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Medical spending is slowing

Dan Crawford | November 22, 2013 1:57 pm

Healthcare

Reflects much of what Bill H.,  Maggie Mahar, and Linda Beale have written…

Via USA Today comes this article and chart:   Health care spending growth

Slower health spending

Comments (23) | Digg Facebook Twitter |
23 Comments
  • little john says:
    November 22, 2013 at 2:46 pm

    This “report”, which is really a White House propaganda piece, reminds me of Rumsfeld’s, “the schools are open, we’re building playgrounds, the hospitals are open…” I guess we could call run, Maggie and Linda the ACA’s neocons.

    • run75441 says:
      November 23, 2013 at 5:32 am

      little john:

      You might wish to add Bruce Webb to your list of ACA Neocons also. The problem is so few do not see beyond the talking heads dialogue which occurs on the Fox News networks and occasionally appears on such stalwarts as the NYT. The S & P Healthcare Indices has been showing a decline in healthcare costs also. This report is “nothing” new and it confirms such to be happening. We could also add Dean Baker to the list of ACA Neocons also:

      “Brendan Buck, spokesman for House Speaker John Boehner, R-Ohio, said the slow growth was the “result of the terrible economy under President Obama, not his health care law.”

      “The idea that it’s the economy is just silly,” said Dean Baker, the co-director of the Center for Economic and Policy Research. “In 2008-2009 — fair enough, but now that we’re four years out, no one could say with a straight face, clearly the economy is worse in 2013 than it was in 2008.”

      Instead, he said, greater attention to cost controls by private insurers and government programs, as well as higher co-pays, have prevented unneeded procedures.

      “Suppose the opposite were happening,” Baker said. “Suppose growth went up to 8%. Does anyone doubt we would blaming President Obama and the Affordable Care Act for that?”

      The arguments being brought forth have no basis and STB’s review will be coming from a healthcare and insurance industry outlook. What do I have to gain or lose, tell me? I am an uninsurable 65 year old male who lived (still alive now) an extremely healthy life style (runner, average weight, snowshoer, backpacker, kayaker, weightlifter, etc.) who has a cholesterol level of 118 (even when I had a heart attack as measured by the ER), etc. I am very low risk according to my cardiologist at U of M and my other one at MedCentral.

      So tell me, why I can not get reasonable healthcare insurance? Tell me why nothing has been done since the failure of Hillarycare by the Healthcare Insurance Industry and the Healthcare Industry to accommodate those who can not afford healthcare or insurance or get it? Tell me how you would pass a bill with the present Repub/Teabagger dominated House? Tell me how you would have gotten past Lieberman who promised to veto Medicare for everyone or 50 and older or Universal with the help of Blue Dogs? Tell me how you are going to get something in place today and around Congress?

      There is NO excuse for not having something in place except the willingness of many congressional senators and representatives who only interest is the appease the likes of the Koch Bros, etc. and the various industries. It appears you are also a part of the insurance industry yourself and which touches upon health issues.

    • Dan Crawford says:
      November 23, 2013 at 11:10 am

      Oh good grief…Bring some numbers of your own.

  • JackD says:
    November 22, 2013 at 4:27 pm

    It might be propaganda but if it’s true, so what?

  • save_the_rustbelt says:
    November 22, 2013 at 4:45 pm

    Just leaving three days of seminar with 400 pages of handouts and notes.

    This reasons for this are very complex and do not necessarily bode well health care system.

    More later.

  • little john says:
    November 23, 2013 at 9:06 am

    I am part of the insurance industry, but I work in life insurance. The major life insurance companies divested themselves of health insurance offerings decades ago for a variety of reasons. I consult with retail agents regarding which plan, carrier and structure would best fit their client’s needs. The majority of those retail agents survive due to their work in the large and small group health insurance marketplace. As a result of that work I get to hear many stories about rising costs in the group health insurance marketplace. I also have experienced a significant increase in my personal health insurance costs over the last decade. So, my personal experience tells me that for individual consumers and employers the cost of health care has increased much more than 1.3% over the last three years.
    In terms of your personal story, I agree that there should be access to healthcare coverage for those who for whatever reason cannot obtain coverage in the traditional marketplace. And while the ACA appears to be a solution to that issue it also seems like it is inflicting havoc, including significant cost increases, on many individuals and groups. A discussion of how a better plan should work and the political realities surrounding the design of such a plan would would be too lengthy for a comment here.
    In addition, an appeal to the authority of Bruce, Maggie and Dean would carry about the same weight, from my point of view, as an appeal from Rush Limbaugh, Bill O’Reilly or Ron Paul.

