What if We Regulated Legal Services Like Health Care?

This is a very interesting post from John R. Graham  with NCPA.  Can you guess what lawyers would have to say if congress tried to do this.  

But if you think about it that is what the lawyers are trying to do in congress with healthcare, so turn about is fair play.  Remember most of the people in congress are lawyers. 

How Much Should Health Insurance Cost?

Re-post from John Goodman Filed under Health Alerts on March 7, 2012.

This post talks about something I have been saying for a long time.  I hope you will check it out.  This is the reason JE Health Care Solutions was started to help people understand how health insurance works and how they can save money  and get better care that they control instead of a 3rd party.

When Will Medicare MSAs Take Off?

Article by "By Greg Scandlen"

This is a very interesting article about   Medicare MSAs.

A False Compromise on Conscience Protections

Re-post of an article by:

 Benjamin Domenech

Benjamin Domenech is managing editor of Health Care News and a research fellow at The Heartland Institute.

I thought this article brought out some great points about Obama's so called compromise on the birth control coverage mandate.

Doctor Outraged After Recommending a Drug (That You May Be Taking)

Once again Dr. Mercola shows that the Drug companies will do what ever they want to to sell their products.  This is why you need to educated yourself.  With today's healthcare delivery system Doctors don't have or take the time to find out if a drug is truly effective or not.  They are relying on the drug co. reps. to give them information and this article shows that you can not always trust that the information is correct.

This is why I write this blog, because we at JE Health Care Solutions what to try and get as much information as possible to you so you can make informed decisions about your health care.  Once again I would love to here from you if you have questions are suggestions of how I can improve this blog. 

With the different programs we can offer you, we can help you get the health coverage that fits your needs and budget.  With programs such as Renco Direct and NACD as well as many others.

213 Women Who Took This Suffered Permanent Disability

I write this blog to try and give my readers information about healthcare topics.  If there is something you would like to find out about please let me know by making comments.  I would love to have your input.

The post today is a re-post of an article by Dr. Mercola concerning  HPV vaccine, Gardasil.  Remember this is information only and not advice.  My goal is to help you become informed "healthcare consumers".  By doing this you take more control of your healthcare.

Selling Primary Care Down The River

Re-post of a post by Jordan Grumet on is blog "In My Humble Opinion".

Let's hope this is not going to be the future for Primary Care Doctors.

The Drug Companies New Profit Weapon (Re-post of article by Dr. Mercola)

I started this blog to inform and educate about the crisis that our health care delivery system is in.  Please understand that I am not saying business should not make a profit, because that is what business is suppose to do so they can create jobs.  What I do have a problem with,  is companies doing in my opinon unethical or at the very leased highly questionable practices that endanger people's lives.  The following article by Dr. Mercola : The Drug Companies' Newest Profit Weapon to Steal Your Money is a major case in point.  As I pointed out in my e-book Health Care Delivery System in America Has Failed (Download your free copy here) The Drug Industry takes a big part of your healthcare dollars.  I think this article makes a strong case for taking back control or your and your family's healthcare.  This is what we at AJ Health Care Solutions is here to help you do, with our Renco Direct and NACD and other programs we can help you take back control.

When you think about all the adds on TV, Newspapers, and every where else for the next wonder drug that is suppose to take care of this or that medical problem remember they are not saying that it is a cure, because it only treats the sympoms.  There is no money to be made if it will cure the illness.  When is the last time you have heard your doctor talk about a cure?  Just think who controls the FDA, how many people that are in lead positions in the FDA come from or go to work for the drug companies. 

If we as healthcare consumers don't start questioning these things and become educated about the healthcare system we will never get back control of our healthcare, nor will cost be brought under control.  The information is out there, you just need to start doing your own research and find it.  This is one of the great advantages we have with the internet today.  

HHS Gives States Flexibility On Health Law's 'Essential Benefits'

This just in from Kaiser Health News.  Thought you would like to Know.  Remember if you can't get or can't afford healthcare insurance, JE Health Care Solutions is here to help with possible solutions.  Our programs with Renco Direct and NACD can give you control of your medical treatment and cost of your medical care.

What Options are there to Meet Your Health Care Needs

In part 3 of this series I want to give you some options you can use to control your healthcare and the cost.

