Here’s a good overview of the immediate impact of Health Care Reform, if it passes…

Seniors: Even though they are being told otherwise, seniors will pay the biggest price for reform. Half of the reason that Sen. Reid got a favorable cost estimate from CBO is because his bill cuts Medicare by $471 billion over the coming decade. An earlier report from the program’s chief actuary says cuts this deep would cause many providers to stop seeing Medicare patients or even to close their doors.

Everyone: The federal government would, for the first time, require every American to have health insurance. The government would stipulate what that mandatory insurance must cover and how much of their incomes people can afford to pay for it, and penalize them if they don’t comply. While some would be eligible for subsidies or waivers, most Americans would face tax penalties of $750 a year or 2 percent of their incomes, whichever is higher, to force compliance.

People buying their own insurance: The CBO says that families purchasing insurance in the individual market would not see a reduction, but rather an increase, in their premiums by $2,100 in the year 2016. That’s over and above the increases they already will be facing as health-insurance premiums continue to rise at about twice the rate of general inflation. A family would pay $15,200 for health insurance by 2016 if Sen. Reid’s bill passes, and $13,100 if it doesn’t. The CBO concluded that premiums in the individual market will be 10 to 13 percent higher in this market than if Congress did nothing.

People who work for small businesses: Those receiving health insurance through their employers will continue to see higher costs, with premiums for a family getting coverage though a small business increasing to $19,200 by 2016 — about the same pace as they would without reform.

People who work for large companies: The White House boasted that under the Senate bill, premiums for employees of large firms would remain mostly unchanged. But that means they would continue to go up almost as fast as they have been, reaching $20,100 for a family and $7,300 for an individual by 2016.

All employers: Companies also face an avalanche of new reporting requirements, penalties, and potential fines. Firms face fines whether or not they provide health insurance if any of their workers get taxpayer-subsidized coverage. And with subsidies available for families earning up to $80,000 a year, the exposure is significant.

Young people: Most haven’t a clue that the federal government is about to slap them with a new mandate requiring them to purchase expensive health insurance. Studies show that they would likely pay premiums two or three times the amount they would normally be charged based upon their age and expected use of health services.

Patients: A new independent board will have the power to cut Medicare benefits, and its decisions can only be overruled by another act of Congress. Private plans are likely to follow its recommendations. Congress doesn’t want to be held directly responsible for the rationing decisions the board inevitably will make, but the voters will quickly figure it out.

Doctors: Starting in March, doctors, hospitals, nursing homes, and others who treat Medicare patients will face a 21 percent cut in their Medicare payments. This means doctors face a permanent lobbying campaign just to keep payments from being slashed.

Health-sector companies: While few people have sympathy for health-insurance companies and drug plans, they, too, will also face onerous new federal regulations and higher taxes — costs that can only be passed on to consumers in the form of reduced benefits or higher premium costs.

States: While about 10 states receive special favors (as in, pay-offs) in the Reid bill, the others will wind up with higher costs for their already budget-busting Medicaid programs. Another 15 million people will be added to the rolls of this program, which was originally intended for low-income people.

Budget watchers: The Reid bill would increase federal spending by $2.5 trillion in the first decade it goes into effect, but it is paid for by a combination of job-killing taxes and unrealistic cuts to Medicare. No one — including the CBO — believes these “pay-fors” are sustainable. As a result, the health overhaul bill inevitably will swell the federal budget deficit.

Health-insurance costs are likely to begin soaring right away, most of the new subsidies for insurance don’t kick in until 2014, higher taxes go into effect almost immediately, and seniors will find it harder and harder to find a doctor to see them and to get the care they need.

NRO

photo credit: vgm8383

Breaking the Bank: Beijing and Health Care

By Chuck Colson

Who cares the most about health care reform? The President? Congress? Seniors? The health insurance industry? Well, the answer will surprise you.

The biggest single vote to be cast on health care reform is taking place in, of all places, Beijing. Chinese officials are questioning American officials about health care reform in the U.S.

The Times wrote, “The Chinese were not particularly interested in the public option or universal health care….They wanted to know, in painstaking detail, how the health care plan would affect the [U.S.] deficit.”

