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State Level Solution for Legal Costs in Health Care

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Malpractice insurance costs have long been a cost driver in health care, fueling unnecessary defensive medicine with a cost of over $600 billion per year.

Wayne Oliver, the Executive Director of Patients for Fair Compensation steps into the Doctor’s Lounge to explain a State level solution to a national problem.

Following a model similar to worker compensation, Oliver is proposing a doctor driven system of accountability in delivering justice and compensation for patients injured by practitioners in their course of care.

Oliver will be our guest on the Doctor’s Lounge this week, so be sure to tune in!

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GA Gov. Deal signs MOC bill into law

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On May 8, Georgia Gov. Nathan Deal signed a bill into law that will prevent the state’s Medical Practice Act from being used to require Maintenance of Certification (MOC) as a condition of licensure or to require MOC to be employed by a state medical facility or for the purposes of licensure, insurance panels, or malpractice insurance.

Read the full article here.


Discover more about MOC from Dr. Meg Edison who touched off a firestorm in late 2015 when she decided she had had enough of MOC.

Edison exposed MOC (maintenance of certification) for ABP (American Board of Pediatrics) as a large scale money making scheme that allowed its leaders a laundry list of luxuries while costing struggling pediatricians thousands in direct fees, testing, and office based self-reporting. She joined us on the Doctor’s Lounge this past April to discuss it in detail.

 

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Analysis of AHCA on Lance Roberts Show

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BYbfW1hIEAAM83TNational board member, Ori Hampel, M.D. appeared on the Lance Roberts Show to analyze the D4PC Foundation position on the recently passed House version of health care reform (AHCA).

Dr. Hampel explained this was not repeal, but the first of many bills needed to undo the damage done over the decades by government interference in health care.

“Health Care and Health insurance are two separate things. Obamacare took [the insurance based third party model] from expensive to ridiculously expensive.”

“Health care is actually affordable… Under Obamacare, catastrophic insurance plans [combined with innovations like DPC] are not allowed – minimum bronze plans are required.”

Roberts gave Dr. Hampel the time to unpack the problems and succinctly explain the solutions that are possible.  Well worth a listen – a great summary of our principles applied to present events.

Listen HERE.

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From ‘repeal and replace’ to ‘replace and repeal’

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If you decided your car is inadequate, you would not sell it before buying a replacement. Let’s take same approach with health care.

We should listen to Newt Gingrich when he advises taking the health care discussion to the American people.

For example, New Jersey Gov. Chris Christie sold pension reform at 80 town halls. We as Americans want to participate in the process and not submit to top-down edicts from Washington.

Let’s ask President Trump to champion our cause. As patients, we do not have a seat at the table with the insurance, hospital and drug companies.

Those of us who have good jobs and salaries want first and foremost to make sure the sick and poor are cared for. Making health care and premiums affordable for all must follow almost simultaneously.

Read Foster Friess’s complete op-ed in the Washington Times. He is also a guest on this week’s Doctor’s Lounge.

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ObamaCare must be fixed before it collapses

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Trump should be applauded for continuing to move forward on this issue. Republicans defending their positions at town hall meetings deserve recognition too. Sticking with a right and just cause, even when is feels like a losing battle, is admirable. However, doing the same thing over and over again and expecting a different result is the definition of insanity.

So, what should be done differently?

The lack of physician input in creating solutions to the healthcare mess is a good start. However, costs for medical care itself have yet to be adequately addressed.

Dr. Hal Scherz, the founder of Docs4PatientCare Foundation, said recently that “the entirety of the healthcare debate is focused on insurance and coverage, instead of the elephant in the room, which is the high cost of the care patients receive. Unless healthcare costs are dramatically reduced, no changes in how people purchase insurance is going to result in meaningful improvement in overall healthcare costs.”

A recent meeting between Dr. Scherz and Health and Human Services Secretary Tom Price “focused on the regulatory burden on doctors and the necessity of freeing physicians to spend more time with patients.”

Dr. Scherz has a point. What better way to bring down medical costs than to reduce obstacles to providing it? Perhaps it is time to argue for deregulating doctors.

Read the full article at The Hill.

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Heartland Institute – Give Each Medicaid Patient an HSA with $7K

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Heartland.org just published an editorial in the Wall Street Journal that upends the regulatory model of Medicaid by streamlining the benefits and getting “the swamp” of Washington, D.C. out of the way.

By Justin Haskins & Michael Hamilton

The GOP’s recently benched health-care bill would have substantially reformed Medicaid by giving the states block grants, along with more flexibility on how to spend the money. But there’s a better model. Republicans should empower Medicaid patients by providing funds to them directly, which would allow them to build a personal safety net that could last a lifetime. A $7,000 health savings account per year would save the government billions of wasted dollars while expanding personal choice.

