Blog and News

Avik Roy of Forbes.com takes on the complexities of health insurance and how government policies have interfered with the operation of the health insurance market in ways that dramatically increases costs. Mr. Roy explains medical underwriting, community writing, guaranteed issue, benefit mandates among other issues. 

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Welcome to D4PC "Morning Rounds", your daily review of healthcare news and information from Washington, DC and around the nation. These briefings will keep you up to date on recent developments and our effort to replace the PPACA with patient-centered reforms that protect the doctor-patient relationship and preserve individual freedom of choice.  

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This "practicing" physician explains how the contraception "mandate" was never about women's' health, but rather another government foray into the doctor-patient relationship and intervening in the health insurance marketplace. 

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From The Daily Caller: 

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Welcome to D4PC "Morning Rounds", your daily review of healthcare news and information from Washington, DC and around the nation. These briefings will keep you up to date on recent developments and our effort to replace the PPACA with patient-centered reforms that protect the doctor-patient relationship and preserve individual freedom of choice.  

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Welcome to D4PC "Morning Rounds", your daily review of healthcare news and information from Washington, DC and around the nation. These briefings will keep you up to date on recent developments and our effort to replace the PPACA with patient-centered reforms that protect the doctor-patient relationship and preserve individual freedom of choice. 

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Jennifer Rubin of The Washington Post's Opinion section delves into the issue of cost-shifting and the role this issue has played in the appeal of the Florida multi-state lawsuit. During oral arguments before the 11th Circuit, the government argued the law was constitutional and the individual mandate was necessary to remedy the alleged burden placed on the healthcare system by cost-shifting.

Rubin first points out that: "As a preliminary matter, this sort of rationale is inappropriate for constitutional analysis. If the Constitution prohibits the government from forcing you to buy something you don’t want, why does a policy argument (cost-shifting) suddenly bestow constitutional legitimacy on the individual mandate?"

Rubin then points out that not only is the basis for the individual mandate on shaky constitutional ground but it is also unsupported by the facts. She cites a Yuval Levin June 9, 2011 post on National Review Online and a Wall Street Journal article by John F. Cogan, R. Glenn Hubbard and Daniel Kessler that demonstrates that Congress relied, as Rubin says, "on sloppy, flawed studies to come up with the cost-shifting rationale."

Read the full article here... 

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Analysis of the problems with the two main proposals for bringing down health care costs from the National Center for Policy Analysis. Bottom line: they won't.

"...let me be the first to open Pandora’s box and reveal three unpleasant truths.

"First, health care spending is growing at twice the rate of growth of our income — clearly an unsustainable and undesirable spending path.

"Second, any plan to reduce the growth rate of federal spending on health care without doing something about health care spending as a whole will necessarily shift costs — to the elderly, to the poor, to state governments, and to anybody other than the federal government.

"Third, neither party is offering a serious plan to control health care spending as a whole..."

Read the full column here. 

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Mr. John F. Cogan
Mr. R. Glenn Hubbard
Mr. Daniel Kessler

Editorial and Corporate Headquarters of the Wall Street Journal
1211 Avenue of the Americas
New York, NY 10036

Dear Gentlemen:

I read your article in the WSJ from Friday March 11th about Obamacare and “cost shifting”. I greatly appreciate your getting out the message that “cost shifting really does not occur”. But, you left out one VERY important point. The doctors are the ones who are carrying the brunt of the cost of the uninsured.

As a member of a major hospital medical staff, I am REQUIRED to see anyone who comes to the emergency room for a urology problem on the day that I am “on call”. I cannot turn anyone away because they cannot pay. Ours is not a charity hospital, but the uninsured know that we do a good job and they come in droves.

Last year, alone, I did over $120,000 in free work. Most of this work was for illegal aliens without any insurance. I will never receive a penny of money for this work and I cannot write it off my taxes. Furthermore, I am held legally responsible should a personal injury lawyer claim the result was less than perfect. This represents mostly surgery that is done on weekends and after hours. This work is a major burden on my family life. To my knowledge, every xray that was done on every one of these patients was done for free by the radiologist on call. To my knowledge, every anesthetic given to every patient was done for free.

I have been a urologist since 1986 and I have never been paid a penny by any government or charitable agency for the work that I have done while on call for the uninsured! Over these many years, I suspect that I have done over 3 million dollars in work for which I will NEVER be compensated in any way! There are about 40 urologists at my hospital, so you can do the numbers and see that we are providing a vast amount of work for "free".

I have NO ability to pass this loss on to anyone! I have contracts with insurance companies and they pay a certain amount for care and there is NO way to get them to increase that amount. Most companies pay about what Medicare pays. I cannot balance bill any Medicare patient and so I get what Medicare chooses to pay for services and have zero ability to influence that dollar amount.

So, the idea that a doctor can “cost shift” is nearly comedic. I wish that the WSJ would speak more with physicians to get a clearer picture of what is really happening. The organization Docs4PatientCare always has members that would be willing to speak to you. Please visit their website to learn what "practicing" physicians are doing to promote practical and affordable medical insurance reforms that preserve the sanctity of the physician/patient relationship while minimizing government control over Americans' personal health decisions. www.docs4patientcare.org.

Many thanks,
Dr. Martha B. Boone 

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