Healthcare Reform

Did you hear Baxter the dog has health insurance?

There is a story that circulated last week on Twitter that a guy enrolled himself on healthcare.gov but the welcome letter that came was addressed to his dog, Baxter. Apparently they mistook his password for his name.

That got me thinking…

Two months ago I had a doctor’s appointment and I had to take my cat (a good old guy) to the vet.  My doctor is phenomenal. He works his tail off.  I received excellent care but he quickly moved on to the next patient. He seemed to be maxed out with time and the demands on him from his medical practice.

My veterinarian is also a phenomenal person. The visit for the cat took approximately the same amount of time. Yet the vet was more relaxed and seems to have more capacity in his practice.

The vet bill was $63 bucks cash.

The doctor’s office filed the claim through my insurance plan and it was knocked down from $120 to $65 bucks.  I paid the $65 bucks to my doctor’s office about 45 days AFTER the date of my appointment.

As I read about how physicians are creating concierge practices, operating outside insurance and considering leaving Medicare, I can’t help but think of those two visits.

I wonder if there is a way to make low dollar costs in healthcare more transparent and efficient. Maybe even the ACA could move in this direction instead of focusing on low copay plans in most of the advertising.

I wonder why we, as a society, seem to be more accepting to pay cash for a vet visit but less likely to be responsible for the full cost of a routine doctor’s office visit — when often they net out to roughly the same cost.

Here is a recent article that appeared in The Wall Street Journal about concierge medicine, titled Pros and Cons of Concierge Medicine.

Happy Thanksgiving to you and yours from all of us at BBG!

Khan Academy Primer on PPACA or Obamacare

The Barrett boys (and their dad) have used Khan Academy to enrich all their learning. I recommend it strongly. Most people reading this post may not need this PPACA/Obamacare primer, but it is very good and bias free.  Check it out and more important, please pass it along to someone who can benefit from a better understanding of the structure of this law that is currently creating such cultural consternations. Enjoy!

https://www.khanacademy.org/humanities/american-civics-subject/american-civics/v/ppaca–or–obamacare

Where Are Our Healthcare Dollars Being Spent?

Quite often in the course of working with our clients on practical and innovative approaches to lower their healthcare costs or mitigate pending increases, we are asked two questions:

“Why is healthcare so expensive?” And “where is the money going?”

The first question is so hugely complicated there may not be enough bandwidth on the internet to analyze it and address it in writing. The second question was addressed in a recent study published by the Agency for Healthcare Research and Quality and related in easier to read fashion in a joint Kaiser Health News/Washington Post article.

While this is really big picture stuff, in answering the question on where the money is being spent, they present some interesting (perhaps only to analytical geeks like me) and startling facts worth taking a moment to contemplate:

  • In 2010, Americans spent @ $1.3 TRILLION on healthcare (This addresses direct payments for care provided during the year.  It jumps to $2.8 TRILLION when you include health care goods and services, public health activities, government administration, the net cost of health insurance, and investment related to health care).
  • 1% of the population accounted for 21% of the $1.3 TRILLION spent.
  • 5% accounted for 50% of all healthcare expenditures.  And, 10% are credited with 66% of the healthcare spend.
  • Contrast that with the 50% of the folks in the U.S. that accounted for less than 3% of the costs.

Our BBG world is micro and hyper-intensively focused on helping mid-size and small employers control costs and improve outcomes one employer at a time. We can’t even begin to suggest we know where the big picture solution lies. That’s for folks a lot smarter and better equipped. It does appear clear however, even to this lay person, that to put a dent in this ever growing cost curve, the lion’s share of the resources and efforts must laser focus on solving the 5% accounting for 50% cost equation…

For more on the study or the article, go here:

http://meps.ahrq.gov/mepsweb/data_files/publications/st421/stat421.shtml

And, here: www.kaiserhealthnews.org/stories/2013/october/08/one-percent-of-costliest-patients.aspx

Looking for Official ACA Information?

Interested in finding what official online resources are available from the federal government for learning about the various requirements and other aspects of healthcare reform?  With implementation of the major pieces of healthcare reform around the corner and the complexity seemingly growing with each passing day, I was.  A cursory investigation led to these six main government-sponsored websites, no doubt there are many others.  Here are the big six for those who might want a handy reference:

Official Site of the Affordable Care Act
https://www.healthcare.gov/

U.S. Department of Health & Human Services (HHS)
http://www.hhs.gov/healthcare/

The Internal Revenue Service (IRS)
http://www.irs.gov/uac/Affordable-Care-Act-Tax-Provisions-Home

U.S. Department of Labor  (DOL)
http://www.dol.gov/ebsa/healthreform/

U.S. Small Business Administration
http://www.sba.gov/healthcare

The White House
http://www.whitehouse.gov/healthreform

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