Determining whether the prices for medicines are appropriate or not is critically important, which is why studies that attempt to answer this question must stand up to scrutiny. Studies that undervalue medicines jeopardize the development of future cures, while studies that overvalue medicines justify the imposition of excessive health care costs today.
A closer look at the evolution of Medicare Advantage demonstrates that the private sector has proven to be a remarkable laboratory for innovation and progress in our health system’s core evolution—to align the payment and care delivery system with value and the outcomes we care about most for America’s seniors.
The prices of health care services are a key consideration in the debate over “Medicare for all” and related single-payer proposals. The term prices refers to the allowed payment per unit of service. In the broadest versions of these reforms, in which commercial insurance plans would transition into a universal Medicare–like program, physicians and hospitals face the prospect of receiving Medicare prices for all patients they serve. Relative to the status quo, in which commercial insurer prices generally exceed Medicare prices, this price reduction could have important consequences for clinicians and patients.
“Medicare for All” proposals may vary greatly, but a common feature is their call for the regulation of prices for hospital care. This element has widespread support among establishment Democrats, and it lacks the enormous cost and controversy associated with other aspects of single-payer health care.
Comprehensive hospital-payment regulation is not a new idea: it’s been widely tried at the state level for half a century, including in Maryland—the only state where it remains. Maryland therefore provides a useful case study.
Public health insurance benefits in the U.S. are increasingly provided by private firms, despite mixed evidence on welfare effects. We investigate the impact of privatization in Medicaid by exploiting the staggered introduction of county-level mandates in Texas that required disabled beneficiaries to switch from public to private plans. Compared to the public program, which used blunt rationing to control costs, we find privatization led to improvements in healthcare—including increased consumption of high-value drug treatments and fewer avoidable hospitalizations—but also higher Medicaid spending. We conclude that private provision can be beneficial when constraints in the public setting limit efficiency.
President Trump on Wednesday announced an executive order on a topic rather far afield from his usual concerns: improving care for patients with kidney disease.
That might seem like an obscure topic, but it’s a crucial one. A shortage of kidneys for transplant kills about 43,000 people every year.
Lawmakers are trying to set aside their irreconcilable differences over the Obama-era Affordable Care Act and work to reach bipartisan agreement on a more immediate health care issue, lowering costs for people who already have coverage.
Returning from their Fourth of July recess, the Senate and House are pushing to end surprise medical bills, curb high prices for medicines, and limit prescription copays for people with Medicare.
Democrats running for president are determined to make the 2020 election a referendum on single-payer health care. My advice: Bring it on. This is a fight President Trump and the GOP should welcome.
But in order to win, the GOP has to come to terms with its past failures, reflect on its limited successes, and chart a new course. We have to boldly define what we are for, not just what we are against, and win the hearts and minds – and trust – of voters.
A federal judge on Monday dealt a blow to the Trump administration by striking down a new rule that would have forced pharmaceutical companies to include the wholesale prices of their drugs in television advertising.
U.S. District Judge Amit Mehta in Washington sided with drugmakers Merck & Co Inc, Eli Lilly and Co and Amgen Inc by halting the U.S. Department of Health and Human Services (HHS) rule from taking effect on Tuesday as planned.
A panel of federal appeals court judges on Tuesday sounded likely to uphold a lower-court ruling that a central provision of the Affordable Care Act — the requirement that most people have health insurance — is unconstitutional. But it was harder to discern how the court might come down on a much bigger question: whether the rest of the sprawling health law must fall if the insurance mandate does.