Hits and Misses

Ambulance at Emergency EntranceEmergency department visits for traumatic brain injury increased 29.1 percent, 2006-2010.

“Buying health insurance across state lines”: The most popular Republican talking point is uncompetitive, unconstitutional, and unnecessary.

Early ObamaCare 2015 premium notices have double digit hikes.

Medicaid expansion creates poverty by punishing work.

Price transparency: Three major insurers to publish provider prices online in 2015.

Study: Surgeries take 25 percent less time in ambulatory surgery centers than hospitals.

Comments (7)

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  1. Devon Herrick says:

    Study: Surgeries take 25 percent less time in ambulatory surgery centers than hospitals.

    My first job in health care was doing the accounting for an ambulatory surgery center. They are fast and efficient. If you’re a doctor, you pull up out front, walk in a facility (that’s much smaller than a hospital), and prepare for surgery. Of course, the real complex patients are often required to have their surgery performed in a hospital. So, the comparison may be apples to oranges.

  2. John R. Graham says:

    Just found a link to an open-access copy of the study on Medicaid by Dague et al: https://app.box.com/s/4yp73agsizcx35j5vvi8.

    (H/T Naomi Lopez, Illinois Policy Institute)

  3. Devon Herrick says:

    Price transparency: Three major insurers to publish provider prices online in 2015.

    This is a good start — but only a start.

    Doctors, hospitals, labs and radiology clinics will not become transparent and compete on price until patients begin to act like consumers. Patients need three things to become consumers:

    1) An incentive to seek out a good price; 2) the knowledge that prices vary from one facility to the next and 3: the tools to identify providers with completive pricing.

    What this means is that health plans need cost-sharing to encourage enrollees not to waste money. At the same time, health plans need to reward enrollees who watch their spending. Health plans need a reference price. Enrollees should face cost-sharing based on that price; and health plans need to communicate that to doctors, hospitals and enrollees. Finally, health plans need to be willing to tell enrollees where to go for a good price. If I have been ordered to get a CT scan, I need my insurers to allow me to compare the price at numerous competing facilities.

    This is similar to an experiment that WellPoint and CalPERS conducted in California with hip replacements. The results were very encouraging.

    • John R. Graham says:

      Exactly! One hand is clapping enthusiastically. It is not really how prices are communicated that is of utmost importance, but how prices are formed. That is a bigger problem to fix.

  4. Joe Barnett says:

    Dean Clancy makes some good points about ““Buying health insurance across state lines.” If that were the only health reform that were enacted, it would be disappointing.

    But I’m not sure that state auto insurance markets work very well, as Clancy claim. About the same percentage of Texas residents lack state-mandated auto insurance as lack federally mandated health insurance. A big, fast-growing part of auto insurance premiums in Texas is coverage for accidents involving uninsured drivers — about 25% of drivers.

    • John R. Graham says:

      True, and I guess if one were to continue the health-care comparison, we would ask the government to fine and subsidize people at different incomes until everyone bought health insurance.

      However, there is a stronger argument for mandatory auto insurance than mandatory health insurance: Auto accidents hurt other people.

  5. Diane says:

    “Emergency department visits for traumatic brain injury increased 29.1 percent, 2006-2010″

    How strange! the article’s explanation that it may not signal more overall injuries, just more people seeking medical care in response to injuries, is interesting. What would have provoked that sudden increase? It certainly can’t be that costs have gone down!