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Category: Direct Primary Care

Why a Telephone Consult is Billed as a Hospital Visit

Posted on April 4, 2023 by Devon Herrick

I have often told the story about the time my wife unknowingly tried to schedule a CT scan at a nearby hospital outpatient department. As luck would have it, prior authorization is all that saved us from a huge bill, of which her share was going to be $2,700. I quickly found a free-standing radiology clinic that had a contract with Blue Cross Blue Shield (BCBS) of Texas for $403. Oddly enough, BCBS was willing to approve a scan at either facility. Nobody called her to explain the huge mistake she was about to make by getting a diagnostic scan at a hospital-owned facility. Here is the thing: Health insurers, Medicare and Medicaid pay hospitals higher prices for the same services that are available elsewhere for a fraction of the cost. Neither do payers alert patients that cheaper alternatives exist.

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Equal Occupational Fatality Day

Posted on April 2, 2023 by John C. Goodman

“Equal Pay Day” calculates how much longer women must work going into this year, to earn what men earned last year, on the average. It occurred on March 14 this year, and was highlighted in Washington, D.C. with the usual liberal fanfare.

Naturally, the calculation ignores the fact that men and women work in very different occupations.

To demonstrate how much that matters, American Enterprise Institute scholar Mark Perry has calculated how many more years women would have to work in their selected occupations before they achieve the same death rate that men endured last year.

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FTC Wants to Ban Noncompete Employment Agreements

Posted on March 27, 2023 by Devon Herrick

I know a doctor who relocated to a small town after being recruited to join a new practice. He sold his house, bought a new one and uprooted his family for a move 150 miles away. It turned out that it was not a lucrative move. His schedule was quickly filled with Medicare patients, most of whom required 30-minute visits due to multiple chronic conditions. He remarked that his pediatrician colleague could see two or three privately insured patients during the time it took him to see one (lower paying) Medicare patient. His income fell far below expectations and he decided to get out.

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Sunday Links

Posted on March 26, 2023March 25, 2023 by John C. Goodman
  • AAF study of the effects of Medicare’s coming drug price negotiations: fewer than 6 million beneficiaries – less than 10% of enrollees – will benefit at all and for those with any saving 69% of will save less than $300. 
  • Given Trump and Biden executive orders promoting the idea, why is it taking so long to allow states to import drugs from Canada?
  • Health Affairs authors: giving insulin to patients for free is cost effective. So why don’t insurers – including Medicare Part D insurers – do that? I explained that months ago.
  • How health care was rationed during the pandemic: Mississippi case study.
  • Left-of-center Tax Policy Center: people earning less than $400,000 will pay more taxes under the new Biden budget proposal.  A lot more taxes!
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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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