Henry Stern of InsureBlog brings us an interview with the whistleblower who has brought a lawsuit against LabCorp for allegedly charging a lower price to United HealthCare than to Medicare. The post is particularly interesting because Hank adds his own thoughts after the interview, and he sees things a little differently than Andrew Baker (the whistleblower). Hank agrees that it does look like LabCorp lowered their fees for UHC […]
[…] She specifically addresses Medicare costs, but it stands to reason that the same cost-saving strategies and paradigm shifts will also help to lower healthcare costs that are being reimbursed by private health insurance carriers. Not only do private carriers tend to follow Medicare’s lead, but the focus on value over volume from a provider perspective will benefit everyone, as it’s unlikely to be applied only to Medicare patients.
[…] Chances are, if you have a claim on your home or auto policy, it will be because of a one-time incident like a fire or a car accident. That can be the case with a health claim too, of course, but many times a large claim on a health insurance policy can be the result of a chronic condition or one that will need extensive long-term treatment. A person might have health insurance at the start of the ordeal, but may lose coverage as time goes on […]
Welcome to Grand Rounds! It’s the third time we’ve hosted Grand Rounds at the Colorado Health Insurance Insider and we’re honored to be hosting again. It was a pleasure to read so many great articles for this edition. Since our blog tends to focus on health care policy and reform, I’m starting things off with the posts that pertain to that topic. Enjoy!
[…] One way or another, we need to seek solutions that will enable Medicare to pay the 10% shortfall that is currently predicted for a decade from now. That can be accomplished by cutting costs, increasing revenues, or both. But we don’t need to start from scratch and overhaul the entire system, especially with the improvements that the PPACA has already created.
[…] If the government can tell the health insurance carriers that no more than 15 – 20% of premium dollars can be spent on administrative expenses, including profits, why can’t similar guidelines be enacted for the pharmaceutical industry? Perhaps then we wouldn’t need to worry as much about who is going to pay the cost of prescription drugs for seniors. And maybe individual health insurance policies could start covering prescriptions with basic copays again.
[…] Over the last several years, most of the major health insurance carriers in Colorado have increased the out of pocket portion that an insured has to pay for prescriptions. Most individual policies now have prescription deductibles, and a lot of carriers have designated very expensive drugs as a separate tier that requires a percentage copay from the insured, rather than a flat amount. And of course, premiums continue to climb. The Makena story is an example of why this happens, and it has nothing to do with health insurance carrier profits. When insureds see their health insurance premiums skyrocket again, where do you think they will point their finger?
Health care costs are rising at a dizzying pace. For most Americans, this translates into increasing health insurance premiums, which are driven mostly by the cost of health care. Getting health care costs under control is a necessary step, and one that politicians generally say is important. But what is said and what is done are not always in line with each other. This outstanding article on Emergency Physicians Monthly is a perfect example of health care costs run amok. […]
[…] In Colorado, all policies have long been required to have a standardized plan description form (separate from the carrier-created marketing brochure), and House Bill 1166 passed earlier this year, requiring that all policy information be written at no more than a 10th grade reading level. But I think that most consumers tend to look at brochures, mailers, online advertising, and other marketing materials designed by each insurance carrier. […]
[…] Personally, I would be open to the idea of seeing a family practice doctor who doesn’t contract with health insurance carriers, and paying for routine care out of pocket, if there were some way to combine that with a discount on our health insurance premiums… If the DocTalker Family Medicine idea were to become more widespread and if insurers could account for this type of care when setting premiums, I can see it making a lot of sense for healthy families who want to use health insurance for large medical bills and budget for smaller bills themselves.
[…] Copays and deductibles have risen for most families over the last few years, even those who don’t have policies that qualify as high deductible. And at the same time, economic stability has decreased for most families. This isn’t a good combination, and Joe’s right about the fact that when people skip necessary routine medical care, it will likely lead to increased medical costs (and declining health) in the future.
Colorado is the only state in the US with an adult obesity rate below 20%, but we’re just barely below that threshold. And according to the Colorado Health Report Card, our rate of obesity is rising faster than the rate for the whole country. I came across a NY Times article about a program that has been implemented in Mass recently, and I would love to see Colorado do the same thing. Maybe we could see our obesity percentage start to fall instead of continuing it’s upward climb. […]
[…] The thought of 30 percent of adolescents being on medication for chronic conditions should make us all sit up and take notice. Hopefully it will fuel the cry for better school lunches and increased attention to prevention of obesity and mental health problems in kids. As a society, we simply cannot afford to continue to increase our utilization of prescription drugs.
