Pre-Existing Condition Insurance Plan Member Claims Average $28,994

It would appear from this article that the uninsured were not as eager to get insurance as we were lead to believe.

http://www.lifehealthpro.com/2012/02/23/cciio-annual-pcip-member-claims-average-28994?utm_source=HCRW&utm_medium=eNL&utm_campaign=LifeHealthPro_eNLs

CCIIO: Annual PCIP Member Claims Average $28,994

By                      February 23, 2012

The Pre-existing Condition Insurance Plan (PCIP) — a new health insurance program for people with health problems — ended 2011 with 48,879 enrollees.

That’s up from none in the summer of 2010, when the program started, officials at the Center for Consumer Information and Insurance Oversight (CCIIO) say in a new PCIP report.

But enrollment is running far below expectations. PCIP designers, and critics, originally were predicting that millions of Americans would rush to sign up for coverage.

The consumers who have enrolled have turned out to be far sicker than officials had anticipated: Enrollees are averaging about $29,000 in claims per year. That’s twice the average traditional state high risk pools have experienced in recent years, CCIIO officials say.

In Colorado, for example, officials have found that enrollees in a state health insurance risk pool program have 137 hospital admissions per 1,000 enrollees per year. The hospital admission rate for PCIP enrollees in Colorado is 562 admissions per 1,000 enrollees per year.

In another state, Kansas, claims expenditures have averaged $1,376 per member per month for state risk pool enrollees and $3,449 per member per month for PCIP enrollees, officials say.

The Patient Protection and Affordable Care Act of 2010 (PPACA) requires health insurers to sell subsidized coverage on a guaranteed issue, mostly community-rated basis starting in 2014.

PPACA drafters included the PCIP program in PPACA in an effort to provide temporary relief for consumers with pre-existing conditions who cannot qualify for commercial health insurance, Medicare or Medicaid.

Many PCIP participants need treatment for conditions such as cancer, ischemic heart disease, degenerative bone diseases or hemophilia, officials say.

People who enroll in the PCIP program are not charged a higher premium because of their medical condition. Premiums may vary only on the basis of age, geographic area and tobacco use.

About half the states are administering their own PCIP programs. The federal government is administering PCIP coverage for residents of the other states.

The states with the highest PCIP enrollment are California, Pennsylvania and Texas.

To keep PCIP from crowding out existing types of private and public health coverage, Congress required that PCIP enrollees be individuals who have gone without health insurance, including state risk pool coverage, for at least 6 months.

Jean P. Hall and Janice Moore have suggested in a PCIP program review released by the Commonwealth Fund in June 2011 that the 6-month waiting period rule may be one program feature that has held down enrollment growth. “Individuals with preexisting conditions not meeting this requirement may choose to enroll in state-based, high-risk pools that do not have this requirement, or they may find other coverage that excludes treatment of their preexisting conditions (i.e., a policy with a rider),” the researchers say.

CCIIO officials say in their report that other program features may contribute to high per-member medical costs. “Coverage related to the care or treatment of an enrollee’s pre-existing condition begins immediately upon the plan’s effective date, unlike other types of insurance coverage currently available in the individual market, which may impose pre-existing condition limits or exclusion periods,” officials say.

In addition, because many people with health problems who have a choice enroll in state health insurance risk pools, which do not require individuals to go without health insurance for 6 months, “PCIP may attract individuals who have been recently diagnosed with a severe illness or condition that requires immediate care or treatment,” CCIIO officials say. “Additionally, people who may otherwise qualify for PCIP may postpone enrolling until they have an immediate need for coverage.”

Allison Bell contributed additional information to this article.

