But now some insurers are offering a positive financial incentive directly to physicians to use specific medications. For example, WellPoint, one of the largest private payers for health care, recently outlined designated treatment pathways for cancer and announced that it would pay physicians an incentive of $350 per month per patient treated on the designated pathway.
.. Further, some health care networks limit the ability of a patient to get a second opinion by going outside the network. The patient is financially penalized with large co-payments or no coverage at all. Additionally, the physician who refers the patient out of network risks censure from the network administration.
Health Law Turns Obama and Insurers Into Allies
“Insurers and the government have developed a symbiotic relationship, nurtured by tens of billions of dollars that flow from the federal Treasury to insurers each year,” said Michael F. Cannon, director of health policy studies at the libertarian Cato Institute.
The relationship is expected only to deepen as the two sides grow more intertwined.
“These companies all look at government programs as growth markets,” said Michael J. Tuffin, former executive vice president of America’s Health Insurance Plans, the main lobby for the industry. “There will be nearly $2 trillion of subsidized coverage through insurance exchanges and Medicaidover the next 10 years. These are pragmatic companies. They will follow the customer.”
.. Since Mr. Obama signed the law in March 2010, share prices for four of the major insurance companies — Aetna, Cigna, Humana and UnitedHealth — have more than doubled, while the Standard & Poor’s 500-stock index has increased about 70 percent.
.. A turning point in the relationship came last fall, after the chaotic debut of HealthCare.gov, when insurers waived enrollment deadlines and helped the White House fix the dysfunctional website.
.. The Congressional Budget Office estimates that 170 million people will have coverage throughMedicare, Medicaid and the insurance exchanges by 2023, an increase of about 50 percent from 2013. By contrast, the number of people with employer-based coverage is expected to rise just 2 percent, to 159 million
.. Aetna, in reporting its third-quarter results, said many people thought 2014 would “spell the death of our industry.” But, the company said, it is having “a very good year,” thanks in part to “excellent performance in our government business, which now represents more than 40 percent of our health premiums.” The company described Medicaid as a “bright spot in the Aetna portfolio.”
.. Eight months after the unit of UnitedHealth Group, called Optum, helped repair HealthCare.gov last fall, the administration hired a top Optum executive, Andrew M. Slavitt, as the No. 2 official at the Centers for Medicare and Medicaid Services. The administration waived conflict-of-interest rules so that Mr. Slavitt could participate in decisions affecting UnitedHealth and Optum.
Man Who Understands 8% Of Obamacare Vigorously Defends It From Man Who Understands 5%
As debate continues in Washington over the funding of President Obama’s health care initiative, sources confirmed Thursday that 39-year-old Daniel Seaver, a man who understands a total of 8 percent of the Affordable Care Act, offered a vehement defense of the legislation to 41-year-old Alex Crawford, who understands 5 percent of it.
Amazon Monopsony like Canadian Health Care
David Ricardo: More to the point, Amazon is doing exactly what the Canadian and British governments (with their government-run health care monopsonies) do with extracting the best terms from pharmeceutical suppliers. Morally, there is no difference between Amazon and the British National Health Service.