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 Friday, February 17, 2017
    Innumerable studies that we’ve written about have shown that the private Medicare Advantage plans have gamed the system at the expense of taxpayers by surreptitiously selectively enrolling healthier, less costly patients, and then, when risk adjustment was introduced to correct for this favorable selection, the plans upcoded to qualify for higher payments by making the patients appear sicker than they really were.

  • Posted on Thursday, February 16, 2017
    Over this decade, with no further changes in our health care financing system, national health expenditures are expected to increase to one-fifth of our GDP. Unfortunately, our current health care financing system remains incapable of containing health care costs.

  • Posted on Wednesday, February 15, 2017
    CMS today released a new proposed rule allegedly designed to “protect patients” by stabilizing the plans offered in the ACA insurance exchanges. A cursory reading of the press release would tend to confirm this intent, but a careful reading of the release and especially the executive summary of the proposed rule will reveal that the rule is designed to improve the market for the insurers with a detrimental impact on potential enrollees of the insurance plans.

  • Posted on Tuesday, February 14, 2017
    This lesson on accountable care, from the Dartmouth Institute, shows us that we still have much to learn. The respected authors state that a long-term commitment to alternative payment model evaluation is necessary. In the meantime, “we know little about the key ACO capabilities that are important to ensuring their success in different organizational or market contexts.”

  • Posted on Monday, February 13, 2017
    There could not be better evidence that the Republicans never did have an effective plan to replace the Affordable Care Act than the fact that they are now advancing legislation to protect the private insurers in the ACA exchanges - reinforcing them rather than shutting them down.

  • Posted on Friday, February 10, 2017
    Man your stations.

  • Posted on Thursday, February 9, 2017
    Without being given a list of choices, when asked “what is the biggest concern facing your family right now,” the most common response was “health care costs” (25%). That places this concern well in front of job security (14%) and household bills (12%) with which it was tied two years ago.

  • Posted on Wednesday, February 8, 2017
    There are two potential adverse consequences of requiring high deductibles in health insurance plans. Developing a serious medical problem can expose the individual to financial hardship. Even more serious is that the potential for financial exposure can cause an individual to make a terribly consequential decision in electing to forgo medical care because of the deductible.

  • Posted on Tuesday, February 7, 2017
    Some long-time readers of these messages may be bored by yet another article confirming that the private Medicare Advantage plans have been successful in being paid significantly more than we are spending for comparable patients in the traditional fee-for-service Medicare program, but it is crucial to understand that this is a major part of the strategy to privatize the Medicare program, and we taxpayers are being cheated as they pull off their scheme.

  • Posted on Monday, February 6, 2017
    Why should Medicaid be a separate program for low-income individuals? Or Medicare for the elderly and those with long-term disabilities? Or a multitude of private plans based merely on employment status? Or, as the Affordable Care Act attempted to address, having to turn to the highly dysfunctional individual insurance market by default?

  • Posted on Friday, February 3, 2017
    Academic medical centers (AMCs), with their great resources and advanced technologies, are ideal to provide specialized care for certain patients with complex medical needs. A high performance health care system should provide equitable access for those who would most benefit from the services offered by AMCs. This study indicates that race and insurance status may contribute to inequities and disparities in access to these facilities.

  • Posted on Thursday, February 2, 2017
    Is this really good enough? Should we vigorously defend the status quo supported by the Democrats? Or should we support Republican policies that would replace the Affordable Care Act - policies that would shift more costs to patients, inevitably increasing the exposure of adults to these difficulties they now face? These are the options currently under debate in Congress. There is another option.

  • Posted on Wednesday, February 1, 2017
    Peter Lee and his staff at Covered California quite appropriately have received accolades for their great work in implementing the Affordable Care Act. It has not been without glitches, such as those in this article, but that should only be expected in a system with such great complexity.

  • Posted on Tuesday, January 31, 2017
    In response President Trump’s January 25 announcement of a series of executive actions on immigration, the national resident physicians’ union, the Committee of Interns and Residents, issued the following statement...

  • Posted on Monday, January 30, 2017
    Although services provided by the traditional Medicare (TM) program and the Medicare Advantage (MA) plans are priced about the same, the health care expenditures of MA plans are about 30 percent lower than their revenues. The difference is lower utilization by patients of MA plans.

  • Posted on Friday, January 27, 2017
    Seema Verma is a conservative ideologue who wishes to convert government health care programs into privatized, consumer-directed models. She has represented some states in negotiating with CMS for waivers to convert their Medicaid programs.

  • Posted on Thursday, January 26, 2017
    For plans sold in the exchanges in 2017, not only have the premiums gone up 25 percent for the popular low-cost silver plans, but the average deductibles for silver plans have increased 20 percent, and over two-thirds of plans now have more restrictive networks (with only 31 percent allowing out-of-network coverage with the penalty of higher cost sharing).

  • Posted on Wednesday, January 25, 2017
    Finally, good news for a change!

  • Posted on Tuesday, January 24, 2017
    Many people have benefited by gaining access and coverage under the Affordable Care Act, but this study shows that far too many people with chronic disease have been left out, particularly amongst blacks and Hispanics.

  • Posted on Monday, January 23, 2017
    Fact Checkers sometimes traverse minefields, and The Washington Post’s Glenn Kessler really blew it when he gave Bernie Sanders Four Pinocchios for telling the truth about the potential lethal consequences of repealing the Affordable Care Act.