Oh, the games we play when it comes to health care affordability. The winners keep winning, and the losers keep losing because the winners set the rules of the game. Winners (insurers, hospitals, doctors, pharma) win by sharing some information about how to play the game while keeping the most important information hidden. But don’t blame the winners for their success; it wouldn’t be possible without the consent of the losers (individuals, small and large employers, and to a lesser extent, government).

For decades, the losers placed their trust, and dollars, in the hands of the winners, and went about their business. Health care costs were a once-per-year conversation and the goal was to get through it. Meanwhile, for the winners, health care was their business, and they spent every day trying to grow it. Now, we ask, has this unequal relationship reached its tipping point or are we all still all-in?

People like me have been saying for years that health care prices are unsustainable and insurers, hospitals, doctors, and Big Pharma should expect a backlash any day now. Wrong. Any day now has turned into ten years and insurers and hospitals are reporting record profits.

It’s So Hard To Say Goodbye To The Health Care Status Quo

Our relationship with the health care status quo has all the characteristics of an emotionally abusive relationship. The relationship started out well enough. About 100 years ago, Baylor University Medical Center in Texas offered a local teachers’ union a deal for hospital services. “For $6 per year, teachers who subscribed were entitled to a 21-day stay in the hospital, all costs included. But there was a deductible. The “insurance” took effect after a week and covered the full costs of hospitalization.” Soon, millions entered into insurance relationships, as the Blue Cross Plans expanded to other states. Continue Reading...

Tags: health care , health care costs, health care choice

‘Tis the season for articles about charities doing great work for those in need. This is not one of them. The charity I want to discuss does great work, but I want to write about how it could increase its impact if its work was required viewing by all Americans. The charity is Remote Area Medical (RAM); founded by the late, British-born philanthropist and adventurer, Stan Brock.

The first time I heard of RAM was in a 2008 interview with Stan Brock on the 60 Minutes television newsmagazine. Remote Area Medical and its thousands of medical and other professional volunteers, provides free medical, dental, and vision care to people who attend their free “pop-up” medical clinics. Stan Brock started the charity in 1985 to help people in third world countries get needed health care. But on that 2008, 60 minutes program, Stan was being interviewed about RAM clinics in Tennessee, USA.

According to a report in USA Today (2018), the United States is one of the wealthiest countries in the world in terms of gross national income (GNI) and gross domestic product (GDP)—ranked #11 and #2, respectively. America is not a third world country and it’s not remote, but somehow needs the free health care services offered by RAM. How RAM got to America is a story of unaffordable private and public (Medicare and Medicaid) health insurance. A significant number of Americans who receive RAM health care services, have or have access to health insurance but cannot afford the premiums and/or out-of-pocket costs the plans require. And many others do not know how to apply for low-cost or free health care.

Nothing says “failing private health care system” like the buckets of pulled teeth noticeable at any RAM event, or the thousands of people that line up the night before the clinics open in their area, to receive preventative health care. Which leads me to this: what if all Americans had to attend a RAM clinic once per year in exchange for tax-free health insurance premiums (employer group health insurance) and other government-subsidized health care benefits? It’s easy to love your private health insurance, as CNN.com likes to remind Medicare For All supporters. It’s hard to look at buckets of extracted teeth, made necessary because most private medical plans don’t provide preventative dental care. Continue Reading...

Tags: Remote Area Medical, health care , Medicare For All, Stan Brock

Sometimes you just gotta geek out over what’s happening in health care even if its implications are years away.

In 2014, Google CEO, Sergey Brin, complained about “heavily regulated” health care that discouraged health care tech entrepreneurship. Last week Google emerged from secret talks with Ascension health system with a deal (Project Nightingale) to analyze and store health care and administrative data. Meanwhile, Amazon, who never shared Google’s timidity on health care, announced its third major health care venture in the last two years—the Amazon Care app. The rollout of the Amazon Care app for its Seattle-based employees comes after Amazon purchased online pharmacy PillPack in 2018 and teamed with Berkshire Hathaway and JPMorgan Chase to create the healthcare company, Haven. It seems like tech companies have found a remedy for health care’s regulatory headaches, or maybe it’s the chance for health care tech glory that they can’t walk away from.

