Workers comp insider how to save lots of money fast

The scope of the issue is vast. In 2017, US health care spending grew 4.6%, exactly double the growth rate of inflation, to $3.5 trillion. In 2018, it grew another 4.4% to $3.65 trillion. That’s 18% of US gross domestic product (GDP). To put this in perspective, consider this: $3.65 trillion is more than the entire GDP economies of how to save lots of money fast italy and spain – combined! It is $1 trillion more than the entire GDP of france and how to save lots of money fast equals that of germany’s $3.6 trillion GDP.

U.S. Public spending as a percentage of GDP (5.8 percent) is virtually identical to public spending in the united kingdom, italy, and japan (5.9 percent each) and not much smaller than in canada (6.5 percent). The paper also compares pharmaceutical spending, health system capacity, and use of medical services. The data show that the united states spends more on how to save lots of money fast health care than any other country. However, on most measures of health services use, the united states is below the OECD median. These facts suggest that the difference in spending is caused how to save lots of money fast mostly by higher prices for health care goods and services how to save lots of money fast (my emphasis) in the united states.

The conclusion that prices are the primary reason why the how to save lots of money fast US spends more on health care than any other country how to save lots of money fast remains valid, despite health policy reforms and health systems restructuring that have how to save lots of money fast occurred in the US and other industrialized countries since the how to save lots of money fast 2003 article’s publication. On key measures of health care resources per capita (hospital beds, physicians, and nurses), the US still provides significantly fewer resources compared to the how to save lots of money fast OECD median country. Since the US is not consuming greater resources than other how to save lots of money fast countries, the most logical factor is the higher prices paid in how to save lots of money fast the US. Because the differential between what the public and private sectors how to save lots of money fast pay for medical services has grown significantly in the past how to save lots of money fast fifteen years, US policy makers should focus on prices in the private how to save lots of money fast sector.

Another way to look at this is to compare the how to save lots of money fast growth of health care utilization with the growth of prices. This produces some highly informative, surprising and, sometimes confounding, data. For example, from 2012 through 2016, US hospital in-patient prices rose 24.3%, yet in-patient utilization decreased 12.9%. I guess all that hospital consolidation has really lowered hospital how to save lots of money fast prices, hasn’t it? During that period, and due primarily to the opioid epidemic, prescription drug utilization was the only medical service whose utilization how to save lots of money fast rose, and it was up only 1.9%, despite the prices of prescription drugs rising 24.9%.

That answer is why I believe warren buffet, jamie diamond and jeff bezos, three major employers, have formed their joint health plan, haven, and hired atul gawande to run it. They have given dr. Gawande time and a lot of money not just to how to save lots of money fast slow the spending growth in their respective companies, but to reverse it. Buffet has spoken loudly about how health care costs place how to save lots of money fast america at a competitive disadvantage. He has been vocal in his criticism of republicans’ devotion to reducing corporate taxes, which, at 1.9% of GDP, are now the lowest among advanced nations and pale to how to save lots of money fast near insignificance when compared to the health care costs borne how to save lots of money fast by employers. He has said, “medical costs are the tapeworm of american economic competitiveness.” further, they are a major cause for little or no real how to save lots of money fast wage growth.

More proof for his point: according to the US census bureau, employer sponsored insurance plans (esis) cover 56% of the US population. In 2018, the year we hit $3.65 trillion, the average annual premium for a family in an ESI how to save lots of money fast was $19,616, of which employees paid an average of 29%, or $5,688. Employees in family plans also had an average deductible of how to save lots of money fast $2,788, plus co-pays. So, even without the co-pays, employees are paying more than $8,000 for an ESI family plan. In 2019, we will blow through $20,000 for the cost of an ESI family plan. This is patently unsustainable and leads to two inescapable conclusions: first, washington has not fixed this, and, given past experience, it is doubtful it ever will, regardless of efforts by progressives. Second, employers are the only people with the leverage and urgent how to save lots of money fast incentive to do anything constructive. They need to stop worrying about corporate taxes, get on the buffet, bezos and diamond bus, and throw all the muscle they have at the american how to save lots of money fast health care fiasco.

