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 Thursday, April 17, 2014
    If you endorse a vague plan based on conventional wisdom rather than evidence and it doesn’t work, how do you revise it? Upon what evidence, by what logic, do you alter this or that part of the plan?

  • Posted on Wednesday, April 16, 2014
    All OECD countries experience maldistribution of the physician supply. Of particular concern is the distribution of primary care physicians, especially the lack of their presence in underserved regions. This OECD working paper describes the problem and suggests some approaches to improve distribution.

  • Posted on Tuesday, April 15, 2014
    The growth in the number of accountable care organizations (ACOs) has been phenomenal considering that they are primarily only a wish on the part of the policy community and bureaucrats that such organizations would increase efficiencies to reduce health care spending, especially when earlier results have been very disappointing. This study has added to the doubts about ACOs by showing that incentive payments that they receive will exceed cost savings unless the ACOs “achieve extremely large efficiency gains” - an extremely unlikely outcome.

  • Posted on Monday, April 14, 2014
    Evidence based health care. Why should that be controversial? Yet it is. It provokes accusations of “cook book medicine,” or “bureaucrats interfering with your health care.” Current efforts in British Columbia can provide us with a more rational perspective than is being provided by these negative memes.

  • Posted on Friday, April 11, 2014
    Quality derives from dedicated professionals, working within a well-designed health care infrastructure, striving to obtain the best health care for their patients.

  • Posted on Thursday, April 10, 2014
    Hopefully the excerpts above from Paul Krugman's review of Thomas Piketty's "Capital in the Twenty-First Century" will entice you to read Krugman's full review, and then that will entice you to read Piketty's full book. If you do so, you'll understand why Krugman says, "we’ll never talk about wealth and inequality the same way we used to."

  • Posted on Wednesday, April 9, 2014
    This study reveals the success rates in obtaining a primary care appointment as a new patient by non-elderly adults, prior to full implementation of the Affordable Care Act. So what was it like then, what will the Affordable Care Act do for that, and what would single payer have done to change the results?

  • Posted on Tuesday, April 8, 2014
    In an effort to privatize Medicare, conservatives in Congress enacted legislation to provide private Medicare Advantage plans with a 14 percent overpayment in order to unfairly compete with the traditional Medicare program. The Affordable Care Act included measures to gradually eliminate this overpayment. CMS appears to be thwarting the intent of Congress to correct this injustice.

  • Posted on Monday, April 7, 2014
    Although the English translation of Thomas Piketty's "CAPITAL in the Twenty-First Century" was published only this month, it has already become a classic in the economics literature. This book is not about health care, but it provides us with an excellent background for understanding why we need to reform our current health care financing system. It is a must read, not just for those advocating for health care reform, but for everyone.

  • Posted on Friday, April 4, 2014
    Diagnostic and therapeutic interventions that are of low value remain a dilemma. In this age with an emphasis on containing costs, should interventions that have a high cost in relation to an anticipated minimal or negligible benefit be avoided simply to help “bend the cost curve”? Or should such interventions be offered since even the smallest potential benefit should not be withheld from the patient if the patient desires such?

  • Posted on Thursday, April 3, 2014
    The extraordinary power of AHIP - the health insurance lobby organization - is currently being demonstrated by its astonishing ability to massively recruit Washington insiders and politicians in its effort to salvage the overpayments being made to the private Medicare Advantage plans.

  • Posted on Wednesday, April 2, 2014
    One of the fundamental policy flaws with a fragmented, multi-payer system of financing health care is that the eligibility of each individual for various sources of coverage is dynamic - ever changing - requiring movement in and out of various forms of coverage or ending up with no coverage at all. This study from the UC Berkeley Labor Center shows that just the movement out of California’s Medicaid (Medi-Cal) and exchange plans (Covered California) is projected to be considerable during a twelve month period.

  • Posted on Tuesday, April 1, 2014
    There have been many isolated efforts to define the conservative, or Republican, or libertarian proposal to replace the Affordable Care Act (ACA or Obamacare), but there is no one model that the Republicans wish to advance in Congress at this time. The Republican controlled House of Representatives has voted fifty times to repeal ACA, but they have not voted on any substitute to address the widely acknowledged deficiencies in health care financing.

  • Posted on Monday, March 31, 2014
    The provisions of the Affordable Care Act (ACA) have provided the nation with health care coverage similar to that which has existed in Massachusetts. However, “the consumer protections for out-of-pocket health care costs are generally better in Massachusetts than those required under the ACA.” Though Massachusetts has better coverage, “Overall, 42.5 percent of all nonelderly adults in the state reported that health care costs had resulted in financial problems or health care access problems for their families in the past year.”

  • Posted on Friday, March 28, 2014
    Although Canada’s single payer system provides excellent coverage for most health care, a market for private health insurance sprung up to cover prescription drugs, dental services and eye care that were not covered by the original program. The for-profit insurers did what they are expected to do. They began by retaining 8 percent of premiums for administrative costs and profits. But after two decades, they now retain as much as 62 percent of premiums for profits, high executive compensation, marketing and other administrative costs.

  • Posted on Thursday, March 27, 2014
    Characterizing the Affordable Care Act as “the lowest common denominator - the most complex system,” President Jimmy Carter tells us that he would have favored “the expansion of Medicare to include all ages.”

  • Posted on Wednesday, March 26, 2014
    What is a patient-centered medical home? To some it means the place you go to get health care - full primary care and a convenient and efficient entry path into more specialized services. To others it means a way of organizing the business of health care to make it more accountable for reducing costs, guided by the dictates of private insurers and government bureaucrats implementing the Affordable Care Act.

  • Posted on Tuesday, March 25, 2014
    This Commonwealth Fund report provides an estimate of the numbers of underinsured - people who could experience financial hardships and impaired access in the face of medical need. Although the authors express optimism that the numbers of uninsured will decline as a result of the provisions of the Affordable Care Act (ACA), there is a high probability that there will be a substantial increase in the numbers of people who will be underinsured.

  • Posted on Monday, March 24, 2014
    One of the more important goals of health care reform was to require plans to provide comprehensive benefits. Although, as with other compromises in the Affordable Care Act (ACA), the legislation fell short, at least they did require that ten categories of benefits be covered, even if insurers were allowed considerable flexibility within each of the ten categories. Now AHIP - the insurers’ lobby organization - is attempting to dismantle the benefit requirement.

  • Posted on Friday, March 21, 2014
    According to the Bloomberg Businessweek report, Ben Rosenthal and reader John Alexander purchased the highest tier plans available - platinum plans - to ensure that they would have coverage for their current physicians and hospitals. No way. Insurers have pushed the perversity of narrow network plans all the way to the top.