Thursday, December 31, 2015
Wednesday, December 30, 2015
Tuesday, December 29, 2015
Monday, December 28, 2015
Sunday, December 27, 2015
Saturday, December 26, 2015
Friday, December 25, 2015
Sanders on Single Payer
http://readersupportednews.org/opinion2/277-75/34235-focus-single-payer-health-care
want to talk with you about one of the very real differences between Secretary Clinton and me that surfaced during last weekend's debate, and that is our approach to health care in this country.
Single Payer Health Care
By Bernie Sanders,
Reader Supported News
24 December 2015
want to talk with you about one of the very real differences between Secretary Clinton and me that surfaced during last weekend's debate, and that is our approach to health care in this country.I was, and all progressives should be, deeply disappointed in some of her attacks on a Medicare-for-all, single-payer health care system. The health insurance lobbyists and big pharmaceutical companies try to make "national health care" sound scary. It is not.
In fact, a large single-payer system already exists in the United States. It's called Medicare and the people enrolled give it high marks. More importantly, it has succeeded in providing near-universal coverage to Americans over age 65 in a very cost-effective manner.
So I want to go over some facts with you and ask that you take action on this important issue:
Right now, because of the gains made under the Affordable Care Act, 17 million people have health care who did not before the law was passed. This is a good start, and something we should be proud of. But we can do better.
The truth is, it is a national disgrace that the United States is the only major country that does not guarantee health care to all people as a right. Today, 29 million of our sisters and brothers are without care. Not only are deductibles rising, but the cost of prescription drugs is skyrocketing as well. There is a major crisis in primary health care in the United States.
So I start my approach to health care from two very simple premises:
- Health care must be recognized as a right, not a privilege -- every man, woman and child in our country should be able to access quality care regardless of their income.
- We must create a national system to provide care for every single American in the most cost-effective way possible.
I expected to take some heat on these fundamental beliefs during a general election, but since it is already happening in the Democratic primary, I want to address some of the critiques made by Secretary Clinton and Rupert Murdoch's Wall Street Journaldirectly:
Under my plan, we will lower the cost of health care for the average family making $50,000 a year by nearly $5,000 a year. It is unfair to say simply how much more a program will cost without letting people know we are doing away with the cost of private insurance and that the middle class will be paying substantially less for health care under a single-payer system than Hillary Clinton's program. Attacking the cost of the plan without acknowledging the bottom-line savings is the way Republicans have attacked this idea for decades. Taking that approach in a Democratic Primary undermines the hard work of so many who have fought to guarantee health care as a right in this country, and it hurts our prospects for achieving that goal in the near future. I hope that it stops.
Let me also be clear that a Medicare-for-all, single-payer health care system will expand employment by lifting a major financial weight off of the businesses burdened by employee health expenses. And for the millions of Americans who are currently in jobs they don't like but must stay put because of health care access, they would be free to explore more productive opportunities as they desire.
So, what is stopping us from guaranteeing free, quality health care as a basic fundamental right for all Americans? I believe the answer ties into campaign finance reform.
The truth is, the insurance companies and the drug companies are bribing the United States Congress.
I want to make health care a right for every American. The health care industry doesn't like that very much, so they're flooding my opponents with cash. Fight back against those who want to stop a Medicare-for-all, single-payer system with a contribution to our campaign.
Now, I don't go around asking millionaires and billionaires for money. You know that. I don't think I'm going to get a whole lot of contributions from the health care and pharmaceutical industries. I don't like to kick a man when he is down, but when some bad actors have tried to contribute to our campaign, like the pharmaceutical CEO Martin Shkreli who jacked up the price of a life saving drug for AIDS patients, I donated his contribution to an AIDS clinic in Washington, D.C.
Secretary Clinton, on the other hand, has received millions of dollars from the health care and pharmaceutical industries, a number that is sure to rise as time goes on. Since 1998, there are no industries that have spent more money to influence legislators than these two. Billions of dollars! An absolutely obscene amount of money. And in this election cycle alone, Secretary Clinton has raised more money from the health care industry than did the top 3 Republicans -- combined.
Now, and let's not be naive about this, maybe they are dumb and don't know what they are going to get? But I don't think that's the case, and I don't believe you do either.
