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 Wednesday, November 25, 2015
    Regarding views toward health care reform, there is a suggestion in these polling results from Gallup that the American public may be influenced more by politics than by policy, but that might be changing.

  • Posted on Tuesday, November 24, 2015
    Although what we needed was a single payer national health program, Congress and the Obama administration elected to protect the interests of the insurance and pharmaceutical industries by allowing their powerful lobby organizations, AHIP and PhRMA, to craft health care reform by merely expanding our fragmented, dysfunctional model that placed their interests first while falling far short of goals that were important for patients - universality, affordability, and health care choices.

  • Posted on Monday, November 23, 2015
    This important study shows that the new hepatitis C drugs, such as Harvoni, are cost effective for early disease as well as late disease. The problem is that about 3.2 million people have hepatitis C infections, and, at a per-patient cost of close to $100,000, the implications are huge for public and private health care budgets.

  • Posted on Friday, November 20, 2015
    This update using the Commonwealth Fund Health Care Affordability Index demonstrates that health care remains unaffordable for one-fourth of privately insured adults and for over half of privately insured adults with incomes below 200% of the federal poverty level (FPL)

  • Posted on Thursday, November 19, 2015
    The Affordable Care Act was designed by the nation’s largest insurers to serve the interests of the nation’s largest insurers. It was almost as if the patients were not much more than a necessary nuisance, required only because an insurance market requires patients to purchase their plans. How is it working out for the insurers?

  • Posted on Thursday, November 19, 2015
    Private insurers use innovation to maintain a competitive marketplace presence for their insurance products. Health care costs are so high that premiums become unaffordable without the introduction of innovations. Two ubiquitous examples are lower-cost narrow networks of providers, and shifting health care costs to patients through higher deductibles. Now Aetna is introducing an innovative plan targeted to one specific disorder - diabetes. How does this work, and who benefits?

  • Posted on Tuesday, November 17, 2015
    A century ago life expectancy was 54. Today it is 79. Public health has played a much greater role in realizing this gain than has clinical medicine. Although most health funds are being directed to clinical services, public health services will need support to continue and to expand the gains that have been more important to society as a whole.

  • Posted on Monday, November 16, 2015
    The deductibles are out of control. The anecdotes in the full article (link above) demonstrate that many people find that their insurance is “all but useless” simply because they cannot afford to pay the deductibles. Anecdotes do not constitute a scientifically valid study, but they certainly do tell us what is happening to individuals out in the real world.

  • Posted on Friday, November 13, 2015
    Opponents of the Affordable Care Act have been using the Oregon Health Insurance Experiment (OHIE) to supposedly show that Medicaid does not improve health outcomes even though the study was not powered to demonstrate such. Thus this new study is important because it does show that Medicaid improves access, improves awareness of important chronic conditions, and improves control of hypertension. The OHIE trial did show that “Medicaid coverage increased health care use, improved patients’ financial security and self-reported health, lowered depression rates, and raised diabetes diagnosis rates.”

  • Posted on Thursday, November 12, 2015
    Many polls and surveys have shown that the majority of United States residents would prefer a single payer national health program. This survey is an important addition since it shows that individuals specifically targeted by reform in Massachusetts - individuals who theoretically would be satisfied with the system if reform met their needs - would still prefer to have a single national health insurance program.

  • Posted on Wednesday, November 11, 2015
    Is our health care system under Obamacare (ACA) an egalitarian system? Although ACA includes numerous policies designed to improve health care equity, it still falls far short. Conservative economist Tyler Cowen agrees, although his proposed solutions may be somewhat different from ours.

  • Posted on Tuesday, November 10, 2015
    Opponents of health care reform frequently dismiss efforts with the statement that the United States has the best health care system in the world. We don’t. This biennial report of OECD indicators provides international comparisons with tables and graphs that can be very useful in explaining why the United States needs to get serious with our health care reform efforts. It is shameful that we fall far behind our peer nations in so many of the crucial health indicators.

  • Posted on Monday, November 9, 2015
    Medi-Cal is a chronically underfunded Medicaid health program for low-income individuals in California. As such, these patients do not receive as much support from the health care community as do otherwise insured patients. This study confirms that cancer patients in the Medi-Cal and in the Medicare/MediCal dual eligible programs have impaired access and impaired outcomes almost comparable to those of uninsured patients.

  • Posted on Friday, November 6, 2015
    One of the more nefarious methods that private insurers use to reduce their responsibility to pay for health care is to refuse to pay for health care services provided outside of the networks of contracted physicians and hospitals that they, rather than the patient, have selected. They have tightened the screws by shrinking these networks and by dropping some of the PPO plans which permitted at least some out-of-network coverage, but at reduced rates.

  • Posted on Thursday, November 5, 2015
    Much has been written about the high costs of defensive medicine - excessive health care services that are delivered merely to protect against the potential of malpractice lawsuits. This study tends to reinforce the belief that there is a solid basis for defensive medicine since higher spending on health care is associated with fewer malpractice claims. But does this additional care represent defensive medicine, or does it represent beneficial health care services that prevent adverse outcomes?

  • Posted on Thursday, November 5, 2015
    Earlier this year medical societies celebrated their success in helping to get Congress to eliminate the Sustainable Growth Rate (SGR) formula - a formula that could have resulted in a 21% reduction in Medicare payments - and replace it with a 0.5% yearly increase for the next few years. There are two important stories here.

  • Posted on Tuesday, November 3, 2015
    In recent years concerns have been raised about the increases in death rates from prescription pain medications, but the magnitude of the problem was not recognized until this landmark study was released yesterday. Midlife deaths from poisonings with alcohol and drugs or from suicide of white, non-Hispanic men and women in the United States have skyrocketed since 1999. Morbidity likewise has increased in this group.

  • Posted on Tuesday, November 3, 2015
    The performance of competing private insurance plans within the ACA exchanges is not much different from the performance of the pre-ACA private plans in the individual market. Trends in higher insurance costs, greater cost sharing, and narrower choices were already occurring, and they continue to grow progressively worse. Access and affordability can only suffer.

  • Posted on Monday, November 2, 2015
    What a great opener for this weekend’s national meeting of Physicians for a National Health Program. An editorial in The Salt Lake Tribune tells us that, as we see the failures of the co-ops, the inadequacies of the exchanges, and "rival steampunk assemblages," it should have been single payer from the beginning.

  • Posted on Thursday, October 29, 2015
    This study shows that not all health plans in the ACA insurance exchanges have a full complement of specialists in their networks. When patients have to obtain their care out of network, they may face impaired access and financial penalties. If private insurers cannot provide the basics, why would we want to include them in our health care system in the first place?