Pioneer ACOs’ Disappointing First Year
The most controversial and heavily hyped healthcare payment reform idea in the Affordable Care Act has been the Accountable Care Organization. Thirty two high performing health systems participated in the Pioneer ACO demonstration, which reported its first year results in the summer of 2013. The blizzard of hype and press releases concealed a lot of problems. Read about the Pioneer ACO’s Disappointing First Year.
Roberts’ “Flying Squirrel” Maneuver Takes Down the Affordable Care Act
The Supreme Court unexpectedly affirms the constitutionality of the Affordable Care Act. In doing so, however, it invalidates a key piece of the law, rendering the expansion of Medicaid “optional” for states. Why the Supreme Court may have dealt a serious blow to health reform.
Letting Go Of Employer-Based Health Insurance
Intense White House criticism of a McKinsey study predicting a large number of employers dropping coverage when the ACA is implemented begs a question. Suppose health reform actually foretells the end of employer based coverage? It might not be a bad thing. This posting is about Letting Go of Employer Based Coverage.
The Unbridgeable Gap between Left and Right on Health Reform
Controversy rages over health reform. A Republican landslide in November, 2010 strips the Democrats of control of the House of Representatives, and brings into office a new wave of conservative Republicans committed to repealing the Affordable Care Act. Many of the newly elected Republican majority do not believe there is a problem of access to healthcare. This posting discusses the unbridgeable gap between Republicans and Democrats on health reform.
Swamp Creature
Republicans have set themselves the political goal of “repealing and replacing” ObamaCare. They are unlikely to succeed and face significant political dangers, as they confront the Swamp Creature called the Affordable Care Act of 2010.
Eight Rules From The Heart Of Power: How Did Obama Do?
In his book on Presidential politics and health reform, Heart of Power, health policy analyst Dr. David Blumenthal offered eight rules for Presidential conduct of health policy. How did President Obama do?
Last Helicopter Out of Saigon!
President Obama is running out of time and public patience in the health reform debate. Obama must move quickly or health reform will slip from his grasp. The political price paid for health reform will be steep.
Panicky People Make Bad Decisions : Salvaging Health Reform after Scott Brown
After Scott Brown’s shocking election to Ted Kennedy’s Massachusetts vacant Senate seat, the Democrats lose their filibuster proof Senate majority. Can health reform be saved? This posting advocated starting over with a stripped down, affordable new bill.
There Be Dragons: The Fiscal Risk Of Premium Subsidies In Health Reform
The core of health reform is transforming a nearly $1 trillion private health insurance market. Health reform legislation will eliminate most of the health insurance industry’s risk management practices (medical underwriting, etc.) and restrict its gross margins and earnings. The Congressional Budget Office issues an astonishingly rosy forecast of how health reform will affect private health insurance markets. What is wrong with their forecast? What are the fiscal and policy risks of health insurance reform?
The Leaning Tower of Jello: Why No-one Believes Health Reform will be Deficit Neutral
Critical to health reform’s enactment is President Obama’s pledge that the bill will not increase federal deficits, already running at $1 trillion a year. Why no-one believes health reform will be deficit neutral, despite Congressional Budget Office assurances.