September 1, 2023 On August 30, 2023, Kaiser Health News reported ("5 Things to Know About the New Drug Pricing Negotiations"):"The Biden administration has picked the first 10 high-priced prescription drugs subject to federal price negotiations, taking a swipe at the powerful pharmaceutical industry. It marks a major turning point in a long-fought battle to control ever-rising drug prices for seniors and, eventually, other Americans."Under the 2022 Inflation Reduction Act, Congress gave the federal government the power to negotiate prices for certain high-cost drugs under Medicare. The list of drugs selected by the Centers for Medicare & Medicaid Services will…
Learning From Others
June 14, 2023 Professor Aaron E. Carroll, MD, MS, is the Chief Health Officer of Indiana University. In a guest essay comparing the US health care system with the systems of five other nations that was published June 13, 2023 in the New York Times ("I Studied Five Countries’ Health Care Systems. We Need to Get More Creative With Ours."), he writes:"America could learn a thing or two from these other countries. We could take inspiration from them and potentially improve access, quality and cost."Though the Canadian system may be more familiar with people in the US due to simple…
Practice Consolidation and Access to Quality Care
May 14, 2023 The New York Times reports on a growing trend among healthcare organizations in the US, the impact of which may be of concern for patients and taxpayers. The Times reported on May 8, 2023 ("Corporate Giants Buy Up Primary Care Practices at Rapid Pace") that:"CVS Health, with its sprawling pharmacy business and ownership of the major insurer Aetna, paid roughly $11 billion to buy Oak Street Health, a fast-growing chain of primary care centers that employs doctors in 21 states. And Amazon’s bold purchase of One Medical, another large doctors’ group, for nearly $4 billion, is another…
Medicaid Re-Enrollment Begins Again
US states are restarting yearly Medicaid and Children’s Health Insurance Program (CHIP) eligibility reviews. The Kaiser Family Foundation reported on February 22, 2023 ("10 Things to Know About the Unwinding of the Medicaid Continuous Enrollment Provision"): "Primarily due to the continuous enrollment provision, Medicaid enrollment has grown substantially compared to before the pandemic and the uninsured rate has dropped. But, when the continuous enrollment provision ends, millions of people could lose coverage that could reverse recent gains in coverage. As part of the Consolidated Appropriations Act, 2023, signed into law on December 29, 2022, Congress set an end of March 31, 2023 for the…
The Existential Threat of Greed in US Health Care
February 7, 2023 The journal JAMA published a Viewpoint on Jan. 30, 2023 by Donald Berwick, MD, MPP, entitled Salve Lucrum: The Existential Threat of Greed in US Health Care.In it, Dr. Berwick contends:"Profit may have its place in motivating innovation and higher quality in health care, as in any industry. But kleptocapitalist behaviors that raise prices, salaries, market power, and government payment to extreme levels hurt patients and families, vulnerable institutions, governmental programs, small and large businesses, and workforce morale. Those behaviors, mostly legal but nonetheless wrong, have now accumulated to a level that poses an existential threat to…
Oregon Becomes First US State To Guarantee Its Residents Access To Affordable Healthcare
January 20, 2023 In the November 2022 general election, Oregon voters narrowly approved Oregon Measure 111, the Right to Healthcare Amendment. The measure amended the state constitution, adding a guarantee of access to affordable healthcare for all Oregon residents. According to Ballotpedia, last accessed Jan. 20, 2023:"Ballot title"The ballot title was as follows:[7]"Amends Constitution: State must ensure affordable healthcare access, balanced against requirement to fund schools, other essential services"Result of 'Yes' Vote: 'Yes' vote requires state to ensure affordable healthcare access. State must balance healthcare funding against funding for schools, other essential services; courts must respect balance."Result of 'No' Vote:…
Massive Savings Possible In US Health System
October 21, 2021 The management consulting firm McKinsey & Company has issued a new report estimating that administrative changes and efficiencies could save the US health system more than a quarter trillion dollars.As noted in a Viewpoint article published in JAMA on October 20: "The analysis dissected profit and loss statements of individual health care organizations, estimated spending on specific processes, and compared administrative spending in health care with that of other industries. The conclusion of the report is that an estimated $265 billion, or approximately 28% of annual administrative spending, could be saved without compromising quality or access by…
Health Care in the US Compared to Other High-Income Countries
On August 4, the Commonwealth Fund issued a new report entitled Mirror, Mirror 2021: Reflecting Poorly / Health Care in the US Compared to Other High-Income Countries. The report compares health care systems in eleven nations: the United States, Canada, Switzerland, France, Sweden, New Zealand, Germany, the United Kingdom, Australia, the Netherlands, and Norway. The report's key findings: "The top-performing countries overall are Norway, the Netherlands, and Australia. The United States ranks last overall, despite spending far more of its gross domestic product on health care. The U.S. ranks last on access to care, administrative efficiency, equity, and health care…
Medical Debt in Collections in the US
On July 20, JAMA published an article on medical debt in collections in the US entitled "Medical Debt in the US, 2009-2020." The researchers found: "In this retrospective analysis of credit reports for a nationally representative 10% panel of individuals, an estimated 17.8% of individuals in the US had medical debt in collections in June 2020 (reflecting care provided prior to the COVID-19 pandemic). Medical debt was highest among individuals who lived in the South and in zip codes in the lowest income deciles and became more concentrated in lower-income communities in states that did not expand Medicaid." August 6,…
