Rescue The American Healthcare System In Six Steps

Rescue The American Healthcare System In Six Steps

According to respected neurologist Dr. Steven Goldstein

Dr. Steven Goldstein of the Houston Healthcare Initiative believes that the U.S. healthcare system can be rescued, and that American business can play an instrumental role. He describes the steps to salvage the industry on the Houston Healthcare Initiative podcast.

The Houston Healthcare Initiative podcast can be heard on: Apple Podcasts, Audible, Audacy, iHeart, Listen Notes, Podcast Addict, Podbay, Podnews,  Stitcher, Soundcloud, and Player FM.

What Needs Rescuing

Rescue Healthcare
Dr. Steven Goldstein describes six steps business can take to reduce costs and maintain employee health.

The current American healthcare system is a mis-mash of government regulations, insurance company and medical industry policies designed to separate the public from its money and provide a minimum of care. The current system does not embrace new treatments or scientific breakthroughs. Insurance companies question the judgement of doctors with double approvals of prescriptions and treatments called ‘pre-authorization.’

Government at the state and federal level demonize off label treatments along with those who advocate them and instead peddle more expensive vaccines and treatments.  It’s a mess.

How to Fix Healthcare

There are practical steps a company of any size can take to transition from the current healthcare system to this new cost-effective solution.

  1. Self-Insurance

In addition to an estimated 20-30% savings compared to regular insurance self-insurance allows a company to adopt new technologies, financial and other incentives to deliver higher quality care at lower cost.

  1. Health Savings Accounts (HSA)

As a practical matter this shifts the costs of routine healthcare to the employee. It allows the employee to pay cash using pretax dollars. Cash prices for tests and procedures are already dramatically lower than insurance company discounts. By paying cash, the administrative costs of processing claims drop dramatically. The employee simply saves receipts and makes a claim only when the receipts add up to the deductible. Additionally, the unused HSA money accrues interest that can also serve as a retirement account for employees.

  1. Establish an Employee Welfare Trust (EWT).

The purpose of the trust is to reduce the cost of reinsurance in later years and to eventually convert the insurance plan from a one-year contract to insurance to age 65. Thus, employees will be able to continue in the plan even if they no longer work for the company if they continue to contribute to the EWT.

  1. Educate employees about what is possible for them. These options include:
    • How to choose a primary physician based on the personal needs of that person,
    • How to shop for medical care and medication,
    • The importance of mental health and the relationship between mental health and the effect on physical health and the immune system,
    • The importance of physical exercise,
    • The importance of financial health and its effect on mental health.
  1. Technologies that can be implemented immediately.

Technology can provide free access to a physician 24/7 for diagnosis, and second opinions. Remote appointments reduce trips to the ER or urgent care. Additionally equip each employee with a thermometer and blood pressure cuff to provide information to the physician. Encourage patients to maintain their own medical records; educate patients on how to do this. Business can also fund fitness apps, gym equipment at the jobsite or gym memberships.

  1. Employ incentives to employees to live a healthy lifestyle. These can be financial incentives or other rewards like increased company contributions to the HSA, lower insurance premiums etc.

In Summary

According to Dr. Goldstein, the means to take control of the healthcare system away from government, big hospital companies, and the insurance industry and create a patient centered system is within our collective grasp. “We just need to do it,” he told his audience. “There are enough remedies in current law available to employers and employees alike to make a major change in the way we all get and pay for medical care.”

If nothing is done to rescue the healthcare business, the public can expect higher costs for insurance with higher deductibles and less coverage. Add to that more regulations and fewer treatments. More government interference with science and medicine and less freedom for our doctors who know us best to treat their patients.

About the Houston Healthcare Initiative

The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To learn more about the Houston Healthcare Initiative please visit www.houstonhealthcareinitiative.org.

To Deliver Preventive Care Enhancing Population Health After Covid-19

While not about health, Franklin was first to say an ounce of prevention is worth a pound of cure.

