The Journal of the American Medical Assn. recently published a very unusual article: a scientific study authored by a sitting president of the United States. That’s never happened before.
In a sense, it’s cool that President Obama cares enough about science to want to publish a paper in one of the world’s leading medical journals. But JAMA has set a bad precedent. The article, on healthcare reform in the United States, is problematic not only in its content but in the threat it poses to the integrity of scientific publishing.
It would be difficult, if not impossible, to find another paper in any scientific journal in which a politician was allowed to subjectively analyze his own policy and declare it a success. This is a textbook definition of conflict of interest.
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Politicians tend to be most enraged by the problems they cause, and the liberal fury against insurance mergers is a classic of the genre. ObamaCare was designed to create government-directed oligopolies, but now its authors claim to be alarmed by less competition.
Last week federal and 11 state antitrust regulators filed a double lawsuit to block the pending $54 billion insurance tie-up between Anthem and Cigna and the $37 billion acquisition of Humana by Aetna.
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The man selected by presumptive Democratic presidential nominee Hillary Clinton as her vice presidential running mate is a strong ally of Clinton’s in her push for improving the Affordable Care Act and expanding Medicaid to more states.
Virginia Sen. Tim Kaine, whom Clinton named Friday as her running mate, has sponsored several bills to fix gaps and glitches in the ACA and to encourage more states to extend Medicaid to low-income adults. None have won Republican support and passed. He also has strongly backed Virginia Gov. Terry McAuliffe’s unsuccessful efforts up to now to expand Medicaid in his own state.
As governor in 2009, Kaine signed a letter with 21 other governors to congressional leaders urging them to enact federal healthcare reform legislation.
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Hillary Clinton led a health care reform effort in the 1990s, promoted medical research as a senator, and has been bashing price-hiking drug companies on the campaign trail and in TV ads.
So there’s every reason to expect her to make health care a major theme when she accepts the Democratic presidential nomination in Philadelphia on Thursday night. What she says about the future of medical research, public health, and the uninsured will give a valuable preview of what her priorities would be — and how far she’s willing to go to co-opt the ideas of her defeated rival, Bernie Sanders.
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Today’s headline in The Los Angeles Times: “California Obamacare rates to rise 13% in 2017, more than three times the increase of the last two years.” The increase will be 17.2% for Anthem and 19.9% for Blue Shield–the largest Obamacare insurers.
Obamacare supporters have long pointed to Covered California as the example of just how good Obamacare could be if the entire program were run as well as it is in California.
Covered California’s average rate increase for 2017 will be 13.2%.
But half of the California market is controlled by two carriers who will be asking for much bigger increases. Blue Shield of California said its average rate increase for 2017 will be 19.9%, the biggest statewide increase. Anthem Blue Cross said it will increase its rates by an average of 17.2% for 2017.
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California’s Obamacare premiums will jump 13.2 percent on average next year, a sharp increase that is likely to reverberate nationwide in an election year.
The Covered California exchange had won plaudits by negotiating 4 percent average rate increases in its first two years. But that feat couldn’t be repeated for 2017, as overall medical costs continue to climb and two federal programs that help insurers with expensive claims are set to expire this year.
The increase announced Tuesday comes as major insurers around the country seek even bigger rate hikes for open enrollment this fall, and the presidential candidates clash over the future of President Barack Obama’s landmark health law.
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Humana will exit eight of the 19 individual health insurance markets where it has sold Obamacare plans this year, the insurer announced Thursday.
The company is still struggling to make a profit on the exchanges, according to its second quarter earnings guidance released Thursday. The company expects to offer individual plans in 156 counties across 11 states compared to the 1,351 counties in 19 states it has offered plans in the year, according to a release.
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More than six years of efforts by Republican and other right-of-center opponents to repeal, replace, or substantially reshape Obamacare have fallen short.
The strategic options ahead for Obamacare critics on the right are:
- Rinse and repeat: more of the same
- Gamble on a more ambitious long-shot strategy
- Adapt tactically in the near term, to minimize future damage
House Republicans released their latest plan – “A Better Way” – to repeal and replace the Affordable Care Act last month. It blends all three of the strategies above, but its lite brew for reform remarkably manages to be both too cautious and too unrealistic all at once.
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House Speaker Paul Ryan says he has heard personally from actuaries for a major health insurer that Obamacare is “failing.” Speaking at a Wednesday breakfast for Ohio delegates to the Republican National Convention, Ryan said that actuaries for Blue Cross Blue Shield have told him the Affordable Care Act is going downhill faster than they expected.
“As I said in the beginning, this healthcare law is going to collapse under its own weight,” Ryan said. “I met with all these actuaries from Blue Cross Blue Shield a little while ago, and they said ‘Well, congressman, the law is failing two years ahead of schedule,'” he added. “Meaning, basically, they saw it coming, but they didn’t think it would be this bad so fast.”
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Things have gone from bad to worse for the Affordable Care Act’s health-care co-op experiment.
Maryland’s co-op, Evergreen Health, filed a first-of-its-kind lawsuit in June against the federal government claiming that private insurers have gamed the system to avoid making “risk adjustment payments.” Under the ACA, insurers with healthier members must make these payments to insurers with unhealthier members. But Evergreen CEO Peter Beilenson argues that his co-op was unfairly labeled as healthier because private insurers encouraged their less healthy members to go to the doctor so their patient pools would appear less healthy. Evergreen is now expected to owe between $18 million and $22 million in risk adjustment payments.
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