Category: Health Care Access

Lifetime HSAs: The ‘Antisocial’ Health Reform that’s Good for You!

DocsMeanIn an ideal world, people would save for retirement, have an emergency fund and save for future health care needs. A mandatory payroll tax dedicated to your health care would be the ideal way to fund your future medical needs. Singapore has such a system, called MediSave accounts. Liberals consider personal accounts to be antisocial, since money in one account cannot be diverted to someone else’s medical needs. However, a dose of antisocial selfishness would benefit our health care system.

Liberals Want to Repeal & Replace Obamacare too… with Free Care

InsFormSmallI recently watched Senator Ted Cruz debate Bernie Sanders on the Future of the Affordable Care Act. Cruz was in top form, while Sanders was congenial but still deluded that we can all have free health care paid for with other peoples’ money. The audience was from all around the country and presumably stacked with invitees from both sides. The moderators would call on audience members to ask pointed questions to specific candidates.

Bernie Sanders’ Single-Payer Utopia

Back in October I wrote “Is Obamacare’s Failure Intentional, to Promote Medicaid-for-All?”  In it I discussed how Bernie Sanders famously advocated for single-payer socialized medicine during his campaign. In 2011, the Vermont legislature passed a bill to create a single-payer initiative known as Green Mountain Care. In 2014 it was abandoned by Vermont’s governor — a Democrat — as being too costly. Green Mountain Care was going to require an 11.5 percent payroll tax and an additional sliding-scale income tax that topped out at 9.5 percent. Despite the heavy tax burden, a single-payer system in Vermont was projected to run deficits by 2020.

Trump Disembowels Obamacare… Slowly and Painfully

InsFormSmallOn the day of his inauguration, President Trump took time out to issue an executive order directing his administration to drag its feet enforcing provisions of the Patient Protection and Affordable Care Act (ACA). Regulators were instructed to “waive, defer, grant exemptions from, or delay…” whenever possible to the “maximum extent of the law.” Many believe this move was intended to destabilize the ACA and hasten its demise without Republicans getting blamed.

FDA Backs Selling Hearing Aids Over the Counter

UntitledghgThe U.S. Food and Drug Administration (FDA) just announced it is taking steps to make hearing aids available over the counter. The FDA plans to immediately stop enforcing a requirement that patients must have a medical evaluation prior to obtaining a hearing aid. The Agency also hopes its move will stimulate a new category of OTC hearing aid products that cost less.  In this regard, hearing aids will function in a manner similar to reading glasses. The move was likely due to prodding by Senators Elizabeth Warren (D-MA) and Chuck Grassley (R-IA), who recently introduced legislation along these lines.

Widespread Government Failure In Health Care

UntitledThe Commonwealth Fund has published yet another survey comparing health care in the United States to health care in other countries. The title emphasizes US Adults Still Struggle With Access To And Affordability Of Health Care.

Really? As I’ve previously written, I agree fully with the Commonwealth Fund scholars that health care in the U.S. is inefficiently delivered and over bureaucratized. Nevertheless, suggesting U.S. health care is the worst overall is not consistent with the data.

The latest survey compares 11 developed democracies. The relationship between government control of health care and various measures of health status is not at all clear, despite other countries having so-called “universal” health systems.

When it comes to actual access to care, 35 percent of low-income Americans (with household incomes below one half the median income) had to wait six or more days to see a primary-care doctor or nurse the last time they needed care. However, so did 38 percent of low-income Germans and 32 percent of low-income Swedes.

Health, Wealth and Personal Responsibility

How much is Obamacare really worth? This is an important question as we approach the incoming Trump Administration. Should he backtrack on his campaign promise to repeal Obamacare on Day One? If Trump merely instructed his HHS Secretary to drop the appeal of House v Burwell most insurers would probably bail out of the market and it would collapse. If Congress uses a Budget Reconciliation process to repeal Obamacare provisions, such as the individual mandate, employer mandate, the Obamacare taxes and the subsidies, the health insurance exchange would probably collapse.

The Big Government Conspiracy to Protect Rich Guys

moneyI am not a proponent of conspiracy theories. That said: some conspiracies are real — and designed to protect the wealthy at everyone else’s expense. I’m referring, of course, to the conspiracy by the medical industrial complex to keep medicine costly. The conspiracy insulates the industry and its practitioners from competition using regulatory barriers and exclusive licensure cartels. At first glance these may all seem reasonable, but they extort one-fifth of our national income.

How Long Should You Have to Wait to See a Doctor?

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How long should you have to wait to see a doctor? Why not just call a doctor?

The patient in the photo was able to get a same-day appointment within 15 minutes of the request and was seen within 10 minutes after arriving. But that is an exception in the United States. A recent article in the American Journal of Managed Care estimated the average physician visit takes two hours (121 minutes). That includes travel time (37 minutes), waiting time (about an hour) and treatment time (10 to 20 minutes). Of course, that’s once you get an appointment.

Medicaid Expansion Also Expands ER Use

A new report in the New England Journal of Medicine found that Medicaid expansion in Oregon actually increased use of the emergency room (ER) by people newly covered by Medicaid. Policy experts had expected ER use to fall as people gained coverage and could have a usual source of care, such as a primary care physician.  Within the first 15 months after gaining coverage, ER use spiked by about 40%, and remained high for subsequent years. It did not appear the people using the emergency room were necessarily substituting ER visits for primary care physicians (PCP) visits. Rather, PCP visits and ER visits appeared to be complementary.

Mercatus senior research fellow Brian Blase covers the implications in much more detail at Forbes. Blase points out that the value of Medicaid benefits is less than the cost, enrollees are misusing their benefits (ER visits when primary care would suffice). ER overuse makes it harder for those truly in need of emergency care to be seen in a timely manner. It is also arguably why the cost of  Medicaid expansion is far above initial projections.