There’s A Lot of Potential In Health Care Data Tech

It’s not surprising that Google changed its mind and inked a health care data deal. Google so wants to join the list of artificial intelligence (AI) pioneers, and having access to mounds of health care data is the first step to AI glory. Seriously, most health care systems around the world currently have AI projects to analyze health care data and monitor patients. And robotic surgery and robotic-assisted surgery has been a thing for well over a decade. Future AI health care projects may include machines that perform tasks currently done by health care professionals. When you think about it, the idea that if you compile enough data from multiple sources (doctors’ notes, physical exams, diagnostic images, etc.), you can teach a computer to diagnose and treat diseases is pretty cool.

Ascension also has a lot to gain if Google can manipulate the millions of patient data records into an AI system that can diagnose and treat diseases. Imagine the savings hospitals would realize if computers could replace some of the doctors and other health care specialists they would otherwise hire to perform these tasks. And it’s not just the potential savings of using artificial intelligence in health care, AI could reduce health care errors and allow hospitals to serve more patients.

Okay, I’m obviously fascinated by the possibilities of AI in health care. And if big tech can meet the privacy and security standards set by federal laws such as HIPAA, I say bring it on. We’ve already given up a lot of our privacy when it comes to health care. We’re willing to wear activity tracking devices, fill out online health risk assessments, and use telemedicine services all in the hope of improving our health or paying less for health care.

While Individual Privacy Concerns Decreases, Regulators Remain Alert

Ten years ago when I was working in private sector Human Resources benefits departments, health care data privacy was a big deal. Many workers balked at completing health risk assessments (HRA) because they thought their employers would use any “negative” health data from the assessment to fire them. They didn’t like the idea of their employer having such personal data. The Equal Employment Opportunity Commission weighed in on workplace wellness programs that charged higher health insurance plan premiums to workers that refused to complete a health risk assessment. Today, you rarely hear about health risk assessment privacy issues. But that’s not to say that privacy and security are not important in health care. The Health Insurance Portability and Accountability Act of 2003 (aka HIPAA) is a reminder to anyone who has or wants to access health care data of how seriously federal regulators take health care data privacy and security.

Between April 2003 and October 2019, the Department of Health and Human Services (HHS) received nearly 221,000 health privacy complaints. Continue Reading...

Tags: health care , health care privacy, HIPAA, Google, Ascension, HHS

The health care status quo is against ‘one-size-fits-all’ health care. Aside from the fact that people have little to no input into the design of the health plans, ‘choice’ has given us an overpriced and overly complex health care system. Could it be that the reason American health literacy is so low is that there are too many types of health plans? Offering one health plan to everyone would not only improve health literacy (or end the need for it), it would save money.

We’re Health Care Stupid…

Despite the efforts of employee benefits managers, consultants, brokers, communications and health care policy experts, Americans have limited health literacy—“the ability to obtain, process, and understand basic health information and services to make appropriate health decisions.” Surveys show that Americans know a lot less about health insurance than they think they do. A 2016 survey conducted by Policygenius, revealed that 96% of Americans don't understand the terms deductible, coinsurance, copay, and out-of-pocket maximum. A 2019 United Healthcare study, as reported by Motley Fool, showed that 90% did not know the insurance terms: premium, deductible, coinsurance, and out-of-pocket maximum.

It’s hard to make wise health care decisions if you don’t understand basic, cost-related health insurance terms that are part of most private health plans. We could eliminate premiums, deductibles, coinsurance, and copays under our current for-profit health care system. No one has to learn these terms. But instead of removing these terms from their health plans, employers and insurers have added more complexity. So-called health plan design innovations are the latest buzz in employer-sponsored health plans. Centers of excellence, reference-based pricing, high-performance networks, etc.: these cost-containment strategies replaced by one simple reform—one health care plan for everyone.

One Health Plan Is All We Need

Employers have it all wrong when it comes to health plan design. We don’t need a thousand different types of health plans, or health plan design innovations. A thousand different health plans require a thousand different documents that insurers must store in their systems. That equals more time spent doing system administration, and less time evaluating health care quality. If we had just one health plan: Continue Reading...

