Health Care Uncovered

Attention All Healthcare Shoppers

Attention all healthcare shoppers. That's right, healthcare shoppers. It's time to steal the deal.

I've written about it in my book.

I've blogged about it here.

It's one of my top tips for cutting healthcare costs.

Comparison shopping is here and will revolutionize, or dare I say reform, healthcare as we know it.

And finally, mainstream media is taking notice as more companies jump on board.

Friday, Castlight Health announced a $81 million joint venture with investors and the Cleveland Clinic to "empower individuals to take control of their health care expenses" by providing the true cost of medical care to consumers.

The New York Times ran a full story about Castlight and the "new" idea of price comparison shopping stating, "Price transparency could significantly change the way health care is bought in the United States. Read the full article here.

But you don't have to wait for Castlight. There are several companies that already provide healthcare pricing.

With over 100 different health plans with 100 different prices for 100 different tests and procedures, you've got to shop around.

Healthcare BlueBook

PriceDoc.com 

NewChoiceHealth.Com

 

What do you think?  

Are You Paying More With Health Insurance?

Are YOU paying more because you have health insurance?

You may be very surprised to learn that sometimes hospitals charge upwards of 400% more for services billed to your insurance company versus paying cash without insurance.

With increasing deductibles and co-insurance, this means you will be the one paying more, not your insurance company.

So why not just ask for the cash price instead of using insurance?

Not so fast.

Watch as Houston's KPRC local news explains.

As you will see, and as I've said before, if you want to save on your healthcare bills, you must know the fair market or cash price and shop around.

If you can prepare ahead of time, look up your tests and procedures at Healthcare Blue Book. If you have insurance compare this price with the hospital's contracted insurance price and their cash price. If you can't do this ahead of time, call the hospital and negotiate your bill. 

I also encourage people without insurance to compare the cash price with the hospital's contracted insurance or Medicare rate.

Keep in mind, not all healthcare services cost less when paying cash. Insurance companies negotiate rates with hospitals which means you should pay less.

The bottom line? The more you know the less you could pay.

Don't let your insurance company leave your assets half covered like a cheap hospital gown.

 

Comments?

The Truth About Healthcare Reform

There should be dancing in the streets.

Over the weekend, President Obama said health reform is already delivering 'real benefits' to millions of people and putting more power in the hands of patients and out of the hands of insurance companies.  

Wait, did I miss the insurance company revolution?

The headlines I read are, "Upset with high cost of healthcare" and "Blue Cross Blue Shield requests to raise premiums 24.6%."

The truth, according to insurance company and industry experts is that mandated coverage that will kick in soon, including allowing adult children to stay on parent's plans, will cause premiums to rise faster and greater than ever before over the next few years.

While Obama pushes expanded coverage, he has ignored skyrocketing medical costs, making it impossible for insurance companies to lower premiums long-term.

If affordable healthcare isn't the goal then Washington has sold us a bill of lies.

Then again, they are allowed to change the rules as they go along.

Case in point. Yesterday, the Congressional Budget Office said the new healthcare law could cost $115 billion more than originally projected over 10 years, while still saving the country money.

Read the full report here.

It looks like health care reform is putting more power in the hands of government, not the American people.

 

What do think? I welcome your comments.

Size Matters for Small Businesses and Healthcare Reform

There's a lot of buzz.

Just about everyone I talk to lately tells me how the health care bill is going to help small businesses.

When I ask, "how?" they're not quite sure. That's just what they've heard. It's all over the news.

And how can I blame them. Most Americans and politicians don't know what's really in the ridiculously long bill written in government speak. Obama himself touts that the bill will be great...once it's finalized.

I hope that means, once it's readable, understandable and SHORTER so my 80 year old grandmother can read it on her Kindle.

Until then, I take two and stay up 'til three in the morning searching the bill for the facts.

It's no surprise, the new healthcare bill will have a big impact on small companies.

What is surprising is that most "small" companies will not get a tax break because "small" only applies to companies with less than 25 employees. Also, any employee who earns more than $80,000 per year will be excluded from the credit.

While Obama has not mentioned health care reform since April 1st, Monday, the IRS sent out postcards to millions of small-business owners, informing them of tax credits they may receive to provide health care benefits to their employees.

When's the last time you got good news from the IRS?

 

Here's what else you may not know:

• The smallest companies (less than 25 employees) with the lowest wage workers will get the biggest tax credit. How many companies are going to hire more than 25 employees?