  • Anna Lee says:
    November 23, 2013 at 10:29 am

    Little John, Your dissing of Dean’s qualifications as like Limbaugh’s begs the question – who is qualified to comment in your opinion? AND what are the key qualifications they have?

    • run75441 says:
      November 23, 2013 at 5:44 pm

      Anna:
      I have argued with him before. Not much will convince him and he is a part of the insurance industry.

  • CoRev says:
    November 23, 2013 at 12:20 pm

    Dan wants a number. Reduced premiums of $2,500 per family per year.
    http://finance.townhall.com/video/remember-when-obama-claimed-the-aca-would-save-families-2500-per-year-n1732869

    How does a reduction in the rate of increase equate to that $2,500 promise? Or we can discuss the 49 states that will have increased premiums: http://www.forbes.com/sites/theapothecary/2013/11/04/49-state-analysis-obamacare-to-increase-individual-market-premiums-by-avg-of-41-subsidies-flow-to-elderly/

    We already know that deductibles and co-pays increased for the lower/mid range ACA plans. We also know that initial enrollments are running ~10:1 for medicaid versus paid enrollees. So this report said: “… Medicare spending had 0.0% growth rate and Medicaid spending was “actually minus 0.5%.” So we are now expected to believe the rate of increase of healthcare went down? If they did it can only be assumed to be a statistical anomaly.

    Wonder what families feel about that statistical anomaly?

    • Dan Crawford says:
      November 23, 2013 at 1:45 pm

      Medicare spending is measurable, as is medicare. Health insurance rate of price increase is measurable.

    • Dan Crawford says:
      November 23, 2013 at 1:54 pm

      CoRev, I am merely reacting to little john’s use of a couple examples as ‘proof’, and then comparing our posts to Rush. He can think anything he wants, and consider equivalencies abut I am nbout ‘authority’, but I am not impressed. Use of this particular USA information was a bit impulsive on my part, but there is good data. There will be lots of things changing…that was in the cards as well when family plans reached 18,000 a year, non cadillac but comprehensive, with 7-8-9 % rises in premiums.

    • run75441 says:
      November 23, 2013 at 5:43 pm

      CoRev;

      Actually no, they did not; not that anything said here will convince you. Citing Roy who knows little about the PPACA and is conservative think-tank mouthpiece will not make your point.

      If you know someone who is uninsured, or buys her own insurance in the individual market– and lives in Texas, North Carolina, Missouri, Oklahoma, Louisiana, Mississippi, or Alabama– chances are greater than 1 in 3 that under Obamacare she will qualify for health insurance that will cost her nothing. That’s right—her government tax credit will cover the entire premium.

      It gets better. After shopping the state Exchanges during the first two weeks of October, McKinsey & Co, a leading global management consulting firm, discovered that people who are currently uninsured (or who buy their own insurance) in Florida, Wisconsin, Georgia, South Carolina, Tennessee, Virginia, Maine, Indiana, Kansas, Nebraska, Utah, Idaho, Montana or Alaska– stand a 1 in 4 chance of qualifying for a $0 policy.

      How can that be? McKinsey explains that their income will makes them eligible for a government subsidy that will be larger than the policy’s premium. Americans earning somewhere between $11,490 and 400% of the FPL ($48, 950 for an individual, $62,040 for a couple, $94,200 for a family) will receive subsidies. The lower your income, the larger it will be, and the more likely it is that your premium will be Zero .

      This table from Credit Suisse reveals that in many states, uninsured Americans earning less than 175% of the Federal Poverty Level (roughly $20,100 for an individual; $21,750 for a couple; $34,170 for a family of three; $41, 200 for a family of four) will be able to find zero-premium plans. Even if you earn somewhat more, it’s well worth the time it will take to check with your state marketplace. You may discover that while coverage isn’t free, your subsidy will bring the cost down to as little as $20 a month.

      Credit Suisse analyst Ralph Giacobbe agrees that roughly “6.5 million Americans … will be eligible for a $0 premium plan.” As a result, he believes that “affordability may not be a roadblock” to achieving the Congressional Budget Office projection that 7 million people will buy insurance in the exchanges in 2014

      “Simply put, we don’t see any logical reason why anyone in this population wouldn’t take free healthcare coverage vs. remaining uninsured.”

