Dec
31

The essential political BS detector

As we head into the election year, we’re going to be inundated with claims, counter-claims, accusations and puffery from candidates at all levels. To separate truth from fiction, I strongly recommend subscribing to FactCheck.org.
To date, some of the most outrageous claims have been about health care. Here’s a few examples pulled from FactCheck’s research.
— Pres. Bush’s veto of the SCHIP bills were based on his claims that the legislation would result in governmental funding of health care for kids in families making up to $83,000 a year. Not true. He also claimed SCHIP was for poor kids – it isn’t – Medicaid is.
–Meanwhile, Congressional Democrats were taking credit for a bill that they claimed would lower Medicare drug costs by allowing HHS to negotiate with drug companies. Yes, Sec. Leavitt could negotiate, but the bill gave him no leverage and prohibited exclusion of some drugs.
–Sen. Edwards claimed that he would force Congress to pass universal coverage or he would take away their health care. But he has no authority to do so, making his claim an empty threat.
–While Edwards was taking credit for what he would do (but can’t), Hillary was falsely taking credit for something she didn’t do – providing health care coverage to National Guardsmen and reservists. (To be fair, she did help expand their coverage and access to same, but her role, and the result, was not nearly as broad as she implied.)
–GOP candidates weren’t spared. Rudy Giuliani butchered statistics in his claim that prostate cancer victims in England had a survival rate of 44%, due to the country’s socialized medicine system. He not only conflated England with the UK, he also used completely false data to make his claim.
–Rudy G gets the award for most bizarre claim; if 50 or 60 million individuals bought their own health insurance, the price of health insurance would be cut in half. That’s just a stunner.
–Mitt Romney, he of the Massachusetts health care reform plan, claimed that “HillaryCare” would be socialized medicine, while his Mass plan is not. Leaving aside the question about what exactly is socialized medicine, what is clear is both plans share a lot more similarities than differences.
— (this isn’t specific to health care, but nonetheless telling) – The US Chamber of Commerce falsely claimed that abusive lawsuits cost the average family $3500 a year.
The net – be very suspicious of politicians bearing categorical statements.


Dec
16

Adios, muchachas y muchachos

I’ve successfully escaped the second nor’easter of the season, and won’t be heard from again until next year (unless I get really bored on vacation).
It has been a good year. Thanks for reading.


Dec
14

ASCs — good, bad, or just ugly?

A recent court ruling in New Jersey could shut down Ambulatory Surgical Centers across the state.
The judge determined that physician-owned ASCs (almost all ASCs are at least partly owned by physicians) violate a state law banning physician self-referral. Not surprisingly, the 200 ASCs in the Garden State (there are about 5000 nationwide) are pulling out the stops to overturn a ruling that, if it stands, would effectively shut down most ASCs in NJ.

Continue reading ASCs — good, bad, or just ugly?


Dec
12

Drug utilization in comp: more details

NCCI’s latest report on drug costs makes for pretty compelling reading. At least among those of us who find this stuff remotely interesting. The report, published this November, adds much-needed depth to our understanding of the factors driving drug costs. Everyone (well, everypne defined as the hundred or so who pay attention to this) knows utilization is the big driver; the study goes well beyond to provide detail on how much utilization contributes and where.

Continue reading Drug utilization in comp: more details


Dec
11

Good thing they have jobs

It was all I could do to not steal his idea.
Bob Laszewski and I were catching up yesterday when he told me about an interview he did with an LATimes reporter. The reporter was working on a story about how several of the GOP candidates’ would likely not be able to get insurance if their health care platforms actually became law.
Fortunately Bob posted on it today, ending my temptation.
The net is this – four of the GOP candidates have had bouts with cancer. In most states, none could get affordable coverage in the individual market today, and their ‘reforms’ would make it even less likely.
And all of them are calling for the free market to solve the coverage problem, including Romney who is actually stumping for less regulation of the insurance market. Makes you wonder if they have any idea what they’re talking about…


Dec
11

The real voter’s perspective

In a reminder of just how disconnected some of us (i.e. me) are from most Americans, a New York Times poll recently came out with all kinds of detailed stats about which candidates are favored by whom how much and why. I was buried in the article, pulled this way and that, contemplating implications and potential campaign changes, looking for new information, subtle implications, analyzing details and pondering away.
And at the end of the piece this priceless line smacked some sense into me:
(the poll) “also found that 45 percent (of Republicans) were unable to say what Mr. Romney’s religion was.”
Yes, health care is important. So is Iraq, and abortion and gay rights and education and taxes and the economy. But most Americans are not paying attention, at least not yet.


Dec
10

Huckabee on health

Bob Laszewski reviews Mike Huckabee’s health care position over at Health Policy and Markets. The net is there’s nothing much different from the other GOP candidates’ positions.
As Bob (and I, and others) have noted previously, there’s just a lot more to the Democratic candidates’ positions on health care than their GOP opponents. Edwards, Clinton, Obama, Richardson all have pretty detailed proposals, while Giuliani, McCain, Romney and Huckabee stick with lists of principles or concept.
There is nothing inherently wrong with either approach, although the public’s high level of interest in health care reform might reward a candidate who appears more interested in the issue. Conversely, the details put out by the Dems may be their undoing.
Any detailed proposal has more vulnerabilities than a ‘policy’ that is limited to general statements.


Dec
10

The return of 24 hour coverage?

A decade ago a lot of folks were working on ’24 hour’ coverage – the combination/integration of workers comp and group health and disability management. AIG, United Healthcare, Reliance National, Broadspire (nee Kemper) and Unisource Administrators were among the players; the Integrated Benefits Institute was founded, and consultants formed practices and marketed their expertise to interested parties. (disclosure – I was heavily involved in the AIG-UHC, Reliance-UHC, and Unisource-UHC-AIG programs)
Then it all sort of faded away, and not much was heard until today’s announcement that Sedgwick CMS and UHC have re-entered the market.

Continue reading The return of 24 hour coverage?


Dec
7

Consumerism’s big problem – reality

A strong dose of consumerism will solve the health care cost crisis because people will be more careful in spending their own money than they are when bills are paid by great big insurance companies. That’s the theory behind the latest ‘innovation’ in health insurance – consumer directed health plans (CDHPs).
Unfortunately, that theory doesn’t work very well in the real world.

Continue reading Consumerism’s big problem – reality