The State Children's Health Insurance Program (S-CHIP) needs to be reauthorized by the Congress. That will cost $13 to $15 billion over the next five years--something I detailed in an earlier post.Compounding the S-CHIP budget dilemma, Medicare physicians are scheduled to have their fee payments cut by 10% on January 1, 2008.When the last Congress reversed the scheduled 5% fee cut for 2007, in
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Browse » Home » Archives for January 2007
The Individual Health Insurance Market Isn't Ready for Primetime
Julie Appleby has an article on the front page of Monday's USAToday covering an issue I dealt with in an earlier post--insurers using post-claim underwriting to rescind people's health insurance policies.President Bush's health plan proposal would encourage consumers to buy their own health insurance. The President, and many others, believe that giving individuals more control over their health
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It's the Cost of Health Care Stupid!!!
We have seen a number of new health care proposals--many I recently cited in a post.My old friend and health care policy mentor, Henry Simmons, who is President of the National Coalition on Health Care, recently released a statement on President Bush's health care proposal.One of the key points he made is that any health reform proposal must be comprehensive and able to slow the growth in health
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Is the Bush Health Plan Tilted Too Far In Favor of Health Savings Accounts (HSAs?)
Chris Lee has an article in today's Washington Post that raises an important question.Has President Bush gone too far in tilting his new health care proposal in favor of health savings accounts (HSAs)?The President would level the health insurance tax preference playing field for consumers whether they get their health insurance at their place of employment or buy it in the individual
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Health Savings Accounts (HSAs) and The Massachusetts Plan--Two Great Experiments
In the wake of the President Bush's new health plan, much has been said about whether we should move to reform the health care system by building upon the traditional employer-based system (preferred by most Dems) or move to a system more controlled by individuals (preferred by most Republicans and the President).Democrats claim the President's plan would wreck the employer-based system--
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The Bush Health Care Plan and U.S. Health Care Reform
It’s a new day in the health care debate. Reform is breaking out everywhere.2007 is shaping up to be the “Year of the Possible” with notable health care reform proposals coming from a number of places almost at once:The new Democratic Congress is setting an ambitious health care agenda as they look to first reauthorize the very successful Medicaid State Children’s Health Insurance Program (
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More on the Bush Health Plan
My good friend Bill Boyles of Health Market Survey offers these comments regarding the President's upcoming health proposal (my own post is below this one):New Bush Proposal Takes Intriguing ApproachAfter six years of offering the same old thing, President Bush Tuesday will propose a creative new health reform that is drawing support from both sides of the political spectrum and could be taken
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New Bush Health Plan Proposal to Be Announced in State of the Union Address
President Bush is about to announce an interesting health care proposal that would cap the tax benefits on the most generous health benefit plans––often held by higher paid executives and some labor unions and use the revenue to cut the number of uninsured.Individuals, whether they got their health insurance from work or paid for it themselves, would get a standard deduction of $7,500 for an
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SCHIP Reauthorization--Will Medicare HMOs Pay for Some of It????
In the post below, I reviewed the need to reauthorize the very successful State Children's Health Insurance Program (S-CHIP).The Congress will have a real challenge coming up with the needed money--$13 billion to $15 billion. Finding the money will be hard because of the House Democrat's pledge to fully fund any spending--their "pay-as-you-go" policy.Where will the money come from?First, the
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Back to "Regular Order"--The House Medicare Part D Drug Bill and SCHIP Reauthorization
The debate over the House Medicare drug negotiation bill is now moving over to the Senate.My post from last Friday (next post below) still reflects what I am seeing on this issue. The Senate will move a drug bill on "regular order" which means we will see the standard committee hearings and process that could lead to floor action later in the spring or summer. The House Medicare Part D drug
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Grassley and Baucus Key to Any Drug Negotiation Compromise
In earlier posts, I have made the point that the House bill to require the federal government to negotiate Part D prescription drug prices will not pass the Senate.Developments in recent days have confirmed that opinion for me. The ranking Republican on the Senate Finance committee, Chuck Grassley, has said he would lead a filibuster of the House bill on the Senate floor and has said he is
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The House Part D Drug Negoatiation Debate is Heating Up!