• Companies with less than 50 employees are not required to provide coverage.

• Small companies with 50 or more employees will have to provide coverage or pay big fines. How many small companies are going to hire more than 49 employees?

• The health care bill does not limit the cost of health insurance premiums until 2014.

• Employees of companies that receive a tax credit cannot receive government assistance with their share of the premium, which may be too high.

Download my full report How the New Healthcare Bill will Affect Small Businesses

Take two and call me in the morning.

 

What do you think? As always, I welcome your comments.

Risky Business For States and High-Risk Insurance Pools

It's less than three months until showtime.

Time for Obama and Health and Human Services Secretary Kathleen Sebelius to shut up and dance. 

Their first move under the new health care legislation is to establish high-risk insurance pools to insure millions of Americans with pre-existing medical conditions. 35 states already have high-risk pools. The new reform bill will provide $5 billion over the next 4 years to expand pools to all 50 states until 2014, when insurance companies will not be allowed to deny coverage based on pre-existing conditions. 

Sounds wonderful right? 

Keep reading.

Officials don't have an estimate of how many people the pools will cover or how the $5 billion will be distributed to states. Health and Human Services hasn't even decided if they will administer their own high risk pool or contract out to the states or a non-profit.

Meanwhile, in a conference call Friday, Sebelius promised, "When it's up and running, the new high-risk pools program will provide immediate relief for millions of Americans."

Huh? In 2008, 34 states with high-risk pools collectively spent about $900 million to subsidize excess losses for some 200,000 enrollees. $5 billion averages $1.25 to $1.67 billion in funding per year. You do the math.

Healthcare inflation and inpatient hospital costs are rapidly rising and hospital claims in high risk groups are considerably higher than the "normal" population. In 2008, the average claim cost per high-risk participant was $9,494 per year or $791 per month.

$5 billion doesn't go far this market. But that's okay. The new bill gives Sebelius the authority to raise premiums and suspend new enrollment.

Still sound wonderful?

To qualify, you must be a U.S. citizen who's been denied coverage due to a pre-existing condition and be without health insurance for at least six months.

Sounds like risky business to me.

 

What do you think? I welcome your comments.

What's Up Doc? America's New Healthcare Bill

My prediction was right.

Less than two weeks before Easter Obama magically pulled the rabbit out of his hat.

"Eh, What's up Doc?"

You've just got yourself 32 million new patients.

Take a number and have a seat America.

 

Here's where the real magic begins.

Let's see if Obama can pull $938 billion out of his hat. Or should I say the American people's?

If I sound snarky it's because I've been reading the 2,309 page health care bill and I'm in no mood to celebrate. There's no time for that. 1911 pages to go and American's want answers. Short ones.

Ok, so here are some answers to your burning questions: 

• All Americans will be required to buy insurance from their employer, the government, or on their own in 2014 or face fines or jail time.

• You will be able to keep your current individual or employer health care coverage but only if you enroll before 1/1/2013.Those not enrolled by this date will have to buy their private insurance through a government Exchange-participating health plan called a Qualified Health Benefits Plan (QHBP). Employers will be required to contribute to the employer plan or the government exchange plan. Employers that don't provide health care benefits will have to pay an excise tax equal to 8% of their annual payroll. Small businesses will get a break.

• A Health Choices Commissioner will establish standards & specified benefits for all QHBPs by 2013. If you choose to keep your old employer or private health plan before 1/1/2013, those required benefits & standards will not apply.

• There will be 4 different types of QHBPs; Basic, Enhanced, Premium, and Premium Plus (includes dental & vision). All plans will have a 1-year contract.

• A Health Advisory Committee will recommend covered benefits in various plans.

• There will be a 30 day QHBP enrollment period. If you do not enroll in a plan during the enrollment period, a plan will be randomly assigned to you automatically.

• A QHBP may not impose any pre-existing condition exclusions.

• Under individual & employer “grandfathered” (non-QHBP) plans, deductibles, co-insurance and co-pays cannot be increased but premiums for high risk groups can, only if they are increased for all enrollees.

• Beginning 2014, all Insurers will be prohibited from rejecting applicants based on health status.

• Annual limits on coverage will be banned in 2014.

• Unmarried adults will be able to stay on their parent's insurance plan until they turn 26, as long as they are not offered health coverage through their employer.

