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.
Census Bureau on the uninsured - August 26, 2008
The Associated Press story just released on the decline of 1.3 million in the numbers of uninsured will surely be welcome news. It was especially good news for those who gained coverage in 2007. Should we be celebrating? Let's look at some of the statistics.Cost of covering the uninsured - August 25, 2008
Previous studies by Jack Hadley and his colleagues have shown that the increase in medical spending that would result from expanding insurance coverage to the uninsured would have been about $55 billion in 2001. For 2008, because of rapid increases in health care costs, continuing growth in the number of uninsured people, and changes in the characteristics of the uninsured population, that estimate has increased to about $122.6 billion. Even at this level, the cost of expanding coverage to everyone would be "remarkably small -- about the same as the growth of real health care spending over eighteen months" (Aaron, Health Affairs blog, 8/25).Adult children covered by parents' plans - August 22, 2008
For those who contend that comprehensive reform is not politically feasible and that reform must occur in incremental steps, this is precisely the type of legislation that they support. Young adults frequently fall through the cracks in health insurance coverage, having one of the highest rates of uninsurance. This legislation provides them with another option for health insurance and, theoretically, should reduce the total numbers of uninsured.Shattuck Lecture on coverage for all Americans - August 21, 2008
It would be worth your time to either watch the video or read the transcript of this very unusual Shattuck Lecture. For one hour Arthur Miller prods this panel on a discussion of important challenges to the American health care system. Comments are invited at the link above.Insurance falls as medical bills rise - August 20, 2008
How well is our health care financing system working? Two-thirds of adults under 65 have problems with their health insurance and paying for health care. Forty-one percent have medical bill problems or are paying off medical debt, even though sixty-one percent of these individuals were insured at the time care was provided.Will the real Harry and Louise please stand up - August 19, 2008
What a refreshing change. In fourteen years, Harry and Louise's breakfast table conversation has changed from, "If we let the government choose, we lose," to "Bring everyone to the table and make it happen." But what does this mean?Maximum coverage as defined by Anthem Blue Cross - August 18, 2008
What's this? Why would a generous offer from a health insurer to assist an insured in receiving maximum coverage benefits be included in a health policy forum? The reason is that the apparent intent of this request is very different from its true purpose, and that difference exemplifies one of the most fundamental flaws in our current health care financing system.Health care cost increases continue to plague employers - August 15, 2008
The health care cost data from these two consulting firms are important because they represent the increases in the costs of employer-sponsored coverage - the Aon survey representing the costs of private health insurance plans, and the PricewaterhouseCoopers survey representing the costs for self-insured employers. A few conclusions can be drawn from these surveys.Winners and losers in balance billing - August 4, 2008
The issue of balance billing stems from a conflict between contracts (health plans) that patients have with their managed care organizations and contracts that physicians and hospitals do not have with the managed care organizations covering patients that they are required to provide services for in emergency situations.Medicare national coverage determinations - August 1, 2008
Medicare national coverage determinations (NCDs) are inevitably controversial. Decisions on what procedures, devices and drugs are to be covered must balance the wishes of patients to have unlimited access to all possible care, regardless of demonstrated benefit or lack thereof, with the responsibility of the stewards of our tax funds to not waste them on care that is of no benefit and often is detrimental.MedPoint and IntelliScript - harmful additions to the administrative excesses - July 31, 2008
MedPoint and IntelliScript represent the type of administrative services that the private insurance industry is selling us. These services are not for the purpose of assisting individuals in gaining access to the health care that they need. These services are for the purpose of allowing the insurance industry to exclude from their plans anyone who might actually need health care. And we're paying more in administrative costs to defeat this risk pooling function of insurance.Woolhandler on the ethics of reform - July 28, 2008
The [President's Council on Bioethics] was formed in 2001 in response to the controversy over President Bush's decision to deny funds for embryonic stem cell research. With a touch of irony for which this administration is famous, many thought that political ethics were compromised in the selection of supposed ethicists who had already expressed biases incompatible with the ability to objectively assess important issues of bioethics. When one of the members of the Council states that they are incompetent to assess the ethical issues in the reform proposals, it does make you wonder.The "dual-eligibles" scam - July 25, 2008
To understand the basis for the problems with the Medicare Part D drug benefit, you need only to recall that the program was designed by the Medicare privatizers in Congress, with the support of two of the largest lobby interests in the nation: the private insurers and the pharmaceutical firms.Is preventing genetic discrimination enough? - July 24, 2008
The need for the Genetic Information Nondiscrimination Act was obvious. The members of Congress recognized that it would be unfair for private insurers to discriminate against individuals based on their family history or genetic makeup. What is perhaps not so obvious is why Congress chose to ignore all other forms of discrimination by private insurers."The Measure of America" - July 23, 2008
When we are addressing the narrower problem of health insurance for everyone, does the broader issue of human development really matter? Well, yes, and here's why.A decade of change for those with chronic conditions - July 22, 2008
It would have been sad if this report had demonstrated that there had been no improvement in access and affordability in the past decade for this expensive, non-elderly population with chronic conditions. What it did show is that access and affordability deteriorated further, even amongst the insured. That's not sad; that's tragic.Means-testing Medicare benefits? - July 21, 2008
Everyone agrees that health care is now so expensive that those of modest means cannot be expected to contribute as much to the financing of health care as those who are more affluent. Traditionally, the Medicare program has been financed primarily through a common risk pool with contributions paid based on income levels. Now, instead of establishing equity through the revenue side of the balance sheet, efforts are being made to shift equity, or the appearance of equity, over to the benefit/expenditure side.AHIP's Campaign for an American Solution - July 18, 2008
So the insurance industry wants to sign up 100,000 individuals in its fan club to provide free marketing for the private insurance concept. In spite of criticisms, the industry has not changed its goals. They want taxpayers to provide coverage for those too expensive to insure - the 20 percent of people who are responsible for 80 percent of health care costs, but the industry is quite willing to offer guaranteed coverage to everyone else - the 80 percent of people who are quite healthy.These GM retirees didn't have a choice - July 17, 2008
Last week, a Quote of the Day message discussed why the overwhelming majority of individuals, except those enrolled in the traditional Medicare program, do not have a choice of keeping indefinitely the private health insurance that they currently have. The largest private health benefit program in the nation, that of General Motors, was used as an example of how even the best could not provide absolute security that you could keep the insurance you have.Response to TNR's Jonathan Cohn - July 16, 2008
The real debate over health care reform today centers over one fundamental choice. Are we going to continue to try to finance health care through private plans competing in the marketplace, a guarantee that access and equity problems would only grow worse, or are we going to use our own government resources to fix our financing system so that it works for everyone?