Insurance

April 7, 2020

With U.S. joblessness spiking, Obamacare once again stays front and center

With 10 million Americans suddenly jobless due to the Covid-19 pandemic, a smack in the face may be coming to partisans who have spent a decade assailing the Affordable Care Act, the landmark measure that offers people help with their health insurance.

Obamacare, studies have shown, already has helped to reduce the ranks of the uninsured by 20 million.

It may play a significant role now in helping the unemployed, too many of whom not only lost their steady income but also their employer-provided health insurance. The preponderance of Americans — more than 150 million of us — get our health coverage through our workplaces.

March 31, 2020

With pandemic straining U.S. health care, what did ACA get done in a decade?

by Patrick A. Malone

As the coronavirus pandemic causes Americans sky-high anxiety about their health and how they might access and afford extensive medical treatment if infected, the nation slid with only modest public attention into the second decade of one of its landmark health care experiments — the Affordable Care Act.

Obamacare became the law of the land on March 23, 2010, when the 45^th president signed the 2,000-page bill for which he had campaigned long and hard. Republicans in the White House and Congress have attacked the ACA relentlessly ever since.

Researchers have spent a decade scrutinizing the ambitious act’s outcomes with zeal. The New York Times summarized some of the independent, nonpartisan evaluations, finding key areas that the public may wish to recognize in how Obamacare changed the complex U.S. health care system, on which Americans spend more than $3.5 trillion annually. In brief, as a result of the ACA, the newspaper reported (with boldface emphases mine):

March 18, 2020

Don’t fall for malpractice malarkey: A briefing details medicine’s many harms

by Patrick A. Malone

Cold, hard facts — not hunches, arguments, or theories — matter most when tough health care decisions must be made. Americans have been reminded of this by painful headlines on the opioid and overdose crisis, the rise of lung injuries and deaths due to vaping, and, yes, now the rapid spread of a new coronavirus. Doctors, hospitals, insurers, Big Pharma, and other major parties in the U.S. health care system aren’t always as candid as they need to be, especially in disclosing how they harm and even kill patients.

That’s a truth (with a small “t”) that readers can discover quickly in the Center for Justice and Democracy’s latest edition of its annual “Briefing Book: Medical Malpractice by the Numbers.” The center, at New York Law School, provides evidence about a field that has become the bogeyman for politicians, policy makers, and medical practitioners eager to hide egregious errors with extreme counter factual assertions.

Malpractice cases in the civil justice system provide important insights and checks on how doctors and hospitals care for the sick, injured, and vulnerable.

March 11, 2020

High court, for third time, takes up a GOP effort to kill popular Obamacare

by Patrick A. Malone

Timing may be everything in life and the law: The U.S. Supreme Court — while giving the Trump Administration a small political break for now — may give the president’s fall reelection campaign plenty of upset still. Whether the court will give the country a health care disaster is another question.

The high court, acting on a request by Democratic state attorneys general, has agreed once more to consider the fate of the Affordable Care Act, aka Obamacare, on an expedited basis, even before a federal trial court and appellate judges finish their consideration of the latest legal challenge to the ACA.

This will be the third time the justices have taken up an ACA lawsuit, with this challenge representing not only another Republican attack on government-assisted health insurance for the poor, working poor, and middle class. This also may be a legal extreme for questioning Obamacare, as the New York Times reported:

February 21, 2020

Will voters buy $1 trillion in U.S. health care cuts, as ’21 budget proposes?

by Patrick A. Malone

President Trump’s 2021 budget proposal is thicker than an old-fashioned phone book. Lots of the document became little more than chaff the instant it was printed, due to the likelihood of big changes in the spending plan by congressional Democrats and lawmakers of the president’s own party.

The fiscal wish list, unsurprising at its contents were, may raise a big political question: How, with evidence like this, does the leader of the free world campaign on a counter-factual argument that his policies and practices protect and advance the health of the American people — a prime concern, pollsters say, of the voting public?

The $4.8 trillion Trump budget, for example, proposes to slash the Medicaid and food stamp programs by $1 trillion over a decade, with presidential critics noting the various, sometimes bureaucratic means to do so, ultimately, will reduce desperately needed social supports and throw millions of vulnerable Americans off aids for their health care. (Federal courts, including the appellate panel overseeing Arkansas, have rejected the latest way the administration and GOP states have sought to reduce Medicaid costs by imposing draconian work, reporting, and qualifying rules.)

