Health Care Policy and Marketplace Review

tag:blogger.com,1999:blog-18451837035682538712009-11-04T11:11:06.828-05:00Health Care Policy and Marketplace ReviewA Health Care Blog––Bob Laszewski's review of the latest developments in federal health policy and marketplace activities in the health care financing business.ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.comBlogger534125tag:blogger.com,1999:blog-1845183703568253871.post-39151956371396542932009-11-03T11:16:00.011-05:002009-11-03T11:49:32.495-05:00The Neutered Public Option—Where’s the Rage?

The public option contained in the House Democratic health care bill is hardly more than a neutered version of the “robust” public option one House Democrat after another said was a minimum requirement to keep their vote on health care reform. After threatening for months to fall on their swords if they didn’t get the “robust Medicare-like” version, there was nothing but enthusiastic support for

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com2tag:blogger.com,1999:blog-1845183703568253871.post-58797363690266422952009-10-30T15:58:00.004-05:002009-10-30T16:09:26.548-05:00Saving Health Care--Saving America

Saving Health Care--Saving AmericaBy BRIAN KLEPPER, DAVID C. KIBBE, ROBERT LASZEWSKI and ALAIN ENTHOVENSo far, Congress' response to the health care crisis has been alarmingly disappointing in three ways. First, by willingly accepting enormous sums from health care special interests, our representatives have obligated themselves to their benefactors' interests rather than to those of the American

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com0tag:blogger.com,1999:blog-1845183703568253871.post-56583838041093743062009-10-29T08:36:00.013-05:002009-10-29T09:30:37.192-05:00The Health Care Bills, the Fine Print, and a Troubling List of Budget Gimmicks

Julie Appleby has an important article today at Kaiser Health News.She has identified an important and before unreported issue in the Senate Finance health care bill.In order to keep the cost of the plan down, the Senate Finance bill literally locks in the erosion of insurance subsidies for middle class families.From her report:"The first year the legislation would take effect, people getting

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com0tag:blogger.com,1999:blog-1845183703568253871.post-48969354596385512422009-10-26T10:55:00.012-05:002009-10-26T11:18:57.780-05:00“The Public Option Is Back in Play”—That Depends Upon Your Definition of the Word “Is”

It appears that Harry Reid is going to include a robust Medicare-like public option in his Senate draft. Speaker Pelosi is also doing her best to put as robust a public option in her House version as she can get the votes for.One press report after another has proclaimed the return of the public option.I’d like to see some of these reporters to do a vote count.No doubt the hype over the public

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com0tag:blogger.com,1999:blog-1845183703568253871.post-80900564382213406472009-10-22T10:59:00.013-05:002009-10-22T12:16:55.842-05:00Doing the Right Thing--The Doc Fix Vote and the CMS Report

Predicting the outcome of yesterday's Senate vote on the $245 billion deficit adding doc fix was easy.Democratic Senate Majority Leader Reid was going to sail this thing through the Senate with almost all Democrats and even a bunch of Republicans onside.Senators are afraid of the docs—after all they have voted for years to waive any cuts. Democrats needed to get this $245 billion cost out of the

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com3tag:blogger.com,1999:blog-1845183703568253871.post-73396368270855457292009-10-19T09:00:00.009-05:002009-10-20T10:33:00.953-05:00The Senate Finance Insurance Reform Rules Have to Be Fixed in Spite of the Gang That Can’t Shoot Straight

Last week the health insurance trade association (AHIP) released a report it sponsored, and was authored by PricewaterhouseCoopers (PwC), that claimed the Senate Finance bill would be problematic for the insurance markets only leading to much higher costs.As I posted last week, my own analysis of the Finance bill gives me big concerns about what it would do to health insurance costs and the

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com1tag:blogger.com,1999:blog-1845183703568253871.post-63566664938928362872009-10-15T09:34:00.007-05:002009-10-15T09:56:48.120-05:00Apparently The "Games" Have Begun--Democrats Move to Fix Physician Fee Problem Off-Budget

Apparently, Democrats are getting ready to pay-off the physicians for their support of the health bills by quickly fixing the Medicare Sustainable Growth Rate (SGR) fee cut problem off-budget and ahead of the pending health care bills.This in today's Kaiser Health News on a Congress Daily Report:Physician lobbyists met with several key lawmakers and administration officials Wednesday to push for

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com7tag:blogger.com,1999:blog-1845183703568253871.post-89671154116889816332009-10-14T09:11:00.004-05:002009-10-14T10:48:32.631-05:00What’s Next? Follow the Money

With the passage of the Senate Finance bill the health care effort now moves to a critical stage with the Senate Majority Leader and the House Speaker now clearly in charge.The more important effort will be Reid’s. Pelosi’s final product will be more predictable (very liberal) but Reid’s will have to be more practical. Every inch Reid moves away from the more moderate Baucus bill will cause

