Author Archives: Reeve Conover

Waiting 19.8 weeks to see a specialist…

In light of the recent push for socialized medicine, or “Medicare for All”, A recent article (click here) looked at Canada’s socialized medicine program with the following findings:

  1. Long waits plague patients in other countries with government-run health care. Take Canada, which outlaws private health insurance for anything considered medically necessary, just as “Medicare for all” would. The median wait for treatment from a specialist following referral by a general practitioner is 19.8 weeks, according to the Fraser Institute, a Vancouver-based think tank. In 1993, the median wait was less than half as much – 9.3 weeks.
  2. Waits are far longer for some specialties. For orthopedic surgery, the median wait for specialist treatment is 39 weeks.
  3. On the other side of the Atlantic, the United Kingdom’s government-run, 70-year old National Health Service, is proving similarly incapable of providing quality care. The system is currently short 100,000 health professionals – doctors, nurses and other workers. It’s no wonder 14 percent of procedures were canceled, right before they were scheduled to occur, during a one-week period in the last week of March 2018. The NHS sees this as an anomaly and an NHS spokesman said, “Actually, only a tiny minority of operations — just 1 in 100 — is canceled on the day.” But still, last July, 4.3 million patients were waiting for an operation – the highest figure in a decade. During the winter, the system goes into crisis mode. Between December 2017 and February 2018, more than 163,000 patients waited in corridors and ambulances for more than 30 minutes before being admitted to the emergency room. To deal with the crunch, officials ordered hospitals to cancel 50,000 operations.

So what about claims that it would cost less?  It sounds too good to be true because it clearly is.  The proposed system in one NY bill presented would cover everyone, with no copays or deductibles and no premiums;  it would be financed by much higher payroll taxes on Employers and Employees alike.  How high is a good question, but when you have eliminated any cost sharing by those covered, all cost containments being eliminated, and the massive disruption to the health care industry you can expect them to be in the range of the proposal by Alexandria Ocasio-Cortez- 70% marginal tax rates.   In fact, every financial evaluation I have seen shows it would not lower cost, but raise them dramatically for all users.

Microsoft and Walgreens join forces to take on Amazon in health care

Paul R. La Monica / CNN Business:   Microsoft and Amazon, the two most valuable companies in the world, are already competing for supremacy in cloud computing. Now Microsoft has its sights set on battling Amazon in the lucrative health care market as well. Microsoft (MSFT) announced a partnership with Walgreens Boots Alliance (WBA) Tuesday. As part of the deal, Microsoft will become Walgreen’s new cloud provider. The two said they will also work on solutions to lower health care costs. Walgreens will open up 12 “digital health corners” in stores that will sell health care-related gadgets. The two companies said the partnership will help Walgreens gain personalized data about their customers’ health, which will allow pharmacists to give better, customized nutrition and wellness solutions. The Microsoft-Walgreens joint venture appears to be a clear move by the two companies to try and counter Amazon’s (AMZN) growing clout in health care.

Reeve Conover recognized for helping consumers with qualified health coverage

Charleston SC – Reeve Conover has been recognized for his hard work and expertise in helping consumers enroll in and manage qualified health coverage through the Health Insurance Marketplace. This nationwide recognition from the Centers for Medicare & Medicaid Services (CMS) as a member of the 2019 Marketplace Circle of Champions highlights Reeve Conover success in enrolling more than 40 consumers during this Open Enrollment Period. “Consumers turn to agents and brokers for trusted advice and guidance in selecting plans, enrolling in coverage, and managing their health insurance policies throughout the year,” said Randy Pate, Director of Center for Consumer Information & Insurance Oversight (CCIIO) operation within CMS, which oversees the Marketplace. “We thank Reeve Conover for his hard work and exceptional service in helping Americans get coverage.” The Marketplace Circle of Champions program recognizes the hard work, expertise and service of Marketplace-registered agents and brokers. Agents and brokers who assist 20 or more consumers qualify for the Marketplace Circle of Champions. Eligible consumers can enroll in Marketplace coverage during this year’s Open Enrollment Period, which runs November 1 – December 15, 2018. Consumers with questions about their coverage or who would like help enrolling, can contact Reeve Conover at 843-800-8190.

Walmart to remain in CVS Network

A lot of back and forth, with public announcements in the last 10 days, but in the end- Walmart has reached an agreement to remain in the CVS network.  So, nevermind!

The battle was over Walmarts demand for higher-reimbursements for its in-store pharmacies.

Oxford New Assistant Surgeon and Co-Surgeon Protocol eff Jan 1, 2019

NOTE- in the past an in-network surgery was generally considered in network for all providers.  This is slowly changing.. and may have financial implications, as most Oxford members do NOT have out of network coverage:

 

We are implementing an assistant surgeon and co-surgeon services protocol with our New York participating (network) providers. Under the protocol, network providers are required to tell their Oxford patients if they are recommending, involving or referring a nonparticipating (out-of-network) assistant surgeon or co-surgeon in the member’s care. The protocol is consistent with New York law that includes protection for consumers from surprise medical bills.

What is changing?

consent form has been created to confirm the members choice of provider when assistant or co-surgeon services are needed. Beginning Jan. 1, 2019, doctors and members will discuss the option of a non-participating assistant or co-surgeon and the financial consequences of using an out-of-network provider. Members will read and sign the consent form confirming their choice to use a network or out-of-network provider and their understanding of the financial impact.

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Reeve Conover is a Registered Representative. Securities offered through Cambridge Investment Research, Inc., a Broker/dealer member FINRA/SPIC. Cambridge and Conover Consulting are not affiliated. Licensed in SC, NC, NY, CT, NJ, and CA.
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