Tags: health care , health insurance , health care literacy

We’ve all heard the stories of people using Groupon and GoFundMe to help pay for medical care. But about a decade before these companies existed, Human Resources departments worried about the financial strain annual health insurance increases and out-of-pocket medical care costs placed on low-paid workers, in particular. How do you pay for food, rent, and transportation when, in 1999, the average health insurance premium for a single person was $183 per month, and the family premium was $483?

Fast forward to 2019, and the average single and family monthly health insurance premiums (for a PPO plan) are $567 and $1,584, respectively.

Every year, purchasing life’s necessities gets exponentially harder as health care costs eat away at wage increases and savings. Even if you have enough money to cover your basic needs, paying $600 to $1,600 (or half of that if getting an employer and government tax subsidy), makes buying a car or a house, or starting a new business, impossible for millions of people. Other rich countries, and poor countries, too, realize this and have rejected overpriced health care. American employers, on the other hand, accept health insurance and health care increases as common practice.

Make Health Care Affordable For Employees, Not Just Employers

Employers are concerned, and even angry, about the never-ending annual health plan increases their insurers insists they need. They just aren't willing to take a really tough stand on the issue. And what would taking a tough stand on health insurance costs look like for employers? Employers should place price caps on insurance premiums and copays (we really need to eliminate deductible and coinsurance amounts).

When health insurers, hospitals, doctors, and drug makers realize that their biggest cash cow, employers, is no longer willing to pay what's billed, prices will come down. Medicare already says what it’s willing to pay and, to be fair; some employers are experimenting with variations of price caps e.g., (reference-based pricing). But small fry health insurance and health care price capping doesn't trickle down to the employee level, at least not enough to make health care and life’s other wants and needs affordable. Capping health insurance costs might also lead to greater health care price transparency. Do you want more money? Show us why you need it. We know you want it, but do you need it, and how much more? Continue Reading...

Tags: health care , health insurance , price caps

If you went to school in the 1980s like me, chances are your teachers taught you to dislike Russia and Africa. Maybe it was the stories of extreme poverty, primitive (by middle class American standards) living conditions, and government oppression that fueled your aversion for these countries. Or, maybe our teachers and politicians relied on stereotypes about these countries to make the U.S. look superior to them. Well, I’ve never been one to go along with the herd—I’ve always wanted to visit Russia and South Africa (Africa is a continent, not a single country).
 
In 2016, I visited Russia, and in 2019 I visited South Africa and a few other African countries. St. Petersburg and Moscow, Russia were as cosmopolitan as any American big city, and the rural areas of Russia resembled some rural areas in America. Johannesburg and Cape Town, South Africa also resembled large American cities. There was nothing strange or exotic about Russia or South Africa. They are poor countries compared to the U.S., but unlike the U.S., they, at least in philosophy and on paper, look to provide health care to all of their citizens as a human right.
 
At Least “They"Support Universal Health Care
 
No vacation of mine to a foreign land would be complete without studying its health care system.
 
Russia and South Africa have major issues with health care access and quality. In the early 20th century, Russia provided free health care to all of its citizens, but later national reforms entitled “all Russians to free healthcare with Obligatory Medical Insurance (OMI). Employers contribute around 2-3% of employees wages into a social tax, of which a small proportion is put into a healthcare fund.” (So, not free.) In practice, however, many take out their own private medical insurance, known as Voluntary Health Insurance (VHI).”
 
The South African government, this month, “published a bill outlining a national health insurance program it intends to roll out over the next seven years. Private insurers will be able to continue operating until the system is fully implemented, after which they will only be able to offer coverage for services that complement those available from the state.
 
The current South African health care system includes a public and private system of hospitals and doctors. Funding comes from fees charged for services and government contributions.
 
The Russian health care system consistently ranks at the bottom among developed nations. It’s common to hear tales of drunken doctors, unsanitary conditions, and bureaucratic chaos. Russia’s private (market) health care system also struggles with quality issues. 
 
South Africa’s public health care system suffers from a doctor brain drain (doctors train in South Africa, but leave to work in other countries), and sub par public health facilities.
 
