Health Care Policy and Reform Insights | NCPA

Category: Health Care Costs

Doesn’t Sound like the Cost Curve is Bending

Hospitals hoping to attract patients and build their brands are teaming up with medical-screening companies to promote tests aimed at consumers worried about potentially deadly heart disease or strokes. What their promotions don’t say is that an influential government panel recommends against using many of the tests on people without symptoms or risk factors…

Such screenings “not only can raise [health care] costs, but also can lead to additional testing that is harmful,” [Steven] Weinberger and two co-authors wrote in the Annals of Internal Medicine journal in August, calling hospital involvement without disclosing potential downsides “unethical.” (Julie Appleby/Kaiser Health News)

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May 15, 2013 | 12 comments | by John Goodman

Why the Job Market Looks So Bleak

I suspect this is happening all over the country. In response to the Affordable Care Act:

Many organizations, including Dallas ISD, are still reviewing how much their bills will be. But some are predicting costs in the millions. The city of Dallas expects a $2.1 million annual increase in health insurance costs by 2014.

Dallas County has estimated its annual tax bill will increase by $4 million by 2018.

The Dallas County Community College District has limited the workload of its adjunct professors to 7.5 credit hours per semester, equal to two full classes and one shared with another professor.

A spokeswoman said the change…will also bring the district’s 2,500 adjuncts under the 30-hour maximum.

The city of Plano, meanwhile, will cut the hours of most of its 60 to 70 employees who work 30 hours but aren’t offered insurance. Offering coverage to all of them would have cost about $1 million.

More at The Dallas Morning News.

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May 14, 2013 | 11 comments | by John Goodman

Kaiser’s Death Panel

A worrisome abdominal pain drove Jalal Afshar to seek treatment last year at healthcare giant Kaiser Permanente…Kaiser granted his request to see a specialist in Arkansas. But it ultimately declined to pay for his treatment there. By June, Afshar said, Kaiser was arranging for hospice care so that he could die at home. Afshar, 58, refused to accept that. Despite Kaiser’s stance, he went back to Arkansas for six months of stem-cell transplants, chemotherapy and other treatments that he says saved his life. Now he owes $2 million for his care and is suing the company in state court for breach of contract and unfair business practices.

Source: LA Times.

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May 13, 2013 | 17 comments | by John Goodman

What Hospitals Cost; What Insurers Pay

Comparing Two Hospitals in Miami, Florida:

Heart attack with four stents and major complications

Average cost	$166,174	$89,027
Average reimbursement	$27,397	$33,129

Intestine procedures with major complications

Average cost	$248,105	$185,927
Average reimbursement	$44,794	$73,455

Permanent pacemaker implant

Average cost	$127,038	$66,030
Average reimbursement	$20,836	$28,668

Source: The Washington Post.

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May 08, 2013 | 17 comments | by John Goodman

One Way to Rein In Health Costs

Days after they were badly hurt in a car accident, Jacinto Cruz and Jose Rodriguez-Saldana lay unconscious in an Iowa hospital while the American health care system weighed what to do with the two immigrants from Mexico…neither had legal permission to live in the U.S., nor was it clear whether their insurance would pay for the long-term rehabilitation they needed.

So Iowa Methodist Medical Center in Des Moines took matters into its own hands: After consulting with the patients’ families, it quietly loaded the two comatose men onto a private jet that flew them back to Mexico, effectively deporting them without consulting any court or federal agency.

David Pitt from Huffington Post.

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May 07, 2013 | 17 comments | by John Goodman

Another Reason Why Accurate Comparison of Health System Costs in Different Countries Is Difficult

In order to compare health costs in different countries, expenditures must be converted into a common currency. In practice, this is a more difficult problem than many people think.

Here’s a graph from The Economist showing how the choice of exchange rate comparison can alter conclusions. The light blue line compares incomes in various countries using market exchange rates. The dark blue line compares incomes using purchasing power parity.

Market exchange rates are the price of one currency in terms of another when currencies are bought and sold on international markets. The demand and supply of international currencies is driven by the markets for internationally traded goods and by capital flows between countries.

Are We Sicker Than People in Other Countries?

Source plus discussion: Frank de Libero at The Health Care Blog.

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Apr 26, 2013 | 15 comments | by John Goodman

Myths About Who Spends Health Care Dollars and Why

The following statistic from the Centers for Disease Control and Prevention (CDC) never fails to shock: the 133-million adults — or “nearly 1 in 2” — with chronic disease account for 75% of spending…

The statistic is intended to demonstrate that a concentration of costs among people with out-of-control chronic disease but actually shows the opposite. It shows a diffusion of costs, not a concentration. 60% of adults accounting for 75% of spending — or even the incorrect 50% of adults accounting for 75% of spending — is about as far from a 20-80 rule as one can get. Basically costs are not concentrated in ongoing day-to-day chronic disease.

The bottom line: in a commercial population there is very little cost to be saved by focusing on trying to get more people to take more drugs to control their conditions.

Full post by Al Lewis at The Health Care Blog worth reading.

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Apr 24, 2013 | 10 comments | by John Goodman

Gaming the System

State governments are reducing the cost of ObamaCare by making sure part-timers go to the exchange:

Virginia, for example, is requiring all part-time employees to work fewer than 30 hours, which will help the state avoid penalties for not providing health coverage…Washington State is in a less common situation, since it already provides coverage for part-timers down to 20 hours a week.

Budget writers in Olympia say their plan would save Washington State $120 million over the next two years. However, it would consequently push more health care costs onto the federal government, since many low-income part-time state employees and education workers would likely qualify for federal subsidies.

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Apr 24, 2013 | 18 comments | by John Goodman

We Pay More for Drugs. Do We Get More?

A contributor to higher U.S. per capita drug spending is faster uptake of new and more expensive prescription drugs in the United States relative to other countries. In contrast, the other OECD countries employed mechanisms such as health technology assessment and restrictions on patients’ eligibility for new prescription drugs, and they required strict evidence of the value of new drugs.

Source: Health Affairs.

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Apr 12, 2013 | 13 comments | by John Goodman