A dose of light reading

August 9, 2013
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Health care is a complicated mess.

So much so, that even top CEOs of large health care organizations tell me privately that they feel overmatched by it.

I certainly do. Which is why I read as much as I can about health care.

So starting with this post, I’m going to periodically give you a peek at my reading list. I’ll highlight reports and reportage that I have found either helpful or provocative. I hope you do too.

I’ll start with something fun: New York Times’ reporter Elisabeth Rosenthal’s thorough look at the orthopedic implant industry, centered in Warsaw, Ind., which some economists call a "cartel." Aggressive markups, by both the device makers and the hospitals that implant the devices, have driven some American patients to fly to Europe, where government price controls help them get hip and knee replacements at a fraction of the cost they would pay in the United States. If such medical tourism becomes a trend, it’s bad news for the folks in Warsaw, where three of the world’s five largest implant makers are based.

While Rosenthal focuses on the orthopedic implant makers, another study shows hospitals have lots of air in their orthopedic pricing. An analysis by two UC-Berkeley researchers of Indianapolis-based WellPoint Inc.’s reference-based pricing experiment in California, which I wrote about earlier, shows that hospitals do respond—quite rapidly—when patients are enabled and encouraged to factor price into their decisions. This study has been getting lots of attention by the press and by health policy researchers. If you want one economist’s take on its significance, look here.

If you're a consumer thinking about buying health coverage in Obamacare's exchanges later this year, the Indiana Department of Insurance came out with a helpful document that is full of examples of how the cost of insurance will change for Hoosiers buying coverage next year. The upshot of the department's analysis is this: healthy people will pay (a lot) more, unhealthy people will pay (a lot) less. I would skip to page 13 of the report to read Appendices 2 and 3, which lay out numerous examples of premium increases and decreases and then more examples that factor in Obamacare’s subsidies.

Finally, if you’re really into the numbers, I suggest you read the actuarial memos filed by each of the three health insurers that will be offering exchange plans in central Indiana. These memos explain each insurer’s assumptions about why costs will rise and for whom:

Anthem Blue Cross and Blue Shield actuarial memo.

MDWise Inc. actuarial memo.

Physicians Health Plan of Northern Indiana Inc. actuarial memo.
 

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  • Indiana Health Exchanges
    A common denominator appears to be that consumers in poor health will pay less, but persons in excellent health will often pay more. In fact, quite a bit more. Not that it is unexpected. Somebody has to pay for the legislation and upper-income earners will certainly be among those that pay a bit more. And of course, different areas of the state will have different availability of carriers and plans. Again, that is to be expected.
  • one thing...
    ...you never mention/ discuss is the fact that there is NO good reason for health insurance in this country to be provided by employers...no other industrialized nation provides health insurance/ health care in this manner and THE answer is single-payer universal Medicare for all and I think you are smart enough to know that JK. If you're not educated on this there are plenty of physicians that will be happy to speak to you about it. Physicians for National Health Program (and state chapter) http://www.pnhp.org/ http://www.pnhp.org/states/indiana

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  1. What became of this project? Anyone know?

  2. Scott, could you post an enlarged photo of the exterior of the building? This will be a great addition to Walnut Street. This area will only continue to develop with additions like this. Also, please give us more updates on the "Cultural Trail light" expansion. Also a great move for the city, as long as there is maintenance money set aside.

  3. Great story IBJ! Citizens don't have a real sense of the financial magnitude of supporting Indy's sports and tourism sector. The CIB was a brilliant idea for creating a highly integrated public-private partnership to support this sector from the economic activity it generates. Unfortunately, most folks think the benefits of that economic activity accrue directly to the City budget, and it doesn't. So though the CIB is facing lean times (covering its costs while maintaining minimally acceptable reserves), the City is operating with deficit - less tax revenue than expenses each year - with a very fragile reserve balance. That's why it's so challenging for the City to fund basic needs or new intitatives (e.g. pre-k education; new jail), and some credit rating agencies have downgraded Indy from it's past stellar AAA status. More reporting on City finances would be welcomed.

  4. Sure, I'll admit that it bugs me to see that the IBJ.COM censors it's blog posts almost as much as the D of I does when someone points out the falsehoods and fabrications. _____But I think it bothers me almost as much that Captain/Defender/Disciple get his yanked too. You see, those of us with a sense of integrity, humanity, compassion, and a need for fact based opinion WANT to see all of his screeds posted. It makes our point so much better than we can do it ourselves.

  5. We're conflating two very different topics. Voter fraud is a myth and excessive gun violence is all too real. I just hope rational gunowners decide to stop being shouted down by the, well, let's call them "less rational" ones.

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