If Only Americans Could Understand Health Care Continue Reading...

Tags: American Health Care, health care

Private health insurers know that someday the inevitable will happen—a significant number of people will refuse or be unable to pay the high health insurance premiums the industry has shamelessly extracted for decades. Insurers also know that all of their “cost-saving” efforts over the years were simply stalling tactics, temporary appeasements to employers (payers) to make them feel like they had some control over their multi-million dollar health plans. Insurers were so confident in their relationships with employers that they even took the name “payers” for themselves. However, lately, large employers have questioned their partnerships with insurers and are taking steps to improve the health care experience for their employees and decrease their health plan budgets. But get this; they’re keeping their private health insurance plans.

Large Employers Are Tinkering With Their Health Plans And Calling It Innovation

If you read about health care even occasionally, you know about the new company, Haven. A venture created by the heads of Amazon, Berkshire Hathaway, and JPMorgan Chase. Large companies that got together to create a health insurance company with the goal of lowering health insurance and health care costs for their employees. The health insurance status quo said, have at it. Private health insurers know better than most what’s required to make health care more affordable—medical care price controls and health care trade-offs. Insurers have perfected the art of managing health care trade-offs—most benefit plan documents contain pages of excluded health care benefits. And since employers aren’t talking about price controls, with the exception of reference based pricing, which is technically a form of price controls but with numbers that are easy to manipulate, insurers aren’t that pressed about this new wave of employer health care “innovation.”


Still, we don’t know what “innovations” to expect from Haven, but based on what I’ve read so far, it involves technology. And Haven’s not the first group of large, wealthy employers exploring how technology can help control health care costs. According to a very informative article in Benefits News, before Haven, there was The Employer Health Innovation Roundtable (EHIR), “a grassroots group made up of nearly 60 of the country’s biggest employers that represent nearly 8 million employees.” This group includes mega companies such as Apple, Target, and Google. Basically, representatives from EHIR watch presentations from health care tech start-ups and decide if they want to pilot the “benefit” at one of their companies and report back its findings to the large group via case study or some other format. Continue Reading...

Tags: health care innovation, health care , health care technology, Haven, EHIR

No one could read the statistics about our broken health care system and walk away thinking it just needs a few tweaks. But that's exactly what the marketing and public relations arms of the health care industry status quo wants us to think. The campaign to push back on Medicare For All (M4A), Medicare Buy-In, and any kind of universal health care program that competes with the for-profit health care system is in full swing. What these ads lack in originality they make up for in gall. But if history is any guide, millions of health care consumers will fall for the health care status quo's economic propaganda.

Health Care Industry Anti-Medicare For All Ads Are Pathetic

Social and other media outlets are currently awash in anti-Medicare For All ads, funded by health care organizations and other businesses.

The Partnership for America's Health Care Future (P4AHCF), recently sent out a tweet warning of a future of high prices, low quality, and fewer health plan choices under Medicare For All. (Someone should tell them that the future is now.)

Between the higher price tag, the lower quality care, and the loss of choice and employer-provided coverage, a “one-size-fits-all health care solution” is hardly a solution at all. Learn more → https://t.co/Z5Z50kYzm0 pic.twitter.com/JEHK0bKqJU

— Partnership for America's Health Care Future (@P4AHCF) February 25, 2019

There’s a fair amount of fear on display these days from some of the most powerful people and institutions on the planet. Trump's afraid of Nancy Pelosi. Billionaires at Davos are afraid of Ocasio-Cortez. Microsoft’s afraid of affordable housing and homeless advocates. And the health care status quo is afraid of losing its ability to charge whatever it wants for its products and services. If history is any indication, this high-powered group of scaredy-cats will ignore their opposers or attempt to appease them with small (in proportion to their total resources) gestures.

Just look at how they've responded so far.

Appease: Trump, unwilling to admit defeat to Nancy Pelosi, agrees to temporarily not get his way.

Ignore: Michael Dell, CEO of Dell Technologies and billionaire attendee at Davos, says voluntary philanthropy is a better solution to inequality than taxing the uber rich. (Like that's worked so far.) He also falsely claimed that increasing rich peoples’ taxes hurts economic growth. Bottom line: Mr. Dell thinks that he knows better than the government how to “fix” inequality.