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Posted in Cost of Health Care, Health Care News, Health Law and Legislation, Obamacare Tagged , , , |

House Panel OKs Medicare Pricing Panel Bill

The MediCrats who authored Obamacare tried to give the appointed IPAB enough freedom to make unpopular decisions about Medicare rate cuts by allowing them to make rate decisions free from judicial review. If this Medicare Decisions Accountability Act passes, the IPAB will be eliminated. 

http://www.lifehealthpro.com/2012/03/01/house-panel-oks-medicare-pricing-panel-bill?utm_source=HCRW&utm_medium=eNL&utm_campaign=LifeHealthPro_eNLs

 

House Panel OKs Medicare Pricing Panel Bill

By          March 1, 2012

Rep. Joseph Pitts, R-Pa. (Courtesy of the House Energy & Commerce Committee)

Republicans had an easy time getting H.R. 452, the Medicare Decisions Accountability Act bill, through a House Energy & Commerce Committee health subcommittee markup Wednesday.

Subcommittee members voted 17-5 to approve the Medicare payment bill.

All Republicans on the subcommittee voted for the bill.

Only 5 of the 11 Democrats on the subcommittee voted against the bill.

Rep. Frank Pallone Jr., D-N.J., and Rep. Edolphus Towns, D-N.Y., crossed party lines to side with the Republicans and vote for the bill.

If passed and implemented as written, the bill would eliminate the Independent Payment Advisory Board (IPAB), a 15-member body created by sections 3403 and 10320 of the Patient Protection and Affordable Care Act of 2010 (PPACA).

IPAB members must be nominated by the president and confirmed by the Senate. But PPACA drafters tried to give IPAB enough independence to make unpopular decisions about Medicare reimbursement rate cuts by allowing the body to make reimbursement rate decisions free from judicial review.

The IPAB members would be paid $165,300 per year and serve 6-year terms, according to Rep. Joseph Pitts, R-Pa., the subcommittee chairman.

If Medicare’s annual per-capita spending is found to exceed a specified limit, IPAB would have to give Congress a proposal for reducing Medicare spending growth. The proposal would take effect automatically unless Congress passes legislation that achieves the same amount of savings.

“Supporters of IPAB tell us that there is nothing wrong with having 15, unelected bureaucrats making binding decisions about Medicare policy,” Pitts said at the markup. “They are not troubled by the fact that there is no requirement for public comment prior to IPAB issuing its recommendations. That IPAB’s actions are not subject to judicial review does not alarm them.”Henry Waxman

Rep. Henry Waxman, the highest-ranking Democrat on the Energy &  Commerce Committee, said the Republicans are mounting another political attack on PPACA.

“For the last year, House Republicans have been claiming – erroneously – that we cannot afford to maintain Medicare’s promise to seniors,” Waxman said. “Yet today, they will vote to repeal provisions in the Affordable Care Act that will save Medicare over $2 billion.”

Waxman says the Republicans have identified no way to pay for the cost of eliminating IPAB.

“Their logic makes no sense: they say we can’t afford Medicare, yet they want to eliminate one of the innovations in the Affordable Care Act that keeps Medicare costs under control,” Waxman says. “It is this kind of political opportunism that is alienating so many Americans from Congress.”

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Posted in Cost of Health Care, Health Care News, Health Care Reform, Health Care Repeal, Health Law and Legislation, Obamacare Tagged , , , , , |

Patient Saves Time and Hassle Using MediBid, Healing Starts Now

Below is a testimonial sent by a MediBid patient, reprinted with permission. This person got a knee MRI and diagnosis for $410 through MediBid the same day, and was prescribed very simple treatment. Had this occurred under a single payer system, chances are the patient would have waited 6-13 months for an MRI, then several weeks for a reading, then several months to see a specialist.

Chances are the patient’s knee would have deteriorated to the point of needing a full replacement in that time. Instead, the patient can treat the disorder very simply and has avoided costly invasive surgery.

I make this illustration because under the traditional model of a medical tourism facilitator, this referral would probably not have happened, since there is no margin for the facilitator, however at MediBid our model works equally well for small procedures and large.

I’ve been hobbling around since New Year’s Eve, when I first noticed what seemed like a very pulled calf muscle.  Thought I had just stayed out too late and hiked around downtown Nashville too much, but it got progressively worse and within a few days, I couldn’t bend my knee.

