Research Roundup: Single Payer; Health Care Sharing Ministries; And Heart Health
Each week, KHN compiles a selection of recently released health policy studies and briefs.
JAMA Internal Medicine:
Lessons From The Canadian Experience With Single-Payer Health Insurance: Just Comfortable Enough With The Status Quo
With single-payer public health insurance again on the political radar in the United States at both the state (California) and federal (Democrat party) levels, the performance of the Canadian health care system during the last 50 years and the lessons it may offer should be considered. Canadians are proud of their universal approach to health insurance based on need rather than income. The system has many strengths, such as the ease of obtaining care, relatively low costs, and low administrative costs, with effectiveness and safety roughly on par with other countries, including those, such as the United States, that spend considerably more per capita. (Ivers et al, 8/6)
Health Care Sharing Ministries: What Are The Risks To Consumers And Insurance Markets?
Health care sharing ministries (HCSMs) are a form of health coverage in which members — who typically share a religious belief — make monthly payments to cover expenses of other members. HCSMs do not have to comply with the consumer protections of the Affordable Care Act and may provide value for some individuals, but pose risks for others. Although HCSMs are not insurance and do not guarantee payment of claims, their features closely mimic traditional insurance products, possibly confusing consumers. Because they are largely unregulated and provide limited benefits, HCSMs may be disproportionately attractive to healthy individuals, causing the broader insurance market to become smaller, sicker, and more expensive. (Volk, Curran and Giovannelli, 8/8)
Efficacy And Safety Of Further Lowering Of Low-Density Lipoprotein Cholesterol In Patients Starting With Very Low Levels: A Meta-Analysis
There is a consistent relative risk reduction in major vascular events per change in LDL-C in patient populations starting as low as a median of 1.6 mmol/L (63 mg/dL) and achieving levels as low as a median of 0.5 mmol/L (21 mg/dL), with no observed offsetting adverse effects. These data suggest further lowering of LDL-C beyond the lowest current targets would further reduce cardiovascular risk. (Sabatine et al, 8/1)
The Henry J. Kaiser Family Foundation:
The Relationship Between Work And Health: Findings From A Literature Review
A central question in the current debate over work requirements in Medicaid is whether such policies promote health and are therefore within the goals of the Medicaid program. Work requirements in welfare programs in the past have had different goals of strengthening self-esteem and providing a ladder to economic progress, versus improving health. This brief examines literature on the relationship between work and health and analyzes the implications of this research in the context of Medicaid work requirements. We review literature cited in policy documents, as well as additional studies identified through a search of academic papers and policy evaluation reports, focusing primarily on systematic reviews and meta-analyses. (Antonisse and Garfield, 8/7)