A recent survey (completed in February 2007) conducted for the PNC Financial Services Group by the Boston-based research firm of Chadwick Martin Bailey found that consumers (especially those with high deductible health plans) want more transparency in health care administration.
The survey was based on telephone calls conducted with 150 executives from U.S. hospitals or health systems, 50 executives from insurance organizations and an online survey of 1,000 U.S. consumers.
Six of ten people who have high deductible health plans strongly agree that their families have become more conscious of health care costs, and some 22% said they compared doctors and hospitals to find the best value for their money.
This finding supports the changing environment that is being brought about by consumer directed health care. As consumers are reintroduced to the process of buying their health care, they are quickly becoming more aware of costs and outcomes. As the consumer directed movement continues to expand, it is becoming clear that the marketplace is responding with pricing transparency, better knowledge of outcomes and generally more informed patients.
Hospitals are working diligently to improve their overall ranking in terms of outcomes. Physician groups are focusing on patient communication. Entrepreneurial companies are developing point-of-sale claims pricing systems to enable patients to learn true costs and to pay for services with debit cards.
Employers are very conscious of wellness programs as a part of the solution to bring health care costs down, thus reducing the cost of insurance benefit plans while gaining a healthier and more productive workforce.
Employers are learning if they don’t already know it, that they must share the premium savings with their employees through funding of Health Savings Accounts and Health Reimbursement Accounts. Those who used the high deductible health plans primarily as vehicles to shift costs are coming to understand that this was a short-sighted approach.
Consumer directed health care is maturing and expanding. That frightens some in government and industry. Some in government don’t relish the idea of empowering the individual since people begin to understand that they don’t need big government to take care of them.
Some in industry and labor circles are similarly wary of these programs. Again, control of members can be threatened when the individuals begin to make their own decisions.
Some in the health care industries are not anxious to see patient independence since they are comfortable with the status quo. However, those same health care providers are being forced to change. They will either adapt to this new era, or risk being relegated to the junk heap as another entity that failed to take the necessary action.
There is a growing tide sweeping over the health care landscape and it is called consumerism.
Thursday, June 14, 2007
Tuesday, June 12, 2007
Wisconsin Health Plan Follow-up...Chapter Two
Another interesting tidbit that was included in the Lewin Study but wasn’t highlighted is this:
Of the some 2.958 million persons currently receiving health insurance benefits through an employer in Wisconsin, the cost for the Wisconsin Health Plan (WHP) will be less than the current costs for only 736,000 persons.
That means that the WHP, a lesser plan, will cost more for the other 2.222 million persons.
Is that not significant enough to warrant mention rather than to be buried on page 49?
How many other nasty surprises are yet to be found?
Is this really what Wisconsin citizens desire?
Of the some 2.958 million persons currently receiving health insurance benefits through an employer in Wisconsin, the cost for the Wisconsin Health Plan (WHP) will be less than the current costs for only 736,000 persons.
That means that the WHP, a lesser plan, will cost more for the other 2.222 million persons.
Is that not significant enough to warrant mention rather than to be buried on page 49?
How many other nasty surprises are yet to be found?
Is this really what Wisconsin citizens desire?
Monday, June 11, 2007
Wisconsin Health Plan Follow-up...Chapter One
Further exploration of the issues surrounding the Wisconsin Health Plan has turned up some very interesting items.
It seems that the Lewin Study discusses an Option 1 that was really the original Plan up until March, 2007. This “option” is actually the original legislation introduced as AB 1140 and is the plan that was the subject of the Legislative Fiscal Bureau analysis. This “option” was presented to everyone as the health care solution that would be fully funded by an assessment of from 3% to 12% of payroll to be paid by employers, and an accompanying assessment of 2% on employee wages.
An independent analysis by the Wisconsin Hospital Association at the time concluded that this plan was under funded by anywhere from $3 billion to $5 billion. This was met by strong disagreement from the author of the WHP.