After scouring the internet and calling my doctor, who happens to be Canadian, and visiting my chiropractor, who also happens to be Canadian, I decided to try what they advised and stay off the knee and ice it.

To be safe, I went down to the new imaging center and paid $27 for digital x-rays, provided on a disc and analyzed by the radiologist as inconclusive.  The good news was that nothing was broken.  They asked me to sign a HIPAA authorization, but I told them I don’t sign those things, which sent them into a tizzy.  They told me they couldn’t see me if I didn’t sign it, but when I repeated that back to them, they realized how silly that sounded, and decided I didn’t have to sign.

Now, two months later, I finally decided to get an MRI.  So, I called my chiropractor and asked if he could call in the order, since I don’t have an MD.  That was at about 12:30.  I compared cash prices on MediBid.com and was able to make a same-day appointment at 5:30 for $410, including the images on disc.  By 6:30, I was done and was on my way home with disc in hand.  How long did that take?

—- T. S. , Tennessee

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Posted in Common Sense Health Care Solutions, Free market medicine, Medical Tourism Tagged , , , , , |

Doctors Firing Patients

Mandatory Vaccinations

It sometimes takes years to develop new drugs, and have them approved, and sometimes even after the drugs are FDA certified, they are shown to have adverse, even fatal effects. Do pediatricians KNOW as a 100% CERTAINTY that there are no chances of ill effects from mandatory vaccinations? Are they able to point to conclusive medical evidence that mandatory vaccination always improves health and saves lives?

There are probably some vaccines that save lives, and really do have positive therapeutic value, but there are likely also some which have enough ill effects that people should have the right to oppose them. It is ok to oppose MANDATORY vaccination without being opposed to some vaccinations.

http://healthblog.ncpa.org/doctors-firing-patients/

Doctors Firing Patients

By Filed under Physicians on February 24, 2012

Pediatricians fed up with parents who refuse to vaccinate their children out of concern it can cause autism or other problems increasingly are “firing” such families from their practices, raising questions about a doctor’s responsibility to these patients.

Medical associations don’t recommend such patient bans, but the practice appears to be growing, according to vaccine researchers.

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Posted in Cost of Health Care, Free market medicine, Health Care News, Patient Privacy Tagged , , , , |

Undercover Grandma and Medicare Fraud

Never mind throwing Grandma off the cliff, watch this Grandma try to “use” her Medicare Benefits

Undercover Grandma and Medicare Fraud

One visit to the doctor’s office opens doors for huge taxpayer rip-offs.

Click on the image to watch the video from ABC News

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Posted in Cost of Health Care, Health Care News, Health Care Reform, Health Law and Legislation, Insurance, Obamacare Tagged , , , , |

An Online Market for Medical Care

http://healthblog.ncpa.org/an-online-market-for-medical-care/?utm_source=newsletter&utm_medium=email&utm_campaign=HA#more-24231

The free market exists in medicine, at least it does online with MediBid.  This is where there is transparency in pricing and competition between physicians for treatments.  Only when these two keys exist can a true free market function properly.  In the end, both physicians and patients win.

Medicine took a wrong turn starting in the 60′s. It was then that the “product” changed from medical care to healthcare, which really meant that the “product” was payments. When we used to buy a car, the price on the window was the base price, and the options were expensive. Today, the sticker on the windo says “zero down, $299 a month”, and in these payments they include a 6 CD changer, electric locks and windows. Options we might not buy if priced separately. We buy healthcare the same way now…we buy payments. Just now we are figuring out that these payments include such things as abortions, contraception, maternity care for men, and 50 year old women, …the list goes on.

An Online Market for Medical Care

By Filed under Health Alerts on February 29, 2012

Can you buy health care the way you buy goods and services on eBay? Almost. A small, emerging online service called MediBid is letting providers bid to provide the care that patients need.