      The only question is this: How many people will hear about the free plans? Can we count on the media to inform the public? (Hat tip to the New York Times for publishing a front-page story about the McKinsey research.) Now, I would love to see the story on FOX – and in Forbes.

      You can help spread the word. Do you know someone who is single, earns somewhere between $11, 490 and roughly $20,100 (175% of the FPL) and does not have employer-sponsored insurance? A graduate student? Your cousin’s son?

      Do you know a family of three with income under $34,170 (175% of the FPL) Perhaps the stay-at-home Mom down the street who just had a baby?

      Good News for 20-Somethings and 30-Somethings

      McKinsey reports that about half of those who will be able to purchase zero-premium insurance will be under 39 years old.

      I originally published this story on the Health Insurance Resource Center Blog. Click there to read the rest of the post—and find out more about the cap on the co-pays and deductibles that someone with a $0 premium plan would pay.

      You can comment on the Health Insurance Resource Center Blog, or you come back here to respond. http://www.healthinsurance.org/blog/2013/11/05/millions-qualify-for-free-health-insurance/

  • CoRev says:
    November 23, 2013 at 2:21 pm

    Dan, I’m just making sense out of a reduction in rates versus an actual reduction in costs. From all anecdotal evidence costs have gone up. to reduce the overall rates, theo only thing that makes sense to me is a reduction in Medicare and Medicaid payments. If that proves to be even partially true, then there will another BIG, BIG complaint against the ACA.

    There is a long and growing list of really, really bad impacts from the ACA, that reports such as this get discredited as they are released. that’s especially true when it is released by the Whiter House.

    There was a lot of discussion re the ACA here early on, and the interpretation of those mostly true analyses has dramatically shifted public opinion against it. Kudos to those who understood it then. I don;t remember anyone predicting the end results except for conservatives.

  • Lyle says:
    November 23, 2013 at 2:37 pm

    On of the things that is happening to begin to control costs is the private industry is looking at charges for individual proceedures at hospitals. For at least some they find variations of a factor of 3 or more in the charges, for institutions that rank the same in quality measures. So they are saying to patients for this proceedure we will re-imburse no more than the 60th percentile of the cost curve. They will pay travel expenses for the patient and a companion if long distance travel is needed. This is called reference pricing. (It is also being used on imaging).
    Now the way the japanese handle pricing would be better to set national price levels (with perhaps local adjustments by region not by institution) I would do this since it seems the system today is designed to avoid at all cost competition on cost, thus limiting the ability of market forces to control it, with physicians not being aware of what their decisions cost. Another interesting idea I have seen is on Electronic medical records the pricing for tests is show before the approval button for the tests is pushed.
    This became clear to my when my PCP prescribed a branded generic that cost $60 a month, that cold be had for $4.

  • little john says:
    November 23, 2013 at 7:34 pm

    Please see Kaiser Health News dated September 11, 2012 for 2012 and previous years health insurance premium increases.
    I don’t doubt the rise in healthcare costs have slowed in recent years. But to credit the ACA is a reach.
    My comparison of Angry Bears to Rush, etc. was not meant as an insult. I was just trying to point out that Dean, Linda and Bruce have a particular political viewpoint as do Rush, Mr. Paul and Mr. O’Reilly. All of them want to analyze data to support their particular political agenda. Excepting Linda and Bruce (I think) that’s also how they get paid.
    Again I admit that I am in the insurance business, but the life business is a totally different business than health insurance. Think morbidity vs. mortality.

    • Dan Crawford says:
      November 23, 2013 at 8:08 pm

      Who gets paid for political agenda on AB?

    • Dan Crawford says:
      November 23, 2013 at 8:41 pm

      “I don’t doubt the rise in healthcare costs have slowed in recent years. But to credit the ACA is a reach”…As stated many times before , the Great Recession is the heavy hitter. The MLR (80% rule) has helped…for me the first years rebate from Tufts was 900 dollars, an indicator that a noticeable slice of my premium was not for medical issues.. A lot less this year, about $150, . The Medicare cost curve has been consistently down sloping as against the trend of premium rises in the private market…Medicare has an impact on billing and related costs in the private market.

      “All of them want to analyze data to support their particular political agenda.” It sounds so even handed and balanced…but no.

