Today, the Manhattan Institute is publishing my 20,000-word, 68-page health reform proposal entitled “Transcending Obamacare: A Patient-Centered Plan for Near-Universal Coverage and Permanent Fiscal Solvency.” It represents a novel approach to health reform: neither accepting Obamacare as is, nor requiring the law’s repeal to move forward. And yet its ambition is to permanently solve our health care entitlement problem, while also expanding coverage for the uninsured.
An informative video on “job creation” in health care. Health Care | Marketplace.org.
CBO | Updated Estimates of the Effects of the Insurance Coverage Provisions of the Affordable Care Act, April 2014April 15, 2014
The Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT) have updated their estimates of the budgetary effects of the provisions of the Affordable Care Act (ACA) that relate to health insurance coverage. The new estimates, which are included in CBO’s latest baseline projections, reflect CBO’s most recent economic forecast, account for administrative actions taken and regulations issued through March 2014, and incorporate new data and various modeling updates.
The state’s Republican-dominated Senate voted Thursday to expand health care coverage to an estimated 50,000 adults using Medicaid funding made available through the Affordable Care Act.
The bill moves to the House, which has passed similar legislation. Gov. Maggie Hassan, a Democrat, praised the bill, calling it “a New Hampshire-specific solution to making sure that we can have health care coverage for working men and women throughout the state who haven’t had it before.”
New Hampshire would join a small group of states, including Arkansas and Iowa, that have opted to expand health care to low-income adults with programs that focus not on expanding their existing Medicaid programs, as 25 other states and Washington, D.C., have done, but on using federal Medicaid money to buy private health insurance.
This chart shows that at least 4.7 million Americans received the cancellation notices. It also provides details about what decision has been made in each state since Obama’s announcement (some states had previously decided to allow insurers to continue older policies for a limited time).
It reflects reporting by AP staffers in every state and the District of Columbia and does not include policy cancelations in the small-business insurance market (December 26, 2013).
Though I’m no expert on ObamaCare (at 10,000 pages, who could be?), I understand that the intention—or at least the rhetorical justification—of this legislation was to provide coverage for those who didn’t have it. But there is something deeply and incontestably perverse about a law that so distorts and undermines the free activity of individuals that they can no longer buy and sell the goods and services that keep them alive. ObamaCare made my mother’s old plan illegal, and it forced her to buy a new plan that would accelerate her disease and death. She awaits an appeal with her insurer.
Will this injustice be remedied, for her and for millions of others? Or is my mother to die because she can no longer afford the treatment that keeps her alive?
In more and more countries, ratings of medicines have become part of the already lengthy process that stands between new treatments and the patients who might be helped. Some ratings take the form of medical-benefit or innovation scales that try to predict the contributions of new medicines to health outcomes, often by comparing new and existing treatments.
In France, for example, the so-called Medicines Evaluation Commission uses a five-point scale ranging from “no improvement” to “major innovation” to rank new medicines against treatments already in use. A recent study of all 10 cancer medicines launched between 2003 and 2005 found that not a single one received a “major innovation” rating from French authorities—though several went on to become widely recognized standards of care.
Other systems—such as England’s—place the new medicines on cost-benefit curves, declaring whether or not they have met certain thresholds before the National Health Service will pay for them. These efforts are known as Health Technology Assessment or comparative-effectiveness research, or CER. Thanks to ObamaCare, CER now is heavily funded in the U.S. It is intended to evaluate established treatments but could evolve quickly into a gate-keeping system….
These efforts have two critical problems. First, it is almost impossible to predict the ultimate value of new treatments before they have been used widely in the actual practice of medicine. Second, expectations about outcomes that dismiss what appear to be small improvements ignore the very nature of progress against cancer. Science, medicine and public-health efforts have moved forward against cancer not in giant leaps but incrementally.