MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'insurance industry'. Sat, 03 Sep 2011 02:22:56 +0100 http://www.medworm.com/index.php?rid=5169545&cid=t_165022_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdo-physicians-have-a-role-in-controlling-healthcare-costs%2F2011.08.27 The Role of Physicians in Controlling Medical Care Costs and Reducing Waste by the RAND Corporation and David Geffen, University of California Los Angeles School of Medicine, Santa Monica was just published in the Journal of the American Medical Association (JAMA).  I do not think the JAMA should have published this article. 1.Why would the JAMA publish such an article? 2. Why are physicians blamed for all the waste in the system? 3. Why is it the physicians’ responsibility to eliminate waste when they are not the cause of the greatest percentage of the waste? “The amount of money spent on medical care is increasing faster than the gross domestic product (GDP), and the federal deficit is increasing.” The initial statement assumes that the government deficit is increasing because phy... Better Health blogs http://www.medworm.com/rss/comments.php?id=5169545 Sat, 27 Aug 2011 21:05:19 +0100 5169545 http://www.medworm.com/index.php?rid=5107514&cid=t_165022_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fphysician-discusses-the-confusing-aspects-of-medicare-part-d%2F2011.08.09 I have discussed Medicare Part B and Part F in recent blogs. A reader asked about Medicare Part D: Dr. Feld “Please discuss Medicare Part D, the drug benefit plan available to seniors. It is very complicated and completely confusing to me. My physician gave me a prescription for Levequin 500 mg once a day for 10 days. The pharmacist told me it would cost me $330 dollars. Medicare Part D would pay an additional $110 dollars for a total of $440 dollars. I asked the pharmacist if there was a generic equivalent. The answer was yes. It cost $10 dollars. This is unconscionable. It is highway robbery. Sincerely a.g.” Several issues are presented in this readers note. It is essential to understand these issues. The issues are an indictment against government “controlled” programs. (m... Better Health blogs http://www.medworm.com/rss/comments.php?id=5107514 Tue, 09 Aug 2011 14:00:44 +0100 5107514 http://www.medworm.com/index.php?rid=4592398&cid=t_165022_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-your-medication-list-makes-you-the-perfect-pharma-target%2F2011.03.14 Give me your medication list and I’ll tell you your health problems. It happens every day in emergency rooms across the country as confused elderly patients present for an acute problem unable to describe their past medical history, but equipped with a list of medications in their wallet: Metformin = Type-2 diabetes Synthroid = Hypothyroidism Lipitor + Altace + Lasix + Slo-K = Ischemic cardiomyopathy Lexapro = A little anxious or depressed Viagra = Well, you know… I bet I’d be right better than 90 percent of the time. Now, imagine you’re a pharmaceutical company wanting to target people with those chronic diseases. Where might you find them? No problem. Just pay the insurers to provide you patients’ drug lists. No names need be exchanged in keeping with HIPA... Better Health blogs http://www.medworm.com/rss/comments.php?id=4592398 Mon, 14 Mar 2011 19:00:00 +0100 4592398 http://www.medworm.com/index.php?rid=3848869&cid=t_165022_87_f&fid=39187&url=http%3A%2F%2Fcovertrationingblog.com%2Fpodpress_trac%2Ffeed%2F809%2F0%2Fsaveobamacareimplications.mp3 Why Big Health Insurance Supported Obamacare, Part IV In the past few posts (in particular, here and here), DrRich has shown why the health insurance industry embraced Obamacare, and indeed, took extraordinary steps to assure that Obamacare became the law of the land. This, of course, is especially interesting in light of the common perception that Obamacare constitutes a major defeat for the greedy health insurance industry. But the fact that big health insurance gave critical support to Obamacare is far more than merely interesting. It has major implications both to supporters of Obamacare, especially the ones who hope for an eventual single-payer outcome, and to opponents of Obamacare, many of whom hope to repeal it after the 2010 mid-term elections. For the health insurance industry to... Better Health blogs http://www.medworm.com/rss/comments.php?id=3848869 Mon, 09 Aug 2010 20:00:46 +0100 3848869 http://www.medworm.com/index.php?rid=3603598&cid=t_165022_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealth-insurance-and-medical-loss-ratio-foolishness%2F2010.05.25 Like Ezra Klein, smart people keep saying foolish things about the health insurance business. This time it’s a pair of bloggers talking about the largest expense that health insurers face — their “medical loss ratio.” According to Richard Dale at the Venture Cyclist: [W]hy do they call it Medical Loss Ratio? Why is looking after me (or you) called “Medical Loss,” when the whole point of a healthcare system is to look after me (or you)? (Sigh.) Alan Katz, one of the leading health insurance bloggers, surprisingly links to this with approval, saying “words matter.” The problem? The word “loss” is probably one of the four oldest words in the insurance industry. I’d say the others are probably “premium,” “commission,” and “profit.” Should we start outlawi... Better