Archive | 9:45 PM

Five years will come and go

9 Nov

The has been a great deal of debate over the level of government intervention in health care as a result of reform legislation.

Here is but one small example of what is contained in the recently passed House bill, HR 3962 you can decide for yourself:

“(C) USE OF COPAYMENTS- In establishing cost-sharing levels for basic, enhanced, and premium plans under this subsection, the Secretary shall, to the maximum extent possible, use only copayments and not coinsurance.”

Those of us who design and manage health plans have known for years that the move to copayments was a mistake because it is far more difficult to keep up with inflation and to maintain a target level of cost sharing. Prescription drug plans have even moved from copays to coinsurance.

However, when it comes to managing costs for ALL plan participants, including the majority in a plan with little or no expenses in a year, it appears the politicians are smarter than employee benefit professionals.

Keep in mind that while employer plan designs are grandfathered for five years under HR 3962, after that all bets are off. That’s a long time for Congress to act to “improve” the benefits.

Perhaps it is really time to retire.

A deal is a deal

9 Nov

A deal is a deal or is it? Here is a summary of the deal made by the Obama administration for hospitals to help save $155 billion for health care reform. What do you think are the chances that anyone will have any idea of these savings or more important, how does this kind of deal help the average American covered by private health benefits? The answer to the last part is simply ( unless you believe hosptals can give up this revenue with no consequences) the private sector will pick up the slack.

And I have another question, if the insurance company premiums are the cause of our woes as many would have us believe, how is it that hospitals are not critized for over charging based on this deal?

The leading hospital groups – the American Hospital Association, the Federation of American Hospitals, and the Catholic Health Association – agreed to accept $155 billion less in Medicare reimbursements over 10 years. In exchange, Sen. Max Baucus (D) of Montana, the Finance Committee chair, agreed to exempt hospitals from the cost-cutting regime under a proposed new Medicare Commission for its first few years of operation. That deal was not clear until the committee released legislative language on its bill. The Congressional Budget Office, for example, was not aware that hospitals were exempt from cuts when it estimated the bill’s impact on the federal deficit.

The full text

9 Nov

If you are interested here is where you can find the full text of health care reform legislation.

http://thomas.loc.gov/

Blogsurfer.us

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