This Week’s Health Policy News Roundup Curated by Jane M. Orient, M.D.
The Burr-Hatch-Upton ObamaCare replacement plan, called the Patient Choice, Affordability, Responsibility, and Empowerment Act, or “Patient CARE” Act, alters somewhat the mechanism for funneling taxpayer money to insurers. The analogue to the Obama income-based subsidy would be called a “means-tested tax credit.” The Republican threshold for cutting off the aid would be 300% of federal poverty level (FPL) instead of 400%. The CARE Act credit could be used for a health savings account, and could be used by Medicaid recipients to purchase private coverage.
Avik Roy compares it with his own plan and a previous Republican proposal: http://www.forbes.com/sites/theapothecary/2015/02/05/the-impressive-new-obamacare-replace-plan-from-republicans-burr-hatch-and-upton/
Obama’s State of the Union message displayed an “obsession with fairness,” writes Chris Conover. Obama said: “This country does best when everyone gets their fair shot, everyone does their fair share, and everyone plays by the same set of rules.” Conover remarks on the unfairness in the Medicaid expansion, and the obliteration of the distinction between deserving and undeserving poor. http://www.forbes.com/sites/theapothecary/2015/01/30/mr-president-if-you-believe-in-fairness-why-did-you-make-medicaid-expansion-so-unfair/print/
But, AAPS asks, what about the different rules for those who pay for the subsidies?
As Republicans try to “fix” the Rube Goldberg apparatus, John Goodman asks why ObamaCare is such a mess in the first place. It was written be special interest groups, and no one was in charge of seeing how the parts would work together. http://www.forbes.com/sites/johngoodman/2015/01/29/why-is-obamacare-such-a-mess-there-was-no-adult-in-the-room-when-it-passed/2/
Greg Scandlen suggests that the problem seems completely intractable because we are looking at it the wrong way. He cites the observation by Robert Grayboyes that “for all the tumult, nothing ever really changes in the health-care system. The landscape is exactly what it was 50 years ago: marked by large hospitals fed patients by scattered physician offices and clinics, that prescribe drugs and medical devices produced by other giant corporations, for all of which enormous insurance companies or government agencies acting in the role of insurance companies pay. All of the “reform” efforts have involved trying to get these same actors to do things slightly differently, and slightly more efficiently.”
The answer, Scandlen writes, is to tear down the walls in the fortress to allow true innovation. The difficulty, of course, is that mighty industries have a vested interest in things staying just the way they are. http://thefederalist.com/2015/02/05/tear-down-the-health-care-fortress-so-we-can-explore-the-frontier/
Social Media:
FORTRESS & FRONTIER/ At @FDRLST, Greg Scandlen applies his great insights to my study. http://t.co/rjhJm5AgsD #innovation HT @patpaule
— Robert Graboyes (@Robert_Graboyes) February 5, 2015
Helpful @commonwealthfnd map of how many would lose subsidies by state if govt loses King v. Burwell. http://t.co/tRIAhvkevZ
— Charles Ornstein (@charlesornstein) February 5, 2015
Revisiting the Zero Deficit Line http://t.co/eCnxcn20fL
— Grüss Gott (@clasicaliberal) February 9, 2015