Buried in the Lewin Study is the fact that the original Plan was indeed under funded by $3.6 billion. It seems strange that this has not been published. If one didn’t know better, it could almost appear as if the author of the Plan was being a bit disingenuous simply to assure that his Plan would continue moving forward. Apparently the end does sometimes justify the means. When you know best what is right for the 5 million citizens of the state, it simply would not do to have facts derail the proposal.
In fact, the March 2nd version of the report pointed out the fatal flaws of the original Plan, and yet that information has not seen the light of day other than in wonk circles.
Stay tuned…more to come!
It seems that the Lewin Study discusses an Option 1 that was really the original Plan up until March, 2007. This “option” is actually the original legislation introduced as AB 1140 and is the plan that was the subject of the Legislative Fiscal Bureau analysis. This “option” was presented to everyone as the health care solution that would be fully funded by an assessment of from 3% to 12% of payroll to be paid by employers, and an accompanying assessment of 2% on employee wages.
An independent analysis by the Wisconsin Hospital Association at the time concluded that this plan was under funded by anywhere from $3 billion to $5 billion. This was met by strong disagreement from the author of the WHP.
Buried in the Lewin Study is the fact that the original Plan was indeed under funded by $3.6 billion. It seems strange that this has not been published. If one didn’t know better, it could almost appear as if the author of the Plan was being a bit disingenuous simply to assure that his Plan would continue moving forward. Apparently the end does sometimes justify the means. When you know best what is right for the 5 million citizens of the state, it simply would not do to have facts derail the proposal.
In fact, the March 2nd version of the report pointed out the fatal flaws of the original Plan, and yet that information has not seen the light of day other than in wonk circles.
Stay tuned…more to come!
Friday, June 8, 2007
Wisconsin Health Plan Study Raises Questions...
There are many questions about the Lewin Study and the Wisconsin Health Plan.
So far, we have heard, through the press, that the Study affirms this is a great idea, will save money for everyone and answers the health care needs of all but 17,000 people in Wisconsin.
All this begs details to support these conclusions that appear to have been drawn by the WHP creators. Rep. Jon Richards (D-Milwaukee) is trying to “fast track” his WHP but is trying to do so without sharing all the facts.
What we haven’t seen or heard is what questions were asked of the Lewin Group? Were those questions agreed to by all member organizations referenced in the press releases? Have there been changes made to the original Plan? Have there been critical questions asked but not answered? If so, what were those questions? Posed by whom? Etc., etc. etc.
Stay tuned. We’ll continue to dig for answers.
So far, we have heard, through the press, that the Study affirms this is a great idea, will save money for everyone and answers the health care needs of all but 17,000 people in Wisconsin.
All this begs details to support these conclusions that appear to have been drawn by the WHP creators. Rep. Jon Richards (D-Milwaukee) is trying to “fast track” his WHP but is trying to do so without sharing all the facts.
What we haven’t seen or heard is what questions were asked of the Lewin Group? Were those questions agreed to by all member organizations referenced in the press releases? Have there been changes made to the original Plan? Have there been critical questions asked but not answered? If so, what were those questions? Posed by whom? Etc., etc. etc.
Stay tuned. We’ll continue to dig for answers.
Monday, June 4, 2007
National Association of Health Underwriters Offers SCHIP Position...
Congress is currently in the midst of reauthorizing the State Children's Health Insurance Program (SCHIP), the state/federal block grant program that funds health insurance coverage for low-income children. It is this program that funds Wisconsin's BadgerCare plan for children. The National Association of Health Underwriters (NAHU) feels that during the reauthorization process, Congress has a great opportunity to make it simpler for states to voluntarily use SCHIP dollars to subsidize private group coverage for eligible children who have access to such private coverage through their parent's employer.
Doing so would have the following benefits:
More families would accept employer-sponsored coverage for their children, lowering the number of uninsured children.
The administrative burden on low-income families would be lessened, as families could be covered together on the same health insurance plan.
It would reduce the “crowd-out” of the private market that occurs when parents decline employer-sponsored coverage in favor of SCHIP coverage for their dependents.
