Tag: "health insurance"

Brookings: The Unaffordable Care Act Lowered Individual Premiums

Significant premium hikes in the Obamacare exchanges have been in the news lately. A Dallas Morning News article recently proclaimed, ‘When your health insurance is bigger than the mortgage, something’s wrong’. Indeed, insurers are charging premiums that about the size of a car payment on a late model used car. For a family the premiums are sometimes as high as a mortgage payment. Yet, insurers are hemorrhaging money – suffering losses to the tune of billions since Obamacare went into effect.

But apparently my perception is dead wrong. A pair of Brookings scholars argue individual premiums are actually lower than they would have been absent the Affordable Care Act. What???

Health Insurers, Hospitals Cannot Figure Out How To Pay For Catastrophic Care

Physician and Nurse Pushing GurneyAn advocate of consumer-driven health care, who makes the case that individuals should control most of our health spending directly, will not get very far before hearing the rebuttal: “When you have a heart attack or get hit by a bus, you won’t be in any condition to negotiate which hospital you go to.”

Fair enough, which is why we advocate insurance for catastrophic events, just like for houses or automobiles. However, in the current system, insurers and hospitals are dropping the ball on even that:

Weakening Business Case For Health Insurance

BoeingBoeing, the giant aerospace concern which is celebrating its centennial this year, has been cutting out the middle-man for health benefits:

In another sign of growing frustration with rising health costs, aerospace giant Boeing Co. has agreed to contract directly for employee benefits with a major health system in Southern California, bypassing the conventional insurance model.

The move, announced Tuesday, marks the expansion of Boeing’s direct-contracting approach, which it has already implemented in recent years in Seattle, St. Louis and Charleston, S.C.

In other examples, Intel Corp. contracted directly with a major health system in New Mexico, where it has several thousand employees.

Retailers Wal-Mart and Lowe’s took a different approach, striking deals with select hospitals across the country for bundled prices on specific surgeries. The companies steer workers to those hospitals.

(Chad Terhune, “Boeing Contracts Directly With California Health System for Employee Benefits,” Kaiser Health News, June 21, 2016)

I recently discussed evidence that insurers inflate rather than decrease prices for medical goods and services.

A Bipartisan “Yes” On A Health Care Tax Credit

health-insurance(A version of this Health Alert was published by RealClearHealth.)

Ready for some good news on health reform? Both the presumptive Democratic candidate for President and the Republican majority in the U.S. House of Representatives agree people should be able to spend more money directly on medical care without insurance companies meddling.

Both sides would be shocked to have their respective health reforms described as sharing any common ground. However, identifying this common ground might be necessary if either side wants to fix the worst aspects of Obamacare.

If Republican politicians in Congress want to give people any relief from the burden of Obamacare, they need to be prepared for the possibility they will have to deal with Hillary Clinton’s White House next year.

Speaker Ryan’s recently released Better Way health reform plan would offer a refundable tax credit for health care, to anyone who does not have employer-based health benefits. This tax credit would increase with age, but be available regardless of income. It would be a fixed-dollar amount for each age bracket. This is superior to Obamacare for at least two reasons.

More Evidence Against Health Insurance

doctor-mom-and-sonDavid Lazarus of the Los Angeles Times, whose columns on health policy tilt heavily towards single-payer advocacy, has done a great service to the cause of consumer-driven health care, describing how much more sense it makes to pay cash prices for health services than pay what your health insurer “negotiates.”

Five blood tests were performed in March at Torrance Memorial Medical Center. The hospital charged the patient’s insurer, Blue Shield of California, $408. The patient was responsible for paying $269.42.

Tests that were billed to Blue Shield at a rate of about $80 each carried a cash price of closer to $15 apiece.

This is one of the dirty little secrets of healthcare,” said Gerald Kominski, director of the UCLA Center for Health Policy Research. “If your insurance has a high deductible, you should always ask the cash price.”

Not all medical facilities will be open to sharing their cash prices with an insured person, Kominski said, but many will.

Is It Now Okay to Sell Your Kidney in the U.S.?

man-in-wheelchairThere is a global shortage of many organs for transplantation. How about just increasing the supply of organs through a free market? The idea of allowing people to sell their organs for personal gain grosses many of us out. Although, it is legal to sell our plasma, and many poor Americans find it profitable to do so.

The moral case for a market in organs has been made by Professors Kathryn Shelton and Richard B. McKenzie at the Library of Economics & Liberty. Yet, it is illegal to sell your organ for transplantation in the U.S. Or is it? A major insurer may have found a side door into this market, by offering up to $5,000 to kidney donors to cover their travel expenses. Clever, eh?

Is this the Insurance Casualty Model; Or Just a Dirty Trick?

The health insurance “Casualty Model” is alive and well in Georgia — but only as a punishment for not signing an in-network agreement or accepting usual and customary reimbursement for emergency room treatments.  At issue is a Georgia hospital (and one in Los Angeles) that are not part of the Blue Cross and Blue Shield of Georgia network. Because neither of the hospitals are part of the insurer’s network, when covered individuals go to the hospitals’ emergency rooms, the insurer sends reimbursement checks for emergency care directly to enrollees. The enrollees are then supposed to endorse the checks over to the hospital.  This is similar to the casualty model when an insurer provides funds for a covered claim and the covered individual shops around and receives a service at the provider of their choice. When someone slid into my car during an ice storm a few years ago, an adjuster came to my office and calculated an estimate. I received the check and was told I could get my car repaired almost anywhere for the estimated amount.

Obamacare Slightly Increased Short-Term Uninsured

NHISThe best measurement of people who lack health insurance, the National Health Interview Survey published by the Centers for Disease Control and Prevention (CDC), has released early estimates of health insurance for all fifty states and the District of Columbia in 2015. There are two things to note.

Texas’ Largest Insurer to Increase Premiums 60%

An article by Ricardo Alonso-Zildivar of the Associated Press claims Texas’ largest health insurer plans to raise premiums by as much as 60 percent next year. The article assures us few people will be harmed — most enrollees have their premiums capped as a percentage of household income. Thus, it’s actually taxpayers who will get gouged. The article does admit that some people — those who are too wealthy to qualify for premium subsidies — may suffer sticker shock next November when they price their coverage for 2017.

Health Insurers Shift More Costs To Taxpayers In Obamacare Exchanges

money-burden(A version of this Health Alert was published by Forbes.)

America’s health insurers are undergoing a crisis of consensus with respect to their engagement with Obamacare. Between 2010 (when the Affordable Care Act was signed), and 2014 (the first year of taxpayer-subsidized coverage in the health insurance exchanges), it was widely understood that health insurers had scored a big win. After all, which other industry could get the federal government to pass a law mandating individuals purchase its product or service as a condition of residency in the United States?

This view was reflected in the stock market’s valuation of health insurers, which outperformed the S&P 500 Index. Since then, of course, we have learned that insurers have been losing money on Obamacare’s exchanges. Further, they have lost the sympathetic ear of the Congressional Republican majority, which has prevented insurers extracting as much taxpayer funding as they had expected from the Treasury. We should not expect insurers which continue to participate in exchanges to just keep losing money. In fact, the evidence indicates some insurers have quickly learned how to shift more costs onto taxpayers, despite failing to win an explicit political commitment to do so.