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Health Costs

Personal health: Sticker shock at pharmacy

My recent sinus infection came on suddenly and painfully. After diagnosing it, my physician e-prescribed me an antibiotic.

cohdra_100_9279This is tricky territory for me. I’m sensitive to some antibiotics. Years ago, I took a couple of varieties to treat similar infections, and wound up with oral thrush in one case and C. difficile in another. Both were 100 times worse than the original ailment.

My physician knew this history. He prescribed a two-week supply of doxycyline hyclate, a dependable antibiotic that he felt I could tolerate well, partly because I had handled it well in the past.

So I headed to my pharmacy to pick up the “doxy.”

“It’s one seventeen,’’ said the clerk, in an oddly sheepish way.

I pulled a dollar from my wallet and extracted some change from my pants pocket.

She looked at the money and said, “No. It’s a hundred and seventeen dollars.’’

“Whoa,’’ I said. “$117?” full story

Is Georgia’s medical access law too weak?

The state insurance department is looking at possible ways to strengthen a Georgia law that requires health insurers’ networks to give consumers adequate access to doctors and hospitals.

“Georgia is not alone: The feds and all the states are looking at the issue,’’ Trey Sivley, director of the Division of Insurance and Financial Oversight for the Georgia agency, told GHN recently.

Healthcare CostThe National Association of Insurance Commissioners is working on a redraft of its model for a network adequacy law. Georgia is studying the NAIC proposals, Sivley said. But he added that the state’s interest in the details “doesn’t mean that we’re going to adopt” the national group’s plan.

Such regulatory changes, if enacted, would coincide with an accelerating trend of health insurers offering consumers more limited choices of medical providers. The resulting health plans have become known generally as “narrow networks.” full story

Poll: Georgians like expansion, but not ACA overall

A new poll finds 60 percent of Georgians disagree with the state’s decision not to expand the state’s Medicaid program, a key provision of the Affordable Care Act.

The health reform law overall, though, fares less well in popularity. According to the survey, conducted by the Schapiro Group in August and sponsored by Healthcare Georgia Foundation, 42 percent of Georgians approve of the ACA and 46 percent disapprove.

Healthcare CostThe survey also found that the cost of care continues to be an important factor in whether consumers receive health care. Forty-two percent of Georgians said they wanted to seek care at some point, but chose not to do so, up from 33 percent the year before. Cost was the most cited reason for that decision.

And 40 percent of the 400 respondents said they think they have paid more for care over the past year.

“As the troubling trend of increased health care costs continues, Georgians who cannot afford health insurance are simply unable to seek or choosing not to seek the medical care they need,” said Gary Nelson, president of Healthcare Georgia Foundation. full story

It’s official: Phoebe settlement is off

The Federal Trade Commission announced Friday that it has rejected a proposed settlement agreement with Phoebe Putney Health System over the latter’s 2011 merger with a rival Albany hospital.

The FTC and Phoebe tentatively reached the agreement last year, appearing to put an end to what was already a long-running, complicated legal dispute. But the federal agency has been signaling for months that it might not take the deal after all.

Phoebe Putney Memorial Hospital

Phoebe Putney Memorial Hospital

The agency’s decision to reject the settlement revives the high-profile regulatory fight between Phoebe Putney and the FTC. The matter will now return to an administrative court, where a hearing is expected over the feds’ antitrust allegations against Phoebe.

The federal agency has contended for three years that Phoebe’s acquisition of Palmyra Medical Center violated antitrust laws, reducing competition and potentially raising prices for consumers.

“We’ve argued all along that this merger would create a monopoly in Albany that would harm consumers and employers in the region,” Deborah Feinstein, director of the FTC’s Bureau of Competition, said in a statement Friday. “Meaningful structural relief is needed to restore competition to this marketplace.”

Phoebe Putney officials called the FTC’s rejection of the deal disappointing. full story

Key activist group sees flaws in state health plan

Last week, when upcoming changes in the state employee and teacher health plan were announced, they drew a generally positive response.

Healthcare CostMembers learned that the 2015 plan would include an increased choice of insurers, which was welcome, and officials presented information showing that many members would see no premium increase.

But after studying the proposed rates in greater detail, a group representing teachers, employees and retirees is voicing concern. It says many of the new options will be unaffordable for members looking to switch from their current plans. full story

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