IN THIS ISSUE:
? House Small Business Committee Hears Physician Woes
? Reimportation ? Latest Hot Topic in Washington
? High Deductible Plans Attractive in Kansas City
? Risk-Based Rating Coming Back in Detroit
? Consumerism Works for Public Programs Too
? Wisconsin Employers Embracing CDHC
? VENDOR CORNER
House Small Business Committee Hears Physician Woes
I testified before the House Small Business Committee, chaired by Congressman Donald Manzullo (R-IL), this week at a hearing on physicians as small business owners. This was a field hearing held in Frederick, MD to get the ideas of members of the local community. Our local Congressman Roscoe Bartlett (R-MD) was there, as was Congresswoman Donna Christensen (D-VI). The hearing was not about any particular legislation, but just about the problems physicians face in maintaining their independent practices.
Witnesses included Dr. and Mrs. Camilo Toro of Frederick Neurology, Dr. Michelle Davis of the National Medical Association, Dr. Jim Pendleton of the Pennsylvania AAPS chapter, Mrs. Elizabeth Chung a Frederick practice administrator, Dr. Christopher Unger of Bethesda, MD, Mr. William Sarraille a local attorney, and Mr. Linwood Rayford of the Small Business Administration.
Among the material handed out by the committee were two articles published by the Objectivist Center, one by Madeleine Cosman called ?The Government?s Envy Engine,? and the other by Edward Hudgins titled ?Doctors Shrug.? Ms. Cosman?s article looks at the (mis)use of Qui Tam actions against physicians. She cites some horrendous examples of doctors being fined huge sums and sent to jail for what amount to billing errors or differences in medical judgment. Mr. Hudgins argues that we are beginning to see a replay of ?Atlas Shrugged? in medicine, where the best and the brightest are refusing to play the game anymore.
My own testimony reiterated what virtually every physician will agree are the big problems ? inadequate reimbursement, excessive regulations, administrative overload, and a tort system that is out of control. I suggested to the committee that, instead of trying to fix these issues directly (which could be un-fixed by the next Congress), they should work on changing the underlying dynamics of our system by allowing patients to control their own resources. This would reduce the need for regulation, increase the income of better physicians (but not the mediocre ones), lower administrative burdens, and reduce the impulse to sue for medical problems.
Committee members were surprisingly savvy about these issues. They had already identified excessive reliance on third-party payment as the core problem, and were very interested in empowering health care consumers.
SOURCES: The Committee will be posting the testimony on its web site at: http://www.house.gov/smbiz/
My statement may be found at:
The two Objectivist Center papers may be found at:
Reimportation ? Latest Hot Topic in Washington
There has been a real split among conservative/libertarian types over the issue of ?reimporting? prescription drugs from Canada and other price-controlled countries. The issue has been hotly debated on our ListServ and other fora in Washington. One side argues that Free Markets demand that people be free to buy stuff wherever it is cheapest, while the other side counters that Free Markets also demand respect for property rights. Price controls amount to a confiscation of intellectual property ? especially when there is a hidden threat by a foreign government to violate patent rights. In the course of these debates, I realized that I knew very little about how Canada?s price controls actually work. But Chris Middleton of the Pacific Research Institute came to my rescue with an excellent description from ?Health Affairs? written by Devidas Menon, CEO of Alberta?s Institute for Health Economics.
SOURCE: www.healthaffairs.org There is a fee for the article, but well worth paying if you want to be up to speed.
Also, you can participate in our ListServ discussions by sending an e-mail to HealthBenefitsReformfirstname.lastname@example.org
High Deductible Plans Attractive in Kansas City
After all the contention and emotion surrounding the Great Debates in Washington, it is refreshing to get out of the Beltway and remember that in the real world people do more than just argue. For instance, Karen Uhlenhuth writes in the ?Kansas City Star? about the Scott Lewis family that decided to forego paying $1,200 to $1,300 a month for HMO coverage and opted instead to pay $500/mo for a $5,000 deductible policy. ?He goes to any doctor he wishes. He doesn?t need permission for any procedure or to see any specialist?. (His) health plan is refreshingly simple ? and cheap.? The article says, while individuals have always been able to purchase coverage like this, ?employers are starting to offer this option.? It cites several local companies where as many as 30% of the workers have opted for consumer driven health plans. The article also cites a local physician who has decided to convert her practice to a cash-only basis, and mentions SimpleCare as an example of a growing trend. The article quotes NCPA?s Devon Herrick, HIAA?s Larry Akey, and Vivius founder Howard Wizig.
Risk-Based Rating Coming Back in Detroit
“The Detroit News” published an article by Lynn Waldsmith that looks at consumer driven health from a different angle. The article asks, ?Why should a thin health-conscious worker pay the same premium as his 320-pound, smoking co-worker?? Such issues, she writes, are helping to fuel the move to consumer driven care, in ?an effort to get people to take more responsibility for their health?? The article goes on to explore the pros and cons of risk-based rating, especially in the areas of smoking and obesity.
Consumerism Works for Public Programs, Too
Writing in the ?Milwaukee Journal Sentinel,? John Torinus says, ?The principles of consumer-driven health care are spreading quickly across private sector health plans,? and calls for similar expectations ?for personal responsibility (to be) built into public sector health plans.? He says medical costs consume 25% of the state budget and are rising at a rate of 15% or more per year. ?Public employees have a huge stake in getting this monster under control because they are sacrificing take-home pay for keeping their ill-designed medical packages in place.?
Wisconsin Employers Embracing CDHC
Also in the ?Journal Sentinel? is an article by Joe Manning that asks, ?When was the last time you asked your doctor how much a procedure or treatment would cost?? Probably never? But that could change soon with the dawning of CDHC.? He expects a ?major shift? in the health insurance industry, but also notes that, ?the concept has its critics.? These include ?Dirk Carson, an executive with Patient Choice, a Minnesota-based health insurer attempting to enter the Wisconsin market,? who says, ?The idea just throws people to the wolves.? The rest of the article is largely favorable and includes the experience of a number of local employers who are moving in the consumer driven direction. Robert H. Booz, who authored a study for Conning Research & Consulting says, ?CDHC market penetration could be as great as 50% within the next five years,? according to the article.
Lumenos announces a new round of venture capital financing. Company president Chip Tooke says the $10 million in new capital ?shows investor confidence continues to cycle very high.? The release doesn?t mention the source of the new money. Contact Mary Angela Shannon at 703-236-6312 or email@example.com
Benemax teams up with UK broker. David Cowes, president of Benemax announced his company is partnering with British broker Leagold Miller to provide health insurance and other benefits to companies with operations in both the U.S. and UK. The combination may also help employers interested in opening facilities in the other country to navigate the regulatory complexities across the ocean. Contact Lisa Jacobson at 617-497-0193 or firstname.lastname@example.org
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