The End of Health Insurance Companies
By EZEKIEL J. EMANUEL and JEFFREY B. LIEBMANEzekiel J. Emanuel on health policy and other topics.
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Here’s a bold prediction for the new year. By 2020, the American health insurance industry will be extinct. Insurance companies will be replaced by accountable care organizations — groups of doctors, hospitals and other health care providers who come together to provide the full range of medical care for patients.
Already, most insurance companies barely function as insurers. Most non-elderly Americans — or 60 percent of Americans with employer-provided health insurance — work for companies that are self-insured. In these cases it is the employer, not the insurance company, that assumes most of the risk of paying for the medical care of employees and their families. All that insurance companies do is process billing claims.
Keeping It Clean: Maine’s Fight for Fair Elections
For more than a decade, a groundbreaking Clean Elections law has helped protect Maine politics from the influence of big money. But what’s happening now that big spenders have free rein to influence elections—and what does it mean for the rest of the country?http://www.yesmagazine.org/people-power/keeping-it-clean-maines-fight-for-fair-elections
Breast Cancer Surgery Rules Are Called Unclear
By DENISE GRADY
Nearly half of women who had lumpectomies for breast cancer had second operations they may not have needed because surgeons have been unable to agree on guidelines for the most common operation for breast cancer, a new study finds. It also hints that some women who might benefit from further surgery may be missing out on it.
Rates of repeat surgery can vary widely by doctor, from zero percent to 70 percent, according to the study.
DHHS shortfall is budget problem, not welfare problem
Posted Jan. 31, 2012, at 4:21 p.m.
It’s a budget problem, not a DHHS problem.
That simple truth should guide members of the Legislature’s Appropriations Committee as they consider Gov. Paul LePage’s proposal to close a $220 million gap in the Department of Health and Human Services budget. Certainly the shortfall is real, and certainly the state can and should consider changing the level of health assistance it provides the needy.
But the governor has defined the problem in very narrow terms, ignoring about $150 million in tax cuts his first budget, signed last year, will provide. Those cuts include a reduction in the top income tax rate from 8.5 percent to 7.95 percent, and a bump in the threshold at which the estate tax kicks in from $1 million to $2 million. Some of the tax changes could be delayed.
Cancer Group Halts Financing to Planned Parenthood
By PAM BELLUCK
In a decision that is inflaming passions on both sides of the abortion debate, the world’s largest breast cancer organization, Susan G. Komen for the Cure, is cutting off its financing of breast cancer screening and education programs run by Planned Parenthood affiliates.
The move will halt financing to 19 of Planned Parenthood’s 83 affiliates, which received nearly $700,000 from the Komen foundation last year and have been receiving similar grants since at least 2005.
Planned Parenthood contends that the Komen foundation is yielding to longstanding pressure from anti-abortion groups, which Komen denies.
A spokeswoman for the Komen foundation, Leslie Aun, told The Associated Press that the main factor in the decision was a new rule adopted by Komen that prohibits grants to organizations being investigated by local, state or federal authorities. Ms. Aun told The A.P. that Planned Parenthood was therefore disqualified from financing because of an inquiry being conducted by Representative Cliff Stearns, Republican of Florida, who is looking at how Planned Parenthood spends and reports its money.
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