KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: Vast Number Of Insurance Products Drives Up Health Administration Costs; Fla. Governor’s Effort To ‘Sabotage’ Health Law

The New York Times: Economix: Waste Vs. Value In American Health Care
The typical American academic health center probably employs 300 to 400 full-time workers just for billing the 50 or more different insurers, each with its own rules, for services rendered patients. ... The authors of a recent paper in Health Affairs estimated that the typical physician spent $82,975 annually in time costs interacting with multiple insurers. ... considerable savings on administrative costs ought to be attainable even within our existing system. Unfortunately, the private sector – both buyers and sellers of private insurance – have shown little inclination to rise to that challenge over the decades. By constantly expanding the supply of different insurance products, each with different rules, they have enhanced administrative complexity (Uwe E. Reinhardt, 9/13).

The New York Times: The Conscience Of A Liberal: Insurance Company With An Army Blogging 
[The] federal government is basically an insurance company with an army, and the insurance side isn't bad. Nondefense spending is dominated by Social Security, which is highly efficient; Medicare, which could do better, but is more efficient than private insurance; and Medicaid, which is much more cost-effective than private insurance. I'm sure that if you look through nondefense discretionary spending you'll find some waste, but no more than in any large organization. More broadly, the US spends twice as much on health care as other advanced countries, with no better results — and that disparity is the result of private-sector, not public-sector, waste (Paul Krugman, 9/12). 

The Wall Street Journal: The Attack On Self-Insurance
The Affordable Care Act is supposed to be a paradise for the middle class, but now that Americans are starting to eat from the tree of knowledge, the liberal deities are trying to force them to stay inside the garden. Witness their crackdown on the booming Obamacare alternative known as self-insurance (9/12).

Boston Globe: Obamacare: Affordable After All
It's not unusual to hear opponents of the Affordable Care Act claim that premiums under the new law won't be affordable. But one of the first and broadest nonpartisan studies strongly suggests that once federal tax subsidies are factored in, premiums will be well within reach for those with moderate incomes (9/13).

Arizona Republic: Fees Up, Goldwater: The Lawsuit Is About Thwarting Obamacare
The Goldwater Institute usually has a good track record of defending state and federal constitutions. Usually. Everyone errs at some point. The institute, unfortunately, picked a whale of a way to be wrong. The conservative think tank's lawsuit to halt Arizona's planned Medicaid expansion is wrong in its analysis of the issue. But more than that, it is wrong in its rationale for filing the suit in the first place, which is more about halting implementation of a federal health-care law it dislikes than about ensuring the Arizona Constitution is honored (9/12).

Tampa Bay Times: Scott's Campaign To Sabotage The Affordable Care Act
Gov. Rick Scott says he sides with Florida's families, yet he is obstructing their access to health care. Citing groundless privacy concerns, the governor is trying to block county health departments from assisting people in signing up for health insurance on the state's online marketplace that will open in a few weeks. It's one thing to voice philosophical objections to federal law. It's indefensible to stand in the doorway and deny Floridians access to health care (9/12).

The Huffington Post: Improving The Public's Health Through The Affordable Care Act
President Obama and the entire Obama administration have made prevention and public health a top priority because of the lasting effects they have on the health of Americans. That is why the Affordable Care Act provides unprecedented resources through the Prevention and Public Health Fund to support community-based strategies to prevent chronic diseases, and to improve public health. The Affordable Care Act also created the National Prevention, Health Promotion, and Public Health Council, which provides federal leadership to engage states, communities, and private partners in creating a healthier America through the recommendations of the National Prevention Strategy -- a blueprint for ensuring Americans are healthy at every stage of life (Health and Human Services Secretary Kathleen Sebelius, 9/11).

Forbes: Labor Leader: Obamacare 'Needs To Be Repealed' If Union Demands Aren't Met
This week, in Los Angeles, leaders of the nation’s labor union movement gathered together for the AFL-CIO’s annual convention. ... union leaders shared their concerns about the impact of Obamacare on union-sponsored health insurance plans. Terence O’Sullivan, president of the Laborers' International Union of North America, said, "If the Affordable Care Act is not fixed, and it destroys the health and welfare funds that we have fought for and stand for, then I believe it needs to be repealed." ... One of the major reasons that people pay dues to unions is because unions do a great job negotiating health benefits for their members. If those members instead have the opportunity to shop for their own non-union-granted coverage on the Obamacare exchanges, workers have far less incentive to join unions (Avik Roy, 9/12). 

The New Republic: The House GOP Is About To Crack Up: Three Theories Why
[The right wing House Republicans'] explicit goal, getting rid of Obamacare, would seem to be out of reach. The political cost of pursuing that goal would seem to be high. Why keep at it? Three theories come quickly to mind: They are delusional. ... They are savvy. ... They are selfish. ... Which theory best explains the right's behavior? Who knows. Probably all three have some truth. But the end result is the same. Conservatives seem determined to provoke a crisis, whether it's over funding the government past September 30 or increasing the Treasury's borrowing limit. If that happens, [Speaker John] Boehner will face a choice. He can stand by while government services and the economy suffer—or, as Greg Sargent recently suggested, he can "cut the Tea Party loose, and suffer the consequences" (Jonathan Cohn, 9/12).

Los Angeles Times: Is CVS Rewards Program Complying With California Law?
CVS Caremark insists that it's just complying with federal law by informing customers that their medical information could be "redisclosed" if they sign up for the company's prescription-drug reward program. Privacy experts, though, question whether CVS is complying with state law (David Lazarus, 9/12).

Medpage Today: Orders, Results, Meaningful Use, Oh My
Managing test orders and results in a medical practice is a critical aspect to providing quality healthcare to patients. Managing those same test orders and results efficiently is critical to controlling operational costs for a medical practice. When physicians tell me that their overhead is too high, I look at how information flows in the practice. One of the key money pits is a poorly designed process for managing orders for ancillary testing. But technology and the Meaningful Use Stage 2 requirements present opportunities to overcome hidden operational costs that have become ingrained in daily activities (Rosemarie Nelson, 9/12).

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