Given the problems that the ACA/Obamacare has faced, were there any realistic alternatives at the time the law was passed, that would have done any better? Megan McArdle, writing at Bloomberg, thinks yes. Specifically, focus on the simple expansion of Medicaid to support low-income Americans rather than trying to set up the complex Exchange infrastructure.
“Here’s my radical plan: If the Obamacare exchanges are going to result in, at best, people being able to buy Medicaid-style plans with limited choices and benefits, then why not just eliminate the middleman and give them … Medicaid?”
Continue reading Health Policy Updates: September 3 2016
The big story this week from the world of health reform was news that Aetna, another large insurer, is massively scaling back its participation in the ACA/Obamacare exchanges. Large financial losses are cited as the reason. Here is a sampling of related stories:
Announcement from Aetna:
“Following a thorough business review and in light of a second-quarter pretax loss of $200 million and total pretax losses of more than $430 million since January 2014 in our individual products, we have decided to reduce our individual public exchange presence in 2017, which will limit our financial exposure moving forward.“
Obamacare pullouts have left some areas of the country with very few options, as reported in Bloomberg:
“The dropouts also undermine a key promise of the law: multiple insurers would compete for consumers’ business each year, and the power of the market would control costs and raise quality. Instead, the opposite is happening.”
Continue reading Health Policy Updates: August 20 2016
I’ve written before, in my health care spending map here, about the problems with fee-for-service reimbursement in medicine. When our financial interest is to provide patients with more medical care, then we doctors tend to do so – often, more than the patient actually needs. There is a new study out this week further demonstrating that doctors do, in fact, respond to the reimbursement incentive. Blog commentary here. Continue reading Health Policy Updates: February 28 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
The cost spiral on pharmaceuticals continues. And it isn’t just the new drugs – manufacturers continue to jack the prices on the old ones, too.
“The new increases despite this criticism “signals there’s still pricing power,” Jefferies analyst David Steinberg said in an interview. “Unlike other countries, there’s no mechanism whereby regulatory authorities can control price.”” Continue reading Health Policy Updates: January 17 2016