Working towards lower healthcare prices
February 09, 2025
At DocSpot, our mission is to connect people with the right health care by helping them navigate publicly available information. We believe the first step of that mission is to help connect people with an appropriate medical provider, and we look forward to helping people navigate other aspects of their care as the opportunities arise. We are just at the start of that mission, so we hope you will come back often to see how things are developing.
An underlying philosophy of our work is that right care means different things to different people. We also recognize that doctors are multidimensional people. So, instead of trying to determine which doctors are "better" than others, we offer a variety of filter options that individuals can apply to more quickly discover providers that fit their needs.
February 09, 2025
KFF Health News published a profile piece of one woman, Gloria Sachdev, who has worked over the years to reduce the growth of healthcare costs in Indiana. She pushed to get a baseline of how healthcare costs in Indiana compared to those of other states: "Rand published a study in 2019 that analyzed the prices paid by private health plans to more than 1,500 hospitals across the nation. ... Indiana landed at the top of the list, with the highest hospital prices among the 25 states initially studied." Since then, the state legislature "enacted laws to combat consolidation, banning large hospital systems from tacking on extra fees, restricting employers from imposing non-compete contracts on primary care physicians, and requiring health care companies to report pending mergers to the state's attorney general." Since then, "Indiana had fallen from the top spot to the state with the ninth-highest prices."
It seems that the fight against consolidation of hospitals and health systems is a major factor in the apparent success. Consequently, the legislature is now considering repealing its Certificate of Public Advantage law, which apparently allows proposed mergers to be "shielded from federal anti-monopoly restrictions."
February 02, 2025
KFF Health News reported on some current differences between telehealth and traditional medicine. On one hand, in areas that might not have as many providers, telehealth might offer some convenient options. On the other hand, one patient that turned to telehealth for mental health noted that "There is no comforting face to validate you."
One professor of public health suggested that telehealth might work better for situations in which the patient already knows what he or she wants (e.g. birth control), and seeks a prescription. In that case, the healthcare professional can help ensure medication safety. Critics of telehealth warn that telehealth offerings "may shortchange patients in need of close, sensitive attention."
Telehealth still seems relatively new as an industry. It may indeed turn out that telehealth can fill certain niches, just as clinics at pharmacies might fill. Or, perhaps telehealth will turn out to be more broadly effective.
January 27, 2025
KFF Health News published an article about how the new White House administration may allow current insurance premium subsidies to expire and the effect that decision might have on those who buy insurance from California's health insurance marketplace. According to some researchers, "Covered California premiums for subsidized enrollees would soar by an average of $967 a year beginning in 2026, and an estimated 69,000 Californians would lose their insurance." Tragic as that might seem, the underlying issue appears to be the cost of healthcare, which in turn, drives up premiums. For context, "California took its own steps last year to make coverage more affordable, eliminating deductibles and reducing other out-of-pocket costs on all mid-tier policies."
The article explains, "While federal and state subsidies have significantly boosted the amount of assistance available, the underlying cost of insurance has continued to go up. Covered California premiums are up by 7.9% on average for 2025, but the extra subsidies shield most enrollees from the increase." So the government subsidies certainly help individuals in the short term, but do not do anything to slow the growth of healthcare costs in the whole system.
January 19, 2025
KFF Health News reported on a long-term trend that the US lacks enough primary care doctors: "The Association of American Medical Colleges projects a shortage of 20,200 to 40,400 primary care doctors by 2036. This means many Americans will lose out on the benefits of primary care, which research shows improves health, leading to fewer hospital visits and less chronic illness."
The article explains that other specialties pay more (in the case of orthopedics and dermatology, about twice as much), and that other specialties garner more respect. The salary differential could be meaningful for some who start their careers heavily in debt because of medical school. Some medical schools now eliminate tuition, which might give some students more freedom to choose. However, free tuition seems unlikely to be enough to balance out the field. Instead, a professor of medicine conveyed that "the U.S. health care system must address the low pay and lack of support."
January 12, 2025
The Federal Trade Commission (FTC) can try to prevent consolidation in different industries and in different markets. For example, if two large healthcare systems are the only two large networks that serve a geographic area, the FTC might oppose their merger. KFF Health News reported that currently 19 states have laws that can exempt hospital systems from the FTC's decisions about mergers, but five states have already repealed those laws, and a sixth one is considering doing so.
Industry consolidation through mergers leads to less competition and is therefore considered anti-competitive behavior. Some previous health networks have been able to convince regulators that a merger might save an ailing health system or that a merger might enable the combined entity to provide better service, potentially at less cost. What those networks claim before the merger might actually be very different from what actually happens after the merger. For example, without adequate competition, the new entity can command higher prices. Of course, once a merger has happened, reversing the merger is difficult. Hence, some states have found that even if hospital systems agree ahead of the merger to comply with certain requirements, such reassurances are not adequate. The FTC has commented that those exemptions "have failed to protect local communities from the harmful effects of anticompetitive hospital mergers." For that reason, some states have reversed their laws to allow those exemptions.