OPTION 1 

Pay cash for your regular doctor office visits

 Find a program that lets you pay cash for your doctor visits at an affordable price. That is where Renco Direct comes in. With this program you become a member of Renco and this will allow you to pay the discount PPO rate that the insurance companies have been using for over 50 years. This works both for you and your Doctor. You pay the discount PPO allowable at the time of your visit and the Doctor does not have to file a insurance claim and wait for his money. This is a win - win situation for both you and your doctor. Also medical decisions are based on your medical needs and not what an outside agency be it government or insurance company decides is best for you or your family. Because this program is a non insurance plan no one is turned down due to pre-existing conditions, and no one is going to deny or delay your treatment. Since you are not filing insurance claims your medical care is you and your doctor's business and nobody else.

 The Renco Direct plan also concludes many more savings programs, such as Prescription discounts, Vision, Dental, Consult a Doctor, Chiropractic Care, and much more.

OPTION 2

Combine Programs

The Renco Direct program works well if you have existing healthcare insurance policy that you like and want to keep, if you could get your rate lower. By increasing your deductible to say $7500 or even $10,000 which will reduce your cost, and using Renco for your regular office visits and having the health insurance policy to take care of the major problems.  Remember your policy most likely has an 80/20 split once your deductible has been met. 

With the Renco program after your insurance company has paid what they are going to pay you would get a final bill from the hospital.  You would then send that to Renco and they will negotiate with the hospital and get you the discount on the balance. 

Remember the main thing is to get quality health care that you and your doctor decide is best for you, and not have an insurance company or the government making the decision for you.  

OPTION 3

Combining The Renco Direct program with an accident policy such as NACD offers that can give you up to $10,000 for each covered accident.  This is an open enrollment  program, which means every body can get this program even with pre-conditions.  Another option is to pick up a policy such as Aflac which pays cash to you.  These programs work quite well with Renco Direct.

Option 4

Another option is to add a Critical Care policy to your Renco Direct program.  This covers the big Illness, such as cancer, heart attack, stroke, etc.  Taking this approach, you are prepared for the big problems while handling the small problems yourself and cutting your healthcare coverage cost without giving up control. 

You can use any one of these options or combination of them to achieve both control of your healthcare as well as the cost.  

As a business owner who wants to give their employees benefits but can’t afford the high cost of healthcare insurance these same options will work.  You can also set-up a HRA program that you can use to help with your tax situation.

For more detailed information on these programs or others please contact us at jehealthcaresolutions@gmail or on our web site http://jehealthcaresolutions.com or you can call 865-357-3379.

How Cost of Health Insurance Is Affecting Business

This is part 2 of my 3 part post. 

 

If you are a small business owner you know how hard it is to keep good employees.  One way business’s have done this is by offering employee benefits.  The cost of these benefits have gone up every year, the biggest driver of these is healthcare insurance.  The following shows what has happen to these cost.

This information is from the Kaiser Report (EMPLOYER HEALTH BENEFITS 2010 REPORT) 

 You can get the full report HERE.

The key findings from the 2010 survey, conducted from January through May 2010, include increases in the average single and family premium, as well as in the amount workers pay for coverage. About a quarter (27%) of covered workers have a deductible of at least $1,000 for single coverage and a greater proportion of workers are enrolled in high-deductible health plans with a savings option (HDHP/SO) than in 2009. Firms responded that they increased cost-sharing, or reduced the scope of coverage, or increased the amount workers pay for insurance as a result of the economic downturn. The 2010 survey continues to track the percentage of firms offering wellness benefits or health risk assessments and also included questions on health plan quality indicators and benefit changes made as a result of the Mental Health Parity and Addiction Equity Act.

The average annual premiums for employer-sponsored health insurance in 2010 are $5,049 for single coverage and $13,770 for family coverage. Compared to 2009, premiums for single coverage are 5% higher ($4,824) and premiums for family coverage are 3% higher ($13,375). Since 2000, average premiums for family coverage have increased 114%. Average premiums for family coverage are lower for workers in small firms (3–199 workers) than for workers in large firms (200 or more workers), ($13,250 vs. $14,038). Average premiums for high-deductible health plans with a savings option (HDHP/SOs) are lower than the overall average for all plan types for both single and family coverage. For PPO's, the most common plan type, the average family premium topped $14,000 annually in 2010.

As a result of factors such as benefit differences and geographical cost differences, there is significant variation around the average annual premium. Twenty percent of covered workers are in plans with an annual total premium for family coverage of at least $16,524 (120% of the average premium), while 19% of covered workers are in plans where the family premium is less than $11,016 (80% of the average premium).

