Posted 5/2/12 on Managed Care Matters
When it comes to health reform, perhaps the only thing Congressional Republicans agree on is they hate ObamaCare.
There’s no agreement on a basic framework much less consensus on an actual bill. Moreover, there are parts of ObamaCare that enjoy solid support amongst many Republicans, complicating the GOP’s efforts to develop an alternative without conceding political ground.
Their dilemma is certainly understandable; as anyone who followed the tortuous path of the PPACA (aka Obamacare), there was precious little consensus among the Democrats who passed the bill. While most had serious issues with various bits and pieces, they held their noses and voted “aye” when pressed.
Continue reading “GOP Alternatives to ObamaCare”
Posted 4/26/12 on Health Care Policy and Marketplace Review
Today’s headline was, “Millions Expected To Receive Insurance Rebates Totaling $1.3 Billion.”
The Kaiser Family Foundation estimates that 3.4 million people in the individual market will receive $426 million in consumer rebates because of the Affordable Care Act’s new MLR rules. In the small group market 4.9 million enrollees will see $377 million in rebates, and 7.5 million people will get $540 million in the large group market.
Continue reading “The Medical Loss Ratio (MLR) Report—Just Fiddling While Rome is Burning”
Posted 4/10/12 on The Government We Deserve
Regardless of how the Supreme Court decides the constitutionality of the individual mandate, the health care debate is now reignited. If the mandate is sustained, the Accountable Care Act enacted under President Obama still has too many kinks to remain unaltered. If it’s thrown out, a return to the unsustainable system with growing numbers of uninsured is not a solution. Yet no fix is possible as long as elected officials dodge the basic arithmetic of health care.
As for the individual mandate, ignore the constitutional briefs for the moment. Ignore also how a mandate helps address problems that arise if insurance companies must offer coverage regardless of prior conditions and people otherwise are tempted to wait until they are sick to buy it. Instead, let’s see how a mandate fits it into the broader arithmetic of paying for health care.
Continue reading “The Supreme Court and the Mathless Health Care Reform Debate”
Posted 3/28/12 on Health Policy and Marketplace Review
First, trying to predict how the Court will rule is at best just speculation. I know what Justice Kennedy said both today and yesterday and it certainly doesn’t look good for the Obama administration and upholding at least the mandate.
But I will remind everyone, based upon oral arguments, most Court watchers expected a ruling in favor of the biotech industry on a recent case involving health care patents. “Surprisingly,” the Court ruled against the industry.
Continue reading “If the Supreme Court Overturns the Individual Mandate”
Posted 12/16/11 on Managed Care Matters
There’s been one consistent finding among all the polls and surveys seeking opinions on health reform: most respondents don’t know much about it and there are many misperceptions and misconceptions about reform.
The good folk at Kaiser Family Foundation have put together an interactive tool to help remedy that situation. The YouToon application shows how reform will impact employers – large, small, and mid-sized; individuals and families, the well-off, middle class, and poor.
It’s easy to understand and a quick read too.
There’s a more “you-specific” tool here that is focused on individuals and families, not employers.
And the Washington Post has an interactive site where you can plug in details on income, family size, source of insurance, and marriage status and get specific info on how reform affects you – specifically – and what, if any, tax impact it has.
First published 6/13/11 on Health Care Reform Update
The past week’s appellate court hearing in Atlanta on the constitutionality of the Affordable Care Act, one of a series along the inevitable road to the Supreme Court, showed that the opposing legal arguments are beginning to be firmly established—with each seeming to confuse the purchase of health insurance with the purchase of health care.
The Atlanta panel of three judges, with both Republican and Democratic appointees, heard arguments for and against the earlier ruling by Judge Roger Vinson in Pensacola that the individual mandate was unconstitutional and so central to the ACA that the entire act should be invalidated, and specifically that while the Commerce Clause of the Constitution gave the government authority to regulate interstate commerce, it did not allow Congress to penalize people for the “inactivity” of declining to buy a commercial product.
Continue reading “Another Legal Round – With A Major Mis-Step?”
First published 3/24/11 on ACO Watch
Healthcare reform used to imply just regulatory change. As time marches on, it also implies market change. Most pundits agree that, whatever happens to the healthcare reform law, whether or not it is found to be unconstitutional, the healthcare business community is unleashed. Change is afoot!
If you follow my naysaying on the issue, then you know I believe the expectations regarding ACOs are overblown and unrealistic. Martians will not land here en masse, although there may be an occasional stow away on a NASA craft. Put another way, as some others have said, ACOs are like unicorns—magical, mythical beasts that no one has ever seen. I don’t expect many to come prancing around in Florida, at least not South Florida, anytime soon.
Continue reading “Ignoring Primary Care, Obscuring The Obvious”