INSURANCE RE-REGULATION PASSES SENATE
Hat's off to Harry Reid, who has spent seven months or so herding cats for the President... In the end, the bill vote was 60-40, with two major jumps left to go.
The Dorgin amendment, for importation for prescription drugs, somehow was controversial, flamed out 51-48.
SOME OF THE GORY DETAILS
Large and small, the nanny corporation remains intact, as real change is too much, apparently. Still, CBO estimates that companies will dump 8-9 million into the (subsidized) 'exchange market'.
Insurance companies can continue to use the non-group market to subsidize their prized clients in the group market (i.e. no public option or similar competition). Their medical loss ratio is "limited" to a staggering 20%, however. [The Swiss, by comparison, say that 'basic insurance' is to be provided at cost by the private sector, i.e near 0%...]
The government will mandate purchase of private, for-profit insurance, on penalty of the tax authorities, creating a potential sore-point with voters. The CBO gleefully projects $2 billion periodically in penalties to be collected from voters...
The government will subsidize the purchase of private, for-profit insurance, creating a strange set of individual incentives, compared to a single-payer model, given that typical healthcare expense is not cost irrelevant
A lot of non-binding cost recommendations could flow from a bucket of money spent to study stuff. A lot. Non-binding. Bucket of money.
Turns out that annual caps may not be that pricey to eliminate. If so, one can hardly understand why eliminating these wasn't done years ago. Unless those estimates are bunk and the growth in expensive, degenerative diseases is paramount.
I have no idea how much getting rid of pre-existing conditions will cost, in terms of average premium increases. (And I'm not going to keep looking in the CBO's work ...).
Rural areas will get direct healthcare investments. The government will take a hand at bolstering the workforce for health-service professionals... This, even while the main thrust of the bill is to adore the 'private sector'.
Monday, December 21, 2009
Snow, Collins, Gregg, Grassley - All vote 'No'
Wednesday, April 15, 2009
The Looming Health Care Battle - Are We Ready
Scanning through the comments here, it looks like some folks (here, here) are getting past the staid. blogospherical opinion-makers on the subject of what do to about healthcare.
Having listened to the recent President's roundtable, I have to say that even I didn't have an appreciation of the scale of the structural changes that could be required.
Getting cost-rationalization in American healthcare may end up being like turning a battleship. For one thing, we have no consensus or rigorous rank-ordering of the cost drivers. For another, there is no consensus on how to attack 'the problem', although many seem to be suggesting that a 'patient centric' focus is the way to grab a hold of this tiger and tame it.
Anyway, the uncertainty mist allows people like Kling to push scary 'tradeoffs' that we aren't even sure are of principal concern.
Related: Smackdown of the size of the 'frivolous lawsuit' cost driver...
Monday, April 28, 2008
The End of Price Insulation
For those familiar with Kling's "Iron Triangle" regarding healthcare, this might be filed under the category of 'the end of price insulation'.
Health insurance companies are rapidly adopting a new pricing system for very expensive drugs, asking patients to pay hundreds and even thousands of dollars for prescriptions for medications that may save their lives or slow the progress of serious diseases.
With the new pricing system, insurers abandoned the traditional arrangement that has patients pay a fixed amount, like $10, $20 or $30 for a prescription, no matter what the drug’s actual cost. Instead, they are charging patients a percentage of the cost of certain high-priced drugs, usually 20 to 33 percent, which can amount to thousands of dollars a month.
The system means that the burden of expensive health care can now affect insured people, too.
No one knows how many patients are affected, but hundreds of drugs are priced this new way.
[I assume this could affect HIV meds, directly, for those few with private insurance.]
If I didn't remember Kling's categories right, please forgive me, and just accept this as a factoid on the road to health care oblivion in the United States.