Health Care Reform

August 13, 2018

After feds bust U.S. rep for insider trading in Pharma stock, will Congress drain ethics swamp?

At a time when prescription drug prices keep skyrocketing and Americans pay hundreds of billions of dollars for medications that account for as much as 15 percent of all U.S. health care spending, federal law enforcers provided a rare and jarring sight with the public arrest of a congressman on charges he engaged in insider trading involving an Australian drug maker.

Chris Collins, a Republican who represents a western New York district and was among President Trump’s earliest and most vocal supporters in Congress, insists he committed no wrong. He says he will be exonerated, but he has pulled the plug on his plans to seek reelection in November.

The sordid details of his financial dealings, as laid out in news stories and a damning indictment, however, may keep front and center not only the charges against him but also troubling questions about members of Congress and their private investing, corporate board roles, and especially their tenacity as Big Pharma lapdogs, instead of being watchdogs on behalf of besieged, too often bankrupted American patient-consumers.

August 9, 2018

For sick seniors, hospitals and nursing homes can be nothing but bad news

by Patrick A. Malone

In many parts of the developing world, families play a big part in patients’ hospital care. They not only sit for long hours with loved ones, supporting and encouraging their recovery. They also may help with direct services, bathing and cleaning patients, tending to their beds and quarters, and even assisting with their medications and treatments.

Such attentiveness from loved ones— once common in this country, too — may be deemed by many now as quaint and unnecessary, what with the rise of big, shiny, expensive American hospitals.

But think again: As Paula Span reported in her New York Times column on “The New Old Age,” care-giving institutions across the country have become such stressful, disruptive places that seniors, especially, not only heal poorly in them but also may be launched into a downward cycle of repeat admissions.

August 8, 2018

Shift-and-shaft: Why is it always patients’ burden to hunt for affordable care?

by Patrick A. Malone

The health policy wonks and those who purport to “reform” the U.S. health care system may be long on academic and other fancy credentials. But they also persist in demonstrating they can be short on old-fashioned common sense, especially about the way most of us lead our lives.

That’s a point emphasized in a recent column in the evidence-based “Upshot” feature of the New York Times, written by Austin Frakt. He directs the Partnered Evidence-Based Policy Resource Center at the VA Boston Healthcare System and is an associate professor with Boston University’s School of Public Health and an adjunct associate professor with the Harvard T.H. Chan School of Public Health.

Frakt looked at some recent research to dissect a question that occupies many experts: Could Americans cut their health care costs by shopping around more for medical services? This is a fond notion held by a slice of health care “reformers,” whom Frankt proceeds to disabuse.

July 25, 2018

Medicaid costs soaring? Blame Big Pharma’s big-dollar state-level campaigns

by Patrick A. Malone

Uncle Sam long has allowed states to set the rules governing how Medicaid works, and a dozen or so of them have decided, with the purported goal of increased fiscal rectitude, to impose harsh rules to force poor, sick, disabled, and aged program participants to work more or to seek employment.

But taxpayers might be better served if the frugal-minded turned greater attention to Big Pharma’s insidious role at the state level in causing Medicaid costs to skyrocket, threatening budgets and creating conflicts in funding other public programs like education and transportation.

The Center for Public Integrity (CPI) and National Public Radio deserve praise for investigating how corruptive, drug-maker money has overwhelmed state officials’ efforts to corral soaring costs of prescription medications covered by Medicaid and governed by a patchwork of rules in each of the nation’s 50 states.

July 10, 2018

Summer’s discontent: Evidence defies partisans on ACA, Medicaid expansion

by Patrick A. Malone

The evidence accumulates that partisans’ persistent attacks on the Affordable Care Act and Medicaid run counter to their constituents’ needs and wishes, but will Republicans course-correct or will voters soon force them to?

It may be inconvenient in these polarized times for public policy to be rooted in research and fact, rather than bluster and shouting. But the New York Times and Washington Post have posted not one but several stories that raise questions about recent actions by the Trump Administration and the Republican-controlled Congress affecting health care access.

