Comments on: The WonkLine: April 28, 2009

By: Lawrence J. O'Brien

Lawrence J. O'Brien — Wed, 29 Apr 2009 13:04:20 +0000

There are 300,000 primary physicians in active practice. If each had responsibility for 1000 patients, all 300 million U.S. residents would have full access to primary care. At the overall average annual visit rate for primary care — 3.3 visits per year per person — a primary doctor working 200 days a year, 8 hours a day, would have an average of 29 minutes for each patient visit, as compared to 5 or 10 minutes in most cases today. If each primary physician had an income of $230,000 — 75% of the median income of specialist physicians according to the AMA — and had a generous overhead of 100% of their salary, the total cost for one primary doctor would be $460,000 per year. 1000 patients would have to pay $460 each per year for full primary care coverage, or slightly over $38 per month per person.
Everyone should think hard about these financial facts, long and hard enough to figure out what is wrong with the current structure, and how to fix it fast. The problem is not insurers; it is specialist physicians who dictate the level of demand for the services that they provide. Get it?

By: jps

jps — Tue, 28 Apr 2009 16:43:48 +0000

Physician shortages can be be addressed by adjusting medicare reimbursement rates, and stop the Graduate Medicare Education program’s practice of paying medical schools to limit the number of physicians they enroll. That subsidy-to-not-produce is a relic of a long-past M.D. glut.

P.S. Thanks for preview! (So much for that excuse….)

By: stateofthedivision

stateofthedivision — Tue, 28 Apr 2009 16:17:48 +0000

WellPoint lost 500,000 members while United saw 900,000 drop coverage.

http://online.wsj.com/article/SB124038527644142693.html

By: stateofthedivision

stateofthedivision — Tue, 28 Apr 2009 16:13:03 +0000

Unlike WellPoint and United, both of which reported big drops in commercial enrollment in the first quarter, Humana’s nongovernmental membership fell only 4 percent during the period. But the insurer predicted that enrollment would decrease further, mainly because of an expected decline in small-employer business.

By: stateofthedivision

stateofthedivision — Tue, 28 Apr 2009 16:11:17 +0000

Premium increases of 11 percent? I predicted health insurance rates would soar to make up for investment losses. It should be more than Humana.

By: stateofthedivision

stateofthedivision — Tue, 28 Apr 2009 16:10:13 +0000

Geithner said the stress test was intended to give people confidence in the system. That likely means a powder puff analysis. That the assumptions aren’t clear is not a surprise to me. It’s odd that Elizabeth Warren doesn’t have access to the criteria/model.

By: stateofthedivision

stateofthedivision — Tue, 28 Apr 2009 16:04:44 +0000

A decade ago health care leaders thought enough money was in the system. It needed redistribution within a system with different priorities.

The number of uninsured grew by over 10 million during that time.