"A Handshake That Made Health Care History"--A Boston Globe Expose: A "Quiet Deal" Between Mass Blue Cross and Boston's Most Powerful Hospitals

In a lengthy expose entitled, "A Hand Shake That Made Health Care History," the Boston Globe details what it called a "gentleman's agreement that accelerated a health care cost crisis" in Massachusetts. The reported deal was between Partners Health Care, the state's biggest health care provider, and Massachusetts Blue Cross, the largest state insurer.The article charges that the agreement all but

How Will the Senate Bill Impact the Insurance Companies and Their Customers?

How will the Senate bill impact health insurance companies and their customers?Even better, how will it impact a not-for-profit health plan--one with a reputation for being a "good guy" that continually wins the country's top awards for member services and with historic profits of less than 1% of premium? And, one that is operating in Massachusetts--a market that has already been through much of

CBO to Health Care Reformers: Naive Policy Makers Need Not Apply

The Congressional Budget Office (CBO) has released two comprehensive papers detailing the policy and financial options for health care reform: Key Issues in Analyzing Major Health Insurance Proposals and Budget Options, Volume I: Health Care.I can't overestimate the importance of these documents to health care reform.I recently did a post as sort of an open letter to the CBO: To the Congressional

The Senate Bill--Wall Street Likes It and the House Will Have To

In morning trading HMO stocks are once again hitting 52-week highs with each of the major publicly traded plans up 3% to 6% from their Friday gains.Hospitals and pharmaceutical companies are also doing pretty well.Liberals have been talking all weekend long about having to make the Senate bill better—and more like the House bill. That just won’t happen. Reid’s 60-vote majority is held together

Conservatives Need to Be Part of Health care Reform

Stuart Butler, Vice President of Domestic Policy at the conservative Heritage Foundation has an op-ed in Thursday’s Washington Times, “Four Steps Can Heal Health Care.”He makes some very valuable points and proposes four steps toward reforming the health care system most people—liberals and conservatives—could agree on:Making sure every working family has access to an affordable private health

“Irrational Exuberance” and Health Care Reform—Slow Down!!!

I think Pete Stark has it right. In a story in The Hill, Stark calls for waiting until later in 2009 or 2010 to move on a big health care reform proposal. The House Ways and Means Health Subcommittee Chair also points out that there are a number of "deferred maintenance" issues that will need to be dealt with sooner—SCHIP renewal, the upcoming Medicare physician fee cuts, and the pending health

"Expanding Coverage Without Increasing Health Care Spending: Dartmouth Institute White Paper Recommends Course for the Obama Administration"

Once again the Dartmouth Institute for Health Policy and Clinical Practice has provided a valuable contribution to our health care reform discussion with their new paper, "Improving Quality and Curbing Health Care Spending: Opportunities for the Congress and the Obama Administration."In my mind the authors made two critical points:We can insure everyone without dramatically increasing national

Who's The Guy Sitting Next to You? The Obama Health Care Reform Parties and Unexpected Guests

The incoming Obama administration is getting a quick start toward health care reform.By the end of the year, they anticipate having thousands of health care discussions in homes, businesses, coffee shops, and the like.About everyone, including the Obama health care team, believe Hillary Clinton's 1993 top-down health care reform process was a big mistake. The new folks don’t intend to make that

Oh, Ease Up on Joe Already

The Democratic rhetoric coming from Capitol Hill today beating on Joe Lieberman is, in the least, disingenuous.The public option has not been tenable for months. It was not just Lieberman that has been against it in all forms--robust Medicare-like or the neutered variety in the House and Senate bills.All of the liberals claiming they weren't going to vote for a health bill without a public option

The Democrats Had Better Hope the Supreme Court Overturns the Individual Mandate Before the Middle Class Understands How Bad It Is For Them

This post first appeared as a column at Kaiser Health News

Is The Individual Mandate Really A Lynchpin In The New Health Law?

If the Supreme Court does rule the individual mandate unconstitutional will it really bring down the whole law?

I don't see it.

