Morning Briefing
Summaries of health policy coverage from major news organizations
Parsing Policy: Lessons On How Well Private Health Insurance Companies Manage Costs; Do We Really Want To Regulate Doctors' Decision Making Like This?
Private health insurers are punching bags of choice in the Democratic presidential primary. 鈥淭he insurance companies last year alone sucked $23 billion in profits out of the health-care system,鈥 Elizabeth Warren fulminated in a June debate. Kamala Harris charged in January that 鈥渋t is inhumane to make people go through a system where they literally cannot receive the benefit of what medical science has to offer because some insurance company has decided it doesn鈥檛 meet their bottom line in terms of their profit motivation.鈥 (Chris Pope, 9/11)
On Jan. 1, 2020, a new Medicare policy is scheduled to go into effect that will eventually require doctors to use a computer algorithm to vet imaging tests to determine 鈥渁ppropriateness.鈥 If the tests, such as CT scans and M.R.I.s, do not meet certain 鈥渁ppropriate-use criteria,鈥 Medicare may not reimburse the cost. Intended to reduce unnecessary imaging, the policy may penalize doctors who don鈥檛 comply by requiring them to get 鈥減rior authorization鈥 before ordering imaging tests in the future 鈥 in other words, to follow another regulation. (Sandeep Jauhar, 9/11)
As we have a vigorous debate among Democrats about what kind of health-care reform would most effectively and affordably provide health insurance for every American, the Trump administration just got some news showing that its efforts to undermine health security seem to be bearing fruit. (Paul Waldman, 9/11)
As the nation moves into the next round of Democratic presidential debates, Sen. Bernie Sanders鈥 鈥淢edicare for All鈥 bill and others like it are once again expected to receive intensive focus. Unfortunately, the consequences for Medicaid, the nation鈥檚 single largest public insurer, have gone virtually undiscussed. This is a mistake. Any move toward a single-payer system needs to take account of Medicaid鈥檚 future and the more than 70 million Americans it covers 鈥 disproportionately people of color 鈥 who live in the most vulnerable urban and rural communities, marked by poverty, elevated health risks and a chronic shortage of accessible services. (Sara Rosenbaum and Stephen Warnke, 9/12)