Medicare Maneuvers, Part 3: The Insurer Showdown
July 16, 2008
It seems that Harry Reid gambled and won. In our previous two posts we described the battle being waged in Congress over the proposed 11% paycuts to Medicare physicians. After the Independence Day recess, the Senate Majority Leader and advocacy groups working on behalf of doctors and seniors - as well as informed and angry constituents - were able to put enough pressure on Senate Republicans to finally cross the aisle.
But party lines weren’t the real issue. The two sides squaring off in this debate were private insurers versus the average American. Why? Two words: Medicare Advantage.
As discussed in our July 2 post, Medicare Advantage came about when insurers convinced government that they were getting good at cutting spending on health care, and that maybe the government should learn from some of their tactics. Heck, they said, let’s just let insurers do the job themselves!
Medicare Maneuvers, Part 2: The Solution?
July 3, 2008
As we wrote about yesterday, payment cuts for doctors who treat Medicare patients finally went into effect July 1. Unfortunately, the first legislative attempt to block the looming doctor payment cuts didn’t come until the end of 2007, and was part of the doomed legislation to improve public funding for children’s health care (see WhatIf’s piece on SCHIP). With the competing SCHIP bills finally all defeated this spring by Presidential vetoes and Republican opposition, there was little time left to deal with doctor payment cuts before the July deadline.
Medicare Maneuvers, Part 1: The Problem
July 2, 2008
Payment cuts for doctors who treat Medicare patients - which have been looming for about a year - finally went into effect yesterday. The payment cuts of 10.6% will affect the 600,000 doctors who treat Medicare patients, and thus millions of elderly and disabled Medicare enrollees who rely on them.
Maybe if you’re under 65 and/or not relying on government health care benefits you think this isn’t your problem. You’re wrong.
A little history (based on the writings of Jonathan Cohn):
Health Care 2.0
June 17, 2008
You may have heard the phrase “Web 2.0.” It refers to how we are now in the second phase of the role that the Internet plays in our lives.
Originally the Web was a source of information and entertainment, written and produced by “professionals.”
In recent years, Internet users have themselves moved onto the Web - actively creating content, blogs, and new software and tools. You could say that the Internet has exploded, and is continuing to explode.
So Health 2.0, then, involves these new ways of using the Web in order to share and make use of health care information. As with Web 2.0, oftentimes this means promoting a very individualized and personal online experience.
DNA, Disease, and Discrimination
June 10, 2008
Can you imagine being faced with the difficult decision of having your breasts removed - not because you have breast cancer, but because you’ve determined that you carry the genes for it? Women at risk for the disease can now find out whether they have the same DNA that killed their mothers and grandmothers.
In recent years, advances in genetic research have helped push medicine into realms once reserved for science fiction.
In the 1850s there were only 140 categories of disease, differentiated by their symptoms. By 1993, genetic mapping had allowed scientists to distinguish 12,000 categories of disease, to determine that some diseases were linked genetically despite having widely different symptoms, and to find better drugs and measures to treat or prevent these diseases.
Can You Profit from Health Care? Part 2
May 21, 2008
A couple weeks ago WhatIf explored whether the U.S.’ largest industry – health care – is recession-proof. It seems health insurance companies’ profits are starting to slip. Rising health care costs means that insurers must pay out more to cover health services, which means they raise the price of their policies to recoup these costs. As a result, the number of employers purchasing insurance is decreasing.
Even so, the nation’s largest publicly-traded health plans say they will continue to raise premium prices and reduce provider payments in order to please Wall Street. “We will not sacrifice profitability for membership,” WellPoint President and CEO Angela Braly said recently.
When Insurers Take Their Toys and Go Home
May 10, 2008
For the past few years there has been work in cities and states across the country to improve our citizens’ access to health care. From San Francisco to Vermont, 39 states and a number of cities are in the process of creating legislation that would help address their numbers of uninsured.
Washington, D.C. is one of these. A look at the trouble our nation’s capital is facing on this issue may shed a light on why the words “health care reform” are often greeted with less than a smile.
Can You Profit from Health Care?
May 7, 2008
…..let’s see…
…it used to be the steel industry…and for awhile it was AT&T
…then in the 90’s, the place to put your money was dot.coms
…is it now health care?
With all the talk lately of economic downturn and recession, in many people’s minds (at least those over 50) lurk the tales of the Great Depression and the infamous 1929 stock market collapse. Heck, we don’t even have to go back that far! Remember the early part of this decade when all the Silicon Valley dot.com stocks plummeted and recently millionaired 25-year-olds found themselves trading in their Porsches for middle management jobs at Starbuck’s?
Insurers Dropping Patients Should Think Twice
April 24, 2008
UPDATE:
On April 17, California’s Department of Managed Health Care announced the state’s most assertive stance yet on policy recission: that an independent arbiter will review and hold accountable the state’s 5 major insurers for its past 4 years of canceled policies. Thousands of people will have a chance to win back their coverage and be reimbursed by the insurers for outstanding medical bills if they were deemed to have had their coverage wrongly rescinded.
Originally posted March 17, 2008:
Dialysis Treatment – A Punch in the Kidneys
April 2, 2008
Here’s a fact that may surprise you: kidney failure is the one disease that you can get coverage for – from the Federal Government - no matter what.
For this reason, after 30 months of treatment by a private insurer, dialysis facilities bill Medicare regardless of whether the patient is over 65 or financially stable. For those with kidney failure (End Stage Renal Disease) due to diabetes or other causes, having a machine take over the complicated (and therefore expensive) task of cleaning their blood several times a week allows them to live.
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