In 2010, covered workers contributed a greater share of the total premium, a notable change from the steady share workers have paid on average over the last decade. Covered workers on average contribute 19% of the total premium for single coverage (up from 17% in 2009) and 30% for family coverage (up from 27% in 2009). As with total premiums, the premium shares contributed by workers vary considerably around these averages. For single coverage, 28% of workers pay more than 25% of the total premium while 16% make no contribution.

Fifty-one percent of workers with family coverage pay more than 25% of the total premium; only 5% make no contribution.  Looking at dollar amounts, the average annual worker contributions are $899 for single coverage and $3,997 for family coverage, up from $779 and $3,515 respectively in 2009. Workers in small firms (3–199 workers) contribute about the same amount for single coverage as workers in large firms (200 or more workers), ($865 vs. $917), but they contribute significantly more for family coverage, ($4,665 vs. $3,652).

NOTE: There was another 10% increase in cost in January 2011. There is no sign that these increased costs are going to slow down anytime soon. Individual plans have followed suit in cost increases.

The following is an example of what happens to your insurance dollars.

ABC co. inc. insures 100 employees. The national Average for a single person is $5000 per year. Cost to the company is $500,000.00 for the 100 employees. On average 90 employees will get about $450.00 annual benefit, 3 employees will get about $5000.00 annual benefits and 7 employees will need be hospitalized.

Average cost for a hospital stay is $30,000.00 of which the insurance co. will pay an average of $10,000.00 after they take there provider network discount. So company wide average benefit paid out is $125,000.00 annually. This means only $.25 of each dollar paid out in premiums goes to your actual healthcare.

As small business owners Jo Anne and I had to find an answer to this problem.  This is what leaded us to starting JE Health Care Solutions.  There are answers out there that puts us in control of our healthcare and cost, but if you don’t know what they are it is hard to deal with.   We went several years with out healthcare coverage because we could not afford it, and were lucky that we did not need it. 

The purpose of this series of posts is to try to give you the information that everyone needs to know.  The 3^rd post will give you some answers to the problem that I hope will give you some options to consider.

Remember you can download my e-book for free at the following link.

Why We need to change our way of thinking about Health Care

PART 1.  The Problem

I am writing this blog post because I am tired of hearing everyone complaining about Obamacare and the high cost of health care insurance, but yet they do nothing to change how they are dealing with their health care.  As long as Americans continue to think someone else is responsible for paying for their health care then nothing will change.  Anytime you have a third-party payer system for anything someone else is going to make the decisions for you.  It is your responsibility, not someone else’s!  Remember, once you give your money to the insurance companies, it is no longer your money, it is theirs.  Think of it this way; if you went to a company and said, “I will pay you so much a month and you take care of my electric bill every month”, don’t you think they are going to control the amount of power you use every month?  So what makes you think health care insurance companies are any different?

Did you know, on average, for every dollar you pay for health insurance, you get about 25 cents of service?  The other 75 cents goes to the insurance companies.  If you think about it, that is not a very good bargain.  Yet we have been doing this since the 1920’s and think it is great.  So who is getting a piece of this 75 cents? 

1.     The Insurance Company now has control of your insurance dollar.

2.     Risk Group: ( Employer Groups) These are the people in your group that are sick, because it is a guaranteed issue group policy.

3.     Government: This is all the laws, regulations, political contributions. taxes, fees, etc.

4.     Labor: Because of labor unions in hospitals, costs are driven up. Labor union demands for high cost insurance plans drive up the cost; things like low co-pay, low cost prescriptions, etc.

5.     Government Programs: Medicare and Medicaid; reimbursements from your policy have to go to help cover the under-payment from these programs.

6.     Big Disease: These are non-profit and put mandates on every ones policies. Things like cancer, heart disease, COPD, etc. Your premiums reflect these costs because all of these have to be covered for everyone.

7.     Drug Companies: The drug companies have put themselves between you and your health care dollar by marketing directly to you with ads for the next miracle drug, so you will self- diagnose and run to your doctor and ask for their drug by name.

8.     Attorneys: These are the tort attorneys that are waiting for your doctor to make a mistake. Malpractice insurance is built into your doctor's cost of doing business but this forces them to do unnecessary tests just to cover themselves against the attorneys.

