Enjoy our most current issue of the most popular medical e-newsletter on the internet.
Blogs and Thoughts for July 13th to July 19th:
Here is what we had this past week
- Disposing Meds by Steven Mussey MD
- $76,000? Nope.
- Country Roads by Pat Conrad MD
- MIPS vs. MOOPS
- What Healthcare Bill Would Work?
- Oh, No, They Put Kenny In The Bladder
- Quote of the Week: Mark Zuckerberg
1. Disposing Meds by Steven Mussey MD
July 19, 2017
The issue is worse than that. See this.
2. $76,000? Nope.
July 18, 2017
When John McCain had his eye surgery that delayed the Senate vote on healthcare you just knew that it was going to be fodder for the critics. Well, here it is:
Not exactly. First of all, no one really knows what the cost of the surgery would have been since there is NO transparency. Would you buy a television or a car without knowing the price? Healthcare is a fantasy world created by these idiots in Congress who have been in cahoots with the insurance industry.
If McCain had one of the health ministries (MediShare, CHM, etc.) then the price, from my experience with my patients, would have been dropped significantly. Using a similar example from someone I know, his cost would have come to about $50K and the health ministry would have paid it all. Even better, the $26K savings would have been applied to his $5K deductible so it would have cost McCain nothing. Would a regular insurance do that?
If McCain had a bare bones plan or catastrophic plan then his monthly fees would have been very reasonable (see these short term plans at United) and his out of pocket cost would have been his deductible or about $10K. Who could afford $10K you say? Well, I pay more than that in a year with my monthly premium and that is before my deductible. And I am not alone.
This article is bogus. I don’t want to say “fake news” but how about hyperbole news or embellished news?
There is an answer. Let the free market work. And take away the special heath coverage for Congress as well.
3. Country Roads by Pat Conrad MD
July 17th, 2017
Well, I guess this is a different spin on it…
The Senate is pretzeled into a fine mess, with Dems shrieking about the GOP slaughtering hundreds of thousands with Medicaid cuts, and wimpy Republicans believing them. Last October, the Kaiser Family Foundation predicted that Medicaid spending GROWTH would decrease from spending 10.5% to 4.5%, an electoral design of ObamaCare, wherein the federal share of spending would very conveniently drop just as the Great Compassionate was to leave office. Congressional Republicans claim that their ObamaCare Lite will only slow the growth of Medicaid, leaving plenty of slop in the trough and more deficit and debt as far as the eye can see. Add to that the billions more the Trump Administration is promising to fight opioid addiction, which will achieve the twofer of further punishing docs, while wasting more taxpayer money.
Never to leave a heart un-bled, Yahoo News has an innovative way to scare us all over any potential cut in this massive welfare program. If we flirt with cutting Medicaid, this could threaten opioid addicts’ survival in West Virginia. The article begins with a sob story over an ambulance crew being helped with a flat by a roadside mechanic save, only to then go to his house and save his OD’ing daughter. That Lifetime Channel setup then leads to the real meat: the EMS service “pays the bills largely through patient insurance — which in this mostly poor, rural area is Medicaid, a program that could see massive cuts under the health care bill championed by Senate Republicans anxious to deliver on their campaign promise of repealing the Affordable Care Act.” They also fear the loss of the state grant that buys Narcan, even as that drug’s price has spiked. I wonder if the drug maker saw a spike in demand as cover for a price jack? After all, it worked for EpiPens, the Mylan CEO responsible being none other than the daughter of West Virginia Sen. Joe Manchin. But I digress…
The EMS director laments, “If there are more Medicaid cuts, and no other help, this would be catastrophic for us, I don’t know if we could survive. We are talking about a potential situation where people would call 911, and there would be no one to help, whether it’s an overdose or a heart attack or a car accident or a broken hip. There would be no one. Can you imagine?”