What were the additional medical setbacks the American public suffered during the Covid-19 Pandemic…..

To Deliver Preventive Care Enhancing Population Health After Covid-19

On the Houston Healthcare Initiative podcast, Dr. Steven Goldstein said that it was possible to reverse the preventative care reversals suffered during the Covid-19 pandemic.  Everyone can stay healthier, and possibly live longer by re-committing to prevention as part of our collective health regimen.

The Houston Healthcare Initiative podcast can be heard on: Apple Podcasts, Audible, Audacy, iHeart, Listen Notes, Podcast Addict, Podbay, Podnews,  Stitcher, Soundcloud, and Player FM.

Pandemic Pull Back

prevention
Routine health medical tests and exams designed to prevent illness fell during the Covid-19 pandemic. Dr. Steven Goldstein expects the number of tests to return to pre-pandemic levels.

How much did Americans miss when it came to preventative or elective care during the pandemic? Quite a bit according to Dr. Goldstein. “The drop off was precipitous and happened in a very short period during the spring of 2020,” he told his listeners. “Vaccinations dropped by 60% in April 2020. In the same period practically, no one got a colonoscopy with an 88% decline for those.”

What Will Happen Now?

Dr. Goldstein said to expect preventive care use to return to its pre-pandemic rates. “But the gaps created over the last year have critical implications for patients’ long-term health and could potentially lead to poorer outcomes over time,” he stated.

The Full Impact of Covid-19

The full effect of the pandemic on the American public is not known yet. But hospitals and health systems are aware of trends caused by delayed health screenings and the worsening of some chronic conditions.

The COVID-19 pandemic led to a decrease in preventive screenings because some patients were hesitant to see their health care provider. That was understandable. “But with more and more places opening, it’s important to get back to the preventative tests, screening and medication that helped you and everyone stay healthy and manage those chronic conditions,” Dr. Goldstein concluded. “Preventive care helps everyone stay healthy.”

The Norm of Preventative Care

Preventative care is and has always been considered best practice for all physicians and their patients.  Finding something and treating it early generally means a better outcome for patients including less expensive treatments. Screenings are important to avoid future health problems or catch them early when they are easier to treat.

Preventive care measures things like cholesterol, body mass, along with breast cancer screenings, prostate cancer screening and some general health counseling. Screening and test diagnosis helps doctors find abnormalities sooner than later. Cancer is the example most know about.  But the same caution with respect to blood pressure, arterial blockages in the heart and other organs are just as important.

“An ounce of prevention is worth a pound of cure.” This saying is reflected in proposed health reform plans and the efforts to increase investments in prevention throughout the U.S. healthcare delivery system. With evidence that nearly 40 percent of all deaths in the United States are due to behavioral causes, attention to prevention has encompassed obesity and tobacco smoking prevention in addition to vaccinations and cancer screening.

Chronic diseases are the leading cause of death and disability worldwide and are linked to increasing health costs. Preventative care is advocated as part of a population health approach and includes both clinical preventative services and screening tests.

Identifying and preventing potential problems downstream is one strategy for controlling utilization and improving health outcomes.Most health plans must cover a set of preventive services — like shots and screening tests — at no cost to you. This includes plans available through the Health Insurance Marketplace®.

About the Houston Healthcare Initiative

The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To learn more about the Houston Healthcare Initiative please visit www.houstonhealthcareinitiative.org.

 

Criticism of Doctor Prescribed Treatments Could Put Patients At Risk

Off Label Prescription

Criticism of Doctor Prescribed Medicine Is A Bad Idea

Off Label Prescription
Off Label Prescriptions. Doctors have the right to prescribe medication for conditions other than the one approved.

