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In 2003, Congress decided to boost funding for Medicare Advantage plans to attract private health plans that could introduce competition into Medicare. Cuts in those payments would disadvantage millions of beneficiaries who find that Medicare Advantage meets their needs better than traditional coverage. Enrollment in all private Medicare health plans has now reached an all-time high of 8.3 million beneficiaries, up from 5.3 million in 200331 and the percentage of beneficiaries who have chosen Medicare Advantage has grown from 12.1 percent of all Medicare beneficiaries in 2004 to 19 percent this year. The added funds also increase the options available for seniors living in rural areas. As we have seen with Medicare Part D, competition among private plans leads to more choices and greater value for seniors. Competing Medicare Advantage plans are offering more choices of plans, more generous benefits, and lower cost-sharing for beneficiaries than Medicare fee-for-service. Seniors who especially value this option are those with modest incomes who do not have supplementary coverage.
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Yet another state turns to Heritage for help setting up a state-based insurance exchange to promote individual ownership of health coverage and to help small businesses cover more of their workers.
A Montana House Republican began the bill-writing process over the weekend to create a state health insurance exchange with the goal of getting virtually every Montanan covered. A bill requested by Rep. Gary MacLaren, R-Victor, would work to create a state health insurance exchange, which would work through existing private insurance companies to make insurance more accessible to individuals.... G. Brian Zins, executive vice president of the Montana Medical Association, said the organization does not have a position on MacLaren?s bill, but he said he was intrigued by Haislmaier?s presentation and thinks Montana should look into such a system. ?(Haislmaier) has a unique point,? Zins said. ?Massachussetts did this. They have a program. That?s why we brought him in. That?s why we?re looking at it.?
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Doesn't it seem like the American aversion to waiting and queuing--a reflection of our individuality and can-do impatience--would undermine any attempt at single-payer government-rationed health care?
The first thing to remember is there are indeed substantial waiting times for treatment in the NHS. In fact, you can look them up... Using my UK address, my local hospital quotes 23 to 54 days for cardiac surgery. You might not think that too bad but please, realize that this is not the time you will wait for treatment. This is the time between your doctor saying "You know, you really ought to see a doctor about that" and your seeing said specialist. Looking at inpatient appointments, it can be up to 148 days: very useful don't you think if you've got a dodgy heart and need surgery rather than toppling over in the street? Again, that isn't the wait for your operation: that's the one to have a bed in hospital overnight if you need a series of intrusive tests.
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This wouldn't be the first Commonwealth study on HSAs to mislead or misrepresent its conclusions. We identified a similar thing here (trumpeting negative survey results as damning HSAs when the survey was conducted before HSAs even existed) and another one here (passing off a study's assumption that HSA take-up rates will be low as the study's conclusion). Shouldn't this kind of thing dissuade media outlets from relying on Commonwealth analyses? (Via NCPA's DPD)
An executive of an upstart airline recently described her company as having three 757s, more than 200 employees, and one big headache: rising health-care costs. Thus, they made the switch to HSAs in 2006, and premiums rose just 5%, compared with a national average of over 8%. Such successes aren't making the news, but overwhelmingly negative stories are. A much reported Commonwealth Fund survey, for example, concluded that enrollment in consumer-driven plans is stagnant, people are grossly dissatisfied, and care is delayed. But the report was flawed on its face: For one, it was unrepresentative, drawn from a pool of "Internet users who have agreed to participate in research surveys.
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As Justice Brandeis wrote, "It is one of the happy incidents of the federal system that a single courageous State may, if its citizens choose, serve as a laboratory; and try novel social and economic experiments without risk to the rest of the country." This strategy served the U.S. so well in welfare reform. Now it's time to rely on it once again for the day's most pressing issue: health care reform and the uninsured. In an insightful editorial, the Examiner makes this point:
In the interim, however, we think states should be freed and encouraged to reform their systems--and potentially serve as a model for the federal government. The bipartisan Health Partnership Act, introduced earlier this month in the Senate with a House counterpart, would do just that.... The approach has been used before. It mirrors pre-welfare-reform legislation waivers that were granted to individual states, including Wisconsin. So what became welfare reform at the federal level essentially was tested in Wisconsin.
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The proposal to force doctors and other health care workers to move to electronic records has been on the table for some time. Initiatives like this, however, show that market forces can organically grow a solution. In this case, e-prescriptions may prove a foot in the door for e-records, the Holy Grail. If Congress wants to speed that process along, rather than enact new mandates, it should think about how to structure a market in medical data that gives patients ownership rights and provides medical providers with incentives to create e-records and use the data from them appropriately and fruitfully. Successful e-prescriptions will demonstrate that the market is well-equipped to provide these services.
To address the problem--€”and give the push for electronic medical records a shove--a coalition of health care companies and technology firms will launch a program Tuesday to enable all doctors in the U.S. to write electronic prescriptions for free. The National e-prescribing Patient Safety Initiative (NEPSI) will offer doctors access to eRx Now, a Web-based tool that physicians can use to write prescriptions electronically, check for potentially harmful drug interactions and ensure that pharmacies provide appropriate medications and dosages.
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The Washington Post strongly endorses the President's proposal to change the tax treatment of health coverage.
