April 22nd, 2011 by Shadowfax in Health Policy, Opinion
Tags: Emergency Medicine, Insurance, Med Mal, Medical Malpractice, Professional Liability, Self-Insurance, Should You Self-Insure?
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I wrote at some length yesterday about the prerequisites for a medical group to self-insure. What I didn’t go into in detail was the why — the benefits and the risks. I’m going to tackle that a bit today.
Potential Benefits to self-insurance
Those who have been around a few years can testify that the medical malpractice insurance market is highly cyclic. It seems that about once a decade a crisis hits. Whether this is a rational market is another question entirely. Some have attributed these crises to macroeconomic factors, like the market crash of 2002, after which insurers had to recoup investment losses, or hurricanes and natural disasters in which insurers cost shifted onto other product lines. Other obervers cite skyrocketing medical malpractice losses as the driver of these intermittent price spikes. I don’t pretend to know the reason, but it’s a reality that prices go up, and sometimes rapidly so, for no apparent reason. Additionally, during these times of market disruption, it’s common for carriers to drop clients, leave states they perceive as too risky, or leave the med mal market altogether.
One big advantage of self-insurance is that you can control your own destiny and insulate yourself from these market forces. You set your own premium and it only has to go up if you deem it necessary and prudent. You have a carrier that is guaranteed to issue a policy, and that will never leave the market. These are not small considerations.
I know a group that liquidated because their insurer dropped them and they could not find insurance; a contract management chain picked up the contract. I know several groups whose insurer stopped writing med mal and they were left high and dry. They had to purchase a group tail at an exorbitant mark-up and scramble on very short notice to find a new carrier, whcih was excruciatingly stressful. So to have carrier permanence, guaranteed issue, and premium stability is a huge benefit of self-insurance. Read more »
*This blog post was originally published at Movin' Meat*
April 22nd, 2011 by admin in Health Policy, Opinion
Tags: Bringing A Drug To Market, Clinical Trials, Costs, DiMasi, FDA, Pharmaceuticals, Research And Development, Science and Medicine
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Despite the variety of health systems across hundreds of different countries, one feature is near-universal: We all depend on private industry to commercialize and market drug products. And because drugs are such an integral part of our health care system, that industry is generally heavily regulated. Yet despite this regulation, little is publicly known about drug development costs. But aggregate research and development (R&D) data are available, and the pharmaceutical industry spends billions per year.
A huge challenge facing consumers, insurers, and governments worldwide are the acquisition costs of drugs. On this point, the pharmaceutical industry makes a consistent argument: This is a risky business, and it costs a lot to bring a new drug to market. According to PhRMA, the U.S. pharmaceutical industry’s advocacy group, it cost $1.3 billion (in 2005 dollars) to bring a new drug to market. The industry argues that high acquisition costs are necessary to support the multi-year R&D investment, and considerable risks, in to meet the regulatory requirements demanded for new drugs.
But what goes into this $1.3 billion figure? Read more »
*This blog post was originally published at Science-Based Medicine*
April 21st, 2011 by Happy Hospitalist in Humor, Opinion
Tags: Hemorrhoids, Medication, Quiz, Shoplifting, Suppository, Theft, Walgreens
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I’m not sure if this is true or not, or if it’s a local phenomenon, but I heard a discussion the other day from a previous Walgreens employee describing the most shoplifted item in their store. Are you ready for this…..
Hemorrhoid creams and suppositories.
There are apparently a lot of a**holes in this world that get rubbed the wrong way.
*This blog post was originally published at The Happy Hospitalist*
April 21st, 2011 by Davis Liu, M.D. in Health Policy, Opinion
Tags: Android, Apple, Atul Gawande, Consumer-Driven Healthcare, Google, Healthcare reform, Kaiser Permanente, What do Americans want?
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The future direction of American health care is unclear. Certainly the cost trend as it exists is unsustainable with health care costs being a major concern of the private sector, the government, and individuals. How does the nation manage costs while ensuring high quality medical care, access, and service? Proposals include increasing competition among insurers, providers, and hospitals to drive down prices or giving more financial responsibility to patients via higher deductibles and co-pays with the belief that they will demand price transparency, shop around for the best price, and as a result slow health care costs.
What if both ideas are wrong?
While it is possible these plans might work, I cannot help but notice the similarities in the challenges for patients in navigating the health care system and consumers figuring out how to purchase and use technology. Walk into your neighborhood electronics store. Individuals are overwhelmed with the number of product choices, manufacturers, differences in technical specifications and features. In the majority of situations, consumers are unsure of what they are purchasing. They want something that just works, whether surfing the internet, making home movies, or being connected with loved ones. The gap in knowledge between an expert and a consumer is great and often unintentional and unapparent. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
April 21st, 2011 by Lucy Hornstein, M.D. in Health Tips, Opinion, Quackery Exposed
Tags: Alternative Medicine, CAM, Fake Medicine, False Health Claims, Fraud, Homeopathy, Illegal, Infomercials
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Imagine hearing a commercial on the radio:
Send us money, and we won’t send you anything in return.
No one would do that, right? How about this:
Send us your money and we’ll send you an empty box.
Better? Not much. Now how is that different from:
Send us money and we’ll send you stuff we’ll call medicine that we claim will help you, but there’s no actual active ingredients in it at all.
I don’t think there’s one bit of difference. Wouldn’t you agree that that commercial is fraud, pure and simple? The problem is that the general public doesn’t understand that the word “homeopathic” means “diluted beyond the point where it contains any active ingredients.”
I’ve recently heard commercials for homeopathic vertigo treatments, eye drops for allergies, irritable bowel, and spider veins on legs. I’m tempted to contact the radio station and complain, but stopped short realizing that their first question is going to be, “But is it legal?”
That’s the problem: it is. So what I want to know is, why? Read more »
*This blog post was originally published at Musings of a Dinosaur*
