Relevant and even prescient commentary on news, politics and the economy.

New Dialogue Rules for the CDC

Trump administration has forbade the usage certain words; “vulnerable,” “entitlement,” “diversity,” “transgender,” “fetus,” “evidence-based” and “science-based” from being used in CDC reports. I wonder what is up next, the burning of books? The Trump administration AND Repubs keep establishing new boundaries for their reach into American lives.

Trump’s Chief of Staff Jim Kelly told the analysts that “certain words” in the CDC’s budget drafts would cause those drafts to be sent back to the agency for correction. I wonder who will get fired first at the CDC?

Here is Treasury Secretary Steven Mnuchin wondering why he did not get the memo . . .

Mnuchin: “Nobody’s told me not to use certain words and I’ve never told anybody in the Treasury not to use certain words.”

You have to wonder whether Steve believes he has been purposely left out. Maybe “evidence based” might work for him if we were to reword it a bit? For example he might (doubtful), he might say;

based upon the evidence of the impact of prior tax cuts, we know that cutting taxes does not stimulate the economy as much as we thought.

Unlikely those words would ever pass his lips.

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December 14, 2012

Today is the fifth anniversary of the slaughter of the innocents at Sandy Hook Elementary School. 20 children between the ages of 6 and seven years old were shot dead as well as six adults who tried to protect them. All because this country’s politicians believes there is nothing which can be done to prevent this from happening and are in the pockets of the NRA.

Not a good day in the history of the United States. And still when these preventable tragedies happen, it is never a good time to discuss why they happened and what we can do to prevent them.

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FCC Just Repealed Net Neutrality

The FCC voted 3-2 Thursday to repeal net neutrality rules, ending Obama-era regulations that prohibited Internet providers from blocking or slowing web content.

Whereas all Internet traffic previously shared same ‘lane,’ it can now be split among different lanes with different speeds.

Those differing speeds could hurt telemedicine since it requires a ‘pretty robust connection,’ said Mei Kwong, interim executive director and policy advisor for the Center for Connected Health Policy. ‘The last thing you want is for the interaction to suddenly freeze or the audio to go out or for the picture to be pixelated.'” Modern Healthcare

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“Congressional Leaders Signal They Intend to Kick the Can Down the Road on CHIP” Again

A Little History of the legislator who wrote the bill:

Chair of the House Appropriations Committee since 2017, Rodney Frelinghuysen’s campaigns have been funded by the aerospace, defense, pharmaceutical and health care industries. On domestic issues, he opposes legalized abortion, Planned Parenthood, sanctuary cities, and federal regulation of greenhouse gas emissions. He endorsed Donald Trump in the 2016 presidential election. He voted to repeal the Patient Protection and Affordable Care Act (Obamacare) and replace it with the American Health Care Act (AHCA). He was criticized for purportedly failing to have in-person town hall meetings since 2013, as well as writing a letter which had the effect of threatening an opponent’s employment.

It does appear Congressman Rodney Frelinghuysen has some irons in the fire when it comes to woman’s healthcare, healthcare in general, the healthcare industry, and who is a priority in healthcare plus sanctuary cities and green-house gases. Definitely unbiased irons as Congressman Frelinghuysen, like Michigan’s Mike Bishop, refuses to meet with his constituents and learn of their interests. His “Chip Further Continuing Appropriations Bill” passed by the Senate was reported-on by the Georgetown University Health Policy Institute, Center for Children and Families’ Joan Alkers. The bill does not solve the 5 year funding issue for CHIP as proposed in another Republican led bill.

What is coming to pass is a stopgap measure taking unused CHIP funding and giving portions of it to states running out of funding. Some states ware better funded due to timing and other reasons. It is as Chairman Greg Walden of the House Energy and Commerce Committee called the stopgap measure:

“a short-term, fill-the-gap for states – a little rescue, lifeline for them right now.“

Portion of the Bill:




‘‘(i) PRORATION RULE. Subject to clause (ii), if the amounts available for redistribution under paragraph (1) for a fiscal year are less than the total amounts of the estimated shortfalls determined for the 3 year under subparagraph (A), the amount 1 to be redistributed under such paragraph for each shortfall State shall be reduced 3 proportionally.