Why would the Chinese be so interested in our deficit? Well, for all intents and purposes, China is the official banker of the United States government. China is the number one foreign holder of U.S. Treasury securities.

The Chinese are nothing if not clever. One investment banker told me that they had converted all of their debt from 30-year maturity to one year. The hard questions they are asking right now are about how much the health care bill will raise the deficit. And make no mistake, if the Chinese decide not to continue financing our debt, the dollar could drop through the floor.

America could have a huge financial crisis. If that isn’t a wake-up call to the politicians, the media, and to the American public, I don’t know what it’s going to take. Sadly, the government doesn’t think that way. The politicians want their pet projects—health care reform or earmarks—and they want them now. No matter that the U.S. budget deficit is at an all-time high. If you or I behaved this way with our personal finances, we’d be broke.

Well, the Chinese are having none of it. And what they are proving is that you don’t need huge armies or navies to conquer America. All you need to do is loan the U.S. government all the money it wants for social reengineering, and then call in the debt. It’s time we all asked the government to be responsible with our money. Deferred gratification and prudence are virtues worthy of Christian individuals and of governments as well. I and other Christians have voiced numerous concerns over the health care reform bill being debated on Capitol Hill—freedom of conscience, the government being involved in end-of life decisions, publicly funded abortion to name a few.

But in the end, it may be that the health care bill being debated on Capitol Hill will turn out to be just too expensive. We cannot afford it. Just ask the Chinese.

New Sermo Survey Indicates Physicians Moving towards Cash-Only Practices

Cambridge, Mass. November 5, 2009 — Sermo (https://www.sermo.com), the nation’s largest online physician community, today announced the results of a new survey, which indicates that physicians are moving towards cash-only practices as they cope with the business realities of an uncertain healthcare environment. The new survey comes on the heels of newly proposed healthcare reform legislation and an expected 21% cut in physician Medicare payments in 2010.

According to a Sermo survey conducted of 1,000 US physicians on Sermo between October 30 and November 4th:

• 61% have accelerated dropping 3rd party payors given the 21% proposed cut in physician payments.
• 91% of physicians state they could discount their services by up to 40% if they didn’t have to pursue reimbursement from third-party payors.

Physicians are more strained than ever before to stay in business and are searching for new models to help them succeed. In fact, according to a recent report from the Health Economics Institute, physicians’ offices spend between $23 and $32 billion dollars a year in administrative overhead trying to get paid by insurance companies.

Due to the increased burden of administrative overhead and cuts in payments for services, many physicians are weighing the benefits of cash-only practices — meaning they would stop accepting any form of insurance and leave patients to seek reimbursement from insurance companies themselves. When asked to select what their goals would be for improving patient care if they moved to this model:

• 80% selected “lower influences of 3rd parties on treatment plans”
• 75% selected “more time with patients”
• 75% selected “encourage patients to have a greater vested interest in their own care”
• 60% selected “provide services to patients that have no insurance or high-deductable HSA’s”
• 60% selected “I could offer patients more flexible payment terms and discounts”

“Our data continues to support the fact that physicians are becoming more and more concerned about the business realities now facing them,” said Dr. Daniel Palestrant, CEO and founder of Sermo.  “Because of this, we’re seeing a powerful trend in the Sermo community where physicians are turning toward new business models that can help improve their financial underpinnings and re-establish the centrality of the doctor-patient relationship.”

To support physicians as they revaluate their business strategies, Sermo today also launched the Sermo Practice Management Exchange™(PME).  PME is a new area within the Sermo community where physicians can share strategies and insights about how to run a successful practice while earning CME credits. To learn more, see press release dated 11/5/09 titled ‘Sermo Launches the Practice Management Exchange™ to Support the New Physician Practice in a Changing Healthcare World.’

About Sermo
Visit http://www.sermo.com.

photo credit: skpy

Doctors, patients routinely discussed payment in days before employer-sponsored insurance

By Richard Craver | Journal Reporter
Published: November 29, 2009

The cost of health care has long been the elephant in the room of doctor-patient discussions.