It would lower costs by taking advantage of any premium dollars employers are willing to contribute toward their eligible employee dependent premiums—money that is now often “left on the table.”
It would also reduce SCHIP costs because the risk associated with covering the children with employer-sponsored coverage would be borne by the private market plan rather than the public program.
Licensed health insurance producers, who are already helping millions of business owners purchase health insurance coverage for their employees nationally, could provide outreach and enrollment assistance at virtually no cost to the SCHIP program.
We believe this is a wise approach and urge that our state Senators and Representatives give careful consideration to these points.
Tuesday, May 29, 2007
Canadian-style Health Care Decried by Canadian...
Brett Skinner, Director of Health, Pharmaceutical and Insurance Policy Research for the Fraser Institute, Canada’s leading think tank is urging that California and other states so inclined avoid the Canadian approach to health care.
“Canada is currently witnessing the failure of its own single-payer health insurance system. Faced with this example, why would Americans want to adopt such a system for themselves? The fact is that the Canadian model is an example of what not to do in health care,” said Mr. Skinner.
He went on to say:
“Canada’s public health insurance monopoly is failing and millions of Canadian patients wait so long for treatment that they are no better off than uninsured Americans.”
The article states that the current average wait time from one seeing his or her family physician to being able to see a specialist is 18 weeks. Statistics show that of the patients who received health-care services in 2005, 11 percent waited longer than three months to see a specialist, 17% waited longer than three months to get necessary non-emergency surgery; and 12 percent waited longer than three months to get necessary diagnostic tests.
While Canadians are forced to wait for treatment, the system legally prevents them from seeking treatment elsewhere and paying for it from their own pocket unless they choose to leave the country.
Most important for any state in the U.S. is that the report produced by the Fraser Institute shows that the Canadian system is not financially sustainable in the long run.
Wisconsin would do well to take Mr. Skinner’s words to heart.
“Canada is currently witnessing the failure of its own single-payer health insurance system. Faced with this example, why would Americans want to adopt such a system for themselves? The fact is that the Canadian model is an example of what not to do in health care,” said Mr. Skinner.
He went on to say:
“Canada’s public health insurance monopoly is failing and millions of Canadian patients wait so long for treatment that they are no better off than uninsured Americans.”
The article states that the current average wait time from one seeing his or her family physician to being able to see a specialist is 18 weeks. Statistics show that of the patients who received health-care services in 2005, 11 percent waited longer than three months to see a specialist, 17% waited longer than three months to get necessary non-emergency surgery; and 12 percent waited longer than three months to get necessary diagnostic tests.
While Canadians are forced to wait for treatment, the system legally prevents them from seeking treatment elsewhere and paying for it from their own pocket unless they choose to leave the country.
Most important for any state in the U.S. is that the report produced by the Fraser Institute shows that the Canadian system is not financially sustainable in the long run.
Wisconsin would do well to take Mr. Skinner’s words to heart.
Friday, May 25, 2007
Jack Lohman's Capital Times Opinion Piece...
Mr. Lohman has used an interesting technique to continue his quest for a government-run statewide equivalent of Medicare.
First, because our political system permits contributions to politicians, and because some of those contributions originate with health care or insurance entities, political corruption is part of the “health care crisis”.
If it is, why do we not tackle political corruption as a separate issue and not throw it into the same basket with health care? Health care in and of itself is far and away a tough enough situation to resolve properly without the added impediment of political corruption tossed into the mix.
Next, he restates his premise that a single payer system of health care would be a windfall for business, the economy of Wisconsin and the citizens who would be the consumers of health care in this brave new world.
Medicare relies upon the private sector insurance companies and health care administrators to pay all its claims. Those costs have been shown to be about 12% of the total claims paid, not 31%. The government cost of operating the system is some 2% to 3% of the total cost. That total administrative cost is about the same as the cost of private sector plans in the state under our free market approach.
“A small payroll tax” of 10% to 15% would be levied on the state’s employers instead of the money currently being spent for the free market version of health care. That would impact the roughly 50% of Wisconsin’s smaller employers that do not currently offer health insurance to employees. A new tax of “just” 10% to 15% would virtually guarantee that those employers would cease operation or move from Wisconsin where that was possible.
