Insight, analysis & opinion from Joe Paduda
Much has been made here and elsewhere of the issue of cost-shifting. Cost-shifting happens when a provider treats a patient, does not receive ‘full’ reimbursement, and then increases what s/he charges another patient to make up the difference.
There’s a lot of evidence that cost-shifting is pervasive, expensive, and results in a hidden tax of about $1000 for the average insured family.
But what forces providers to treat the uninsured?
In a word, EMTALA.
One of the more thoughtful pieces on individualism v. community responsibility has been (electronically) penned by Sarah Dine at Health Affairs’ blog.
Richard Eskow didn’t want me to have all the fun.
He’s taken the arguments against a libertarian free market health care funding and delivery system to their logical conclusion – no insurance for most of us, lots of bankrupt folks, and then a single payer system.
Libertarians, you have been warned!
Perhaps.
But I think not. At least the smarter ones won’t.
Health plans/insurers/managed care companies are all suffering from mature market malaise. This dread affliction affects companies toiling in an industry with very low growth, dominated by a few large competitors, wherein these competitors can only grow by taking market share from each other (by slashing price) or by acquiring whatever companies are left to buy.
Unless, the market gets bigger.
This is the fourth year my firm has surveyed workers comp payers on prescription drug management. We’ve learned a lot every year, and 2007 is no exception.
If you want a copy of the survey report, email me at jpadudaAThealthstrategyassocDOTcom.
Meanwhile, here are a few highlights.
Continue reading What payers are saying about comp drug costs
There’s a bit of confusion out there re why people don’t have health insurance.
There are likely multiple reasons; some people choose not to, others can’t afford it, and for the rest coverage may just not be available. Here are the facts.
From the big big world of national health care reform, we’re heading to the tiny niche of drugs in workers comp, where some pretty interesting things are happening.
Well, interesting to the six or eight people who are remotely interested in WC drug management.
One of the more puzzling arguments against universal coverage is that advanced by the worthies at the Cato Institute. They argue that if insurance companies could just charge people based on their risk profile, the market would solve the problem of coverage.
I don’t follow the logic.
Continue reading ‘Free markets’ in health insurance just don’t work
Medicare’s admin expenses are not really that much lower than private insurers’. Before single-payer advocates start accusing me of being an industry shill, check out the facts.
A few Coventry workers comp folks were not happy with my characterization of their customer service as less than optimal. They all noted that their customers seem happy and appreciate the high level of service at Coventry.
I don’t doubt that some customers are pleased; I also know that some are not.
