Physician Patient

Archive for November, 2014

Time for Post-Obamacare Health Care

Tuesday, November 25th, 2014

Since HMOs came on the scene over four decades ago, health care in Minnesota has dramatically changed. Ironically, In 2014 the idea of enhancing a patient’s access to private medical practices which are not subordinated to payments from insurance companies and the micro-management of government or insurance company administrators and bureaucrats is a “new” concept for most patients and doctors in Minnesota.

Regarding government programs, in recent years Minnesota state government has allied with (nonprofit) Minnesota HMOs to “manage” the expanding Medicaid population. But Minnesota’s contracting Medicaid HMOs assume no financial “insurance” risk for this activity and are making lots of money doing it. HMOs claim that their government Medicaid contracts are “proprietary” and thus are immune from the scrutiny of policymakers and Medicaid patients and families. This must change in 2015.

Voters in the November 2014 election empowered new political leadership in the Minnesota House of Representatives and the US Congress — an opportunity and responsibility to change course on misguided health care policy. Our legislators and advocates can put forth real patient-centered health care insurance reform measures by following John Goodman’s six principles: Enhancing patient power, insurance coverage portability, choice of providers and coverage through competition, fairness, access to true health care insurance, and universal coverage.

Healthcare Solutions for
Post-Obamacare America

In keeping with a year’s worth of opinion polls, the midterm elections once again demonstrate the American electorate’s disdain for the federal takeover of the nation’s healthcare system. The question is: will the new 114th Congress pass legislation designed to correct only the surface flaws of Obamacare—or will it try to address the deeper, systemic problems that plague American healthcare? And which principles should policymakers embrace in order to craft common-sense reform?

Fortunately, Independent Institute Senior Fellow John C. Goodman, who has contributed to the healthcare debate for more than three decades, offers thoughtful answers in an insightful and timely new study, Healthcare Solutions for Post-Obamacare America

Part I of Goodman’s report looks at the six major problems of the Affordable Care Act. Part II takes a closer look at six principles for commonsense reform—choice, fairness, universal coverage, portability, patient power, and real insurance. Part III puts forth additional proposals, including four measures such as a fixed-sum tax credit, along with Goodman’s vision for a more equitable healthcare system.

Whether you’re a policymaker eager for fresh ideas or a concerned citizen who wants to better understand the causes and cures for America’s healthcare predicament, read Goodman’s diagnosis and prescription for a vitally needed contribution to the healthcare policy debate.

Available as a downloadable pdf or a printed report
52 pages
8.5 x 11 inches
11 figures, 1 table
ISBN 13: 978-1-59813-202-1

MPPA Meeting Thursday, November 13, 2014, 6 PM at the Central Medical Building, St. Paul.

Thursday, November 13th, 2014

1. Those present, Lee Beecher, President, Don Gehrig, Dave Feinwachs, Peter Nelson, Bob Geist, Mike Ainslie, Doug Smith, and Dave Racer

2. MN Provider Coalition bill—Dave Feinwachs, discussed the essential part of the non-discrimination bill, which thanks to a loophole in PPACA could require insurance companies to let patients spend their own money wherever they like and would mandate that such payments be fully credited to their insurance plan deductible. It is neither an AWP bill nor a scope of practice bill.
Action: It was recommended by the Board that the MN Provider Coalition delete other elements of the bill in order to emphasize patient freedom.

3. Blue Print for Health Care—Peter Nelson, discussed at length the competition model for health competition model to make medical care affordable emphasizing reduction in barriers to employer-base defined contribution insurance. It could provide a reasonable way for small businesses to afford employee health insurance. It will be the prime focus of efforts for this Blue Print moving forward. The rest of the points for increasing competition and innovation including multi-state medical insurance consortiums are mostly for discussion upon which future actions could be implemented.
Action: It was moved that MPPA approve the Blue Print. Motion passed unanimously

4. The 6th US circuit ruling in the Hi-Lex case—Dave Feinwachs discussed this case of the MI Blues Corporation, which when acting as an ERISA plan TPA for a small 800 person company making auto parts, was found to be faking provider fees paid and pocketing the discount unknown to the company paying for their employees’ care. The courts called this fraud and award damages to Hi-Lex Company. What was curious is that the defendants expert witness was the Milliman Company, which testified that this is the way al managed care companies do business. As Dave Feinwachs noted, the argument that stealing is ok, because everyone is doing it, lost. He is looking for a local company with an ERISA self-insured insurance plan.
Dave Racer later sent a URL to the US Appeals Court ruling of May 14, 2014:

5. The meeting was adjourned at 8PM.

6. The next meeting date will be in early 2015.

Respectfully submitted
Robert W. Geist MD
Secretary pro-tem