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Category: Public Insurance

Health Plans Now Required to Post Prices. Will it Help?

Posted on July 1, 2022 by Devon Herrick

An article in Kaiser Health News explained that health plans are now required to post the prices they have negotiated with all in-network health care providers. Failing to do so will result in substantial fines. The new rule is the result of an executive order then President Trump issued back in 2019.

Price transparency is the holy grail in health policy. There is not one price, but many prices depending on who the payer is. There is the list price that nobody pays unless uninsured and caught off-guard. There’s the cash price paid after receiving care. It is often same as the list price. Then there is the (lower) negotiated cash price if uninsured and paid in advance of receiving care. Then there are the prices Medicare pays and Medicaid pays. Health insurers may all have different prices for the same procedures. Indeed, prices vary tremendously across facilities. A knee replacement may be $30,000 at one hospital and $130,000 at another.

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A tale of Two Eye Surgeries: Why One Cost Four Times the Other

Posted on June 27, 2022 by Devon Herrick

Danilo Manimtim and his wife Marilou both had cataract surgery in Fresno, California in late 2021 and early 2022, respectively. Manimtim, a retired orthopedic surgeon, calculated that since he had met his deductible, his cost-sharing would amount to about $750. He sought care at an outpatient department of a local hospital. As I’ve often said, if you are physically capable of walking, never, ever seek any kind of care at a hospital. Manimtim failed to realize that his health plan, the California Public Employees’ Retirement System (CalPERS) health plan, uses an innovative system known as reference pricing. Anthem Blue Cross managed the plan for CalPERS.

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Doctors Hate Insurance Companies Meddling with Patient Care

Posted on June 23, 2022 by Devon Herrick

A survey found that nearly 90% of doctors believe barriers erected by health insurance plans have negatively impacted patient care. The survey also found that doctors are so fed up that two-thirds would not recommend a career in medicine while nearly half (48%) are considering leaving medicine for another career. The survey was 600 physicians with practices in primary care.

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Alcohol, Drugs, Homelessness and Crime

Posted on June 23, 2022 by John C. Goodman

Scott Alexander reviews Michael Shellenberger’s San Fransicko:

putting it all together and squinting really hard, I think we can tell a story where 10-20% of the homeless are seriously psychotic, and another 20-30% have contributing mental health conditions including depression, PTSD, and others. Somewhere between 25% and 50% of the homeless have substance abuse problems, and this probably mostly overlaps with the 25% – 50% who have psych diagnoses.

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For many years, our health care blog was the only free enterprise health policy blog on the internet. Then, when the NCPA closed its doors, the health blog stopped as well.

During this five-year hiatus no one else has come forward to claim the space. So, my colleagues and I have decided to restart the blog in connection with the Goodman Institute. We invite you and others to use this forum to share your views.

John C. Goodman,

Visit www.goodmaninstitute.org

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