‘‘(I) IN GENERAL.—For the period beginning on October 1, 2017, 8 and ending December 31, 2017, with respect to any amounts available for redistribution under paragraph (1) for 11 fiscal year 2018, the Secretary shall redistribute under such paragraph such amounts to each emergency shortfall State (as defined in sub-15 clause (II)) in such amount as is equal to the amount of the shortfall described in subclause (II) for such State and period (as may be adjusted under subparagraph (C)) before the Secretary may redistribute such amounts to any shortfall State that is not an emergency shortfall State. In the case of any amounts redistributed under this subclause to a State that is not an emergency shortfall State, such amounts shall be determined in accordance with clause (i).

What is Stopping CHIP Funding?

The Hill blames it on Congress not reaching an agreement on how to fund the CHIP for children. The issue lies with the Republican Congress which wishes to take funds from other programs, etc. to fund the Children Health Insurance Program.

• Additional Means testing of certain higher income seniors. (if you start with this, it will grow to other things also. This is another Republican scam.)
• Allowing states to kick out Medicaid beneficiaries if they win the lottery (This can be done by asking for a waiver from the Republican run CMS).
• Shortening the grace period for people paying their Obamacare premium payments late. (The point to this is to penalize those who have lower incomes and have trouble paying during certain time periods.)
• Cutting more than $5 billion from the Affordable Care Act’s prevention and public health fund. These funds are used for the ACL, CDC, and SAMHSA programs.

Not satisfied with holding children hostage in the continental United States, Republicans are also holding Puerto Rico Medicaid funding hostage.

Another funding option suggested by Chairman Greg Walden of the House Energy and Commerce Committee is;

“letting states receive more money for CHIP from the Centers for Medicare and Medicaid Services (CMS). This would not be new money, but would come from the agency’s unused funds.”

With Walden’s suggestion there would be no additional funding. This option would pit the needs of CHIP against the needs of Medicaid and Medicare. All of the funding options proposed either grow into something worse down the road for children and the elderly or steal from funding for those needing healthcare, programs again for the elderly and also programs for minorities and low-income constituents.

Its beginning to look a lot like Christmas for Republicans will be stealing healthcare from children and those who can least afford it or lose it.

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Why I Do Not Say Much on Facebook

I have watched Ken Houghton, Tom Bozzo, and Daniel Becker out on Facebook and have sometimes made a few not to serious remarks. Similar interests. There are some I just associate with who like to engage in politics which I usually ignore. I go out of the way not to engage with people because you would have a better conversation talking to a wall at times. This commentary defies logic, shows no understanding of what is taking place, and neither does she care how many will be hurt by this. It was hard to pass up. I am sure this person will eventually drop me.

Sheri: A very important component of the proposed tax changes will help ensure homeownership remains a valuable financial incentive over renting — and a big reason why I’m a republican — homeownership is truly a HUGE part of the American dream. Any presidential administration that enacts laws that erode it is NOT okay in my book. If you got socked with the ‘3.8% property sales tax’ since 2012, go ahead and flip the bird at Obamma’s picture if it makes you feel better. Thank God we again have a republican president that gets how crucial real estate is to our economy and way of life!!

A few points to note regarding the proposed tax changes related to real estate:

A last-minute change to the Senate version would make up to $10,000 in property taxes deductible. Previously, the Senate version had eliminated the property tax deduction entirely. The change aligns with the property tax cap set in the House bill.

One difference between the two bills is that the Senate version retains the deductibility of mortgage interest payments on up to $1 million of indebtedness; the House version caps
indebtedness at $500,000.

Now, members of the Senate and the House must meet to agree on a final bill. It’s not too late to make your voice heard. Tell your members of Congress that incentives for homeownership and the capital gains tax exclusion on the sale of a home MUST be protected.

Myself: It is not often I say much out here as much of what is said defies reason. I assume you make >$200,000 AGI as a single person or >$250,000 AGI as a member of a marriage? It is then the investment tax hits with after another exclusion.

Another limitation is that it’s imposed on the smaller of:

1. A person’s investment income, or
2. The amount by which AGI exceeds the threshold amounts of $250,000/$125,000 or $200,000.

But there is more. There is a limiting factor on the house sale:

It only applies to home sale profits above a $500,000/$250,000 exclusion.

When the portion of the profit above $500,000/$250,000 causes the seller’s AGI to exceed the threshold amounts.

Let’s say a couple has an AGI of $325,000 and sells their home at a $525,000 profit (not sale proceeds, but profit). $500,000 of that gain is excluded; the $25,000 isn’t, and raises their AGI to $350,000.

