Tag Archives: uninsured

Health Policy Updates: December 10 2017

Health care spending continues to increase – the rate of increase in 2016 was 4.3%, down from 5.8% in 2015 but still greater than inflation. Health care now takes up 17.9% of the US economy. The out-of-pocket costs borne by patients, though, are up more sharply.

“A shift toward insurance plans that transfer more of the burden of health care costs onto patients helped fuel the rise in out-of-pocket costs. In 2016, 29 percent of people who receive insurance through employers were enrolled in high-deductible plans, up from 20 percent in 2014. The size of the deductibles also increased over this time period, a 12 percent increase in 2016 for individual plans, compared with a 7 percent increase in 2014.”

  Continue reading Health Policy Updates: December 10 2017

Health Policy Updates: May 1 2016

I have written about price variability in medical care in this space previously. New this week is a study in Health Affairs further demonstrating the huge differences in prices for medical procedures, depending on where you get them done. The related problem of the lack of price transparency to US consumers is included in my health care spending map.

Sarah Cliff talks about the study in Vox. Continue reading Health Policy Updates: May 1 2016

Health Policy Updates: September 5 2015

Drugs are getting more and more expensive, as we all know. In a Health Affairs discussion of this problem, comes a new idea about how to manage it – “participative pricing.” That is, other entities than drug manufacturers should decide how “valuable” a drug is based on the benefit it brings to patients, and this consensus should be reflected back into the price. This article has many good observations; I’ll limit myself to just a couple.

“A few jaw-dropping facts quickly illustrate the pattern of rising drug costs. The average annual cost of cancer drugs increased from roughly $10,000 before 2000 to over $100,000 by 2012, according to a recent study in Mayo Clinic Proceedings.”

“On the surface, it appears as if drug manufacturers are unduly milking the udder of American health care reimbursement, even as it runs dry for insurers and providers.”

Continue reading Health Policy Updates: September 5 2015

Health Policy Updates: March 21 2015

One health-related commonly-accepted fact in economics circles is that productivity – ie, the efficiency of health care workers – has been stagnant for some time. Another way of saying this would be that when health care grows in its outputs (more care for more patients), it has had equivalent growth in its inputs (doctors, nurses, facilities, medicines, etc); we have NOT gotten more efficient, and have NOT found out how to do more with less.
However, this recent piece in Health Affairs seems to find the opposite of this accepted wisdom:
These findings suggest that productivity growth in US health care could be better than is sometimes believed, and may help alleviate concerns about Medicare payment policy under the Affordable Care Act
If the ACA is doing anything, it seems to be lowering the ranks of the uninsured. See the chart in this story.
Also, if anyone can tell me what the calzones (samosas? dumplings?) shown in the photo at the top of the article has to do with anything, I am quite curious.
From the time that open enrollment began in October 2013 to present, the rate of uninsured Americans decreased by 35 percent. That is the biggest improvement in 40 years.”
It is getting harder and harder to be a community hospital these days:
Experts and practitioners cite declining federal reimbursements for hospitals under the Affordable Care Act as the principal reason for the recent closures. “
A recent report by the AMA concludes that doctors are going to need some help moving away for fee-for-service medicine, which is still the dominant payment model in US healthcare.
Meanwhile, population health can require the need for data and related infrastructure so doctors know the histories of their patients’ care and who they’ve been treated by and when. Doctor practices often don’t have that, which is going to be a more prevalent problem.”

Health Policy Updates: September 20 2014

Bloomberg has created a score of health care “efficiency” between countries, basically measuring life expectancy and other outcomes vs. the amount of $$$ sunk in.
Very cool, but no big surprises…ie, don’t click through if you are hoping to see the US do well!
The makers of Sovaldi, one of the new effective-but-expensive HepC drugs, has been working on contracts with developing countries to sell the drug for less:
This particular study may go some way to upending a lot of accepted “truths” about US health care! The conventional wisdom, from studies out of Dartmouth, is that the huge regional variation in health care costs across the country is due to “physician factors” – ie, in some places the physician culture is just to order more tests and do more procedures. I generally subscribe to this view. However, this recent work suggests this is NOT the case, and that regional variation is actually explained by “patient factors” – ie, in some cases patients are just sicker and need more care.
The findings contradict prior research claiming that most of the variation in Medicare spending can be attributed to geographic differences in medical ‘practice styles’ (the extent and intensity of medical interventions in a given area), thus calling into question the claim that the U.S. could save up to $700 billion in health care waste and inefficiency if all providers were to emulate the practices of low-costs states.”
In case you hadn’t heard, the uninsured rate in the US is currently the lowest on record. Is this the ACA kicking in? Or the economic recovery?
An interesting adverse consequence of requiring insurers to insure the sick (the “pre-existing” condition ban of the ACA): they are finding other ways of recooping their costs. Basically, they are starting to indirectly charge sicker patients more.
The Affordable Care Act bans insurance companies from discriminating against patients with health problems, but that hasn’t stopped them from seeking new and creative ways to shift costs to consumers.”