    • run75441 says:
      November 25, 2013 at 7:27 pm

      Little John:

      When CBO’s Douglas Elmendorf can write that the PPACA is bending the Healthcare Industry curve, it is time to take notice. I have little respect for Elmendorf as he is definitely partisan and he is the one who put the nails into the coffin of Hillarycare which would have come at 1/54rd the cost of the PPACA. What have we done since then? http://www.forbes.com/sites/rickungar/2013/02/12/new-data-suggests-obamacare-is-actually-bending-the-healthcare-cost-curve/ “While the new data suggests that some of the changes in how providers are paid for delivering healthcare began—and were having a positive impact—prior to passage of Obamacare, the ACA codifies these changes in payment procedures for physicians and hospitals, taking what now appears to be programs that are slowing the growth in costs and applying them to all providers throughout the nation.” http://www.benefitspro.com/2013/09/03/rand-forecasts-few-premium-increases-under-ppaca “The Rand Corp. says rates generally will not be higher as a result of the act’s implementation, as now configured. Moreover, Rand found that workers at firms employing fewer than 100 workers are expected pay almost 6 percent less in premiums in 2016 than without the health care reform law. Nationally, the report said, average premiums for equal plans would cost $5,837 with Obamacare in effect and $6,192 without it — a $355 savings. Premiums at large companies weren’t examined in the report. http://www.dailykos.com/story/2013/10/31/1252127/-Study-ACA-provides-97-of-Americans-with-equal-or-more-affordable-coverage# Here are the highlights:
      – 80% of Americans get insurance through their employers and are relatively unaffected.
      – 14% of Americans were previously uninsured and will finally gain access to affordable health care through the exchange.
      – 3% of Americans buy insurance on the individual market, and they will not see a significant change in their policy. Some of them will save money over their previous insurance.
      – 3% of Americans who are in the individual insurance market will have to pay more for an ACA-compliant plans.
      http://transitions.s410.sureserver.com/2013/11/04/will-health-insurance-costs-rise-for-young-adults/ But the critics overlook some important caveats.

      The first is that young adults can stay on their parents plan until age 26 under ACA. This has been a wildly popular feature since it was introduced pre-ACA.

      The second is that in states that are expanding Medicaid, young adults who are living on limited incomes will now be covered. The expansions will raise the income thresholds for eligibility to 138% of the federal poverty line and cover single individuals, not just parents. That includes quite a few young people. In 2012, according to the U.S. Census, roughly 28% of young people aged 18-24, and 23% aged 25-34 had incomes that fell into that range.

      The third caveat is that many other young adults will be eligible for subsidies that will lower their premiums. According to the left-leaning Urban Institute, only 11% of young adults under 27 who are currently buying individual insurance (non-group) will face full costs of health care, and only 14% of the currently uninsured will.

      That waitress that Chris Conover uses as an example likely falls into one of the above scenarios. If she pulls in $20,000 a year waiting tables, she is probably now opting for no insurance, taking the gamble that she’s young and healthy enough to risk it. Under ACA, she will be required to be insured or face a penalty, but she will also be eligible for a subsidy, given her income. The subsidy will bring her premiums down to $85 a month, or a little over $1,000 a year, not the $3,000 a year Conover claims

  • CoRev says:
    November 23, 2013 at 8:51 pm

    Run, I believe your main point is there are several millions eligible for free to highly reduced plans. That’s never been the issue. Its getting them to trust the site enough to sign up, and having enough full-pay enrollees to keep the rates low enough to attract more full-payers. Otherwise my point is supported that medical costs will continue to go up, even it the number of enrollees are paid out of tax revenues.

    If you have better numbers for states where rates will increase and how much then present them.

  • save_the_rustbelt says:
    November 24, 2013 at 10:51 am

    healthcare.gov and the other topics in the news are minor, like an iceberg the real action is below the surface, and the real news is the reactions of employers, insurers and providers.

    • Dan Crawford says:
      November 24, 2013 at 1:48 pm

      LOL…I thought rusty said wait before making predictions as truth corev. Not a confirmation of your points. My bet is there will be sharp regional differences, and not simply based on red and blue. How diagnostics and prescription of interventions can vary greatly on procedures. Also, the differences in major hospital charges and smaller hospitals in the area may be significant. How rural services are affected will be worth watching.

  • CoRev says:
    November 24, 2013 at 1:15 pm

    Rusty, I completely agree with your comment and would add the security issues are still to be discovered. Their discovery will be very painful to the individuals affected and costly to the tax payers to pay off the law suits.

  • sammy says:
    November 24, 2013 at 8:34 pm

    run,

    As a place to go to get free healthcare insurance, the website seems to be working well.

    What does that mean for the rest of us?

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