I was quoted in the Washington Post today reiterating my concern that the House Part D drug negoatiation bill is a hollow political charade on the part of the Dems:"The federal government can get lower prices, but only if it's willing to exclude a certain number of drugs from the formulary," said Robert Laszewski, a nonpartisan health policy consultant in Washington. "And that's a huge political
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Health Care Trend Falling
According to a CMS report published in the latest issue of Health Affairs, health care spending increased 6.9% in 2005--the third consecutive year it has fallen.Given that medical cost trend, as reported by the health plan industry, fell again in 2006, I fully expect CMS to report a 2006 trend rate of around 6.5% when they do their calculation again next year. And, given that trend looks to be
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Good for the Governor of California!!!!
Governor Schwarzenegger’s new health plan proposal is full of controversy.It puts a provider tax on doctors and hospitals (which the docs have predictably already attacked), it hits HMO profits by putting a 15% cap on expenses and profits (WellPoint is currently operating on about a 20% expense and profit margin), and it mandates that both individuals, and employers with more than 10 employees,
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More on the Democratic Part D Drug Negotiation Debate
A friend in big pharma responded to my earlier post on Part D disagreeing with me that the Democratic proposal is not a threat to the drug industry.He made two points:The Dem bill does not prevent the government from requiring each and every plan to prior authorize a medicine for which it is unable to negotiate an "acceptable" price. They see such restrictions as possible because this would not
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HMO Stocks Fall on Medicare Advantage Worries---What Took So Long?
HMOs that play in the Medicare Advantage world fell on Wall Street last week on worries that the Democrat Congress has the power to end the industry's generous payments.Well, what took so long?Of course the Medicare Advantage payments are going to fall when the Democrats get around to the budget this fall.For the complete story on why you can see my earlier post on this.
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Bravo Kaiser Permanente!--As the Insurance Industry Defends Screwing its Customers
I have always had the greatest respect for Kaiser Permanente (KP) and the way it has always conducted itself--in its operations and in the policy debate.That confidence was reaffirmed this week when KP announced that it is working with the California Insurance Commissioner to craft new guidelines for an insurer's ability to cancel, or rescind, insurance coverage when the applicant made
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The Democrats' Hollow Part D Proposal
The House Democrats have announced the form their Part D prescription drug legislation will take.Throughout the 2006 campaign, they had pledged to lower senior prescription drug prices by requiring the federal government to negotiate directly with the drug companies--something the 2003 Medicare Act specifically prohibited. The Democrats went further saying that these negotiations would make it
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More Trouble for Humana's Part D Program
Boston's mayor has been sharply critical of Humana for raising his city's Part D premiums by 130%. Get in line Mr. Mayor, they've done it to millions of seniors who bought their plans!Joe Paduda, in his Blog "Managed Care Matters" has a post today that hits the nail right on the head.You can read more about how Humana got itself into this position in an earlier post I did on the subject of Part D
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The New Congress––Sniping or Civility?
Jerry Ford's funeral took place in our capital city today. I will admit to always being a fan.He gets an unfair rap for not doing a lot during his administration. But just getting our country back on track in the wake of Watergate was a major accomplishment in itself. Let's also not forget that he was the President who signed ERISA into law--something that was a major bipartisan
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Health Care Middlemen––Don't Forget Value!
Friday's Wall Street Journal ran the last of a series on health care "middlemen."The theme was about people taking big money out of the already incredibly expensive health care system but questioning whether they leave a commensurate value.The series included:"As Patients, Doctors Feel the Pinch, Insurer's CEO Makes a Billion," April 18."Selling Generic Drugs by Mail Turns Into Lucrative Business
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