Insight, analysis & opinion from Joe Paduda
I’m having a tough time getting mad at United Healthcare. The huge managed care company is under fire for penalizing docs who use any lab other than UHC’s preferred partner, LabCorp. The AMA, regulators, individual physicians, and a few consumer groups are all screaming about UHC’s heavy-handed, dictatorial infringement on their right to practice medicine.
They’ve got it all wrong.
If consumerism is going to work, the consumers are going to have to think about costs. Problem is, the real consumers (physicians) don’t think about patients’ out-of-pocket costs.
At least not when it comes to diagnostics and hospitalizations.
What gets lost in the healthcare debate is the impact of our dysfunctional system on individuals and families. Jon Cohn of The New Republic and elsewhere has gone a long way to personalizing the health care mess in his new book, “Sick”.
Jon’s also leading a debate on the topic at TPM. Several health care types including your author are arguing to and fro, while others are keeping us honest.
Insurance companies, employers, and TPAs rely on vendors to process bills, build and operate networks, manage prescriptions and PT, support litigation, and provide expert advice on problematic medical issues. In many instances the vendors are selected thru a competitive bidding process, wherein the lowest bidder gets the deal, or at the least has a much better chance of landing the business than their more costly competitors.
But in others, the selection process goes on seemingly without end.
If watching the legislative process in DC is akin to watching sausage made, the passage of the Medicare Drug bill might be akin to the composting process. Roy Poses at Health Care Renewal reflects on “60 minutes'” recent piece on the making of Part D; Roy’s deep experience with big pharma adds a good bit of perspective.
Health care reform is coming; read Roy’s piece for a heads’ up on what the legislative process may look like.
Bob Laszewski weighs in on the Wellpoint insurance cancellation debacle. As a former health insurance company president, Bob’s perspective is unique.
California, New York, and Texas are all in various stages of reforming their workers comp systems. Florida’s reforms have been in place for several years, and rates have dropped thru the floor. WC premiums have decreased even more, with some employers seeing cuts of 50%. South Carolina may also see changes, and there are initiatives on the table in several other states as well.
Lower costs are great, for the buyer. Employers can move on to other important issues, shoving risk management initiatives to the bottom of the pile. They can move their business easily, as there are more work comp insurers clamoring for their business, eager to lower premiums even further in an effort to capture market share.
But there can be a significant downside to successful reform efforts.
Jane Hiebert-White at Health Affairs has just posted the latest and greatest of the health policy blogosphere. Her edition is rich with the latest on policy, with compelling posts for and against “socialized medicine”.
Read on!
Consumer directed health plans will make all of us better users of the health care system. We’ll shop for price, be careful about what procedures we get from whom for how much how often. We’ll bargain, examine data, and carefully compare providers.
And as a result, we’ll all save a bundle, and the US health care system to boot.
Sort of.
More evidence is emerging about the rather minimal impact medical malpractice has on medical costs.
