A project of the Galen Institute

Issue: "Premiums/Costs"

Choosing a $10 medical test over a $10,000 one

Jason Fodeman
Washington Times
Fri, 2014-08-22
"Research published last week in the British Medical Journal Open provides interesting insight into the cause of rising health care costs. Analysis of the study raises concerns that Obamacare could ultimately bend the cost curve up. The University of California at San Francisco research studied variations in the average charges of 10 commonly ordered outpatient blood tests in California hospitals in 2011, using data from the reports of nonfederal, general acute-care California hospitals to the California Office of Statewide Health and Planning Development. The researchers uncovered significant and substantial variation in hospital charges across the Golden State. For example, the median charge for a basic metabolic panel (a routine laboratory test that includes such tests as sodium, potassium and glucose) was $214. Yet, for the 189 California hospitals that reported this test, the charges ranged between $35 and $7,303."

Unemployed by ObamaCare

Fri, 2014-08-22
NOTE: This story is behind a pay wall. "Most of the political class seems to have decided that ObamaCare is working well enough, the opposition is fading, and the subsidies and regulation are settling in as the latest wing of the entitlement state. This flight from reality can't last forever, especially as the evidence continues to pile up that the law is harming the labor market. On Thursday the Federal Reserve Bank of Philadelphia reported the results of a special business survey on the Affordable Care Act and its influence on employment, compensation and benefits. Liberals claim ObamaCare is of little consequence to jobs, but the Philly Fed went to the source and asked employers qualitative questions about how they are responding in practice. The bank reports that 78.8% of businesses in the district have made no change to the number of workers they employ as the specific result of ObamaCare and 3% are hiring more. More troubling, 18.2% are cutting jobs and employees.

Poll: 69% favor Prop. 45 measure on regulating health insurance rates

Chad Terhune, Los Angeles Times
Thu, 2014-08-21
"A new poll shows 69% of California voters back Proposition 45, a November ballot measure giving the insurance commissioner the power to stop excessive health-insurance rate increases.. The Field Poll released Wednesday indicates broad support statewide for Proposition 45 ahead of what's expected to be a costly and contentious battle between consumer groups and health insurers. Overall, 69% of registered voters said they favored the health-rate regulation measure while 16% opposed it and 15% were undecided heading into the Nov. 4 election. The poll found that a majority of registered Democrats and Republicans in the state supported Proposition 45. Among Democrats, 75% of those surveyed offered support while 58% of Republicans also favored it."

Risky Business: Will Taxpayers Bail Out Health Insurers?

John R. Graham, National Center for Policy Analysis
Thu, 2014-08-21
"Despite the president’s assurance that “if you like your health plan, you can keep your health plan,” Obamacare caused significant disruption to people’s coverage as the health insurance exchanges prepared for their first open enrollment. Beginning October 1, 2013, insurers knew they would struggle to price policies in the exchanges accurately. The Affordable Care Act (ACA) included three mechanisms to backstop insurers’ risks: risk adjustment, reinsurance and risk corridors.

The Secret Committee Behind Our Soaring Health Care Costs

Katie Jennings
Politico
Thu, 2014-08-21
"It was late in the afternoon on a warm Friday in early fall and Doug Sumrell was mowing the lawn outside his suburban home in Evans, Georgia. As he pushed the mower across the yard, Sumrell began to feel faint — his chest tightened and the back of his neck started throbbing — so he went inside to take a break and drink a glass of water. But each time he went outside to finish the job, the feeling came back. He drove himself to the hospital as the sun was setting. On the way there, he left a message for his primary care doctor, Dr. Paul Fischer. At the hospital, a cardiac enzyme test showed Sumrell’s levels were extremely high, a strong indication that Sumrell had experienced a heart attack. The emergency room doctors said that they wanted to admit him, but it was already after midnight and Sumrell’s symptoms had subsided. His wife was out of town and their dog Buddy needed to be let out. Sumrell checked himself out of the hospital. He was jolted awake at 7:30 a.m. by the telephone.

