Posted on 03/27/2014 10:13:38 AM PDT by Star Traveler
The problems with the implementation of the Affordable Care Act may be masking another major change in the way health care is delivered to U.S. consumers, experts believe.
At a conference in Washington on Thursday, health care and business professionals said that there’s an increasing trend in the industry toward cutting insurance companies out of the process entirely, as large, regional hospital systems move into the insurance business.
Dr. Kenneth L. Davis, CEO and president of Mount Sinai Health System, the largest health care provider in the state of New York, said that starting next year, Mt. Sinai will begin offering its own Medicare Advantage plan. It will look for other opportunities to bring premium payments directly into the hospital system, rather than filtering them through insurance companies.
Davis said he expects organizations similar to his to move in the same direction. “Inevitably the large systems are going to move to take part of the premium dollar,” he said.
(Excerpt) Read more at thefiscaltimes.com ...
Cons? The bean counters in the hospital will end up doing the same thing the beancounters in the insurance company do.
Except for catastrophic issues it will be a good thing.
i am talking about the company/corporation, not individual docs/nurses.
I can get all the "access" I want. I can walk into any doctor's office, go to any hospital in the area, go to any emergency room, or even go to any critical care facility around and get any X-ray or lab test - and you name it.
I just CANNOT PAY for it "out-of-pocket.
So, that's why I pay monthly premiums to have the coverage that I do ... :-) ...
SSDI is a major scam created by government. Obama loosened the criteria and its exploded. That problem will be solved politically and hopefully soon.
Good intro to hospital economics: http://www.econtalk.org/archives/2008/12/lipstein_on_hos.html
All you wanted to know about SSDI abuse here: http://www.econtalk.org/archives/2012/04/autor_on_disabi.html
I work with hospitals every single day and they vary quite a bit. Most of the people there are truly there to help people.
The bean counters will refuse care just like the insurance companies do. They’ll also probably put pressure on doctors to reduce costs.
IMO, it will be far better than the insurance companies and certainly better then a single payer govt controlled system.
Same problem with psychiatry. They pay the same for drugs as they do talk therapy both of which show equivalent outcomes. You can see 4-8 clients who take drugs to every one talk therapy patient. Government intervention distorts markets. I once told that to a top US Government HS teacher (liberal) who was incensed and vehemently denied it.
I asked him for an example where government intervention didn’t distort a market and he was silent. Sadly, he’s still a liberal.
But if I moved down the block from New Haven, and had to go to a different hospital that was closer, then I would still get terrific care, but how would it be paid for if I was insured at New Haven?
And that's an important point you make about what I affectionately refer to as "flyover country"...there are a couple "mega-hospital" systems where I live, that seem intent on swallowing up every other small hospital system around (it's unpleasant to watch!), and, more to the point, there are many people in rural Ohio areas that have various options now (they are going to have to travel either way) that they may lose if, say, Cleveland Clinic just takes over Ohio. Something about that idea makes me very uncomfortable!
It's a smaller market here, and one, two, or three mega-hospital systems could easily cover everyone in the state...
Perhaps I'm being paranoid? lol! I do not like the Cleveland Clinic, so maybe I'm just biased, but if you have to get your insurance from your hospital, it wouldn't work to have all these smaller local hospitals everywhere, and we're seeing that already with the Clinic's continual localized take-overs, buy-outs and expansions...
In a real free market for healthcare in which everyone paid their way prices would drop 90%+. The vast majority of healthcare that people use is a fairly narrow band. Plus, knowing that you’re responsible encourages responsibility.
The Mortgage Bankers and Realtor Assoc. are two of the biggest opponents to school reform via vouchers or a marketplace for education. They also, by their lobbying, gave us the RE meltdown.
You gotta be kidding ... LOL ... that absolutely the stupidest thing I've heard of.
In my case, I've got five medications that I'm on for controlling certain medical conditions ... of which I didn't even know I had, until some tests were run in the hospital. Now, I keep up on trying to understand the medications and their uses and interactions, and I do understand a bit of it, but I can tell, it would take an education like a doctor (for me to gain) in order to have a fuller and complete understanding.
On top of that, would I have known that a certain lab result meant a certain deficiency that I had to have a medication for? No, I wouldn't have known before, but I'm reading up on it now - and I still don't fully understand it. SO ... how am I going to self-prescribe on thes conditions and pick the right medication?
That's just plain stupid and a prescription for disaster!!
I doubt it's good. Once the hospital becomes the insurance company, they have maximum incentive to not diagnose anything that will be expensive to treat.
It'd be back to the HMO days where they wouldn't run any tests. They'd just tell you it's heartburn and it'll go away in a few weeks.
With insurance separate from providers, the providers are free to test and diagnose as they believe appropriate.
Obama was way ahead of them.
The key here is to keep insurance companies away from “being a doctor” and/or keep them away from treating patients like a “paint-by-number” picture that was a fad a while back.
No checks except doctors that dont want to be sued.
I personally am in a Hospital insurance plan in addition to my Medicare. My cost of coverage directly out of pocket expense is less than $250 per month and it covers everything. If I have to go in to the emergency room I pay $75 and if admitted to hospital from the ER I pay $20 per day for hospital stay.
I am covered where ever I travel. All the out of net work hospital needs do is call an 800 number for approval. This has worked very well for me and I have wonderful doctors.
Good point/question. I pay cash for "normal" doctor visits. The price is usually good.
FMCDH(BITS)
They will not be allowed to sell the plans unless emergent treatment (strict legal definition) is covered at any hospital in the U.S., just like any other plan sold today.
That club could then voluntarily (if they so desired) pick and choose which other private clubs they could partner with to offer the perks of the club to.
The key is to restrict access to only those in the club, avoiding the mandate to provide emergency medical care to any and all who show up regardless of their ability to pay. And to cut costs by eliminating the middle man (insurance companies) and the associated hassle of trying to collect from them.
“Its probably good. Depends on the checks and balances. Insurance companies sure don’t have our best interest in mind.”
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I doubt it’s good. Once the hospital becomes the insurance company, they have maximum incentive to not diagnose anything that will be expensive to treat.
It’d be back to the HMO days where they wouldn’t run any tests. They’d just tell you it’s heartburn and it’ll go away in a few weeks.
With insurance separate from providers, the providers are free to test and diagnose as they believe appropriate.
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I agree. Plus, if Dr Death Emmanuel likes it, that tells me it can’t be good for We the People.
More correct to say it takes the place of Part A and Part B and can replace Part D, but not always.
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