The reference to Medicare costing more per capita then would the program Lohman espouses is concerning. He maintains that the state-run program would actually save money over Medicare in that all citizens would be rolled into the pool thus spreading the risk. He ignores the fact that Medicare reimbursements are barely more than $0.50 on each billed dollar. The amount unpaid by Medicare is transferred to the free market programs through increased retail fees at the point-of-care. That alone is a big part of the health care crisis which is largely a health care cost crisis as we’ve argued before.
An alternative would be for those same health care providers to decide whether or not they could continue in business if all reimbursements were now at or below the level of Medicare reimbursements. Another alternative would be for the state to hire the providers of care to take all the egregious “profit” out of the equation. Yet another alternative is for rationing of the then available health care services by the state agency charged with running the health system. Each of those alternatives certainly has a nice ring to them; it’ll be really difficult to decide which to use. Maybe we can have some of each.
And then there is another “small tax” to take away all co-pays, deductibles, dental and vision expense. That would complete the loop. The entitlement mentality that is a large part of the current problem would have become the mentality of us all, and we would’ve driven more jobs out of Wisconsin.
But, we would’ve completely eliminated the insurance industry, all the agents, etc. And that seems a primary goal for effective health care reform from Mr. Lohman’s perspective.
Finally, the argument returns to that of “Business Ethics 101”.
We are finally in agreement: all sides of this debate must be completely honest and ethical because this is far too important a debate to permit it be limited or twisted.
First, because our political system permits contributions to politicians, and because some of those contributions originate with health care or insurance entities, political corruption is part of the “health care crisis”.
If it is, why do we not tackle political corruption as a separate issue and not throw it into the same basket with health care? Health care in and of itself is far and away a tough enough situation to resolve properly without the added impediment of political corruption tossed into the mix.
Next, he restates his premise that a single payer system of health care would be a windfall for business, the economy of Wisconsin and the citizens who would be the consumers of health care in this brave new world.
Medicare relies upon the private sector insurance companies and health care administrators to pay all its claims. Those costs have been shown to be about 12% of the total claims paid, not 31%. The government cost of operating the system is some 2% to 3% of the total cost. That total administrative cost is about the same as the cost of private sector plans in the state under our free market approach.
“A small payroll tax” of 10% to 15% would be levied on the state’s employers instead of the money currently being spent for the free market version of health care. That would impact the roughly 50% of Wisconsin’s smaller employers that do not currently offer health insurance to employees. A new tax of “just” 10% to 15% would virtually guarantee that those employers would cease operation or move from Wisconsin where that was possible.
The reference to Medicare costing more per capita then would the program Lohman espouses is concerning. He maintains that the state-run program would actually save money over Medicare in that all citizens would be rolled into the pool thus spreading the risk. He ignores the fact that Medicare reimbursements are barely more than $0.50 on each billed dollar. The amount unpaid by Medicare is transferred to the free market programs through increased retail fees at the point-of-care. That alone is a big part of the health care crisis which is largely a health care cost crisis as we’ve argued before.
An alternative would be for those same health care providers to decide whether or not they could continue in business if all reimbursements were now at or below the level of Medicare reimbursements. Another alternative would be for the state to hire the providers of care to take all the egregious “profit” out of the equation. Yet another alternative is for rationing of the then available health care services by the state agency charged with running the health system. Each of those alternatives certainly has a nice ring to them; it’ll be really difficult to decide which to use. Maybe we can have some of each.
And then there is another “small tax” to take away all co-pays, deductibles, dental and vision expense. That would complete the loop. The entitlement mentality that is a large part of the current problem would have become the mentality of us all, and we would’ve driven more jobs out of Wisconsin.
But, we would’ve completely eliminated the insurance industry, all the agents, etc. And that seems a primary goal for effective health care reform from Mr. Lohman’s perspective.
