If the Supreme Court decides against the Obama administration in the case, leaders in Congress are indeed determined to pass legislation to protect coverage for an estimated six million people. ObamaCare has so distorted the market for individually-purchased and small group health insurance that Congress has little choice but to throw them a safety net.
To learn more, read Tom Stossel’s “Pharmaphobia,” on how rules against pharmaceutical marketing and industry-sponsored research are undermining innovation.
via Pharmaphobia – AEI.
New Report Shows States Had Serious Questions about Obamacare Tax Credits in 2011 | Competitive Enterprise InstituteApril 16, 2015
Today the Competitive Enterprise Institute (CEI) released a report by finance expert Scot Vorse that shows many states knew as early as 2011 that they might not receive tax credits if they opted out of establishing a state-based health insurance exchange. Whether nonparticipating states had adequate knowledge that they were putting their Obamacare subsidies at risk is a critical question in CEI’s Supreme Court case, King v. Burwell.
Vorse obtained emails related to a January 2012 letter sent by seven states to the U.S. Department of Health and Human Services (HHS). While Obamacare supporters have dismissed this letter as a “spoof,” these state emails show the letter was a carefully crafted and coordinated effort by the states to get detailed information about the exchanges from HHS.
“Notably, the states explicitly asked HHS to explain what authority it had to administer tax credits on federally established exchanges,” Vorse writes.
These reforms are worthwhile, but they are really minor in comparison with the far more consequential provisions in the legislation related to the payment of physicians under Medicare. Unfortunately, many in the GOP seem completely unaware of how these provisions will work.
The heart of the bill is a new, two-tiered indexing system for physician fees. Physicians who agree to participate in Medicare Accountable Care Organizations (ACOs) — or in similar structures established by the Medicare bureaucracy — will receive a permanent 0.75 percent increase in their fees each year. Physicians that don’t join an ACO will be placed into a new Merit-Based Incentive Payment System, or MIPS. Under MIPS, the Medicare bureaucracy will assess the “quality” of a physician’s services to patients and reward or penalize them accordingly. On average, physicians in MIPS will receive a payment increase of 0.25 percent every year — far below the annual payment increase for physicians in ACOs.
The actuaries who assess Medicare finances for the administration have looked at these provisions and come to the perfectly rational conclusion that physicians will have little choice but to join an ACO to get an extra 0.5-percentage-point bump in their payments every year. By 2019, the actuaries assume that 60 percent of all physicians taking care of Medicare beneficiaries will be part of an ACO, up from 25 percent today. By 2038, they assume that 100 percent of physicians participating in Medicare will be a part of an ACO or a similar structure invented by the Medicare bureaucracy.
Medicare Part D Responsible For 60 Percent of Medicare’s Spending Slowdown | Health Policy Blog | NCPA.orgApril 15, 2015
When Medicare added Part D, the prescription-drug benefit, via the Medicare Modernization Act (2003), its framers decided that every beneficiary would receive the benefit from a private plan, not from the government directly.
The benefits of this design continue to show themselves. In Health Affairs, Loren Adler and Alex Rosenberg conclude that the Part D benefit is responsible for 60 percent of the reduction in the rate of Medicare spending since 2011.
The Physicians Foundation released a survey last fall in which 20,000 doctors responded by email to an array of questions.
Of the respondents, 46 percent gave Obamacare a D or F grade, while 25 percent gave it an A or B grade.
In addition, two-thirds of those responding said they did not accept health insurance plans offered through the Affordable Care Act’s online insurance exchanges.
University of Miami Business Law Review.
Full text: http://business-law-review.law.miami.edu/wp-content/uploads/2015/04/Miller-Unfair-Coercion-or-Greater-Deference.pdf
The erosion of the belief in health care as a government-protected right is perhaps the most dramatic reflection of these trends. In 2006, by a margin of more than two to one, 69-28, those surveyed by Gallup said that the federal government should guarantee health care coverage for all citizens of the United States. By late 2014, however, Gallup found that this percentage had fallen 24 points to 45 percent, while the percentage of respondents who said health care is not a federal responsibility nearly doubled to 52 percent.
‘Equal pay day’ this year is April 14; the next ‘equal occupational fatality day’ will be on July 29, 2027 – AEI | Carpe Diem Blog » AEIdeasApril 14, 2015
Based on the most recent BLS data, the next “Equal Occupational Fatality Day” will occur about 13 years from now – on July 29, 2027. That date symbolizes how far into the future women will be able to continue working before they experience the same estimated loss of life that men will experience in 2014 from work-related deaths. Because women tend to work in safer occupations than men on average, they have the advantage of being able to work for more than a decade longer than men before they experience the same number of male occupational fatalities in a single year.
What economic lessons about health care can we learn from the market for cosmetic procedures? – AEI | Carpe Diem Blog » AEIdeasApril 9, 2015
1. For the top ten most popular cosmetic procedures last year, none of them has increased in price since 1998 more than the 45.8% increase in consumer price inflation (the price for the hyaluronic acid procedure wasn’t available for 1998), meaning the real price of all of those procedures have fallen over the last 16 years.
2. For three of the top five favorite non-surgical procedures in 2014 (botox, laser hair removal and chemical peel), the nominal prices have actually fallen since 1998 by large double-digit percentage declines of -23.6%, -31.2% and -30.1%. That is, those prices have fallen in price since 1998, even before making any adjustments for inflation.
3. Most importantly, none of the ten cosmetic procedures in the table above have increased in price by anywhere close to the 88.5% increase in medical care services since 1998. The 33.7% average price increase since 1998 for last year’s top five most popular surgical procedures, isn’t even close to half of the 88.5% increase in the cost of medical care services over the last 16 years.