In my first post, I described the major features and basic approach of HR 3962, as well as the provisions of the bill that would go into effect more or less immediately.  This post will look more closely at some of the bill’s basic insurance reform elements.  In a final post, I will discuss the [...]

On October 12 America’s Health Insurance Plans (AHIP) released a commissioned report by Price Waterhouse Cooper (PWC), “Potential Impact of Health Reform on the Cost of Private Health Insurance Coverage.”   The study reported that health care reform as envisioned by the Senate Finance Committee would raise the cost of private health insurance by 23 percent [...]

Insurance exchanges, or “Gateways” as they are called in the Senate HELP bill, are a key element in all of the congressional health reform proposals, as well as the proposal outlined by President Obama in his speech to Congress. The exchange is not some new heavy-handed government regulatory body. Rather, the purpose of the exchange [...]

Uwe Reinhardt’s assessment of President Obama’s address to Congress on health reform tops the list of most-read Health Affairs Blog posts for September.  Additional comment on all posts is always welcome. 

Grading The President’s Health Care Speech
by Uwe Reinhardt
Health Affairs Briefing: Bending The Cost Curve In Health Spending
by Chris Fleming
Regional Payment And Delivery Reforms: Critical To [...]

The Senate Finance Committee is now considering a proposal that would impose an aggregate tax of $6.7 billion dollars per year on “any U.S. health insurance provider,” in proportion to market share, whether for profit or not for profit, but not on employers who “self fund” their employees’ coverage.
About 160 million Americans have private health [...]

In recent days, Republican leaders on Capitol Hill have taken up the argument that the Democratic health reform bills represent a “government takeover” of the health care system.  These claims misrepresent the substantive content of the bills, since the approach of the main committee bills is to extend employer-sponsored, private insurance.  But this rhetorical exaggeration [...]

The biggest flashpoint in the ongoing debate over the future of the U.S. health system is whether Congress should change the balance of power that now favors the private health insurance industry. Opponents of the idea argue that a public health insurance plan competing with private insurers would lead to inferior health care, harm providers, [...]

Editor’s Note: In terms of “bending the cost curve,” health-care providers in La Crosse, WI., have clearly demonstrated the ability to deliver high-qualty care for comparatively low costs. La Crosse was one of ten communities featured at a July 21 conference in Washington, D.C. titled “How Do They Do That?  Low-Cost, High-Quality Health Care in [...]

After decades of teaching, I view everything around me as a final exam and assign it letter grades.
Naturally, I graded President Barack Obama’s speech as well. The overall grade is A–, a highly respectable grade at Princeton, although there is variation around this overall average for the different themes in the speech.
The elegance and force [...]

One by one, various cars are falling off the chugging legislative locomotive of Obama-style health “reform” as it tries to climb hills that are too steep.  The public plan option has checked in for rehab as a co-op and even some end-of-life counseling.  Bending-the-cost-curve measures were turned upside down by the Congressional Budget Office in July.   [...]

In the debate about health reform, many issues are getting an inordinate amount of attention, but one is not getting the detailed consideration it deserves. How it is finally resolved is likely to be one of the key factors of the ultimate plan’s success or failure. That issue is the design of the health insurance [...]

Editor’s Note: In the post below, Uwe Reinhardt proposes to move from the present, price-discriminatory system of private-sector pricing of health services toward an all-payer system that could serve as a transition to an eventual system based on bundled payments per episode of illness for acute care, or capitation for chronic care.
In a response to Reinhardt’s [...]

The recent confusion surrounding the health care industry’s statement about reducing the growth in health care costs by 1.5 percentage points annually — it is a goal, the industry clarified, not a year-by-year target — underscores the need to put mechanisms in place to ensure that the industry’s spending growth target is met. Nonetheless, I [...]

One of the most controversial parts of the Obama health reform campaign platform was its pledge to create a new Medicare-like public health insurance offering that would “compete” with existing private insurance plans, and put pressure on them and on providers to hold down costs.
It would do this mainly by using Medicare-like pricing leverage to [...]

If Congress creates a new national insurance exchange as part of health reform legislation, should a public plan be included as one of the options? That is the subject Jacob Hacker, Len Nichols, and Stuart Butler explored in a recent Health Affairs Blog roundtable. The full roundtable is posted here, and some of the highlights of the [...]

Editor’s Note: If Congress creates a new national insurance exchange as part of comprehensive health reform, should a public plan be offered as one of the choices for consumers? That contentious question was the subject of a Health Affairs Blog Roundtable including Stuart Butler, vice president, domestic and economic policy studies, at the Heritage Foundation; [...]

In interviews with Health Affairs, government ministers in Germany and the Netherlands talk up market-oriented refinements to their universal health insurance systems for the future. But the news from Europe isn’t all happy: an unsettling survey in the United Kingdom finds that some physicians believe that the market will unravel the government-owned and -operated National [...]

The Medicare Modernization Act (MMA) has succeeded in providing seniors with more “choice” among Medicare Advantage (MA) private health insurance plans. However, particularly in rural areas, much of the increased choice stems from a proliferation of private fee-for-service (PFFS) plans, which mimic traditional Medicare’s fee-for-service structure but receive reimbursements that exceed spending in the traditional [...]

The spread of convenience clinics—or “McClinics”—has been debated across the health care blogosphere in recent weeks, stemming in part from Wal-Mart’s announcement that it plans to open hundreds in coming years. Yesterday, the subject was the question of the day on the Wall Street Journal’s health blog (sparked by a Journal op-ed by Grace-Marie Turner, president [...]

Old hands in Washington are getting a here-we-go-again feeling about health care these days. Candidates and polls are pushing reform toward the top of the nation’s agenda. Many states are on the march. Realism occasionally rears its head in the right places: Controlling cost growth seems to be recognized increasingly as a priority of the [...]