Appease (with a catch): Microsoft, responds to years’ of criticism for exacerbating the affordable housing crisis in the city of Seattle, by creating a multi-hundred-million-dollar housing loan program, along with a much smaller grant to address homelessness. This is a loans-to-pay-for-future-loans program in lieu of higher taxes; with a much smaller grant program thrown in to make it appear more generous. (Where does this I know how to address housing policy issues better than government attitude come from?)

Appease (latch onto): Health insurers and hospitals, in an attempt to forestall Medicare For All, are rolling out small-scale programs to address social determinants of health—‘the circumstances in which people are born, grow, live, work, and age’ that affects their health status and leads to health inequality. (Marmot, Sir Michael, The Health Gap (The Challenge Of An Unequal World): Bloomsbury Press, 2015). By making a small financial commitment now against health care inequality, which was never a major concern of theirs, health insurers and hospitals, hope the public will ignore their ever-increasing, opaque prices and poor health outcomes, on the part of hospitals and doctors. Continue Reading...

Tags: health inequality, Social determinants of health, health care , Medicare For All

If there’s a new year’s prediction that’s easy to make, it is that health insurance and health care prices will rise. The year 2017 was a hugely profitable one for large health insurers, and as predicted premium prices increased significantly in 2018. In 2018, health insurers again saw significant increases in quarterly profits and, you guessed it, monthly premiums increased in 2019. Annual health insurance premium increases are a trend with no end in sight because, why not. Medical care and pharmaceutical prices also rise each year in our anything goes health care system.

Meanwhile, people who have health insurance don’t want to use it because even with insurance, they may have to pay high medical bills when they receive care. Other people, especially in the individual health insurance market, are going without health insurance. After years of paying thousands of dollars each year in insurance premiums and deductibles, they have nothing else to give. Which makes me wonder: with all the frustration over ever-increasing health insurance and health care prices, will 2019 be the year the health care status quo loses its political and cultural support?

It’s On! (The Health Care Value Debate)

Maybe it's me trying to deal with the anger I feel about the 25% increase in health insurance premiums Cigna gifted me this year, but I’m starting to get a sense that 2019 won’t be business as usual for our greedy health insurance and health care industries. Or maybe it's a number of other signs I’m seeing in the health care reform policy debate:

• The new Democrat-led Congress elected to protect health care access, address health-insurance and health care costs, and explore universal health care options like Medicare-For-All or Buy-In, and Medicaid-For-All or Buy-
• The growing demand for real health care price data and all-payer claims databases by individuals and state governments, respectively
• The consistent reporting of and angry responses to outrageous medical care costs like the $629 Band-Aid, $4,000 surgical screw, and $52,000 per month prescription drug
• The study of health care value both nationally and internationally—what are we getting for the trillions we are spending, and what’s the real cost of innovation

Tags: health care , health insurance premiums

The announcement by Amazon's Jeff Bezos, Berkshire Hathaway's Warren Buffett and JPMorgan Chase's Jamie Dimon, about a new health care company they were forming to address rising health care costs, enraged some health insurance companies. Some of these insurers were clients of JPMorgan Chase so Dimon assured them that only employees of the three companies would benefit. But Dimon recently admitted feeling annoyed by the response of the health care companies. He expected "a lot of these people we already do business with to call us up and say, ‘What can we do to help?" He expected a partnership.

So far the public response from big health insurance company CEOs has been diplomatic. Cigna CEO, David Cordani, stated in multiple interviews with the financial press that he sees the venture as "an opportunity." Aetna's CEO, Mark Bertolini, also to the financial press, said, “There is an unmet consumer need in health care." And UnitedHealthcare CEO, David Wichmann, said, "We invite innovation in health care." But Wichmann also said, "Our goal is to help people and make the health system work better for everyone. If Amazon can contribute to that, they should bring it." This refreshingly honest statement from Wichmann and his singling out of Amazon, implies that at least one big insurer considers the new company to be a competitor. But it is the sentiment expressed by outgoing CareFirst BCBS CEO, Chet Burrell, when he said, "What exactly are they going to do differently?" that is mostly likely what the big insurers are all thinking.

