Tag Archives: Health Care Costs

Benefits Industry Leaders Warned About Medicare for All

It is amazing, but not surprising that we are seeing more and more business leaders coming out to prevent Americans from getting single payer health care under an improved and expanded Medicare for All.

The following article from BenefitsPro.com is aimed at warning the benefits industry not to underestimate single payer, and advises them on how to deal with this.

Naturally, it is all about selling a product to make a profit from not covering all Americans, and only those who get their health insurance from their employers, since that is what the article discusses.

They don’t care about the millions who are uninsured, under-insured, or who can’t afford insurance, let alone the cost of prescription drugs and medically necessary treatments. What matters to them is how many benefit packages they can sell to employers.

One thing to note from the article, Nelson Griswold said the following at the NextGen Growth & Leadership Summit:

“Once a country has moved to government-controlled health care, it has never gone back. My prediction is that we’ll have single payer in five years.”

I hope he’s right, as far as his prediction is concerned. However, he is also right about one other thing, No country has or will give up their current system for the one we have here in the US. They would be crazy to do so, and we are crazy for not doing what they have been doing for many years, and they are doing ok with theirs.

Change is hard, but once change happens, people generally feel that the change was worth it, and that all the worrying and apprehension over that change was misplaced, misguided, and silly.

So it will be with Medicare for All. They said the same thing about Medicare, and they recruited a has-been actor who would later turn politician to scare the living daylights out of seniors with the phrase, “socialized medicine.” Now, many Americans like Medicare. And the term, “socialized medicine” has another meaning. It means that capitalist medicine is better than socialized medicine, but that too has been proven wrong.

Anyway, here’s the link to this warning shot across the bow of single payer from an unexpected sector of the medical-industrial complex and consulting industry.

https://www.benefitspro.com/2019/02/08/why-single-payer-may-be-closer-than-you-think-and-what-to-do-about-it/?kw=Why%20single-payer%20may%20be%20closer%20than%20you%20think%20%28and%20what%20to%20do%20about%20it%29&slreturn=20190113103133

 

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Hospital prices, not physicians, drive cost growth, Health Affairs says | Healthcare Dive

Here’s another article about prices from last Tuesday that should be read in conjunction with today’s article on prices.

If we keep doing the same things over and over again to make things better, and they don’t work, that is a sure sign we are crazy, so ideas like antitrust enforcement, while a good idea in general business, and the incentivizing of more cost-efficient physician referrals, only scratches the surface.

The real problem is how health care in the US is just another revenue stream for investors and stockholders of insurance companies, pharmaceutical companies, and hospitals and hospital systems, as I reported also today in Hospital Mergers Improve Health? Evidence Shows the Opposite – The New York Times

So here is last Tuesday’s article:

The report suggests measures aimed at cutting healthcare costs focus on issues like antitrust enforcement and incentivizing more cost-efficient physician referrals.

Source: Hospital prices, not physicians, drive cost growth, Health Affairs says | Healthcare Dive

Surveys Say Health Care More Expensive for US Workers

A post on LinkedIn by Jaimy Lee, Health Care Editor at LinkedIn, reported Thursday that a pair of surveys indicated that health care is getting more expensive for many workers in the US.

Ms. Lee states that,

“Of the roughly 50% of Americans who get their health insurance from their employer, the cost of the average single premium rose 3% and the average family premium jumped 5% from 2017 to 2018, according to the Kaiser Family Foundation. That means premium rate increases are rising faster than inflation, which rose 2.5% during the same period.”

In addition, the Kaiser survey reported that:

  • The average annual premium last year for one person was $6,896 and $19,616 for a family in 2018. (Workers have to pay for, on average, between 18% and 29% of their premium.)
  • The average deductible amount for single coverage in 2018 was $1,573. That’s similar to 2017.

And that a separate survey stated that, 45% of Americans between the ages of 19 and 64 years old were underinsured — meaning they have health insurance but their out-of-pocket costs exceed at least 10% of their household income — in 2018. [Emphasis added]

And, in a blow to those who would like to keep the current employer-based system and not move towards an improved and expanded Medicare-for-All system, a growing number of the underinsured are people who get their health benefits through their employers. That’s up 20% over the last four years. (Traditionally the underinsured are adults who buy insurance on the individual market.)

