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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 Wednesday, September 28, 2016
    We still hear that employers are adopting wellness programs in order to reduce the future costs of their health benefit programs by making their employees healthier. There could be no better evidence that these programs do not work than the fact that the top award for a workplace wellness program went to an employer whose employees’ health deteriorated.

  • Posted on Monday, September 26, 2016
    Merrill Goozner certainly understands the political realities about health policy. To a question on health costs that could be part of tonight’s presidential debate, he suggests an answer for the candidates that aligns with the current financing system under the Affordable Care Act. Unfortunately, because of the restrictions he apparently placed on himself, it’s a terribly deficient answer.

  • Posted on Friday, September 23, 2016
    For a pharmaceutical firm infamous for abusive pricing of their products, a 9.9% increase is an obvious attempt to keep under the radar by avoiding a double digit increase, but nobody is fooled by this. Valeant could have had a 9.8% increase, but, no, it had to be 9.9%.

  • Posted on Thursday, September 22, 2016
    It is really a sad commentary on the dysfunctional state of our health care financing system when insurance deductibles - supposedly designed to make patients better health care shoppers - have caused such great financial burdens that a market of plans has been generated to insure against deductibles and other cost-sharing losses that frequently are no longer affordable.

  • Posted on Wednesday, September 21, 2016
    What problem is being addressed by the establishment of direct primary care practices (DPC)? The administrative hassle in dealing with a multitude of payers is replaced with a single retainer fee paid by the patients. That benefits physicians by reducing overhead expenses and freeing up time for a more relaxed clinical work environment.

  • Posted on Tuesday, September 20, 2016
    Much has been written about the anticipated large increases in premiums for the nongroup health plans being offered through the ACA exchanges (Marketplaces) compared to the more modest increases in premiums of employer-sponsored group plans. This new Urban Institute report shows that premiums adjusted for plan equivalence for the nongroup exchange plans have actually been lower than those of employer plans. So what is the significance of this?

  • Posted on Monday, September 19, 2016
    Under their conservative government, Australia seems to be creeping toward American-style privatization of their health insurance. Over 90 percent of Australians are concerned about this “Americanization” of their system. Can’t we learn something from them?

  • Posted on Friday, September 16, 2016
    This week an intensive campaign is being initiated in support of a “public option” - offering the choice of a public, nonprofit insurance plan which competes with private health plans. Our enthusiasm should be tempered.

  • Posted on Thursday, September 15, 2016
    We read repeatedly about how out-of-pocket health care spending is exposing patients to financial hardship. Yet our policymakers are continuing to expand that exposure under the screwball concept that spending out of pocket makes patients better health care shoppers, which we know is not true. It only makes them forgo beneficial care. Today’s number should be an awakening call: in 2015, out-of-pocket health care expenses shoved 11 million individuals into poverty!

  • Posted on Wednesday, September 14, 2016
    Although most media attention has been directed toward health plans offered by the ACA exchanges, most individuals actually obtain their insurance through their employment, so it is important to observe what is happening there, and the news is not so good.

  • Posted on Tuesday, September 13, 2016
    The good news is that more people than ever now have health insurance. The bad news is that 29 million people remain uninsured with little hope that this number will decrease significantly because of our flawed model of health care financing. The other bad news, which does not appear in this report, is that costs are up, out-of-pocket spending is less affordable, and patients are losing choice of their health care professionals.

  • Posted on Tuesday, September 13, 2016
    Elliott Fisher and his colleagues at the Dartmouth Institute are generally credited with introducing in 2006 the concept of the accountable care organization (ACO) - coordinated organizations of hospitals and their extended medical staffs that would improve quality and lower costs (HMO 2.0?). The concept was incorporated into the Affordable Care Act. But by 2011, we should have been concerned when Elliott Fisher said, “there are some really important questions about whether this will work.”

  • Posted on Monday, September 12, 2016
    Yes, this is yet another report that confirms that enrolling in HSA-eligible high-deductible health plans is associated with a decline in physician visits and in high-value preventive services. This negative impact occurs across all income levels but is twice as great amongst lower-income individuals than it is for those with higher incomes.

  • Posted on Thursday, September 8, 2016
    More numbers. Moving directly to the point, HHS and others keep assuring us that the anticipated greater increase in ACA insurance premiums will not be a problem for the 85 percent of individuals who receive premium subsidies through the ACA exchanges. Well it is a problem not only for the 15 percent of individuals in the exchanges who do not receive subsidies but also for those who buy their individual plans outside of the exchanges.

  • Posted on Wednesday, September 7, 2016
    Six years after the enactment of the Affordable Care Act, we have achieved less than half of the goal of covering all of the uninsured - a decline from 48.6 million in 2010 to 27.3 million earlier this year. Many are celebrating this as a great success, but others do not out of concern for the 27 million who remain uninsured. Besides, there are many other observations in this report that should concern advocates of health care justice for all.

  • Posted on Wednesday, September 7, 2016
    Although this study was somewhat selective and its generalizability may be limited, nevertheless, it does show that physicians spend a tremendous amount of time on work that does not involve direct clinical face time with patients. This study and other observations suggest that much of this work is related to record documentation.

  • Posted on Tuesday, September 6, 2016
    Labor Day seems to be an opportune time to step back and take a look at how today’s labor force is faring. Wages are stagnant. The income and wealth inequality gap has increased in recent decades. Financial hardship is rampant. This has coincided with the suppression of unions and their bargaining power.

  • Posted on Friday, September 2, 2016
    Although more people than ever now have health insurance, there remain intolerable deficiencies in our health care financing system that clearly demand remedy. Two associate editors of the American Journal of Public Health debate the two approaches to reforming health care: Hillary Clinton’s expansion of ACA, and Bernie Sanders” single payer reform.

  • Posted on Thursday, September 1, 2016
    Under private insurance, a person who is admitted to an in-network hospital may unavoidably or inadvertently receive care from a professional, such as an anesthetist, who is not in the insurer’s network, and thus the patient may be responsible for the entire bill rather than the insurer’s normal contracted amount. This legislation corrects that injustice by making the patient responsible only for cost sharing that is no greater than it would have been had the provider been in the network.

  • Posted on Wednesday, August 31, 2016
    Over two-thirds of health care in California - 71 percent - is paid for by the government, using our taxes. That is even greater than the national taxpayer share of health care - 64 percent (increasing to 67 percent in 2024) - as demonstrated by Himmelstein and Woolhandler.