With Friends Like These

How long did health insurers think they could hand-deliver products that cut costs by shifting it to employers and their employees? Large employers were early adopters of skin-in-the game cost-cutting strategies like PPO and HDHP plans and know the limits of these schemes. Now, these employers want to see lower health care prices, which means health care insurers have to step up their game. To lower health care prices for their employer groups, insurance companies have to get greater price discounts from hospitals, doctors and pharmacy benefit managers, not just focus on employee behavior. Continue Reading...

Tags: Amazon, Jeff Bezos, Berkshire Hathaway, Warren Buffett, JPMorgan Chase, Jamie Dimon, health care

About every July 4th or after a presidential election writers try to explain the American Identity. Some of them, especially of late, conclude that the American Identity is in crises. America does not know who she is. Others say America knows who she is—she is freedom of speech, religion, and opportunity. America is individualism. If there is an American Identity crisis, it is because we have replaced these freedoms with government interference.

There's no denying American democracy is under attack, but ironically our present debilitating state has crystallized our identity. As the famous quote by Carl Jung, "you are what you do, not what you say you'll do." America is and has always been what it does, not what it says.

America is a place where:

• Slumlords rent substandard, barely habitable housing to the poor because people will pay to live there
• Payday lenders, check-cashing centers and prepaid debit card providers keep the working poor in a cycle of debt offering services traditional banks will not
• Children, under strict rules, receive summer meals from food trucks
• Families wait days to receive free dental care at tent clinics where buckets of pulled teeth pile up
• Hospitals charge the poor and uninsured full price for the same medical care the rich and insured receive at a steep discount
• A cancer-stricken Senator who's been on the receiving but never the giving end of compassion, votes to put in motion a vote that will make health care more expensive for the poor, sick and elderly

Tags: health care , American identity

It is no secret that I am not a fan of the American health care system or health care professionals. I even dislike TV medical dramas. All that hero-worshipping makes me sick. Yeah, I said that.

But before you condemn me you should know that I am not alone in my dislike and distrust of the American health care system and doctors. Surveys show that a majority of Americans share my negative sentiments about both. And it makes perfect sense that the medical establishment has lost its halo. In fact, it is about time.

Doctor Worshipping Is Dead

For all the criticism the White House gets for the Affordable Care Act (aka Obamacare), people are starting to wonder what were the “healers” doing these many decades to improve medical care access and affordability? Nothing. The media coverage and political fighting about Obamacare, and high deductible health plans put a spotlight on the many shortcomings of the current health care system. More people now see the health care establishment as part of the health care cost problem, not as a neutral third party bullied by government and insurance companies.

The positives of receiving good medical care (as an individual) no longer negate the ills inherent in the entire system. The health care establishment finds itself in a you’re either part of the solution or part of the problem moment. And not surprisingly, the system doesn’t get it. They think they can lobby, whine or bully their way back into the good graces of society. It’s not working.

People Want Doctors To Take Responsibility For National Health Care Issues Continue Reading...

Tags: health care

I’m not bragging when I say that I’ve been blessed with good health. I’m extremely grateful that I am healthy, pain- and disease-free for almost 50 years. However, my good health is not all about luck. I don’t smoke, I don’t drink alcohol, I move around throughout the day and I cook most of my meals. Lately, I’ve upped my health game by cutting out sugar and other food additives. I’m earning my good health because I’m afraid of illness and disease. I don’t want to be at the mercy of the American health care system.

The Darker Side Of Health Care

This week I had an opportunity to witness a part of our health care system most of us rarely think about, but should. Rehabilitation and nursing home care. It was an educational but difficult experience for me.

I was visiting an elderly aunt undergoing rehabilitation following the amputation of her leg. Despite the gravity of her situation her rehabilitation has been successful in that she is strong enough to hop around on one leg. She believes that with a prosthetic leg or braces to assist her in walking, she is capable of living independently once again. But there she sits, with no idea of if or when she will receive this final treatment. And she doesn’t sit alone. This place was full of individuals in various states of rehabilitation; however, most of the patients are there for custodial care.

