Can a public health insurance option hold down health care spending?
In a previous column I asked, "So if it is new and better medical treatments ... and expanding health insurance coverage that increases overall spending on health care, how are we going to get this spending under control?"
Indeed, that is the $ trillion question.
One way that has been proposed to hold down health care spending is through a public health insurance option: a government run health insurance plan to compete with private health insurers. It would aim only to cover its costs. The theory is that a government plan could restrain health care costs through its bargaining power with health care providers. Using this bargaining power, it will set prices it will pay for certain procedures just as Medicaid and Medicare now do.
Paul Krugman, Nobel Prize winning economist and New York Times syndicated columnist argued the case this way, "And that's why the public plan is an important part of reform: It would help keep costs down through a combination of low overhead and bargaining power. That's not an abstract hypothesis, it's a conclusion based on solid experience. Currently, Medicare has much lower administrative costs than private insurance companies, while federal health-care programs other than Medicare (which isn't allowed to bargain over drug prices) pay much less for prescription drugs than nonfederal buyers. There's every reason to believe that a public option could achieve similar savings."
Democrats are putting faith in a public health insurance option that would compete with private insurance plans. Three congressional committees with jurisdiction over health care legislation have offered a reform package that includes a new public health insurance option.
But will it really work? If the major cause of rising health care spending is new and better and more costly treatments, bargaining power alone will not do the trick. In Krugman's own words, written in 2005, he seems to recognize this fact. He said then, "Consider what happens when a new drug or other therapy becomes available. Let's assume that the new therapy is more effective in some cases than existing therapies - that is, it isn't just a me-too drug that duplicates what we already have - but that the advantage isn't overwhelming. On the other hand, it's a lot more expensive than current treatments. Who decides whether patients receive the new therapy? ... Eventually, we'll have to accept the fact that there's no magic in the private sector, and that health care - including the decision about what treatment is provided - is a public responsibility."
We could cite many cases about what is the appropriate medical treatment to be given in individual cases. Who's to say that the 55 year old male with hip soreness and pain should receive that hip transplant, or whether physical therapy, massage and anti-inflammatory drug treatment will suffice? Or whether the 50 year old with chest pains while mowing the lawn really needs those stints implanted into his arteries, rather than more traditional, less costly treatment. Or whether pain in the balls of my feet after playing tennis really mean I need repeated trips to the podiatrist for injections as opposed to some simple soaking of the feet after playing?
In the presence of private health insurance most of these decisions are made by the patient and his doctor, and in most cases the most expensive treatment is the one chosen.
By making the decision about treatment, in Krugman's words, "a public responsibility" we take the decision about treatment out of the hands of the patient and doctor. In many cases medical decisions on treatment will be decided by some kind of committee. To be fair, I suppose the more expensive treatment would be available if a patient were willing and able to pay for it out of pocket. That could work in the case of the trips to the podiatrist, but it effectively prices out hip transplants or stints for most patients.
That is what scares most people about a public health insurance option. Not that it will drive private insurers out of the market entirely, but that it will force private insurers to mimic what goes on in a public plan, to cover only those treatments decided by committee to be appropriate.
There are probably other kinds of reform of our health care system that could help restrain costs, for example, a system in which health insurance was only for catastrophic health care costs, and that health insurance benefits were taxable as income so as to remove the tax subsidy to health care spending. These might do a lot to contain spending. But these changes are too fundamental to be politically feasible.
So the Krugman of 2005 may be right. If we wish to continue with the basic structure of the way we provide health care through third party payment (subsidized health insurance that covers almost everything for everyone), the only feasible way to contain our health care spending may be to make health care treatment decisions by committee.
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Saturday, July 4, 2009
"Let's Hang All The Lawyers" said the Bard: Why We Shouldn't
Unlike the US, where just about any Tom, Dick, or Harry can go sue someone in court (perhaps even on television!), most civil cases do not even reach open court in the UK. Several thousand civil lawsuits are claimed yearly, yet only a small percentage of them are argued in front of a judge and jury. Most civil actions are resolved through statutory or voluntary complaints procedures, or through mediation and negotiation. In commercial property and building disputes, Arbitration is also common.
The way in which the British legal system is structured places a great deal of power in the hands of solicitors and their expertise in out-of-court methods of settlement, rather than barristers (trial lawyers), whose expertise is focused in court arguments. This can be very deterring for anyone about to enter a legal process, of any type. This is especially true for personal injury and property (private or commercial) - after all, in such a procedure oriented system, he who has the best solicitor wins.
Inexperienced citizens often find Personal Injury law an especially tricky field. There is a time limit on taking legal action for compensation, you have to know all the information you need for your claim, and there is quite a lot of legal paperwork involved. A personal injury case, whether physical or psychological, against an individual or a corporation, should only be navigated with the help of a savvy and experienced solicitor at the helm. There are depositions, proofs, claims assessment, and many other tiny details that most people are absolutely ignorant of (and most wish to remain so).