The couple’s revised AGI exceeds the $250,000 threshold for joint filers by $100,000. That’s more than the amount of their taxable gain ($25,000). So the 3.8% is applied to the smaller of these two amounts. They owe a surtax of $950 ($25,000 x 3.8%).

There has always been a capital gains tax on homes when you sell them and it is wise to keep your receipts on renovation of a home as that comes off of the profits in the end when you make the final reckoning. This tax does not apply to everyone in the US. I certainly do not have $250,000 or $200,000 in AGI income. Of the ~156 million of Household Taxpayers, ~5.5 million Households exceed $200,000 in income annually or ~3.5% of the total (Tax Policy Center numeric).

The 3.8% tax itself + the 9 tenths of 1% go to fund healthcare, Medicare, and Medicaid. Now as far as the GOP Tax plan of which ~66% of will go to less than 1% of the household taxpayers (~1 million households), those making less than $75,000 will start to see their taxes rise even before 2027. The GOP tax plan is a scam and rides on the backs of the middle class.

Sheri: While that is true, it doesn’t change the fact that it is a grossly unjust tax, which was put in place to support Obummer’s ‘ACA’. People making $250k/yr are already paying high taxes, and it is tough enough to make money on investments in this economy — 0.25% interest on a CD — no thanks. Any ‘surplus’ taxes that discourage investing in RE are a bad thing.

Myself: I will stand by my understanding as will many other people. It is a tax giveaway to less than 1% of the taxpaying households making greater than $500,000 . It is not hard to make money on investments.

Sheri: It’s still a ‘take from the successful to give to the poor’ SURPLUS tax, and it applies to couples who make $250k, and individuals who make $200k, which in today’s economy is by no means ‘wealthy’. I’m sick and tired of liberals thinking taxation is the answer to everything — it is not.

Myself: It is obvious you did not read all of what I said. Please take a moment and read it all.

Sheri: It is OBVIOUS you are a liberal.

Myself: Non Sequitur.

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What Republican Iowa Senator Grassley Really Thinks . . .

of His Constituents.

Iowa Republican Senator Grassley came out publically stating he wants to eliminate the estate tax to help Iowan farmers stay on their family farms. In rebuttal, the Des Moines Register had this to say:

Of the numbers of Iowans paying the estate tax, they can be quantified in the dozens each year. Out of the 1.45 million Iowans filing federal tax returns, the numbers of Iowans over the last five years paying estate taxes numbers from 32 in 2012 to 61 in 2015 according to IRS data. Further-more, the vast majority of those probably were not farmers or small business owners.

Despite evidence to the contrary, Finance Committee member Sen. Chuck Grassley still insisted the estate tax is potentially a ruinous burden on Iowa farmers and small business owners.

Earlier this year either in a blatant misleading statement or in total ignorance, Grassley said;

“The federal estate tax may force family members to liquidate to pay the death tax. It is harder than ever for families to pass down the family-run farm or business from one generation to the next. The death tax creates financial hardship for family businesses to survive and thrive.”

Today, the estate tax is a 40 percent tax on wealth assessed when a person die. It is applied on assets > $5.5 million for individuals and $11 million for couples. The House and Senate proposal doubles those exemptions to $11 million and $22 million. The House version abolishes the tax completely in 2024.

Iowan Republican U.S. Reps. Steve King and David Young joined the chorus with King insisting the estate tax;

“often falls hardest on family-owned farms and small businesses.”

and Young called the repeal being a massive giveaway:

“a ‘myth,’ that the repeal of the estate tax would be a massive giveaway to the wealthiest Americans.

The estate tax (sometimes called the death tax) negatively impacts farms and businesses all over the 3rd District. … Death should not be a taxable event and families should not have to fear the Internal Revenue Service and more taxes making it more difficult and costly to pass on the farm or family business to the next generation.”


No shame amongst politicians who are either ignorant on the topic, outright lying, or believe the populace is so unknowledgeable of the facts, they can say anything and be believed.

Kristine Tidgren, assistant director of the Center for Agricultural Law and Taxation at Iowa State University, told the Register;

“I have not come across any examples of an Iowa family that had to sell the farm to pay the estate tax,” adding, “I don’t think the current estate tax system threatens family farmers.

IRS data from 2016 confirmed the 682 tax filers in the entire country who owed estate taxes owned farm assets and represented ~ 13 percent of the 5,219 estate tax returns in which taxes were owed.

