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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.
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Posted on Friday, March 12, 2010Throughout the reform process members of Congress have been fighting over whether or not the reform legislation should include the option of purchasing a government-sponsored plan through the proposed insurance exchanges - the so-called "public option." Since Congressman Alan Grayson introduced the "Public Option Act" or "Medicare You Can Buy Into Act" three days ago, a wave of enthusiastic support has been generated based on the perception that this is the perfect solution. Today's comment briefly discusses this legislation, and it will sound really great at first blush, but do not draw any firm conclusions until you read through to the end.
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Posted on Thursday, March 11, 2010Since the failure of the Clinton effort at reform there has been an intense campaign by innumerable entities to educate the nation on the problems with our health care system and the potential impact of the various solutions. The results of the surveys reported in this Health Affairs article are sobering, if not depressing.
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Posted on Wednesday, March 10, 2010Rather than using excerpts from the JAMA article by Hochman and McCormick as today's qotd, their op-ed in today's Los Angeles Times provides an even better summary of their findings along with their astute comments. Their op-ed obviates the need for me to provide any additional commentary.
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Posted on Tuesday, March 9, 2010There is an important debate taking place as to whether or not the Obama proposal, based on the Senate bill, will control health care costs. President Obama and his supporters contend that every idea on controlling costs is in this bill. The private insurance industry contends that premiums will continue to increase at unsustainable levels because this measure does very little to control rising costs. Who is right?
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Posted on Monday, March 8, 2010So 99 percent of metropolitan areas have "highly concentrated" private insurance markets, and price competition of private insurers continues to decrease as private insurers are "more willing than ever to walk away from existing business." Competitive pricing has almost disappeared from the private insurance market, so insurance has become a "take it or leave it" proposition.
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Posted on Friday, March 5, 2010Instances of blatant fraud in health care provide great fodder for the media. The identification and prosecution of criminals in Florida becomes national news. Those who claim that fraud and abuse are a primary reason for high health care costs use such stories to say that the government is not doing its job in identifying and prosecuting these crooks, when the stories are about the government doing its job in identifying and prosecuting these crooks.
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Posted on Thursday, March 4, 2010This report from The Boston Foundation contains two very important fundamental proposals designed to reduce health care costs for municipal governments in Massachusetts. One of them directly relates to health policy, but the other, which is perhaps even more important, relates to the freedom of workers to negotiate for a level of total compensation that meets their most basic needs.
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Posted on Wednesday, March 3, 2010To understand that incremental reforms have not worked, all you have to do is look at the increasing numbers of uninsured, the greater numbers with inadequate insurance, the steep increases in health care prices, the perversities of the private insurers, and the administrative waste and other dysfunctions of our multi-payer and non-payer system. Everyone agrees that incrementalism has failed us, even Tom Daschle and Don McCanne.
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Posted on Tuesday, March 2, 2010Wake up! Big changes are coming in health care financing!
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Posted on Monday, March 1, 2010When WellPoint's CEO Angela Braly boasts that a 40 year old woman can purchase $1,500 deductible coverage from them for only $156 per month, it's important to see how they define that coverage.
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Posted on Friday, February 26, 2010The private insurers claim that health care costs are the major cause of high health insurance premiums. That is true. So where do we place the blame for failure to slow cost escalation?
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Posted on Wednesday, February 24, 2010When most of us are concerned about skyrocketing health care costs, the private insurers have concentrated on their more immediate concern: How can they maintain a market presence by making their health plans more affordable?
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Posted on Tuesday, February 23, 2010During the national health reform dialogue, opponents of comprehensive reform frequently attempt to reframe the problem as a lack of individual responsibility for personal health. If people would eat better, exercise, and not smoke, many of the reform proposals would not be necessary. This concept has now been co-opted by many of the nation's large employers as they introduce wellness programs into their companies. What has been their experience?
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Posted on Monday, February 22, 2010The greatest significance of President Obama's health care reform proposal released today is that he has now formally placed his stamp of approval on the fundamental policies already contained in the House and Senate reform bills. While remaining silent on some of the third rail issues (public option, Medicare buy-in, pregnancy termination, etc.), he and his staff merely tweaked the bills and added insurance premium rate review, whatever that's worth, and some rhetoric on waste, fraud, and abuse.
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Posted on Friday, February 19, 2010Although the Obama administration continues to advocate for reform based on private health plans, they have seized on the current outrage over skyrocketing insurance premium increases to to demonstrate why reform is essential. Although they are attacking the private insurance industry, they continue to push for a reform model that provides this market with tens of millions of new customers.
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Posted on Thursday, February 18, 2010"The County" - a hospital to which emergency patients with no money and no insurance are shipped. Most of us remember when The County was always the provider of last resort.
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Posted on Wednesday, February 17, 2010At what level do we say that the rate of coverage under a universal program is "close enough"? For Medicare Part A, we've already answered that question. Covering 95 percent of those over age 65 is "close enough," leaving 1.6 million seniors out of the Part A program (primarily hospital care).
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Posted on Monday, February 15, 2010In perhaps the greatest irony of the reform process, President Obama has scheduled a bipartisan health care summit in which the Democrats will submit a right-wing proposal similar to that crafted by conservative economist Mark Pauly and his market-oriented colleagues. The Republicans will offer nominal proposals that would provide no significant benefit in correcting the problems that we face with our health care system.
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Posted on Friday, February 12, 2010For purposes of these ballpark calculations, revenues are assumed to be premiums paid for purchase of the private plans (ignoring investment returns on reserves). The revenues are split into 1) a fund to be used to pay for health care benefits, and 2) funds to operate the business entity that is selling insurance services. The latter portion includes all administrative expenses and other costs of running their businesses, plus profits.
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Posted on Thursday, February 11, 2010Many experts touting the Congressional reform proposals have singled out the insurance exchange concept as being one of the most important avenues of reforming the private health insurance market. MIT Professor Jonathan Gruber was involved in designing the Massachusetts exchange and has been an independent-expert-on-the-dole for the administration and Congress as they move forward with the concept of private insurance exchanges.