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, April 20, 2015
    Thomas Edsall states that, as income and wealth inequality have expanded, the number of Americans who believe that health care is a right has declined from a majority to a minority. Of particular concern is Matthew Luttig’s finding, supported by others, that “rising inequality in the United States has largely promoted ideological conservatism.”

  • Posted on Friday, April 17, 2015
    One of the primary purposes of the Affordable Care Act was to control health care spending. After five years, the impact on spending appears to be negligible except for a slight decline in use of beneficial services as a result of higher deductibles and less accessible provider networks - exactly the wrong way to control health care spending.

  • Posted on Thursday, April 16, 2015
    Some say that my comments of over a decade ago were prescient. They were not. The current disarray of our health information technology system (HIT) was fully predictable.

  • Posted on Wednesday, April 15, 2015
    New York and California have fully implemented the provisions of the Affordable Care Act whereas Florida and Texas have not. As a result, Florida and Texas have more people who are uninsured, more people who experience cost-related access problems, and more people with medical bill problems or medical debt.

  • Posted on Tuesday, April 14, 2015
    Those supporting further implementation of the Affordable Care Act (ACA) while rejecting more comprehensive reform are trying to make the overpriced and inadequate private health plans work for us. John Geyman reminds us of some of the reasons why the private plans are actually the cause of several of the problems we face today. We need to replace them with a single payer national health program.

  • Posted on Monday, April 13, 2015
    The Senate is back in session this week and is expected to rush through H.R.2 - the House approved “SGR fix.” SGR has got to go and CHIP needs to be funded, but the unproven and administratively burdensome replacement for SGR, along with the Medicare tweaks, are worse than the current fee-for-service method of financing health care.

  • Posted on Friday, April 10, 2015
    Next week, when the Senate returns from its break, they will likely approve House-passed H.R.2 - the “SGR fix” - a bill that is being used as a vehicle to move Medicare closer to privatization by taking small incremental steps in increasing Medicare premiums and deductibles - features that are more characteristic of private individual plans than public social insurance programs.

  • Posted on Thursday, April 9, 2015
    Employers have discovered that they can relieve themselves of much of the burden and costs of administering their employee health benefit programs, while using defined contributions to shift more costs to their employees, simply by referring them to private insurance exchanges. This is really catching on now with over 100 percent annual growth in the past three years, and an anticipated enrollment of 40 million by 2018.

  • Posted on Wednesday, April 8, 2015
    “Cadillac tax” is a label that creates the impression that the excise tax is applied primarily to plans with exceedingly generous benefits that only the wealthiest amongst us would purchase - a sector that could easily afford the excise tax. That is not true.

  • Posted on Tuesday, April 7, 2015
    CMS has done it again. For the fourth year in a row, CMS has used innovative methods to boost the payment rates for Medicare Advantage plans, more than compensating for the required reductions in overpayments mandated by the Affordable Care Act.

  • Posted on Monday, April 6, 2015
    People want health care coverage that works for them, but they are very concerned about their direct costs, including insurance premiums, deductibles and out-of-pocket expenses for their pharmaceuticals. They rightfully complain about these costs, yet how often do you hear them complain about their payroll deductions for Medicare? They want Medicare to be there when they retire.

  • Posted on Friday, April 3, 2015
    This nine-page brief from AcademyHealth provides an excellent summary of the status of the policy science behind narrow provider networks in health insurance plans. Since health care reform is about the patient - at least it certainly should be - it is helpful to read this while continuing to ask yourself how this helps the patient. Patient advocates will discover the shocking truth.

  • Posted on Thursday, April 2, 2015
    By Amelia M. Haviland, Matthew D. Eisenberg, Ateev Mehrotra, Peter J. Huckfeldt, and Neeraj Sood | National Bureau of Economic Research, March 2015
    This study will no doubt be used to claim that high deductible health plans with health savings accounts (CDHPs - consumer-directed health plans) are effective in reducing health care spending without causing any harm. However, the conclusions that can be drawn are far more limited.

  • Posted on Wednesday, April 1, 2015
    Goals of Massachusetts health care reform included extending coverage to low-income individuals (disproportionately comprising racial and ethnic minorities) and to reduce disparities in care. How well these goals have been achieved is particularly important since it can predict how effective the Affordable Care Act (ACA) - the same model as the Massachusetts plan - will be in achieving these goals.

  • Posted on Tuesday, March 31, 2015
    Right now in the United States there is an intense campaign to control health care spending by changing payment systems to reward value over volume even though the knowledge of methods and effectiveness of doing this is quite primitive. This study from England’s National Health Service provides some limited insight on this approach.

  • Posted on Monday, March 30, 2015
    Value rather than volume. Quality rather than quantity. Paying for performance. Reducing costs by eliminating wasteful services. Making providers accountable and rewarding them based on the value of their services. These concepts have become memes in the political and policy communities yet with very little in the health policy literature to confirm that these should be the driving principles behind health care financing reform, though there are quite a few studies that confirm that these concepts lead to mediocrity, at best.

  • Posted on Friday, March 27, 2015
    The decision of the U.S. Senate leadership to delay consideration of H.R. 2 (the SGR repeal bill) until after they take a two week recess provides us with an opportunity to join with others in demanding removal of two provisions that would be very harmful to our traditional Medicare program - means-tested premiums for Medicare Parts B and D, and imposing deductibles for beneficiaries of Medigap plans.

  • Posted on Thursday, March 26, 2015
    H.R. 2 passed in the House today by a vote of 392 to 37. It goes to the Senate where it will be voted on tomorrow. But is this really about the “doc fix” - eliminating SGR? Speaker of the House John Boehner clarifies that for us. It’s about entitlement reform and H.R. 2 begins that process.

  • Posted on Wednesday, March 25, 2015
    At this time Congress should simply repeal SGR, fund CHIP, fund community health centers and the National Health Service Corps, and refer all other provisions for further study by the appropriate committees.

  • Posted on Wednesday, March 25, 2015
    In the fervor to finally rid us of the flawed SGR model of setting Medicare payment rates, Congress is about to pass legislation (H.R. 1470) that includes ill-advised, misguided and detrimental policies that could cause irreparable harm to our traditional Medicare program. Instead, Congress should revise the current legislation to comply with the following recommendations.