We interrupt our regularly-scheduled blog on the Blockchain in artificial intelligence (A.I.) to review the possible impact on healthcare, post-midterm elections in the United States.<\/p>\n
First, we write this blog from the epicenter of election controversy in Palm Beach County, Florida. \u00a0It is hard for anyone who has paid attention to the U.S. midterm elections to not know that there are major efforts underway for a recount of votes in this county (where President Trump is a part-time resident) specifically in the U.S. Senate race and for governor of the state of Florida. \u00a0There are two takeaways from this situation.\u00a0 First, the U.S. electorate is nearly equally divided in philosophy, and second, the total incompetence that has placed Palm Beach County again in the middle of the election; it was too close to call.<\/p>\n
However, the key take-away from the U.S. elections is that the number one concern of Americans as surveyed, is not the economy. \u00a0The economy in the United States is roaring. \u00a0If you don\u2019t believe me you can ask the Federal Reserve Open Market Committee, who has been raising interest rates, and expects to continue raising interest rates at least through 2019. \u00a0It is not concerned over terrorism, security, politics, or the headlines of Russian collusion in the 2016 elections. \u00a0It was, by a large margin, concerns over healthcare. \u00a0By some reports, 70% of those surveyed after they voted, believe that the U.S. healthcare system needs dramatic change.<\/p>\n
Many Democrats ran on protecting the \u201cpre-existing protection\u201d part of the affordable care act of 2010 (ACA) also commonly referred to as Obamacare. \u00a0We totally agree that the single best thing of the ACA was the protection of pre-existing conditions.<\/p>\n
Another concern of Americans is the sky-high drug prices. \u00a0That subject we have written about extensively in these blogs, and we agree with consumers. \u00a0What many do not know is what is yet to come about healthcare cost in the United States. \u00a0Over the next few years there are a number of highly specialized gene-based drugs that will be entering the marketplace in America. \u00a0Some of these drugs, or better yet treatments, could cost $250,000 to $1 million to materially treat or put in remission major debilitating diseases.<\/p>\n
Based on the results of the election, we can categorically say that the ACA will not be repealed with the Democrats in control of the U.S. House of Representatives, or what other countries call the lower chamber. \u00a0We do expect that the President will use his executive powers to limit even more of what is left of the ACA, if no bipartisan agreement is reached. \u00a0This will likely mean that even more cases will be destined for review and interpretation by the U.S. Supreme Court.<\/p>\n
It is possible that in a new unexpected compromise, both houses and the President could take up modest action to stabilize the ACA in the private insurance markets. \u00a0The premiums are expected to increase modestly in 2019; however, they have stabilized at very high rates.<\/p>\n
One thing that nearly all parties agree on though is Americans, employers, and the government are paying too much for prescription drugs, and particularly when referenced to the same drug cost in Europe and other developed countries. \u00a0If drug price reform or restrictions are placed in narrow legislation, we predict that it will receive bipartisan support, and the President\u2019s support. \u00a0It is also likely that if it is part of a complicated wide-reaching legislation, that includes drug issues, it is likely to be blocked in the U.S. Senate, and will never reach the President\u2019s status for signing.<\/p>\n
Another issue of unity is a subject of in-network and out-of-network charges for those that are insured today. \u00a0In many cases, patients have no way to know who is in their network and who is not. \u00a0A patient undergoing surgery could be treated by a doctor that is in their network and have an anesthesiologist or pathologist, whom they do not know, be out-of-network and providers will routinely bill for out-of-network balance billing. \u00a0That gap, or balance billing, could range in the thousands of dollars for a procedure, such as surgery.\u00a0 This is unexpected and very confusing to consumers. \u00a0It is also unfair and should be illegal. \u00a0I can feel the pain personally because it has happened to me on more than one occasion. \u00a0Nearly every American has experienced it, generally in emergency situations.<\/p>\n
Because of referendums at the state level, it is guaranteed that the Medicaid program will be expanded, taking advantage of the existing ACA opportunity. \u00a0This, along with potential changes to fix the ACA, could actually inspire other states that have not participated in Medicaid expansion, to adopt a \u201cnew ACA,\u201d and those actions could materially expand coverage to millions of Americans.<\/p>\n
In this blog, we have never advocated replacing the ACA \u2013 only materially modifying it. \u00a0By a large margin, that seems to be what most Americans want, and politicians on both sides of the political spectrum have noticed it.<\/p>\n
We also expect material movement on price transparency of healthcare cost to consumers. \u00a0We operate in a dark pool in healthcare cost, because in most cases consumers have no idea what the cost is going to be. \u00a0Providers generally charge what is referred to as a usual and customary, and never did they receive that payment from state and federal programs. \u00a0I have yet to see an insurance company pay that usual and customary charge. \u00a0It is the customers, who are without insurance, that pay most of the time the usual and customary charge. \u00a0This modification will be difficult and hard-fought. \u00a0In the interim, American innovation and ingenuity may impact this segment of healthcare, by providing technology solutions, where consumers will know exactly what they will pay for care, before the care is provided.\u00a0 This is a new concept and one that has been applied in nearly every consumer facing industry in America, today.<\/p>\n
In line with price transparency, a new federal law takes effect on the first day of 2019, forcing hospitals to list usual and customary prices on their websites. \u00a0We expect that to be the beginning of material transformation and transparency in healthcare cost. \u00a0Hospitalization accounts for over one third of all healthcare expenditures in the United States.<\/p>\n
In summary, we expect more Americans to have healthcare insurance by 2020, just in time for the presidential elections in November 2020. \u00a0We expect healthcare cost to go up 6-7% over the next two years, and maybe even as much is 8% by 2022. \u00a0We are still as a country dealing with healthcare insurance and coverage, and not fundamental changes in healthcare cost. \u00a0We think that with better use of technology and more consumer control of their healthcare cost (who is also economically benefitted to stay healthy) will reduce the overuse of healthcare, along with paying providers to keep patients healthy, will be collectively the only cure for the U.S. healthcare system.<\/p>\n
-Noel J. Guillama, President<\/p>\n","protected":false},"excerpt":{"rendered":"
We interrupt our regularly-scheduled blog on the Blockchain in artificial intelligence (A.I.) to review the possible impact on healthcare, post-midterm elections in the United States. First, we write this blog from the epicenter of election controversy in Palm Beach County, Florida. \u00a0It is hard for anyone who has paid attention to the U.S. midterm elections to not know that there are major efforts underway for a recount of votes in this county (where President Trump is a part-time resident) specifically in the U.S. Senate race and for governor of the […]<\/p>\n","protected":false},"author":6,"featured_media":3890,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-3889","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"https:\/\/pwer.com\/wp-content\/uploads\/2018\/11\/AdobeStock_22668110.jpeg","_links":{"self":[{"href":"https:\/\/pwer.com\/index.php?rest_route=\/wp\/v2\/posts\/3889","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pwer.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pwer.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pwer.com\/index.php?rest_route=\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/pwer.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3889"}],"version-history":[{"count":1,"href":"https:\/\/pwer.com\/index.php?rest_route=\/wp\/v2\/posts\/3889\/revisions"}],"predecessor-version":[{"id":3891,"href":"https:\/\/pwer.com\/index.php?rest_route=\/wp\/v2\/posts\/3889\/revisions\/3891"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pwer.com\/index.php?rest_route=\/wp\/v2\/media\/3890"}],"wp:attachment":[{"href":"https:\/\/pwer.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3889"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pwer.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3889"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pwer.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3889"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}