Unbiased Analysis of Today's Healthcare Issues
What is Medicare Part D? Medicare Part D began in 2006 and provides insurance coverage for pharmaceuticals for the elderly. The program is set up so that the government does not purchase the drugs directly, but subsidizes private prescription drug plans, which then negotiate prices with the pharmaceutical companies. There are two types of Part…
Throughout its history, Medicaid provided health insurance for the nation’s poor. It did this by reimbursing providers on a fee-for-service basis. In the 1990s, however, California and other states decided to let private insurance companies bid for the right to provide services for Medicaid patients. These HMOs would receive a fixed per patient per month…
Consumers are starting to pay a larger share for high priced drugs. According to the N.Y. Times (“Co-payments“), insurance companies “…are charging patients a percentage of the cost of certain high-priced drugs, usually 20 to 33 percent, which can amount to thousands of dollars a month.” Medicare’s drug plans have introduced new fee schedules where…
David Whelan chronicles the rise (and possibly future fall) of Medicare Advantage programs in his article “Unfilled Prescription” in Forbes. Earlier laws privatizing Medicare, starting with a pilot program in 1985, were written to give insurance companies only 95% of the money otherwise spent per Medicare member. The insurers were supposed to figure out how…
Medicare is inefficient and expensive. Medicare has been expanded through Medicare Part D, which covers prescription drugs. Can expanding an inefficient, expensive system be a good thing? Gary Becker argues yes. Since drugs have high fixed research costs but low marginal costs, having the government pay for drugs can increase innovation. In fact, a working…
A recent article in the Journal of Health Economics found that increasing Medicare reimbursement may have no meaningful effect on hospital use or patient outcomes. “There is widespread concern about the quality of health care in the US, and the effect of provider payments on the quality of care is an important and unsettled issue…
The [Medicare Hospital Insurance Trust] fund also continues to fail our long-range test of close actuarial balance by a wide margin. The projected date of HI Trust Fund exhaustion is 2019, the same as in last year’s report, when dedicated revenues would be sufficient to pay only 78 percent of HI costs. Projected HI dedicated…
Merrill Goozer reports (“CMS okays heart scan…“) on how Center for Medicare and Medicaid Services (CMS) has reversed a policy to stop paying for heart scans. There has been no clinical evidence to show that these expensive heart scans identify heart disease any better than less expensive procedures (i.e.: stress tests). Physician revenue, however, would…
Michael Cannon reports (“Pennsylvania Proposes to Defraud Non-Pennsylvanians“) that Pennsylvania is manipulating the Medicaid system. Pennsylvania is increasing Medicaid payments to hospitals (thus increasing the amount of federal matching funds) with one hand, but with the other is creating a tax on “profits of general hospitals in two counties, Allegheny [Pittsburgh] and Philadelphia.” Thus, the…
The Wall Street Journal has an interesting article (“Markets and Medicare“) by John Goodman, President of the National Center for Policy Analysis. The article has some innovative suggestions regarding how to improve the health care system. Medicare should allow alternative payment mechanisms, such as compensating doctors for e-mail and telephone communication with the patient (I…