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Morning Briefing

Summaries of health policy coverage from major news organizations

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Wednesday, Apr 26 2017

Full Issue

Thoughts On How Trump Could Shift His Health Care Focus; Safeguarding People With Pre-Existing Conditions

Editorial pages across the country include ideas about how the Trump administration and GOP lawmakers should shift their repeal and replace efforts as well as other reflections on the health care system.

Rather than renew their failed effort to repeal and replace Obamacare, President Donald Trump and congressional Republicans should move on to another aspect of health care: the need to contain costs and improve value. Such a shift would allow them to be far more productive. For many if not most Americans, cost trends and value matter more than what鈥檚 happening on the individual insurance exchanges. Progress on this front would raise people鈥檚 take-home pay and improve the nation鈥檚 long-term fiscal balance, while also constraining the growth in premiums for those who buy insurance on the exchanges. (Peter R. Orszag, 4/25)

The recent U.S. House decision to pull the first iteration of the American Health Care Act (AHCA) off the floor doesn鈥檛 necessarily mean efforts to reform health care are at an end. As members of Congress work to develop legislation that will change the current health care system, they must develop policy that ensures people with pre-existing conditions will receive coverage without additional costs in premiums, deductibles or coinsurance for their pre-existing condition. (John Meigs Jr., 4/26)

On the campaign trail, Donald Trump鈥檚 proposal on health care was nebulously perfect. Obamacare 鈥 that is, the Affordable Care Act 鈥 would be gone, he told his cheering supporters, replaced by something cheaper, better and more expansive that wouldn鈥檛 be burdened by the hated word 鈥淥bama.鈥 When it came time to deliver on that promise, very early in his administration, the bill that was offered up was somewhat distant from that target. (Philip Bump, 4/25)

President Trump had hoped to celebrate his 100-day mark by boasting of his success in obliterating his loser predecessor鈥檚 signature domestic accomplishment 鈥 and in replacing it (naturally, since Trump is a winner) with something that delivers more and better health care for less money. Instead, one of his chief 100-day accomplishments may be that he鈥檚 in the process of making Obamacare more popular. A new Post-ABC News poll finds that 61 percent of Americans now favor keeping and improving the Affordable Care Act, while only 37 percent favor repealing and replacing it. Crucially, it also finds that huge majorities reject the ideas at the core of the latest version of the GOP replacement that Trump is championing. (Greg Sargent, 4/25)

A Tennessean article this year highlighted the efforts of a Nashville-based company to promote health care price transparency. ... Consumer empowerment in health care requires reliable price information. Online price comparison websites will be a critical building block in harnessing free market forces to control health-care spending. (Rick Abramson, 4/25)

We鈥檝e already seen that repealing Obamacare is politically perilous. Now there鈥檚 a new complication: It may also violate international law. The United Nations has contacted the Trump administration as part of an investigation into whether repealing the Affordable Care Act without an adequate substitute for the millions who would lose health coverage would be a violation of several international conventions that bind the United States. It turns out that the notion that 鈥渉ealth care is a right鈥 is more than just a Democratic talking point. (Dana Milbank, 4/25)

In March, it was discovered that the Mayo Clinic's CEO, John Noseworthy, had asked staff to "prioritize .鈥.鈥. commercially insured patients" over those covered by Medicare or Medicaid. Observers described the message as being in poor taste but surprising only because someone publicly discussed the policy鈥攏ot that hospitals were trying to bring better-paying patients through their doors, even when those hospitals are not-for-profit organizations that receive tax exemptions in return for providing community benefits. (Elizabeth Whitman, 4/24)

Gov. Scott Walker, in response to Health and Human Services Secretary Tom Price鈥檚 request for states to 鈥渋nnovate鈥 their Medicaid programs, has laid out a proposal that would decrease access to health care for our most vulnerable, humiliate and marginalize those with addiction, and increase government bureaucracy. The core elements of the proposal include charging premiums, co-payments for unnecessary ER visits, work requirements for non-disabled adults, maximum enrollment periods, and, most sensationally, drug testing of Medicaid recipients. (Rebecca Bernstein, 4/25)

Here鈥檚 what Singapore鈥檚 conservative admirers get right: Singapore really is the only truly universal health insurance system in the world based on the idea that patients, not insurers, should bear the costs of routine care. But Singapore isn鈥檛 a free market utopia. Quite the opposite, really. It鈥檚 a largely state-run health care system where the government designed the insurance products with a healthy appreciation for free market principles 鈥 the kind of policy Milton Friedman might have crafted if he鈥檇 been a socialist. Unlike in America, where the government鈥檚 main role is in managing insurance programs, Singapore鈥檚 government controls and pays for much of the medical system itself 鈥 hospitals are overwhelmingly public, a large portion of doctors work directly for the state, patients can only use their Medisave accounts to purchase preapproved drugs, and the government subsidizes many medical bills directly. (Ezra Klein, 4/25)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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