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.

How To ‘Hack’ Your Health Savings Account

How To ‘Hack’ Your Health Savings Account

On the latest edition of the Houston Healthcare Initiative podcast, respected Houston based neurologist Dr. Steven Goldstein describes how people can best use the often-overlooked benefit known as the Health Savings Account.

The Health Savings Account, or HSA, is a type of savings account that is used for medical expenses. Congress established them in 2003 for those with high deductible health insurance. It is a way to pay cash for routine medical care with pretax dollars. Because the HSA requires a high deductible health insurance account, routine healthcare expenses are not covered, but can be paid for by the HSA. HSA’s are potentially a good value for those who can take advantage.

The High Deductible Health Insurance Plan

A high deductible insurance plan is one where the deductible is higher than with other policies. The ‘deductible’ is the amount the patient has to pay out of pocket before the insurance kicks in. A high deductible is usually between $3,000 – $10,000. “Of course, the higher the deductible; the lower the premium,” Dr. Goldstein told his listeners.

Who Should Consider an HSA?

First, who is this not for? “If you are already sickly and have $5-10,000 in medical expenses every year, the high deductible policy with HSA is probably not for you,” Dr. Goldstein said. “The time to start a high deductible plan with HSA is when you are young and well. Even if you had $10,000 in expenses in one year, it is highly unlikely these expenses would continue every year.”

Tax Free Deposits

The money deposited into the HSA account is not taxed. Many companies contribute to an employee’s HSA to encourage its use. Further, HSAs feature a triple-tax benefit: money the employee contributes to the HSA can be written off on taxes and thus reduce an income tax bill. “Money in your HSA grows tax free, Dr. Goldstein reported. “When you withdraw money for qualified medical expenses, no tax is paid on the withdrawal. However, if you withdraw money for non-medical expenses, you do pay tax as well as a penalty.”

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. Houston Healthcare Initiative seeks to change the way people think about healthcare. Find healthcare pricing and local provider rates!

 

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.

How Haven Failed at Repairing America’s Healthcare System

How Haven Failed at Repairing America’s Healthcare System. The reason that healthcare and associated costs for medical treatment are so high is the way pricing is established, managed care. Making healthcare more affordable and accessible was what Haven was supposed to do.  Its failure to address how prices are kept artificially high via managed care was among its biggest failures.

The lessons available from this epic ‘bellyflop’ are the subject of the latest Houston Healthcare Initiative podcast, hosted by respected Houston based neurologist Dr. Steven Goldstein. The Houston Healthcare Initiative podcast can be heard on: SoundCloud, Radio.com, Spotify, ListenNotes, iHeartRadio, Podcast Addict, Stitcher, BackTracks,PlayerFM, and the Houston Healthcare Initiative web site.

Resource Rich but Still A Bust

Haven was a joint venture between Amazon, Berkshire Hathaway and JPMorgan-Chase. Its purpose was to use the leverage of its tens of thousands of employees and its expertise in technology to improve the healthcare system.

Managed Care Keeps Prices High

Haven Failed to Fix Healthcare
How Haven Failed at Repairing America’s Healthcare System. Haven was a $100 million bellyflop of a failure, as represented here.

Haven worked at the edges of what really made medicine expensive and avoided the fundamental challenge of the managed care model. “We need a system that enables hospital systems to profit from the improved health of the population rather than the amount of ‘sick care’ delivered,” Dr. Goldstein told his podcast audience. “Innovative ideas need to focus first on improving health. The only way for this to happen is for hospital systems to profit from this outcome.”

How?

One example of how to accomplish this, is for hospitals to offer Medicare pricing to patients without insurance at Medicare rates. In return for the discounted prices, patients would pay the hospital a monthly fee. They would also pay a monthly fee into a savings account in order to pay the hospital bill. In this scenario, the hospital would collect the monthly fee even if no patients were admitted to hospital. If patients were kept well, the need for hospitalizations would decrease. “In this environment, the innovative ideas of Haven would have found a much warmer reception,” Dr. Goldstein said.

No Reason for Change or New Ideas

Haven also failed to understand why the medical business was not interested in new, innovative ways to provide and charge for medicine. The reasons were simple. Insurance companies and providers make lots of money from the current way of doing things,” Dr. Goldstein said. “There are few enticements for them to change and why should they when money is pouring in and there is no pressure to do things differently.”

Thanks, But No

Would the ‘industry’ be open to creative ideas and problem solving when it comes to pricing, service delivery or an emphasis on making the public healthy and not just treating illness? “Probably not,” Dr. Goldstein reported. “The current system of managed care frowns on innovation. It controls innovation by only paying for services that have codes. It likes to use words like usual and customary. Medicine lags behind the tech world by approximately 25 years. So no, in a change averse industry I would not look for any creative approaches to take place except over long periods of time.”

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.

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.

With Haven in the rearview mirror… Failures to Reform U.S. Healthcare System Are Because the System Is the Problem

Haven Failure
In spite of the high tech ability and deep pockets of the joint venture partners, Haven went out of business on January 31, 2021.

Big fail. Haven, a joint venture between Amazon, JPMorgan-Chase, and Berkshire Hathaway, booted the chance to reform their collective employee health insurance, in part, by not working on the correct challenge, according to respected neurologist Dr. Steven Goldstein.  Dr. Goldstein hosts the Houston Healthcare Initiative podcast with a focus on reforming the highest priced healthcare system in the world. Haven is the most recent, but likely not the last, story of corporate good intentions not delivering what was hoped. So, what’s the right challenge?

The System Is the Problem

“Our current healthcare system is focused on treating sick people, not preventing illness,” Dr. Goldstein told his audience, and he gave an example. “The more people there are in hospital beds, the more money is made by the hospitals, doctors and everyone else involved in patient care.” The U.S. healthcare industry is a volume-based scheme of reimbursement for getting paid. Better patient health is not part of the current equation.

More of the Same

The business system Haven tried to disrupt offers no tie to healthier outcomes for patients or incentives for those same people to take better care of themselves. “It’s just more of the same,” Dr. Goldstein said. “Haven failed at reforming their collective employee health insurance in part by not working on the correct challenge but instead ‘worked on the fringes’ of a non-competitive business.”

Worthy Goal but Poor Execution

At Haven, the published goal was improving healthcare services and lower costs for the three companies’ employees. With a heavy reliance on ‘big data’ and the ability to analyze patient information in big amounts, Haven promised to make primary care easier to access, prescription drugs more affordable and render insurance benefits easier to understand. While essentially getting nowhere but costing a lot of money to get there, Haven shut down without affecting the healthcare industry at all.

Healthcare as a Commodity?

The best way to ensure an adequate supply of anything at the lowest possible price is to permit the laws of supply and demand to work. “But as we also know, that is not what we have and not the way costs are assigned or managed by insurance companies, hospitals and pharmaceutical companies that assign prices,” Dr. Goldstein said.

Employee & Patient Voices Heard for a Change?

The public has little to say about how pricing is determined but could have a great deal to say with the right type of organization. The correct method available to everyone is via the non-profit, employee-owned healthcare cooperative.

The cooperative or ‘co-op’, can replace traditional health insurance for qualified individuals and families. Co-ops can also provide incentives for members to adopt healthier lifestyle habits. Financial incentives based on lifestyle would result in lower healthcare costs by decreasing utilization. Ownership of the cooperative would pass the savings from the cooperative to the employees. Co-ops can allow employees to remain members even if they leave the company. By transferring ownership of the cooperative to the employees, companies are no longer responsible for healthcare and can concentrate on their core business.

How Co-ops Work

Co-ops provide affordable medical coverage through a combination of negotiated rates, low monthly payments, personal accountability and lifestyle incentives. “By organizing their workers and families, businesses of any size can overcome this less than efficient way of doing things,” Dr. Goldstein said. “For example, financial incentives based on choices about diet and exercise will result in lower healthcare costs by decreasing utilization. The ownership of the cooperative will pass the savings from the cooperative to the employees. But there are other benefits that will make those employees healthier.”

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.

For These Uncertain Times What Type of Health Insurance Is Best?

In wake of the election which insurance is best?
Three in ten uninsured adults in 2019 went without needed medical care due to cost. 

In wake of the 2020 election outcome…

For These Uncertain Times What Type of Health Insurance Is Best?

November 24, 2020 – According to Dr. Steven Goldstein, founder of the Houston Healthcare Initiative, “with the current system we have, I would buy a policy that has a high deductible,” he told his podcast audience. “This is sometimes known as ‘catastrophic’ health coverage. Then I would pay cash for my health expenses.”

That times are unsettled was never truer than in 2020. With the U.S. House and the presidential election settled, the majority of the senate remains undecided and will stay that way until the two runoff elections for both Georgia senate seats on January 5, 2021. The implications for the U.S. healthcare system are many. What can or should Americans do in the near term? Listen to “The Houston Healthcare Initiative Podcast to find out. The Houston Healthcare Initiative podcast can be heard on SoundCloudGoogle PlayLibsyn FeedStitcheriHeartRadioSpotify, and the Houston Healthcare Initiative web site.

Cash & Catastrophic Coverage

According to Dr. Goldstein, cash payments are accepted for most if not all medical charges and prescription drugs. Do not try to get the ‘insured’ rate to put against your deductible. Paying cash is much less desirable with the insured rate. “Most people will never reach their deductible amount anyway,” he said. “This arrangement is the best value for people under the current system. So, while at the doctors’ office show them your insurance card but tell them you are paying cash.”

Return of the Mandate?

Most Americans get their health insurance through their employer. The Affordable Care Act, also known as Obama Care, made more choices for insurance available and penalized people who did not purchase health insurance. While not ideal, it was a way to get more people covered by private insurance than before. Plus, it offered subsidies for those who could not afford insurance.  But at the same time, it was the mandate and accompanying monetary penalty that seemed to make the policy so unpopular with many. “The overall insurance industry and its approach to paying for healthcare are very flawed in fundamental ways,” Dr. Goldstein told his listeners. “We can spend time and money to make a bad system work better and that is probably what will happen in the near term.”

Likely Short-Term Changes

Some near-term changes are likely to be mandates for private firms and their employees to provide for and buy health insurance. The cost of care for uninsured workers is often passed along to the insured through taxes and other mechanisms. There are employed people now who go without health insurance and keep the part of their pay that would go to health insurance. One economic rationale for employer mandates is that the cost of care for uninsured workers is often passed along to the insured through taxes and other mechanisms. Mandates are, in part, an attempt to eliminate those who opt out of available coverage.

American Attitudes About Caring for Each Other

Generally, Americans have decided that we will treat sick and injured people who do not have insurance, but that treatment is not free. “So, we have all these schemes for the uninsured, or others to make people buy insurance,” Dr. Goldstein said. “While caring for the sick and injured is laudable, paying for it is another matter, like with the Obama Care mandate.”

Three in ten uninsured adults in 2019 went without needed medical care due to cost. Studies repeatedly demonstrate that uninsured people are less likely than those with insurance to receive preventive care and services for major health conditions and chronic diseases. Not having insurance is generally a financial issue and one that leads to unhealthier people. “With the catastrophic coverage, patients are able to be seen as many practices will not see anyone without insurance,” Dr. Goldstein said. “Paying cash for services and not applying them to the deductible will both save money and result in a healthier population.”

About 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.

Are There Alternatives To Traditional Health Insurance?

Alternatives to Health Insurance

November is health care selection month…

Are There Alternatives To Traditional Health Insurance?

November 16, 2020 — With November the time many Americans are asked to choose their health insurance coverage, the cost, expense, and value are on people’s minds. Are There Alternatives To Traditional Health Insurance? Healthcare is expensive. The healthcare and medical insurance industries are massive with billions of dollars of income. They are able to buy advertising and lobbyists to gain every advantage that money can buy. As Americans try to find ways to pay for it, do any really have any chance of meaningful change for an industry that all but regulates itself? Or should we just resign ourselves to healthcare and insurance companies doing and charging what they want with little if any restriction on them?

Alternatives To Big Insurance

According to Dr. Steven Goldstein, founder of the Houston Healthcare Initiative, there are ways to be insured and save money. As he told his podcast audience, the best alternative to insurance at this time is the healthcare cooperative. The Houston Healthcare Initiative podcast can be heard on SoundCloud, Google Play, Libsyn Feed, Stitcher, iHeartRadio, Spotify, and the Houston Healthcare Initiative web site. When combined with a health savings account and a high deductible, sharing of healthcare costs will go down.

Take Care of Yourself

Of course, the best way to lower costs is to lead a healthy lifestyle. Exercise, diet, limited alcohol consumption, adequate sleep and not smoking are the best ways anyone can be healthier. But for those who refuse these, there should be consequences. “There needs to be consequences for individuals that do not take care of themselves,” Dr. Goldstein told his audience.   “For those that do nothing, laws need to be changed so that care would only be provided at charity hospitals. I know this is a radical change of thinking, but I believe it would go a long way to improving public health. Subsidizing unhealthy behavior only leads to more unhealthy behavior.”

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 learn more about the Houston Healthcare Initiative please visit www.houstonhealthcareinitiative.org.

Compare Democratic and Republican Healthcare Plans and What the Public Can Do About Them

Compare Healthcare By Party

Compare Democratic and Republican Healthcare Plans and What the Public Can Do About Them. The healthcare and medical insurance industries are massive with billions of dollars of income. They are able to buy advertising and lobbyists to gain every advantage that money can buy. To listen to the podcast, click below. 

Do we really have any chance of meaningful change for an industry that all but regulates itself? Or should we just resign ourselves to healthcare and insurance companies doing and charging what they want with little if any restriction on them? On this podcast, with what is a more optimistic point of view is respected Houston based neurologist and founder of the Houston Healthcare Initiative, Dr. Steven Goldstein.

Healthcare reform according to the Democrats is some form of single payer system. According to the Republicans it means more price transparency and more competition between insurance companies. The Democratic reforms will indeed lower healthcare costs by fiat and not cause any appreciable decline of public health. However it also will not improve public health. It will however make individual patients unhappy because of rationing of care. The Republican reforms will have little effect on lowering costs but will avoid the rationing of care. It also will not improve public health. No matter which reforms are adopted patients will be unhappy with the results. Also no legislation will be passed without the blessing of the insurance companies, pharmaceutical companies and hospitals.

What Can The Public Do?

Individuals and companies need to walk away from the insurance system. If enough companies  and individuals leave, the current system will collapse. The best alternative to insurance at this time is the healthcare cooperative. When combined with a health savings account and a high deductible sharing of healthcare costs we can begin to see a gradual reduction in cost. Of course, the best way to lower costs is to lead a healthy lifestyle. This will indeed improve public health. For the medicare age groups, the managed medicare plans lower costs by partial rationing of care combined with encouraging a healthy lifestyle. I do not have the statistics as to whether or not managed medicare plans improve public health.

What About Obamacare?

Didn’t the Affordable Care Act, also known as Obama Care, make more choices for insurance available and penalize people who did not purchase health insurance?Yes, but look what happened to health insurance premiums. They kept rising even faster than before. The subsidies, while allowing more people to be covered by insurance, were a boon to the insurance companies allowing for the increase of premiums and increasing the number of policies sold. This is why the insurance companies and hospitals were in favor of the bill in the first place. We can see the result- higher premiums. Things are worse than they were before. The overall insurance system is flawed in fundamental ways. We are spending time and money to make a bad system work better and that is probably what will happen in the near term.

There needs to be consequences for individuals that do not take care of themselves.             They can subsidize the government insurance by paying the government a higher premium; pay for care themselves or do nothing. For those that do nothing, laws need to be changed so that care would only be provided at charity hospitals. I know this is a radical change of thinking but i believe it would go a long way to improving public health. Subsidizing unhealthy behavior only leads to more unhealthy behavior.