Evidence of Extreme Inefficiencies in the Health Care Industry

Sarah Kliff: “A lipid panel is one of the most basic blood tests in modern medicine … And that all makes it a bit baffling why, in California, a lipid panel can cost anywhere between $10 and $10,000. In either case, it is the exact same test.”

“For this research, published in August in the British Medical Journal, [researchers] compiled reams of data about how much more than 100 hospitals charged for basic blood work. The prices these facilities charged consumers were all over the map.”

“The charge for a lipid panel ranged from $10 to $10,169. Hospital prices for a basic metabolic panel (which doctors use to measure the body’s metabolism) were $35 at one facility — and $7,303 at another.”

“For every blood test that the researchers looked at, they found pretty giant variation:”

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What does this tell us about American health care? “For one, there’s not much price transparency: it’s really hard to know whether one hospital is charging $10 or $10,169 because prices are rarely listed.”


Which States Will Be Hardest Hit if SCOTUS Guts Subsidies?

Wall Street Journal: “Florida, North Carolina and Texas would be among the states hardest hit if their health-insurance subsidies are struck down by the Supreme Court. Those states had the highest number of consumers who were eligible for tax credits when selecting a plan on the federal website, government data show.”

“Affordable Care Act enrollment figures released Tuesday give the most up-to-date snapshot of which states would bear the brunt of any loss of subsidies.”

“In Florida, about 1.6 million people who picked a plan on the federal site were eligible for financial assistance, according to the new report. In Texas, more than one million were eligible; in North Carolina, more than 550,000; and in Pennsylvania, more than 430,000.”

7.7 Million Will Qualify for Obamacare Subsidies

The Hill: “Nearly nine in 10 people who signed up for healthcare from the federal government this year qualify for subsidies, the Obama administration announced Tuesday.”

“A total of 7.7 million people would receive subsidies this year in the roughly three-dozen states using – a figure that has held steady since ObamaCare’s first year.”

“The Obama administration touted the figure Tuesday to show that the vast majority of people in states using the federal exchange rely on subsidies as the Supreme Court weighs a case that could eliminate them.”

“‘These numbers show just how important the tax credits are to millions of Americans and to the insurance markets in those states,’ said Health and Human Services Secretary Sylvia Mathews Burwell, pointing to states like Texas, Florida and North Carolina.”

A Growing Fear of a Massive Healthcare Meltdown

The Hill: “Republicans are under pressure to prove they can avert a massive healthcare meltdown if the party wins its latest ObamaCare battle in the Supreme Court this spring.”

“While top Republicans in the House and Senate said this week that they are nearing a consensus on their efforts to create a back-up plan for the subsidies, almost no details have been shared about the half-dozen plans unveiled in the last two weeks. Most of the proposals are drawing criticism from their fellow conservatives behind the scenes.”

“’It’s a couple lines in an op-ed. Who knows what it really means? In some of those, they may not know, frankly,’ said one conservative strategist and former Hill healthcare staffer.

“Creating even a temporary solution for ObamaCare subsidies is a huge dilemma for the GOP-controlled Congress. Some Republicans have even said, albeit quietly, that the party could be better off if the administration’s policy survives the Supreme Court challenge.”

“’Then we won’t be put into a really difficult spot and can move on. There is something really appealing about that,’ one GOP Senate aide said.”

An Increase in Vaccine Skeptics?

Gallup: “A slight majority of Americans, 54%, say it is extremely important that parents get their children vaccinated, down from the 64% who held this belief 14 years ago. Another 30% call it ‘very important’ — unchanged from 2001. The rest, 15%, consider it “‘omewhat,’ ‘not very’ or ‘not at all important,’ up from 2001.”

Trend: How important is it that parents get their children vaccinated -- extremely important, very important, somewhat important, not very important, or not at all important?

“The discussion of vaccine disadvantages may be having some effect, as the percentage who say vaccines are extremely important is down slightly. Additionally, a small segment of the population remains skeptical about the benefits or safety of vaccines — including 9% who say vaccines are more harmful than the diseases they are designed to protect, and 6% who say certain vaccines can cause autism.”

In a related story, the Seattle Times reports that “new research from Washington State University finds that scare tactics aimed at vaccine skeptics may actually make the problem worse, not better.”

“Emotional appeals about the health risks of skipping shots and heart-tugging photos of unvaccinated kids sick with measles or whooping cough appear to backfire among those most suspicious of medical experts.”

Obamacare Enrollment Nearing 12 Million

Huffington Post: “Close to 12 million people are covered by health insurance plans purchased from an Obamacare exchange, Health and Human Services Secretary Sylvia Mathews Burwell said at the White House Monday. More than half of these enrollees are new to the program.”

“The enrollment total surpasses the Department of Health and Human Services’ projections, but is lower than what the Congressional Budget Office expected.”

“‘Nearly 11.7 million Americans signed up or were re-enrolled through the marketplace as of Feb. 22,’ Burwell said. ‘We are finally moving the needle on reducing the number of uninsured.'”

