Health Policy
ISSUE SUMMARIES
Issue summaries provide a quick reference to Centrists.Org general principles and most important links, within each topic area.
Health (Basics)
Costs, Competition and Chronic Care
Medicare Reform and Prescription Drugs (General)
Medicare Modernization Act of 2003
Universal Coverage
Performance and Liability Reform
AARP “Victory” In Court Would Reduce Retiree Health Benefits
03.30.2005 || Yesterday's decision by the U.S. District Court striking down regulations exempting an employer’s coordination of retiree health benefits with eligibility for Medicare or state-sponsored retiree health benefits from the Age Discrimination in Employment Act (ADEA) represents a victory of ideology over common sense and will likely result in a reduction in retiree health benefits.
Briefing and Perspective: The Flu Vaccine Crisis
11.03.2004 || On October 5th, flu vaccine manufacturer Chiron announced that there would be a halt to vaccine production this year. Policymakers need to identify practical ways to provide incentives and simplify vaccine production so that breaks in the supply chain will not produce the devastating panic situation that we see in the news today.
Briefing: Federal Activity on Implementation of Electronic Health Records (EHRs)
revised 09.09.2004 || Although everyone seems to agree that patients should have secure, portable records of their medical history and current treatments, there is no consensus on the policies needed to achieve that goal.
Charts: Uninsured Now 45 Million, 2004 Health Insurance Premiums Up 11.2 Percent
revised 09.09.2004 || Last month, the Census Bureau reported that the number of people without health insurance rose by 1.4 million in 2004, to 45 million. This morning, the Kaiser Family Foundation announced an 11.2 percent increase in health insurance premiums in 2004.
Policy Report: Senator Kerry's Health Proposal -- Prospects for Bipartisanship?
Report in .PDF format (easier to print)
08.25.2004 || Senator Kerry's proposal avoids the usual pitfalls of Democratic health reform efforts. Several elements of the plan are likely to attract on-going bipartisan support, regardless of who wins the election. Modified versions of Kerry's plan could be scaled to fit the budget, with costs ranging from roughly $200 billion over 10 years to $700 billion or more.
Rising Health Costs Reduce Wage Growth
07.29.2004 || This morning's new Employment Cost Index data contain three lessons: (1) in dollar terms, wages are growing at the slowest pace in 20 years, (2) adjusted for inflation, wage growth is falling again, and (3) rising health costs are one reason wage growth is so sluggish.
Commentary and Outline: Senator Frist's Health Reform Proposal
revised 07.19.2004 || Between Senator Frist's new plan and Senator Kerry's campaign proposal, we have a coherent framework for bipartisan action on health costs and coverage.
Improving the Medicare Drug Discount Cards
06.22.2004 || With a few technical fixes and one big attitude adjustment, the Medicare discount cards will be a successful new model of a public-private partnership.
A Constructive Conservative Approach on Health Coverage for Small Business
06.21.2004 || A new report by the Heritage Foundation's Stuart Butler exhorts conservatives to improve employer-based coverage, not reject it. This is good practical advice, and it should help reduce the fear factor that sometimes accompanies conservative health ideology.
Democratic Leaders Should Embrace the Drug Discount Cards (CentristPolicyNetwork.Org)
06.02.2004 || The Medicare drug cards do no harm, might actually help quite a few people, and offer a significant benefit to low-income seniors.
Detailed Issue Summary: Medicare Modernization Act of 2003
05.15.2004 || This new Issue Summary contains a detailed description and preliminary evaluation of the Medicare drug bill.
Commentary: Cover the Uninsured? Not This Week
05.11.2004 || What a joke. The Robert Wood Johnson Foundation is allegedly spending $100 million to publicize "Cover The Uninsured Week." Meanwhile, Congress re-hashes old failed dead proposals and the Bush Administration offers nothing of consequence.
Testimony: Prepared Statement for the HHS Task Force on Drug Importation
04.27.2004 || Free import and export of drug prices may seem like a good deal for rich countries with high prices. But it could be a bad deal for poor countries, which would not be offered low prices for medicines.
Private Health Plans in Medicare -- Cost Trends and Ideological Battles
04.21.2004 || This report attempts to put the debate over Medicare's private plans into perspective, using new calculations of spending trends and a characterization of the political forces battling over the prospect of direct public-private competition in Medicare.
Understanding Health Coverage Policy in Washington -- The Borg vs. the Klingons
03.29.2004 || Remarks by Jeff Lemieux to the Consumer Directed Health Care Conference, Spring 2004, Las Vegas. Historically, national health policy has been dominated by the galactic struggle for and against socialized health insurance. Liberals are the Borg; Conservatives are Klingons.
Conservative Health Scholars Urge "Fix" to Drug Benefit, Building on Discount Cards
revised 04.01.2004 || The conservative Heritage Foundation and Galen Institute separately published new reports yesterday arguing that the Medicare drug discount card program should be made permanent, with the addition of a catastrophic drug benefit.