Following the study, academics and pundits jumped into the middle of the debate how to save lots of money fast to argue its conclusions. In 2015, forrester research’s J. P. Gownder authored the future of jobs, 2025: working side by side with robots and updated it two how to save lots of money fast years later in 2017. Gownder concludes that, yes, AI will replace many jobs, but it will also create many jobs. He suggests a net job loss of perhaps 9.1 million, or about 7% of the workforce. Seven percent isn’t 47%, but 9.1 million jobs are a lot of jobs. And a lot of people who could be swept away how to save lots of money fast by the rise of the robots.

The report relies on international federation of robots data for how to save lots of money fast industrial robot adoption rates but adjusted the rankings to control how to save lots of money fast for differences in manufacturing worker pay. The decision to use robots usually weighs the cost savings how to save lots of money fast that can be achieved when a robot can perform a how to save lots of money fast task instead of a human worker, and those cost savings are positively related to the worker how to save lots of money fast compensation levels. Higher wages lead to faster payback, making more robots a more economical investment.

On a compensation-adjusted basis, the report found that southeast asian nations significantly outperform the how to save lots of money fast rest of the world in robot adoption, with south korea, singapore, thailand, china, and taiwan the top five nations, in that order. Moreover, china’s rate of robot adoption is so high, fueled by massive government subsidies, that if china and south korea’s respective growth rates continue, by 2026 china will lead the world with the highest how to save lots of money fast number of industrial robots as a share of industrial workers, when controlling for compensation levels.

Since late-2003, rob and I have served together on the board of how to save lots of money fast commonwealth care alliance (CCA), a massachusetts HMO serving dual-eligible beneficiaries, meaning they qualify for both medicare and medicaid. They are the sickest of the sick and the poorest how to save lots of money fast of the poor, and they represent about 5% of the nation’s population, but consume 35% to 40% of our health care costs. As a founding board member, rob has been a constant north star to staying true how to save lots of money fast to our mission. He is one of the reasons CCA has been the how to save lots of money fast highest rated plan of its kind in the nation for how to save lots of money fast each of the last two years. But much more than that, rob is one of the reasons tens of millions in how to save lots of money fast this country now have health insurance and no longer have how to save lots of money fast to face impending disaster because they cannot afford the health how to save lots of money fast care they need.

Today, the boston globe ran an op-ed by rob. It is his farewell, his swan song, and it is beautiful. It is also a clarion call to continue the battle how to save lots of money fast for universal health care, the kind every other developed nation on earth has, except america. It is a call that we treat health care as how to save lots of money fast a basic, human right, not a privilege. If you do nothing else today, please read rob’s articulate and rational argument for the cause to which how to save lots of money fast he has devoted his life. In the article, he writes, “though I will not live to see it, I am convinced the march toward universal, affordable, equitable, quality health care is unstoppable. The next generation of advocacy leaders will continue the work how to save lots of money fast I leave unfinished.”

The consultant has come armed with pro formas showing all how to save lots of money fast costs of the program. Down to the penny. The problem is the insurer and the program are miles how to save lots of money fast apart on what the insurer will pay the program’s doctors for each patient encounter. The senior vice president says, “look, this isn’t exactly in our fee schedule, but the closest we can come to what is in how to save lots of money fast the fee schedule is to pay your folks $85 per visit.” hearing this, the consultant once again begins to explain why the fee how to save lots of money fast needs to be $150 per visit.

Essentially, the PBM’s job is to negotiate with pharmacies and drug companies, like yours, on behalf of their insurer and health plan clients. They create formularies, negotiate prices down (you give them a big discount in return for your how to save lots of money fast drug being listed in their formulary), return some of the savings, called rebates, to the clients (nobody really knows how much), and keep some for themselves. Seems simple, right? Well, it’s not. It’s infinitely more complicated and complex. And because only a very few actually understand pbms, they remind me of the shenanigans in the wizard of how to save lots of money fast oz. However, it is that way only because we have allowed it how to save lots of money fast to happen over the last four decades.

