Source: Kaiser Family Foundation Commission on Medicaid and the Uninsured, January 28, 2008
From press release:
New reports released today by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) describe aggressive efforts by states in the past year and a half to expand coverage to low-income children and their families, but the actions may be curtailed as a deteriorating economic climate and new limits on federal assistance take effect.
A downturn in the economy, the federal failure to reauthorize the State Children’s Health Insurance Program (SCHIP) and new federal rules affecting Medicaid and SCHIP eligibility all suggest that the recent period of aggressive expansion of coverage by states may be over. This is the conclusion based on a series of new studies by the KCMU, including a 50-state survey of eligibility and enrollment rules in Medicaid and SCHIP for children and families, interviews with Medicaid directors in ten states representing all regions of the country, and recent studies of enrollment in Medicaid and SCHIP.
● Health Coverage for Children and Families in Medicaid and SCHIP: State Efforts Face New Hurdles
● Current Issues in Medicaid: A Mid-FY2008 Update Based on a Discussion with Leading Medicaid Directors
● SCHIP Enrollment in June 2007: An Update on Current Enrollment and SCHIP Policy Directions
● Medicaid Enrollment in 50 States: December 2006 Update
● State Children’s Health Insurance Program (SCHIP): Reauthorization History
Source: Katherine K. Shea, Sara R. Collins, and Karen Davis, Commonwealth Fund, January 2008
From the overview:
The 13th Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey asked a diverse group of experts for their perspective on the health care reform proposals of the 2008 presidential candidates. Survey participants strongly support reform proposals that applied a mixed private-public market approach. Additional favored policy strategies for reform include a requirement for individuals to obtain health insurance, new private market regulations, and a requirement for employers to provide coverage or contribute to a coverage fund. Alternatively, respondents think proposals that focus on tax incentives to purchase individual private health insurance are not an effective method for controlling the rising costs of health care or achieving universal coverage. Health care opinion leaders call for the next president to simultaneously address universal coverage and quality, efficiency, and cost containment policies to move our health care system toward high performance.
● Reform Is No ‘Either-Or’: We Must Fix the Payment System Along with Access
Darrell Kirch, M.D, president and chief executive officer of the Association of American Medical Colleges
● Tough Choices Ahead: Candidates Ignore Pain of Needed Cuts to Health Costs
Dallas L. Salisbury, president and CEO of the Employee Benefit Research Institute and a member of The Commonwealth Fund Commission on a High Performance Health System
● Data Brief
Source: Jill Eden, Ben Wheatley, Barbara McNeil, and Harold Sox, Institute of Medicine/National Academies Press, 2008
From press release:
Solutions to some of the nation’s most pressing health problems hinge on the ability to identify which diagnostic, treatment, and prevention services work best for various patients and circumstances. Spending on ineffective care contributes to rising health costs and insurance premiums. Variations in how health care providers treat the same conditions reflect uncertainty and disagreement about what the standards for clinical practice should be. Patients and insurers cannot always be confident that health professionals are delivering the most effective care.
A new report from the Institute of Medicine offers a blueprint for a national program to assess the effectiveness of clinical services and to provide credible, unbiased information about what really works in health care. The report recommends that Congress direct the U.S. Department of Health and Human Services to establish a program with the authority, expertise, and resources necessary to set priorities for evaluating clinical services and to conduct systematic reviews of the evidence. This program would also be responsible for developing and promoting rigorous standards for clinical practice guidelines, which could help minimize the use of questionable services and target services to the patients most likely to benefit, said the committee that wrote the report.
● Report Brief
● Report Summary
Source: Robert J. Blendon, Drew E. Altman, Claudia Deane, John M. Benson, Mollyann Brodie, and Tami Buhr, New England Journal of Medicine, Vol. 358 no. 4, January 24, 2008
For the first time since 1928, neither the Democratic nor the Republican party has an incumbent president or vice president among the candidates in its field, so both primaries are particularly open to all challengers and very competitive. In this article, we report findings from public opinion polls that assessed how health care issues might affect voters’ choices in the 2008 presidential primaries.
This article examines the role of health care in the 2008 presidential primary elections in two ways. First, it draws on data from multiple opinion surveys to better understand how Republicans and Democrats differ in their values, beliefs, and attitudes with regard to health care and health care policy. Second, it focuses particularly on voters who say they are going to participate in the early Democratic and Republican primaries and caucuses, looking at differences in their health care preferences and the extent to which the health care issue is affecting their vote.
Finally, we explore how the differences in views and desires concerning health care among Republicans and Democrats are reflected in the kinds of proposals being put forward by the major candidates, and we assess the ways in which these divisions might affect the general-election campaign.