A First Look at the New Medicare Trustees Report
preliminary 03.23.2004 || The drug benefit will substantially increase the overall cost of the program. But the drug law didn't contribute much to the fact that Medicare's Part A Trust fund is now estimated to be depleted in 2019, seven years earlier than the previous estimate.
CBO vs. The Bush Administration on Medicare -- A Difference of Opinion, Not a "Raised" Estimate
03.23.2004 || The Administration's long-suppressed cost estimate of the Medicare drug bill is higher than the original Congressional estimate. The delay caused people to assume the estimates have been revised upward. However, that is not true.
The Administration Finally Releases Some Medicare Drug Estimates (CentristPolicyNetwork.Org)
03.22.2004 || The real scandal of last year's Medicare bill was the official reluctance -- from both the Congressional leadership and the White House -- to share analytic material with the public.
The Durbin-Lincoln Small Employers Health Benefits Program (SEHBP)
revised 03.04.2004 || A bill introduced today by Senators Richard Durbin and Blanche Lincoln would create a new version of the popular Federal Employees Health Benefits Program (FEHBP) for small businesses.
Kerry's Health Care Populism -- How Deep? CentristPolicyNetwork.Org)
02.27.2004 || In an interview in Businessweek, Senator Kerry offers an explanation for his populist health care rhetoric.
The Curious, Counter-Intuitive Relationship Between Medicare Costs and HMO Enrollment
02.08.2004 || In a weird way, Congress set the stage for future savings when it raised payments to Medicare HMOs in last year's Rx drug bill.
A Different Approach to Medical Malpractice Reform (CentristPolicyNetwork.Org)
02.03.2004 || Last year, Senator Michael Enzi introduced a bill (S. 1518) that would encourage comprehensive malpractice reforms and reductions of medical errors.
CBO's New Brief on Medical Malpractice Implies that Capping Awards is Not Enough
01.25.2004 || Limiting awards in malpractice cases is not enough to really change medical practices and customs. We need an emphasis on expedited compensation for victims and dramatic improvements in patient safety too.
Medicare Follow-Up? (CentristPolicyNetwork.Org)
01.04.2004 || Congress should start smoothing over the Medicare Rx bill's rougher edges, even if it means spending more.
Explaining Premium Support: How Medicare Reform Could Work
revised 11.06.2003 || The premium support concept is both loved and vilified, but it is not very well understood. This report outlines the structure of a national (federal employees-style) premium support system in Medicare. It includes the basic rationale for premium support and a step-by-step example of how premiums would be calculated.
Testimony: Improving Chronic Care in Medicare
11.04.2003 || Statement for Senate Special Committee on Aging's Forum on Disease Management in Medicare.
Suggestions for Income Testing in Social Insurance Programs
10.27.2003 || On reflection, the debate over income testing in Medicare is larger than the prescription drug bill in Congress -- it raises fundamental questions about how Americans want social insurance programs to work.
Drug Benefits and the Emperor's Clothes (CentristPolicyNetwork.Org)
10.25.2003 || On the surface, the biggest Medicare dispute isn't about drug benefits, it's about "premium support." But the underlying problem is not competition -- it is the drug benefit itself.
New Chart: Conference Drug Benefit
10.23.2003 || The proposed Medicare drug benefit could suffer adverse selection and an upward spiral in premiums unless seniors were compelled to enroll by other means.
Rx Plan "A" is Alive and Twitching (CentristPolicyNetwork.Org)
10.15.2003 || Something had to give. The Medicare drug benefit being prepared for final passage in Congress is over-promised. So what is the solution? Tax cuts. No joke.
Expanding the Health Care Tax Credit (CentristPolicyNetwork.Org)
10.06.2003 || Expanding the Health Care Tax Credit (HCTC) to all unemployed workers would be an affordable "next step" on the path toward health coverage for all Americans.
Economic Perspective: When Are Health Costs Excessive if $15,000 is Average?
10.01.2003 || In a Sept. 29 commentary in Tax Notes, economist Gene Steuerle fantasizes about a rational Medicare reform and prescription drug debate.
From The Hill, October 1, 2003 (www.thehill.com)
A Better Drug Benefit
"The Medicare drug benefit pending in Congress is flawed. The design was a rare political compromise; however, the result is a tortured policy that may be unworkable in practice."
New Medicare and Rx Drug Resources (CentristPolicyNetwork.Org)
09.25.2003 || Includes side-by-side analyses from the Congressional Research Service, and text of low-income/catastrophic drug proposals.
From Transitional to Universal Health Coverage
09.24.2003 || A step-by-step approach that builds from "transitional" health insurance for the unemployed toward a more general system of tax credits and purchasing options that would substantially reduce the number of uninsured.
Passing the Feasibility Test: A Low-Income and Catastrophic Medicare Drug Benefit
09.24.2003 || With the Medicare conferees running low on time, a simpler drug benefit based on discount cards might be an acceptable solution.
