Weirdest thing: if you tax something, you get less of it.
To help pay for President Barack Obama’s health law, Congress enacted a 2.3 percent tax on the sale of medical devices used chiefly by doctors and hospitals, such as pacemakers and CT scan machines.
The tax took effect in January 2013. For the first six months of that year, the IRS estimated it would collect $1.2 billion from the tax.
The audit said the IRS collected only $913 million — 24 percent less than the estimate.
The Treasury audit blames noncompliance for the freefall in revenue, and it’s entirely possible that that’s true. In part. However… maybe hospitals are holding off for a while on buying more pacemakers and CAT scan machines. Because the reason why when you tax something, you get less of it is because people are not made of money – and, outside of Congress, folks have these things called ‘budgets.’ They take a percentage increase in overhead more seriously than the Democratic party does, apparently.
Well, we all do.
Moe Lane
It’s worse than that. It’s complete and unmitigated CF at all levels.
Two quick examples.
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My oldest daughter is medically fragile. She’s on anticoagulants. Her levels need to be tested regularly lest she begin clotting off her artificial heart valves in one direction, or become a hemophiliac in the other.
We own the machine to run these tests.
Due to some obscure portion of Obamacare, the Insurance company has been unwilling to help provide test strips, even though one visit to the Coumadin Clinic costs them more than a year’s worth of test strips. IIRC, we’ve been fighting this battle since November.
Last month, the Insurance company found a loophole where they could help with test strips “on a trial basis” for an unknown number of members. (We weren’t among those them, and I don’t know how many were allowed. I only know of one for certain.)
But there’s a problem. With insurance agencies not covering the test strips, the manufacturer wasn’t able to sell them in any quantity. And, as best I can track down, was forced to pay the medical device tax on all the test strips they manufactured, but couldn’t sell. (As well as taxes on inventory. Not to mention, payroll, benefits, and all the bills of running a factory that isn’t actually bringing in any money.)
Care to guess what happened to that production line?
Now that some can purchase them again, there are none to purchase.
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The second is more of a Kafkatrap. The same daughter is double-covered by two separate insurances, which normally works well/keeps us sane/keeps us from penury.
But not when it comes to testing blood sugar. One of the insurances entered into an exclusive agreement to only cover diabetic supplies from one supplier. The other entered into a similar agreement, but with a different supplier. They both have a policy that if the other refuses payment, so will they.
You can see the problem.
(The solution, so far as there is one, is to make sure the claim only goes to the company that will honor it, and paying the rest out of pocket.)
You have my sympathies, Luke, for what it’s worth. If we ever meet up in meatspace, lunch is on me.
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That said, crap like this leads me to not feel any sympathy whatsoever toward the insurance industry.
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Mew
Seriously, insurance companies suck.
Id still take them over single-payer any day.
Agreed.
Agreed.
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Mew
Lots of them suck.
But there are a few good ones out there. We had nothing but good things to say about our experiences with Riverside.
Too bad my wife’s employer dropped the option.
Thanks for the offer, but the first round of drinks sounds better.
(And the second is mine.)
Fair enough.
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Mew
Luke, I don’t know if this will help or not, but both Wal-Mart and Target sell a house-branded glucose meter that’s somewhat cheaper than the name-brand ones. The kicker is their strips are MASSIVELY cheaper–about $10 per box of 25. My friend, who’s in his 30s and is a brittle type-1 diabetec on an insulin pump, tests 5 times a day, and recommends the Target one. It’s branded Up and Up, but it’s just a rebadged model from another name brand. (The WM one is also a rebadged model from a different brand.)
Thanks. I’ll look into it.
We’re fortunate that we don’t have to test very often. Her problem is GI, rather than endocrine. Functionally it has the same effects as diabetes, but it’s *much* easier to treat and control.
Seconding the recommendation for the Walmart meters and strips.
The latest odd insurance thing to pop this week: patients usually can get 90 day supply of meds for cheaper than (3) 30 day fills, now one of the insurers is charging a premium on 90 day fills as a ” convience” fee! Between this, all the contradictory mandates, and electronic records, no wonder many of my colleagues are leaving practice
Question – are they leaving the practice, or are they setting out their own shingles and being picky about how they get paid?
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Mew
mixture of both. Some are retiring early or finding alternative avenues of employment. Many are are trying out boutique med if possible, this is the retainer fee model. The concern is among many is with the coming doctor shortage in primary care, will a “solution” be imposed on doctors that is even more devestating to professional autonomy.