Health Care Reform Articles - August 22, 2015

Insurance lobby that fought Hillarycare and Obamacare now has sturdy bridges to Democrats

By Alec MacGillis 
Truthout, Aug. 16, 2015

When the former head of the U.S. government's health insurance programs was hired in July to run a lobby that had spent tens of millions of dollars trying to derail Obamacare, it was more than just another spin of Washington's revolving door.

Marilyn Tavenner, former administrator of the Centers for Medicare and Medicaid Services, became chief executive of America's Health Insurance Plans, the industry's main lobbying group, which is known as AHIP. As the latest of a half-dozen prominent architects and overseers of Obamacare to move into the health industry, her move signified growing ties between health insurers and Democrats despite battles over the Affordable Care Act.

The relationship has long been marked by ambivalence and tension. Tavenner's predecessor at AHIP, Karen Ignagni, was a former Democratic staffer on Capitol Hill, but the insurance lobby led the way in defeating the Clinton health coverage plan in 1993 and secretly spent about $100 million to attack Obamacare even as it negotiated to make it palatable to the industry. More recently, as the law added millions to the insurance rolls and generated big profits for many companies, they have turned to defending it.

The connections may continue or strengthen if Hillary Clinton wins the Democratic nomination and the presidency. That's because a Washington firm called the Dewey Square Group, which is closely identified with the Clinton campaign, was at the center of the industry's efforts to win influence among Democrats — at a time when the two sides were sharply opposed.

Full story: http://www.truth-out.org/news/item/32352-insurance-lobby-that-fought-hil...

Alec MacGillis covers politics for ProPublica.

http://www.truth-out.org/news/item/32352-insurance-lobby-that-fought-hillarycare-and-obamacare-now-has-sturdy-bridges-to-democrats#

EDITORIAL

Help From the Obama Administration for Community Health Centers

By THE EDITORIAL BOARD

AUGUST 19, 2015

The Obama administration last week announced a big increase in support for community health centers in the latest expansion of a program that has a long bipartisan history and robust bipartisan support today.

The health centers got a start under President Lyndon Johnson’s war on poverty, expanded slowly over the years, and then got a huge lift from President George W. Bush, who doubled federal financing for the centers over five years and created or expanded almost 1,300 clinics in medically underserved areas. He admired the cost-effectiveness of the nonprofit centers, which treat low-income people and recent immigrants in poor urban neighborhoods and isolated rural areas and serve patients who would otherwise seek more expensive care in emergency rooms or hospitals.

The 2010 Affordable Care Act further expanded the program with increased funding over a five-year period, and the larger system of clinics is one of health care reform’s most praiseworthy achievements.

Today the health centers have become the largest primary care system in the United States. They serve some 23 million patients a year in over 9,000 locations across the country. Their professional association says they save the health care system some $24 billion a year by providing timely treatment and preventive care designed to meet local needs and preferences. The government says their quality of care equals and often surpasses that delivered by other primary care providers.

Last week the Department of Health and Human Services announced that it would distribute $169 million provided by the Affordable Care Act to open 266 new health centers in 46 states, the District of Columbia and Puerto Rico. That is on top of more than 700 new health centers that have already opened as a result of the A.C.A. They were all financed by a trust fund that could not be touched for five years and by annual discretionary appropriations that can be cut at any time.

The trust fund and a related trust fund for the National Health Service Corps that supplies most of the doctors and other health professionals who serve in the community health centers were set to expire after their five-year run at the end of September.

Fortunately, in the spring, Congress by overwhelming margins extended funding for the centers and health service corps for another two years as part of legislation notable mainly for fixing a flawed Medicare payment formula for doctors and extending an important children’s health insurance program. This will keep the program safe through the 2017 fiscal year but it will need to be nurtured in the years beyond.

http://mobile.nytimes.com/2015/08/19/opinion/help-from-the-obama-administration-for-community-health-centers.html?emc=edit_tnt_20150819&nlid=1311158&tntemail0=y&_r=1&referrer=

THE NEW HEALTH CARE 

Health Proposals by Walker and Rubio Are Less Concerned About the Poor

AUG. 18, 2015

by Margot Sanger-Katz

Obamacare gives federal money to poor people to help them get health insurance. Scott Walker, Wisconsin’s governor, has a replacement plan. It would give federal money to old people instead.

There are many, many other differences between Obamacare and Mr. Walker’s plan, announced Tuesday in a white paper and a policy speech. But that difference points to the key similarity between the plans, and the most consequential change.

The similarity: Both embrace the notion that the federal government should have some responsibility for making insurance affordable for people who don’t get it through their jobs. The Walker plan, and a similar though vaguer plan announced by Senator Marco Rubio on Tuesday in an editorial in Politico magazine, thinks that responsibility should, in part, take the form of federal money. Both Republican presidential candidates would give individuals tax credits they could use to shop for health plans.

But the Republican plans differ substantially from Obamacare in their vision of how the money should be doled out, and what it should be used to buy. The Walker and Rubio proposals call for a much less regulated insurance market, where the federal government exercises little oversight over the products in the market.

http://www.nytimes.com/2015/08/20/upshot/walker-and-rubio-health-proposals-are-less-concerned-about-poor.html?hp&action=click&pgtype=Homepage&module=first-column-region&region=top-news&WT.nav=top-news&abt=0002&abg=0

Arkansas Governor Wants to Keep Medicaid Expansion, but With Changes

By ABBY GOODNOUGHAUG. 19, 2015

WASHINGTON — Gov. Asa Hutchinson of Arkansas on Wednesday told an advisory group weighing the future of the state’s alternative Medicaid expansion that he favored keeping it — but only if the federal government allowed changes that seemed intended to appeal to conservative legislators who continue to oppose the program.