• In 2010, Medicare recipients who reach the "doughnut hole" in the program's drug plan will get $250. In 2011, the costs of brand name drugs in the doughnut hole will be reduced by 50%. The doughnut hole will eventually be eliminated.

• Starting in 2010, preventative care for Medicare recipients will be free of co-pays and deductibles.

• Early retirees, 55 years and older and not eligible for Medicare, could get 80% of their medical claims over $15,000 (up to $90,000) reimbursed through the government reinsurance program until 1/1/2014. Claims will have to show actual prices and any discounts received.

 

"That's All Folks!"

What do you think? I welcome your comments.

Washington in Wonderland: Will Healthcare Reform Improve the Deficit?

I feel like I've fallen down a rabbit hole into Wonderland.

As the eve of one of the most important congressional votes on health care reform in our nation's history approaches I'm bewildered by what I'm seeing.

Childish remarks and fighting between political parties, politician's children being used to attack the "opposition," political Tea Parties protesting across the nation, money used to sway democratic votes for a bill that a majority of Americans oppose, a president who's stopped listening, and a partisan budget office that would have us believe that this legislation will improve the deficit.

I must be in Wonderland. They're all mad here.

Maybe I can't remember, but when was the last time a U.S. government funded program actually saved money by expanding services? Expensive services.

You've been drinking too much Wonderland tea if you believe any budget committee can "estimate," as they call it, the costs of health care over the next 20 years. Especially with no mention in the bill of controlling costs and inflation. The real cause of our health care crisis.

This isn't the first trip to Wonderland. Similar promises were made with the introduction of Medicare in 1935 followed by one amendment after another to try to save the system from bankruptcy.

During the 1950's and 60's Congressional amendments to Social Security took place in even numbered years (election years) because the bills were politically popular.

The honeymoon was over in the late 1970's and early 80's as the deficit grew. Social Security reform soon meant tax increases and benefit reductions and became known as the "Third Rail of American Politics." Touching it meant political death.

In 1977 President Carter tried to save Social Security from collapse by increasing income withholdings from 2% to 6.15%, proclaiming, "Now this legislation will guarantee that from 1980 to the year 2030, the Social Security funds will be sound."

So much for that.

Medicare costs have risen from $3 billion in it's first year to $500 billion today and still struggles to survive.

Have we learned anything?

"Those who cannot learn from history are doomed to repeat it." - George Santayana

I hope we don't repeat the past. I hope this is just a dream.

 

What do you think? I welcome your comments.

A Witch Hunt in Washington: Health Insurance Companies to Blame

There's a witch hunt in the streets of Washington this week.

As protests outside the Health Insurance Plans meeting reach fever pitch in D.C., it is quite clear Americans blame the insurance companies for the rising costs of health care.

I admit, I've had my own fantasies of cruel and unusual punishment.

But wait. Let's step back and widen the lens, lest our emotions cloud reality.

While I don't intend to defend the insurance companies, I can't ignore that there's been almost no focus on the skyrocketing increase in the cost of medical care.

40% increases in hospital costs, extraordinary increases in drug prices (more than doubled from 2000-2008) and expensive, unnecessary medical tests and procedures can't be ignored.

Consider that profit margins from insurance companies are 4% while profit margins from pharmaceutical companies are 20% and biotech 29%. There's plenty of blame to go around.

It's astounding. A quarter of American health care dollars are spent on unnecessary tests to protect themselves from being sued. As a health care provider, I know we can add unnecessary medications to the list.

A survey of Massachusetts doctors found that 83% ordered unnecessary tests, hospital admissions, and referrals that costs $1.4 billion a year in that state alone. A problem that costs $700 billion nationwide. A problem that gets passed on to you and me.

Now, I know a lot of us were conditioned to believe that the "doctor knows best," but this belief has come with a huge price.

If we want true health care reform, we must be conscious of how we spend our health care dollars so we can collectively drive down costs.

I urge everyone to question all tests, procedures, medications and referrals by asking your doctor the following:

• Why do I need the test, medication, procedure or referral?
• What is it going to show or do for me? 
• Is it absolutely necessary to make a diagnosis?
• What are the possible side effects or complications?
• Is there a cheaper alternative?  i.e. ultrasound vs. CT scan
• Will my insurance pay for it?
• What will I have to pay out of pocket?

If the answers are not clear and convincing, do not agree to it.

Doing this can potentially save you, and the nation, a lot of money and grief in the long run.

Well, it's a start anyway.

