I often write about how the U.S. health care industry is predicated on maximizing revenue against third party payers, primarily employer plans. Health insurers negotiate prices with providers but about half of people in private health insurance are covered by self-insured employer plans. That means an insurer is often managing the plan but not taking on any risk. Some benefits brokers have told me insurers frequently profit off third-party claims due to spread pricing. That is, charging the employer plan slightly more for a procedure than what the insurer paid the provider. That is problematic because the party negotiating the prices (insurers) profits every time they spend (someone else’s) money. That is not a very strong incentive to hold prices down, or steer enrollees to the cheapest options.
Category: Devon Herrick
Are Eyeglasses Held Hostage to Enrich Optometrists?
About the time I reached 40-years of age many of my peers began having trouble with their arms being too short or the print on newspapers being too small. Often it was both. I didn’t have the same problem but about 10 years ago I realized I couldn’t read highway signs that were blocks ahead. I went to an optometrist for an eye exam and he wrote me a prescription for eyeglasses. In the past 10 years I’ve seen an optometrist four times and each time the prescription had not changed.
Here’s the deal. If I break a pair of glasses that worked perfectly and it’s been more than a year since my eye exam, I am required to get an eye exam in order to replace my glasses. This happened to me once when my glasses fell between my car seat and broke when I adjusted the seat. Although my optometrist told me he didn’t expect my vision would change for 10 years, the law still requires me to have a valid prescription even if I’m only needing an extra pair of glasses. It varies by state. Some states allow prescriptions to be valid for longer than a year.
Mosquitoes Have a Plethora of Ways to Hunt Humans
An article in The Atlantic delivers some bad news. The damage done by mosquitoes is immense and they’re not easy to stop.
The insects’ infatuation with us is costly: By way of the many, many deadly pathogens they carry, mosquitoes kill more people than any other animal on Earth does (except, well, us).
It turns out that mosquitoes are complex creatures that track us in numerous ways.
Nearly Half of Cancer Deaths Could be Avoided
Many people worry about cancer in their lifetimes. Mutual of Omaha has even sent my wife and me applications for ‘cancer insurance’ on two separate occasions so cancer is undoubtedly something many Americans fear. A new study suggests there is something better that Americans could do to protect themselves from cancer than enroll in Obamacare or buy Mutual of Omaha’s cancer insurance. Americans who want to avoid cancer can lead healthier lifestyles: don’t smoke, limit drinking and avoid being overweight.
Globally, nearly half of deaths due to cancer can be attributable to preventable risk factors, including the three leading risks of: smoking, drinking too much alcohol or having a high body mass index, a new paper suggests.
The research, published Thursday in the journal The Lancet, finds that 44.4% of all cancer deaths and 42% of healthy years lost could be attributable to preventable risk factors in 2019.
The research was funded by the Bill and Melinda Gate Foundation.