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, February 11, 2016
    Seasonal agricultural workers do not fit into a neat slot in the dysfunctional, fragmented financing system that President Obama and Congress have selected for us.

  • Posted on Wednesday, February 10, 2016
    One of the more important considerations in selecting plans offered through the insurance exchanges is whether or not an individual’s physicians and hospitals are included in the provider networks selected by the insurer. Although this is supposed to place more control into the hands of the health care consumer, in fact, the insurer is free to change the provider network at any time, yet the patient is prohibited from changing insurers outside of the open enrollment period. Patients lose their providers and can’t do anything about it until open enrollment for the next year.

  • Posted on Tuesday, February 9, 2016
    Covered California - one of the more successful state-operated ACA insurance exchanges - has two features that are currently being considered for the federally-operated ACA exchanges: standardized cost-sharing designs and active purchasing of plans.

  • Posted on Monday, February 8, 2016
    Section 1332 of the Affordable Care Act allows states to pursue waivers allowing alternative approaches to implementation of the Act as long as they comply with certain minimal requirements. In December, HHS released an advisory which gives guidance to what sort of innovations might be approved. This Deloitte health policy brief includes this guidance in updating the description of Section 1332 waivers and how the states may use them.

  • Posted on Friday, February 5, 2016
    There are two important reasons for distributing this update on how much we spend in taxes for the health system. One is that most people do not realize how much they are already spending for health care through mostly opaque tax policies - approaching two-thirds of our national health expenditures! Right now the more important reason is that people are bashing single payer reform with reports and articles based on selected taxes drawn from single payer financing proposals - particularly countering the brief single payer proposal from a leading candidate for the Democratic nomination for President. Misinformation is rampant.

  • Posted on Thursday, February 4, 2016
    No matter what legislation, regulations, rules or advisories our government produces, the private insurance industry will always find ways to skirt the intent of this oversight in order to maximize their business goals, usually at a cost to patients and public and private payers. The current efforts of insurers to manipulate the brokers are a prime example of how they will continue to work the system to advance their own interests.

  • Posted on Wednesday, February 3, 2016
    It has long been recognized that the benefits of the Medicare program are inadequate, leaving too many exposed to financial hardship and impaired access due to financial barriers. Some are protected with retiree health benefit plans or with backup by the Medicaid program, but for others, the private Medigap insurance plans were developed. This article shows that the rules for Medigap plan eligibility may still leave vulnerable those who quality for Medicare based on a disability - some of the most neediest of Medicare beneficiaries.

  • Posted on Tuesday, February 2, 2016
    The losses experienced by Blue Cross and Blue Shield of North Carolina represent a problem prevalent throughout the nation wherein patients, when they become ill, enter the system during special enrollment periods and then exit once their health care needs are met. The insurers along with CMS have diagnosed the problem. There is nothing wrong with our system of private insurers. It is the patients who are to blame because they are gaming the system.

  • Posted on Monday, February 1, 2016
    Currently the two leading candidates for the Democratic nomination for president are debating whether or not a single-payer Medicare-for-All universal healthcare system is politically feasible. Paul Song provides us with evidence that our current system is inadequate and unsustainable, so the real debate we should be having is whether we should leave our health care system under the control the industries and policies that are responsible for much of what is wrong, or if we should initiate a transformational movement that will include Medicare-for-All so that we can have “the humane and comprehensive health care system we as a society truly deserve and already pay for.”

  • Posted on Friday, January 29, 2016
    In the political battle over Bernie Sanders’ proposal for a single payer national health program, it is unfortunate that the perspective of just how much single payer would benefit Americans is being lost in all of the clamor.

  • Posted on Thursday, January 28, 2016
    One of the arguments made for choosing the incremental policies of the Affordable Care Act (ACA) over a comprehensive single payer model of reform was that the politicians wanted to avoid disrupting the part of health care financing that was working well - particularly the employer-sponsored health plans. So are employees being assured of adequate health care coverage?

  • Posted on Wednesday, January 27, 2016
    Although a majority of Americans favor a national health program, many in the policy and political communities express a preference for incrementally building on the existing multi-payer system, as modified by the Affordable Care Act (ACA). Although 64 percent of our heath system is already funded through our taxes, our government gives control of much of our total spending to the private sector, such as the private insurance companies. Thus the private sector is the source of much of the incremental changes that are taking place. Now that Fidelity Investments is entering the scene, what incremental change are they offering that will benefit patients?

  • Posted on Tuesday, January 26, 2016
    Drug prices are a problem, so much so that many people will not fill their prescriptions unless they have a drug plan that will cover most of the costs. The United States relies largely on market solutions through pharmacy benefit managers (PBMs), rather than through government administered pricing. Markets and the government function quite differently.

  • Posted on Monday, January 25, 2016
    For the past four years, the private insurance industry, led by their lobby organization - AHIP, has been successful in offsetting the reductions in overpayments that have been made to the private Medicare Advantage plans - reductions that are required by the Affordable Care Act. AHIP has now commissioned Avalere to produce a study that purportedly shows that they will need higher capitation payments than the CMS’s risk adjustment program would allow. The release of this study is the first step in their campaign to, once again, offset the decreases required by ACA.

  • Posted on Friday, January 22, 2016
    The concept of a single payer national health program - Medicare for all - has become part of the political debate leading up to the presidential primaries. To no surprise, the rhetoric has been driven by politics which characteristically reduces important concepts to sometimes meaningless or deceptive sound bites. The media, including liberal pundits who should know better, have made the debate a battle of words rather than ideas. We at PNHP believe that facts should guide the national debate, and thus this release.

  • Posted on Thursday, January 21, 2016
    We often hear that we cannot afford the taxes to pay for a single payer national health program - an improved Medicare for all. Yet we are already paying most of the taxes that would be required; it’s just that they are relatively obscure and thus not recognized by most taxpayers.

  • Posted on Wednesday, January 20, 2016
    They say that the historic gains in health coverage for Hispanic children is one of the many accomplishments of the Affordable Care Act (ACA) that we can celebrate. From 2013 to 2014 the number uninsured Hispanic children declined from about 2 million to 1.7 million.

  • Posted on Tuesday, January 19, 2016
    This study shows that individuals with high-deductible health plans (HDHP) are no more likely to select their care based on their out-of-pocket costs than do individuals enrolled in traditional health plans without high deductibles. As the editorial states, it is likely that “getting enrollees to make higher-value decisions remains a mirage.”

  • Posted on Monday, January 18, 2016
    Martin Luther King, Jr. already said it, and that was half a century ago.

  • Posted on Friday, January 15, 2016
    Matthew Yglesias tells us that “the overwhelming preponderance of the cost savings in a Medicare-for-all plan comes from the lower reimbursement rates,” thus “adopting a single-payer structure is neither necessary nor sufficient to achieve the gains.” He then criticizes single-payer proponents for not stating this publicly. What Matt does not seem to understand about PNHP is that we are meticulous with our facts, so we would never state something that is so misleading as to be untrue.