“Doctors generally avoid asking patients about health insurance and finances because physicians want what they believe is best for their patients,” said Mark Hall, a professor of law and public health at Wake Forest University School of Medicine.

“What’s best might not always be most affordable.”

That’s changing. Millions of Americans have no health insurance, and many of those that do are facing increasing costs, higher deductibles and larger co-pays.

The result: doctors and patients are being encouraged — if not forced — to talk money upfront like they would about buying a set of tires.

Not having the conversation could prove financially devastating. Researchers at Harvard University reported that medical problems caused 62 percent of all personal bankruptcies in 2007. Of those bankruptcies, 60 percent of the filers had private medical insurance.

Then again, having the discussions could open a Pandora’s Box for physicians.

Such as:

□ How much should a physician know about a patient’s job status, or consider the employer’s financial health, in determining ability to afford medical services?

□ Is there financial liability and ethical accountability for recommending the most costly surgical procedure, which could drain the patient’s overall finances if they lose their job and health insurance and can’t afford the bill?

□ Is there financial liability and ethical accountability for recommending a lower-cost option that significantly affects the patient’s quality of life — living with more pain than necessary — or projected lifespan?

□ How much defensive medicine — ordering tests that are borderline necessary to defuse any potential legal action — should be practiced?

Hall studied such issues for three years and co-wrote a report that recently appeared in The Journal of Family Practice.

“Each year, doctors are finding more and more that patients are coming in carrying substantial deductibles and having to pay more out of pocket,” Hall said. Physicians told of patients who left prescriptions unfilled or refused to get diagnostic treatments because they couldn’t afford them.

“Every level of stress needs to be identified and addressed, with job stress often going hand-in-hand with financial stress,” Hall said.

“More physicians are finding a balance of something good enough at a lower cost, such as a generic drug over a brand name. They are using professional judgment with practical wisdom as they provide a tray full of options to their patients.”

…

When asked when a doctor should address medical costs with a patient, she said “always and as often as possible.”

“Ultimately ­– it is the patient’s choice — but being informed well of the options, possibilities, treatment, recovery, etc., is important. Why wouldn’t all patients wish for this type of care?”

“We have to be persistent in wringing out what costs we can, to come up with other alternatives, which sometimes takes some creativity,” Long said.

“But that’s true of many of my patients in this economy. There’s no question patients are having to portion out their health-care dollars.”

Freda Springs, a spokeswoman for Novant Health Inc., said that its physicians view discussing health-care costs “as an obligation in caring for the whole person.”

“Patients will often confide in their physician when they will not confide in others,” Springs said.

“What we try to do is coach our physicians to ask pertinent questions, and if they believe the patient needs assistance, to get them to the customer-service navigator while they are in the office.”

Families USA, a consumer-advocacy group in Washington, recently released a consumer guide that offers strategies, tips and warnings to consumers to manage medical debt and avoid bankruptcy.

“Medical debt is a stealthy fiend, striking unexpectedly and feeding on both a family’s rising health-care expenses and what may be a growing inability to pay because of a loss of a wage earner’s income,” said Ron Pollack, the executive director of Families USA.

The group said that medical debt is a growing problem for both people who are uninsured and people who are underinsured — those with coverage with high deductibles, high co-payments, many uncovered benefits, and what it considers as insurers’ arbitrary limits on coverage.

Pollock said that medical debt contributes to mounting credit-card debt and can threaten a family’s housing security by putting rent or mortgage payments out of reach.

Dr. David Miller, an associate professor at Wake Forest who focuses on general internal medicine, treats mostly low-income patients at the Downtown Health Plaza.

Five years ago, he was the one initiating conversations on the cost of treatment.

“Nowadays, it’s more like 50-50,” Miller said. “It often starts when I begin to recommend a course of treatment. They are more upfront about saying ‘I really don’t have a lot of money right now.’

“It’s most uncomfortable when I talk with patients who want to put off further treatments for several months, or don’t get a prescription filled, because of concerns about cost.

“There are others who put off treatment out of a hope that they’ll land a job with health benefits by the time something might get serious,” he said.

A recent study of North Carolina employers by Mercer Human Resource Consulting found that they expect to pay a smaller increase in employee health-insurance costs next year.

