Archive for the ‘Single payer’ Category

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Two Gatherings! Two Directions!

November 21, 2010
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This past week two gatherings addressed health care reform.

Liberty bell in Philadelphia

Liberty Bell in Philadelphia

The International Federation of Employee Benefit Plan (IFEBP) hosted its Annual Conference in Honolulu, HI.  Approximately 5,000 representatives from employer sponsored benefit plans and from benefit trust funds, as well as the professionals and vendors that serve them gathered to hear speakers address the changing world of health and pension benefits.

A major topic of discussion was the short and longer term implications of the Patient Protection and Affordable Care Act (ACA).  What do employee benefit plans need to do this month or this year?  What will the ACA mean for the longer term viability of employer sponsored health care?

The other gathering was much smaller. About 135 activists, most of them unpaid, met for the Healthcare-NOW! Strategy Conference in Philadelphia to discuss how to organize and build for another, very different, future for health care – single payer.

Anxiety about the future

The wonderful Hawaiian weather could not mask the anxiety felt by many plan sponsors over the future of employer sponsored health care.  Speakers tried to compare the ACA with ERISA, the landmark 70’s law that reshaped the landscape for pension plans adding stability and some legal protections to employer pension plans.  Yet thirty five years ago pension plan sponsors were very nervous about ERISA.

Continue reading ‘Two Gatherings! Two Directions!’

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Support for Single Payer in MA and VT

November 7, 2010
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Some recent bright spots did shine through among the depressing election results this past week.

In Massachusetts, voters and docs expressed support for a single payer solution to the continuing health care crisis.

Fall in New England

Fall in New England

Massachusetts is the state that gave us the Connector – the model for the Affordable Care Act that is now the target of the anti-incumbent horde that is invading Washington DC.

I have noted here before that the Massachusetts model might have been an acceptable state model given the restrictions that federal law imposes on the ability of states to be truly innovative with health care reform.

An individual mandate might even work in a state with a high level of income and a low rate of uninsured. Continue reading ‘Support for Single Payer in MA and VT’

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It’s the Price, Stupid! Or Not!

October 31, 2010
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Happy Haloween

Happy Halloween

It’s the Price Stupid is the title of a seminal paper in Health Affairs that concluded that the United States pays more for health care and receives less than in other developed countries.

It is also a theme resurrected by Alec MacGillis in a Washington Post article last week.

The argument goes like this.   The United States pays more for health care than anywhere else on the planet, as much as 50% more than the average for other developed countries.

Yet we get fewer services;  fewer physician visits, fewer hospital admissions, fewer days in the hospitals.     It doesn’t take a Ph.D. statistician to conclude that we are paying too much per unit of care.

But does health care reform fix it?

To MacGillis cost controls means price control. Continue reading ‘It’s the Price, Stupid! Or Not!’

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Will PPACA Increase Employer Health Insurance?

September 11, 2010
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Can you really trust computers?

The New England Journal of Medicine recently reported on a Rand study that concludes that the Accountable Care Act will result in a large net increase in employer-sponsored insurance offers.  They predict that the number of workers getting insurance from their employers will rise from the current 60% to 86%.KFF dw_09_08_2010

The Rand study was based on computer modeling.  Is there reason to think that the model is based in reality?

Yes and No

The study itself points to the reality of the experience in Massachusetts where employer based coverage increased after passage of a similar health reform initiative.

In addition, there is this little quirk in the recently released Kaiser Family Foundation 2010 Employer Benefit Survey.

Katherine Hobson writes about it on her blog at the Wall Street Journal. Continue reading ‘Will PPACA Increase Employer Health Insurance?’

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PPACA Raises Barriers to State Single Payer Efforts

August 14, 2010
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Last week’s post highlighted encouraging initiatives in several states to implement a single payer system within a single state.

This was always a daunting challenge even before health reform.  The Patient Protection and Affordable Care Act has raised the bar even higher.

Hawaii

Hawaii

ERISA and its preemption

Before PPACA a legal hurdle called the ERISA preemption severely hamstrung state health reform efforts.  For those of us in the employee benefits profession, ERISA, including its preemption clause, is our bible or at least our Deuteronomy.

ERISA was passed by Congress in 1974 to regulate employee benefit plans.  The preemption clause precludes states from regulating employee benefit plans.  There were two exceptions to that preemption and both are instructive. Continue reading ‘PPACA Raises Barriers to State Single Payer Efforts’

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