9.      Billings and Collections: This would not be needed if it weren't for insurance companies. Billing is needed to handle the paper work involved with filing with insurance companies. Collections are needed because the insurance company can deny your claim and they have to collect from you.

10.  Claims: A lot of claims are denied or delayed. The claims job is to save the insurance companies money by denial or delaying claims.

11. Case Manager: The case manager's job is to approve the least expensive treatment and the doctor with the lowest.

All of these entries are between you and your doctor, and thus, your health care.

This is a health care delivery system not health care.

This ends part 1.  Please be looking for part 2 and 3 over the next few days.  I have written an e-book about this, which has a lot of reference material in it.  You can download it at the following link.  It is free, because I am trying to help as many people as possible to become informed consumers on health care.

 Download E-Book 

It is free

Mark Levin Show: Death Panels Will Be A Reality With Obamacare

 I thought this was a very interesting and everyone needs to hear this.  It will not make you happy, but you need to know about it.  This is why we do what we do to try and educate people about what is going on with our healthcare in America.  If we the people, don't work to get the government out of our healthcare then we will all suffer.

A neurosurgeon, vetted by Levin's staff, calls Mark and talks about what he knows about Obamacare Death Panels. From 11/22/11.

CLICK HERE TO WATCH VIDEO

Very Interesting Article about the: Preventive Services Task Force

Here is an article by:
 By Scott Gottlieb with AEI
Scott Gottlieb, MD (scott.gottlieb@aei.org) is a resident fellow at AEI. Dr. Gottlieb consults with health care companies.
Key points in this Outlook:

• Under President Obama’s health care plan, the United States Preventive Services Task Force now wields great power to decide which health services (like mammograms) doctors should provide, yet it has few checks on its sweeping authority.
• Its mandates are likely to raise health insurance costs and premiums, while reducing the number of covered preventive services.
• To improve accountability for an agency that is both out of date with the medical community and out of touch with the public, Congress should closely monitor the impact new mandates have on patient care.

Under the Patient Protection and Affordable Care Act (PPACA), a previously obscure government advisory body has acquired vast authority to decide which health care services Americans will have access to. The United States Preventive Services Task Force (USPSTF) was created in 1984 as a government advisor with the mission of assessing the clinical utility of preventive health measures such as screening tests and issuing nonbinding recommendations about which measures doctors should incorporate into routine medical care. PPACA gives the USPSTF’s recommendations the force of law, making them de facto mandates on which preventive services private health plans and public programs such as Medicare must pay for. Services that do not make the USPSTF grade are unlikely to be covered at all. The USPSTF was not designed to wield this kind of sweeping and binding authority. It does not maintain the transparency, deliberative process, appeal process, or requirements for public notice and comment that are hallmarks of sound regulatory policymaking. Moreover, because the USPSTF has few guidelines governing its function, it has great flexibility to adapt its criteria and grow its mandate in ways that may conflict with political goals and public sentiment and lead to unintended consequences.
I highly suggest you read the full article by Clicking on the link below.

http://www.aei.org/outlook/101088

Renco Direct Makes Major Upgrades to Healthcare Program

Well here it is the new and improved Health Care Savings program from Renco Direct.  Direct Concepts Healthcare that had been the program of parent company Renco Direct is now Renco Direct.  

The improvements are many!

“Consult A Doctor” which gives you access to a Doctors 24 hrs 365 day a year by phone or internet (there is no cost).  Physicians discuss symptoms, recommend treatment options, diagnose many common conditions, and prescribe medication when appropriate.  He will call in your prescription to your pharmacy.  Never wait for a doctor again!

We now are with Aetna Dental for our Dental plan

We are now using BEECH STREET PPO along with GALAXY.

Toll-free telephone counseling service and referrals to a               nationwide network of professional counselors and resources.

Long Term and Elder care.

Care Management Associates are available 24 hours a   day, 7 days a week, to provide assistance with elder care concerns, answer long-term care questions and help locate local assistance.

Comprehensive website that offers features such as skill sheets, condition research, caregiver advice, two minute test, care giver tools, resource finder and member reports.

 3,500 nurses and social workers provide telephonic and in-home      evaluations (for an additional discounted hourly or package fee).