Even that numeric likely overstates the number of primarily farm operations subject to the tax. A 2015 Congressional Research Service report projects that 65 farm estates annually across the U.S. face an estate tax liability. Less than a quarter of these, the report finds, lack sufficient funds to pay their tax bills.

There is no fool like an old fool and Senator Grassley who has served 7 terms in the Senate confirmed it by getting indignant when challenged on his beliefs.

“I think not having the estate tax recognizes the people that are investing, as opposed to those that are just spending every darn penny they have, whether it’s on booze or women or movies.”

Grassley could not have stated it any better what he thinks of his constituents. His work, argument, and effort is not to eliminate the estate tax to benefit working constituents; but, it is an effort to protect and separate the ownership class from the rabble, his constituents. His comments prompted a pointed response from Pat Rynard of the Iowa Starting Line:

It is difficult to think of a more condescending, elitist worldview – that if you are not ultra-wealthy, it is clearly because you are wasting all your money on alcohol, frivolous fun, and prostitutes (I assume that’s what he meant when he said women). Certainly, it could not be because people are struggling to find decent-paying jobs, are burdened with debt from the college education needed to attain better jobs, or are paying outrageous sums for health insurance and medical bills. Nope, it must be because they are all getting hand jobs from hookers in the back of a dark movie theater while downing a bottle of Jack Daniel’s.

Describing himself as a farmer Senator Grassley runs a farm in Butler County with his son and grandson. Initially Grassley stated his own family farm would not be subject to the estate tax and then changed his mind after rethinking his farm.

If he and his wife died on the same day, the estate would be subject to the $5.5 million exemption rather than the $11 million exemption and likely would have to file an estate tax return.

Enough said.

Mr. Grassley will retire on lifelong healthcare benefits and a nice government pension thanks to his liquor swilling constituents who repeatedly elected him to office. Later in another interview, Mr. Grassley stated his comments were taken out of context.

Hat Tip to Tom Sullivan @ Hulabaloo.

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CVS Phamacy Chain buys Aetna Healthcare Insurance

Pharmacy chain CVS Health has agreed to buy health insurer Aetna for $69 billion in cash and stock, retaining its current management, the companies announced late Sunday.

The deal brings together one of the largest providers of pharmacy services with the No. 3 U.S. health insurer, which together would establish a healthcare giant with more than $240 billion in annual revenue.

The CVS-Aetna deal would likely give the combined company bargaining power in negotiating with hospitals and pharmaceuticals if they chose to go in that direction. There has not been much to control the rising cost of pharmaceuticals since Congress has blocked Medicare/ACA (Part D) from negotiating pharmaceutical pricing. The possibility of more insurers combining with pharmacy retail businesses. United Healthcare may be looking to do the same.

Interesting Direction . . . .

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Healthcare Costs and Its Drivers Today

I have been doing my typical reading on healthcare in the US and ran across several articles which seemingly come together at various points in the dialogue and are written by different authors. I decided to tie them together into a much wider and telling story.

An interesting point being was made by MedPage Today’s Dr. Milton Packer on his blog, “people suffer and die because Payors (Healthcare Insurance) is cost effective.” He starts his discussion on the opiate epidemic in the US, opiates are being prescribed by doctors for pain relief and . . .

“Patients are becoming addicted to opiates after the initial 10 day prescription with one-fifth of patients still using opiates a year later. There is no need to prescribe opiates as other less addictive pain-relief formulations are available, which are not commonly prescribed.” This raises the question of why?

Payers will not pay for the alternatives. The less-addictive opiates are more expensive and payers have declined to support them. Patients get addicted because prescribing for the lower cost and highly addictive opiates saves the payers money initially (me).

September 17, 2017, the New York Time and ProPublica (independent, nonprofit investigative journalism organization) collaborated on an article concerning the opiod epidemic in the US.

At a time when the United States is in the grip of an opioid epidemic, many insurers are limiting access to pain medications that carry a lower risk of addiction or dependence, even as they provide comparatively easy access to generic opioid medications.

The reason given: Opioid drugs are generally cheap while safer alternatives are often more expensive.

While the pharmaceutical manufacturers, distributors , and doctors have come under scrutiny; insurance companies and the pharmacy benefit managers (CVS Caremark, Express Scripts and OptumRx) make the final decisions as to what is covered. It could be something as simple as a higher tier and deductible to block usage.

