On October 20, Blue Cross Blue Shield of Michigan lost in the U.S. Supreme Court. The justices dismissed their case without review. The charges of fraud, as well as the court-ordered $6 million penalty, are now a matter of record.
HMOs & Managed Care
ST. PAUL, Minn.—Next month, South Dakota voters will see an initiative on their ballots that could put health care decisions back in their own hands.
Government wants doctors paid for “value.” On July 1, Politico held a briefing called “Value vs. Volume.” Data-crunchers, in cahoots with government, say access to our private medical data can be used to pay doctors for “value,” instead of for the services they provide to patients.
A lawsuit has unexpectedly revealed Obama's rationing plans. The Administration says states can cut Medicaid payments to doctors and other providers to hold down costs. This is a breathtaking statement. President Obama's signature law, Obamacare, adds 16 million people to Medicaid. It offers states the "opportunity" to expand Medicaid at no cost for the first two years, and then offers to pay 90% of the cost in perpetuity of all individuals eligible under the expansion. The law also increases payment to primary care doctors for two years to encourage them to accept more Medicaid patients.
Do conservative organizations all sing the same health care tune? No, writes John Goodman at the National Center for Policy Analysis. In fact, I'd argue that sometime they are singing in complete dissonance.
Obamacare is coming. Soon everyone will feel the painful realities of what the Democrat-empowered Congress imposed on the nation. It's going to be more painful than many experts predicted. Besides the negative impact on quality of care, there will also be significant cost increases leading to reduced access to health insurance and patient care.
WALTER MCCLURE, who worked with Paul Ellwood to create the HMO, was interviewed in August 2012. Minnesota's health care system is close to where he wants health care to be with outside analysis of patients and doctors. From the Interview: "When [McClure's] team started on [cost and quality] assessment in the 1980's, the idea that someone would be looking over a physician's shoulder was considered communism. Physicians were convinced of their right to autonomy. However, by 2008 Minnesota's private and voluntary sector had accomplished a sea change in this culture with 85 percent of providers in the state participating in having their outcomes measured." [our emphasis]
Paul Ryan is Romney's choice. Conservatives remember with glee how Ryan shredded Obamacare at the President's health care summit. Ryan said the bill was "full of smoke and mirrors." He looked right into the President's eyes. Six minutes later, Obama could barely respond. Ryan's Medicare proposal now takes center stage. In March, Paul Ryan created shock waves with the Medicare reform proposed in his 2013 budget called "The Path to Prosperity."
Some State legislators believe a federally-approved Exchange established by the State will be better than a federally- imposed Exchange established by the Secretary of Health and Human Services (HHS). However, the federal law makes it clear that every Exchange must conform to federal requirements, including pending regulations. Thus, a “State Exchange” is actually an imposed Federal Exchange. Some might call it a "lobster trap" for States - once in, there's no getting out.