So, what can we do about it?
Changing the health care laws in this country in such a way that guarantees health care as a right and not a privilege will require nothing short of a political revolution. That's what this campaign is about and it is work we must continue long after I am elected the next President of the United States.
And because of the success we have enjoyed so far, I am more convinced today than ever before that universal quality health care as a right for all Americans will eventually become the law of the land.
It is the only way forward.
Thank you for standing with me on this important issue.
Thursday, December 24, 2015
Wednesday, December 23, 2015
High Deductibles and Narrow Networks: The Achilles Heel of the ACA'S Health Insurance | John Geyman
High Deductibles and Narrow Networks: The Achilles Heel of the ACA'S Health Insurance | John Geyman
"It is time to replace it with a more accountable system with universal access, cost containment, lower administrative overhead, and a service-oriented culture--single-payer national health insurance (NHI)."
"It is time to replace it with a more accountable system with universal access, cost containment, lower administrative overhead, and a service-oriented culture--single-payer national health insurance (NHI)."
Tuesday, December 22, 2015
Monday, December 21, 2015
Sunday, December 20, 2015
Supporting single-payer, universal health care
Supporting single-payer, universal health care
"Many of the false arguments used against universal health care absolutely apply to our current system of relying on private insurance. Reliance on private insurance has proven to be bad for individuals, for business, for health-care providers, for the economy and our society. Still there are those who will claim socialized medicine is bad for our country. I suspect that if we could find the original sources of these claims, they would have very familiar-sounding names from the health insurance industry."
"Many of the false arguments used against universal health care absolutely apply to our current system of relying on private insurance. Reliance on private insurance has proven to be bad for individuals, for business, for health-care providers, for the economy and our society. Still there are those who will claim socialized medicine is bad for our country. I suspect that if we could find the original sources of these claims, they would have very familiar-sounding names from the health insurance industry."
The Fate of Obamacare - The New York Times
The Fate of Obamacare - The New York Times
Coment from PNHP:
Coment from PNHP:
ACO
Proponents
Submitted
to the Health Care Financing Task Force by the Board of Directors of
the Minnesota Chapter of Physicians for a National Health Program
December
18, 2015
MN PNHP’s last letter to the Task Force presented evidence indicating ACOs do not cut health care expenditures, and may in fact raise them when the costs required to set up and run ACOs are taken into account. In this letter we call your attention to an article that ran on the front page of the New York Times on December 15. That article reinforced our conclusion that the task force should not recommend any policies that will encourage the spread of ACOs.
The Times article presented evidence indicating the endorsement of ACOs by President Obama and the Affordable Care Act has encouraged mergers among hospitals and clinics, and that this has in turn driven up health care costs. What makes the article particularly interesting is that it contradicts research authored by Elliot Fisher, the man who invented the phrase “accountable care organization” along with Glenn Hackbarth (former chair of the Medicare Payment Advisory Commission) in 2006.
The online version of the Times article http://www.nytimes.com/interactive/2015/12/15/upshot/the-best-places-for-better-cheaper-health-care-arent-what-experts-thought.html is entitled, “The Experts Were Wrong About the Best Places for Better and Cheaper Health Care.” The “experts” referred to in the title include Elliot Fisher and other scholars at Dartmouth who produce the Dartmouth Atlas, and other experts who relied on the Dartmouth Atlas, including Atul Gawande, author of the famous 2009 New Yorker article that influenced President Obama’s thinking about cost containment.
The Dartmouth Atlas divides the country into 306 “hospital referral regions” and compares per capita Medicare spending among regions. For the last two decades, Fisher and many others have claimed that the low Medicare costs in places like Grand Junction, CO and Rochester, MN were not only reflective of total per capita costs in those areas, but were due to the presence of large hospital-clinic systems in those areas. Both claims were dubious when they were made. Now it appears both claims are wrong.
According to the Times’ article, many of the areas shown to be low-cost by Medicare data alone are high-cost areas when measured by expenditures by insurance companies. Moreover, it appears that the large “integrated systems” that Fisher et al. are so passionate about, now called ACOs, are raising costs because they are so big they can force even large insurers like UnitedHealthCare to pay them high rates.