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com1tag:blogger.com,1999:blog-1845183703568253871.post-27907596322200741752009-10-13T07:00:00.001-05:002009-10-13T07:44:44.300-05:00The Senate Finance “Cadillac” Health Insurance Excise Tax Collects Almost Five Times More Revenue in 2019 Than It Does in 2013

Critics of the Pricewaterhouse Coopers (PWC) report on the Senate Finance bill have been making the argument that the analysts are not giving credit for the changes in behavior the bill would create. In short, the notion that, for example, insurers would pass on billions in taxes on high cost health plans to customers is flawed because the Baucus bill would provide the incentive to lower the cost

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com13tag:blogger.com,1999:blog-1845183703568253871.post-45777956919291553042009-10-12T08:44:00.023-05:002009-10-14T12:46:42.827-05:00The Senate Finance Health Bill Has No Clothes

Readers of this blog know that I have lots of concerns for the Senate Finance health bill primarily because it does not so much represent health care reform as just an expensive entitlement expansion.Readers also know the insurance lobby--AHIP--is not one of my favorite organizations.But I will tell you the report by Pricewaterhouse Coopers (PwC) commissioned by the AHIP and released this morning

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com10tag:blogger.com,1999:blog-1845183703568253871.post-32659281306470633142009-10-08T10:04:00.029-05:002009-10-08T15:30:30.452-05:00The Democratic Health Care Bills Could Be A Disaster for the Insurance Pool

With Baucus gutting his fine for not having health insurance there would be no reason for people to buy it. In 2013, for example, there would be no fine for not having insurance. By 2014 the penalty would be $200 per adult and it would rise to $400 in 2015, $600 in 2016, and $750 by 2017. Coupled with the expectation middle class families would have to pay $6,000 to $10,000 a year for insurance

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com3tag:blogger.com,1999:blog-1845183703568253871.post-33492518869990246802009-10-08T09:25:00.009-05:002009-10-08T12:04:24.995-05:00Managed Care: Because I'm A Scorpion, And It's In My Nature - An Editorial On Health Reform

Carl McDonald is a Managing Director at Oppenheimer & Company. He is one of the most followed health insurance industry analysts who can regularly make stock prices rise and fall with his comments. Today, he and colleague James Naklicki offer an "editorial" on the current health care proposals pending in Congress. I will suggest that their analysis of the impact of potential "reform" on consumers

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com1tag:blogger.com,1999:blog-1845183703568253871.post-69896643276399703892009-10-07T10:58:00.000-05:002009-10-11T20:01:41.250-05:00Health Care and the Nobel Peace Prize

October 8th, 2009President Obama this morning: “I will accept this award as a call to action, a call to all nations to confront the common challenges of the 21st Century.”I was in a private meeting last week where I heard a longtime and influential Washington insider describe her view of the Obama health care effort. Her point was that the White House has approached the effort more from an ego

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com4tag:blogger.com,1999:blog-1845183703568253871.post-11649812862317981772009-10-06T09:44:00.000-05:002009-10-06T09:44:00.061-05:00What a Tax on "Cadillac" Health Insurance Plans Would Really Mean to Mainstream Americans

Milliman consulting actuary, Robert Dobson, is out with a must read paper for those that think the "Cadillac" health plan tax makes sense.The bottom line:"The idea of taxing so-called Cadillac plans may not sound unreasonable upon first glance. But an actuarial view quickly reveals that the high cost of these plans has as much to do with the characteristics of the covered population as it does

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com5tag:blogger.com,1999:blog-1845183703568253871.post-10518918593250796102009-10-05T09:22:00.007-05:002009-10-05T09:51:10.297-05:00Will We Get a Health Care Bill in 2009? We Are About to See the Convergence of Three Powerful Forces

It’s decision time. The Congress will or won’t pass a major health care bill during the next few weeks.Will we get health care reform in 2009?Almost certainly not. As I have been saying for months, if we get a bill it will be more a trillion dollar entitlement expansion funded by relatively minor provider cuts and about $500 billion in tax increases. That is not health care reform.Will we get

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com5tag:blogger.com,1999:blog-1845183703568253871.post-41112334648112156682009-10-04T23:10:00.014-05:002009-10-04T23:38:27.112-05:00Just Exactly What is "Health Care Security?"

