The types of financial shocks hospitals currently face illustrate the problems inherent in Democrats’ proposed expansions of government-run health care.
The coronavirus pandemic has inflicted such vast damage on the American economy that one damaged sector has gone relatively unnoticed. Despite incurring a massive influx of new patients, the hospital industry faces what one executive called a “seismic financial shock” from the virus.
The types of shocks hospitals currently face also illustrate the problems inherent in Democrats’ proposed expansions of government-run health care. Likewise, the pay and benefit cuts and furloughs that some hospitals have enacted in response to these financial shocks provide a potential preview of Democrats’ next government takeover of health care.
The federal government has made huge progress in lowering regulatory barriers in order to accelerate access to health care during the coronavirus crisis, including allowing patients to talk with their doctors by telemedicine visits. But one group of particularly vulnerable patients has been left out: Medicare beneficiaries needing access to infused or injected drugs that generally must be administered by clinicians in doctors’ offices or hospitals.
To prepare for a coronavirus surge, initial public-health guidance advised hospitals and medical facilities to shut down for non-emergency care. The motivation was largely to preserve medical resources for those infected with the coronavirus, although another benefit has been to reduce the virus’s contagion to other patients.
Acting on federal advice, 31 states and the District of Columbia restricted non-emergency care at hospitals and surgery centers, including cancer treatments and other potentially life-saving services. Others voluntarily shut down elective services. On the positive side, the chain reaction will accelerate adoption of telehealth, which was vastly underutilized despite its promise to streamline care, reduce wait times, keep sick people out of waiting rooms, and address geographic disparities in access to care. On the negative side, hospital capacity has idled, devastated provider revenue, and led to widespread furloughs.
The administration’s guidelines for “Opening Up America Again” rely heavily on the ability of states to develop a robust COVID-19 testing capacity, and Congress is negotiating adding as much as $25 billion to this week’s funding bill to significantly expand testing.
A dramatic increase in coronavirus testing is needed before people will feel safe to return to work and the marketplace, but an equally dramatic shortage of testing capacity threatens to cripple the recovery.
Ten years ago, in late March 2010, the Affordable Care Act (ACA), also known as ObamaCare, became law.
Everyone loves the icebreaker game “Two Truths and a Lie” where you try to pick which of three statements is false. Can you guess which of the following is NOT true about the ACA?
A. The ACA resulted in a dramatic increase in the number of people with health insurance, mostly by expanding private health insurance.
B. The ACA caused health insurance premiums and deductibles in the individual market to skyrocket.
C. The ACA caused health insurance plans to narrow their networks, in other words, to restrict which hospitals and providers were available to people with ACA coverage.
A. LIE! While the ACA did dramatically increase the number of people with health coverage, it primarily did so by expanding the Medicaid program. A new paper from the Galen Institute makes this abundantly clear. Here are a few facts from the paper:
We need to be smart about how we use public resources to respond to the coronavirus outbreak. Two major crises are facing the country right now: 1) the negative health impact and associated deaths from the virus, and 2) the enormous economic impact of large numbers of businesses and schools shutting down.
Congress needs to wisely allocate public resources to address both and not be distracted by long-held ideological pursuits. Many people are providing advice on how to best help businesses and workers weather the storm. For health care, it is crucial to recognize that this is a public health crisis and not an issue of longer-term health financing or coverage.
State and federal laws and regulations are hindering the private sector’s efforts to help fight the outbreak.
Effectively responding to the coronavirus epidemic requires innovation from private companies, medical professionals, and entrepreneurs. These folks are ready to perform heroic acts, but government rules and red tape are getting in their way. To take one tragic example, it appears that problems at the Centers for Disease Control led to early delays in testing and unreliable tests.
We must untangle this red tape to save lives. Hospitals and medical facilities in hotspots already are overwhelmed with patients, and the demands placed on them will only increase in the coming months. They need to rapidly expand capacity now to avoid being forced to ration care, as we already see happening in Italy, later.
If Medicare for All should ever become reality, America would face a far greater cost than the multi-trillion dollar price tag. This government controlled, single-payer health care system would come at the expense of Constitutional rights that are supposed to be preserved, protected, and defended. This should come as no surprise where health care is concerned.
The current multitude of health care rules and regulations have essentially buried the prohibition against federal interference in the practice of medicine (42 USC 1395). Therefore, it is no wonder that lawmakers are considering socialized medicine as a supposedly viable solution to our health care coverage challenges. However, in exchange for that universal coverage, with private health insurance practically eliminated, Medicare for All legislation overlooks the conscience rights of medical professionals in the effort to prohibit patient discrimination.
A New Paper By Doug Badger & Brian Blase |
Surprise medical bills are a source of frustration for many Americans, and legislation to address the problem appeared to be on a fast track early in the year. But action has since slowed, primarily due to a stand-off between the two powerful interest groups that often benefit from surprise medical bills: providers and insurers. Complicating this political calculus, Congress has its own interests in seeing this as a “pay for” to extend other unrelated health programs.
One plan Congress is considering would extend federal rate-setting schemes—a practice that is at the heart of proposals to move toward a single-payer system—to private physicians and health programs. Another would enact an arbitration model, which has a host of problems including imposing contractual terms on parties that have not entered into a contract.
If Congress makes rate-setting the solution to surprise bills, which consumers rightly resent, it may be difficult to explain why it shouldn’t adopt the same approach to medical bills that aren’t surprises, which consumers also often find unpleasant.
Congress should adopt a more thoughtful, targeted approach to the problem. This paper offers solutions to protect patients from surprise bills primarily by preventing insurers and providers from giving false and misleading information to consumers and by requiring that patients receive a good faith price estimate in advance of receiving scheduled care.
Truth-in-advertising protections combined with a good faith estimate requirement leaves one scenario in which patients need protection from surprise medical bills—emergency services at out-of-network facilities. Patients should be protected from balance billing in this situation, and Congress should apply existing federal regulations to determine the rate that insurers compensate providers in this narrowly-defined instance.
Many consumers want greater transparency in health care. Equipping them with timely and accurate information about medical prices would help reverse the sclerotic effect of price opacity. It would create room for price competition that could lead to the redesign of insurance products. And it would redirect the efforts of government, one of the leading causes of wasteful and inefficient medical spending, toward enabling a consumer-centered marketplace that curbs health care costs through choice and competition.
New York state is grappling with a Medicaid shortfall in the billions of dollars. And one of the main reasons is improper enrollment.
Using annual information from the Census Bureau to assess the demographic make-up of Medicaid enrollees over time, researcher Aaron Yelowitz and I estimated that 2.3 million to 3.3 million Medicaid enrollees nationally make an income in excess of what is allowed.
This is of increasing importance given that ObamaCare massively expanded what was historically a welfare program for vulnerable populations like the disabled and low-income children and pregnant women — and tens of billions of taxpayer dollars are at stake.