Category: Health Alerts

John R. Graham Appointed Principal Deputy Assistant Secretary at HHS

Capture24The political website Politico (gated) broke the news that NCPA senior fellow, John R. Graham, will be the next principal deputy assistant secretary for planning and evaluation at the U.S. Department of Health and Human Services. The Daily Caller also broke the news earlier this week with a rather provocative headline: “Trump Admin Appoints Healthcare Reform Expert To HHS Amid Obamacare Negotiations.” The photo was taken during Graham’s Congressional testimony on the individual mandate, which can be viewed here.

An announcement by NCPA CEO Jim Amos can be found here:

We at NCPA are excited to learn that President Trump and Secretary Tom Price have chosen our trusted and accomplished colleague, NCPA Senior Fellow John R. Graham, to lead the Division of Planning and Evaluation at the U.S. Department of Health & Human Services. Mr. Graham has a record of accomplishment in many areas of health policy, including payment reform, regulation of drugs and devices, comparing international health systems, and the importance of incentives in medical innovation. Everyone who has worked with Mr. Graham has experienced his collegiality, humor, intelligence, and organizational and thought leadership. Although we are sorry to lose him from our team, we know his new colleagues – and the American people – will benefit greatly from his skills and drive to put patients before politicians in health reform. Mr. Graham’s senior appointment by the Trump Administration is yet another example of NCPA’s impact on public policy.

 

 

Invisible High-Risk Pools

Five people waiting in waiting roomThere has been some discussions about invisible high-risk pools. That is a condition where the state assumes responsibility for some subset of sick enrollees’ high claims cost. For instance, Alaska began subsidizing the cost for a few individuals so the remaining 25,000 Alaska Obamacare enrollees would not be priced out of the market.

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Propping Up Obamacare: Playing the (Bad) Hand You’re Dealt…

Caduceus with First-aid Kit --- Image by © Royalty-Free/Corbis

Caduceus with First-aid Kit — Image by © Royalty-Free/Corbis

Obamacare is enrolling too many sick people and too few healthy ones to prevent a death spiral. The Centers for Medicare & Medicaid Services (CMS), a unit of the U.S. Department of Health & Human Services (HHS), has proposed a new rule to stabilize the Obamacare markets for individual health insurance. This was the first rule issued since Dr. Tom Price was appointed HHS secretary. The proposed Market Stabilization rule includes a number of measures to prevent people from entering the market when sick and exiting when healthy.

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Obamacare Repeal & Replace 2.0: Where Do We Go From Here?

220px-Tom_PriceThe failed House Republican American Health Care Act (AHCA) was always a work in progress. The three-phased approach to reform health care called for passage of the AHCA to repeal the Affordable Care Act (ACA) taxes and mandates; and slow the growth in Medicaid (phase one). Phase two was the selective tweaking of Obamacare regulations by the Secretary of Health and Human Services. Phase three was to be a forthcoming health care bill to revamp onerous insurance regulations.

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Third-Party Payment Is The Root Cause of Health System Dysfunction

InsFormSmall(A version of this Health Alert was published by RealClearHealth.)

Largely absent from the vigorous debate over reforming the nation’s health care laws is the understanding that simply being covered by health insurance does not reduce health care costs.

Before the Affordable Care Act (ACA) passed in March 2010, President Obama repeatedly promised that the typical family’s health premiums would go down by (sometimes “up to” but frequently “on average”) $2,500. That decline did not occur because the ACA strengthened the control that insurance companies—as opposed to patients—have over health care spending. In fact, Americans’ increasing dependence on health insurance over the last seven decades has been a major contributor to exploding health costs.

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California Single-Payer Bill Looks Backward, Not Forward to A New Era of Patient Choice

Covered California(A version of this Health Alert was published by the Orange County Register.)

Here we go again. The California state legislature is considering yet another bill to impose a so-called single-payer, government monopoly, health care system. This has long been an obsession of the militant California Nurses Union, because a health system under total government control would suit the narrow interests of union leaders. They would accrue power similar to that wielded by other public-sector unions and might even be able to negotiate contracts similar to those enjoyed by state and local employees, which are driving public finances across the state into the ditch.

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The Logic Defying CBO Obamacare Replacement Score Breaks Its Own Rules, Among Other Problems

220px-Tom_Price(A version of this Health Alert was published by Forbes.)

Dr. Tom Price, the U.S. Secretary of Health & Human Services has said the Congressional Budget Office’s recent “score” of the Republican Obamacare replacement bill defies logic. Even worse, it defies the very rules which govern the CBO.

The 2016 Budget Resolution, agreed by both the House and Senate in May 2015 directed the CBO to do so-called dynamic scoring of major legislation.  Dynamic scoring includes proposed laws’ macroeconomic effects. It is especially important when new laws cut taxes, as the American Health Care Act would do. Old fashioned, static analysis does not result in accurate estimates.

For example, say a 10 percent tax on a base of $100 million raises $10 million. Cutting that tax to five percent would cut revenue by $5 million, under static analysis. This ignores the economic growth that would occur as a result of the tax cut.

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Bargain Basement vs. the Sky is the Limit Health Care

Caduceus with First-aid Kit --- Image by © Royalty-Free/Corbis

Caduceus with First-aid Kit — Image by © Royalty-Free/Corbis

How much should a healthy person’s health insurance premiums reflect the cost of another person’s poor health status? Stated another way, how much should society invest in care for the sickest individuals? Moreover, should society invest in primary care or inpatient care?

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Every State Must Close Obamacare’s Special Enrollment Loopholes

Obamacare-protest-AP(A version of this Health Alert was published by Forbes.)

So, the Republican Repeal-and-Replace Obamacare train has finally left the station. Although free-market health reformers are divided on the merits of the American Health Care Act, as introduced by the Energy & Commerce and Ways & Means Committees of the U.S. House of Representatives, no-one can deny the Republicans have kept their promise to take up health reform as their first order of legislative business.

However, new legislation takes a long time to get to the President’s desk. Meanwhile, the Trump Administration has the unenviable task of enforcing a law they know harms Americans. They are doing the best they can to offer relief through administrative rule-making.

On February 17, the Centers for Medicare & Medicaid Services proposed a new rule to address one reason why Obamacare premiums jumped 25 percent this year: The exchanges attract too many sick people and not enough healthy people. This is called a death spiral; and one reason it occurs is the Obama Administration allowed people to jump in and out of the exchanges too easily.

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Medical Drug Tourism: An Odd Byproduct of High Drug Prices

Capture14On numerous occasions President Trump has lambasted drug companies for their high drug prices. He has suggested on more than one occasion Americans should be allowed to import medications from abroad where they are cheaper. Allowing private citizens to import their own drugs is a form of arbitrage. Arbitrage is when people are able to take advantage of discrepancies in prices in two different markets and bypass the higher prices by purchasing the lower-priced product in a cheaper market. For instance, you could argue that buying from Amazon is a form of arbitrage to avoid paying higher prices at your local brick & mortar store.

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