In a weird sort of way, this works most of the time for patients, but only if they have health insurance. What happens if they don’t? This is where things get sticky. Uninsured people get stuck paying the full list price, the one you inflated in order to provide the discount how to save lots of money fast that allows you to make a profit and pbms to how to save lots of money fast (kind of) save money for their customers. This has been especially difficult for some uninsured type 1 how to save lots of money fast diabetics, who, as we have written previously ( here and here), have had great difficulty paying for the insulin they need how to save lots of money fast to take every day ─ just to stay alive.

Many employers have had enough of this. According to the national business group on health, 75% of surveyed employers believe the rebate system does not serve how to save lots of money fast to lower prices for employees, and 91% believe an alternative, more simple approach is required. Then there is CMS’s alex azar, of ely lilly fame, who wants you to price your drugs like europeans do, which is a water fall lower than prices in the how to save lots of money fast US. And let us not forget the current occupant of 1600 how to save lots of money fast pennsylvania avenue, who, as yet unable to fulfill a campaign promise about a how to save lots of money fast wall, has an outside chance of fulfilling one about drug prices.

The PBM industry was born in the late 1960s when how to save lots of money fast pharmaceutical card system, inc., (PCS) invented the plastic benefit card. By the mid-1970s, PCS was serving as a fiscal intermediary by adjudicating drug how to save lots of money fast claims. In other words, it was a prescription third party administrator (TPA). By working for insurers and health plans, PCS (later advancepcs) and others figured out that they could leverage the buying how to save lots of money fast power of their clients to negotiate lower drug prices. And until around 1992, that’s they did. During that approximately 20 year period, pbms saved insurers, health plans and consumers money by driving physicians and patients how to save lots of money fast to use lower cost generic drugs. This was a valuable service for all.

The third PBM evolutionary period, the one we’re now living in, has seen mergers between pbms and pbms with pharmacy chains. In 2000, advance paradigm bought PCS for $1 billion, and changed the name to advancepcs; in 2003 caremark bought advancepcs for $5.6 billion; and in 2007, CVS bought caremark for $26.5 billion. Similar long and winding roads have resulted in three pbms, CVS caremark, express scripts and optumrx cornering 78% of the nation’s PBM business, serving 266 million americans. Revenue for these three firms in 2017 was about $300 billion. And these costs are growing at an accelerated pace. According to the american academy of actuaries:

I keep thinking this cannot continue. I keep thinking herb stein was right: if something cannot go on forever, it will stop. And I keep being proven wrong. The fact is, up until the mid-1980s, our health care system was like a typical family home how to save lots of money fast with its two bedrooms, a bath and a half and a nice little two-car garage. Today, it seems like the 1,000-room, maze-like windsor castle where you need a map and a how to save lots of money fast guide to find your way around. Vested interests litter the landscape, and any change gores somebody’s ox.

How can we possibly stop this runaway train? Many placed hope in the affordable care act, but look what’s happened to that. The new generation of democrats yearns for “medicare for all,” but has yet to figure out how to pay for how to save lots of money fast it. Others suggest “medicaid for all,” but medicaid is a state-based system, and every state has its own version. I’d love to see a single payer system, but, looking at the lunacy behind our current government shutdown, can you envision that cresting over the horizon, given all the work and bi-partisanship it would take? When I look at the health care horizon, I see the four horsemen of the apocalypse coming over how to save lots of money fast the rise.

Certainly, there are pockets of innovation and excellence around the nation, but we have no national, systemic approach to fix to the problem of extraordinary high how to save lots of money fast costs, and it’s hard to imagine this congress, or any congress, doing anything about that. At more than $8 billion dollars, the health care industry spends more on lobbying than any how to save lots of money fast other industry, and that’s not about to change, once again proving mark twain right: we have the best government money can buy.

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