There is No Free Lunch and There is No Free Contraception

Robert Laszewski

Posted 2/10/12 on Health Policy and Marketplace Review

The otherworldy Obama Administration solution to the contraception firestorm might work politically but it makes no sense in the real world. The President, hoping to quell a growing political firestorm, today announced a new policy that no longer requires religiously affiliated organizations to provide employees with contraception coverage in health-insurance plans. Under the new policy, insurance companies will be required to offer free contraception for their employees and dependents. The administration’s idea is to shift the onus for the coverage from the employer to the insurer. Catholic leaders, and lots of other people, had objected to the requirement, which exempted churches but not hospitals, charities and universities with religious affiliations. So, let’s just play a game here. The religious organization just pretends that it has nothing to do with it but the insurance company pays for it anyway. Hey, the insurance companies are rich. Continue reading “There is No Free Lunch and There is No Free Contraception”

A Thousand Dollars Says Dr. Ezekiel Emanuel Is Wrong About ACO’s Long Term Prospects

Jaan Sidorov

Posted 2/1/12 on the Disease Management Care Blog

Approximately 15 years ago, the Disease Management Care Blog was a speaker at a conference with an audience mostly made up of managed care leaders. It boldly argued the nation’s disease management vendors were going to help put the nation’s health insurers out of business by simultaneously assuming risk and lowering costs.

Hows that for chutzpah. The DMCB was never invited back, but not because it isn’t an outstanding conference speaker who deserves fat fees.

It was because it was utterly wrong.

And so is this online commentary on accountable care organizations (ACOs) courtesy of the The New York Times. In it, Dr. Ezekiel Emanuel boldly predicts that by 2020, ACOs will drive health insurance companies out of business. They’ll do that by assuming full risk, dropping patient barriers to care, coordinating services, fostering communication, promoting health, banning fee-for-service, increasing efficiency, relying on evidence-based care, being locally responsive and competing against other ACOs on cost and quality

Dr Emanuel is being astonishingly overconfident for four reasons.

Continue reading “A Thousand Dollars Says Dr. Ezekiel Emanuel Is Wrong About ACO’s Long Term Prospects”

Only Docs Can Do It

Merrill Goozner

First published 5/19 on Gooz News

Do what, you ask? Cut costs. So say Victor Fuchs and Arnold Milstein in a sprightly overview of the roadblocks to cutting health care costs in the latest issue of the New England Journal of Medicine.

The short essay begins with the observation that the most cost-effective and often highest quality health care systems in the U.S. (usually organized as non-profit, integrated groups like Kaiser Permanente or Intermountain Health) deliver care at 20 percent less than the national average. Spread their model to the rest of the system and it could lop a whopping $640 billion off the national health care tab.

Continue reading “Only Docs Can Do It”