Imagine the following scenario: A nameless corporate delivery lorry slams into you on the motorway (let's say the M4), breaking your leg and wrecking your car completely. You can't go to the office for two weeks, since you're in hospital, and your insurance isn't paying you your total loss for the car for another month, causing emotional and financial distress (you have to hire a car). There is a time limit to your ability to take any compensation action against the company that owns the lorry and pays the driver. In cases such as this, a good solicitor will not only settle with a compensation for the car, loss of income and medical expenses. A good solicitor can also get compensation for the emotional distress, and perhaps even enable you to hire a driver to take you the office.
Now, try to imagine navigating the legal pitfalls against a corporation with a team of power-lawyers all riled up to stop any lawsuits from coming through the chinks. Corporate lawyers will trip you over with obscure clauses in the law, bury you in paper (sacrificing a rain forest or two in the process), and generally make your life intolerable. If you're already suffering from the personal injury, this isn't much help.
Another field that often embroils the poor, unsuspecting citizen in murk is property law. Considering that a great national pride in Britain is home ownership and property acquisition, it is no wonder that property disputes arise more often than not. Both private and commercial property laws are complex and convoluted, and even the smartest person on earth might not understand them if they haven't read and practiced the law. Legal transition of ownership problems and bad legal advice have crushed many dreams of home ownership, as well as business ventures and development projects.
This does not mean that you should rush off and sue your ex-boss for emotional distress because he fired you with a form letter. After all, this isn't the United States, where lawsuits appear to be some type of national sport. What it does mean, is that if facing a legal entanglement, be it property, personal injury, divorce, or some other area, find the best solicitor for you. One that is knowledgeable and experienced, and most importantly, that you feel comfortable with.
The way in which the British legal system is structured places a great deal of power in the hands of solicitors and their expertise in out-of-court methods of settlement, rather than barristers (trial lawyers), whose expertise is focused in court arguments. This can be very deterring for anyone about to enter a legal process, of any type. This is especially true for personal injury and property (private or commercial) - after all, in such a procedure oriented system, he who has the best solicitor wins.
Inexperienced citizens often find Personal Injury law an especially tricky field. There is a time limit on taking legal action for compensation, you have to know all the information you need for your claim, and there is quite a lot of legal paperwork involved. A personal injury case, whether physical or psychological, against an individual or a corporation, should only be navigated with the help of a savvy and experienced solicitor at the helm. There are depositions, proofs, claims assessment, and many other tiny details that most people are absolutely ignorant of (and most wish to remain so).
Imagine the following scenario: A nameless corporate delivery lorry slams into you on the motorway (let's say the M4), breaking your leg and wrecking your car completely. You can't go to the office for two weeks, since you're in hospital, and your insurance isn't paying you your total loss for the car for another month, causing emotional and financial distress (you have to hire a car). There is a time limit to your ability to take any compensation action against the company that owns the lorry and pays the driver. In cases such as this, a good solicitor will not only settle with a compensation for the car, loss of income and medical expenses. A good solicitor can also get compensation for the emotional distress, and perhaps even enable you to hire a driver to take you the office.
Now, try to imagine navigating the legal pitfalls against a corporation with a team of power-lawyers all riled up to stop any lawsuits from coming through the chinks. Corporate lawyers will trip you over with obscure clauses in the law, bury you in paper (sacrificing a rain forest or two in the process), and generally make your life intolerable. If you're already suffering from the personal injury, this isn't much help.
Another field that often embroils the poor, unsuspecting citizen in murk is property law. Considering that a great national pride in Britain is home ownership and property acquisition, it is no wonder that property disputes arise more often than not. Both private and commercial property laws are complex and convoluted, and even the smartest person on earth might not understand them if they haven't read and practiced the law. Legal transition of ownership problems and bad legal advice have crushed many dreams of home ownership, as well as business ventures and development projects.
This does not mean that you should rush off and sue your ex-boss for emotional distress because he fired you with a form letter. After all, this isn't the United States, where lawsuits appear to be some type of national sport. What it does mean, is that if facing a legal entanglement, be it property, personal injury, divorce, or some other area, find the best solicitor for you. One that is knowledgeable and experienced, and most importantly, that you feel comfortable with.
Green Cross Guaranteed Acceptance Health Insurance
Private Managed Health care System for those Denied Health Insurance
Or Quality Benefits
Nationally people and families are happy to find one company that is working with people who have medical issues that forestall them from qualifying for health insurance. That company is Green Cross Managed Health care. These families no longer have any need to worry about having access to quality medicare and related benefits. Green Cross Managed Health Care is the one company that provides it all.
