Quote of the Day

PNHP's Senior Health Policy Fellow Don McCanne, M.D. writes a daily health policy update, taking an excerpt or quote from a health care news story or analysis on the Internet and commenting on its significance to the single-payer health care reform movement. PNHP posts Dr. McCanne's listserv here; to subscribe to the listserv, please visit the Quote of the Day the mailing list website.

  • Posted on Monday, June 29, 2015
    In his dissent, Justice Antonin Scalia placed the importance of a negligible textual drafting error over the importance of the clear intent of the Affordable Care Act (ACA) to expand health care coverage to more people while trying to keep insurance affordable. With a full reading of both the majority opinion and Scalia’s dissent, it is clear that Justice Scalia’s opposition was based on ideology, with only token references to law.

  • Posted on Friday, June 26, 2015
    What should the consumer expect from marketplace competition? Business experts tell us that competition is the key to higher quality at lower cost. So what has competition between private health insurance plans brought us?

  • Posted on Thursday, June 25, 2015
    According to the Supreme Court, Congress’s plan was “to improve health insurance markets, not to destroy them,” and thus they upheld the subsidies for the plans offered through the state insurance exchanges. But Congress has failed to establish a process through which absolutely everyone is assured of health care when needed. That is, Congress has established health care as a right only in selected circumstances, but not for everyone. In contrast, as the authors of the NEJM article state, “…under the Court framework, a completely single-payer system is more constitutionally sound than the ACA statutory design…” Enacting a single payer system would finally establish health care as a right throughout the United States.

  • Posted on Wednesday, June 24, 2015
    Discussions of expanding health care coverage to everyone frequently result in expressions of concern about immigration policy. That unauthorized immigrants place a burden on our public resources has become a meme that is not substantiated in fact. This study adds to the evidence that unauthorized immigrants contribute more toward our public resources than they consume in benefits. Their contributions have reinforced our Medicare trust funds.

  • Posted on Tuesday, June 23, 2015
    In his enthusiastic endorsement of single payer Medicare for all, Robert Reich also renews the call for the “public option” of allowing people to purchase Medicare through the exchanges established by the Affordable Care Act. During the health care reform process, the public option had wide support, but was first weakened considerably and then eventually rejected by Congress in a power play by Sen. Joseph Lieberman.

  • Posted on Monday, June 22, 2015
    This report from the Congressional Budget Office (CBO) is important because it describes the consequences of repealing the Affordable Care Act (ACA) - a goal of many conservatives in Congress. But there also is an important sub-story here - the advent of the use of “dynamic scoring” by the CBO and its potential implications.

  • Posted on Friday, June 19, 2015
    Although it was important to include a drug benefit in the Medicare program there was concern that the conservatives designing the program wanted to allow the market to work its magic. The program was to be administered by private pharmacy benefit managers (PBMs) rather than the government. In fact, the government was even prohibited from negotiating drug prices with the manufacturers. Further, it was thought that the benefits of improving access to drugs would make patients healthier thus reducing future costs for Medicare.

  • Posted on Thursday, June 18, 2015
    Here’s a shocker. Enactment and implementation of the Affordable Care Act has been and continues to be unethical, under the “principle of equipoise.” How could that be?

  • Posted on Wednesday, June 17, 2015
    Medicaid patients throughout the nation are being transferred into Medicaid managed care plans, allegedly to provide more coordinated care at a lower cost. There has been some justifiable concern that these plans may not be delivering on their promises. This auditor’s report of California’s Medi-Cal managed care plans provides some limited insight into the performance of these plans.

  • Posted on Tuesday, June 16, 2015
    Everywhere you turn these days there is rampant speculation on what the impact will be of the soon-to-be-released Supreme Court decision on King v. Burwell - the case on whether or not subsidies can be provided to enrollees in federal ACA insurance exchanges. In the long run, the outcome doesn’t matter.

  • Posted on Monday, June 15, 2015
    A cursory glance at this article suggests that it is simply one more study that confirms that high deductible plans decrease health care spending, and since you already know that you might be tempted to pass on reading today’s message. But don’t skip this one if you wish to better understand just what impact high deductibles really do have.

  • Posted on Friday, June 12, 2015
    The growth in enrollment in private Medicare Advantage (MA) plans has been largely due to the attraction of not having to pay a premium for the plans. The trade-off is that the patient is exposed to higher out-of-pocket expenses.

  • Posted on Thursday, June 11, 2015
    Every member of the House of Representatives needs to read this NEJM article before the crucial vote tomorrow on fast-track authority. If Congress grants the President fast-track authority and eventually provides nonnegotiable blanket approval of TPP, “the United States could be signing away its authority to regulate critical aspects of health policy for years to come.”

  • Posted on Wednesday, June 10, 2015
    The Senate has already approved fast-track trade authority, and the House will vote on it in just two days. If it passes, it will allow President Obama to send Congress the Trans-Pacific Partnership trade agreement (TPP) for an up-or-down vote, with no amendments allowed.

  • Posted on Tuesday, June 9, 2015
    The single payer model of health care reform supported by Physicians for a National Health Program (PNHP) requires that the for-profit elements of the health care delivery system be converted to nonprofit status. This report provides a prime example of the rationale of that proposed policy.

  • Posted on Monday, June 8, 2015
    Who does not believe that absolutely all of us should have the health care that we need when we need it? Well, one obvious group is our elected legislators. Otherwise we would have had a universal national health program many decades ago. What can Florida add to our understanding of this resistance to ensuring universal care?

  • Posted on Friday, June 5, 2015
    Most states are moving most of their Medicaid patients into Medicaid managed care programs. As of 2011, 74% of Medicaid patients were in Medicaid managed care organizations (CMS data). The states contend that this shift will improve care coordination while reducing costs. What does this report from The Urban Institute show us?

  • Posted on Thursday, June 4, 2015
    By now there can be absolutely no lingering doubt that the Medicare Advantage plans are ripping off the taxpayers. The NBER paper by Geruso and Layton confirms that the “private Medicare Advantage plans generate 6% to 16% higher diagnosis-based risk scores than the same enrollees would generate under fee-for-service Medicare.”

  • Posted on Wednesday, June 3, 2015
    “Effectuated” enrollment in the ACA exchange plans is an evasive term to obscure the fact that 13 percent of those enrolled for 2015 had already dropped out by the end of the first quarter. Also, when they decided that previous anticipated levels of enrollment were unrealistic, they set a lower goal which they now report that were able to meet. Surprise!

  • Posted on Tuesday, June 2, 2015
    The outrageous price of drugs has been a topic of a plethora of news reports, and for very good reason. Thus it is encouraging that the nation’s cancer specialists, at their recent national meeting, brought the topic of rising cancer drug costs front and center.