Health Benefit Exchange

Has health care improved since the ACO went into effect??  We have been told that already the ACA has saved millions and perhaps billions of dollars. How is that so?  Where are the details?

I have an open mind and I am willing to consider the facts....so just show me the numbers. How is it that the government has infused billions of dollars into health IT and providers must now support it operationally ? Given the lifetime of IT hardware and software obsolescence in five years at the most it will all have to be upgraded and/or replaced with a second generation of sofware that has real meaningful usability, not the garbage that HHS is insisting we use to accomodate the "quants" at HHS who massage the information spewing out of their machines.

Health care now supports an industry of high tech that has nothing to do with patient care. Vendors of hardware, software, consultants, IT consultants, a stream of auditors, review firms, outcome studies. What idiots think we are saving money?  The money in health care no longer is going to patient care......it is going to many parasitic organizations.  The only good thing about it is that unemployment would be much worse than it is already.

How long will  health benefit exchanges  be useful after the initial period of signing up the uninsured. Surely it will cost a great deal to fix it, and maintain it.

If the affordable care act continues to roll out the next five years will be a financial and health disaster.

For all the details on Health Benefit Exchanges and which insurance companies have signed up here is the list. It does not mean your doctor will accept these plans since the reimbursement rates in the Affordable Care Act will be very low compared to the current rates.

Stay tuned.

Health Reform: A Play in Multiple Acts

It is a very exciting and troubling time  for health care in the United States.  The stage is set for multiple acts occurring simultaneously.

For those who have boots on the ground with financial commitments and assets the changing landscape means unknown profits (if any) or losses.  Health institutions and providers charged with improved outcomes and 'less cost' are facing the conundrum of supplying more care with less money.

Leonard Zwelling M.D., a Houston physician who was a congressional staffer during the writing of the affordable care act puts it this way, as he discusses a statement made by

Norman Ornstein, a scholar at the American Enterprise Institute, one of the leading experts on the workings of Congress, summed it up in one sentence during a briefing for the press and politicos in November 2008. He said:

"Every one's idea of health care reform is the same: I pay less."

Where I was trying to get my head around a solution to the three tenets of my idea of health care reform, everyone around me was trying to preserve or increase his piece of the health care payoff pie. I was looking for a legislative solution to assist the country in arriving at the place where the rest of the civilized world was - the provision of some form of universal health care as a right of citizenship. Everyone else was looking to cut a deal that preserved his place at the trough of health care profiteering. Guess who won?

With the full cooperation of the Congress and the White House, health care was not even remotely reformed. The Affordable Care Act is not about health care reform. It is about money, particularly preserving the insurance industry's hold over how health care dollars are spent.

Hospitals and providers had little to do with the Affordable Care Act.

"The Affordable Care Act continued to allow hospitals to jack up prices with no relation to actual costs. Only the doctors gave up something because, unlike the insurance industry and the pharmaceutical industry, medicine did not speak with one voice when lobbying on Capitol Hill and thus could largely be ignored. This is health care reform? I don't think so.

The reason the Affordable Care Act did what it did is because that's what it aimed to do - increase access to insurance for the uninsured, get everyone else to pay for it, and make sure no one currently in the health care business loses a dollar from the amounts they are already extracting from patients and doctors alike.

Complicating Ornstein's comments are the multiple scenes ongoing in the 'reform' efforts

Technological advancements such as

Health information technology which includes electronic health records, health information exchanges, the proposed upgrading of the ICD - 9 to ICD -10, the advances in mobile health, telemedicine and more.......

The increased regulatory arm with meaningful use in 3 steps.  MU is linked with financial  incentives from CMS to offset the expense of providers and hospital acquisition of electronic medical records.

The challenging role of an unproven health benefit exchange system, with an incomplete back end disconnecting the actual payment to insurers.





The details of connecting the dots are only now coming into focus for bureaucrats and congress who badly underestimated the complexity of health care delivery.  The turmoil is clearly more evident among providers, hospitals and the patients who are the "guinea pigs"

During the next 12 to 24 months the 'symphony" will unfold.  Will it be harmonious or an unfinished symphony?

Poll: Americans better understand, still don’t love, health-care reform

Lake forming behind an Ice Dam

The recent melt-down of the Affordable Care Act's opening of the Health.gov website served to cast a spotlight on the entire law.  More than 60% of the public pretend to know what it is about. That is about the same as Congress knew when they voted to enact the bill into law.

Despite and perhaps because of it's sudden visibility and the topic of all news media most know of it's shortcomings and how it was passed with major deceptions on the part of the Democrats, HHS, and President Obama's administration.

According to the Seattle Times, "A poll released today by Harris Interactive dug more deeply into the opinions of the uninsured, who face penalties if they don’t get insurance by March of next year. The survey found that more than one-third of uninsured Americans say they are prepared to make health-insurance choices — but 31 percent said they didn’t know about the health insurance exchanges set up to sell the coverage.

On top of that, 61 percent of the uninsured say they have done “nothing” in the past year to get ready for the Affordable Care Act. More than half say they don’t know what they’re going to do about the requirement that they get insurance."

As you may recall, it’s been rough going since the Oct. 1 launch of online insurance markets created to enroll people in individual insurance plans. The federal site, which serves 36 states, essentially wasn’t working for weeks and only really kicked into gear over the last week or so. Washington state’s site had some hiccups, then got itself sorted out, but in the past few days has been down again for software fixes.

Added to those technical glitches like a bee sting on a raging sunburn was the outcry by folks who learned their individual and family insurance plans were being canceled at the end of the year. People felt betrayed by President Obama’s promise that if you liked your health care plan, you could keep it.

A survey conducted and released last week by Gallup found that only 37 percent of Americans approve of the Affordable Care Act or would like to see it expanded while 52 percent want it revised or repealed (the rest are undecided).

The crazy thing — given all of the recent attention to the problems with the roll out of the health-insurance exchanges — is that public opinion hasn’t changed a whole bunch from the same Gallup survey nearly three years ago. In January 2011, 37 percent of those surveyed approved of the ACA while 57 percent did not.

So it begs the question: How and Why was the ACA passed into law?

Many think this was a major move toward consolidating control of healthcare costs, and giving government a major role in 1/6th of the American Economy. It effectively destroys a major freedom of choice of what Americans buy in a market place.

How could public opinion remain so constant despite the tumult in recent news? It could come down to politics.

The Seattle Times teamed up with the Elway Poll in September to take the ACA pulse of Washington residents. It turned out that public opinion on health-care reform largely hewed with political leanings.

In that survey, 80 percent of Democrats approved of the Affordable Care Act, while 80 percent of Republicans did not.

This may reflect more upon the discordance between Democrats and Republicans overall, including budget difficulties which are also severe given the expanding national debt.  Republicans are vehement about corraling the national debit, which will again take canter stage in March 2014.