The survey of 99 North Carolina employers — all with at least 10 employees — found an average projected increase of 4.7 percent over 2009 costs. The employers said they expect to achieve that goal by passing on more costs to their workers or by changing insurance plans or insurers.

Without making those changes, the average increase would be 7 percent.

Steve Graybill, a Mercer senior consultant, said that consumers could “benefit immensely” from having a discussion on the cost vs. the benefit of treatment options.

“That way, the doctor and consumer can agree upon an informed course of action,” Graybill said. “Most insured consumers do not even understand their maximum out-of-pocket cost should they have a major event.

“We will be unable to get medical cost under control unless we are all more educated on the cost of treatment.”

Hall said he encourages patients to bring up financial concerns in the examination room.

“You shouldn’t be afraid to talk to doctors about having to pay for things,” he said.

It’s not like having those conversations would be groundbreaking, Hall said. Several generations ago, before employer-sponsored health insurance was standard, doctors hashed out payment with patients daily.

Hall said that many doctors need training on how to effectively talk with patients about money.

“The experienced physicians interviewed for this study suggested asking patients not about ability to pay, but instead about the extent of the patient’s insurance coverage,” Hall said.

“That way, they could avoid the embarrassment some patients feel admitting they can’t afford their doctors’ bills. This is just a fact that the doctor wants to know about.”

Hall said that by having the cost conversations, “if a patient subsequently chooses to take a cheaper route, there’s little chance of a lawsuit because the choice is ultimately for the patient, not the doctor, to make.”

photo credit: The Library of Congress

On Tuesday, CBO director Douglas Elmendorf told Sen. Baucus’ committee that its plan to cut $123 billion from Medicare Advantage would cost some 2.7 million people to lose this coverage altogether and result in lower benefits for the rest. The program will become so unattractive that people will quit buying the policies in the future.

The fact is that if you like your current coverage, you’re out of luck.

In recent years, over 10 million beneficiaries, or more than 20 percent of those on Medicare, have chosen private Medicare Advantage health plans over the government’s traditional fee-for-service program.

About 660,000 people nationwide – or 7 percent of Medicare Advantage enrollees – are in plans that are set to close. Between now and Jan. 1, they can switch to another private plan or join Medicare’s traditional fee-for-service program.

Medicare Advantage enrollees who do nothing and remain in the same plan in 2010 will see their monthly premiums increase an average of 32 percent, according to an analysis by the Kaiser Family Foundation.

In addition, seniors will have fewer “zero-premium” plans next year.

According to the Baltimore Examiner, The AARP stands to win big on the current reform plan.

The 2008 AARP financial statement shows the group received nearly $653 million in royalties from private insurance companies that sold products referred by AARP in 2008, while taking in $249 million in membership dues.

Seniors have basically two choices for Medicare supplemental insurance, the first one is a government run supplement called “Medicare Advantage,” the second one is called “Medigap” insurance and is sold by private insurance companies. This medigap is what the AARP endorses, and gets royalties on.

Section 1161 of the House bill would slash payments to Medicare Advantage health plans used by 20 percent of seniors and cause them to lose some benefits, including vision and dental coverage, thus forcing them into the private insurance supplements such as AARP offers.

The good news, if there is any, is that seniors now have an alternative to the AARP.

Association of Mature Americans Citizens offers all the benefits of an AARP membership. AMAC offers discounts and medical insurance.

AMAC memberships are only $12.50, per year, for the whole family.

photo credit: Esthr

Do you believe Harry Reid?

Committee Report of the America’s Healthy Future Act of 2009

If you have a lot of time on your hands and are looking for the latest copy of the Senate bill, you can download it here.

Healthcare Premiums Could Spike 20 Percent:

Many small employers face hikes of 20% or more for health benefits in 2010, local insurance brokers say. Large firms are in line for a more-moderate average increase of 5.8%, although that’s the steepest in four years, according to a recent survey of Chicago-area firms by Lincolnshire-based Hewitt Associates Inc.

Business hasn’t taken advantage of health savings account insurance plans, and now may be the time to revisit this approach to insuring employees.

