Seeing, hearing, reading, and feeling the new grassroots ferment among progressive Americans for a single-payer health care system, my gut reaction is: I get it. As newly documented in Elizabeth Rosenthal’s book, An American Sickness,1 and the Commonwealth Fund’s report, Mirror, Mirror 2017,2 our health care system provides shockingly poor value and outcomes, and rests on a foundation of greed. It deserves fundamental change.
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Republicans have now failed twice to repeal and replace ObamaCare. But their whole focus has been wrong. The debate centered, like ObamaCare, on the number of people with health insurance. A more direct path to broadening access would be to reduce the cost of care. This means creating market conditions long proven to bring down prices while improving quality—empowering consumers to seek value, increasing the supply of care, and stimulating competition.
People will be able to enroll in Obamacare plans directly through web brokers and health insurers for 2018, which will reduce the need for federal outreach funds.
That feature will likely be included in an upcoming Department of Health and Human Services proposed rule under review at the Office of Management and Budget, Joel White, president of the Council for Affordable Health Coverage (CAHC), told Bloomberg BNA Sept. 22. Congress isn’t likely to provide more funding for Affordable Care Act outreach activities, so “HHS is going to have to figure out ways to expand options for consumers to get enrolled,” White said HHS officials have told his group. The CAHC is a broad-based group of health-care industries.
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The actress Julia Louis-Dreyfus announced on Twitter that she has been diagnosed with breast cancer. We all wish her a speedy and complete recovery. Still, this would not normally be a topic for The Apothecary, except that in making her announcement, she used her diagnosis as a plug for “universal health care,” with the implication that universal health care would improve survival rates. Actual data from countries around the world, with and without so-called universal health care, do not support that contention.
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Republicans are willing to provide insurers with two years of ObamaCare subsidies under a bipartisan market stabilization bill, according to the Senate Health Committee chairman.
Sen. Lamar Alexander (R-Tenn.) said continuing cost-sharing reduction subsidies for two years is a key part of the stabilization package he is trying to negotiate with Sen. Patty Murray (D-Wash.).
Alexander and Murray are continuing to try to rally Republicans and Democrats around a short-term plan to lower ObamaCare premiums in 2018 and 2019.
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The #3 reason Medicare-for-All as conceived by Senator Sanders is a bad idea is because of the inevitable rationing it will produce. In other well-known single-payer systems, this rationing takes several forms, including restrictions on the availability of treatments or, more commonly, rationing by waiting.
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The #2 reason this plan is a bad idea is the enormous amount of waste it would create due to moral hazard. Moral hazard is the technical term used by health economists, but it refers to something every reader intuitively understand even if the term itself is unfamiliar. If you give something to someone for free, they will use more of it and they also will be less likely shop vigorously for a lower price. In short, such consumers will typically use more and pay more (i.e., be willing to accept a higher price) for “free” services.
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With one exception, every tax known to man shrinks the economy to some extent resulting in a loss of welfare for consumers and producers [1]. That is, “whatever you tax, you get less of,” whether that be labor, consumption of various products, capital or anything else policymakers have figured out how to tax. The exact amount the economy shrinks (which in turn determines the size of the associated welfare losses to consumers and producers) depends upon exactly what is taxed.
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Obamacare has not done much to slow the growth of health care costs. Government actuaries project that health spending will grow 5.8% a year over the next decade — substantially faster than growth in the economy. Could Republican proposals to sell health insurance across state lines bend the cost curve and make premiums health plans more affordable ?
The idea seems simple enough. Right now, if you are buying your own health insurance, that coverage must be sold by an insurer regulated in your state. Instead of a national market, health insurance is sold in 51 state markets (including D.C.) with differing regulations.
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During his short stint leading health policy for the Trump administration, Dr. Tom Price spearheaded a number of efforts to ease the regulatory burden on the industry, especially for his peers in the physician community.
While few expect the administration to dial back on that commitment, Price’s resignation Friday as HHS secretary could, at least momentarily, force agency heads to tap the brakes on any bold new policies.
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