Physician prescribed Ivermectin to help treat Covid-19 may not be the biggest challenge facing doctors today. The bigger problem is likely the deliberate interference with a doctor’s ability to prescribe and treat patients as they believe is best. This is the subject of the latest edition of the Houston Healthcare Initiative Podcast which can be heard on : Apple Podcasts, Stitcher, Podbean, Soundcloud, and the Houston Healthcare Initiative website. The virulent criticism and mischaracterization of doctor prescribed Ivermectin as a possible treatment for Covid-19 is one sign that medicine can be and is politicized.

Off Label Prescriptions

This repercussions and longer-term consequences of political interference with doctors and their patients includes the freedom to prescribe ‘off-label.’  Off-label prescriptions occur when a physician gives a drug that the U.S. Food and Drug Administration (FDA) has approved to treat a condition other than the one diagnosed. The pressure on Ivermectin and last year’s with Hydroxychloroquine, were both more affordable remedies than other top dollar treatments or even vaccines.

Why The Controversy? Politics

The government under both Republican and Democratic administrations tried to dictate what treatment should be used to treat Covid infections. “The now vice president of the United States declared during the debates in 2020 that she would not take a vaccine based on who the president was and what he recommended,” Dr. Goldstein said. “Any medical recommendation from anyone other than a doctor familiar with a patient’s history is not credible.”

Off Label Successes

There are many examples from the history of medicine where an individual physician working alone has made a major breakthrough with what was at the time thought unconventional. “Dr. Ignaz Semmelweis saved the lives of numerous mothers by suggesting OB doctors wash their hands before delivering a baby,” Dr. Goldstein said. “He was ridiculed by the medical establishment at the time as the germ theory of infections was not yet discovered.”

More recently two Australian doctors, Barry J. Marshall and Robin Warren, found that stomach ulcers were caused by bacteria. “They also were ridiculed by the medical establishment until they won the Nobel Prize,” Dr. Goldstein told his listeners.

Stop Politicizing Medicine

Dr. Goldstein’s conclusion from this latest flap regarding off-label prescriptions, “allow physicians to pursue different treatments for Covid. Stop politicizing the treatments and stop publishing premature articles in the press for or against any unproven treatment.”

About The Houston Healthcare Initiative

The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To learn more about the Houston Healthcare Initiative please visit www.houstonhealthcareinitiative.org.

3 Goals: Healthcare Changes to the American Families Plan Could Create Affordable Healthcare

Hand writing What You Need To Know with marker, business concept background

3 Goals: Healthcare Changes to the American Families Plan & Health Savings Plans Could Make Medical Expenses More Affordable.

The new administration, like all of them, has plans for Americans and their healthcare. On this edition of the podcast Dr. Steven Goldstein, who founded the Houston Healthcare Initiative, will get us all better acquainted with what those proposals are and explore other possible ways for how healthcare can be fixed. The Biden administration has three goals.

3 Healthcare Changes are Goals for the Biden Administration.
There are three healthcare priorities for the Biden administration plus one more that Dr. Steven Goldstein suggests.

To listen to the podcast, click this link: https://soundcloud.com/harold-nicoll/three-biden-administration-healthcare-goals-plus-one-not-included. 

The Covid 19 Response

Of the three goals, first is the Covid-19 pandemic response. Part of the goal is to prevent over capacity of limited hospital beds and critical care space during spikes in the virus outbreak, like those occurring now. Others include the ability to establish temporary hospitals and better ways to track Covid surges via technology. Making telehealth options more widely available, tasking all relevant federal agencies to set up temporary hospitals and getting the Center for Disease Control (CDC) to develop real-time tracking dashboards to better predict when surges will happen, where they are and other details needed to better inform healthcare professionals about the evolution of the pandemic.

The Affordable Care Act

The second of the three priorities has to do with the Affordable Care Act, or as it is more popularly known, ObamaCare.

The idea is to reduce medical costs for the American public. As part of a separate pandemic relief bill, there is $34 billion to help Americans who buy insurance from the health plan marketplaces that were created by Obama Care now through 2022.  Those who know about it state that this would help lower and middle-income Americans who have fallen through the cracks of the government’s eligibility requirements for ObamaCare subsidies. It would also help people who choose policies with lower premiums and higher deductibles. There is also assistance for the unemployed.