America has often been a country of opportunity unless (a) you have got a pre-existing medical condition, or ( b ) you have lost your job and employer-paid health insurance. Personal health insurance firms either reject those people coverage or sell them a policy that excludes covering the existing health condition. People under the age of 65, who have a persistent diseases or medical problem, are left without usable options to give them access to quality medical care they need or to protect their fiscal assets.
Once employed, the responsibility of the employee is to work with a nurse medical care advocate in ways to improve their own health and wellness. Reporting to the managed care team and following wellness programs are part of the work job outline. Bringing the patient's accountability back to the healthcare system has been proved to lower medical costs about by 30 percent and allow group medical care coverage to be extended to those with existing medical conditions.
The Green Cross program is administered by employing evidence-based clinical guidelines. Green Cross isn't an insurance plan, but rather a cooperative effort between Green Cross, Specialty Consultants , Health Benefits Executives , Care Management Nurses, and twin work service providers. Green Cross offers a variety of programs, including group programs for small and medium companies, and programs for individuals. We are able to usually provide benefits for folk who've been declined by Health Insurance firms. We may be able to offer our programs through the use of a twin job process - consisting of customer collaboration in health reporting and management.
Smaller businesses can recognize significant savings, while offering a much needed benefit to their employees. The team approach to driving the cost of health care down works and it is the most effective way we have found to contain the spiraling healthcare costs.
Or Quality Benefits
Nationally people and families are happy to find one company that is working with people who have medical issues that forestall them from qualifying for health insurance. That company is Green Cross Managed Health care. These families no longer have any need to worry about having access to quality medicare and related benefits. Green Cross Managed Health Care is the one company that provides it all.
America has often been a country of opportunity unless (a) you have got a pre-existing medical condition, or ( b ) you have lost your job and employer-paid health insurance. Personal health insurance firms either reject those people coverage or sell them a policy that excludes covering the existing health condition. People under the age of 65, who have a persistent diseases or medical problem, are left without usable options to give them access to quality medical care they need or to protect their fiscal assets.
Once employed, the responsibility of the employee is to work with a nurse medical care advocate in ways to improve their own health and wellness. Reporting to the managed care team and following wellness programs are part of the work job outline. Bringing the patient's accountability back to the healthcare system has been proved to lower medical costs about by 30 percent and allow group medical care coverage to be extended to those with existing medical conditions.
The Green Cross program is administered by employing evidence-based clinical guidelines. Green Cross isn't an insurance plan, but rather a cooperative effort between Green Cross, Specialty Consultants , Health Benefits Executives , Care Management Nurses, and twin work service providers. Green Cross offers a variety of programs, including group programs for small and medium companies, and programs for individuals. We are able to usually provide benefits for folk who've been declined by Health Insurance firms. We may be able to offer our programs through the use of a twin job process - consisting of customer collaboration in health reporting and management.
Smaller businesses can recognize significant savings, while offering a much needed benefit to their employees. The team approach to driving the cost of health care down works and it is the most effective way we have found to contain the spiraling healthcare costs.
Friday, July 3, 2009
An overview on the Medicare Supplement Plans
Medicare Supplement Insurance plan is a type of private health insurance policy offered by the private insurance companies selling Medicare policies to their original Medicare policyholders. The Medicare Supplement Plans helps the policyholders to provide some of the health care expenses, which are not or partly provided by the original Medicare policies. It helps to fill the gap that is left behind by the original policies between their policy coverage and the original medical expenses of the policyholder. And for that reason the Medicare Supplement Plans are also known as the Medigap policies.
To enroll in a Medigap policy a person should already be a beneficiary of original Medicare part A and B. The person needs to pay a Medigap part B premium on monthly basis with a premium to the insurance company. It is always better to get enrolled for a Medigap policy within thirty days of getting the Medicare and it will help in obtaining an improved coverage at a better rate. Though the Medicare Supplement Plans are totally under the administration of the private insurance companies, but still they are allowed to sell only 12 standardized Medigap plans. And these plans are labeled under the letter covers A through L. Each of these policies provides different set of policy coverage and repayment plans. And with these it is possible to fill up the gap left behind by the.
