Why Does Health Care Cost So Much?

[Greed]

Doctor stops accepting insurance, lowers prices and posts costs online

Doctor stops accepting insurance, lowers prices and posts costs online
By Mike Krumboltz | The Sideshow –
Tue, May 28, 2013

A family practice doctor in Maine is refusing all forms of health insurance, including Medicare, in order, he says, to provide better service to his patients.

Dr. Michael Ciampi told the Bangor Daily News that he wants to practice medicine without being dictated to by insurance companies.

On April 1, Ciampi lowered his prices and posted the costs online. For example, an office visit in which patients discuss "one issue of moderate complexity or 2-3 simple issues" costs $75. When Ciampi accepted insurance, the visit would run $160, according to the Bangor Daily News.

The fact that Ciampi lists the prices, he says, means no surprises for his patients.
Say you're an established patient who can't make it to the doctor's office but wish to speak to him over the phone? A 10-minute conversation will run you $20. Each additional five-minute block will cost you $10. A minor surgery, like the draining of a boil will cost between $100 and $150.

Dr. Ciampi told the paper that some patients have left his practice, but that all seem to understand what motivated him to make the change.
Via the Banger Daily News:

Insurance companies no longer dictate how much he charges. He can offer discounts to patients struggling with their medical bills.

He can make house calls. "I’m freed up to do what I think is right for the patients," Ciampi said. "If I’m providing them a service that they value, they can pay me, and we cut the insurance out as the middleman and cut out a lot of the expense."​

Ciampi told the paper that he collects payment at the end of each session (he doesn't send bills), and he sees each patient himself. Patients with insurance can submit their receipts for reimbursement, if the insurance company allows for that, according to Ciampi's family practice site.

http://news.yahoo.com/blogs/sidesho...ance-lowers-prices-posts-costs-194405203.html

 

[Greed]

The Side Effects of Delaying Obamacare

The Side Effects of Delaying Obamacare
By Evan Soltas Jul 2, 2013
7:24 PM CT

The Obama administration has decided to delay until 2015 its enforcement of the employer mandate, a provision in its health-care law that requires businesses to provide insurance to employees. Assistant Treasury Secretary Mark J. Mazur announced the change in a statement on Tuesday, noting the administration’s concern that businesses won’t be ready to comply.

My colleague Chris Flavelle writes that the decision boosts the odds that other groups will be able to win further changes to the law, such as eliminating the excise tax on medical devices. It may also create some stress on the implementation of two other parts of the health law: the individual insurance exchanges and the individual coverage mandate.

The essential challenge with adjusting Obamacare is that it is an interlocking combination of policies. The coverage mandates, for instance, pair with regulations that make coverage more generous and more expensive. Without them, the higher cost of insurance might cause the healthiest to opt out, further raising insurance premiums and creating a spiraling problem known as adverse selection. The employer mandate would have worked in a similar way by relieving pressure on the individual market.

That said, there is a strong case for getting rid of the employer mandate. Employers shouldn’t sponsor insurance in the first place, as it masks the true cost of care to employees and creates incentives for over-insurance. It also increases the cost of hiring, locks employees into their jobs, and splits the market for insurance into one for individuals and one for employers, which impedes risk-sharing in the individual market.

The value of the employer mandate is to help smooth the transition to the new law. Employers who would have otherwise covered their employees may now choose to defer those plans a year. That may be especially appealing with the law’s new and looming standards for what insurance must cover. Since the individual mandate still exists, however, those employees will now be forced into individual exchanges.

That might be OK if the individual exchanges can handle the additional volume. But this delay -- and it is the second, counting one on exchanges for small businesses -- will raise concerns about the exchanges’ readiness. It certainly increases the burden of new insurance applicants.

The Department of Health and Human Services has repeatedly reassured the public that the exchanges will be ready by Oct. 1. But the work ahead remains daunting. And the exchanges have few participating insurers in many areas of the country. That lack of competition becomes a larger problem with more people to insure.

Another issue is that 43 percent of the uninsured don’t know they need to buy insurance, according to a newly released Gallup poll. That’s approximately 20 million Americans. Some of them might have been covered by next year by their employers -- so this decision adds more work to the Obama administration’s incipient effort to educate the public on the law.

The Obama administration’s decision needs a warning label: "Side effects from the delaying the employer mandate may include headaches and nausea as the health law is put into place."

http://www.bloomberg.com/news/2013-07-02/the-side-effects-of-delaying-obamacare.html

 

[QueEx]

Re: The Side Effects of Delaying Obamacare

The checks are in the mail:
Obama to announce health insurance
rebates for 8.5 million Americans​

McClatchy Washington Bureau
Thursday, July 18, 2013

The Obama administration is pushing back against the Affordable Care Act naysayers.

One day after House Republicans passed legislation to delay enforcement of the health care law's individual mandate, President Obama will take to the airwaves to announce that checks are in the mail for 8.5 million Americans who'll split more than $504 million in rebates from their heath insurance company, thanks to a provision of the health law that penalizes insurers for wasteful spending.