Medicare Reform

One of the more visible proposals is to increase the age of people who are eligible for Medicare from the current 65 to 60 years of age.

“While we can think of these as beneficial to society, there is a considerable cost that comes along with it,” Dr. Goldstein told his listeners. “Instead of transferring more money to people, there are other ways to use existing healthcare payment strategies that will benefit everyone.” So why not fund Health Savings Accounts (HSA’s) with this same amount of money?  It is tax-advantaged when received, if the money earns interest while in the health savings account the account owner can keep it and be prepared to pay cash for more health-related expenses. So what is a health savings plan?

Prescription Drugs

The Trump Administration launched a “Transparency in Coverage” ruling in December of 2020 that required health insurers to disclose current drug prices and provide patients with personalized cost estimates. The Biden Administration hopes to increase these efforts by repealing existing laws that prevent Medicare from negotiating lower prices with drug corporations. “Plenty of people believe that the government already uses its mass buying power with Medicare to negotiate better rates,” Dr. Goldstein said. “That is not the case.”

Health Savings Accounts

The Health Savings Account. or HSA, is a type of savings account that is used for medical expenses. HSA’s were established for those with high deductible health insurance coverage. HSAs and high-deductible health plans were created to help control health care costs. The idea is that people will spend their health care dollars more wisely if they’re using their own money. The money deposited by individuals into their HSA account is not taxed.

Further, HSAs feature a triple-tax benefit: money you contribute to your HSA can be written off on your taxes and thus reduce your income tax bill; money in your HSA grows and compounds assuming investments rise. All is tax-free over time; and when HSA money is withdrawn for qualified medical expenses, no tax is paid on the withdrawal. It is owned by the individual so that he or she can pay their healthcare costs. These include everything from doctor visits to blood tests, paid for with cash from the health savings accounts.

As always, information about this and more than 50 other podcasts can be heard and read about at the website, www.houstonhealthcareinitiative.org.

About The Houston Healthcare Initiative

The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To learn more about the Houston Healthcare Initiative please visit www.houstonhealthcareinitiative.org.

The Number of Primary Care Doctors is Shrinking, and That is Really Bad News

Primary care shrinking
Access to primary care physicians is a matter of the number of doctors who choose to pursue primary care as a career. Pay for those roles is lower than it is for most specialists and no surprise, fewer are choosing to go into this important part of the healthcare profession.

On the Houston Healthcare Initiative Podcast

The Number of Primary Care Doctors is Shrinking, and That is Really Bad News

July 20, 2021 – The Number of Primary Care Doctors is Shrinking. An important contributor to the health of Americans is shrinking and the effects on the overall health of people in this country is and will continue to be negatively impacted. This is the subject of the latest edition of the Houston Healthcare Initiative Podcast.

Lower Pay

Fewer medical school graduates are choosing primary care because it pays significantly less than other specialties. Worse still, a lower number of primary care doctors is linked to 85 deaths every day, according to a study published by the National Academy of Sciences. Can primary care doctors make more money? “Under the current system of payment via employer funded health insurance it will be challenging to make that case,” Dr. Goldstein said. “But there may be a chance for new primary care doctors to ignore most of the insurance companies and their accompanying rules and work on a cash basis.”

Cash Only Please

Even patients who have their own health insurance can often save themselves money by paying cash. Doctors will not have to hire staff to process insurance claims, hassle with them over payment or non-payments. Patients save money on premiums and the doctors have fewer expenses. Patients pay less, doctors keep more of the fees because of lower expenses.