Medical Health Adviser

Navigate the healthcare and insurance systems

Find the best doctors, hospitals and other providers

Resolve insurance claims and billing issues

Save time  and money on healthcare bills

Locate and research current treatments for a medical condition

Explain test, treatment and medications

Health Cost Estimator — a pre-service pricing decision support tool

Medical Supplies

 Save 20% to 50% and receive a $5 discount on orders of  $100 or more

Toll-free and online ordering for convenient home delivery on a wide range of health and wellness products.

 Pet Care

      Yes we now offer a pet care program that will save you 25%on your Vet visits and 5% to 35% on other services and supplies.

The best part of the upgrade is that you can now purchase the entire program for the same $88 dollars per month per family or just purchase the part that meets your needs. 

The Following is how the programs cost break out.

Med Plus: $30.00 per month per family:

Includes:  Hospitals, Doctors, Ancillary services,  and Medical Health Advisory.

          

           Dental Plus: $28.00 per month per family:

 Includes:  Dental, Vision, Pharmacy, Hearing, Alternative &     Chiropractic, 24 hour nurse hot line, Durable Medical Supplies, Travel Assistance, Prescription Care.

          

           Extended:  $30.00 per month per family:

Includes:  Consult a Doctor, Pet Care, Vitamin and     Diabetic supplies, Long Term Care, Renco Health and Beauty.

TOTAL COST For All Three programs is still $88 per month per family.

      

       A free Prescription discount card is included with all 3 packages.  We also still have the Rx aid program for people on the High Cost prescriptions.

Renco Direct has also added a totally new program called: 

Lifestyles:  $11.95 per Month per family:   

Includes: Legal Services, Roadside Assistance, Dining Discounts, Recreation Discounts, Golf Savings,    

Hotel Savings

More states are being brought on board with our programs:

FL,  UT, and Ks will be up in the next few weeks.  The only states we will not be available in will be WA and Vt.  That means we will be available in 48 states.

We here at JE Health Care are extremely excited about these major upgrades to the Renco Direct program and look forward to helping you meet you and your family health care needs.

To get more details about our program go to the Contact Us button enter your information and be will get back to you as soon as possible.  Or call 865-357-3379 or go to http://rdhc.jehealthcaresolutios.com

Renco Direct Making Major Upgrades to Healthcare Program

Renco Direct the parent company of Direct Concepts Healthcare will be making major improvements to their healthcare program.  The addition of several new programs will enhance our program making it the best alternative to high cost health care insurance.

Stay up to date on these upgrades to our program by Subscribing to our blog.

Potential Impact of Health Reform on the Cost of Private Health Insurance Coverage

Written By: PriceWaterhouseCoopers Staff

Published In: PriceWaterhouseCoopers

Publication date: 10/01/2009

---

Health reform could have a significant impact on the cost of private health insurance coverage.

There are four provisions included in the Senate Finance Committee proposal that could increase private health insurance premiums above the levels projected under current law:

- Insurance market reforms coupled with a weak coverage requirement,
- A new tax on high-cost health care plans,
- Cost-shifting as a result of cuts to Medicare, and
- New taxes on several health care sectors.

The overall impact of these provisions will be to increase the cost of private insurance coverage for individuals, families, and businesses above what these costs would be in the absence of reform.

On average, the cost of private health insurance coverage will increase:

- 26 percent between 2009 and 2013 under the current system and by 40 percent
during this same period if these four provisions are implemented.

- 50 percent between 2009 and 2016 under the current system and by 73 percent
during this same period if these four provisions are implemented.

- 79 percent between 2009 and 2019 under the current system and by 111 percent
during this same period if these four provisions are implemented.

Down Load full PDF report:

Is the High Cost of Health Care Insurance Killing your Budget

According to the Kaiser Foundation 2010 report, the cost of employer sponsored health care insurance has gone up 46% since 1999 to 2010 .  This means the national average of health insurance is now costing about $13,770 for family coverage per employee per year, as compared to $6438 in 1999.  At the same time the average deductible has gone from $500 to $2500 during the same time.  This means you are paying more and getting less.  Where most insurance companies use to have an 80/20 split after the deductible was met, they are now starting to go to a 70/30 split and in some cases a 60/40 split.  Individual plans have risen at about the same rate.

So what is the answer? 

The first thing you need to do is get out of the health care delivery system.  Health care delivery is what we have now, not health care.  You need to take control of your health care as an individual or as an employee and quite expecting someone else to do it for you.  To do this we must find a way to control the cost as well as control our own health care.  If you are a business owner, and it does not matter what size form the sole proprietor to a corporation you have to take control of cost and health care, and help your employee’s do the same.

