The Hidden $700 Billion Debt Owed to Public Workers – Hit & Run : Reason.com

September 22, 2017

Connecticut, for example. Last year’s state budget (the current state budget is still being hammered out) projected $731 million to cover health care costs for retired state employees in 2017, compared to just $698 million for the health care costs of current employees.

Because Connecticut failed to save-up for the long-term costs of their retirees, state taxpayers are now paying more money to cover the costs of people who aren’t providing any government services—because they are retired—than for people who actually are.

Source: The Hidden $700 Billion Debt Owed to Public Workers – Hit & Run : Reason.com


Medicare-For-All Would Increase, Not Save, Administrative Costs

September 20, 2017

In a previous report, I found that Medicare’s administrative costs amounted to about $509 per primary beneficiary, and private plan administrative costs were about $453 per beneficiary. That means, in effect, that private health plans’ administrative costs were about 10 percent lower than Medicare’s. However, Medicare spends more on actual medical care (payments to hospitals, doctors, and other health care providers), so if you expressed administrative cost as a percentage of total costs (administrative plus medical), you’d get 6 percent for Medicare and 13 percent for private health plans – a result that is exactly backwards.

Source: Medicare-For-All Would Increase, Not Save, Administrative Costs


2017’s City Uninsured Rates | WalletHub®

September 15, 2017

The national uninsured rate is on an upward trend this year, following a record low of 8.6 percent in the first quarter of 2016, according to a survey conducted by the Centers for Disease Control and Prevention. But how widely do the rates differ from city to city?

With U.S. health-care reform still in limbo, WalletHub’s analysts measured the uninsured rates for 547 U.S. cities and broke them down even further by age, income level and race. In addition, we conducted the same analysis at the state level. Read on for the complete ranking, a ranking by city size and a full description of our methodology.

Source: 2017’s City Uninsured Rates | WalletHub®


Congress’ illegal and egregious Obamacare exemption, explained

September 12, 2017

Contrary to assurances and in violation of federal law, the Obama administration shielded lawmakers from an effective pay cut of up to $12,000 each by granting Congress several types of special treatment unavailable to the public. It deemed Congress eligible to participate in D.C.’s small-business exchange, though both federal and D.C. law prohibit it. That form of special treatment gave rise to another: It made Congress the only large employer in the country that can make tax-free contributions toward its employees’ exchange-plan premiums. The act of issuing those payments conflicts with other federal laws, and bestows yet another form of special treatment on Congress: Members of Congress and their staff are the only group of federal workers who receive FEHBP premium contributions for non-FEHBP coverage.

Source: Congress’ illegal and egregious Obamacare exemption, explained


What Does It Cost to Create a Cancer Drug? Less Than You’d Think – The New York Times

September 12, 2017

What does it really cost to bring a drug to market? For years, the standard figure has been supplied by researchers at the Tufts Center for the Study of Drug Development: $2.7 billion each, in 2017 dollars. Yet a new study looking at 10 cancer medications, among the most expensive of new drugs, has arrived at a much lower figure: a median cost of $757 million per drug. (Half cost less, and half more.)


States Lift More Hurdles To Physician Assistants

September 9, 2017

“In 2016, every state made at least one PA-positive change to their laws or regulations (and) this tidal wave of support is continuing in 2017,” Jenna Dorn CEO of the American Academy of PAs said of the myriad legislative and regulatory changes. “State and federal lawmakers recognize the value of the PA profession and understand that removing outdated PA practice barriers enhances patient access to care.”

Source: States Lift More Hurdles To Physician Assistants


Insurer Market Power Lowers Prices In Numerous Concentrated Provider Markets

September 7, 2017

Using prices of hospital admissions and visits to five types of physicians, we analyzed how provider and insurer market concentration—as measured by the Herfindahl-Hirschman Index (HHI)—interact and are correlated with prices. We found evidence that in the range of the Department of Justice’s and Federal Trade Commission’s definition of a moderately concentrated market (HHI of 1,500–2,500), insurers have the bargaining power to reduce provider prices in highly concentrated provider markets. In particular, hospital admission prices were 5 percent lower and cardiologist, radiologist, and hematologist/oncologist visit prices were 4 percent, 7 percent, and 19 percent lower, respectively, in markets with high provider concentration and insurer HHI above 2,000, compared to such markets with insurer HHI below 2,000. We did not find evidence that high insurer concentration reduced visit prices for primary care physicians or orthopedists, however. The policy dilemma that arises from our findings is that there are no insurer market mechanisms that will pass a portion of these price reductions on to consumers in the form of lower premiums. Large purchasers of health insurance such as state and federal governments, as well as the use of regulatory approaches, could provide a solution.

Source: Insurer Market Power Lowers Prices In Numerous Concentrated Provider Markets


Americans Support Price Shopping For Health Care, But Few Actually Seek Out Price Information | RAND

September 7, 2017

The growing awareness of the wide variation in health care prices, increased availability of price data, and increased patient cost sharing are expected to drive patients to shop for lower-cost medical services. We conducted a nationally representative survey of 2,996 nonelderly US adults who had received medical care in the previous twelve months to assess how frequently patients are price shopping for care and the barriers they face in doing so. Only 13 percent of respondents who had some out-of-pocket spending in their last health care encounter had sought information about their expected spending before receiving care, and just 3 percent had compared costs across providers before receiving care. The low rates of price shopping do not appear to be driven by opposition to the idea: The majority of respondents believed that price shopping for care is important and did not believe that higher-cost providers were of higher quality. Common barriers to shopping included difficulty obtaining price information and a desire not to disrupt existing provider relationships.

Source: Americans Support Price Shopping For Health Care, But Few Actually Seek Out Price Information | RAND


Politics, Hospital Behavior, and Health Care Spending

September 4, 2017

This paper examines the link between legislative politics, hospital behavior, and health care spending. When trying to pass sweeping legislation, congressional leaders can attract votes by adding targeted provisions that steer money toward the districts of reluctant legislators. This targeted spending provides tangible local benefits that legislators can highlight when fundraising or running for reelection. We study a provision – Section 508 – that was added to the 2003 Medicare Modernization Act (MMA). Section 508 created a pathway for hospitals to apply to get their Medicare payment rates increased. We find that hospitals represented by members of the House of Representatives who voted ‘Yea’ on the MMA were significantly more likely to receive a 508 waiver than hospitals represented by members who voted ‘Nay.’ Following the payment increase generated by the 508 program, recipient hospitals treated more patients, increased payroll, hired nurses, added new technology, raised CEO pay, and ultimately increased their spending by over $100 million annually. Section 508 recipient hospitals formed the Section 508 Hospital Coalition, which spent millions of dollars lobbying Congress to extend the program. After the vote on the MMA and before the vote to reauthorize the 508 program, members of Congress with a 508 hospital in their district received a 22% increase in total campaign contributions and a 65% increase in contributions from individuals working in the health care industry in the members’ home states. Our work demonstrates a pathway through which the link between politics and Medicare policy can dramatically affect US health spending.

Source: Politics, Hospital Behavior, and Health Care Spending


Blame Congress for high health-care costs

September 4, 2017

Hospitals in districts where a Republican congressman supported the Medicare Modernisation Act were five times more likely to receive a waiver than those in ones where a Republican lawmaker voted against. Those hospitals spent 25% more than they otherwise would have in the seven years after the law, according to the researchers. Between 2005 and 2010 the 29 hospitals that received the most lucrative waivers spent an average of $1.25bn more than if they had not received one.

Source: Blame Congress for high health-care costs