Policy Perspectives: Undoing A Health-System Fix That Works; Stabilizing Obamacare Requires Bipartisanship
Editorial writers address a range of health policy issues -- including some that touch on topics related to the Affordable Care Act and others that address politics, state-level Medicaid issues and efforts to expand the Medicare program.
The Wall Street Journal:
A Health-Care Fix That Works, Now Being Rolled Back
President Trump is correct: Health care is “complicated.” If you’ve ever received a hospital bill, you’ve seen it for yourself. America’s health-care system is a tangle of providers, all paid separately for each and every thing they do. One emergency-room visit can result in a dozen different bills. This fee-for-service model, which has dominated American health care for decades, is hardly efficient. Paying for inputs — tests, procedures, hospital stays and the like — creates incentives for overtreatment, with little regard for coordinating care or improving patient outcomes. ... Unfortunately, the Trump administration is halting the shift to advanced payment models. (Jason Furman and Bob Kocher, 8/20)
Arizona Republic:
Obamacare Can't Be Fixed (Or Even Stabilized) With Bipartisan Plan
The Problem Solver Caucus proposal has been a useful way for its members to shout: Hey, look at us! We’re bipartisan! But in terms of making the individual market work for those not seriously sick or heavily subsidized, it’s pretty worthless. (Robert Robb, 8/18)
Louisville (Ky.) Courier-Journal:
Rand Paul Should Get On Board With GOP Or Get Out
In short, he is not really a member of any established political party but is himself a political party of one. This is rather embarrassing given the fact that Kentucky’s other Republican senator is one Mitch McConnell, the Senate's majority leader. The ultimate challenge of any majority leader is to be an accurate vote counter. With only 52 Republican votes available in the 100-member Senate, in the recent effort to repeal Obamacare, Sen. McConnell was surely frustrated to find that not only could he not depend on the all-out support of his fellow Kentucky senator, but that that senator was actually opposed to the “repeal and replace” legislation stitched together at great effort by a coalition of conservative and moderate Republican senators. (Bob Heleringer, 8/16)
Louisville (Ky.) Courier-Journal:
I Didn’t Give That 'team' My Soul Or My Ideology
Apparently, there is a new source of fake news that the Courier-Journal's recent columnist frequently reads. Because the accuracy of his account of what happened last month during our efforts to repeal Obamacare is laughable at best, and egregiously misleading at worst. For the record, yes, I do belong to a “team” in politics. I ran as a Republican. I caucus as a Republican. I vote for people sometimes because, while I have misgivings, in general, they believe similar things. But I didn’t give that “team” my soul or myideology. I join with them when I agree, or when I don’t have a strong opinion. I go against them plenty of times, such as on privacy and civil liberties, and, all too often, unconstitutional war. (Sen. Rand Paul, 8/18)
RealClear Health:
Is Obamacare Fueling The Opioid Overdose Death Rate?
The ACA requires insurance companies to charge the same insurance premiums to individuals regardless of whether they already have expensive health conditions. This policy, known as community rating, has had the effect of causing premiums to skyrocket across the board, as was shown in a recent study by McKinsey and Company. The ACA’s “risk-adjustment” program, meanwhile, was intended to compensate insurers for the cost of taking on enrollees who are already sick, but the program systematically underpays. It amounts to an effective penalty on networks that are seen as having the most appealing benefits for insurance enrollees who are already sick. (Jeffrey A. Singer, 8/21)
Austin (Texas) American-Statesman:
Rural Hospitals Are Vanishing; Keep Medicaid In Texas
As for Medicaid, cutting funds and limiting program expansion would most certainly be devastating for families, rural hospitals and the communities they serve. In Texas, for example, 46 percent of children in rural areas and small towns are enrolled in Medicaid or the Children’s Health Insurance Program compared with 41 percent in urban areas, according to a report by the Georgetown University Center for Children and Families. (Michael D. Williams, 8/21)
The Columbus Dispatch:
Don’t Override Budget Vetoes
The budget battle between Gov. John Kasich and his fellow Republicans in the General Assembly is about to resume, with the Senate poised to take a crack at reinstating some of the provisions Kasich struck from the two-year spending plan. ... The House already voted to override 11 of the vetoes. If the Senate, which could take action as early as Tuesday, does likewise, the ill effects could include destabilizing the state’s efforts to manage Medicaid and foolishly jeopardizing state parks and other lands for a short-term paycheck. Thankfully, the House refrained from overriding the most important of Kasich’s vetoes: the one with which he nixed a freeze on enrolling Ohioans in Medicaid via the Affordable Care Act’s expansion. (8/21)
Los Angeles Times:
Here's How Expanding Medicare Could Set Us On The Path To Universal Health Coverage
With the near-complete collapse of the Republican attack on the Affordable Care Act having locked away the GOP’s traditional repeal-or-nothing stance, the path to a clear-eyed assessment of how to improve American health coverage.That has given the idea of single-payer a jump-start. But it hasn’t done much to clarify the most important question: How do we get there from here? (Michael Hiltzik, 8/18)