Covid Pandemic Bankrupts Many Practices

In addition to a shortage of practicing doctors, primary care visits declined significantly during the COVID-19 pandemic. Add to that a good number of primary care practices were not able to access federal funds and relief and went under. “If these trends continue, it will have a very negative impact,” Dr. Steven Goldstein told his listeners. “Regular visits to the primary care or family doctor allows that physician the chance to know his or her patients better. What are their medical histories, prescribed medication, allergies, or family histories that could affect a diagnosis? These are details that the primary care doctor will know because he or she has a history with patients.”

What Difference Does It Make?

A single visit to a primary care doctor makes a difference for the patient. “When you get sick, that doctor knows how to treat you,” Dr. Goldstein said. Primary care is a health care component where an increased supply is associated with better population health and more equitable outcomes. “For this reason, primary care is a common good, which makes the strength and quality of the country’s primary care services, or its lack, a public concern.”

About the Houston Healthcare Initiative Podcast                                                                   The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To hear the podcast go to: SoundCloud, iHeartRadio, Stitcher, Backtracks, LibSyn, or the website at www.houstonhealthcareinitiative.org. Dr. Goldstein insists that for the health and welfare of the American public, the congress must pass reforms that limit the influence of the pharmaceutical industry and its lobby.

UnitedHealthcare and the non-emergency emergency… Who Decides If You Need To Visit The Emergency Room?

UnitedHealthcare
UnitedHealthcare delayed a controversial decision to retroactively declare treatment in an emergency room not an emergency.

UnitedHealthcare and the non-emergency emergency…

Who Decides If You Need To Visit The Emergency Room?

On the latest edition of the Houston Healthcare Initiative podcast, respected neurologist and Houston Healthcare Initiative founder Dr. Steven Goldstein discusses the proposed UnitedHealthcare policy of after the fact review and in some cases possible denial of  some emergency room visits. The Houston Healthcare Initiative podcast can be heard on: SoundCloud, iHeartRadio, Stitcher, Backtracks, LibSyn, Soundcloud, or the website at www.houstonhealthcareinitiative.org.

Declaring the Emergency, a Non-Emergency

UnitedHealthcare is the nation’s largest health care insurer. In early June 2021 UnitedHealthcare announced that it would change how they assess emergency department claims, and thus allow ‘United’ to retroactively deny claims it deemed “non-emergent” or not an emergency. The aim is for the insurance company and their customers to save money, but others say the consequences could be more costly or even deadly. The new policy was originally scheduled to begin on July 1, 2021 but after a wave of criticism from among others, the American College of Emergency Physicians, United backed off and later said they would wait until the pandemic was past to make a decision about this decision.

Bad Policy With Usual Solutions Tried

Like the American College of Emergency Physicians Dr. Goldstein also believes this policy is unwise. “The answer is not to retroactively deny payment for ER care already rendered,” he told his listeners. “What this does is force the hospitals to refuse care for “non-emergency care” as defined by UnitedHealthcare. However, this is not practical because the hospital is more afraid of a potential lawsuit if a patient is refused care and has a poor outcome as a result. The patient then will be stuck with a large bill that cannot be paid.”

Dr. Goldstein states this is another example of an insurance company trying to “manage care.” “They (insurance companies) see a problem, namely they think that Emergency Room services are over-utilized and think they can manage the problem,” Dr. Goldstein said. “They try their usual method of operation and simply deny payment.”

On The Other Hand

UnitedHealthcare claims there are big problems with the misuse of emergency rooms which costs the U.S. healthcare system roughly $32 billion annually. UnitedHealthcare states that misuse typically manifests as patients seek out costly care for minor ailments that could be addressed through other avenues like an urgent care type of clinic. According to the UnitedHealthcare web site, “two-thirds of hospital ED visits annually by privately insured individuals in the U.S. – 18 out of 27 million** – are avoidable.”

Does UnitedHealthcare Have A Point?

Dr. Goldstein stated that United had a point “if the point is that healthcare administered in an emergency room is too expensive.” But he also point out, “UnitedHealthcare negotiated the prices they pay with the hospitals. If it is too expensive, why did they negotiate such a high price?”

About the Houston Healthcare Initiative Podcast

The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To hear the podcast go to:

Dr. Goldstein insists that for the health and welfare of the American public, the congress must pass reforms that limit the influence of the pharmaceutical industry and its lobby.

8 Questions and Answers… What to Know When Considering a New Doctor

8 Questions and Answers…

What to Know When Considering a New Doctor

What to Know When Considering a New Doctor. Eight answers from a practicing physician. 

May 11, 2021 – What should anyone know or ask when considering a new doctor or primary care physician? On his regular podcast, Dr. Steven Goldstein, founder of the Houston Healthcare Initiative tells his listeners what to know and ask when considering a move and why we all even need our own primary care physician. Below is a list of questions and Dr. Goldstein’s answers to them.

Where to Listen

To hear the Houston Healthcare Initiative podcast, visit one of the following: :  Apple Podcasts, LibSyn, Spotify, Radio.Com, Listen Notes, iHeart Radio, Podcast Addict, Podbay, Backtracks, Player FM, Stitcher, and SoundCloud.

Questions and Answers

  1. Why is choosing a regular or primary care doctor such a big deal?

“If you don’t have a regular or primary care doctor, you could be missing out on a very important relationship with someone in a position to help you stay healthy and live the best life possible.  Over time, a regular or primary care doctor learns all about you and your history. So, choosing one is very important and the right time to find one is when you do not need one for any type of immediate care.”

  1. A regular primary care physician knows us, which is good. But what other reasons are there to have one?

“People with primary care doctors are more likely to get preventive services, including cancer screenings, and report significantly better health care access. According to the Journal of American Medicine, Americans with primary care doctors received significantly more high-value care and reported significantly better health care access and experience. Patients in states that spend more on primary care have fewer hospitalizations and emergency room visits. So, there is no doubt that a regular or primary care physician is an important part of anyone’s health and well-being.”

  1. How does one go about finding a primary care doctor?

“Make sure that the doctor you choose or consider, offers easy access – either by phone, email, telemedicine visit, or office visit. You should shop the price and accessibility in advance so that you are not desperate when a health issue arises. An alternative is to identify a doctor hotline to call in an emergency.”

  1. How does the patient know if he/she can afford care and what is the best way to pay?

“When you make an appointment with a new doctor, ask what the cash price for your initial visit will be and ask to compare it to the discounted price your insurance company has negotiated. You may need to speak to the billing office or the office manager to find this out. A common answer is that it depends on the complexity of your problem. When you hear this ask, ‘can you give me a range from a routine to a complex visit? Can you also tell me what my insurance allows?’ If you have the temperament, you can also try to negotiate a cash price. If you are treated poorly or they refuse to give you this information, find another doctor.”

  1. What should a new patient expect on their initial visit?

“When you first arrive, you will be greeted by a receptionist and given multiple forms to complete in the waiting room. Make sure when you come to the ‘consent for treatment’ form you are not agreeing to any test the doctor orders, but you reserve the right to accept or refuse any test in advance. Then you will be escorted to a room where a medical assistant will record your symptoms, take your vital signs and depending on the doctor’s specialty might wish to perform ‘routine’ tests. You can feel free to question the reason for these tests and have a perfect right to refuse them if you do not understand.”

  1. So, some tests are not really needed?

“Precisely. But it is not because anyone is being dishonest. According to a study in the journal Academic Emergency Medicine, the top two reasons doctors ordered tests was fear of missing something that would help them diagnose their patients, and protection against malpractice. The authors of that survey also say that nearly all of the emergency room doctors—97%—admitted to personally ordering unnecessary imaging tests.”

  1. It’s easy for people to be intimidated by their doctor and not be keen to pose questions. So, to help get us started what should we ask?

“You can ask how the doctor arrived at the diagnosis. You can ask if doing any of the tests ordered will affect his treatment plan and are there alternative ways of arriving at the diagnosis. You can ask about the prognosis and what to expect from treatment including possible side effects and what to expect if the condition is untreated. At the end, send yourself another text when the doctor leaves the room. This will document the time the doctor spent with you and this information can be useful to be sure you are not overcharged, your time with the doctor was adequate and a good value.”

  1. I know my primary care doctor has some lab testing capability in his office and others also have x-ray machines. The convenience notwithstanding, are we obligated to do the tests where the doctor sends us?

“No. There is no need to get testing done at the doctor’s office

or at a facility recommended by the doctor. These prices are almost always better at an independent facility and are usually much better than the insurance company discounted price. Your objective is to be as healthy as possible. But no one should have to go broke in the process.”

More Than Just Another Doctor

A primary care physician is more than just a doctor. Over time, he or she learns the nuances of their patients’ medical history, reaction to medications, health goals, lifestyle, treatment preferences and whether or not a caregiver is supporting you in managing the individual’s health. Nothing is more personal. Paying for it is also personal. The time to check prices and ask questions is early in the process of selecting a doctor, not when arriving in an emergency room. Remember too that those who have a regular or primary care physician will be in better shape because of it.

Conclusion

Listen to the over 50 episodes of the Houston Healthcare Initiative podcast on the website, which is www.houstonhealthcareinitiative.org. Plus, there is lots of other information associated with those podcasts and news coverage about Dr. Goldstein and the work he does with the Houston Healthcare Initiative.

 

The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To learn more about the Houston Healthcare Initiative please visit www.houstonhealthcareinitiative.org.

Where did the money go? Insurance companies keep about 33% Healthcare By The Numbers

Where did the money go? Insurance companies keep about 33%… 

Healthcare By The Numbers

Where did the money go? What is the American public buying when it pays for its health insurance and is it a good value? If the public knew that their insurance company kept as much as 33% of what they spent how would they react? While there is nothing wrong with making a profit, there is also no issue with insisting that money provide a good value. On his weekly podcast, Dr. Steven Goldstein describes in detail where all that money goes. The Houston Healthcare Initiative podcast can be heard on : Apple Podcasts, LibSyn, Spotify, Radio.Com, Listen Notes, iHeart Radio, Podcast Addict, Podbay, Backtracks, Player FM, Stitcher, and SoundCloud.

Where Does That Money Go?

Most people and their families who have health insurance, have it through their employer. The business pays for some if not most of the premiums and the employees pay deductible and out of pocket costs. But where does all that money really go? Does the public purchase more benefits or receive a better value as a result of what they were charged for that insurance?

Hospitalization Charges & Costs

When Paying for Healthcare?
Is what the public paying for healthcare and health insurance a good value?

Dr. Goldstein told his listeners, that in 2018 the average cost of hospitalization was about $10,000.00. The average charge for hospitalization with private insurance was about $20,000.00, thus the amount charged was double the cost. “Now let’s multiply that same number by a sample of the population, Dr. Goldstein proposed. “The average number of hospitalizations per year was about 9 for every 100 people. So, for those nine, the amount the insurance company collected was $180,000.00.” But there was more to healthcare payments than simple hospitalization. “People often go to the doctor and have what are classified as outpatient charges. Those are charged at about $500.00 a year, per person,” he said.

Add Drug Costs

The drug costs across the population were estimated at $1200.00 each. “We can reasonably assume that drug costs are higher for the over 65 population,” Dr. Goldstein said. “Now, for people under 65 years of age the expense estimate is less. So, the amount paid overall by the population of 100 people is about $500.00 each. The total for 100 people at $500.00 each is another $50,000.00.”

Factor Insurance Into The Equation

To get to the ultimate amount of money spent and where it all ends up, the cost of insurance factors in. “Say someone has a $50,000.00 deductible along with discounts they receive from the Preferred Provider Organization (PPO), we can figure a $20K discount for our 100 people,” He said. “Or charges to them all of $30,000.00.”

