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. Those of you yelling to deport them all should at least understand that the law allows minors (if not from a bordering country) to argue for asylum. If you don't like the law, you can petition Congress to change it. But you can't blindly scream that they all need to be deported now, unless you want your government to just decide which laws to follow and which to ignore.

  2. 52,000 children in a country with a population of nearly 300 million is decimal dust or a nano-amount of people that can be easily absorbed. In addition, the flow of children from central American countries is decreasing. BL - the country can easily absorb these children while at the same time trying to discourage more children from coming. There is tension between economic concerns and the values of Judeo-Christian believers. But, I cannot see how the economic argument can stand up against the values of the believers, which most people in this country espouse (but perhaps don't practice). The Governor, who is an alleged religious man and a family man, seems to favor the economic argument; I do not see how his position is tenable under the circumstances. Yes, this is a complicated situation made worse by politics but....these are helpless children without parents and many want to simply "ship" them back to who knows where. Where are our Hoosier hearts? I thought the term Hoosier was synonymous with hospitable.

  3. Illegal aliens. Not undocumented workers (too young anyway). I note that this article never uses the word illegal and calls them immigrants. Being married to a naturalized citizen, these people are criminals and need to be deported as soon as humanly possible. The border needs to be closed NOW.

  4. Send them back NOW.

  5. deport now

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