Insight, analysis & opinion from Joe Paduda

Jan
2

and the nominees are…

Hey, Managed Care Matters was nominated for one of the Best Medical Weblogs of 2006!.
Thanks to whomever entered the blog, and I’ll send out info on voting when it starts (tomorrow, I think).
Also in the running for the “Best Health Policy/Ethics Weblog” are Hank Stern’s InsureBlog, Health Business Blog, Rita Schwab’s MSSPNexus, Kevin, M.D., Roy Poses’ Health Care Renewal, and Effect Measure.
Now that’s SOME competition!


Jan
2

Ezra on Universal coverage

Ezra Klein opines in his recent editorial in the LA Times that conditions are, if not ripe for a move towards universal coverage, at least we’re getting closer to harvest time.
A couple of (relatively) minor nits. Hospital profits are not exactly “skyrocketing”. Yes, they’re healthier than they have been of late, but low-single-digit margins are not even out of sight, much less out of the troposphere. Second, Ezra claims that the nation won’t countenance a continuation of today’s health care mess. I disagree – as one who said “we can’t take it anymore” ten years ago, I’ve been amazed by Americans’ ability to take it, at least when it comes to over-priced health care of mediocre quality.
Those points aside, Ezra’s inventory of environmental and political factors is compelling. There is no doubt that we are getting closer. There is also no doubt (at least in my mind) that Americans’ ability to tough it out, endure, and/or ignore this problem is akin to the legendary endurance of the Russian peasant.
Until and unless a plurality of major corporations, labor groups, and middle-class voters decides this is really important, it’s highly unlikely we will have a major move towards universal coverage in the next year or two.
Therefore, I’ll stick with my prediction of last year – we’ll have some form of universal coverage before 2011. And not too much before.


Jan
1

Catching up

Ten days away does wonders.
My real job was rather hectic last year, so I missed out on a few notable events, and finally got a few minutes to warap up some of 2006’s more interesting developments.

Continue reading Catching up


Dec
22

Till 2007

MCM will be taking a vacation till January 2. To all – best of the season, rest up, we have a lot to do next year.


Dec
22

How HMOs make money

It’s called “managing the delta.”
The health plan business is pretty healthy these days, and the reason is simple – HMOs are keeping health care cost increases under 6% while increasing premiums by 7%+.
Sure, expense management is key, but so is revenue management. The question is, can HMOs manage cost increases for more than a few quarters? History indicates Not.
Thanks to Bob Laszewski for doing the heavy lifting by explaining how this happens.


Dec
22

Even more Mystified

A couple of sources informed me that the company CorVel bought in California is actually a Work Comp claims company – a third party administrator or TPA.
This is really confusing. Not only does CorVel sell their services to TPAs, but the TPA business in California is in the tank these days. While this may have helped CorVel get a good price, it also means opportunities are limited.
Not only does the stock price bewilder me, so does the strategy.


Dec
20

An expert joins the health blog-o-sphere

Bob Laszewski is one of the best-connected and most perceptive people on the national health care policy scene. He’s also a good friend. Bob recently joined the health blogging world and is posting at Health Policy and Marketplace Review.
Bob’s background is impressive – former head of two life and health insurers, founder of an international health policy advocacy group, consultant to Congressional committees and often cited on NPR, the McLaughlin Group, the NewsHour, and the Sunday morning news shows.
His most recent post is on health care cost trends, and the puzzling drop in health insurance premium increases. Well worth the read.


Dec
20

Improving Wyden’s Healthy Americans Act

There is one significant blind spot in Sen. Ron Wyden’s (D OR) Healthy Americans Act – because the benefit plan is based on the one enjoyed by Congresspeople and Federal employees, it fails to consider that many Americans can’t afford the maximum out-of-pocket limit, while to others it is a mere pittance .
The problem with the FEHBP and Congressional plan is all those folks have jobs so they can afford deductibles. A lot of folks working at Walmart can’t. As presently constructed the plan looks a little, well, elitist.
The fix is simple.

Continue reading Improving Wyden’s Healthy Americans Act


Joe Paduda is the principal of Health Strategy Associates

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