It is here the distinction between price and costs reveal an interesting outcome. Insurance will generally pay two thirds of the cost with the other, remaining third paid by the individual in the form of co-payments and applied deductions. “If we add these costs together, we find the total charges for 100 people = $300,000.00,” Dr. Goldstein declared. So where does the other one third go?  “The very cheapest Blue Cross policy for a 31-year-old male living in zip code 77096 (the Houston are) was $257/month or $3084/year, said Dr. Goldstein. “The cost for 100 people would be $308,000.00 annually but would have a $7400.00 deductible.”

For someone age 50, the cost was $4000.00 annually. The high deductible means that outpatient care is not paid for and that the insurance only pays for the reinsurance and hospitalization costs of $200K. So, who benefits the most from these expenditures?

No surprise, it’s the insurance company. “The gross profit for them is at least $100K. That is income per 100 patients of at least $300K less claims of $200K.” Is this a good value for the public? It’s a fair question and good way to think about healthcare costs.

A study in ‘Health Affairs’ co-authored by a Princeton University health economist, found that Americans use the same amount of health care as residents of other nations. They just pay more for them. U.S. hospital prices are 60% higher than those in Europe. Government efforts to reform health care and cut costs raised them instead. “Our system is broken and needs to be overhauled,” Dr. Goldstein said. “Efforts at reform, that we have talked about before on the podcast, are a waste of time and effort when the overall system for providing and charging for healthcare is so fundamentally broken.”

About Dr. Steven Goldstein and the Houston Healthcare Initiative

The Houston Healthcare Initiative (HHI) was founded by respected, Houston neurologist Dr. Steven Goldstein. Like many Americans, Dr. Goldstein is concerned about the state of the U.S healthcare system and the sorry state of the public’s health. The Houston Healthcare Initiative web site is an aggregator of news, healthcare pricing information, and resources for those who want to help drive reform for the healthcare industry. HHI’s emphasis for reform is on free market innovation and personal responsibility. Learn even more here at https://houstonhealthcareinitiative.org/about-us/.

The goal of the Houston Healthcare Initiative is to be a catalyst for change in the way Americans receive and pay for medical treatment. To cause change the site aggregates information, tools, and targets for the reform of the healthcare industry with an emphasis on free market innovation and personal responsibility. Visit online at www.houstonhealthcareinitiative.org.

Healthcare by the Numbers

Where Does the Money Go When Paying for Healthcare; Prices, Costs, and Value…

Healthcare by the Numbers

March 23, 2021 – On the latest edition of the Houston Healthcare Initiative podcast, Houston based neurologist and the founder of the Houston Healthcare Initiative Dr. Steven Goldstein, describes the numbers and dollars associated with health insurance and hospitalization costs. This to inform us all where the money that individuals and employers contribute goes and who really profits most.

Dr. Seven Franklin
Where does your money go when paying for health insurance?

The answers are surprising when it comes to cost, price, and the ultimate value those with health insurance derive from the premiums they and their employers all pay. Ultimately, did the public purchase more benefits or receive a better value as a result of what they were charged? “There is nothing wrong with making a profit, but most people will want to know what they bought and was it worth it,” Dr. Goldstein told his listeners.

Additionally, Dr. Goldstein describes the profits hospitals and health insurance companies accrue, what percentage of their payments actually go to help pay for their healthcare and how much the insurance companies keep. All this to help the public decide if this money was well spent or if it could be better managed.

Where To Listen

The Houston Healthcare Initiative podcast can be heard on: Apple Podcasts, LibSyn, Spotify, Radio.Com, Listen Notes, iHeart Radio, Podcast Addict, Podbay, Backtracks, Player FM, Stitcher, and SoundCloud.

About the Houston Healthcare Initiative

The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To learn more about the Houston Healthcare Initiative please visit www.houstonhealthcareinitiative.org.