 

What do you think? I welcome your comments.

 

Cartoons by Andertoons

Paying for Healthcare: It's Time to Get in the Game

I don't know about you, but I'm growing tired of the daily political news surrounding health care reform with nothing being done for the American people now. My stomach turned when I read, effective Monday, Medicare payments to providers were cut 21%, stopping all payments from Washington for at least 2 weeks while they come up with a plan. "The GOP rejects Obama's compromise." "Major insurers face further investigation over rate hikes." "Wasteful medical spending driving health care costs." And that's only page one.

Nowhere do I read about solutions.

With 14,000 people losing their health insurance every day and skyrocketing premiums and deductibles, Americans can't wait for Washington's plan. We need solutions now. We need to take our power back and get in the game.

Let's start with what we CAN control; How much we will pay for healthcare. Maybe this will bring back competition and fair pricing, instead of being billed 3 to 15 times the actual cost of care.

We’ve sat back for too long not knowing (or caring) what that test, procedure, treatment or surgery is going to cost until we get the bill in the mail. Usually, it’s not until we see in black and white what we’re going to have to pay out of our own pocket that we feel differently about the price.

You wouldn’t dream of buying a new car without knowing what its fair market value is, let alone drive it home and wait for the bill!

Why is it different when it comes to healthcare?

We’ve seen a shift in this way of thinking in the cosmetic and elective plastic surgery industry where it’s cash only driven. Here, men and women are very motivated to shop for the best price. Don’t believe me?  Google™ “best price for breast augmentation” and see how many websites come up – 7,080,000! You’ll find prices clearly listed and very competitive. In fact, prices for breast augmentation have remained steady over the last 10 years and the industry is BOOMING! Today, thanks to new fair healthcare pricing laws and websites, we’re starting to see a more level playing field and the game is changing in our favor.

To find ‘fair market value’ prices for surgery, hospital stays, doctor visits, medical tests and dental work, I highly recommend Healthcare Blue Book. Just enter your zip code and the procedure or test and they’ll give you a fair estimate of what it should cost based on solid data for Healthcare Blue Book. Now you have some leverage.Take that estimate and have a conversation with your provider or hospital. Negotiate a price that's fair upfront.

CEO Dr. Jeffrey Rice has many success stories from people who’ve used his website to lower their medical costs and adds, “Sometimes paying cash up front is better. One woman paid 20% less than she would have through her insurance company by paying cash instead,” crediting Healthcare Blue Book for giving her the ‘fair market’ cash price before her appointment. He said he knows insurance companies that consistently charge their members more than the ‘fair market’ price for services.

They do this because they think we're in the dark about prices and there's no competition threatening their profits. 

It's time for us to step into the light and start changing the game.

Other Fair Pricing Websites:

NewChoiceHealth.Com - Lookup medical facilities and compare costs for common procedures such as MRIs, EKG, Mammograms, and more. Enter your city and state to shop locally or Nationwide from over 20,000 medical facilities for over 400 of the most commonly performed medical procedures.

PriceDoc.Com - Connects you to affordable, quality doctors and dentists in your area. Enter your zip code and the procedure or specialty and you’ll be connected with physicians in your area along with their profile. You can then make a direct online   Some providers list the cash price for you to ‘click and reserve.’ You can also "name your price" for the procedure you need.

HospitalBillReview.Com (800)906-8085 - has medicare rates for every procedure by every hospital.

What do you think? As always, I welcome your comments.

Obama's Dirty Plan to Pass Health Care Bill

Be very afraid.

Obama has found a way to pass the current health care bill without Republican approval.

A tactic that would force lawmakers to pass the Senate health care bill as it exists now -- with no changes - just in time for Easter dinner.

Yes, that's right.

On the eve of the big health care summit in Washington, which democrats and republicans expect little to come out of, there is a bigger agenda for Obama; to prove the Republicans are not cooperating so he can use what's called budget reconciliation, a provision of the 1974 Congressional Budget Act, to pass his health care bill with only 51 votes, hijacking the Republican senate majority's right to filibuster.

President Clinton tried to use reconciliation in 1993 to pass Hillary's health care plan but was denied.

If Obama gets his way, it will show once again that Washington is not listening to the American people. That they do not have to work together to come up with a health care plan that will benefit Americans. 

The only power is our voice and it's time to turn up the volume.

Can you hear me Mr. President?

 

What do you think? As always, I welcome your comments.