Obamacare Or Not, Republicans Should Focus On Reducing The Cost Of Health Care

Avik Roy
Forbes Magazine
Thu, 2014-08-21
"For all the endless talk about reforming the health care system these past five years, it’s remarkable how little we’ve done to solve its actual problems. Spending hundreds of billions of taxpayer dollars to subsidize insurance coverage for several million people? That’s the easy part. The hard part is addressing the fact that American health care is so expensive. The high price of U.S. health care is the fundamental reason tens of millions of Americans are uninsured. It’s the principal suppressor of middle-class wage growth. It’s a constant threat to businesses’ operating margins, and it’s the primary driver of the federal debt. In May the American Health Policy Institute surveyed the chief human resource officers of 360 large employers, representing 10 million workers.

Carondelet to pay $35 million in rehab overbilling case

Modern Healthcare
Wed, 2014-08-20
"Carondelet Health Network, a Tucson, Ariz.-based division of Ascension Health, has agreed to pay $35 million to settle allegations that two of its hospitals inappropriately billed Medicare and other federal health programs for inpatient rehabilitation care. The settlement is the highest amount paid in Arizona under the False Claims Act, according to the U.S. attorney's office in Phoenix. From 2004 to 2011, the Justice Department alleged, the Carondelet hospitals billed the government for inpatient rehab services for patients who didn't meet coverage criteria. The Roman Catholic hospital system “expressly denies” the allegations in the settlement agreement."

More Bad News for Obamacare

Megan McArdle
Bloomberg
Tue, 2014-08-19
"Last Monday, Jed Graham of Investor’s Business Daily reported that insurers say Affordable Care Act enrollment is shrinking, and it is expected to shrink further. Some of those who signed up for insurance on the exchanges never paid; others paid, then stopped paying. Insurers are undoubtedly picking up some new customers who lost jobs or had another “qualifying life event” since open enrollment closed. But on net, they expect enrollment to shrink from their March numbers by a substantial amount -- as much as 30 percent at Aetna Inc., for example. How much does this matter? As Charles Gaba notes, this was not unexpected: Back in January, industry expert Bob Laszewski predicted an attrition rate of 10 to 20 percent, which seems roughly in line with what IBD is reporting. However, Gaba seems to imply that this makes the IBD report old news, barely worth talking about, and I think that’s wrong, for multiple reasons."

CT’s individual insurance market grew 55 percent under Obamacare

Arielle Levin Becker, Connecticut Mirror
Tue, 2014-08-19
"The number of Connecticut residents covered by health insurance purchased through the state’s individual market rose by nearly 60,000 since last year, a 55 percent increase since the implementation of major provisions of Obamacare, according to figures released by the Connecticut Insurance Department. The data also show that more than half the people who bought their own health insurance last year have maintained their old policies or other plans purchased late in 2013. But more than 50,000 of them won’t be able to keep their health plans beyond this year, potentially setting up a repeat of last fall’s turmoil and frustration among people whose policies were discontinued."

Obamacare Opponents Who Won On Subsidies Ask SCOTUS To Take The Case

Tue, 2014-08-19
"Obamacare challengers in the Halbig case have asked the D.C. Circuit Court of Appeals not to review a three-judge panel's ruling against federal exchange subsidies, instead calling for "final resolution by the Supreme Court." The backstory: one month ago a divided three-judge panel prohibited Obamacare subsidies for residents buying from the federal exchange. The Obama administration asked the full D.C. Circuit bench to rehear the case, which is reserved for matters of exceptional importance. The challengers don't want that, because if they lose at the D.C. Circuit it would make the Supreme Court less likely to take the case. "There is no doubt that this case is of great national importance. Not due to the legal principles at stake—this is a straightforward statutory construction case under well-established principles—but rather due to its policy implications for ongoing implementation of the Affordable Care Act ('ACA').

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