This week, reports surfaced to confirm that the Trump administration is actively engaged in ACA sabotage. The strategy is to quite literally inflict financial harm on the American people, by way of increasing insurance premiums on the exchanges.
“For months, officials in Republican-controlled Iowa had sought federal permission to revitalize their ailing health-insurance marketplace. Then President Trump read about the request in a newspaper story and called the federal director weighing the application. “
As long as Trump is out to sabotage things, how about women’s health and rights?
“The new rules take effect immediately. And they allow large, publicly traded companies to seek an exemption from the birth control requirement if they have a religious or moral objection to providing such coverage. The Obama administration barred these large businesses from such exemptions.”
Continue reading Health Policy Updates: October 8 2017
The September issue of Health Affairs was a special edition, focusing on the topic of health care market concentration in the US. I’ve pointed to the closely related issue of hospital consolidation as one of the biggest drivers of increasing health care costs.
As one of the featured studies in this special issue found, the health care market in the US continues to concentrate, with more and more health systems merging into larger and larger networks. The end result of this is not more efficient care for the patient, but simply higher prices, as these large networks exert their monopoly power:
“Although provider concentration could produce efficiencies that benefit purchasers of health care services, the evidence does not point in that direction. For example, reviews of studies of hospital markets have found that concentrated markets are associated with higher hospital prices, with price increases often exceeding 20 percent when mergers occur in such markets. Of even greater concern, the reviews found that these price increases did not appear to improve quality: In some cases, higher hospital concentration was associated with higher mortality rates.”
Continue reading Health Policy Updates: September 9 2017
With the prices of many new specialty pharmaceuticals skyrocketing, the number of patients qualifying for Medicare’s “catastrophic” prescription drug provision is skyrocketing as well.
“Experts say the rapid rise in spending for pricey drugs threatens to make the popular prescription benefit financially unsustainable. Nonpartisan congressional advisers at the Medicare Payment Advisory Commission have called for an overhaul. The presidential candidates, as well as the Obama administration, have proposed giving Medicare legal authority to negotiate prices.”
Continue reading Health Policy Updates: July 31 2016
A very detailed, and very good, piece in Politico about the ongoing cost problem facing the ACA/Obamacare. Fewer young and healthy people have signed up than anticipated, leaving the average costs higher for everyone else. As a result, insurance companies are losing money, and are raising their prices to try to catch up. Trends like this are concerning that we may be seeing the early stages of a “death spiral,” in which prices continue to rise higher than more and more people are able to afford.
I found this article to cover both the successes and the problems of the ACA in a fair and comprehensive way, and recommend it highly.
“A close look at what’s really keeping the exchanges underwater suggests that some of the problems are self-inflicted wounds by Obama and his administration; others are the handiwork of Republican saboteurs, who undercut the safeguards intended to help companies weather the uncertainty of the new law…None of the problems are insurmountable, but if they aren’t fixed, the law could find itself in a mounting crisis—what observers call a “death spiral”—in which competition vanishes, costs skyrocket, and a dwindling pool of insurers offer policies so expensive that health insurance is as out of reach as it ever was.” Continue reading Health Policy Updates: July 24 2016
I have written in this space before about how the growth of large health care providers can contribute to the increasing cost of medical care. This week saw another couple of interesting articles on the topic.
The first reported on new evidence to support the emerging consensus that large hospital systems drive up prices as they gain monopoly power. A wave of consolidation in California has been linked to an increase in prices that its hospitals charge.
“Researchers said this gap of nearly $4,000 per patient admission was not due to regional wage differences or hospitals treating sicker patients. Rather, they said California’s two biggest hospital chains, Dignity Health and Sutter Health, had used their market power to win higher rates.” Continue reading Health Policy Updates: June 19 2016