A little side trip here and a continuation of the above. A week or so ago, I ran across another MedPage Today article by Dr. Packer; “ Who Actually Is Reviewing All Those Preauthorization Requests and How the System Works.” Dr. Packers was giving a talk on advances in medicine with regard to heart failures to a room of about 20 or so doctors who were retired.

Since many of them were no longer involved in active patient care, he wondered why they might want to hear a presentation on new advances in heart failure. Here was their answer:

Doctors: “We no longer care for patients, but we care about what’s going on. You see, most of us are employed by insurance companies to do preauthorization for drugs and medical procedures.”

Dr. Packer: I just gave a talk about new drugs for heart failure. Are you responsible for preauthorizing their use for individual patients?

The answer; “Yes.”

So did I say anything today that was helpful? I talked about many new treatments. Did I say anything that you might use to inform your preauthorization responsibilities?

“Oh, we’ve heard about those drugs before. We are asked to approve their use for patients all the time; but, we don’t approve most of the requests. Nearly all of them are outside of the guidelines we are given.”

I just showed you evidence that these new drugs and devices make a real positive difference in people’s lives. People who get them feel better and live longer.

“Yes, you were very convincing. But the drugs are too expensive. So we typically reject requests, at least the first time. We figure that, if doctors are really serious, then they should be willing to make the request again and again.”

If the drugs will help people, how can you say no?

“You see, if it weren’t for us, the system would go broke. Every time we say yes, healthcare becomes more expensive, and that isn’t a good thing. So when we say no, we are keeping the system in balance. Our job is to save our system of healthcare.”

But you are not saving our healthcare system. You are simply making money for the company that you work for. And patients aren’t getting the drugs that they need.

“You really don’t understand, do you? If we approve expensive drugs, then the system goes broke. Then no one gets healthcare.”

“Plus, if I approve too many expensive drugs, I won’t get my bonus at the end of the month. So giving out too many approvals wouldn’t be a smart thing for me to do. Would it?”

Now before you start on insurance companies and doctors; understand, this is not as free a market place as many would assume. In all of their political wisdom, Congress favors pharmaceutical companies over doctors, insurance companies, and the welfare of the constituents. Through legislation, Congress has made it impossible for insurance companies to negotiate pharmaceutical pricing in Medicare Part D insurance and also the ACA. Furthermore with the consolidation happening in healthcare, negotiation by insurance companies with a consolidating and growing healthcare industry is becoming more and more difficult as the former does not have as great of leverage. You have read my argument calling out of Single Payor, Medicare-for-All, Public Option, etc. as the cure for today’s healthcare issues and rising cost not being enough as the ACA and Part D were specifically blocked or the cost issue unaddressed in the legislation written by Congress. If these issues are not addressed from the very beginning, we will be fighting the same issues with rising costs a decade later with other programs.

At this point, I begin to disagree with Dr. Packers as he goes on to say:

“So we spend more for healthcare than any other country in the world; but, Americans do not get the care they need. There is a simple reason. Treatment decisions are not being driven based on a physician’s knowledge or judgment. They are being driven by what payers are willing to pay for.”

It is true that patients may not get some of the healthcare they need at the time due to denial, which can be appealed to the ACA, and can be a tiring process. It could be approved, passed on to patients, resulting in higher premiums the following year, and the Part D Risk Corridor program pay for it if excessive for the present year. What Dr. Packers does not mention is the rising prices and cost of drugs being blamed by pharmaceutical company on R&D, tooling up to manufacture, etc. The counter argument is much of the R&D is funded by the US government through tax deductions and write-offs for pharmaceutical R&D and capital Overhead. Pharmaceutical profits are double digit at ~25% beating out hospital supplies and healthcare insurance, which is already limited in what can be charged back to the insured by the MLR. To blame insurance companies totally for the higher costs in healthcare is false. Furthermore, a doctor’s decision do not always lead to less costly cures or practices.

Maggie Mahar of Health Beat Blog would take the subject of costs a step farther and state Medicare will approve anything the FDA approves for usage regardless of the quality of outcome when measured against older proven treatments. Notably the VA does limit its pharmacy and its care is rated higher than that of today’s commercial, for-profit healthcare to which most citizens are exposed.

Dr. Donald Berwick, President Obama’s proposed appointment for Medicare and who was in charge of Medicare and Medicaid for 17 months stated;

“20 to 30 percent of health spending is ‘waste’ that yields no benefit to patients, and that some of the needless spending is a result of onerous, archaic regulations enforced by Medicare and Medicaid.