The New York Times article is about a paper published by the National Bureau of Economic Research. The paper was written by Zack Cooper, an economist at Yale, and three others http://www.healthcarepricingproject.org/sites/default/files/pricing_variation_manuscript_0.pdf
Cooper et al. examined the cost of health care spending for three large insurance companies by “hospital referral region.” The Times article begins by placing two maps of the country side by side. One shows high- and low-cost regions according to the Dartmouth Atlas, and one shows high- and low-cost regions according to Cooper et al.’s data. There is some overlap but not much.
Here is the Times’ summary of the findings by Cooper et al.
Health care researchers who have seen the new findings say they are likely to force a rethinking of some conventional wisdom about health care. In particular, they cast doubt on the wisdom of encouraging mergers among hospitals, as parts of the 2010 health care law did.
Larger, integrated hospital systems – like those in Grand Junction – can often spend less money in Medicare, by avoiding duplicative treatments. But those systems also tend to set higher prices in private markets, because they face relatively little local competition.
“Price has been ignored in public policy,” said Dr. Robert Berenson, ... former vice chairman of the Medicare Payment Advisory Commission, which recommends policies to Congress. “That has been counterproductive.”
We agree with Dr. Berenson’s remark. Public policy, in Minnesota and across the country, has followed conventional wisdom since the early 1970s. It has encouraged reducing volume of medical services by herding doctors into larger organizations – HMOs beginning in the 1970s, now ACOs – so that they can bear insurance risk. This policy has ignored the impact of higher administrative costs and consolidation (in both the provider and insurer sectors) on price.
We urge task force members to focus on price, not volume. After a half century of experimenting with HMOs, PPOs etc., it is clear that pushing doctors into “integrated systems,” whether we call them HMOs or ACOs, cannot cut costs, and that the agglomeration of providers into these large entities is creating serious side effects, including concentrated market power.
Saturday, December 19, 2015
Friday, December 18, 2015
The Magical World of ACA Funding | THCB
The Magical World of ACA Funding | THCB
"Revenue was to be generated (in large part) by a series of taxes on a variety of different sources. These taxes did not fare so well in the current budget."
"Revenue was to be generated (in large part) by a series of taxes on a variety of different sources. These taxes did not fare so well in the current budget."
The problem of Obamacare's large knowledge gap
The problem of Obamacare's large knowledge gap
"Not only do most uninsured Americans not know when the deadline is, but many may be mistaken in the belief that they can't afford coverage — apparently, many people with moderate incomes are unaware of available financial aid that can significantly cut the price of their monthly premiums. Separately, some of the uninsured don't know they could qualify for Medicaid, the government program for the poor, which would cost them little or no money."
"Not only do most uninsured Americans not know when the deadline is, but many may be mistaken in the belief that they can't afford coverage — apparently, many people with moderate incomes are unaware of available financial aid that can significantly cut the price of their monthly premiums. Separately, some of the uninsured don't know they could qualify for Medicaid, the government program for the poor, which would cost them little or no money."
Medicaid Privatization Gets Messy in Iowa - Bloomberg Business
Medicaid Privatization Gets Messy in Iowa - Bloomberg Business
"Nationally, the shift to Medicaid managed care hasn’t been proved to save money, and the approach has a mixed record on how patients fare.."
"Nationally, the shift to Medicaid managed care hasn’t been proved to save money, and the approach has a mixed record on how patients fare.."
Thursday, December 17, 2015
Tuesday, December 15, 2015
The Experts Were Wrong About the Best Places for Better and Cheaper Health Care - The New York Times
The Experts Were Wrong About the Best Places for Better and Cheaper Health Care - The New York Times
Comment from Kip Sullivan: This morning's NY Times has a delicious article on the front page
debunking the ACA's theory of cost-containment, namely, overuse is
what's causing US health care costs to skyrocket, and the solution is to
push doctors into ACOs so they can bear insurance risk. In fact, the
paper provides evidence indicating that precisely BECAUSE the ACA
encourages consolidation of hospitals and clinics into ACOs, costs are
going up.
