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, October 30, 2014
    One of the more alarming trends in health insurance innovation is the increasing use of narrower provider networks. Patients are losing their choice of their health care professionals and hospitals. Not only can this result in impaired access and longer wait times, it also can unfairly benefit the insurers by discouraging sicker patients from enrolling because of concerns about being unable to access the care that they need - especially specialized services.

  • Posted on Wednesday, October 29, 2014
    Assuming the allegations of this lawsuit prove to be true, it appears that private Medicare Advantage insurers contracted with a private company that hired health care professionals to do in-home health assessments, not for treatment purposes but merely to collect data that, combined with innovative coding, could be used to increase government payments based on inflated risk scores.

  • Posted on Tuesday, October 28, 2014
    Many consider Vermont to be the trailblazer for a state single payer program, serving as a model for other states to enact single payer reform. Vermont does have lessons for the rest of us. Let’s see what they are so far.

  • Posted on Monday, October 27, 2014
    It's shameful. Although the Affordable Care Act (ACA) specifically prohibits discrimination based on sex, employers are still able to provide plans that are based on the underwriting characteristics of their employees. This Mercer report compares workforces that are over 65% female with those over 65% male and shows that females receive less generous health benefits - paying 31% more for deductibles and 31% more for the premium contribution for family coverage.

  • Posted on Friday, October 24, 2014
    Another unique feature of the U.S. health care system that sets us apart from other nations: “You just can’t trust doctors nowadays, but my doctor is really good.” What can we make of this?

  • Posted on Thursday, October 23, 2014
    The health care system in the United States is unique for its profound administrative waste. This article by Steffie Woolhandler and David Himmelstein demonstrates the intensity of the administrative burden on physicians - a burden that is correlated with lower career satisfaction.

  • Posted on Wednesday, October 22, 2014
    In a JAMA editorial commenting on an article about price transparency and health care spending, Uwe Reinhardt first describes the ridiculous system we currently have, concluding, “the much ballyhooed consumer-directed health care strategy so far has been more a cruel hoax than a smart and ethically defensible health policy.”

  • Posted on Tuesday, October 21, 2014
    Last month CVS announced, with considerable fanfare, that it would discontinue sales of tobacco products at its drugstores - a move that would cost it $2 billion in annual sales. After a month-long publicity campaign touting its altruistic action in support of a healthier America, we learn of the not-so-noble purpose of their decision.

  • Posted on Monday, October 20, 2014
    When the Affordable Care Act (ACA) was being crafted, it was almost as if the designers thought that they were developing a relatively static system. They would simply cover the lowest-income individuals with Medicaid, make available subsidized private plans for moderately-low-income individuals, and then use individual and employer mandates, under threat of penalty, to force the rest of the uninsured into private plans. Although a limited amount of churning in and out of various plans and programs was expected, what they did not seem to understand was how unstable these categories actually are. The churning is massive.

  • Posted on Friday, October 17, 2014
    The Affordable Care Act provides a 90 day grace period during which health care coverage through exchange plans is continued before insurers can cancel the plans for non-payment of premiums. However, the insurers must pay claims for only the first 30 days, whereas providers are not allow to collect from the patient during the remaining 60 days. After 90 days of nonpayment of premiums, the patient can be retroactively billed, though collection can be difficult since most of these patients do not have enough funds to pay their premiums, much less their health care bills.

  • Posted on Thursday, October 16, 2014
    When the topic of controlling health care costs comes up, those opposed to single payer reform, and, for that matter, opposed to the Affordable Care Act, frequently cite the need for malpractice reform, often claiming that defensive medicine (ordering unnecessary tests and medical interventions merely to prevent lawsuits) is a major cause of excess health care spending. This article casts doubt that malpractice reform would reduce supposed defensive medicine.

  • Posted on Wednesday, October 15, 2014
    Private insurers use narrow networks of physicians and hospitals so that they can negotiate more favorable provider rates which then supposedly allows them to keep their insurance premiums more competitive. The trade-off is that patients lose their choice of providers and increase the risk that they will suffer severe financial penalties because of unavoidable circumstances wherein care is obtained out of network, or worse, care is not received at all because of impaired access.

  • Posted on Tuesday, October 14, 2014
    As the Affordable Care Act (ACA) was being crafted, it was recognized that the expansion of coverage under Medicaid could result in greater access problems because of the low Medicaid payment rates and the lack of willing providers. In order to improve access, at least to primary care, it was decided to increase Medicaid primary care payment rates to the same level as Medicare for the years 2013 and 2014. As with so many of the ACA provisions, this seemingly simple solution has proven to be more complex.

  • Posted on Monday, October 13, 2014
    This new survey conducted by the Associated Press-NORC Center for Public Affairs Research confirms, once again, that private health insurance in the United States often is not providing adequate financial protection for those with health care needs. More than 16 million people who have private insurance “face major financial hardships like going without food or using up all of their savings as a result of medical bills.” The one-half of Americans who use hardly any health care at all likely do not realize that they are one major illness away from similar financial hardship.

  • Posted on Friday, October 10, 2014
    Our policy wonks continue to look for methods of controlling health care costs that will protect the role of private insurers, and, above all, prevent us from drawing the inevitable conclusion that we desperately need a single payer national health program. Reference pricing is one more supposed cost-saving tool that has garnered much interest. What is it and will it work?

  • Posted on Thursday, October 9, 2014
    Low-income patients strongly support the Medicaid program. It provides better financial protection than does private insurance, and they perceive the care to be of high quality. Their primary concern is that “private coverage was seen as offering better access to and more respect from providers” than does Medicaid.

  • Posted on Tuesday, October 7, 2014
    This WSJ opinion article is from the conservative American Enterprise Institute (AEI). When they say that “health costs are the biggest driver of income inequality in America today,” this should provide us with common ground to simultaneously address both income inequality and the health care crisis.

  • Posted on Tuesday, October 7, 2014
    Large retailers are infamous for low wages and limited benefits. Walmart has been a special target of critics, no doubt in part because a few members of the Walton family are amongst the very wealthiest people in the world - not just in the top 1 percent, but at the very top of the 0.01 percent. Providing more generous health benefits for all of their employees would cost only a small fraction of the annual net gain in wealth of the Walton family.

  • Posted on Monday, October 6, 2014
    Former Kaiser Permanente CEO George Halvorson said, “Everyone at KP, including myself, strongly preferred the model where there was no cost for the patient.” So why did they start selling plans with deductibles?

  • Posted on Friday, October 3, 2014
    Our two major public programs for health care financing - Medicare and Medicaid - continue down the path of privatization, with the complicity of the Department of Health and Human Services (HHS).