Aaron E. Carroll, a professor of pediatrics at Indiana University School of Medicine and health care policy analyst, wrote for the New York Times’ evidence-based “Upshot” column about research on the ACA-driven expansion of Medicaid. It has prompted publication, he reported of “77 studies, most of them quasi-experimental in design … They include 440 distinct analyses.” Of these works:

July 2, 2018

High-deductible nightmares: the health insurance crisis partisans ignore

by Patrick A. Malone

While political partisans pound without pause for extreme changes in the Affordable Care Act, Medicare, Medicaid, and other government programs that seek to assist the poor, sick, children, and others with access to health care, they’re ignoring the medical nightmare that’s afflicting ever-rising numbers of middle- and upper-class Americans who get their health coverage at work: high-deductible health insurance.

Families long have been staggering under sudden and sizable medical expenses they may be forced to bear because they need health insurance and only can afford their employers’ offerings by reducing their monthly premiums with high-deductible policies. They’re betting they won’t be hit with thousands of dollars in out-of-pocket medical costs.

They’re losing that wager. Often. A lot. And dealing with dire consequences. As Bloomberg News Service reported:

June 25, 2018

No summer break for partisans’ extreme attacks on health care access

by Patrick A. Malone

Americans who are poor, middle-class, chronically or mentally ill, disabled, frail, elderly and young — most of us, really — may need to keep our fingers crossed that the relentless attacks on health care access fail again.

Partisans who don’t get the concept of health care as a right have opened many fronts and are especially active of late, with proposed bureaucratic re-alignments of the federal government, promotion of “skinny” or junk health insurance plans, and efforts to slash support for public programs that boost the health of tens of millions through Medicaid, Medicare, food aid, and health coverage for kids of the working poor.

If you’re working and get your health insurance through your job, as most Americans do, you shouldn’t think that you and yours will be magically exempted from Republicans’ hammering at the U.S. health care system.

June 11, 2018

Will voters recall what Trump and GOP do on health, not just what they say?

by Patrick A. Malone

As voters make up their minds about this fall’s mid-term races, they may wish to burn into their memories how the Trump Administration has dealt, so far, and especially in recent days, with government social programs that have huge effects on Americans’ health and lives.

Take, for example, the late-week, late night announcement by the U.S. Department of Justice that it will decline to defend yet another part of the Affordable Care Act, as 19 states, most red and led by Texas, attack Obamacare in the courts. The legal aspects of this decision will keep lots of law degree holders and their kindred men and women in black robes arguing, heatedly, for a while. There also may be huge political smoke clouds.

But keep in mind this basic fact from the actions by the Justice Department led by Attorney General Jeff Sessions: The nation’s crack legal team is asserting that it is unconstitutional for the ACA to bar insurers from declining coverage due to preexisting conditions.

June 3, 2018

Virginia expands Medicaid coverage, as Obamacare foes lose another state

by Patrick A. Malone

Hundreds of thousands of poor, middle-class, old, sick, and young Virginians will get increased access to health care as the Commonwealth, joining 33 states and the District of Columbia, saw the crumbling of five years of fierce GOP-led opposition to an expansion of Medicaid under the Affordable Care Act, aka Obamacare.

Partisans, who reviled an enlarged role of the state in health care, got to pin a partisan fig leaf on the state’s move, by amending the social support program to force more recipients to work or show that they cannot, to receive Medicaid benefits.

Although neither the Trump Administration nor congressional Republicans are likely to heed it, Virginia and other states are sending a clear message that voters see health care as a right, not a privilege, and that voters will go to the polls to deal with those who claim to represent them but who make a near religion out of seeming to want to punish the sick and poor and to make costlier the already skyrocketing price of medical services.

May 18, 2018

Virginia, Maryland, and kids bear early brunt of partisan health care attacks

by Patrick A. Malone

As the nation churns toward the midterm elections, the Trump Administration has sent stark messages to voters about how they may wish to respond to Republicans’ unceasing attacks on health care and health insurance for the middle class and the poor.

The failed campaign to repeal and replace the Affordable Care Act, aka Obamacare, and the follow on steps, administratively and as part of the $1.5 trillion tax bill that benefited rich corporations and the wealthiest Americans, likely will hit Virginia and Maryland residents hard if they’re seeking health coverage under the ACA.

The two states are among the first to report insurers’ requested rate increases for 2019 — and the increases will be significant, reported Modern Health Care, a trade industry publication, which said: