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ObamaCare Update
In
the March 8-9, 2014 weekend section of the Wall Street Journal, there was a very
interesting article entitled, "The Making of ObamaCare." It was particularly
interesting because it was penned by Dr. Ezekiel Emanuel, Rahm Emanuel's
brother, who also happens to be a physician and special advisor to our President
on health policy. The article concentrates on three major policy points that
relate to ObamaCare which merit our consideration, and we will discuss each, as
follows: firstly, the change of policy as to how doctor's bill insurance
companies for services rendered to their insured patients.
Currently, the vast
majority of doctors charge individual fees for services rendered. The new
approach would be for doctors to bundle payments rather than charge for
individual fees for services. This means that a doctor would bill for a medical
"episode of care" rather than for each individual service rendered. There
appears to be concern that doctors-and hospitals-bill for procedures
unnecessarily just to make money, a practice I have not seen with any of my
doctors, personally. With hospitals, it is impossible for me, or any consumer,
to tell. Hospital bills, when the patient receives them at all, are
indecipherable to the layman.
So there is a push to
change this. The White House is excited about this change because policy makers
believe the change will control costs, and, hopefully, will improve patient
care. It is undisputed that any efforts to avoid or discourage fraud are
preferable and prudent. While it was not adopted across the board, ten test
projects have been implemented to see how this new approach works.
Secondly, The
President, along with the support of the American Medical Association, has begun
consideration of major medical malpractice reform at the federal level. This
will be challenging because, ordinarily, the area of medical malpractice is
controlled by local governments, but an attempt to reign in the current climate
of the institution of massive malpractice claims is a positive thing. Finally,
in 2018, a "Cadillac Tax" will be levied on the purchasers of expensive medical
insurance plans as a source of revenue to cover the costs of ObamaCare. All of
the foregoing is extremely interesting, and we will be tracking progress for our
readers.
In a related area, the
impact of ObamaCare on Medicaid in New York has proven to be remarkably
positive. Twenty-five percent of New York City residents already receive
Medicaid benefits of one sort or another. There is an effort to combine Medicaid
and the ObamaCare-New York Exchanges under the umbrella of the New York State
Department of Health, where Medicaid already resides. It is envisioned that the
consolidation will enable the New York Exchange's counselors to assist
applicants and provide appropriate services in a more comprehensive, straight
forward and simple manner, with the bonus of excellent consumer outreach. This
places New York in the unique position of already being in the foreground of
medical insurance reform!
We are still greatly
concerned about the lack of protection to an applicant's personal information
when he or she is shopping for medical insurance in New York, or anywhere else,
for that matter. We hope that New York State secures the website soon, so that
applicants can take advantage of what appears to be some excellent options
without fear of identity theft. We will keep you posted as to any developments
in that regard.
The above list is for general information purposes
only. It is not intended to constitute individual legal advice or a specific
recommendation to any particular client.
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