Throughout my near daylong stay at this facility, I saw dozens of individuals in wheelchairs. Others were confined to their beds most of the day. These are the individuals with serious cognitive disabilities. There were as many staff members as patients—including certified nurse aids (CNA), registered nurses (RN), licensed practical nurses, medical doctors, social workers, dietitians, physical, occupational and speech therapists, and recreation therapists.

This was American health care in action and it left me feeling hopeless and scared.

Is This Even Health Care? Continue Reading...

Tags: health care

Who should have health insurance and why is a matter of intense debate in this country. Some people believe that only those who can afford to purchase insurance should have it. Others think that it is an absolute right of every American. And many people, depending on their own situation, fall somewhere in between these two views. But is this the health care debate we should be having?

Conservative Segregated Health Insurance

Two weeks ago Speaker of the House of Representatives, Paul Ryan, proposed putting people with preexisting medical conditions in state-run high-risk pools. A tried and miserably failed "solution" for people insurance companies don't want to insure adequately, if at all. Ryan wants to segregate those with high cost medical care expenses from those with little to no cost. That means the healthy and mostly younger crowd will pay a lot less for their health insurance and the unhealthy and mostly older people will pay a lot more, or go without coverage.

Progressive Segregated Health Insurance

This week, Democratic presidential candidate, Hillary Clinton, proposed allowing individuals as young as 50 to buy-in to Medicare. A never tried but often discussed plan that would help those who are not quite old enough for Medicare, ineligible for Medicaid, but can't afford private insurance coverage, if not provided by an employer.

Private Insurer Segregated Health Insurance

And it’s not just politicians that want to segregate the health insurance market more than it already is, private companies want a piece of the action too. Zoom+, a medical and dental care provider and, more recently, health insurance company, targets well-off millennials for their services and plans. Zoom claims millennials are an underserved market but the fact that they do not accept Medicare or Medicaid patients in their practice proves the real reason behind their youthful approach to health insurance is money. Millennials, on average, don’t need as much medical costly medical care as Medicare and Medicaid enrollees do. And Zoom+ is just one of several insurers try to carve out the millennial crowd. Continue Reading...

Tags: health care

You constantly hear from doctors that they are overworked, over-managed and overwhelmed by bureaucracy and patient expectations. That government and hospital administrators interfere with their relationship with their patients. Is all of this whining legitimate or are doctors trying to deflect from their own failures? Well, some of the whining is legitimate but a lot is not. Doctors and other medical care providers still have ultimate responsibility for patient care and they alone are failing to provide the level of care they claim to aspire to.

Currently, the health care industry is plagued by failure:

• Medical errors that kill over a quarter million people each year
• Opioid addiction that kill thousands each year
• Superbugs (bacterial infections) that are resistant to common antibiotics

• Congress would hold a hearing to determine a cause and propose policy solutions
• The White House would call for an emergency health care summit and propose policies to address these issues
• The candidates for President of the United States would say, forget affordable health care, we need care that does not indiscriminately kill

Tags: health care

Democratic presidential candidate, Bernie Sanders, relentlessly scoffs at the idea that Wall Street is Too Big To Fail. But it is his proposal to provide Medicare For All that exposes the real industry that is, in many people’s mind, Too Big To Fail—health care. A recent Washington Post article all but admits this and the Post is not alone in its thinking.

Throughout this very long campaign cycle countless politicians, policy wonks, economists, writers and everyday people have characterized Medicare For All as unrealistic or in Hillary Clinton’s recent words, “…too good to be true...” Seriously, how many euphemisms can opponents use to say what they’re really thinking—the health care industry is such a big part of our economy that we can’t change it. They are, however, right about health care being a large part of the U.S. economy in terms of money and jobs.

• Health care expenditures make up 17.5% of the nations gross domestic product (GDP). That means it is basically about 20% of the entire U.S. economy
• We spent a little over $3 trillion for health care in 2014
• The health care industry employs over 13 million workers and is the largest private sector business sector

Tags: health care , price transparency, Drug price controls