The first step to doing this is to become educated about our health care delivery system  and why it has risen in cost at such a high rate.  One place to get a quick education is at Care Liberty.  Dennis Rowley has worked as an insider in the health care insurance industry and has a lot of the answers.   Click here for the video:   Problem with third party payer system

Here is a quick example of how it works.  You go to the doctor whose cash price for a visit is $100, you pay a co-pay (if you have a health care policy),  the doctor files the paper work with your insurance company.  The insurance company then pays the doctor not the cash rate but the PPO Allowable which in this case is $50.  You have already paid $25 so the insurance company pays the other $25.  Lets say your policy cost you $700 a month.  That means you paid $725 for that office visit that month.  The average family goes to the doctor 6 to 8 times a year.  So you are paying $8400 a year for your policy and $200 a year for doctor visits for a total of $8600 for the year.  On average for every dollar you spend on health insurance you get a 25 cent back.  Is that a smart investment?

I don’t think it is.  If you got that kind of return on any investment you would be broke very quickly, because you are losing 75 cents on every dollar you are investing.    

Now what happens at the doctor’s office?  He has to turn your file over to someone in is office who does the paper work to file your claim with the insurance company.  The insurance company has 30 days to respond and usually what happens is they sent a letter back to the doctor office and want to know why you had come to see him.  The insurance company has another 30 days to respond and if the doctor is lucky he may get is $25 from them.  Usually it takes 60 to 120 days before he sees that $25.  He has to pay for is office overhead and expenses so he may see $10 of that $50 as profit before taxes.  Does this tell you why if your lucky you may see him for 5 mins.?  He has to see as many patients in a day as possible to make a living.

I hope you now understand why I say we have a Health Care Delivery System and not Health Care today.  In my next post I will explain how we got to this point.  So please Subscribe via email to my blog so you will get all of my post as I explain more.

New Article by: Dennis Rowley

The Health Care Delivery System Admits To The Poisoning Of Millions Of Americans

If anyone reading this still believes that the health care delivery system is a good thing, consider the fact that the drug companies – a charter member of the health care delivery system – makes money from illness, not from getting you well. There is no money – AND I MEAN ZERO CASH – to be made in the current health care delivery system from curing Americans. Cures are nonexistent. In fact, a medical professional who uses the word “cure” in referring to a patient's disease or disorder can be fined, lose their license, or even be imprisoned for doing so.

Why? The reason is simple. There is far too much money to be made from “treatment.”
The AMA – the self-ordained health care watchdog - makes money every time you go to the doctor or pharmacy.

The health insurance companies do the same.

And the drug companies make buckets of money by keeping Americans sick. If it were not true, then there would be no need to hide behind the FDA and to penalize supplement companies for using nutritional therapies. Nutritional therapies, as a rule, carry no side effects. On the other hand, the average prescription has at least 70 published side effects. That is a verifiable fact! The health care delivery system has agreed to publish the poisonous facts and hand it out with every bottle of pills they push on you. Yet no one seems to notice! Or care!

The health care delivery system is corrupt. The financial incentives to get and keep people healthy don't exist. The health insurance companies, the drug companies, the tort attorneys, the AMA and the government all bill and collect hundreds of billions – trillions – from illness.

If there was a true financial incentive to keep people healthy that would be big business.
But cure is not big business not - treatments are - $2.3 trillion big!

Trusting the health care delivery system with your health is a lot like trusting Michael Vick to sit your dog.

If you agree and want a better way that will save you money and keep you healthier, go to www.CareLiberty.com and sign up get all of your health care and ObamaCare questions answered. 

Reposted by: JE Health Care Solutions A solution that gives you control of your Health Care.

What are Accountable-care Organizations and how do We Avoid them

According to AVERY JOHNSON  of the The Wall Street Journal in New York

ClickHere for the full Article.

“ In broad outline, these entities propose to unite doctors and clinics or hospitals in groups that pool their resources with the goal of trimming spending while boosting the quality of care. When the group can show that it is improving care and delivers it for less than the cost projected—arrived at by crunching historical patient data for that market—a share of the savings goes to the ACO's bottom line”

“ACOs exist more on paper than in reality, for now. But a few organizations up and running for decades do closely resemble how the concept can work. One of the most prominent is Atrius Health of Newton, Mass., an alliance of five medical groups comprising more than 800 physicians, about 700,000 patients and 30-plus care centers in eastern Massachusetts.”