Ms. Lee closes her post on employer-based health care underinsured workers with the following from Vox:

“In a great historical irony, the evident faults of employer-sponsored insurance are helping fuel a new appetite for Medicare-for-all, a single-payer system where everybody gets health coverage from the government,” writes journalist Dylan Scott. “Shifting 160 million people from the coverage they currently get through their jobs to a new government plan is a lot of disruption — and disruption, especially in health care, has historically made a lot of Americans nervous.”

They may be nervous at first, but it would be much better to be fully insured and nervous for a short time, than to be uninsured and nervous worrying about how they will afford ever increasing costs of insurance.

Medicare-for-All is the only way to provide such piece of mind.

Run For the Border (Not a Taco Bell Commercial)

Yesterday, one of my contacts in the medical travel space commented on an article that was posted on LinkedIn that explained why the author was sent south of the border to purchase prescription drugs (you thought I was going to just say drugs, right?) for his company.

He found out that the same drugs, made by the same manufacturer, but packaged in Spanish were much cheaper than ones packaged in English and sold north of the border.

I decided to ask for his permission to re-post his article, and with his kind permission, I am doing so here in its entirety, as posted to LinkedIn. Here is the link in case you want to read the original.

Why Pharma Sent Me South of the Border…

Published on February 3, 2019

You may have heard of people heading to other places for medical care, but is it really the right thing to do?

We know that the cost of healthcare is ridiculous. And, of course, no one is to blame…right? (Tongue in cheek)

I can’t blame the doctors – they’re great folks just trying to charge enough to cover the bills after all the red tape is required from insurance, Medicare, federal regs, etc. I can’t blame the hospitals – most of them are running in the red from having to support a widespread indigent population with recurring visits for drug overdoses and covering that overhead with Medicare reimbursement rates of 20%. I can’t blame the insurance companies – they’re the good folks just trying to break even as “non-profits”, right? (Just ask them) I can’t blame us the patients…after all, we’re just trying to get the care we need (note sarcasm as a handful overuse and abuse the system). I can’t blame pharma because they’re just trying to make drugs that save the world (snark, snark). I can’t blame government – they’re just trying to do the most for society (OK…ran out of snarks).

With no one to blame, no one is responsible to fix this.

What does this mean for me as an employer? It’s simple…

HEALTH CARE REFORM STARTS WITH ME…

No outside party can do it – I have to find ways to partner with my employees to find the right solutions to help manage costs. Let’s talk about just one of them.

SOUTH OF THE BORDER DRUG RUNS

It sounds ominous, but it’s one of the best thing we’ve found. Here’s the opportunity – I can get the same medication from the same manufacturer at substantially lower costs because I get it from a pharmacy that just happens to be located five minutes over the Mexican border. It comes in the same packaging, but it’s just written in Spanish. We verify the sourcing, we verify the manufacturing, we verify everything… And everything is above board. By working with the hospital where the pharmacy is located, we coordinate care with the physician in the United States to ensure that the patient has the right prescription, is seen by a physician in Mexico, and receives the quality product when they arrive. Legally, they can transport up to a 90 day supply over the border per day. To make it worth our while, we have them fly down to San Diego, have a courier pick them up and take them over the border for the first 90 day supply, transport them back and have them stay overnight in San Diego. The next day, the transport picks them up, takes them down for the second 90 day supply, bring them back and they fly home. That way they can get a 180 day supply per trip.

So what’s the catch?

I can’t think of one yet. Last year, our company ran a beta test with two individuals with a specialty drug each. We pay for their travel down, pay for the courier to transport them over the border to the hospital where they are met with the physicians at the hospital, we pay for the pharmacy representative, the medication, the overnight accommodations in San Diego, and a stipend to cover food and ancillary costs. What’s in it for the employee? We also cover their co-pay so they do not have to cover any costs for the medication – the medication becomes free to them, saving them hundreds of dollars if not thousands of dollars a year. Additionally, they get to keep any money that they save from the per diem money that we provide to them for their daily costs.

What’s in it for us is the employer?

Last year, after paying for the medication, all of the transportation costs including the employee costs of travel, the concierge fees for our broker who assists us with this arrangement, and all additional fees, the savings on these two individuals for one medication a piece was well over $70,000.

Do I have your attention?

Everything is legal. Everything is above board. Everything is safe. And the customer service is beyond everything that we can imagine.

This is not unique to us. The State of Utah just adopted this as their primary option for specialty medications for their employees. As I understand it, they are using a different service than I do. However, the results are similar.

