Congress passing expansions to coverage for children (SCHIP) fading fast, the light also grew dimmer for California’s lawmakers hoping to make inroads into healthcare reform in that state.
With support by Arnold Schwarzenegger, the state’s largest HMOs and payers are set to receive major public dollars in the form of employer- and taxpayer-based subsidies to fund its version of universal insurance coverage.
Not surprisingly, advocacy groups are calling foul at what they see as a greenlight to future abuses by third parties, making healthcare access and affordability increasingly out of reach at taxpayer expense. Critics of Hillary Clinton’s healthcare proposals point out the possibility of similar scenarios; considering the scope of the economy in California, we may just find out how forced insurance coverage ultimately benefits major payers who hardly need the increase in their financial incentives.
The explosion of Medicare Advantage plans during the Bush Administration has sparked increasing interest in regulatory control. One of the areas of concern is in the implementation of so-called inclusive special needs plans–programs specially designed for vulnerable beneficiaries in an array of institutions.
The most vulnerable may include the elderly, the disabled, those in certain chronic medical disease management programs, or a combination of all three. Of course, insuring the soundness of individual programs is no small feat, and it represents just another layer of bureaucracy in the face of other concurrent Medicare legislative mini-crises. | LINK
Should we just throw our hands up? A healthcare policy fellow from Brookings laments the pie-in-the-sky attitude politicians (mostly Democrats, to be sure) take toward their efforts in laying out reform agendas. Citing a litany of past failures in the last century, the writer acknowledges the fervor of political leaders in their quest to make healthcare delivery work for everybody while noting the insistence of policy shapers that the U.S. remain economically competitive while doing so. A tough task, indeed, especially when so much of this country’s GDP goes to an industry whose ultimate quality parameters seem to stay elusive to so many who have a political or financial stake in it. Is comprehensive reform akin to running into a brick wall with nothing to show for it? | LINK