Mr. Hutchinson, a Republican who took office in January, created the advisory group to recommend whether to change or replace the state’s “private option” version of Medicaid expansion. The program’s fate will ultimately be decided by the Republican-controlled legislature, which is likely to meet in a special session this year to vote on it.

Arkansas is among the states that have had the largest reductions in their uninsured rates under the Affordable Care Act, according to several national surveys. Under its private option, which Republican legislators devised as a politically acceptable alternative to expanding traditional Medicaid as the federal health law envisioned, the state has used federal money to buy private insurance for more than 200,000 low-income individuals.

But the private option itself has been unpopular among many Arkansas Republicans — even as several other states, including Indiana and Iowa, have adopted versions of it — and the Legislature must reauthorize financing for it every year, putting its future in constant jeopardy.

In a speech to the advisory group and a separate legislative task force, Mr. Hutchinson recommended changes that include requiring enrollees whose income is above the federal poverty level to pay premiums equaling 2 percent of their household income, and shifting people below a certain income level to traditional Medicaid — which may well prove less expensive — instead of giving them private insurance.

He also suggested requiring people with access to employer-sponsored insurance that meets the standards of the Affordable Care Act to sign up for that coverage instead of falling back on Medicaid. The state would cover their deductibles and co-payments, he said.

http://www.nytimes.com/2015/08/20/us/arkansas-governor-wants-to-keep-medicaid-expansion-but-with-changes.html?&moduleDetail=section-news-4&action=click&contentCollection=U.S.&region=Footer&module=MoreInSection&version=WhatsNext&contentID=WhatsNext&pgtype=article

Early-Stage Breast Condition May Not Require Cancer Treatment

By GINA KOLATAAUG. 20, 2015

As many as 60,000 American women each year are told they have a very early stage of breast cancer — Stage 0, as it is commonly known — a possible precursor to what could be a deadly tumor. And almost every one of the women has either a lumpectomy or a mastectomy, and often a double mastectomy, removing a healthy breast as well.

Yet it now appears that treatment may make no difference in their outcomes. Patients with this condition had close to the same likelihood of dying of breast cancer as women in the general population, and the few who died did so despite treatment, not for lack of it, researchers reported Thursday in JAMA Oncology.

Their conclusions were based on the most extensive collection of data ever analyzed on the condition, known as ductal carcinoma in situ, or D.C.I.S.: 100,000 women followed for 20 years. The findings are likely to fan debate about whether tens of thousands of patients are undergoing unnecessary and sometimes disfiguring treatments for premalignant conditions that are unlikely to develop into life-threatening cancers.

http://www.nytimes.com/2015/08/21/health/breast-cancer-ductal-carcinoma-in-situ-study.html?emc=edit_na_20150820&nlid=1311158&ref=headline

Costs imposed by 'medical industrial complex' defy reason

By Wendell Potter

In my column last week I suggested that one of the reasons Americans tolerate paying so much more for health care than citizens of any other country — and getting less to show for it — is our gullibility. We’ve been far too willing to believe the self-serving propaganda we’ve been fed for decades by health insurers and pharmaceutical companies and every other part of the medical-industrial complex, a term New England Journal of Medicine editor Arnold Relman coined 35 years ago to describe the uniquely American health care system.

One of the other reasons we tolerate unreasonably high health care costs is gullibility’s close and symbiotic relative: blind adherence to ideology.  By this I mean the belief that the free market — the invisible hand Adam Smith wrote about more than two centuries ago and that many Americans hold as a nonnegotiable tenet of faith — can work as well in health care as it can in other sectors of the economy.

While the free market is alive and well in the world’s other developed countries, leaders in every one of them, including conservatives, decided years ago that health care is different, that letting the unfettered invisible hand work its magic in health care not only doesn’t create the unintended social benefits Smith wrote about, it all too often creates unintended, seemingly intractable, social problems.

In a commentary for The Catholic Spirit, Jason Adkins, executive director of the Minnesota Catholic Conference, wrote after the 2011 government shutdown in Minnesota that, “The inability (of state lawmakers) to compromise (on the budget)…was not based so much on stubbornness or sheer partisanship as it was on adherence to ideological principle.”

He went on to note that “an almost slavish adherence to ideology in politics can and does inflict harm to the very people public officials claim to serve.”

http://www.publicintegrity.org/2015/06/08/17460/free-market-ideology-doesnt-work-health-care

Americans Don't Like Pharma And Think They're Getting Ripped Off

By Jeffrey Young
The Huffington Post, August 20, 2015

WASHINGTON -- Americans use prescription drugs and they know these medicines help people, but they still don't care much for pharmaceutical companies and think the industry is too money-hungry, according to a new survey.

More than seven in 10 Americans think prescription drug prices are unreasonable, the Henry J. Kaiser Family Foundation reported Thursday. And nearly eight in 10 people who actually take those drugs feel the same way.

Almost three-quarters also correctly observed that Americans tend to pay higher prices than people in other countries, where governments typically control prices directly.

And though the survey indicates that most people have health insurance that allows them to afford these medicines -- meaning Big Pharma isn't about to see its sales numbers shrink -- it also shows sincere dissatisfaction with drug companies and the amount of money they charge for their products.

Some positive findings for pharmaceutical companies: 62 percent of those surveyed agreed that prescription drugs are good for people.

And that's about all the good news the Kaiser Family Foundation has for the industry.

Just 42 percent of Americans have a favorable opinion of drug companies. That makes them slightly more popular than oil companies, and less popular than the rest of the health care system -- including health insurers -- airlines and banks.

http://www.pnhp.org/print/news/2015/august/americans-dont-like-pharma-and-think-theyre-getting-ripped-off