It benefits the employer through reduced premiums, and the employee gets the the savings account (that carries over each year). Over a few years the account becomes sizable.

The real benefit to the insurance plan is that by paying for medical care, patients learn the real value of the care they are receiving. Also, doctors like being paid at the time of service, and often offer discounts for doing so.

The health savings plan also provides a tangible reason to focus on wellness. When it’s your money, you tend to look after it more than when it’s free.

The Patient-Doctor Alliance offers many health insurance options for out members. You can find out more by clicking here.

You can also read more about health savings accounts here.

photo credit: the_amanda

According to Rasmussen

Just 38% of voters now favor the health care plan proposed by President Obama and congressional Democrats. That’s the lowest level of support measured for the plan in nearly two dozen tracking polls conducted since June.

The latest Rasmussen Reports national telephone survey finds that 56% now oppose the plan.

Support dropped  9% in one week. One would think that with the public firmly against the plan, that the Democrats would slow down.

American’s become wary of the bill, and as political payoff is being added to the bill almost daily, it will continue to drop.

A quick read of The Democrats’ Health Care Delusion by Rich Lowry says it all:

If it passes, people years and even decades from now will look back and ask, “What were they thinking?” It’s a rare opportunity to see a train wreck at its inception, as the conductors make the decisions with malice afterthought that will ramify disastrously.

Everyone agrees that the nation is on an unsustainable fiscal path. So Democrats will add a $2.5 trillion entitlement to hurry us further along the path. Tax hikes that could go to reducing the deficit they’ll plow into the new entitlement. Medicare cuts that could shore up Medicare’s own shaky finances, they’ll plow into the entitlement too (if the cuts happen at all).

The new entitlement will grow at a projected 8 percent a year, and it’s only through gimmickry it’s made to look deficit neutral in the first decade. The cost curve of health care will be bent up, and insurance premiums, too, will rise. For all of this, ObamaCare will still leave 24 million people without health insurance.

If nothing else, watching the Democrats sacrifice so much on behalf of this monstrosity is fascinating, appalling — and dramatic. Common sense suggests that they shouldn’t do it. The basic laws of political physics say they can’t do it. And yet on they march.

Let’s hope they dexide to rethink the plan before it’s too late.

photo credit: cobalt123

The Republicans have put forth their ideas on healthcare reform and although it’s unlikely any items would be adopted, it makes a lot more sense than the 2,000 page bill the Democrats are trying to pass.

The Patient-Doctor alliance in not partisan… but we see the that the Republican proposals do align with our vision of true reform. And they wouldn’t increase debt or lower the standard of care.

They are:

Number one: let families and businesses buy health insurance across state lines;

Number two: allow individuals, small businesses, and trade associations to pool together and acquire health insurance at lower prices, the same way large corporations and labor unions do today;

Number three: give states the tools to create their own innovative reforms that lower health care costs; and

Number four: end junk lawsuits that contribute to higher health care costs by increasing the number of tests and procedures that physicians sometimes order not because they think it’s good medicine, but because they are afraid of being sued.

These solve the major issues facing American doctors and patients: Lowering health care costs through allowing better choices on insurance; and tort reform to end the practice of defensive medicine.

With the Democrats fully in control of congress, it’s unlikely that these will see the light of day. And unfortunately America is likely to be subjected to reform that does nothing to solve the main issues of health care.

photo credit: Andrew Aliferis

When Michael Moore sees Obamacare as an insurance company win, you know that this reform has gone off the rails.

The reform bill actually means 5 years of new taxes and cuts, before any change happens. At a trillion dollar cost over 10 years.

When government takes over the industry, no one wins.

It’s time to make your voice heard and let your elected representatives know where you stand. Americans can reform the system if doctors and patients act now and take on the challenges.

Tort reform through mediation. The end of defensive medicine. Less costly insurance through health savings accounts.

Common sense solutions that won’t bankrupt the country…

Act now before it’s forced on America.

Here’s the bill if you can find the time to read it.

Or, click here to see a side by side comparison of the house and senate bills (and Obama’s initial goals).

Another video showing the comparison here.

photo credit: Reza Vaziri