Patients must be able to pay cash. They fill out medical questionnaires; they can upload their medical records; and they can request the procedure they need. The patient’s identity is kept confidential until a transaction is consummated. MediBid-affiliated physicians and other medical providers respond by submitting competitive bids for the requested care.

Business at the site is growing. For example, last year the company facilitated:

*  More than 50 knee replacements, with an average of five bids per request and some getting as many as 22. The average price was about $12,000, almost one-third of what the insurance companies typically pay and about half of what Medicare pays.
*  Sixty-six colonoscopies with an average of 3 bids per request and some getting as many as six. The average price was between $500 and $800, half of what you would ordinarily expect to pay.
*  Forty-five knee and shoulder arthroscopic surgeries, with average prices between $4,000 and $5,000.
*  Thirty-three hernia repairs with an average price of $3,500.

MediBid facilitates the transaction, but the agreement is between doctor and patient, both of who must come to an agreement on the price and service.

One key component of all this is the willingness to travel. If you ask a hospital in your neighborhood to give you a package price on a standard surgical procedure, you will probably be turned down. After the government suppression of normal market forces for the better part of a century, hospitals are rarely interested in competing on price for patients they are likely to get as customers anyway.

A traveling patient is a different matter. This is a customer the hospital is not going to get if it doesn’t compete. That’s why a growing number of U.S. hospitals are willing to give transparent, package prices to out-of-towners; and these prices often are close to the marginal cost of the care they deliver. Interestingly, a lot of the out-of-towners getting the cut-rate prices are foreigners.

North American Surgery has negotiated deep discounts with about two dozen surgery centers, hospitals and clinics across the United States, mainly for Canadians who are unable to get timely care in their own country. The company’s cash price for a knee replacement in the United States is $16,000 to $19,000, depending on the facility a patient chooses.

But the service is not restricted to foreigners. The same economic principles that apply to the foreign patient who is willing to travel to the United States for surgery also apply to any patient who is willing to travel. That includes U.S. citizens. In other words, you don’t have to be a Canadian to take advantage of North American Surgery’s ability to obtain low-cost package prices. Everyone can do it.

The implications of all this are staggering. The United States is supposed to have the most expensive medical care found anywhere. Yet many U.S. hospitals are able to offer traveling patients package prices that are competitive with the prices charged by top-rated medical tourist facilities in such places as India, Thailand and Singapore.

All of this illustrates something many of my readers already know. Markets in medical care can work and work well — provided government gets out of the way.

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Posted in Common Sense Health Care Solutions, Economics, Free market medicine, Health Care News, Medical Tourism, Medical Travel Tagged , , , , , |

Newt Gingrich needles Obamacare in Nashville

http://www.bizjournals.com/nashville/blog/2012/02/newt-in-nashville-needles-obamacare.html

Ralph Weber of MediBid was contacted by the Gingrich campaign to participate in a Health Care round table discussion in Nashville during a campaign stop there yesterday.  It was unanimous at the round table that Obamacare is horrible and must be repealed.  Ralph presented Newt with a copy of MediCrats and a Stop ObamaCare bumper sticker.  The following article contains quotes by Ralph, as well as the video which follows the article. 

Four years ago, Ralph participated in a Healthcare panel with then presidential hopeful Rudy Giuliani. It seems that both Rudy and Newt recognize that free market solutions will solve this “healthcare crisis”, and not the government.

Newt Gingrich needles Obamacare in Nashville

Nashville Business Journal by Chris Silva, Staff Reporter

Date: Monday, February 27, 2012, 2:37pm CST – Last Modified: Tuesday, February 28, 2012, 1:02pm CST

Republican presidential nominee hopeful Newt Gingrich was in town this morning talking health care as part of a panel discussion that took aim at the Affordable Care Act, which has become a key topic this election year.