February 6, 2020

With U.S. health care costs sky-high, why gouge programs to help vulnerable?

by Patrick A. Malone

If rigorous research drove policy making in a more optimal fashion than it now apparently does, how might politicians and regulators react to findings like these:

The well-respected Commonwealth Fund has revisited earlier studies, finding anew that the United States “spends more on health care as a share of the economy — nearly twice as much as the average [industrialized Western European] country — yet has the lowest life expectancy and highest suicide rates among the 11 nations. The U.S. has the highest chronic disease burden and an obesity rate that is two times higher than the average [in comparable Western industrialized and European countries.] Americans had fewer physician visits than peers in most countries, which may be related to a low supply of physicians in the U.S. Americans use some expensive technologies, such as MRIs, and specialized procedures, such as hip replacements, more often than our peers. Compared to peer nations, the U.S. has among the highest number of hospitalizations from preventable causes and the highest rate of avoidable deaths.”

Even while spending more than any other nation on health care and getting poorer outcomes, which Americans bear the heaviest burdens of the system’s costs? Here’s what researchers at the nonpartisan and independent RAND Corporation have found in a newly published study:

February 4, 2020

Calif. wins $344M mesh case, but $215M may not settle harmed gymnasts’ suit

by Patrick A. Malone

The public’s health and safety sometimes find protections in the civil justice system and sometimes under regulators’ threat. Here’s hoping that whatever means are required, just and proper outcomes result.

For women, two separate suits have sought a modicum of justice for sexual abuse of talented young gymnasts by a predatory caregiver and damages tied to the maker of what has become a notorious material for supposed surgical repairs in the pelvic area.

For parents, the positive but potentially inconvenient recent news is that regulators finally have cracked down on risky baby sleepers, ordering the recall of tens of thousands more of them.

January 20, 2020

On MLK Day, never forget his view: ‘Injustice in health is the most shocking …’

by Patrick A. Malone

With the nation taking a holiday to celebrate the remarkable life of the Rev. Dr. Martin Luther King and his pioneering push for Americans’ civil rights, it may be worth remembering that his far-reaching visions of equality and social justice were deeply unpopular in their time, as was he.

King infuriated many, including in medicine and health care, observing, for example, that:

“Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death.”

January 14, 2020

Here’s a cause for anger and despair: We’re all forced to pay $8,000 ‘health tax’

by Patrick A. Malone

Even as economic inequity and inequality fuel a nationwide plague of “deaths of despair,” a runaway and inefficient health system hits Americans hard in their pocketbooks, in effect imposing an $8,000 annual tax on every household, a pair of leading economists say.

The crushing cost of the U.S. health system, exceeding $1 trillion a year, forces all Americans to pay this “tribute,” as if it were going to a foreign power, except this is a toll on themselves that we tolerate and allow, say Anne Case and Angus Deaton. The Princeton economists have reached this conclusion, as part of their research for their upcoming book, “Deaths of Despair and the Future of Capitalism.”

Case told economists at a San Diego conference: “A few people are getting very rich at the expense of the rest of us.”

January 8, 2020

Hospital mergers and acquisitions aren’t great for patients’ care, study finds

by Patrick A. Malone

Big hospitals keep getting bigger. But, contrary to what the suit-wearing MBAs may claim, the rising number of institutional mergers and acquisitions isn’t necessarily better for patients and their care.

At hospitals subjected to corporate wheeling and dealing, the quality of care got worse, or, at best, it stayed the same and didn’t improve, a new study in the New England Journal of Medicine reported.

Researchers scrutinized federal data “from 2007 through 2016 on performance on four measures of quality of care … and data on hospital mergers and acquisitions occurring from 2009 through 2013,” they said. These measures, the Wall Street Journal reported, included: patient satisfaction; deaths within a month of entering the hospital; return trips to the hospital within a month of leaving; and how often some heart, pneumonia, and surgery patients got recommended care. They looked at 246 hospitals involved in M&A activity, controlling their findings with data from 1,986 institutions not similarly affected.