Tag: "health policy"

The Silly Appeal of Expanding Medicaid for All

DocsMeanMany people believe Obamacare was a conspiracy, with asinine design features intended to cause the program to fail. The primary goal in the minds of conspiracy buffs’ was to usher in a single-payer program of Medicare for All once Obamacare collapsed under adverse selection. The theory goes something like this: with nowhere to turn except the government, Americans would finally throw up their hands and acquiesce to government intervention. Seniors purportedly all love their Medicare, so why not expand the program to cover even more people?

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Technology & Cost Containment—Why Doesn’t Medical Technology Bring Down the Cost of Healthcare?

Capture14Technology is a significant driver of high health care spending. For instance, many treatments common today were not available 40 years ago. Yet, treatments and therapies that have been in use for decades are still quite expensive. In typical consumer markets, the quality of technology gets progressively better while the (real) inflation-adjusted prices often fall as older technology is surpassed by newer technology. This is especially true of consumer electronics but also of true of automobiles, appliances and other types of consumer goods. The inflation-adjusted prices of consumer goods have held steady because consumers are price sensitive, rewarding the firms who successfully compete for their business.

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Advice to the New FDA Commissioner

prescription-drug-shortageWriting in The Hill, Mercatus Senior Research Scholar Robert Graboyes discussed ways to boost the U.S. Food and Drug Administration’s productivity.  He and coauthor Jordan Reimschisel discussed seven things the FDA could do to speed approval of drugs and medical devices.

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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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Hillary’s Campaign to Lower Drug Costs is a Real Downer

captureSpending on prescription drugs has grown tremendously over the past few decades. This is mainly due to the increase in the number of diseases and conditions treated using drug therapy. The truth is: most drugs are dirt cheap! However, a small portion — maybe 1 or 2 percent — are rather costly. As a result of that small percentage, drug prices have become a campaign issue accompanied by plethora of bad ideas.

Early in his campaign, Donald Trump even came out with some doozies, such as having the government negotiate drug prices for Medicare and importing drugs from abroad (that is: importing other countries’ price controls). He has since ceded these populist talking points to Hillary in favor of free-market ideas. He now advocates getting government out of the way, allowing competition to flourish. He understands that bureaucratic red tape at the U.S. Food and Drug Administration often prevents competition from holding drug prices in check.

Hillary Clinton is another story.

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The Regulatory State Reaches The Wellness Industry

Women joggingThe Equal Employment Opportunity Commission (EEOC) has finalized rules on how employers can use wellness programs. By current federal standards, the rules are concise: 19 pages pertaining to the Americans with Disabilities Act and 17 pages pertaining to the Genetic Information Nondiscrimination Act. Both laws are extremely popular. The ADA (1990) passed by 91-6 in the U.S. Senate and 377-28 in the U.S. House of Representatives. The GINA (2008) passed by 95-0 in the Senate and 414-1 in the House.

These laws are meant to prevent discrimination. However this bumps against the real world where health insurers cannot charge different premiums to individuals who are sick. The Accordable Care Act (2010) allows employers to offer incentives to workers who participate in wellness programs, and can offer financial incentives up to 30 percent of premium (or up to 50 percent for anti-smoking programs). However, participation in a wellness program also necessitates surrendering personal health information to an employer who would otherwise be barred from having it (under the Health Insurance Portability and Accountability Act, 1996).

Because employers cannot use underwriting for medical risk to charge different premiums to different employees, it is hard to avoid the conclusion that wellness programs are less designed to make or keep employees well, as to ensure healthy people are attracted to the employer and sick people are not. Evidence suggests this is the real consequence of workplace wellness programs.

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Texas’ Largest Insurer to Increase Premiums 60%

An article by Ricardo Alonso-Zildivar of the Associated Press claims Texas’ largest health insurer plans to raise premiums by as much as 60 percent next year. The article assures us few people will be harmed — most enrollees have their premiums capped as a percentage of household income. Thus, it’s actually taxpayers who will get gouged. The article does admit that some people — those who are too wealthy to qualify for premium subsidies — may suffer sticker shock next November when they price their coverage for 2017.

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A Health Reform Agenda to Replace Obamacare

The most pressing goal of health reformers in Congress should be to replace all the costly provisions in Obamacare with the consumer-friendly health plans Americans prefer. In the process, reformers must change the way medical care is financed so that consumers have control over their health care dollars, as well as the means to pay for medical care over their lifetimes. As a starting point, Congress should repeal the individual and employer mandates and taxes of the Patient Protection and Affordable Care Act (ACA).

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Jindal’s Attack on Walker’s Health Plan is Off-Base

Yesterday, I addressed Governor Scott Walker’s health plan in largely positive terms. Governor Bobby Jindal, a competing Republican presidential contender, has launched a broadside against Walker’s plan, describing it as a “new federal entitlement.”

JW

The charge is way off-base. Governor Jindal proposed a health reform back in 2014, via his America Next policy shop. The point of contention is that Governor Jindal’s proposal would not offer everyone a refundable tax credit. Instead, it would eliminate the exclusion of employer-based health benefits from taxable income and replace it with a standard deduction.

I criticized the proposal when it was issued. True, it is an easier switch than a refundable tax credit. On the other hand, a deduction does nothing for low-income households – which means the welfare state continues to exist. Jindal himself proposed throwing $100 million more at states to fund their medical safety nets.

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