Finally, the argument returns to that of “Business Ethics 101”.
We are finally in agreement: all sides of this debate must be completely honest and ethical because this is far too important a debate to permit it be limited or twisted.
Thursday, May 24, 2007
Fixing an Ailing State Health Program...
Maine created Dirigo as the panacea to solve the uninsured problem of its citizens. Dirigo has been, by most counts, a failure having attracted only 13,000 participants.
For the second year in a row, a new bill is coursing its way through the political process that would put another twist on this failed program.
Dirigo would become self-funded and apparently Maine would be its own reinsurer. This is intended to permit the replacement of Anthem that had the audacity to earn a profit of some $3.6 Million from its work on Dirigo.
States have every right to experiment with what their citizens believe ought to work, but they really should be more careful than is the case with some.
Maine will find itself in the health care authorization business. Rationing is the term that comes to mind. Political forces will be pushed and pulled by the heartbreak that illnesses and need for treatment bring. Politicians seem to believe that the supply of money is endless, and will be hard-pressed to save themselves from approving new coverage to gain votes.
Inevitably, there will be budget pressures and those will lead to increased cost-sharing with those covered, or increased taxes, or more stringent rationing…and likely a combination of the three.
Wisconsin needs to take note as it debates the issues involved with health care.
For the second year in a row, a new bill is coursing its way through the political process that would put another twist on this failed program.
Dirigo would become self-funded and apparently Maine would be its own reinsurer. This is intended to permit the replacement of Anthem that had the audacity to earn a profit of some $3.6 Million from its work on Dirigo.
States have every right to experiment with what their citizens believe ought to work, but they really should be more careful than is the case with some.
Maine will find itself in the health care authorization business. Rationing is the term that comes to mind. Political forces will be pushed and pulled by the heartbreak that illnesses and need for treatment bring. Politicians seem to believe that the supply of money is endless, and will be hard-pressed to save themselves from approving new coverage to gain votes.
Inevitably, there will be budget pressures and those will lead to increased cost-sharing with those covered, or increased taxes, or more stringent rationing…and likely a combination of the three.
Wisconsin needs to take note as it debates the issues involved with health care.
Wednesday, May 23, 2007
Canadians don't care for Sicko...
…so read the headline for an article written by Peter Howell for the Toronto Star on May 20, 2007.
He stated that Michael Moore took quite a verbal beating during an interview at the Cannes Film Festival where Moore has been touting his latest “documentary”. I quote from his article:
“We Canucks were taking issue with the large liberties Sicko takes with the facts, with its lavish praise for Canada’s government-funded medicare system compared with America’s for-profit alternative.”
“…Sicko makes it seem as if Canada’s socialized medicine is flawless and that Canadians are satisfied with the status quo.”
“Other Canadian journalists spoke of the long wait times Canadians face for health care, much longer than the few minutes Moore suggests in Sicko.”
“Sicko, to be released in North America on June 29, is by turns enlightening and manipulative, humorous and maudlin. It makes many valid and urgent points about the crisis of U.S. health care, but they are blunted by Moore’s habit of playing fast and loose with the facts. Whether it’s a case of the end justifying the means will ultimately be for individual viewers to decide.”
The U.S. health care industry knows this is coming and feels alternately threatened, angered, frightened and somewhat helpless. What can be done to blunt this latest of Moore’s film adventures?
Those who care must become much more knowledgeable about Canadian, British, French and Cuban health care issues and how those systems compare to that of our country. Moore has changed his original tactics and now attempts to cajole, instead of club, folks to get them to see his point of view.
His tactics require that spokespeople for the industry assure that they too change their tactics. They can no longer simply criticize the messenger; they must become sufficiently knowledgeable as to be able to refute the wild claims one-by-one.
We are disadvantaged by the fact that his public relations machine is running at full speed and has been for awhile. We have yet to see the film in its entirety and do not yet understand the nature of his various claims and/or charges. We must begin to act now in order to counter the various “issues” soon after the initial screenings in this country.
