Category: Health Care

By Mike Klein Four years ago Lee Gross saw the medical sands were shifting.  His insurance-based primary care practice near Sarasota, Florida was in danger of extinction unless Gross and his physician partners developed a different strategy.  Medicine, it seems, was also no longer much fun. “Any physician will tell you a lot has changed in medicine in the last ten to fifteen years,” Gross said this week in Atlanta.  “The paperwork gets absolutely crazy.  You’re basically no longer interacting with patients.  You’re just a cog in the wheel doing what the insurance companies are telling you to do.” Gross also saw a real possibility that his entire medical business model would vanish.  “Independent practices are becoming dinosaurs.  All the… View Article
By Grace-Marie Turner and Tyler Hartsfield President Obama promised middle-income families they would not see their taxes go up “one single dime” as a result of ObamaCare. But millions of such Americans are indeed paying to finance the gargantuan health overhaul law through hidden taxes and fees, many of which already are driving up the cost of their medical care and health insurance. In total, the 21 taxes in ObamaCare will extract $1 trillion over a decade, nearly double the $569 billion that Congress’ Joint Committee on Taxation estimated at the time the law passed in 2010. The first wave hits many higher-income people who got a rude awakening about the health law’s new and higher taxes when they filed… View Article

Thinking Outside the ObamaCare Box

By Kelly McCutchen Health care costs threaten to bankrupt our country. Debates over Medicaid expansion, the Medicare “doc fix,” the State of Georgia’s health plan, coverage of autism and so many other health care issues merely shift these costs from one party to another. The time has come for a “let’s go to the moon” challenge that truly addresses the underlying problems. Higher education costs are on a similar trajectory. A few years ago, governors Rick Perry of Texas and Rick Scott of Florida challenged their higher education institutions to design a four-year bachelor’s degree program for $10,000 or less. Not $10,000 a year but $10,000 for all four years. Many schools rose to the challenge, met it and now… View Article

Designing An Alternative to Medicaid Expansion

Key components for an alternative to Medicaid expansion: Catastrophic insurance. A private insurance policy provides catastrophic coverage, protecting individuals (and taxpayers) from large, unexpected expenses and giving individuals peace of mind that they are covered if they need major surgery or need expensive treatment for a condition such as cancer. Private insurance means individuals avoid the problems with many providers refusing to see new Medicaid patients. Reasonable cost sharing. The coverage is not free, but requires reasonable payments of up to 5 percent of income. This limits “crowd out” where individuals who are already paying for insurance drop their private insurance for the “free” government coverage. According to the Census Bureau, 222,000 adults with income below the Federal… View Article
Georgia Public Policy Foundation senior fellow Ron Bachman discussed Medicaid expansion and improved access to health care during a recent guest segment on GPB’s “On The Story.”  The video is available online.  Bachman supports improved access to healthcare for all Georgians but he opposes Medicaid expansion. “I am worried about access to real quality healthcare,” said Bachman. “In the private market 79 percent of physicians accept children but in the Medicaid market only 47 percent do.  One of the reasons we have our emergency rooms and hospitals packed with so many Medicaid patients is that primary physicians won’t see them so their only choice is to go to emergency rooms.” The panel moderated by Bill Nigut and Bobbie Battista… View Article
There are many downsides to adding even more people into an expensive, over-regulated Medicaid program,[1] but that doesn’t mean Georgia shouldn’t try to propose a better option. This is an opportunity to create a less expensive, more effective plan.   Goals of Expanded Access: Insure for unexpected, expensive health care outcomes to protect individuals and taxpayers Improve health outcomes by improving access to primary care Discourage expensive trips to emergency rooms for routine care Discourage crowding out private insurance coverage Called “the most innovative and successful reform of Medicaid in the history of the program” by Forbes magazine’s Avik Roy, Indiana’s expansion of health insurance to low-income citizens is a good model to analyze. Healthy Indiana[2] The Hoosier State’s… View Article
The federal government spent more on broken state-run exchanges than it did on its own troubled system. Of the 14 states, plus the District of Columbia, that established their own health insurance coverage under Obamacare, seven remain dysfunctional, disabled, or severely underperforming. Development of those exchanges was funded heavily by the federal government through a series of grants that totaled more than $1.2 billion—almost double the $677 million cost of development for the federal exchange. The Reason Foundation published a rundown of the troubled state exchanges and the federal grants they qualified for. Oregon No exchange failed more fully or more spectacularly than Cover Oregon. The site was touted as an ambitious, expansive vision for what a state-run exchange… View Article

Concierge Care for the Little Guy

By Jordan Bruneau Imagine filing a home insurance claim every time the neighbor’s kid cut your lawn. That’s how physician Lee Gross sees the U.S. health care system: We use insurance for basic maintenance. Filing claims for a stubbed toe or cold has driven up the cost of health insurance in much the same way that filing claims for a fresh coat of paint or carpet cleaning would drive up the cost of home insurance. “We are taking affordable primary care,” Gross says, “and bundling it together with a health insurance program that has to cover hospitalizations, chemotherapy, expensive surgeries and end-of-life care.” The key to bringing down health insurance costs, he claims, is to divorce basic maintenance from insurance-based… View Article
By Medicaid needs reform, not expansion. This federal–state health care program provides health care to over 60 million Americans and consumes a growing portion of state and federal budgets. Research shows a long history of Medicaid enrollees having worse access and outcomes than privately insured individuals.[1] Due in part to low reimbursement, one in three doctors refuses to accept new Medicaid patients.[2] Despite access issues, Medicaid spending continues to grow. In 2010, total federal and state spending on Medicaid exceeded $400 billion.[3] Instead of reforming Medicaid, the Patient Protection and Affordable Care Act (Obamacare) expands eligibility to all individuals earning less than 138 percent of the federal poverty level (FPL).[4] The Medicaid program is… View Article

ER Costs vs. the new model of Direct Primary Care

The cost of the average ER visit is $969. Cost of primary care for a year under a new model: $600 to $720 a month for adults, with lower fees for children, according a New York Times report. In this new model, called Direct Primary Care (DPC), “patients pay a monthly flat fee directly to a personal physician—cutting out the insurance companies—to cover primary care, is known as concierge care. Long existent as a niche market, it has been derided as an elitist model for the rich and never seriously considered as a health reform for the general population.” In “Concierge Care for the Little Guy,” Jordon Bruneau, describes the practice of Dr. Lee Gross: For $83 a… View Article

The Foundation should take a lot of pride in your influence on Georgia governmental policy over the past several years. If you look back on several things that you were crying in the wilderness about several years ago, you will find that Governor Miller adopted them…your influence and your pressure on that process has been a major factor in governmental policy in Georgia. You should be congratulated.

Governor Sonny Perdue more quotes