Read the full paper here

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Direct Primary Care Model Gains Momentum in Multiple States

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Direct primary care (DPC) is gaining legal momentum at the state level as a viable means for physicians to provide primary care to patients at a lower cost than traditional practice models.

For years, physicians who wanted to adopt DPC had to battle with insurers and state regulators, but now 18 states have enacted laws that recognize the practice model and make it easier for physicians to implement it. Just this year, Kentucky passed new legislation, and West Virginia and Arkansas revised their statutes regarding DPC. Eight other states have pending legislation, and in three of them — Indiana, Colorado and Alabama — the legislation is awaiting only the governor’s signature.

The DPC model once was widely treated by states and the federal government as health insurance. But as a federal bill to address this problem awaits action, many states have moved to exempt DPC practices from unnecessary insurance regulations and to establish rules governing the model, such as restrictions that prohibit these practices from billing insurers for consultations on a traditional fee-for-service basis.

Read the full article here.

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There’s a growing movement of surgery centers and specialists that list their prices and don’t take insurance

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When Cheryl Millican found out she needed surgery, her Dallas-based doctor told her it would cost roughly $38,000 out of pocket.

Millican, who doesn’t have insurance, needed a hysterectomy, a procedure that removes all or part of the uterus. It wasn’t an emergency situation, so when a friend told her about a place in Oklahoma that could perform the surgery for $8,000, she decided to look into it. That included the cost of the procedure itself, an overnight stay, a follow-up appointment, and any other meetings ahead of time.

In August 2016, Millican drove the three hours to the Surgery Center of Oklahoma in Oklahoma City to get the procedure for $30,000 less than she might have paid.

In March, Business Insider reported on a new movement happening with primary care doctors. It’s called direct primary care, and it works like this: Instead of accepting insurance for routine visits and drugs, these practices charge a monthly membership fee that covers most of what the average patient needs, including visits and drugs at much lower prices.

It’s happening at a time when high-deductible health plans are on the rise — a survey in September found that 51% of workers had a plan that required them to pay up to $1,000 out of pocket for healthcare until insurance picks up most of the rest.

Read the full article at Business Insider.

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A Plan to Repeal and Replace Obamacare

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Obamacare is a proven policy failure. Congress and the Trump Administration must completely repeal the law, beginning by seizing the opportunity to accomplish as much of repeal as possible through the reconciliation process. Congress must focus on the fundamentals: equalizing the tax treatment of health insurance; restoring commonsense regulation of health insurance; and addressing the serious need for reform in Medicare and Medicaid by adopting policies that give individuals control over their health care. High quality health care means all Americans should be free to choose a health care plan that meets their needs and reflects their values. Congress must act now to repeal Obamacare and replace it with a new set of options that empower Americans, not government.

Read the full report at Heritage.org.

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Alabama Should Open Up Doors to Direct Primary Care

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Alabama should consider making sure direct primary agreements do not constitute insurance under state law, one of the greatest hurdles facing DPC models today. This would free doctors and patients from many expensive regulations imposed under the state’s insurance code. It would also help open up the state’s health care market to more DPC programs and improve health care freedom across Alabama. According to the Docs4PatientCare Foundation, “14 states [have] thus far [chosen] to clarify that DPC is not a ‘risk-bearing entity’ for the purposes of regulation by state insurance commissioners.” Similar proposals have been introduced over the past year in Georgia and Tennessee, and another will soon be introduced in Maine.

Under a direct primary care program, patients pay a monthly membership fee, typically ranging from around $50 to $80. As part of the membership, patients receive a more generous allocation of appointments than they would under most traditional plans, even when taking into account some same-day appointments and house calls. The guarantee of a set monthly fee removes the layers of regulation and bureaucracy created by the traditional insurance system and allows physicians to see fewer patients and focus more on each patient.

Routine tests and procedures are also included in most DPC plans, and lower membership fees are often charged for programs that do not provide these additional services. According to the Docs4Patient Care Foundation, under a DPC model, medical practice overhead can be reduced by as much as 40 percent. Proponents of DPC programs agree these services are best used in conjunction with a high-deductible health care insurance plan or another form of catastrophic coverage to handle in-patient health care services. The American Academy of Family Physicians has endorsed the DPC model.Direct primary care empowers patients and doctors, giving them more freedom to establish and participate in health care provider models that work best for all patients. Alabama should remove unnecessary regulatory barriers to direct primary care to help revitalize the state’s primary health care system.

Direct primary care empowers patients and doctors, giving them more freedom to establish and participate in health care provider models that work best for all patients. Alabama should remove unnecessary regulatory barriers to direct primary care to help revitalize the state’s primary health care system.

Read the full research and commentary at The Heartland Institute.org

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