We will be rolling this out to all of our employees this year. As you can imagine, there is great anticipation about how much we can save as we consider solutions and opportunities with program such as this. When it comes to healthcare, it is a game – and the people who understand the rules will win. The ones who do not understand the rules of the game will continue to pay more and lose.

Until we get a handle on controlling costs with things such as pharmaceuticals, we must continue to look for new ways to control these costs. If you would like additional information on the solution, feel free to message me.

In the meantime, feel free to get a hold of my pharma tourism broker – I promise I don’t get anything from this. I just share good news is I get it. @rockstarcurrywillix

Here’s to your success!

Dr. Wade Larson

@DrWadeLarson

wade@wadelarson.com

http://www.wadelarson.com

Low Wage Workers Pay More For Health Care Than High Wage Workers « Workers Comp Insider

Tom Lynch, of LynchRyan, posted this last week, but due to a technical error, it did not reach his audience. This article should be cited by anyone who encounters libertarian know-it-all’s on the Internet who put the blame of our expensive health care system on such individuals as lawyers, as one such person I recently debated. Also, the chart from the OECD should be cited over and over again when defending the subject of improved Medicare for All single payer health care. However, Tom does not support Medicare for All, which is understandable, but not a viable position given the overwhelming support it has among many Americans.

Here is Tom’s article:

Anyone who can rub two brain cells together knows America spends more, much more, on health care than any other developed nation, as this chart from the Organization for Economic and Cooperative De…

Source: Low Wage Workers Pay More For Health Care Than High Wage Workers « Workers Comp Insider

Comment By Don McCanne

Don McCanne outlines below some things the previous post, Universal healthcare could save America trillions: what’s holding us back? | Opinion | The Guardian left out.

Here are Don’s Comments:

Those who are up to date on the health policy literature may not find much new here, but there are a few points worth emphasizing:

* It is irrefutable that a well designed, single payer Medicare for All program would meet our health reform goals of affordability, universality, equity, effectiveness and efficiency.

* The barrier to reform is not financing since we are already spending enough to pay for such a system, especially once administrative efficiency is factored in.

* Using taxes to pay for the system should not be a problem since our current public spending on government-financed health programs, on tax expenditures for employer-sponsored plans, and on the purchase of health care for public employees would already pay for much of the system, and the remaining taxes needed would be offset by the elimination of insurance premiums, deductibles and other cost sharing.

* The fact that the taxes would be progressive would be a small step to help offset the egregious inequities in income that hold back too many of us who are contributing our fair share of effort to society while too often having to scrimp on essential needs. Tax policies should be used to adjust inequities that result in a select few being able to accumulate obscene levels of wealth – amounts far, far in excess of what their personal efforts contribute to society. They will not suffer from a very modest reduction in their excesses.

* The primary barrier to reform is political. Although Adam Gaffney says, “Good numbers do not a political movement make,” they sure do help. Advocacy is much easier when the facts are on the side of the people. So let’s all get out and nurture that political movement that we need.

The policy fight should be over. It is a political battle that we now face.

Health Insurance Costs Accelerating for Workers | HealthLeaders Media

This is a follow-up to my previous post, Health Care Costs Rising for Workers. My post then cited a Kaiser study; this article references the University of Minnesota’s State Health Access Data Assistance Center.

On Monday, I reported that there is an effort underway to discredit the move towards single payer by various groups, and even Howard Schultz, the outgoing Chairman of Starbucks said the following back in June:

“It concerns me that so many voices within the Democratic Party are going so far to the left. I say to myself, ‘How are we going to pay for these things,’ in terms of things like single payer [and] people espousing the fact that the government is going to give everyone a job. I don’t think that’s something realistic. I think we got to get away from these falsehoods and start talking about the truth and not false promises.”

So, if these two studies are accurate, and there is no way to prove they aren’t, then both Mr. Schultz and the various groups attempting to derail single payer, are only going to make things worse for workers, and for everyone else.

Oh, and by the way, there have been studies that indicated that we could afford single payer health care, especially a report sponsored by a Koch Brothers backed think tank, Mercatus.

So, consider the following from this Health Leaders article back in October of this year.

The average premium for employer-sponsored plans rose $267, or 4.4% between 2016 and 2017, which is twice the increase recorded between 2015 and 2016.

Source: Health Insurance Costs Accelerating for Workers | HealthLeaders Media