Yes, as the EMS medical director in a very rural county with plenty of drug addicts, I certainly can imagine that a poor area can only provide scant resources over which different patient groups will compete. And yes, I imagine without a blank check without end, some folks will actually die for lack of rapid medical attention. The Hatfields vs. McCoys have now become the Cardiacs vs. the Addicts. And what response does this silly author elicit?
“Not only are rural health care providers heavily dependent on Medicaid, many of those covered by Medicaid are the ones being treated for drug abuse. According to the West Virginia Department of Health and Human Resources, roughly 50,000 of those who are covered through the Medicaid expansion were treated for substance abuse last year — a number many state officials expect to increase amid a drug crisis that appears to be getting worse by the day.” I read that as journalistic extortion, flatly threatening that if we don’t increase Medicaid funding (with money we don’t have), there will be even more untreated addicts prowling the backyards.
It is arguable that the existence of Medicaid has abetted and encouraged many self-destructive behaviors, including inappropriate demand for and access to opioids, often provided by the very docs who now worry they would be cut off from the government teat. This story is another example of single-wing emotionalism that overpowers other serious questions. For instance, who is going to pay for all of this?
4. MIPS vs. MOOPS
July 16th, 2017
This just in:
A congressional agency, MedPAC, recently issued its June report highlighting the need to improve the Merit-based Incentive Payment System (MIPS) track part of the Quality Payment Program (QPP) by reducing administrative burden and increasing the importance of positive patient health outcomes.
Here is the funny part. Does anyone believe a plan using terms such as “merit based”, “incentive payment” and “quality payment” would ever be able to reduce administrative burden?
Add to this that they still want to INCREASE the importance of positive patient health outcome?
Who thinks up this crap?
5. What Healthcare Bill Would Work?
July 15th, 2017
I am no economist but my job as a direct primary doctor has proven that the free market works. Even more importantly, it proves that the insurance companies are needed very rarely. They don’t need to navigate your care. They don’t need to negotiate prices for you. They don’t need be called “your healthcare provider”. They are there to be a safety net when a catastrophe happens. That should be all. Consumers can bring prices down if they are left to their own devices.
With all this I still don’t know what EXACT plan will work but I know we are in the right direction if the insurers are pissed off about it. Remember, they LOVED Obamacare!
This article in the Washington Post was titled Health insurers have been strangely quiet about undoing Obamacare. Until now. It went on to say:
Cruz and Lee’s amendment, called the “consumer freedom amendment,” would allow insurance companies to sell cheap health plans that don’t meet the Affordable Care Act’s coverage requirements as long as insurers also agree to sell a plan that does. For example, an insurer could sell a skimpy plan without maternity coverage or reject people with certain preexisting conditions — so long as they sell a plan that doesn’t do those things. The idea, endorsed by Vice President Pence, is that healthy people would be able to buy only the coverage they want.
But in a letter to lawmakers and a document circulating on Capitol Hill, health insurers’ trade groups said that policy would destabilize the insurance marketplaces, cause premiums to rise unsustainably for people with chronic health conditions and leave fewer and fewer insurers selling plans — all the hallmarks of a death spiral.
“I’m writing to make clear my view on how the ‘Consumer Freedom Option’ is unworkable as it would undermine preexisting condition protections, increase premiums and destabilize the market,” Scott Serota, president and chief executive of the BlueCross BlueShield Association, wrote to Cruz and Lee.
I call bulls%t on the insurance trade groups. They are worried about only one thing and that is their profits. I only hope that this plan would put them in a death spiral!
6. Oh, No, They Put Kenny In The Bladder
July 14th, 2017
Just some of the fun we used to have with the Placebo Journal. BTW, the foley balloon in the top picture makes Kenny’s head and the big prostrate makes up his bladder.
7. Quote of the Week: Mark Zuckerberg
July 13th, 2017
“In a world that’s changing really quickly, the only strategy that is guaranteed to fail is not taking risks.”
UNTIL NEXT TIME, KEEP SMILING, KEEP LAUGHING AND KEEP OUT OF THE SAMPLE CLOSET!
Douglas Farrago MDTweet