Families on the receiving end of those rebates will get checks averaging $100. A few will of them will be on hand today when President Obama touts the success of the ACA's 80/20 rule that requires insurance companies to spend at least 80 percent of their premium dollars on medical care or quality improvements and no more than 20 percent on administrative costs and overhead.

Insurers that violate the rule must pay rebates to their customers.

Last year, nearly 13 million people split $1.1 billion in rebates based on their 2011 premiums. But as more companies complied with the 80/20 rule in 2012, the payouts were cut by more than 50 percent.

The Obama administration has also been buoyed by preliminary data that suggests greater competition will lower premiums for people who buy individual coverage outside the workplace.

In New York, state officials announced that individual premiums in the marketplace will be lower than projections by the Congressional Budget Office.

A new analysis by the Obama administration found that in 11 states where data is available, the lowest cost "silver" plan - which covers 70 percent of medical costs - will cost, on average, 18 percent less than the CBO estimated.

And an ACA provision that allows states to review any double-digit premium increases appears to have had a chilling effect on the practice. In 2010, 75 percent of insurers proposed double-digit rate increases, but that number has fallen to 14 percent in early 2013, according to senior administration officials.

In Oregon, several proposed rate hikes in the individual market were cut by amounts ranging from a few percentage points to 30 percent. Similar results were reported in Washington, D.C., Rhode Island and Vermont.

Earlier this week officials in New York announced that final rates in the individual market would be at least 50 percent lower on average than current rates.

Preliminary rates for young men, the group most likely to face "rate shock," have also been encouraging in some places. Nationally, about 750,000 young men ages 18 to 34 have individual coverage, but won't qualify for a premium tax credit next year. Many expect these customers to forego coverage altogether and just pay the fine for noncompliance.

But in Los Angeles County, which has more uninsured people than any other county in the nation, senior administration officials said the cheapest "silver" plan would cost a 25-year-old $174 a month, while a catastrophic plan would cost about $117 a month. Only young people who don't qualify for a tax credit and earn too much to get Medicaid can get catastrophic coverage under Obamacare.

After a wave of reports predicting higher premiums, the Obama administration is basking in the round of positive news.

The question is: will it last?
​

SOURCE

 

[QueEx]

Re: The Side Effects of Delaying Obamacare



CLICK: State-by-state breakdown of health insurance rebates

 

[thoughtone]

source: Think Progress

Thanks To Obamacare, New Yorkers’ Health Insurance Premiums Will Plunge 50 Percent

Health care premiums on the individual market will tumble by at least 50 percent as a result of the Affordable Care Act, the New York Times reported on Wednesday. The state joins Oregon, Montana, California, and Louisiana in reporting lower than expected rates in the law’s new health care marketplaces.

Economists expected the law to significantly decrease premiums in the Empire State, which in 1993 prohibited insurers from denying coverage to individuals with pre-existing conditions, required carriers to charge “all consumers the exact same rate,” but did not compel young and healthy people to enroll in coverage. As a result, insurers dramatically increased prices and enrollment in the individual market “steadily diminished.” Today, just 17,000 New Yorkers “buy insurance on their own.”

The health law’s requirement to purchase insurance and the managed competition structure in the new exchanges will now increase enrollment, state officials predict, as New Yorkers will see lower premiums and will be able to choose from 17 different insurance plans when enrolling in coverage in October:

Beginning in October, individuals in New York City who now pay $1,000 a month or more for coverage will be able to shop for health insurance for as little as $308 monthly. With federal subsidies, the cost will be even lower. [...]

State officials estimate as many as 615,000 individuals will buy health insurance on their own in the first few years the health law is in effect. In addition to lower premiums, about three-quarters of those people will be eligible for the subsidies available to lower-income individuals. [...]

The plans to be offered on the exchanges all meet certain basic requirements, as laid out in the law, but are in four categories from most generous to least: platinum, gold, silver and bronze. An individual with annual income of $17,000 will pay about $55 a month for a silver plan, state regulators said. A person with a $20,000 income will pay about $85 a month for a silver plan, while someone earning $25,000 will pay about $145 a month for a silver plan.
​

The exchanges are creating “a very different dynamic” for insurance companies, Sabrina Corlette, a professor at Georgetown University’s Center on Health Insurance Reform, told the New York Times. “t’s prodding them to be more aggressive and competitive in their pricing.”

The news comes as the House of Representatives prepares to vote on delaying the employer responsibility provision and the individual mandate, which is partly responsible for New York’s lower health care rates. During an appearance on CSPAN’s Washington Journal, Rep. John Fleming (R-LA) defended the votes and sought to dismiss the premium drop.

“People with more health care problems by law their rates will have to come down, but somebody has to pay for that,” he said. “It will be a combination of younger, healthier people who will have to pay higher rates, and that is if they opt in, which we believe many won’t. There is $1 trillion worth of taxes.”

 

[thoughtone]

What if the Federal Government Negotiated Pharmaceutical Prices for Seniors? An Estimate of National Savings