The President has said many times this health care debate is about "health care security." But the fact is that, under the Democratic bills now being considered, many middle class families (those making between $50,000 and $100,000 a year) would not be able to afford to buy a health insurance policy even with the proposed federal government subsidies.Under the House Energy bill a family making

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com4tag:blogger.com,1999:blog-1845183703568253871.post-67191755312725435002009-09-17T11:55:00.006-05:002009-09-17T17:05:50.987-05:00Getting a Health Bill Done—Special Interest Politics Versus Public Support

It is becoming more and more clear to me that the White House health care strategy this fall is based upon a belief they have been very successful in neutralizing the health care special interests and have therefore prepared the way to a legislative victory.Each of the key stakeholders—doctors, hospitals, drug companies, device makers, and insurers are in a terrific place should any of the health

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com4tag:blogger.com,1999:blog-1845183703568253871.post-63521876595774726152009-09-16T08:40:00.005-05:002009-09-16T12:14:48.581-05:00Health Care Outlook Not Improving

The next big test for a health care bill in 2009 (notice that I did not call it health care reform) will come in Senate Finance.The final vote in that committee will tell us a lot about whether the Democrats have any chance for 60 votes in the full Senate. So far, it does not look good.I have the greatest respect for Senators Baucus and Grassley and their good faith efforts to find a bipartisan

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com8tag:blogger.com,1999:blog-1845183703568253871.post-86233017026834385932009-09-14T06:00:00.004-05:002009-09-14T10:02:49.722-05:00The Proposed Health Insurance Company Taxes To Pay for Health Care––You Really Need to Know What “Loadings Available” Means

The Congress has investigated about every conceivable way to tax people to pay for the health care proposals—a millionaire’s tax, bigger taxes on home mortgages and charitable contributions, and a couple of dozen more ideas.Now Congress looks to be the most interested in taxing insurance companies to pay for a big chunk of their health care proposals. The new taxes would come in two parts––a 35%

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com5tag:blogger.com,1999:blog-1845183703568253871.post-27492490454139686622009-09-13T11:35:00.005-05:002009-09-13T13:15:14.024-05:00What Voters Really Think About Evidence-Based Health Care

I want to call you attention to an important survey done by the California-based Campaign for Effective Care. They surveyed California voters on their understanding of evidence-based medicine.The bad news is that patients think their health care treatment is generally evidence-based even though that assumption is highly questionable. The good news is that patients want it to be evidence-based.At

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com3tag:blogger.com,1999:blog-1845183703568253871.post-44664499168995879262009-09-12T10:01:00.002-05:002009-09-12T10:01:00.136-05:00"Please Don't Call It Health Reform"

Readers of this blog already know of my disappointment in what the White House and many in Congress are calling "health care reform."So, I was happy to see Alain Enthoven's recent KHN op-ed.Here is a small portion of it:"Once again the President did not put forth serious proposals to reduce the growth rate in health expenditures in his speech last night. Obama likes to talk about the iconic

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com7tag:blogger.com,1999:blog-1845183703568253871.post-5536353912639026182009-09-11T08:45:00.013-05:002009-09-11T10:19:23.083-05:00Curb Your Enthusiasm! Health Care Will Still Be Very Hard to Do

I guess all of us in the health care debate are a bit bipolar. From lots of folks thinking health care reform was in critical condition a couple weeks ago we’ve now gone to lots of reports extolling a newfound optimism in the wake of the President’s impressive speech this week.Don’t interpret this post as my thinking health care reform is something we should be putting off—it’s already 20 years

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com0tag:blogger.com,1999:blog-1845183703568253871.post-87173872985265082732009-09-02T01:00:00.001-05:002009-09-02T01:00:01.018-05:00The Obama Administration––What Will They Do Next?

How’d you like to be a fly on the wall in those White House health care meetings this week?It looks to me like they have two choices—neither attractive to them:1. Full Speed Ahead, Damn the Torpedoes – This might also be called the Pelosi Option for the Speaker’s intransigence for compromise. Just keep driving the existing Democratic bills through. This has the advantage of keeping the liberal

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com2tag:blogger.com,1999:blog-1845183703568253871.post-8841405243704971402009-09-01T17:19:00.009-05:002009-09-02T13:58:25.794-05:00Will Republicans Be Spoilers Or Problem Solvers on Health Care Reform?

by BRIAN KLEPPER and DAVID C. KIBBEIn theory Congress' return next week from recess could offer a new beginning to the health care reform process, giving everyone a chance to take a deep breath and recalibrate the components of change.Nine months into the wrangling around a new Administration, the talk-show right has seemingly hijacked the discussion on health care, Democrats' signature issue,

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com1tag:blogger.com,1999:blog-1845183703568253871.post-37464078920655538662009-08-31T11:38:00.011-05:002009-08-31T17:31:26.876-05:00Making Health Care Reform "Deficit Neutral" Accomplishes Little--So Why Is That the President's Health Care Reform Budget Objective?

For me, one of the more amazing things about this health care debate is the way the press and many advocates of health care reform have accepted the notion that the fiscal objective should be to pass a health care bill that is "deficit neutral."With health care costs unsustainable, why is that an appropriate goal?Deficit neutral means that any impact of a health care bill on the federal budget

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com1