Health blogs http://www.medworm.com/rss/comments.php?id=3603598 Wed, 26 May 2010 01:00:39 +0100 3603598 http://www.medworm.com/index.php?rid=3533838&cid=t_165022_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fone-more-medical-acronym-for-the-pile%2F2010.05.05 In medicine, hardly a week passes without the introduction of some new acronym, previously unspoken in the average practice, which then grows to prominence — take HIPAA, PECOS, CPT, ICD, etc. — the list goes on and on. I believe that after 14 years of practice I’ve earned the right to introduce an acronym of my own: CRAPP. For the last several months, my partner and I have used this term to describe the volumes of denials, pre- and prior- authorizations (is there really a difference?), and faxes that seem to grow like weeds on the fertile planting grounds of our desks. More specifically, in our office the acronym CRAPP stands for: Continuous Restrictive And Punitive Paperwork. To put it blithely, CRAPP could represent any document you wish someone had put on your partner’s ... Better Health blogs http://www.medworm.com/rss/comments.php?id=3533838 Wed, 05 May 2010 12:00:11 +0100 3533838 http://www.medworm.com/index.php?rid=3453931&cid=t_165022_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2010%2F04%2Fmassachusetts-foreshadowing-our-nations.html Paul Levy, President and CEO of Beth Israel Deaconess Medical Center in Boston, MA, today suggests we watch Massachusetts for what might be coming with health care reform:Things are playing out just as one might predict in the Massachusetts small business and individual insurance market. The Insurance Commissioner turned down proposed rate increases, the state's insurers appealed to the courts, and now they can't write policies.Perhaps more concerning is what Dennis Byron, a commenter on Mr. Levy's blog says about insurance exchanges:I care because I am one of those that has been cancelled by my insurer (Fallon) solely I believe because I am an individual, have been told to go to the exchange, but the exchange does not work. This is a perfect example of why you don't want the guys that run... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=3453931 Fri, 09 Apr 2010 13:18:00 +0100 3453931 http://www.medworm.com/index.php?rid=3254476&cid=t_165022_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2010%2F02%2Ffor-love-or-insurance.html For this 45 year-old decently divorced woman with C4 complement deficiency, marriage is for insurance.-WesTV spot: NBC5 Chicago Web Sights, 9 Feb 2009Musings of a cardiologist and cardiac electrophysiologist. (Source: Dr. Wes) Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=3254476 Tue, 09 Feb 2010 14:40:00 +0100 3254476 http://www.medworm.com/index.php?rid=3182198&cid=t_165022_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2010%2F01%2Fjust-call-me-doctor-snitch.html In a continuing effort to drive a stake though the doctor-patient relationship, insurers are now turning to doctors to serve as their investigatory snitch in attempts to deny patients coverage:"To your knowledge, as the patient been seen by any other healthcare professional for the above condition between the dates of 12/01/08 and 03/01/09? ____ YES ____ NOIf yes, please provide the name(s) and address(es) of the other healthcare professional(s):"Like I have nothing better to do than to serve the simultaneous roles of deep throat and directory assistance operator for an insurer...-WesMusings of a cardiologist and cardiac electrophysiologist. (Source: Dr. Wes) Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=3182198 Mon, 18 Jan 2010 14:49:00 +0100 3182198 http://www.medworm.com/index.php?rid=3156492&cid=t_165022_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2010%2F01%2Fnevada-supreme-court-denies-insurance.html Could this be the start of a trend?The Nevada Supreme Court on Friday upheld a ruling that a Las Vegas police officer was not entitled to coverage for heart disease.Under state law, a police officer continuously employed for more than five years is entitled to the presumption that any heart disease is work related. Patricia Guesman, however, was denied coverage by both the hearing officer and a district judge.The Supreme Court noted coverage is not automatic if “after the police officer's annual medical exam, the examining physician ordered her in writing to correct a predisposing condition that was within her ability to correct and the officer failed to do so.”The three-justice panel of Ron Parraguirre, Michael Douglas and Kris Pickering pointed out that smoking is a predisposing cond... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=3156492 Sat, 09 Jan 2010 15:26:00 +0100 3156492 http://www.medworm.com/index.php?rid=3100781&cid=t_165022_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FbmiVeQhPtSY%2F By Alan ReynoldsDuring the runaway inflations of 1974 and 1979, Presidents Ford and Carter suggested that inflation was caused by the profligacy of American households. President Ford’s infamous “Whip Inflation Now” speech, for example, said, “Here is what we must do, what each and every one of you can do: To help increase food and lower prices, grow more and waste less; to help save scarce fuel in the energy crisis, drive less, heat less.” Much of the recent discussion of health care costs likewise treats this as a problem caused by a demonic private insurance industry, and therefore requiring such “reforms” as expanding Medicaid to the non-poor and Medicare to the non-old. The facts are quite different, as shown in “The Evolution of Medical Spending Risk” by Jonathan Gr... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3100781 Thu, 17 Dec 2009 17:52:23 +0100 3100781 http://www.medworm.com/index.php?rid=3023147&cid=t_165022_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2009%2F11%2Fwhen-insurers-dominate-market-share.html Prices rise:One factor that could be driving larger increases locally: Blue Cross & Blue Shield of Illinois, which historically has used its dominant 50%-plus marketshare to undercut competitors' prices, has been more aggressive with rates this enrollment season, brokers say."Blue Cross is the one company that is consistently coming in with higher renewal increases," says Rob Wilson, an insurance broker and president of Westmont-based Employco Group.A Blue Cross spokeswoman declines to comment.Funny that when hospital systems coalesce and raise prices to remain "competetive," the FTC cries foul, but when the insurance industry does the same thing, the FTC can't be bothered.But then, the government knows what's best for patients, right?-WesMusings of a cardiologist and cardiac electrophysio... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=3023147 Mon, 23 Nov 2009 16:19:00 +0100 3023147 http://www.medworm.com/index.php?rid=2963118&cid=t_165022_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2009%2F11%2Fhealth-care-insurance-gift-cards.html ... for Florida residents, they're just in time for the holidays!Starting this month you can find these gift cards at any Winn Dixie and in November you can find them at CVS pharmacy stores.There are two types of gift cards available. One is called "the blue health care card" It acts like a temporary health insurance. For $59.00 it gives you health insurance coverage for one to 2 1/2 months based on your age. Here's how it works. You buy the gift card at the store, and the person receiving the card activates it. Then they enroll in a variety of plans offered. After that, you'll receive a package in the mail with a member id card.You can use the temporary insurance gift card to see a doctor, a dentist, at the pharmacy, or for lab work.The other gift card is called the family blue discount c... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=2963118 Wed, 04 Nov 2009 19:53:00 +0100 2963118 http://www.medworm.com/index.php?rid=2958887&cid=t_165022_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2009%2F11%2Fwhen-hoop-jumping-becomes-patient-care.html "Doc, I've got good news and bad news.""What's that?""Well, I've lost six more pounds!" "Wonderful! What's the bad news?""Well, you know that new-fangled drug you gave me that works so well for my atrial fibrillation?""Yes.""We'll, I'm part of that AARP Medicare Advantage Part D drug plan, and I just got the "partial" approved drug list for 2010 in the mail. My drug's not on the list, so I called and found the drug's been moved from a Tier II drug to a Tier III drug. That means it will cost me twice what I paid for it this year. That's gonna be tough, doc. I can't afford it.But I also read that if you call this '800' number and speak to them, they'll allow me to obtain an exemption to keep the drug on Tier II for next year."I called the number as I typed his note. The patient seemed please... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=2958887 Tue, 03 Nov 2009 13:31:00 +0100 2958887 http://www.medworm.com/index.php?rid=2858649&cid=t_165022_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2009%2F10%2Fspecialists-become-hospitalists.html From Columbus, Ohio:In the past, hospitals hired primarily family doctors who would refer patients to the facility for medical tests. Now, hospitals are employing more specialists.For example, having a neurologist or cardiologist on staff allows quicker patient consults than waiting for a private-practice doctor to come to the hospital."The reason we even employ specialists is to provide inpatient coverage on our floors in the hospital," said Cindy Sheets, senior vice president ambulatory services for Mount Carmel Health System.Another reason specialists are consolidating with hospital systems is the high cost of bringing on other experienced specialists that have insurance "tails" from their former practice. These insurance "tails" assure continued malpractice insurance coverage on patien... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=2858649 Sat, 03 Oct 2009 21:48:00 +0100 2858649 http://www.medworm.com/index.php?rid=2610890&cid=t_165022_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FpdgGefsqbyw%2F Reading the New York Times’s coverage of a Senate committee’s recent vote on health care legislation, I was struck by the following statement from Sen. Dodd: If you don’t have health insurance, this bill is for you,” said Senator Christopher J. Dodd, Democrat of Connecticut, who presided over more than three weeks of grueling committee sessions. “It stops insurance companies from denying coverage based on pre-existing conditions. It guarantees that you’ll be able to find an insurance plan that works for you, including a public health insurance option if you want it.” The bill would also help people who have insurance, Mr. Dodd said, because “it eliminates annual and lifetime caps on coverage and ensures that your out-of-pocket costs will never exceed your ability to... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2610890 Thu, 16 Jul 2009 13:05:02 +0100 2610890 http://www.medworm.com/index.php?rid=2561355&cid=t_165022_111_f&fid=34716&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FNurseRatchedsPlace%2F%7E3%2FRofKW5BgfLQ%2F My apologies to James Carville. I plagiarized his tagline because the insurance industry has forgotten about sick people during our national healthcare debate. I remember when nurses and insurance companies use to get along with each other. Back in the 1960s, these nurses even took time out of their busy schedules to pose for one of their ads. We took care of patients at the bedside, and the insurance companies paid the hospital bill. It was as simple as that, but then things started to change. It began with three little letters—HMO. Insurance companies are spending a lot of time and money trying to scare people into opposing President Barack Obama’s ideas on health care reform. They are especially working hard to torpedo the public option plan. That plan would allow you to keep y... Nurse Ratched's Place blogs http://www.medworm.com/rss/comments.php?id=2561355 Wed, 01 Jul 2009 14:13:31 +0100 2561355 http://www.medworm.com/index.php?rid=1943295&cid=t_165022_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2008%2F11%2F07%2Fimproving-access-to-medicines-for-nhs-patients%2F sets out a series of recommendations on improving access to medicines for NHS patients.  It also makes recommendations on the consequences for NHS patients of seeking additional private care.   This has led to the issuing of a Draft guidance on NHS patients who wish to pay for additional private care for consultation supported by an Equality Impact Assessment. To gain further insight into the subject Paying for (expensive) drugs in the statutory system: an overview of experiences in 13 countries provides international comparisons of access to medicine. Posted in Decision Making, Equity, Financial Management, Grey Literature, Health Economics, Health Needs, NHS, Primary Care   Tagged: Ethics, Financial Management, Grey Literature, Health, Health Service Economics, Insura... Fade Library blogs http://www.medworm.com/rss/comments.php?id=1943295 Fri, 07 Nov 2008 13:56:22 +0100 1943295 http://www.medworm.com/index.php?rid=1779130&cid=t_165022_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2008%2F09%2F10%2Fmaking-the-nhs-the-best-insurance-policy-in-the-world%2F from the think tank Reform identifies that universal access to health care is a key element of a sccessful health service but that international case studies show that universal insurance based health services: provide reasons for individuals and authorities to value long term improvements in health and wellbeing define exactly what individuals are covered for, ending the postcode lottery and empowering individuals to demand their rights from providers achieve greater value de-politicise healthcare The report proposes changing the NHS funding model to an insurance based model that is tax funded to ensure access but builds in competition based on the indivduals choice of health care provider.  This the report believes will ensure the NHS is not in the hands of politicians and that... Fade Library blogs http://www.medworm.com/rss/comments.php?id=1779130 Wed, 10 Sep 2008 05:51:37 +0100 1779130 http://www.medworm.com/index.php?rid=1564243&cid=t_165022_136_f&fid=36032&url=http%3A%2F%2Fblog.healthtalk.com%2Fbreast-cancer%2Flife-with-breast-cancer%2Fwe-the-people-demand-healthcare-reform%2F Last week, CNN reported that lobbyists spend 2.5 billion dollars to influence the American government. As startling as that figure is, a full 20 percent of that (about 500 million dollars), is spent by the healthcare industry. Imagine, that is approximately 1.2 million dollars on healthcare for each man woman and child in the United States. I don’t know about you, but by my calculations that is enough money to ensure coverage for everybody. Even more provoking is the question of how much profit is made by the health insurance industry if they can afford to throw away this kind of money to influence policy? Further, how is this money spent, who does it go to and what do they do with it? For the sake of all Americans we need answers to these questions. While most families are struggling to... Life with Breast Cancer blogs http://www.medworm.com/rss/comments.php?id=1564243 Thu, 03 Jul 2008 00:09:14 +0100 1564243 http://www.medworm.com/index.php?rid=1158361&cid=t_165022_134_f&fid=36049&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FDiabetesNotes%2F%7E3%2F218414784%2F This study showed that when you remove those barriers, people started using these high-value services significantly more. These results bolster the idea that health insurance benefits should be designed in ways that produce the most health per dollar spent.” What can be done? How do we tangibley make it happen? Do you pay for all your diabetic supplies? Do you fill all your prescriptions, or have to pick and choose? via University of Michigan Health System Share This (Source: Diabetes Notes) Diabetes Notes blogs http://www.medworm.com/rss/comments.php?id=1158361 Thu, 17 Jan 2008 19:36:33 +0100 1158361