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, July 30, 2015
    At the 50th anniversary of Medicare we can be thankful for the assistance it has provided to our seniors and those with long term disabilities in improving access to care and in making health care more affordable for them. However, Medicare does have significant deficiencies and this is a good time to look at them and see what we can do to improve the program.

  • Posted on Wednesday, July 29, 2015
    State efforts to establish single payer systems have had difficulties because the existing waiver processes for use of federal funds have been quite limited in their scope, and ERISA restrains state regulation of employer-sponsored health plans. The workarounds have been difficult and are a major reason that several states with promising proposals have backed off on their efforts.

  • Posted on Tuesday, July 28, 2015
    Peter Lee and James Robinson tell us that the Affordable Care Act (ACA) is working as intended - “using market forces to hold down costs,” and that California proves it by holding average premium increases down to 4% for the second consecutive year. But Covered California functions as an “active purchaser.” Does that mean it is functioning as an agent facilitating a free market between buyers and sellers of insurance, or is it functioning as a bureaucratic regulator dictating which insurers and which products are allowed in the exchange markets?

  • Posted on Monday, July 27, 2015
    Mark Wendell Potter’s words. If we want an improved Medicare for all, we need to focus on strengthening the traditional program “to make it every bit as comprehensive and attractive as a Medicare Advantage plan.” Yes, but even more than that.

  • Posted on Saturday, July 25, 2015
    It is an extraordinary article that explains the what, why and how we ended up with the wrong prescription for our sick health care financing system. Though a fairly long article, reading it and sharing it with others is an imperative.

  • Posted on Friday, July 24, 2015
    This report compares drug spending in the United States with other OECD nations and contrasts the higher prices in Medicare Part D with the lower prices in the Veterans’ Benefits Administration (VBA) and the Medicaid programs. Although supporters of the Medicare Part D drug program continue to tout the savings from the plans, this report shows us how we would be far better off if we used a public purchasing program such as that of the VBA instead of depending on competition of private pharmacy benefit managers wherein the government is prohibited from interfering in negotiations.

  • Posted on Thursday, July 23, 2015
    Fifty years ago Medicare was established as an egalitarian program designed to ensure affordable access to care, beginning with our senior citizens, with plans to eventually cover everyone. Financing was through equitable payroll taxes and general revenues based on ability to pay. Benefits were the same for everyone eligible. Its success can be attributed to citizen solidarity in support of this highly popular program.

  • Posted on Wednesday, July 22, 2015
    Of medical school graduates in 2001, one-fifth of those graduating from UCSF and one-third from Stanford did not proceed into residency training for clinical medicine. Many of them instead were drawn into entrepreneurship, especially digital health.

  • Posted on Tuesday, July 21, 2015
    If a person is insured and needs medical care, is there any circumstance under which the health plan should not pay for that care when it is covered by the plan?

  • Posted on Monday, July 20, 2015
    As Anderson says, “The Affordable Care Act was really about coverage. It wasn't about affordable care.”

  • Posted on Friday, July 17, 2015
    For decades we have been hearing from politicians that Medicare is going broke, especially when looking at long-term predictions. Yet as the years roll by, the predictions are continually revised downward in the short term, demonstrating that the doom and gloom of past predictions were not warranted. Yet since long-term forecasting is uncertain, should we be considering major policy changes in Medicare financing? Specifically, should we consider converting Medicare from a social insurance program to a defined-contribution program as politicians are now suggesting?

  • Posted on Thursday, July 16, 2015
    Although the Affordable Care Act included provisions to reduce the overpayment of private Medicare Advantage plans, each year HHS/CMS has used innovative measures to offset these reductions to ensure the viability of these plans. Now former CMS administrator Marilyn Tavenner has been selected to be president and CEO of the insurance lobbying organization, AHIP, the most influential outside organization during the health reform process. When asked about her priorities would be as head of AHIP, Ms. Tavenner said she "wanted to protect Medicare Advantage.”

  • Posted on Wednesday, July 15, 2015
    With the rapid increase in the prevalence of high-deductible health plans (HDHPs), many patients are finding that their out-of-pocket expenses when they need to access health are excessively burdensome, resulting in financial hardship, and often resulting in forgoing beneficial health care. Supporters of HDHPs say that health savings accounts (HSAs) are the answer - simply use your own HSA to pay for the care you need before the deductible kicks in. How well is that working?

  • Posted on Tuesday, July 14, 2015
    Cuba is the first nation to be validated by the World Health Organization as having reduced maternal-fetal transmission of HIV to such a low level that it no longer constitutes a public health problem. Their success is attributed in part to “an equitable, accessible and universal health system in which maternal and child health programs are integrated with programs for HIV and sexually transmitted infections.”

  • Posted on Monday, July 13, 2015
    This paper was published in 2007, before the formal process leading to the Affordable Care Act was underway. Today, Austin Frakt, in his blog, “The Incidental Economist,” published excerpts from it, quite appropriately, because the reform process has not effectively addressed this important topic: Distributive injustices in U.S. health care.

  • Posted on Friday, July 10, 2015
    We already know that high deductibles and other cost sharing can result in financial hardships for individuals who develop major medical problems. But how many face the additional burden of having to pay the high deductibles in the years following? This study provides an answer.

  • Posted on Thursday, July 9, 2015
    This pair of Point-Counterpoint articles from the Journal of Health Politics, Policy and Law renew the debate over the Affordable Care Act versus Medicare for All. Laurence Seidman presents the solid case for the policy superiority of the single payer Medicare for All model while Harold Pollack also acknowledges the superior policies of single payer, yet rejects it based on our dysfunctional health care politics.

  • Posted on Wednesday, July 8, 2015
    Can we balance the benefit of spending reductions associated with high deductibles and other cost sharing with the potential reduction in beneficial health care services that can result from patient exposure to out-of-pocket expenses as a prerequisite for health care access? Perhaps a better question is, should we?

  • Posted on Tuesday, July 7, 2015
    Outrageously high pricing is not the only problem we face with new pharmaceutical products. We are inundated with new drugs that provide little or no improvement over existing products. This exposes us not only to the higher prices driven by new patents, but also to the potential of serious adverse effects that may not be recognized until the new drugs have been on the market for a period of time.

  • Posted on Monday, July 6, 2015
    Although it will be about three months before we have the final health insurance premiums for 2016, the information we have already can warrant a few preliminary observations.