A Drop in Obamacare’s Price Tag

National Journal: “Obamacare’s insurance subsidies will cost $200 billion less than expected, the Congressional Budget Office estimated Monday.”

“CBO projected that the government would spend $849 billion on the subsidies over the next 10 years, down from its January estimate of $1.1 trillion. Why? The big reason is that health insurance premiums are expected to increase at a much slower rate than had been anticipated.”

Margot Sanger-Katz: “The revisions reflect growing evidence that health care spending in the country — which has traditionally grown much more quickly than the overall economy — is entering a new, more moderate era. It is still rising, but not very much any more.”

“That could eventually be not only a boon for consumers, but it could also have big implications for the federal budget: If the Congressional Budget Office is right, the amount the federal government pays for health insurance in the coming years will be hundreds of billions of dollars lower than it recently forecast, meaning a much smaller federal deficit.”

“The change, of course, means that the health reform law is now forecast to cost the government substantially less than originally expected. The net savings to the program could be about $142 billion over 10 years.”

What Would Ending Obamacare Subsidies Look Like?

New York Times Editorial Board: “If the Supreme Court rules that no federal tax credit subsidies can be provided to Americans buying insurance on federal health exchanges in 34 states, the economic effects could be devastating.”

“The Obama administration has said that it has no backup plan to cope with the loss of subsidies. The congressional Republicans who want to destroy Obamacare offer no meaningful plans to deal with the consequences.”

“Beyond economic damage, the lack of insurance almost always means that sick people get less care, with greater risk of death.”

“The political opponents of Obamacare seem to think this fight is about ideology. What they refuse to acknowledge is the human toll and the economic devastation that destroying the heart of health reform will bring about.”

Republicans Mull Over Obamcare-Lite

Jonathan Weisman: “As the Supreme Court deliberates over the law’s fate, the search for a replacement by Republican lawmakers is finally gaining momentum.”

“The prospects of legal victory have also raised practical and political fears that Republicans will take the blame for the health care crisis that would follow. A legislative scramble is underway.”

Aides to senior House Republicans said Thursday that committee chairmen were meeting now to decide whether a budget plan — due out the week of March 16 — will include parliamentary language, known as reconciliation instructions, that would allow much of a Republican health care plan to pass the filibuster-prone Senate with a simple majority.

Uwe Reinhardt: “But these plans essentially want to do away with the employer mandate, modify the individual mandate … and we could go into a death spiral in the individual insurance market because healthy people won’t buy it. The risk pool will keep getting sicker and sicker.”

Greg Sargent also expresses skepticism about a Republican alternative: “Both plans were devoid of specifics. And what’s more, during oral arguments, the idea (floated by Scalia) that Congress might provide such a contingency plan was basically laughed out of the Court. Understandably so: No one who watched the chaos around Homeland Security funding could possibly imagine Congress producing any such plan.”

Jonathan Weisman: “Republicans hope to keep health care a front-burner issue — and turn the 2016 election into a choice between Mr. Obama’s health care program and a detailed, conservative alternative.”

The High Cost of Unplanned Pregnancies

Christopher Ingraham: “Unintended pregnancies cost American taxpayers $21 billion each year, according to a new analysis released by the Guttmacher Institute. That averages out to a cost of about $366 per every woman of childbearing age in the U.S. Overall, more than half of U.S. pregnancies are unintended, and roughly 1-in-20 American women of reproductive age have an unplanned pregnancy each year.”

“Both the rate and cost of unplanned birth vary considerably by state. As a percent of all births, unplanned births ranged from 31.8 percent in New Hampshire to 56.8 percent in Mississippi. Overall, states in New England and on the West coast had the lowest rates of unplanned birth, while Southern states had the highest.”

“In some states — Georgia, Mississippi and Oklahoma — more than 80 percent of unplanned births were paid for by public dollars.”

“If these numbers seem high, they could be a lot higher. Current investments in family planning services, like contraception, family visits and STD testing, save taxpayers $15.8 billion and prevent 760,000 abortions each year, according to a 2014 analysis in the Milbank Quarterly. Guttmacher estimates that expanding these services further could cut the cost of unintended pregnancies by an additional $15 billion.”

Obamacare Subsidies Case: It’s Not All Doom and Gloom

Margot Sanger-Katz: “The case before the Supreme Court this week will not wipe Obamacare off the books.”

“Unlike the case the court considered in 2012, which could have erased the Affordable Care Act entirely, this one concerns the application of only one provision of the law, and only to certain states. A ruling for the plaintiffs in the case, King v. Burwell, would carry huge consequences in many states, but 15 million of the people estimated to get insurance under the law would still get it, according to an Urban Institute estimate.”

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“The list of policy changes that would be untouched by any legal ruling is very long.”

“Even the law’s expansion of insurance coverage to the uninsured — the piece directly challenged by the lawsuit — will not completely evaporate.”

“Even in the worst case for Obamacare, with a win for the King plaintiffs followed by no congressional, regulatory or state policy action, the law would still reduce the number of uninsured Americans by about two-thirds of what it would accomplish unchallenged.”