Fulcrum Strategies, analyzing changes in health care and how they affect you

If proposed legislation allowing Americans to buy a Medicare policy at age 50, instead of 65, passes - who benefits? Is this a good idea we should be embracing immediately? Or is there a flip side to this coin that we haven't fully investigated? Ron discusses what moving the Medicare eligible age to 50 could mean for patients, employers, insurance companies, and healthcare providers.

A recent Kaiser Foundation study indicates we could save 350 billion dollars annually if we paid all physicians and hospitals at Medicare rates. It sounds good in theory, but what's the rest of the story? You can't reduce one person's expense without cutting another's revenue, so who bears the real cost of our "savings"? Ron discusses the real-world impact of the study on the medical community.

2020 is over, back to normal - right? What can medical practices expect in 2021 as all of America tries to get back to what we had before the pandemic? Ron discusses patient volume, politics, and more as we look forward to a new year.

Congress is, to hopefully no one's surprise, overreacting. They're proposing legislation to limit the ability of hospital-based physicians to make a living, and decide for themselves the kinds of business relationships they enter, by passing a law forcing them to accept an arbitrary standard set by entities who stand to make a profit by doing it. It's like paving your entire yard because you have a few weeds. Actually, it's like having a government agent walk up to your door, tell you you have a weed problem, then inform you they're going to pave your yard whether you like it or not. Blanket surprise-billing legislation is not the answer to the anecdotal stories about big bills from non-contracted practices. Ron discusses some of the reality of Surprise Billing and what it could mean for physicians, and those of us who rely upon them.

Ron discusses what could happen if COVID ran unchecked through America.

"COVID Fatigue" has become a real force in our lives. From the monotony of isolation to the stress of loss, it affects those of us "behind the lines" in real ways. What about those on the front lines of the fight? For them, the fatigue is littoral. Doctors, nurses, EMS, hospital staff, they've been at it non-stop for nine months, and if they tire, if they're "overrun", there's just us to try to hold back the tide. Ever been to the beach? Ever tried to hold back the ocean? Ron discusses the state of front-line healthcare workers and what we might do to help.

It applies to so many situations, "don't hate the player, hate the game". Insurance companies are playing the game according to the rules they have and they're making record profits. Do we hate them? Or the game they're forced to play to maximize their shareholders' investments? The system we have now incentivizes payers to make life miserable for the 5% of health care consumers who account for 50% of all health care spending. They use tools like prior-authorization, pre-certification, fail-first pharmacy and more, all to try to make expensive members go somewhere else. What if we changed the system? Ron explores what we might be able to do to change the rules of the game and move payer's focus off shedding expensive members and onto efficiently caring for them.

So much is "up for grabs" in the next few months. Depending on the results of the election and the confirmation hearing, we could see Democrats take the Presidency and control of the Senate, as well as Republicans get the Affordable Care Act struck down by the Supreme Court. What would it mean if both sides got their way? What would happen to physicians? Hospitals? Us? Ron discusses this possible scenario and its impact on society.

President Trump spoke on Thursday about his plans for the future of health care in our country. He even signed executive orders designed to advance his agenda - but what did they accomplish? Will the directives actually change healthcare as we know it, or were they primarily political "press releases" and little more? Ron discusses his take on the plans released yesterday by the Trump administration.

Candidate Biden has released a number of details regarding what he would do for health care in America if he becomes president. Ron reviews the proposal point by point and describes how Biden's planned changes would affect American consumers and the doctors who care for them. What should physicians do to prepare for the eventuality that some or all of these changes happen? Listen to our latest podcast and find out.