Quote of the Day Category

OECD: Health at a Glance 2015

In: Quote of the Day

Opponents of health care reform frequently dismiss efforts with the statement that the United States has the best health care system in the world. We don’t. This biennial report of OECD indicators provides international comparisons with tables and graphs that can be very useful in explaining why the United States needs to get serious with our health care reform efforts. It is shameful that we fall far behind our peer nations in so many of the crucial health indicators.

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Medi-Cal is a chronically underfunded Medicaid health program for low-income individuals in California. As such, these patients do not receive as much support from the health care community as do otherwise insured patients. This study confirms that cancer patients in the Medi-Cal and in the Medicare/MediCal dual eligible programs have impaired access and impaired outcomes almost comparable to those of uninsured patients.

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One of the more nefarious methods that private insurers use to reduce their responsibility to pay for health care is to refuse to pay for health care services provided outside of the networks of contracted physicians and hospitals that they, rather than the patient, have selected. They have tightened the screws by shrinking these networks and by dropping some of the PPO plans which permitted at least some out-of-network coverage, but at reduced rates.

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Much has been written about the high costs of defensive medicine – excessive health care services that are delivered merely to protect against the potential of malpractice lawsuits. This study tends to reinforce the belief that there is a solid basis for defensive medicine since higher spending on health care is associated with fewer malpractice claims. But does this additional care represent defensive medicine, or does it represent beneficial health care services that prevent adverse outcomes?

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Earlier this year medical societies celebrated their success in helping to get Congress to eliminate the Sustainable Growth Rate (SGR) formula – a formula that could have resulted in a 21% reduction in Medicare payments – and replace it with a 0.5% yearly increase for the next few years. There are two important stories here.

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In recent years concerns have been raised about the increases in death rates from prescription pain medications, but the magnitude of the problem was not recognized until this landmark study was released yesterday. Midlife deaths from poisonings with alcohol and drugs or from suicide of white, non-Hispanic men and women in the United States have skyrocketed since 1999. Morbidity likewise has increased in this group.

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The ACA insurance exchange model has failed

In: Quote of the Day

The performance of competing private insurance plans within the ACA exchanges is not much different from the performance of the pre-ACA private plans in the individual market. Trends in higher insurance costs, greater cost sharing, and narrower choices were already occurring, and they continue to grow progressively worse. Access and affordability can only suffer.

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What a great opener for this weekend’s national meeting of Physicians for a National Health Program. An editorial in The Salt Lake Tribune tells us that, as we see the failures of the co-ops, the inadequacies of the exchanges, and “rival steampunk assemblages,” it should have been single payer from the beginning.

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Adequacy of Outpatient Specialty Care Access in Marketplace Plans Under the Affordable Care Act By Stephen C. Dorner, MSc; Douglas B. Jacobs, ScB; Benjamin D. Sommers, MD, PhD JAMA, October 27, 2015 In this study of federal marketplace plans, nearly 15% completely lacked in-network physicians for at least 1 specialty. We found this practice among […]

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Brief Comments on ColoradoCare By Ida Hellander, M.D., David U. Himmelstein, M.D., and Steffie Woolhandler, M.D., M.P.H. Physicians for a National Health Program, October 27. 2015 Organizers for the ColoradoCare ballot initiative have contacted some activists in Physicians for a National Health Program seeking their endorsement and financial support. We summarize, below, our understanding of […]

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Physicians for a National Health Program's blog serves to facilitate communication among physicians and the public. The views presented on this blog are those of the individual authors and do not necessarily represent the views of PNHP.

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