PA Gov Aims To Fund Coverage for Uninsured

There's politicking going on in Pennsylvania as Democratic Gov. Ed Rendell has threatened to fund his plan to offer more affordable health care to nearly 800,000 uninsured adults by tapping into a $400 million state fund that helps doctors pay their malpractice insurance costs.

Time out. There's a state fund for comparatively wealthy physicians to cover the depredations of the insurance industry, but not for the working poor -- for whom it's a matter of life and death? Don't get me wrong, the cost of malpractice insurance is another example of the insurance industry run amok. But the fact that the state stepped in to help the doctors does show the relative strength of concern for physicians vs. for the working class. And how com the Right continues to argue that malpractice costs are part of the reason for high medical costs in the U.S., if there are, evidently, state funds helping out?

Here's a 2005 pdf report that shows that

• Over the last five years the amount the major medical malpractice insurers have collected in premiums has more than doubled, while their claims payouts have remained essentially flat.
• Some malpractice insurers substantially increased their premiums while both their claims payments and their projected future claims payments were decreasing.
• Malpractice insurers accumulated record amounts of surplus over the last three years.

Back to the governor -- a year ago he introduced Cover All Pennsylvanians. The single-payer movement in Pennsylvania was frustrated by that plan, because although Rendell has said he'd sign a single-payer bill if it passed the Legislature, instead he put forward his own plan, which does nothing to rein in costs. Those following the Pennsylvania reform effort call Rendell's bill "No Health Insurance Company Left Behind," and note that "Capital Blue Cross’s CEO, Anita Smith, was standing at Rendell’s side when he introduced his bill." Oddly enough, Pennsylvania lawmakers "showed little interest in helping to fund it with a tax on businesses that did not offer health insurance to workers."

The state's doctors could pay a price if no agreement is reached soon. The governor has declined to approve medical malpractice subsidies, known as abatements, through the state's MCare program until lawmakers agree to fund Cover All Pennsylvanians. If no deal is struck by March 31, the unsubsidized bills will come due.

Furthermore, the governor has pledged to campaign against Republican legislators in the fall, if they continue to balk.

The response seems to be a GOP yawn and shrug.

NC Blue Cross publishes prices

Medical News Today reports that Blue Cross Blue Shield of North Carolina is publishing online (for its members only) the prices it pays for thousands of procedures. Here's some examples:

• Physician office visits, with separate categories of average costs for a variety of services for men, women and children. For example, the average cost BCBSNC pays statewide for an annual physical examination for a 35-year-old man is $279, including recommended lab work and immunizations. A child's doctor visit for a cold typically costs the company $75.
• Diagnostic screenings and surgical procedures, with average costs broken out by place of service. For example, an MRI provided in an outpatient hospital setting costs BCBSNC $1,975 on average, while the same scan in a freestanding facility costs $933. Anterior cruciate ligament (ACL) surgery costs the company an average of $10,337 if done in an outpatient hospital setting, and $6,859 if done in an ambulatory surgical center. The average cost for an outpatient colonoscopy is $2,040 at a hospital, $1,203 at an ambulatory surgical center and $889 in a physician's office.
• Total average costs for treatment of diseases and conditions. For example, the average total that BCBSNC would expect to pay for a member who requires heart bypass surgery is $57,280, including office visits, hospital costs, drugs, tests and other services. A typical course of breast cancer treatment, including surgery, costs $26,749.
• The Health Cost Estimator includes prices BCBSNC pays for the most commonly used prescription medications. Members can learn, for example, that a brand name cholesterol-lowering drug can cost as much as $150 or more for a month's supply, while a generic drug can cost as low as $20 per month.