Austin Frankt: ObamaCare will destroy employer-sponsored coverage and that’s a good thing.
A report by the Center for American Progress and the Commonwealth Fund claims health reform will reduce health costs. Chris Jacobs slices and dices it here.
Tag Archives: Commonwealth Fund
Patients Managing Their Own Health Care Budgets
Critics of consumer-directed health care often argue that patients are not knowledgeable enough and the market is not transparent enough for consumerism to work in health care. But a new study by The Commonwealth Fund says there is an international trend toward self-directed care (SDC) and it is focused on a most unlikely group of patients: the frail, the old, the disabled and even the mentally ill.
- In the United States, Medicaid “Cash and Counseling” programs — underway for over a decade — allow home-bound, disabled patients to manage their own budgets and choose services that meet their needs.
- In Germany and Austria, a cash payment is made to people eligible for long-term care — with few strings attached and little oversight on how the money is used.
- In England and the Netherlands, the disabled and the elderly manage budgets in a manner similar to Cash and Counseling in the United States.
- Also in this country, Florida and Texas have SDC programs for patients with serious mental illness and the Veterans Administration has an SDC program operating in 20 states for long-term care and mental illness.
And, as I wrote in an earlier version of this post at the Health Affairs blog, it appears that we have barely scratched the surface in taking advantage of patient power opportunities.
[Wait a minute. Aren’t we usually critical of Commonwealth Fund studies at this site? Yes, but CWF studies often come with press releases, hoopla, fanfare and the touting of public policy implications. I found this study back in the archives, covered with dust and mold, underneath stacks of other papers — figuratively speaking, of course — to be found only by the diligent and the tenacious.]
httpv://www.youtube.com/watch?v=T6ya7ZRlrEo
“I did it my way”
Continue reading Patients Managing Their Own Health Care Budgets
Wishful Thinking Has No Limits
We have previously reported that the federal government is the primary cause of health care inflation. And every country that has ever adopted national health insurance has experienced higher-than-expected health spending. Yet the Commonwealth Fund thinks that virtually all past proposals for national health insurance in the U.S. would have made costs lower, not higher. Here are their estimates:
Source: The New York Times
After-Hours Care in the UK: Available on Paper, But Not in Practice
According to The Commonwealth Fund, “[o]nly 29 percent of U.S. physicians said their practice had arrangements for getting patients after-hours care — so they could avoid visiting a hospital emergency room. Nearly all Dutch, New Zealand, and UK doctors said their practices had arrangements for after-hours care,” including 89 percent of UK practices.
While UK after-hours care may look good on paper, the online Telegraph reports that only 1 in 4 people who want after-hours care actually sees a physician in the parts of the UK with the best after-hours performance. In the sections of the country with the worst performance, only 1 in 50 people actually gets the after-hours care they want.
Continue reading After-Hours Care in the UK: Available on Paper, But Not in Practice
Americans Get More Mammograms, Colonoscopies, etc. than Europeans
We don’t get a little bit more. We get a whole lot more. But first things first.
If you are like me you probably have noticed a claim being repeated over and over again, like a steady drumbeat: that Americans spend more, but get less care. The latest, from the Commonwealth Fund (CWF), is published in Health Affairs. According to the journal’s press release:
American doctors are significantly behind many of their counterparts elsewhere in providing access to high-quality care and use of health information technology.
According to CWF, U.S. physicians are worse than those other developed countries at providing after-hours care — leaving no choice but the emergency room. Far more than in other countries, U.S. patients have difficulty paying for medications and care and U.S. doctors are more likely to be hampered by insurance coverage restrictions.
“Our weak primary care system puts patients at risk and results in poor health outcomes and higher costs,” CWF president Karen Davis told Reuters. Other countries have solved problems the United States is still struggling to conquer, she said. “U.S. primary care lags behind care in other countries on key measures,” said a Health Affairs press announcement.
All this had me in a real funk until I discovered through my own prying — and without the aid of any press release — an article in THE VERY SAME JOURNAL that reported on the care actual patients actually receive. You can’t imagine how surprised I was.
Continue reading Americans Get More Mammograms, Colonoscopies, etc. than Europeans
Health Reform Policy Update
Podesta (video): Tax pot to pay for health care.
Baucus bill will require hospitals to list “standard charges for items and services.” Problem: Standard charges are fiction.
WellPoint study reinforces prior findings: Health reform will push up premiums.
Health Care Cost: $8,160 per Person
That's $32,640 for a family of four, according to the latest Health and Human Services report. But average family medical bills are nowhere near that amount. Why? Because most of these costs are hidden. About half is hidden in the taxes you pay.
The burden of health care will become even more disguised if the Commonwealth Foundation and health advisors to Barack Obama have their way. They want to increase the hidden (tax) burden in order to limit the visible expense to no more than 10% of income [see here].
Of course, they have it exactly backwards. We should limit everyone's tax burden to no more than 10% of income and let people have direct control of everything else.
Five Bad Ideas from Commonwealth, Part II
I've never met anyone who would like to forgo his private health insurance for enrollment in Medicaid. Yet this is what many mainstream health policy wonks and most left-of-center health proposals have in mind for the less fortunate. A Commonwealth Fund publication makes five policy proposals. I have already discussed three of them here. The remaining two are:
- Enroll in Medicaid laid off workers who are ineligible to pay premiums to remain in a previous employer's health plan.
- More ambitiously, expand Medicaid to everyone with incomes below 150% of the poverty level.
Is this the way you want your tax dollars spent? Continue reading Five Bad Ideas from Commonwealth, Part II
Five Bad Ideas From Commonwealth, Part I
When the occasion arises for [passage deleted by the NCPA's internal editorial censor], our friends at the Commonwealth Fund rarely disappoint. A new publication recommends five ideas, all designed to keep laid off workers in their former employer's plan or to enroll them in Medicaid. Neither option is what people want or need.
Three of the recommendations (some versions of which are likely to be included in the final economic stimulus package) are as follows:
- Extend from 18 to 24 months the period in which people can remain in their former employer's health plan by paying the full premium plus 2%.
- Provide a government subsidy for such options equal to $342 per month (individuals) or $907 per month (families).
- Let Medicaid top up the subsidy for low-income families, bringing the total government contribution to $392 per month (individual) or $1,057 per month (family).
Ask yourself this question: If you had billions of dollars for health insurance subsidies, is that the way you would spend it? Continue reading Five Bad Ideas From Commonwealth, Part I
Commonwealth Votes Early ― for Obama
After noting that its own plan (cost = $163 billion in 2008) "is similar to Obama's proposal," the Commonwealth Fund has done a side-by-side of the McCain and Obama health plans….and…..(are you ready?)….it likes Obama's better. The report:
- Presents no new research, but instead cuts and pastes from other studies.
- Cherry picks the evidence – choosing to report only on what's good for Obama and bad for McCain, including ignoring a University of Minnesota economists' finding that the McCain plan would cut the number of uninsured in half.
- Neglects to say that the Obama plan is completely pie-in-the-sky, with virtually no funding source now that Obama has pledged a maximum tax rate of 20% on capital gains and dividends and no payroll tax on the rich for the next decade.
- Neglects to say that the McCain plan is designed to be revenue neutral over 10 years (no need to raise taxes) but will probably fall short if it cuts the number of uninsured in half.