This is the State that has Rommycare and they are having all kinds of problems with it.  What it really is, is more Health Care Delivery. not quality Health Care, where someone else is making medical decisions for you instead of you making them for yourself and your family.  Guess who will be making those decisions for you and your family?  A panel of 15 People that are appointed as government appointees. Is this what we want to hear?  No, enough with the government, insurance companies, AMA, and the drug companies making our decisions!

According to an article by ANNA WILDE MATHEWS  for the Wall Street Journal Hospitals and Doctors are pushing back against this as well.  Click Here for the complete Article.

“Hospitals and doctors are pushing back against an Obama administration initiative that urges them to create new organizations to coordinate the care of groups of Medicare patients.
The voluntary program seeks to save money and improve treatment. But the health-care providers say the rules proposed for the initiative are too onerous and the financial incentives too weak, and that they will participate only if the program gets a major revamp.
The deadline for response to the proposal is June 6, but health-care providers have already been unusually vocal in their complaints. "It's pretty much a nonstarter as structured," said Anders M. Gilberg, an official at the Medical Group Management Association.”

Obamacare is what is driving this program.  If you look at it, it will only lead to rationed care for people on Medicare.  Obamacare came from the same people who now run commercials showing a Congressman throwing Granny off a cliff.  Well, who is really throwing Granny off the cliff?

Until we, as Americans, step up and take responsibility for our health care, this problem will never be solved.

HOW DO WE DO THIS?

Step Number One:  Change your mindset that someone else is going to pay for your health care.
Step Number Two:   Start paying cash for your doctor visits.

The best way to buy anything is to buy it direct.  We buy our cars, food, and just about everything else directly so why should Medical Care be any different?  Because we have been told for more than 50 years that we have to have medical insurance to get medical care.  Number one, this is a lie; if you need medical care and go to the emergency room, they have to treat you to the best of their ability, regardless of your ability to pay.  I am not saying this is what you should do if you can pay but I am saying that you do not have to have insurance to get medical care.

A medical care delivery system is not medical care.  We don’t buy car insurance to cover the cost of gas, oil changes, tires, and the minor repairs.  We buy it to pay for the major problems, i.e., if we have a wreck.  Yet we buy health care insurance so we can go to a doctor’s office and pay a $25 to $35 co-pay and pay hundreds of dollars a month for this privilege.  Does this make sense to you?  It doesn’t to me! 

I know you are asking, “How can I pay cash to go to the doctor when an office visit might cost $110 to $140 for a visit?”  You don’t have to do that either.  You can negotiate with your doctor for a discounted cash rate or you can become a member in a PPO directly.  Remember, insurance companies have been using PPO Rates for 50 years or more, so why should you not be able to do the same thing?  I am not talking about a medical discount program, I am talking about a true Medical Savings program.  One such program is Direct Concepts Healthcare  which puts you into two of the largest PPO’s in the country;  PHCS and Galaxy Networks.  This includes Doctors, Hospitals, and all the service’s, i.e., labs, x-ray’s, MRI’s, etc.  It also has a prescription discount program that will save you 10% to 80%.  It also includes Dental, Vision, and Alternative Health Care, plus more.  All for $88 per month, per family, with no restrictions for pre-existing conditions.  There is also an Rx program for FDA approved, name brand Prescriptions, based on family income for $20 per month, per prescription.  This is a separate program and you do not have to be in the $88 program to join it.


By paying the PPO rate, you are getting the same rate that the insurance companies pay the doctor; the difference is the doctor gets the full  PPO payment at the time of your visit.  He doesn’t have to file insurance papers and wait to get his money from the insurance company. Which, by the way, will be the PPO Allowable, not his cash price. And you are not paying an insurance company hundreds of dollars a month.  It also gives you and your Doctor control over your treatment without the government or insurance company telling him what treatments he can and can’t give you or your family.

It is up to YOU to decide if you are going to control your health care are let the government, Insurance companies, or someone else decide your health care future.

Stay tuned for the next update.  I hope I am helping you to become informed  about what is going on in the Health care industry and a way to protect you and your family.  Be sure to sign up to get regular updates by Subscribing via email on the right hand side of our blog.