As stated earlier the Medigap insurance plans are labeled under the letter covers A through L. And each of these plans provides different benefits. But the plans under the same latter cover should cover the same benefits irrespective of any company you buy it from. But the policy premium may vary from company to company. The part A plan deals with the basic benefits of and of course with least expenses. While the Plan B covers somewhat more than plan A. It not only covers the basic benefits but also provides Medigap part A deductibles. Plan C also includes the basic benefits along with Medicare Part A deductible and skilled nursing coinsurance with foreign travel emergency. It also provides hospital and medical costs along with blood. Next is Medigap part D. The part D plan provides all the benefits of plan C and also it includes at home remedy as an extra benefit. Medigap plan E provides preventive care along with all the facilities provided by plan D. Medigap plan F is for those patients who consult with doctors who do not agree to Medicare project. It also includes blood related costs. The plan G is also similar to plan F also with the extra feature of at home recovery. Medigap plan H includes prescribed drug coverage. Plan I is also similar to plan H along with the facility of excess doctor charge and at home recovery. Next is plan J. This plan covers all the benefits that are offered by Medicare plans. And for that reason this is the most expensive of all the above-mentioned plans. Therefore it can be said that this plan is only for those who can meet the expense. Both of the plans K and L offer the basic benefits and help to cover large amount but at a lower premium with a higher deductibles. These two plans have been newly launched and not yet widely obtainable.
To enroll in a Medigap policy a person should already be a beneficiary of original Medicare part A and B. The person needs to pay a Medigap part B premium on monthly basis with a premium to the insurance company. It is always better to get enrolled for a Medigap policy within thirty days of getting the Medicare and it will help in obtaining an improved coverage at a better rate. Though the Medicare Supplement Plans are totally under the administration of the private insurance companies, but still they are allowed to sell only 12 standardized Medigap plans. And these plans are labeled under the letter covers A through L. Each of these policies provides different set of policy coverage and repayment plans. And with these it is possible to fill up the gap left behind by the.
As stated earlier the Medigap insurance plans are labeled under the letter covers A through L. And each of these plans provides different benefits. But the plans under the same latter cover should cover the same benefits irrespective of any company you buy it from. But the policy premium may vary from company to company. The part A plan deals with the basic benefits of and of course with least expenses. While the Plan B covers somewhat more than plan A. It not only covers the basic benefits but also provides Medigap part A deductibles. Plan C also includes the basic benefits along with Medicare Part A deductible and skilled nursing coinsurance with foreign travel emergency. It also provides hospital and medical costs along with blood. Next is Medigap part D. The part D plan provides all the benefits of plan C and also it includes at home remedy as an extra benefit. Medigap plan E provides preventive care along with all the facilities provided by plan D. Medigap plan F is for those patients who consult with doctors who do not agree to Medicare project. It also includes blood related costs. The plan G is also similar to plan F also with the extra feature of at home recovery. Medigap plan H includes prescribed drug coverage. Plan I is also similar to plan H along with the facility of excess doctor charge and at home recovery. Next is plan J. This plan covers all the benefits that are offered by Medicare plans. And for that reason this is the most expensive of all the above-mentioned plans. Therefore it can be said that this plan is only for those who can meet the expense. Both of the plans K and L offer the basic benefits and help to cover large amount but at a lower premium with a higher deductibles. These two plans have been newly launched and not yet widely obtainable.
Dentist Services available for needy
As per the world health organization dentists are the part of caring organization and dentistry is defined as the science and art of diagnosing, preventing and treating injuries, diseases and other malformations in jaw, teeth and mouth. Dentistry is considered to be an ethical practice and like other doctors dentists should practice to put the welfare of patients above any other considerations.
There are a number of recognized dental specialties today like endodontists, oral surgeons and physicians, oral pathologists and orthodontists, maxillofacial surgeons, paediatric dentists, periodontists and other special need dentists. There are a range of dental services provided by general dental practitioners. However the majority of dental practitioners work in private and thus the cost of service is somewhat higher for low level income group.
Affordable dental care is not found everywhere especially in today's world where becoming a dentist is seen as a very lucrative career. One such avenue where in one can find affordable dental care is within medical colleges and universities. Such school offer affordable dental care which is at reduced rates as the students studying at such colleges perform most of the work. People who can not afford the high costs of dental implants have in the past used services of such universities and colleges to good means. Besides, these are a good way of getting affordable dental care for people with no dental insurance coverage. However on the cons side these surgeries and implants are done by students so is not a completely professional service and some patients might be apprehensive about it.
There are a number of recognized dental specialties today like endodontists, oral surgeons and physicians, oral pathologists and orthodontists, maxillofacial surgeons, paediatric dentists, periodontists and other special need dentists. There are a range of dental services provided by general dental practitioners. However the majority of dental practitioners work in private and thus the cost of service is somewhat higher for low level income group.
Affordable dental care is not found everywhere especially in today's world where becoming a dentist is seen as a very lucrative career. One such avenue where in one can find affordable dental care is within medical colleges and universities. Such school offer affordable dental care which is at reduced rates as the students studying at such colleges perform most of the work. People who can not afford the high costs of dental implants have in the past used services of such universities and colleges to good means. Besides, these are a good way of getting affordable dental care for people with no dental insurance coverage. However on the cons side these surgeries and implants are done by students so is not a completely professional service and some patients might be apprehensive about it.
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