Obamacare has two very bad features: unaffordable out-of-pocket costs and perilously narrow networks. If you combine last year’s average (unsubsidized) premium with the average deductible, a family of four had to pay $25,000 before getting any benefits at all from their plan. Also, the average plan looks like Medicaid managed care with a high deductible, excluding access to the best doctors and the best hospitals. More
On June 7th the U.S. Food and Drug Administration approved a new drug to treat early-stage Alzheimer’s disease. Is this good news for patients suffering with Alzheimer’s disease? Probably not and certainly not for taxpayers. The clinical trial data found little evidence the drug works. One Phase 3 clinical trial showed a slight slowing in cognitive decline, while the second clinical trial failed to show any improvement. More
What’s behind the slowdown in vaccinations? The consensus among experts is those not yet vaccinated either 1) don’t want the vaccine 2) harbor some doubts about vaccine safety or efficacy, or 3) simply lack the motivation to find vaccine providers and make an appointment. Vaccine hesitancy accounts for about one-third of adults. For example, the Kaiser Family Foundation ran a survey in April that found 15 percent of respondents who had not received the vaccine plan to “wait and see.” Another 6 percent will get vaccinated “only if required,” and 13 percent refuse to get the vaccine. More
One reader posed the question, how does the tax break for employee health insurance harm our health care system? Short answer: over time the practice reduced competition, which weakened cost-control and resulted in health care inflation three times that of consumer inflation. Consider this: once covered by generous health plans, workers cared less about what medical care cost because their health plans paid most of the tab. Employers didn’t care what things cost because they were passing on the costs to workers (indirectly) in lieu of higher cash wages. Third party administrators (TPAs), who manage the benefits for employers, didn’t much care what things cost because they were passing on the costs to employers with a mark-up. The more money spent, the more TPAs earn. More
Dallas Mavericks owner Mark Cuban has done some innovative thinking on how to reform the health care system. The Cuban plan is similar to an idea once proposed by Milton Friedman and also by Harvard economist Martin Feldstein. In a nutshell, people would be responsible for medical bills up to a certain percent of their income, and government would pay everything above that. In other words, people would pay ordinary bills out-of-pocket, and government would provide catastrophic coverage for the large bills. More.
The intellectual collapse of liberalism and conservatism at the end of the 20th century created space that the cancel culture moved quickly to occupy. The world of ideas abhors a vacuum. Absent the traditions bequeathed to us by the Enlightenment and the Age of Reason, the cancel culture was only too willing to serve up irrationality and unreason. More
What about Joe Biden’s promise that the next big spending bill won’t cost anyone a dime if they make less than $400,000? All economists think that the corporate income tax is partly paid for by lower wages for workers. The only question is: How much of the cost is born by labor? Larry Kotlikoff and his colleagues, using the most sophisticated model of international financial flows that exists, have concluded that the full burden of the corporate income tax falls on workers. Not just in this country. But in every country. The editorial board of the Wall Street Journal says they agreed with him. More
Why is it controversial to expand the physician supply, creating more competition? Doctors oppose it, just like they oppose expanding the scope of practice for nurse practitioners. Doctors don’t want me to be able to see a nurse practitioner or physician assistant for a wart on my toe unless that NP/PA works for them.
How did doctors get so powerful? In the first half of the 20th Century, the American Medical Association (AMA) waged a largely successful battle to close medical schools that trained competing physicians. …. More than half of American and Canadian medical schools were closed…. Thus, the job of a physician was yanked out of reach of all but the smartest, most disciplined, wealthy elites. More
John Goodman was the first person to note that health plans would respond to Obamacare incentives by imposing high deductibles (three times what is normal for employer plans) and narrow networks (as bad or worse than under Medicaid). Along with Boston University economist Laurence Kotlikoff, he has now proposed simple, straightforward reforms to both problems in an editorial published in The Hill. More
Can we transform the entire health care system by empowering the roughly 60 percent of patients who are in private health plans? That’s the premise of a new book I just read by Todd Furniss (@TFurniss on Twitter). The author of The 60% Solution: Rethinking Healthcare, believes there are five major reforms necessary to empower patients and help them get better care at better prices. These include: (1) change governance, (2) modify health savings accounts (HSAs), (3) clear prices, (4) standardize accounting and information technology in the medical industry and (5) emphasize primary care. More