An Exit Strategy for the Medicare Conferees (CentristPolicyNetwork.Org)
09.11.2003 || A zero-premium "catastrophic" benefit for seniors with the highest drug expenses (and additional benefits for seniors with low incomes) could help avoid an impasse on the Medicare drug bills pending in Congress.
California Bill Gives Universal Coverage Efforts a Bad Name
09.07.2003 || By casting employers as the sole solution to health coverage crisis, the bill will mobilize the business community in opposition. As a result, the California effort is likely to be a setback for bipartisan national efforts to cover the uninsured.
Socializing Drug Development Costs After FDA Approval Is Not Feasible
08.23.2003 || After-the-fact, taxpayer-paid R&D for drugs would almost certainly be more problematic than the current pricing system.
Rural Health Care: Rights and Responsibilities
revised 08.25.2003 || To qualify for new subsidies included in the Medicare Rx bills, rural health providers should be required to sign up with PPO plans in Medicare.
New Charts: What Seniors Would Pay for the Standard Drug Benefit in the Medicare Bills
08.20.2003 || Seniors would face a tough choice under the House and Senate drug proposals.
A Reminder: Chronic Care Should Be The Focus of Medicare Reform
08.08.2003 || Yesterday's Washington Post Column by Eric DeJonge and Bruce Leff points out the importance of reforming Medicare for improved chronic care.
"Dynamic Scoring" in Health Care
08.07.2003 || The extra analysis within "dynamic" or long-term estimates of tax cut proposals was helpful to Congress. Now, CBO should try to point out the long-term or other analytic considerations of the Medicare bills recently passed in the House and Senate.
Lessons from the New CBO Medicare Estimates
07.28.2003 || 10 new insights and questions stemming from CBO's recently completed estimates of the House- and Senate-passed Medicare and prescription drug bills.
Helpful Chronic Care Initiatives in the Medicare Bills
07.22.2003 || Some praiseworthy new proposals to improve chronic care are buried deep within the House and Senate Medicare bills.
Two Promising Approaches to Expanding Health Coverage
revised 07.21.2003 || A Senate proposal for transitional coverage for the unemployed and a new House bill creating health insurance subsidies for low-income families are politically feasible and analytically praiseworthy.
Medicare Needs FEHB-Style "High Option" Health Plans (CentristPolicyNetwork.Org)
07.14.2003 || Federal employees have better health benefits than those offered in Medicare. But they also pay a much higher share of the cost, and their premium could go up further if they choose costlier-than-average plans.
Medicare's Fee-For-Service "Savings" Are Really Costs
revised 07.28.2003 || The House and Senate Medicare drug bills contain illusory, distant-year cuts in payments to health providers that are never intended to materialize.
2003 Medicare and Drug Resource Page
CentristPolicyNetwork.Org)
07.13.2003 || Extensive links to think tank research and commentary on the current Medicare debate.
From Roll Call, July 7, 2003 (www.rollcall.com)
On Medicare and Budget Numbers, CBO is Failing
"Congress is poised to enact a Medicare drug benefit based on bad information. The Congressional Budget Office has failed its duty to provide lawmakers with a thorough and balanced analysis..."
A State-By-State Approach to Universal Health Coverage
07.06.2003 || Economists Henry Aaron and Stuart Butler propose a federalist, state-by-state approach to end the deadlock on universal coverage.
Drug Benefit Costs 1 Percent of GDP in 2030 (If CBO is Right)
06.25.2003 || Centrists.Org projects that the drug benefit being considered by Congress will raise Medicare spending 5.6 percent of GDP to 6.6 percent in 2030, based on an extension of CBO's estimate of S.1 .
Medicare vs. FEHB Spending: A Rare, Reasonable Analysis
06.23.2003 || A new analysis by the Joint Economic Committee staff provides the most balanced data so far in this weird and mostly unproductive debate.
Will the Senate's Medicare PPO Program Work?
06.11.2003 || The main element of reform in the Senate Medicare proposal, the new Preferred Provider Organization (PPO) program, could fail to get off the ground because of arcane "scoring" or cost-estimating contortions.
The Pointless Debate Over "Efficiency" of Government-Run vs. Private Health Insurance
05.12.2003 || According to PPI, it's like debating McDonald's vs. Burger King.
CBO Releases New Estimates of Number of Uninsured
05.12.2003 || CBO's new estimates of the number of uninsured imply a two-part strategy: (1) transitional coverage for people between jobs, and (2) permanent coverage for low-income workers.
A Bipartisan Compromise on Transitional Health Coverage
revised 04.28.2003 || A simple plan to cover 3.5 million unemployed workers.
Commonwealth Fund's Surprisingly Relevant Universal Coverage Proposal (CentristPolicyNetwork.Org)
04.26.2003 || Are liberals finally proposing realistic paths toward universal coverage?The President's Medicare Framework: Good Ideas, Bad Rhetoric04.20.2003 || Although its pro-HMO rhetoric was weird, the President's Medicare framework is a constructive step on the path to a new and better Medicare.
