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 Tuesday, October 6, 2015
    In 1997, The New England Journal of Medicine published a landmark article that showed that Medicare patients who enrolled in private Medicare HMOs exited them when they developed a need for a greater amount of health care: “The Medicare-HMO Revolving Door — The Healthy Go in and the Sick Go Out”

  • Posted on Monday, October 5, 2015
    Although the media are covering this story as a shortfall in the risk corridor stabilization funds, the real story here is about the behavior of private insurers competing in the insurance exchanges established under the Affordable Care Act (ACA). An explanation is in order.

  • Posted on Friday, October 2, 2015
    By Douglas Jacobs | Health Affairs Blog
    Kristin Agar, a 63-year-old social worker, was diagnosed with lupus in 2008, a rare disease in which the body’s own immune system can cause serious damage to the kidneys, brain, skin, and joints. Unfortunately, despite having insurance coverage, Kristin has found that the drug she needs to treat her lupus is unaffordable.

  • Posted on Thursday, October 1, 2015
    For decades, Arnold (Bud) Relman had warned us about the medical-industrial complex that displaces the noble traditions and ethics of medicine in which patient service is paramount with the business model of health care in which patients become a means to build models in which success is measured by profits and stock performance. Did we listen?

  • Posted on Tuesday, September 29, 2015
    Because of ever-increasing health care costs, all nations are concerned about the fiscal sustainability of their health care systems. The United States has the highest costs - theoretically the least sustainable system - thus this report should be useful for our policymakers since it describes various approaches to sustainability by economically-developed member nations of OECD, informing us on both beneficial and detrimental policies.

  • Posted on Monday, September 28, 2015
    Is the Affordable Care Act a misnomer? Although half of the individuals who visited the insurance exchanges and did not enroll obtained coverage outside of the exchanges, the other half did not enroll because they found the plans unaffordable.

  • Posted on Friday, September 25, 2015
    How do people select their health plans? The most immediate concern to the plan purchaser is the premium that must be paid, and most will choose a plan with low net premiums. To gain greater market share, insurers will reduce premiums by shifting more of the health care costs to the patient, especially through higher deductibles.

  • Posted on Thursday, September 24, 2015
    Dr. Aaron Carroll’s frank discussion of his chronic medical problem and the nuisances he faces in interacting with our health care system struck a chord with many - both for the empathy engendered because of his medical condition, and especially for the crying shame that this prominent physician has to go through hoops to make our health care system work for him, suggesting that it might not work well for any of us.

  • Posted on Wednesday, September 23, 2015
    The United States and Canada were following the same health care cost trajectory until Canada established single payer systems in each of their provinces. They elected not to cover pharmaceuticals. The OECD data demonstrate that this omission was a mistake.

  • Posted on Tuesday, September 22, 2015
    In words, the graph shows that, for the past five years, inflation is flat, workers earnings are flat, employer-sponsored health insurance premiums are continuing to increase, and health insurance deductibles are skyrocketing!

  • Posted on Monday, September 21, 2015
    The pharmaceutical industry has run amok, and we are all suffering as a result. We are paying higher taxes and higher insurance premiums to create “rents” for the likes of Martin Shkreli. (You’ll understand what this means if you simply read the excerpts above.)

  • Posted on Friday, September 18, 2015
    As we celebrate the successes of the Affordable Care Act, it is sobering to realize that the increasing prevalence of underinsurance is leaving many patients dependent on community health centers, much as they were before, when they were uninsured.

  • Posted on Thursday, September 17, 2015
    Although questions and concerns have already been raised about the SmithKline Beecham study of the use of Paxil in adolescents, this study provides definitive answers in that it is a reanalysis of the full original data set that had not previously been released. Contrary to the original, ghostwritten published report that concluded that Paxil was safe and effective for depression in adolescents, this meticulous reanalysis of the same data led to the conclusion that Paxil is actually ineffective and harmful.

  • Posted on Wednesday, September 16, 2015
    The good news in this annual Census Bureau report is that there were significant increases in the numbers insured as a result of implementation of the Affordable Care Act - primarily in direct-purchase due to the mandate and in expansion of the Medicaid program. The bad news is that 33 million remain uninsured and, though not in the Census report, tens of millions are under-insured.

  • Posted on Tuesday, September 15, 2015
    This important study adds to the data that show that the Centers for Medicare and Medicaid Services (CMS) is using its Medicare Hospital Readmissions Reduction Program (HRRP) to penalize hospitals that care for a disproportionate share of sicker, more socially disadvantaged patients - penalties that arise from characteristics of the patient population rather than from characteristics of the hospitals serving them.

  • Posted on Monday, September 14, 2015
    Although the Obama administration continues to tout the successes of Medicare accountable care organizations (ACOs), according to this article using government data, the ACO program resulted in a net loss of nearly $3 million to the Medicare trust fund. Thus their headline: “Medicare Yet To Save Money Through Heralded Medical Payment Model”

  • Posted on Friday, September 11, 2015
    We are moving full steam ahead with delivery reform through alternative payment models in which accountable care organizations (ACOs) are anticipated to play a major role. That is why it is important to read and understand the vision that our CMS bureaucrats have for the future of Medicare.

  • Posted on Thursday, September 10, 2015
    When we enact an improved Medicare for all, it would be important for Medicare to have the power to negotiate better drug prices with the prescription drug companies. The Prescription Drug Affordability Act of 2015 would establish that principle, clearing one more hurdle on our way to health care justice for all.

  • Posted on Wednesday, September 9, 2015
    Although there are innumerable surveys available on health savings accounts (HSAs), this is the definitive word since it used actual US tax records of filings on these tax-advantaged accounts. We can now say with absolute certainty that four times as many high-income and older tax filers both established and fully funded their HSAs as did low-income and younger filers.

  • Posted on Tuesday, September 8, 2015
    Now that the Affordable Care Act has withstood constitutional challenges and five years of implementation, attention has turned to efforts to improve quality while controlling costs - paying for quality rather than volume through various pay-for-performance schemes (P4P) including Medicare's value-based purchasing (VBP) and the Hospital Readmissions Reduction Program (HRRP). Those closely following the reform process realize that such efforts to date have provided only negligible, if any, improvements in quality and cost containment.