Gingrich was joined by health care executives and physicians at the round table discussion, hosted at the offices of Baker Donelson Bearman Caldwell & Berkowitz. While he’s in stark opposition to “Obamacare,” Gingrich had some of the more moderate comments on the panel.

“Think about this as the beginning of the replacement debate, and not just the anti-Obamacare debate,” said Gingrich, who is in Nashville today to make multiple appearances as he attempts to stave off competition from other GOP candidates Mitt Romney and Rick Santorum, who is leading in state polls.

“A lot of this predates Obama,” Gingrich continued, referring to the dynamic problems facing the nation’s health care system, including millions in uninsured and underinsured and the lack of a universal medical payment system that revolves around quality and performance. “We’ve really been drifting down this road from a dozen different directions for a very long time.”

That doesn’t mean Gingrich wore kid gloves, however. The health reform law “highlights how incredibly dumb the system is,” he said.

The former House speaker said he has worked extensively on both health care and matters pertaining to national security – and that health care is more convoluted, hands down.

“Health is ten times more complicated,” Gingrich said. “Almost nobody in politics can really approach it creatively because they get too tired. It is so hard and so dense.”

Health care leaders and politicians can work toward building a better system by listening to those on the ground level who are trying to come up with practical solutions, Gingrich said.

GOP presidential nominee hopeful Newt Gingrich hosted a panel discussion today slamming President Obama's health care reforms.
GOP presidential nominee hopeful Newt Gingrich hosted a panel discussion today slamming President Obama’s health care reforms
 

“People get in rooms and discuss abstract concepts and they put together rules, and then you have people who are actually practical, who are trying to do something, but they’re not as important as the people who are theoretical,” Gingrich said.

Other panel members did not hide their disdain for the Affordable Care Act.

“I think the Obama administration has a death grip on a loser,” said Merrill White, president-elect of the Tennessee Orthopaedic Society.

“The Medicrats in Washington are able… to put in what they want” with the health reform law, said Ralph Weber, president and CEO of MediBid, a company based in Wilmington, Del., that allows patients to post a request for a procedure that doctors then bid on.

Scotte Hudsmith, CEO of Franklin-based Parental Health, was also on the panel. He asked Gingrich for his advice on how companies like his can try to get their innovations in front of the government for reimbursement consideration.

Gingrich scoffed at the notion of working through the government, and recommended that Hudsmith talk to private retailers like Wal-Mart and Kmart.

The GOP candidate also took a shot at Romney, saying “Romneycare” was not that much different than Obamacare.

Romney has also publicly stumped to repeal and replace the Affordable Care Act, but has come under fire in the past from other Republicans for implementing near universal care while he served as the governor of Massachusetts.

The bottom line is that changes are needed at the top, Gingrich said.

“Health and education are the two places where we socialize behavior to avoid responsibility,” he said. “And they both are failing. We allow people to say it’s somebody else’s problem.”

NEWS FOOTAGE OF TOWNHALL (click image to link to video)

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Posted in Free market medicine, Health Care News, Health Care Reform, Health Care Repeal, Obamacare, Politics Tagged , , , , , , , |

Can Health Care Be Bought and Sold on eBay?

Further proof that free market healthcare is the answer. If you want real healthcare prices, you need competition. More government regulation of healthcare eliminates competition and only equals less transparency in prices. Here at Medibid we bring costs down by providing transparency and access to our patients. It is very refreshing to see real costs in healthcare for once. You should give it a try. In order to get actual pricing, all you need to do is click HERE to create a request.

http://townhall.com/columnists/johncgoodman/2012/02/25/can_health_care_be_bought_and_sold_on_ebay

Can Health Care Be Bought and Sold on eBay?

John C. Goodman    John C. Goodman

We’re not quite there yet. But there is a new website that is getting close.

A small, emerging online service called MediBid is creating an actual market that puts doctors together with patients who need care.

Here’s the best thing about it. Patients who use this service can cut their health care costs in half. No, that’s not a misprint. Patients who obtain care through MediBid pay about half as much as BlueCross pays. Ditto for all the major employer plans as well as the other big insurance companies. Patients frequently pay even less than what government pays under Medicare.