[…] Maybe if doctors and patients were all aware of the fact that exercise is more beneficial in the long term than anti-depressants, we could start to cut down on the number of anti-depressant prescriptions being written. Lower utilization of pharmaceutical products would be helpful in terms of limiting the overall cost of medical claims and thus the price of health insurance as time goes on. […]
[…] MD Whistleblower had a couple good observations:
– Dentists prescribe prophylactic antibiotics (ATBs) with routine recklessness… Many dentists irrationally prescribe ATBs before teeth cleanings and other procedures.
– Not a syllable in the ~2000 page health care reform law that affects dentists.
[…] Ultimately, I’d like to see us reach a point where medication waste is virtually eliminated. Medication bottles that allow pills to be removed but not re-inserted, or a switch to only using blister packs for pills, could allow even partially used prescriptions to be returned to pharmacies for redistribution. And with the cost of prescriptions becoming more of a barrier between patients and needed treatment, the destruction of perfectly good unused medication seems like a travesty.
How To Cope With Pain brings us a truly amazing video. It’s a reminder to be thankful for all that we have, and for the things in life (like this video) that inspire us. It’s well worth the five minutes it takes to watch it.
Amy Tenderich of Diabetes Mine shares a “would you rather…?” moment from her 9-year old daughter. It’s a poignant reminder, seen through the eyes of a child, that all of the parts of our lives – even the bad parts – combine to make us who we are […]
Welcome to the Health Wonk Review. 2009 has been an exciting year for health care reform, and last Saturday’s passage of HR3962, the Affordable Health Care for America Act, has given us plenty to talk about. For anyone who hasn’t kept up on the details of the House reform bill, I want to start things off with a four-part series from Tim Jost, who holds the Robert L Willett Family Professorship of Law at the Washington and Lee University School of Law. His articles were published at Health Affairs Blog, and amount to an excellent primer, written in plain English, for people who want to understand HR3962, but don’t have time to read all 1990 pages […]
Pfizer was also illegally marketing Bextra, Lyrica, and Zyvox. They have settled for a record $2.3 billion, but Dr. Zhang points out that the sum is equal to three weeks of sales at Pfizer. Seems a bit paltry when you think about it. It’s like fining the average family a couple thousand dollars. Sure, it would sting a bit, but it wouldn’t really take that long to pay it off and forget about it. […]
Has anyone else noticed that the the term “health insurance reform” has started to be used in place of the term “health care reform”? Perhaps reform proponents are counting on the poor perception of the health insurance industry held by many Americans. By renaming the reform, perhaps they believe that more people will support it. […]
The Colorado House killed a bill today that would have required Colorado health insurance companies to cover oral chemotherapy pills. Diane Primavera (D-Broomfield), sponsored Senate Bill 250 in the House, and had support from patient advocate groups and the pharmaceutical industry. But the House Health and Human Services Committee voted 7 – 4 to kill the bill. […]
[…] Our system doesn’t reward doctors who spend time with their patients. Instead it rewards doctors who see the most patients in the least amount of time (writing a prescription for an antibiotic is a good way to move patients along). Expecting change to come from patients isn’t fair. But it’s also not fair to expect change to come from the medical profession as a whole until we make some changes to how doctors are reimbursed for the services they provide.
Diane Primavera, our local Colorado state representative from Broomfield, has proposed a bill that would prevent health insurance companies from canceling policies of insureds who choose to enroll in clinical trials of experimental treatments. We appreciate Primavera’s healthcare reform efforts for Colorado. […]
Louise and I were watching Saturday Night Live last night and the first commercial after one of the skits was for “Abilify”. A lot of times SNL has a parody commercial right after the skits before the real commercials. I was 100% sure this was a parody, obviously a joke name, a list of really… Read more about Abilify vs Havidol
Since health insurance is our niche, I tend to focus on health insurance related articles when I highlight entries for the Colorado Health Insurance Insider. But this week some posts that caught my eye had nothing to do with health insurance at all. I just liked them, and thought you might […]