The Amazing Noncollapsing U.S. Health Care System — Is Reform Finally at Hand?
Source: Commonwealth Fund, January 15, 2008
Eighty-one percent of Americans believe that in order to help reach the goal of health insurance for all, employers should either provide health insurance to their workers or contribute to the cost of their coverage, according to survey data released today by The Commonwealth Fund. Nearly nine of 10 (88%) Democrats, nearly three-quarters (73%) of Republicans, and nearly four of five (79%) Independents would support such an employer “play or pay” requirement.
In addition, the survey, conducted between June and October of 2007, found that a wide majority of Democratic (67%), Republican (66%), and Independent (70%) voters believe that health insurance costs should be shared by individuals, employers and the government. Further, a majority of the public was strongly or somewhat in favor of requiring individuals to have health insurance coverage–with government help for those who cannot afford it. Sixty-eight percent of Americans favor such a proposal, with 80 percent of Democrats in support, and more than half of Republicans (52%) and two-thirds of Independents (68%) in favor, according to a report on the survey findings, The Public’s Views on Health Care Reform in the 2008 Presidential Election.
+ Issue Brief
Envisioning the Future: The 2008 Presidential Candidates’ Health Care Reform Proposals
Sara R. Collins and Jennifer L. Kriss, Commonwealth Fund, January 2008
Source: Linda J. Blumberg, John Holahan, Urban Institute, January 29, 2008
In this brief we conclude that, absent a single payer system, it is not possible to achieve universal coverage without an individual mandate. The evidence is strong that voluntary measures alone would leave large numbers of people uninsured. Voluntary measures would tend to enroll disproportionate numbers of individuals with higher cost health problems, creating high premiums and instability in the insurance pools in which they are enrolled, unless further significant government subsidization is provided. The government would also have difficulty redirecting current spending on the uninsured to offset some of the cost associated with a new program without universal coverage.
Source: Jessica P. Vistnes and Barbara S. Schone, Health Affairs, Vol. 27 no. 1, 2008
Using data from the Medical Expenditure Panel Surveys for 1997 and 2005, spanning the eight-year period after enactment of the State Children’s Health Insurance Program (SCHIP), we examine whether the composition of insurance coverage has changed for working families. Public coverage has played an increasingly important role for working families with children. For families without access to job-based insurance, roughly two-thirds of single-parent and over half of two-parent families with children had at least one family member covered by public insurance in 2005. Among families with access to job-based insurance, nearly half of minority single-parent families had at least one family member with public coverage.
Source: Debra J. Lipson, James M. Verdier, and Lynn Quincy, Mathematica Policy Research, Inc., December 2007
In this evaluation of Maine’s health reform plan, researchers examine interim indicators of progress after two years of program implementation. Since enacting comprehensive health care reform in 2003, the effort has helped expand coverage for low- and moderate-income individuals. Yet by late 2006, the initiatives had enrolled less than 10 percent of previously uninsured residents.
Researchers identify both the successes and challenges of the program. They also consider how Maine’s experiences could serve as a lesson for other states which are exploring initiatives to expand access and provide affordable insurance.
Source: The Commonwealth Fund
U.S. health spending is projected to increase from 16 percent of GDP in 2006 to 20 percent in 2016–from $2 trillion to $4 trillion. Meanwhile, the number of uninsured Americans continues to rise. In this report prepared for The Commonwealth Fund Commission on a High Performance Health System, the authors examine 15 federal policy options that have the potential to lower health spending relative to projected trends. They include policies that would: produce and use better information for health care decision-making, promote health and enhance disease prevention, align financial incentives with quality and efficiency, and correct price signals in health care markets. Combining policies would capture the synergistic benefits of individual changes. If implemented along with universal health insurance, a combination of selected options could save $1.5 trillion in national health expenditures over 10 years, while also improving value in terms of access, quality, and health care outcomes.
Source: New Labor Forum, Fall 2007
By Jacob Hacker
America’s $2.2-trillion-a-year medical complex is enormously wasteful, ill-targeted, inefficient, and unfair. The best medical care is extremely good, but the Rube Goldberg system through which that care is financed is extremely bad–and crumbling. One out of three non-elderly Americans spend some time without health insurance every two years, and the majority of those remain uninsured for more than nine months. Meanwhile, runaway health costs have become an increasingly grave threat, not just to the security of family finances, but also to corporate America’s bottom line. The United States spends much more as a share of its economy on health care than any other nation, and yet all this spending has failed to buy Americans the one thing that health insurance is supposed to provide: health security.