First, the individual mandate isn't even close to what it has been made to be -- a provision that would protect the integrity of the health

The Medicare Buy-In Is Dead--The Liberals Are Now the Swing Votes in Health Care

The Medicare buy-in idea is dead. After Democratic Congressman Weiner's candid comment, “Never mind the camel’s nose, we’ve got his head and neck in the tent," no senator from the likes of Arkansas or Indiana is going to vote for this.Add to that yesterday's critical Washington Post editorial and the sharp response from the various doc and hospital lobbies and this was dead before Reid's request

How Can We Accomplish Health Care Reform If Everyone Ends Up Getting More?

I doubt anyone would disagree with the statement that America’s health care costs are too high, continue to grow at an unsustainable rate, and reform is critical to control costs, get everyone covered, and improve quality.In the wake of the election, I see one positive and magnanimous press release after another coming from the health care special interests. The press is full of daily stories

Back to the Future—Biggest Health Plans Reported to be Building Their Own Political Coalition

I had a real sense of déjà vu this morning reading Bara Vaida’s story in Kaiser Health News:Five of the nation's largest health insurance companies are taking a key step toward building their own inside-the-Beltway coalition to influence implementation of the new health law and congressional efforts to change it. The companies – Aetna, Cigna, Humana, UnitedHealthcare and Wellpoint – are shopping

Selling Insurance Across State Lines--Now the Dems Are Pushing the Idea--Why It Won't Work

A favorite Republican health care soundbite calls for making the health insurance system more efficient by letting health plans sell across state lines.Now Democrats are jumping on that idea. The latest public option idea would have the Office of Personnel Management (OPM) contract with national not-for-profit health plans and introduce those plans into local insurance exchanges--that would be

Liberal Demands Over Giving Up the Public Option Threaten Health Care Deals

I actually feel for Harry Reid this morning.He was on his way. He had mastered an incredibly fine balance in his health care bill.No it wasn’t real health care reform and it wasn’t going to bend any curves but the Dems long ago gave up on that looking for one big political “W” instead.The liberals were finally backing off on the public option there never were the votes for. But even the “neutered

The Latest Version of the Public Option—The Democrats Could Have Saved Us Lot of Time If This is What They Call a “Public Option”

If the latest version of the public option is something that will give its proponents reason to argue they still have a way to "make the health insurance market much more competitive," then a motor scooter is a Ferrari.The details are still fuzzy but the word is that senators are working toward a compromise over the controversial public option that would create something that:Would be run by the

What Would Happen If You Were To Pass a Big Health Care Bill Without Bipartisan Support?

During the recent health care debate I heard many people on both sides of the debate worry out loud about passing a heath care bill that did not enjoy broad support.I guess this question is no longer a theoretical one.December will be a big month when it comes to seeing some of the fallout accruing from the very partisan passage of the Patient Protection and Affordable Care Act.First, the White

Good For Orszag--Budget Director Discusses Cost Containment in Dem Bills

I was encouraged by remarks White House Budget chief Peter Orszag made in Washington yesterday.There has been substantial debate in recent days about whether the pending House and Senate bills have the kind of robust cost containment we need to really "bend" any health care cost "curves."Readers of this blog know of my concern that these bills amount more to expensive entitlement expansions than

We Can Save 30% By Getting Rid of the Waste in the U.S. Health Care System—Sounds Like "Groundhog Day" To Me

As we begin the health care reform discussion in earnest, many are pointing out all of the waste in the system and the need to research what works best, provide the incentives to do it, manage the big spenders’ chronic care better, make better use of heath information technology, and encourage wellness and prevention.One of the disadvantages of being at this for more than 20 years is that I feel

There Are Four Health Insurance Renewal Cycles and Two Elections Between Now and 2014—Could be Sort of Like a “Death By a Thousand Cuts” for the Dems

The Congressional Budget Office (CBO) issued a report today saying that if the Reid bill becomes law the price of non group policies would be about 10 percent to 13 percent higher in 2016 than it would be under current law. The CBO projects that small group and large group premiums would be about the same in 2016 as they would have been anyway as the benefits of the bill would offset some of its