The posturing over the continued destruction of the ACA continues. Republican WA Congresswoman Jamie Herrera Beutler, after voting to end the mandate on the ACA, now expects Washington State Insurance Commissioner Mike Kreidler to fix the problem she and her colleagues are creating. Her expectation of the State needing to fix this issue, while her constituents lose their health care coverage in Pacific County after her party’s work to destroy the healthcare act, is pathetic. Does she not understand how insurance works? Where was she educated?
There is no free lunch. You voters in Pacific County elected this fraud to Congress. She promised you the end of Obamacare, and has fought to destroy the Affordable Care Act, with dire warnings issued by the insurance companies that without a mandate for care, they cannot guarantee affordable insurance rates, nor even the ability for the middle class constituents that counted on her to help them find affordable care. So now you are going to pay for the outcome of your vote. It is not up to Mr. Kreidler to fix a problem that Congress has been hell bent on creating. If Representative Beutler wants to see a fix for the problem, perhaps she can support a universal health care option that can give all of her constituents a chance to see a doctor, or other healthcare provider, as every other developed country in the world has already done. America is currently 27th in the world in it’s indices of health, not number one. Representative Beutler is helping us not only stay that way, but fall even further behind the rest of the world.
She wants to blame it on the State, but she is complicit in the problem’s creation. You can’t have it both ways.
This is an ugly story from both sides of the issue. The big Pharma companies are looking to claw back some of their profits, and some hospital districts, such as Jefferson County Healthcare, may be using the system in a way it was not intended, meaning that it is unclear that the patients who were intended to benefit from this, actually are seeing benefits. JHC has a relationship to somehow share these discounts with Safeway, where they send patients for filling the discounted drug. Is the patient actually seeing a discounted price or is the hospital somehow using this to generate more profits? I am under the impression that Kitsap County is using the program more as it was originally intended, meaning that the monies are passed directly to the consumer who benefits from the discount. Is that not true here? It appears not to be.
The program, known as 340B, requires pharmaceutical companies to give steep discounts to hospitals and clinics that serve high volumes of low-income patients.
Under 340B, named after the section of the Public Health Service Act that authorizes it, eligible hospitals buy drugs at a discount from the pharmaceutical companies and then are reimbursed for those purchases from Medicare. The drugs are purchased under the Part B program, which covers expensive chemotherapy and other treatments in a hospital, doctor’s office and clinics.
Heated And Deep-Pocketed Battle Erupts Over 340B Drug Discount Program
A really good look at what needs to change in Electronic Medical Records (EMRs also known as Electronic Health Records). As I have said in other posts, we are in the worse possible moment for EMRs. They have automated data collection by imposing huge data entry burdens on healthcare providers. That has been done for the benefit of the incredibly wasteful insurance industry. EMRs are not helping physicians or ERs to do a better job and they are not being used to their potential. Want proof?
Yet such systems have had little impact on quality improvement and cost reduction to date. Indeed, clinicians routinely criticize them, lamenting that they waste their time, are rigid and not user-friendly, and interfere with their patient interactions. Many health care organizations are suffering more pain than gain as they struggle to integrate new IT systems into their operations. For example, in January 2017, MD Anderson Cancer Center announced that it would lay off 900 employees, or about 5% of its workforce, largely because of financial losses attributable to a new EHR system.
Here’s a long, thoughtful article about what needs to change.
And the proof is in the pudding. Yes, virtually all Port Townsend physicians work for the hospital. Are costs higher here? You bet. Lots. Now a study by UC Berkeley shows it’s more than just us.
If a local hospital recently bought your physician’s practice, chances are the costs of your treatment will go up.
The intent behind hospital/physician consolidation was to achieve better coordination and care for patients. However, some experts think consolidation reduces competition, resulting in higher prices.
This article does a good job of highlighting why we pay more at Jefferson Healthcare, even though it’s a publically owned hospital. We are designated a “critical access” hospital, meaning we are rural, which gives JHC much greater flexibility of charging. JHC and Port Townsend are in a strange situation, in that we are designated the same as a very remote hospital, say in Eastern Washington, or Forks. Though we are only a short drive from non-rural designated systems in Poulsbo or Seattle. The take away is that unless you can afford to pay more for your care, or weigh the cost and hassle of traveling, you will pay less (sometimes significantly less) for the same care by going to Seattle or even in some cases, Poulsbo. I’ve personally found it to be dramatically less, especially for procedures and labs. If you can, always shop your medical care. Jefferson Healthcare is in the process of evaluating their charges, based on customer complaints. The unintended consequence of all this is that the poor and lower income people pay a much higher percent of their income for healthcare by living here and not shopping their healthcare. They often don’t have the time to do so, and often aren’t even aware of the problem in pricing.
Medicare patients’ out-of-pocket costs for outpatient care are significantly higher at critical access hospitals than at other acute care hospitals, and the reason for the difference in cost is buried in a 1997 law.
This was sent out by the Jefferson Healthcare on their concerns to changes to the 340B program. This program has been used to theoretically fund low cost prescriptions. There are a variety of points of view about what the program has actually achieved, but the hospital is adamantly opposed to the cuts to it. We likely can discuss this more at the next Citizen’s Healthcare Access group meeting in September in Port Townsend.
340b letter PDF file. Here’s the first page so you can decide if you want to read the whole PDF.
Good short article detailing the problems facing independent medical practitioners today. This is the state of medicine we are in. Jennifer Hanscom is the CEO and executive director of the Washington State Medical Association.
When I began my career at the Washington State Medical Association in 1996, 38 percent of physicians were in solo practice; today that number has plummeted to less than four percent. For comparison, during that same period only 18 percent of physicians were in practices of 100 or more physicians and a good percent of those practices were large independent clinics. Today, over 61 percent of physicians practice in groups of more than 100 physicians, with most employed by integrated systems.