Wow, another incredibly hectic week. Health policy has never been so frenzied…even though we ought to be getting used to it by now.
To sum up the horse-trading, by Monday night enough Senate Republicans had come out against the Better Care Reconciliation Act that it became clear the bill would never pass. Senate Leader Mitch McConnell, followed by Donald Trump, quickly reverted to the old “repeal and delay” strategy of voting to repeal the ACA in two years time, giving a prolonged interval to work on replacement. This strategy already failed back in February. Again, enough Senate Republicans came out against “repeal and delay” by Tuesday that this, too, seemed unlikely.
“But it became quickly apparent that GOP leaders, who were caught off guard by defections of their members Monday night, lacked the votes to abolish parts of the 2010 law outright. Three centrist Republican senators — Susan Collins (Maine), Shelley Moore Capito (W.Va.) and Lisa Murkowski (Alaska) — all said they would oppose any vote to proceed with an immediate repeal of the law.”
(the repeal and delay strategy, by the way, would result in 32 million Americans losing insurance, according to the CBO report that came out Wednesday).
Despite what looks like a lack of sufficient vote and the continually-damning CBO scores, GOP leadership continues to plan for a vote next week.
Continue reading Health Policy Updates: July 23 2017
Bill Clinton caused a still last week for using the word “crazy” to describe Obamacare. This was particularly questionable, argues Avik Roy, given the similarity of Hillary Clinton’s plan to Obama’s during the 2008 election season.
“If Hillary had won in 2008, and it had been her plan instead of Obama’s that became law in 2010, Hillarycare would be imposing exactly the same rate hikes as Obamacare has.”
Sarah Kliff sorted through Clinton’s remarks here.
Continue reading Health Policy Updates: October 8 2016
With an election coming up (as well as the first debate, next week!), to the extent that health care gets discussed at all, we are likely to hear the idea of “high deductible” health care plans getting touted as a solution to our health care cost problem. The idea is that by putting more of the cost burden on patients (aka, “cost sharing”), these types of insurance plans will force patients to become smarter consumers of health care and shop for high-value, low-cost providers. The evidence, however, is that people don’t use lower-cost care, then just use less care in general. Which has concerning implications for long-term health outcomes.
“In one sense, then, the high-deductible plan did accomplish a key goal: lower health spending. But when the researchers looked at why spending dropped, they found it had nothing to do with smarter shopping. The average price of a doctor visit wasn’t dropping. Instead, under the high-deductible plan, workers just went to the doctor way less.” Continue reading Health Policy Updates: September 24 2016
Bernie Sander’s new single-payer health care plan was introduced at the beginning of the week, and Ezra KIein of the left-leaning Vox media was not so keen. Big promises of new benefits, but where exactly was the money to pay for it coming from?
“All in all, Sanders wants to raise taxes by a bit over a trillion dollars per year — which may not sound like much to those who remember the Obamacare debate, but remember that the numbers that got thrown around for Obamacare were 10-year estimates. Adding inflation, Sanders will be raising taxes by close to $15 trillion when the Congressional Budget Office applies its normal scoring window.”
Continue reading Health Policy Updates: January 22 2016
From Health Affairs, thoughts on how to move away from fee-for-service reimbursement and towards value-based payment in cancer care:
“The Center for Medicare and Medicaid Innovation (CMMI) has announced the Oncology Care Model (OCM) for physician practices that administer chemotherapy to Medicare patients. Its key features are a monthly care management payment for each patient throughout the six-month episode as well as performance-based payments.” Continue reading Health Policy Updates: November 15 2015