Insight, analysis & opinion from Joe Paduda
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.
I’ve been following with interest the political slap fight surrounding the Obama v Clinton/Edwards positions on mandated coverage. And just when I was getting ready to wax eloquent yet again, into the mailbox arrives Maggie Mahar’s well-written, comprehensive, thoughtful and adult discussion of the subject.
Dammit, she’s hogging all the good stuff.
And I have nothing to add. At least not now.
Wellpoint, the for-profit owner of Blues plans in fourteen plus states, is doing well in California. United Healthcare is most definitely not. The whys and wherefores are both instructive and predictive.
Always one to oblige fellow blogger and Cavalcade of Risk Hank Stern (he of InsureBlog fame), I eagerly agreed to host this week’s edition of the CoR.
Little did I suspect just how popular the ‘cade has grown – I’ve been inundated with entries
Continue reading Cavalcade of Risk – the pre-holiday edition
Yesterday was the beginning of a review of workers comp bill review vendors; today we’ll continue with a look at FairIsaac, a firm that provides software and performs bill review and Coventry.
Networks aren’t the only work comp managed care service experiencing change these days. The bill review business is also looking a bit tumultuous, with the landscape shifting in response to, as well as independent of, Coventry’s moves.
I’ll be examining the industry this week, looking at a few of the major entities at a time.
Paul Krugman and Ezra Klein say yes, mandated universal coverage would – and it is also a key part of serious health care reform. Richard Eskow says no; we have to fix the cost problem before we can cover everyone, and mandates won’t achieve universal coverage (actually Richard says 100% effectiveness, which I agree with – but 99.5% is fine with me).
The first part of the question is rather basic – can a mandate, that is, required coverage for all residents, actually cover all residents?
WorkingRx lost a court case in Utah recently, in yet another setback to the third party biller industry.
This comes on the heels of other successful legal challenges to WRx, which was recently acquired by its only real competitor – Third Party Solutions.
“Utilization changes are the driving force in drug cost changes for WC.”
That’s the key takeaway from the expanded version of NCCI’s annual WC Prescription Drug Study; this 2007 edition goes well beyond prior editions to include more detailed information on cost drivers, stat-by-state variations, generics, and the growth in drug spend during the life of the claim.
But the key is utilization.
The key takeaway? Utilization, not price, is driving drug spend.
In the almost-two years we’ve been publishing Health Wonk Review, we’ve been fortunate to entice some of the clearest thinkers in the web-o-sphere to host each bi-weekly edition.
Roy Poses et al at Health Care Renewal keeps that tradition alive, adding posts from a few newer entrants while artfully weaving in contributions to produce a cohesive, highly readable edition.