Here’s the worst thing about it. Once ObamaCare kicks in, entrepreneurial ventures like this one will probably be nipped in the bud. That’s because the Obama administration doesn’t believe that patients can or should be able to buy care in an open marketplace. In fact, once they get through implementing the 2,700-page bill with 159 regulatory agencies and 10,000 pages of regulations, patients are unlikely to ever see a real price for any type of care.

At least for the time being, however, a market for medical care is emerging. Here’s how it works.

Patients who are willing to travel and able to pay cash, can request bids or estimates for specific medical procedures. They fill out medical questionnaires and they can upload their medical records. The patient’s identity is kept confidential until a transaction is consummated. MediBid-affiliated physicians and other medical providers respond by submitting competitive bids for the requested care.

Business at the site is growing. For example, last year the company facilitated:

* More than 50 knee replacements, at an average price of about $12,000, almost one-third of what the insurance companies typically pay and about half of what Medicare pays.
Sixty-six colonoscopies with an average price between $500 and $800, half of what you would ordinarily expect to pay.
* Forty-five knee and shoulder arthroscopic surgeries, with average prices between $4,000 and $5,000.
* Thirty-three hernia repairs with an average price of $3,500.

MediBid facilitates the transaction, but the agreement is between doctor and patient, both of who must come to an agreement on the price and service.

One key component of all this is the willingness to travel. If you ask a hospital in your neighborhood to give you a package price on a standard surgical procedure, you will probably be turned down. After the government suppression of normal market forces for the better part of a century, hospitals are rarely interested in competing on price for patients they are likely to get as customers anyway.

A traveling patient is a different matter. This is a customer the hospital is not going to get if it doesn’t compete. That’s why a growing number of U.S. hospitals are willing to give transparent, package prices to out-of-towners; and these prices often are close to the marginal cost of the care they deliver. Interestingly, a lot of the out-of-towners getting the cut-rate prices are foreigners.

North American Surgery has negotiated deep discounts with about two dozen surgery centers, hospitals and clinics across the United States, mainly for Canadians who are unable to get timely care in their own country. The company’s cash price for a knee replacement in the United States is $16,000 to $19,000, depending on the facility a patient chooses.

But the service is not restricted to foreigners. The same economic principles that apply to the foreign patient who is willing to travel to the United States for surgery also apply to any patient who is willing to travel. That includes U.S. citizens. You don’t have to be a Canadian to take advantage of North American Surgery’s ability to obtain low-cost package prices. Everyone can do it.

The implications of all this are staggering. The United States is supposed to have the most expensive medical care found anywhere. Yet many U.S. hospitals are able to offer traveling patients package prices that are competitive with the prices charged by top-rated medical tourist facilities in such places as India, Thailand and Singapore.

All of this illustrates something many of my readers already know. Markets in medical care can work and work well — provided government gets out of the way.

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Posted in Business and Medicine, Canadian Healthcare, Common Sense Health Care Solutions, Cost of Health Care, Free market medicine, Health Care Reform, Medical Tourism, Obamacare Tagged , , , |

Milton Friedman on Socialized Medicine

Memorize the 3 questions, and use them every day.

http://www.youtube.com/watch?v=VPADFNKDhGM&feature=related

Milton Friedman on Socialized Medicine

Nobel Laureate Economist Milton Friedman explores the unsettling dynamics set into motion when government imposes itself into the health care system. (1978)

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Posted in Economics, Free market medicine, Health Care Reform, Obamacare Tagged , , |

Milton Friedman Puts A Young Michael Moore In His Place

Milton is great, what more can I say?

http://www.youtube.com/watch?v=cD0dmRJ0oWg&feature=related

Milton Friedman Puts A Young Michael Moore In His Place

*This is not the real Michael Moore*

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Posted in Economics, Free market medicine Tagged , , |
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