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.
As if voters didn’t have enough reasons to question government-run health care, the Wall Street Journal provided yet another last week. The paper ran a lengthy expose highlighting numerous cases of doctors previously accused of negligence receiving “second chances” in the government-run Indian Health Service (IHS), resulting in incidents wherein at least 66 patients died in IHS care.
Earlier this year, the Journal ran a separate investigative article explaining how the Indian Health Service repeatedly ignored warnings about a physician accused of sexually abusing patients, moving him from hospital to hospital. Together, these articles describe a broken culture within the Indian Health Service, demonstrating how government-run health systems provide poor-quality care, often harming rather than helping vulnerable patients.
The share of recipients who aren’t eligible has grown sharply since the expansion began in 2014.
Medicaid expansion was a key component of ObamaCare. In 2014 when the expansion started, the feds stopped doing audits of states’ Medicaid eligibility determinations. The Obama administration’s goal was to build public support for the new law by signing up as many people as possible. Now, after a four-year hiatus, the Centers for Medicare and Medicaid Services have begun auditing program eligibility again. According to a report released Monday, the audits found “high levels of observed eligibility errors,” meaning a significant number of people are enrolled in Medicaid who shouldn’t be.
Hospitals and insurers will howl, but the Trump administration today took a big step toward consumer empowerment with administrative actions designed to increase price transparency for hospital and other medical charges.
Galen Senior Fellow Brian Blase, who was instrumental in developing the executive order on price transparency issued in June, congratulated the administration for its proposed and final rules today. “Transparent prices, particularly linked with incentives for consumers to search for value, will put downward pressure on health care costs and should reduce inefficient spending.”
On November 1, 2019, presidential candidate Elizabeth Warren (D., Mass.) published a lengthy monograph describing how she would pay for her plan to replace the U.S. health care system with a single, federally-run insurance agency: what she describes as “Medicare for All.”
In this paper, we analyze each of Warren’s proposals in detail. While some of Warren’s proposals would in fact succeed in raising taxes or reducing spending, others would not.
Most Democratic presidential candidates are supporting some version of Medicare for All, a radical proposal to put Washington in complete control of the health-care system. Joe Biden, however, promises to “protect and build on the Affordable Care Act,” the last Washington health-care experiment, which is better known as ObamaCare.
Yet ObamaCare largely failed in its primary goal—to create a better market for individual health insurance. The ObamaCare exchanges are performing much worse than expected when they were launched in 2014. And this has nothing to do with the Trump administration. Rather, the law failed because of its perverse construction.