The Data Agenda

Saturday, September 28, 2013

The Tools of ACA for Lowering Costs

ABC News ran an article on the Affordable Care Act that made little mention of the effect of various "free" services on costs. Upon pointing this out, another reader commented that those services "will lower costs because treatable illnesses will be caught early before they are very expensive to treat and irreparable damage has been done."

The assumption in "treatable illnesses" lowering costs is that only those with illnesses are getting that "free" treatment.

Thursday, September 26, 2013

The Individual Mandate's Impossible Mission

Healthwatch is carrying the water for the Administration. Upon a West Virginia Democrat departing the ACA reservation, it concludes its reporting by noting:
Delaying the individual mandate would deal a severe blow to the healthcare law and could make it altogether unworkable.

The unpopular provision was included in the healthcare law to help prevent massive premium increases.
One has to ask the question, How did the health insurance industry ever exist before the individual mandate of the Affordable Care Act?

Medical Devices: Not necessarily about electronics

A variety of medical devices commonly used in hospital surgical procedures experienced a significant dip in prices over the past six years, according to the Advanced Medical Technology Association. These devices include:

  • drug-eluting stents (34 percent price decline)
  • pacemakers (26 percent price dip)
  • artificial hips (23 percent price decrease)
  • artificial knees (17 percent price drop)

Read more: Hospitals driving down price of medical devices

The Purpose of EMRs

EMRs are not designed for patient care because our medical system is no longer designed for patient care. Our medical system is being redesigned to provide health services to consumers, and EMRs are morphing into superb tools for a service industry.
  • EMRs are designed to collect increasingly detailed customer information.
  • EMRs are designed to facilitate market research.
  • EMRs are designed to standardize and automate transactional complexity.
  • EMRs are designed to smooth handoffs across the supply chain.
  • EMRs are designed to orchestrate and monitor production lines.
  • EMRs are designed to minimize production costs and maximize revenues.
  • EMRs are designed to provide quality assurance based on exact specifications.
  • EMRs are designed to prevent and quickly detect malfunction and non-compliance with specifications.
Read more: Why Doctors Will Never Ever Like EMRs

Thursday, September 12, 2013

ACA fees and taxes raising costs for employers

From CNNMoney

Transitional reinsurance fee: This fee will be imposed on employers for the next three years and will go towards helping the state-based insurance exchanges, where individuals can find coverage, pay for large claims. The fee will be $63 per insured member in 2014, but is expected to decrease in the latter two years. Delta said this fee will cost it more than $10 million next year.
Patient Centered Outcomes Research Institute fee: This charge will go to pay for a new agency tasked with giving patients a better understanding of the prevention, treatment and care options available, and the science that supports those options. Employers will be charged $1 per insured person this year, $2 in 2014 and then increases with inflation in health care spending for the next five years.
Health insurer fee: This annual fee is aimed at helping pay for the implementation of ACA. It will be about 2.5% of total premiums in 2014 and is expected to go up to 4% by 2017. Beyond that, it will rise with the growth in premiums. Insurers are expected to pass this fee through to employers.
'Cadillac' tax: Starting in 2018, employers who offer rich benefit plans -- where the total premium will cost more than $10,200 for an individual plan or $27,500 for family coverage -- will have to pay the so-called Cadillac tax, a 40% tax on the amount over the threshold. This tax is prompting companies to shift more medical expenses onto employees, which not only brings down the price of the premiums, but also pushes employees and their spouses to consider other options available to them, said Sandy Ageloff, senior consultant with Towers Watson, a professional services firm.
Individual mandate: Also adding to employer costs is the Obamacare requirement that Americans obtain insurance or face a penalty starting in 2014. That will prompt many employees who had opted out of their company's coverage to sign up. Delta, for instance, estimates this will add $14 million to its costs annually.

Tuesday, September 10, 2013

Options for replacing the Affordable Care Act

From Forbes:
Comprehensive Republican health reform plans introduced in Congress
Let’s start with 5 comprehensive health reform proposals that have actually been introduced in Congress—some well before President Obama even was nominated for president, and all months before the House (11/7/09) or Senate (12/24/09) voted on what eventually became Obamacare.