Insight, analysis & opinion from Joe Paduda

Oct
19

Jason Shafrin on HWR

Our favorite health care economist hosts this week’s edition of HWR, in his usual organized style. Jason’s introduced a new idea – post of the week.
See if you agree…


Oct
18

The first fill conundrum

OK, we’re now going to abruptly transition from the broad interest (Canadian health care policy) to the hairs-breadth narrow – this is for the folks who deal with workers comp pharmacy issues.
One of the biggest challenges facing WC payers is getting claimants into their PBM program. My firm has surveyed payers about WC pharmacy management each spring for four years, and this is the one issue where there has been no change over that time.
Retail pharmacies’ difficulties in determining eligibility is the key reason per-script costs are so much higher in WC than in group health, Part D, or individual heath insurance.
Here’s why.

Continue reading The first fill conundrum


Oct
17

Candidate platform cheat sheet

The good folks at the Kaiser Family Foundation have put together a really useful tool to compare all the Presidential candidates’ health care platform planks.
You can slice, dice, and choose which candidates you want to compare. And yes, it even includes Tom Tancredo and Mike Gravel. It includes details on cost, coverage, role of public v private insurance, tax implications, mandates…the works.
And primary source links are provided too. This is really great work.


Oct
16

Those damn immigrants

Taking our jobs, robbing our stores, staring at our womenfolk, speaking them funny langwidges, and using lots of health care. It’s no wonder the dam’ US of A is hurting, with all them furriners here.
Can’t speak to the jobs, robs, or staring, but I do know the complaints about illegal immigrants using lots of care and driving up our costs are wildly overstated.

Continue reading Those damn immigrants


Oct
15

The Faux Canadian

A fake email from a fake Canadian has been circulating in cyberspace. It purports to help we Americans understand the problems inherent in mandated universal coverage by exposing the dark and dirty secrets of Canada’s dysfunctional health care system.
The complete debunking is provided below, but here are the key points
— each province has slightly different plans, with different funding mechanisms.
–These may or MAY NOT require payment of premiums or copays.
–Illegal immigrants are NOT covered by most provinces.
–Waiting lists have been declining for most services in most areas for the last several years.
–Most provincial plans cover almost all drugs, with some (relatively minor) exceptions.
Here’s the complete debunk of the faux Canadian email.

Continue reading The Faux Canadian


Oct
12

The GOP disconnect

What’s missing from Sen. McCain’s new health care proposal is also absent from those put forth by Giuliani and Romney – any connection to the real world of the middle class. Their programs are heavy on tax policy with a dollop of FDA streamlining, accompanied by lofty paeans to the free market and reliance on individuals’ ability to make the right choices.
What they don’t do is increase the availability of insurance, reduce its cost, or address exclusions for pre-existing conditions. Yet these are precisely the problems faced by voters today.

Continue reading The GOP disconnect


Oct
10

Complacency’s cost

With workers comp rates dropping everywhere, many employers are ignoring safety, risk management, and loss prevention.
That’s not smart. One of the smartest people in the industry is warning that now is not the time to lose focus – Frank Pennachio’s piece is a wake-up call for employers lulled into complacency by the persistent soft market.

Continue reading Complacency’s cost


Oct
9

Do you trust Microsoft?

Is it just me, or does anyone else think that Bill Gates has zero credibility when it comes to advocating for a seamless, integrated streamlined system to collect, store, and disseminate health care data?
I’m writing this on a Mac, because I finally threw my Windows PC out the window after one too many system freezes, followed by some unintelligible error message, which presaged a long and frustrating effort to get it resolved.

Continue reading Do you trust Microsoft?


Joe Paduda is the principal of Health Strategy Associates

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A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.

 

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