Wednesday, May 13, 2015

FAQ Follow-up

The NPR / Kaiser Health News report on Monday's ACA FAQ XXVI says it all.  
Free means free. The Obama administration said Monday that health plans must offer at least one option for every type of prescription birth control free of charge to consumers. The instructions clarify the Affordable Care Act's contraceptive mandate. 
If you want the backstory, read Robert Pear's April 29 article in the New York Times "Insurers Flour Rules Covering Birth Control, Studies Find."  However, it's clear at least to the FEHBlog that the ACA regulators did not believe that insurers were flouting any rules because the agencies applied the new mandates to the next plan year, not immediately.   ACA FAQ XXVI illustrates the fact that the ACA turned health insurers, including FEHB plans, into public utilities. Whether that's good or bad is for readers to judge.

ACA FAQ XXVI also mandates that free colonoscopies must include free anesthesia.  The FEHBlog, as an older gentleman, applauds that mandate. Yesterday the Washington Post reported that endoscopy centers are beginning to use a machine to perform anesthesia at colonoscopies.   The machine called Sedasys is manufactured by Johnson & Johnson and is FDA approved over the objections of, of course, anesthesiologists.  (As a guild member, the FEHBlog cannot possibly sneer at another profession for attempting to protect their turf.)   The machine, which of course is monitored by nurses, works and here's the rub --
Sedation can cost even more than the colonoscopy, with anesthesiology fees adding up to $2,000. By contrast, Sedasys costs $150 to $200 each time.
If a drug manufacturer such as Gilead Sciences had been pricing Sedasys, the price would have been $2,000 each time or maybe $1995.

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