At present, people who get health insurance from employers pay no tax on the value of the benefit. Someone with a marginal tax rate of 35 percent and a generous insurance policy worth $20,000 a year gets a $7,000 tax break. But people who buy insurance on the individual market must usually do so with post-tax dollars, so their tax break is normally zero. The administration proposes to eliminate that unfairness by giving salaried workers and freelancers the same tax deduction.
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Unpack the story, and the alleged tax hikes are not what they seem. Yes, some workers with especially generous insurance plans--those costing about $4,000 more per year than the average family plan--would face tax increases. But even those facing potential tax hikes may be able to move to the individual market and, using the proposed tax deduction, reduce or eliminate the higher taxes. And in addition, millions of workers would gain the power to purchase affordable health insurance that is now denied to them because their employers do not pay for it. This sort of equal treatment would give all Americans choices about what sort of coverage they want--a far better state of affairs that today's prevalent one-size-fits-all employer-sponsored options and government programs.
About 30 million Americans could face a tax hike under President George W. Bush's plan to expand health insurance coverage and address rising health care costs, the White House said on Monday.
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But the president’s plan is solid. If enacted, it would be the boldest free-market health-care reform ever, and the biggest step toward tax reform in years.
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Protectionism in action. States say they're concerned about citizens' health care options and affordability, and some states are even working to offer socialist-style health coverage plans that provide low-income families with drug benefits. But let the market lower prices at no cost to taxpayers? Forget about it!
In an effort to protect retail pharmacies, a number of states are questioning whether Wal-Mart’s low-cost generic drug program violates their laws against unfair competition. Wal-Mart Stores Inc. announced last September that it would sell 291 generic drugs for $4 a prescription in the Tampa area at Wal-Mart, Neighborhood Market, and Sam's Club pharmacies. The Bentonville, Ark. company shortly thereafter announced the expansion of the program to all states and to 331 generics. According to published reports, however, several states have challenged the program. Wal-Mart has acquiesced to a certain degree to some states, agreeing to raise the price of 56 of the 331 generic drugs from $4 to $9 in California, Colorado, Hawaii, Minnesota, Montana, Pennsylvania, Tennessee, Wisconsin and Wyoming.
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How we wish we had seen that headline back in 2003. But it is still good news with respect to imposing "negotiation" and with it de facto price controls on drugs in Part D.
But Richard G. Frank, a professor of health economics at Harvard, said that some of these drugs "really make a difference in people's lives." The drugs may be expensive, Dr. Frank said, but imposing cost controls may pose "particular risks to precisely the research and development that should be most encouraged."
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The Post runs a nice profile on NCPA's John Goodman.
Goodman is confident that their popularity will grow. Just this month, he noted, Congress made health savings accounts more attractive by substantially increasing the tax-free amount that Americans can contribute to them every year. "We are on a health-care spending path that's unsustainable," he said. "Someone is going to have to choose between health care and other uses of money. If you want someone else to make those choices for you, you can join an HMO. But if you want to make those choices yourself, these accounts give you the financial ability to make them."
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A Blue Ribbon Commission? What's wrong with Dirigo won't be fixed by having the best and brightest intervene. The biggest problem is that it doesn't offer consumers real choice, opting instead to offer six complicated, canned, state-defined benefit plans that, it turns out, Maine's citizens don't want. Corralling the same people who designed this mess into a room to figure out how to fix it just isn't the answer.
Maine's Dirigo Health Reform Act drew national attention when it was signed into law in 2003, making Maine the first state in recent years to enact legislation aimed at providing universal health care access. The law, which went into effect Jan. 1, 2005, is designed to contain health care costs and ensure access to health care for all. When it passed in the Legislature, its goal was to insure 31,000 people in its first year and to cover all of the state'€™s 130,000 uninsured by 2009. The program has fallen short of its goals -- 12,153 were enrolled in the Dirigo Choice health insurance program at the end of October -- and was placed under review this year by a Blue Ribbon Commission representing business, insurers, consumers, labor and the state.
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Yet another unintended consequence should Congress mandate Medicare price negotiation with drug companies.
Michael J. Fox made headlines for Democrats in the recent election campaign by promoting federal funding of embryonic stem cell research that the actor deems critical to finding a cure for Parkinson's Disease. Unbeknownst to him, his message was part of a massive bait-and-switch. That's because the Democrats also promised Medicare reforms that would have the effect of denying seniors access to new Parkinson drugs and of undermining investment in stem cell research--indeed, in all kinds of pharmaceutical research.
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The author of a consumer budgeting weblog realizes just how much money he can save with a high-deductible health insurance plan.
After asking around a bunch, I decided to go with Blue Cross, where I’ve had insurance before. They haven’t been great, but they’ve been better than Aetna, by previous provider. The options were interesting. I’ve always heard the personal finance mantra of, "€śGo with a high deductible, you'll save yourself money!" I didn'€™t realize just how much money I'€™d save by following that advice. I eventually decided to go with a $1,500 deductible, which, compared to the $250 deductible I had before, will in all likelihood save me between $200 and $1,000 over the next year. If the worst happens and I max out the amount I could possibly spend on health costs with this insurance plan, it's still only about $100 more than I would spend with a low deductible plan.
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