Agents certainly understand many of the faults of the current U.S. health care system. They must not be seen as defensive, however, when it is they who have been preaching to the choir for the past decade or better.
Agents simply need to occupy the high ground of truth and reason. The Coalition for Sensible Health Care Solutions is a solid platform on which to build consensus.
He stated that Michael Moore took quite a verbal beating during an interview at the Cannes Film Festival where Moore has been touting his latest “documentary”. I quote from his article:
“We Canucks were taking issue with the large liberties Sicko takes with the facts, with its lavish praise for Canada’s government-funded medicare system compared with America’s for-profit alternative.”
“…Sicko makes it seem as if Canada’s socialized medicine is flawless and that Canadians are satisfied with the status quo.”
“Other Canadian journalists spoke of the long wait times Canadians face for health care, much longer than the few minutes Moore suggests in Sicko.”
“Sicko, to be released in North America on June 29, is by turns enlightening and manipulative, humorous and maudlin. It makes many valid and urgent points about the crisis of U.S. health care, but they are blunted by Moore’s habit of playing fast and loose with the facts. Whether it’s a case of the end justifying the means will ultimately be for individual viewers to decide.”
The U.S. health care industry knows this is coming and feels alternately threatened, angered, frightened and somewhat helpless. What can be done to blunt this latest of Moore’s film adventures?
Those who care must become much more knowledgeable about Canadian, British, French and Cuban health care issues and how those systems compare to that of our country. Moore has changed his original tactics and now attempts to cajole, instead of club, folks to get them to see his point of view.
His tactics require that spokespeople for the industry assure that they too change their tactics. They can no longer simply criticize the messenger; they must become sufficiently knowledgeable as to be able to refute the wild claims one-by-one.
We are disadvantaged by the fact that his public relations machine is running at full speed and has been for awhile. We have yet to see the film in its entirety and do not yet understand the nature of his various claims and/or charges. We must begin to act now in order to counter the various “issues” soon after the initial screenings in this country.
Agents certainly understand many of the faults of the current U.S. health care system. They must not be seen as defensive, however, when it is they who have been preaching to the choir for the past decade or better.
Agents simply need to occupy the high ground of truth and reason. The Coalition for Sensible Health Care Solutions is a solid platform on which to build consensus.
Monday, May 21, 2007
Hospitals Threatened by Gov. Doyle...
Governor Doyle has threatened the hospitals in Wisconsin by stating they would receive no Medicaid rate increase unless they accepted his 1% of gross revenue hospital tax proposal.
The Wisconsin Hospital Association is opposed to the tax with a chief reason being their fear that the additional Federal money that would flow into the state as the result of this “tax” would not go entirely to the hospitals. They also stated that the acceptance of the Governor’s proposal in this instance would cause such an approach to become the approach of choice for years to come.
The assessment would generate some $202.5 million in 2008 with only $136.9 million going back to the hospitals, and would generate some $212.7 million in 2009 with $147.3 going back to hospitals.
It seems obvious that the hospitals have every right to be concerned even in the face of the Governor’s threat.
By the way, does anyone have any idea where all this newfound money will come from? Of course. We all pay our taxes to the U.S. and the state; and any hospital shortfalls will be collected from those who use those facilities.
We citizens just seem to have really deep pockets…at least to the Governor!
The Wisconsin Hospital Association is opposed to the tax with a chief reason being their fear that the additional Federal money that would flow into the state as the result of this “tax” would not go entirely to the hospitals. They also stated that the acceptance of the Governor’s proposal in this instance would cause such an approach to become the approach of choice for years to come.
The assessment would generate some $202.5 million in 2008 with only $136.9 million going back to the hospitals, and would generate some $212.7 million in 2009 with $147.3 going back to hospitals.
It seems obvious that the hospitals have every right to be concerned even in the face of the Governor’s threat.
By the way, does anyone have any idea where all this newfound money will come from? Of course. We all pay our taxes to the U.S. and the state; and any hospital shortfalls will be collected from those who use those facilities.
We citizens just seem to have really deep pockets…at least to the Governor!
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