PNHP has been trying to communicate this fact to the
Health Care Financing Task Force: Overuse and the fee-for-service system
are not the problem, and cramming doctors into HMOs/ACOs so that they
can bear more insurance risk is not the solution. I hope task force
members read this article.
The article is based on a
soon-to-be-published paper by the National Bureau of Economic Research.
The paper shows that the overuse mavens who publish the Dartmouth Atlas
got it all wrong. They became very excited in the early 1990s about
Medicare data as computers made it possible to compare Medicare spending
region by region. By becoming obsessed with Medicare data and ignoring
data from the private sector, they convinced themselves of the wrong
solution. This is a great illustration of why drunks never find their
keys: They only look under the streetlight because that's where the
light is good.
Comment from Kip Sullivan: This morning's NY Times has a delicious article on the front page
debunking the ACA's theory of cost-containment, namely, overuse is
what's causing US health care costs to skyrocket, and the solution is to
push doctors into ACOs so they can bear insurance risk. In fact, the
paper provides evidence indicating that precisely BECAUSE the ACA
encourages consolidation of hospitals and clinics into ACOs, costs are
going up.
PNHP has been trying to communicate this fact to the
Health Care Financing Task Force: Overuse and the fee-for-service system
are not the problem, and cramming doctors into HMOs/ACOs so that they
can bear more insurance risk is not the solution. I hope task force
members read this article.
The article is based on a
soon-to-be-published paper by the National Bureau of Economic Research.
The paper shows that the overuse mavens who publish the Dartmouth Atlas
got it all wrong. They became very excited in the early 1990s about
Medicare data as computers made it possible to compare Medicare spending
region by region. By becoming obsessed with Medicare data and ignoring
data from the private sector, they convinced themselves of the wrong
solution. This is a great illustration of why drunks never find their
keys: They only look under the streetlight because that's where the
light is good.
Monday, December 14, 2015
Sunday, December 13, 2015
Saturday, December 12, 2015
Friday, December 11, 2015
Lone profitable ACA insurance co-op losing millions - Yahoo Finance
Lone profitable ACA insurance co-op losing millions - Yahoo Finance
I'm guessing the devils in the political details. Killing the public option was a big deal for the insurance companies and this co-op ideas was a compromise. But, as with county based purchasing in MN, I assume the non-profit co-ops got short changed in terms of money and red tape requirements.
I'm guessing the devils in the political details. Killing the public option was a big deal for the insurance companies and this co-op ideas was a compromise. But, as with county based purchasing in MN, I assume the non-profit co-ops got short changed in terms of money and red tape requirements.
Wednesday, December 9, 2015
Tuesday, December 8, 2015
More Former Inmates Getting Medicaid Under Obamacare, Study Finds - US News
More Former Inmates Getting Medicaid Under Obamacare, Study Finds - US News
Getting coverage upon release needs to become a mandatory part of our criminal justice system. Mental health and chemical abuse are major contributing factors to criminal behavior and access to treatment is essential.
Getting coverage upon release needs to become a mandatory part of our criminal justice system. Mental health and chemical abuse are major contributing factors to criminal behavior and access to treatment is essential.
This Could Be the Obamacare Outcome We've All Been Waiting For -- The Motley Fool
This Could Be the Obamacare Outcome We've All Been Waiting For -- The Motley Fool
"In exchange for spending more money on
their members up front, it's possible that chronic and serious diseases
that are the primary expense culprit for insurance companies can be
caught before they become a serious issue. Thus, while health benefit
providers may be spending more now than they would like to, their
long-term outlook is also looking brighter presuming the current
generation of members is now going to be healthier than the last
generation given expanded access to medical care."
"In exchange for spending more money on
their members up front, it's possible that chronic and serious diseases
that are the primary expense culprit for insurance companies can be
caught before they become a serious issue. Thus, while health benefit
providers may be spending more now than they would like to, their
long-term outlook is also looking brighter presuming the current
generation of members is now going to be healthier than the last
generation given expanded access to medical care."
Needed: Domestic Disarmament, Not 'Gun Control' | Amitai Etzioni
Needed: Domestic Disarmament, Not 'Gun Control' | Amitai Etzioni
This could be a major public health effort.
This could be a major public health effort.
Monday, December 7, 2015
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