The public plan continues to preoccupy the health policy blogosphere.
Alex Hankins of OpenMarket.org criticizes HHS Secretary Kathleen Sebelius’ support for a public plan option and says, “There can be no real competition in the market if one player makes the rules for the others and cannot run out of money.”
Charlie Baker, who runs the private health insurer Harvard Pilgrim says on the company’s Let’s Talk Health Care blog he’s not worried about the government’s impact on competition, but rather if the government will be able to administer and manage such a plan.
The problems we face as a nation with respect to health care costs and quality are not going to get better until Medicare gets serious about changing the way it does business. I’ve said this before, and I’ll say it again – if Medicare is just Medicare – as it is and as it has been – health care reform, with or without whatever reforms are currently being discussed – will not result in lower costs or higher quality.
Howard Gleckman of Tax Vox has a message for opponents of a public plan: “This debate is over. You lost.” Gleckman points to the number of Americans in Medicare, Medicaid, CHIP, TRICARE and the VA and says:
But even using the most narrow definition—those getting direct government coverage– more than 80 million Americans already have such insurance. That’s half as many as have employer-sponsored insurance, but it’s still a lot of policies…It is no surprise that critics of health reform would revive the old Harry and Louise argument that government is trying to take over your health care. But if that’s a problem, it has been one for decades.
Jordan Cohen of Health Reform Watch looks at studies on health insurance market consolidation and its effect on premium prices and quality of care. Cohen says, “Unfortunately, the issues regarding competition have been over-simplified or simply ignored.”
Meanwhile, Time’s Karen Tumulty mulls over yesterday’s HELP Committee markup:
Whether or not health care reform actually passes in the end, this may be remembered as the week that the reality of the challenge such a massive overhaul poses finally dawned on lawmakers. And that reality is this: It’s all about the dollars.
Consultant Bob Laszewski takes stock of the discord from yesterday and suggests a new tactic altogether , linked to a bill by Sen. Ron Wyden, D-Ore. and Bob Bennett, R-Utah :
The Congress is stuck in the mud on health care reform. The Congressional Budget Office (CBO) continues to demand real health care reform and not the cost containment “lite” stuff they’ve largely been asked to score so far…It’s time to take another look at the bipartisan work Wyden-Bennett has accomplished in order to get the process unstuck … The Wyden-Bennett Healthy Americans Act is a health care reform proposal that would creatively used the tax system to change the incentives—in this case replacing the tax exclusion with a tax credit as Elmendorf has suggested.
Health Care Renewal’s Roy Poses, a physician and professor of medicine at Brown University, explains his support for comparative effectiveness research. Poses says:
In particular, for many clinical problems, and for many sorts of patients, no one has ever done a good quality study that compares the plausible treatments for those problems and those patients. When the only studies done compared individual treatments to placebos, and when even those were restricted to narrow patient populations unlike those patient usually seen in daily practice, physicians are left juggling oranges, tomatoes, and carburetors.
Poses says comparative effectiveness research provides the evidence needed to compare outcomes for different patient populations and different treatments.
Sarah Lovenheim of the Post’s Daily Dose looks at a new study that found treatments for chronic illness are the main driver of health care costs for women.
Heritage’s The Foundry has an open letter from their CEO to President Obama, saying, “we think that some proposals being made by the White House are advertised on false premises,” such as doubting the President’s statement that ‘anyone who likes their health insurance can keep it,’ and outlining points of their preferred approach to health reform.