He listed five reasons for what he described as the ‘extremely high level of waste.’ They are overtreatment of patients, the failure to coordinate care, the administrative complexity of the health care system, burdensome rules and fraud.

Much is done that does not help patients at all and many physicians know it.”

That is the same Medicare/Medicaid being touted by many proponents today as an alternative.

Speaking of costs and pricing for pharmaceuticals, there have been recent incidents of skyrocketing costs on particular drugs. A short while ago, I wrote a post concerning the appointment of Alex Araz as the new HHS Secretary replacing Dr. Tom Price. Formerly, Alex Araz was the CEO of the pharmaceutical giant Eli Lilly & Co.’s U.S. division. He also served under George W. Bush administration as the HHS General Counsel and Deputy Secretary. During that stint, he received praise for his management competence with the HHS; although, he did not have a healthcare background prior to this position.

Here it gets interesting when examining what took place during his tenure with Eli Lilly. One of the leading costs identified in pharmaceuticals increases has been in the rising cost of diabetes medication.

“While the Tweeter-in-Chief, Trump tells us presidential campaign contributor Alex Azar will be a ‘star’ who will lower prescription prices,”

Public Citizen’s Peter Maybarduk (Director) had this to say: “Eli Lilly is notorious for spiking prices of a century-old isolated hormone during Azar’s tenure as president and vice president. Eli Lilly raised the price of Humalog by 345%, from $2,657.88 per year to $9,172.80 per year.

Maybe President Trump in appointing Alex Azar to be HHS Secretary should have asked the 6 million diabetic Americans whose insulin prices have more than tripled under Azar’s watch at Eli Lilly.”

This has nothing to do with R&D and has more to do with pharmaceutical companies controlling the market regardless of supply and throughput restricted manufacturing (capacity).

What I have tried to do is tie these articles together into one cohesive story of how the pharmaceutical industry, insurance, and healthcare can have an impact on healthcare costs. For those who are interested, my background does include working in the manufacture of hospital supplies and pharmaceuticals. Using various citations from these articles, I have tried to touch upon the impact of insurance companies, the healthcare industry, government intervention under the HHS, one particular Med in the market place, etc. Overall, what is going on in the marketplace.

Another article, I read the other day gets into the foundation of what is happening based upon a recently completed study by JAMA. Using this study, the Methods Man, Dr. Perry Wilson (MedPage Today) examines what is driving healthcare costs in his article Here’s What’s Really Driving Healthcare Costs using data from Factors Associated With Increases in US Health Care Spending, 1996-2013 and the US Disease Expenditure Project. Dr. Wilson breaks it down using three simple charts which I have consolidated to one.

Dr. Perry Wilson starts off making an overall point about the rising cost of healthcare from 1996 to 2013 and stating; “after accounting for inflation, healthcare expenditures increased $933.5 billion from 1996 to 2013.”

Going on: “Healthcare expenditures in the US being high and rising rapidly is nothing new, but the study appearing in the Journal of the American Medical Association identifies the exact components of healthcare that are driving those soaring costs. The data from this study suggests traditional economic forces break down in the US healthcare market.

Different chronic diseases have different patterns of price increases. The biggest increase was seen in diabetes care, as you can see here, driven largely by the rising costs of pharmaceuticals.”

The Chart breakdowns reveal the various impacts of healthcare costs moving from left to right and then downward:

• 50% of the increase in healthcare costs was simply due to higher prices.

• Inpatient care or Service Utilization (purple) went down from 1996 – 2013 as outpatient treatment increased; however, the price of the remaining inpatient care went up much more – increasing overall inpatient care spending by around $250 billion.

• Different Chronic Diseases have different patterns of price increases. The biggest increase was seen in diabetes care and driven largely by the rising prices of pharmaceuticals.

The takeaway drawn by Dr Perry Wilson: “Regardless of the disease, it is clear, the price of what we’re buying – whether a drug, an ED visit, or a hospital stay – not the amount of what we’re buying is the major driver of cost increases. Efforts to reduce the consumption of healthcare may not bend the cost curve as much as efforts to reduce its price.”

You can not make an argument about the regulation of costs “not” being one of the dynamic components of a healthcare plan given the continuous unhindered industry driven rising cost of healthcare. Yet, every healthcare plan I have read fails to mention cost regulation specifically, provide remedy for it, and many assume a natural occurrence of control.

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