Paying More Getting Less
Dollars & Sense html
by Joel Harrison - who I met when we were Summer Camp Counselors
Article on Organ Transplants
Prescription drugs. This is the fastest growing health care expense, and it is projected to grow at 20 to 30 percent each year over the next several years. There are many newer, more expensive drugs on the market, and the use of these prescriptions is exploding. In addition, with so much television advertising, many consumers ask their doctors for expensive, brand name drugs when there may actually be a generic drug that works just as well.
Costs of some Rx's
Prescription Drug Trends Fact Sheet KFF.org
Public Citizen Rx R & D Myths
Cost of developing new technologies and treatments. Over the past decade, scientists have made significant advancements in the treatment of certain diseases. Unfortunately, just like any new product, the cost of developing these new technologies and treatments is extremely high. Plus, unlike other technology, health technology generally doesn't decrease in price over time.
How Changes in Medical Technology Affect Health Care Costs KFF.org
Increased demand for health care. More and more people with medical insurance are relying on the health care system as new technologies and treatments become available. This leads to a greater number of claims for payment by insurance companies, the costs of which are passed back to health care consumers. (articles on how to be an "active consumer") Employer-sponsored coverage consumer demand for broad networks of hospitals and physicians and the easing of restrictions by health plans, coupled with hospital consolidation and a reduction in excess capacity, have increased the bargaining clout of some hospitals vis-a-vis health plans.
"Hospital spending is back with a vengeance, and the likely causes are the retreat from tightly managed care, which has increased demand for hospital services, and rising labor costs,"
The hospital industry says rising costs simply reflect rising demand. "The driving factor is Americans are using more hospital services."
But health insurance companies say hospitals negotiating for money, not simply consumer demand, fueled the increases.
America's aging population. The "baby-boom" generation is entering its peak health-care-using period. In fact, over eighty million Americans will turn 50 in the next 10 years. The cost of providing health care to them will be staggering.
Medicare Supplement Increases
Increase in uncompensated care. There are an estimated 44 million Americans who don't have health care insurance, and the cost of providing care to this group is borne indirectly by the insured consumers.
New legislation. Proposed government mandates--such as the
Patients' Bill of Rights,
Medicare
reform, and
health care tax changes--will continue to drive health care costs up.
AB 88
Maternity
Small Group Reform
COBRA,
HIPAA,
Privacy
Infertility
Costs of Infertility Treatment
cal health reform.org/
All of these increased costs flow through insurance companies and eventually trickle down to employers in the form of higher medical costs.
"The volatile combination of rising costs, increasing premiums, and a slowing economy have set the stage for consumers to pay more for care and an increase in the number of uninsured Americans," Ginsburg said.
heartland.org/
upenn.edu/
semo.edu/
Medical care prices advanced 0.3 percent last month and were 4.3 percent higher over the year. bls
CHFC Articles
In the private insurance market, cost containment is largely left to market forces. Insurers compete with one another for customers partly on the basis of price. When the insurers are managed care plans, they have some influence on medical costs through their contractual relationships with participating providers, who may agree to fee constraints because of their desire to be included in the plan's provider networks and to have access to that source of business. Health plans often also implement various utilization controls to limit service use.
Price competition among providers is less intense, since most consumers of health care are covered by insurance and are thus relatively insensitive to provider prices. However, various forms of patient cost-sharing are designed to give consumers incentives to avoid excess utilization and to choose less expensive medical alternatives.
The public-sector buyers achieve cost control primarily through administered prices for providers. The state sets the fees it will pay Medi-Cal providers and health plans participating in either Medi-Cal or Healthy Families, and has other features in place to control utilization.
Although there is no consensus about what proportion of our resources should be devoted to medical care, many believe the present system does not adequately contain costs. Health expenditures have risen more rapidly than wages and represent an increasing proportion of total spending.
20 percent of Californians remain Uninsured More than half of California’s uninsured children are eligible for public health insurance
Health Care Costs 101 CHCF.org
Health Care Spending CHCF.org
Insurance Fraud
Cost Containment
Kaiser Family Foundation - Tons of Information
health affairs.org/
ahcpr.gov/
icd9 data.com/
CPT (Current Procedural Terminology) Code/Value Search
Medicare Billing Codes & Reimbursement
Excerpts of Blue Shield's Rate Filing
to Calif. Department of Insurance
(PF-2010-02083
San Francisco Chronicle )
Study of 10 health plans in CA and how they actually perform - Georgetown University
I haven't figured out who sponsors them or where they get their data from
Video Samples of Accidents covered by medical insurance
Video's of Surgeries NIH
NIH Health Topics
Blue Cross Statement on Employers rising costs
Agency for Health Care Resarch & Quality
Health reform is high on the political agenda in California, and things are moving fast. www.CalHealthReform.org was created to help keep Californians up-to-date on the major proposals, analyses, hearings, and news. We also provide resources to help explain the issues and a discussion forum where you can share your ideas.
Fraud - Medicare Billing Codes?
Blue Cross Provider Quality Finder Links
America's Health Insurance Plans - merged with Health Insurance Institute of America
State Health Facts.org
Zip Codes & Obesity Seattle PI Reporter
More info from Blue Shield on why premiums are increasing
Blue Cross letter to Employers
Samples of Accidents covered by medical insurance
Looking at premiums as an INVESTMENT, rather than an expense.
                   
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