Archive for the ‘health care’ Category

At The Bottom Looking Up

Tuesday, November 13th, 2018

What does a nation owe its citizens with respect to health care?

For nearly all members of the Organization for Economic and Cooperative Development (OECD), the answer is guaranteed, high-quality, universal care at reasonable, affordable cost. For OECD founding member America, the answer seems to have become an opportunity to access care, which may or may not be of high-quality at indeterminate, wildly fluctuating and geographically varying cost.

It is indisputable that the US devotes more of its GDP to health care than other countries. How much more? For that answer we can turn to many sources, roughly all saying the same thing. The OECD produces annual date, as does the World Health Organization, among others. Another reliable and respected source is The Commonwealth Fund, which conducted a study of eleven high income OECD members including the US. The collection of health care cost data lags, so data from this study is mostly from 2014. Here is the cost picture:

As you can see, in 1980, US spending was not much different from the other ten OECD countries in the study. While high, it was at least in the same universe. But now, at 50% more than Switzerland, our closest competitor in the “how much can we spend” sweepstakes”, we might be forgiven for asking, “What in the name of Hippocrates happened?” As if this weren’t enough, the 2014 GDP percentage of spend, 16.6%, has now risen to nearly 18%, according to the CMS.

So, what do we get for all that money? We ought to have the highest life expectancy, the lowest infant mortality rate and the best health care outcomes in the entire OECD. But we don’t.

For many readers, it is probably galling to see both the UK and Australia at the top of the health care system performance measure and at the bottom of the spending measure. In the early 2000s, each of these countries poured a significant amount of money into improving its performance, and the results speak for themselves.

Consider all of this mere background to the purpose of this blog post.

Last week, we wrote about the terrible, 40-year stagnation of real wage growth in the US, pointing out that in that period real wages in 1982-1984 constant dollars have risen only 4.5%. But, as we have seen, health care spending did not follow that trajectory. This has resulted in tremendous hardship for families as they have tried to keep pace with rising health care costs. For, just as US health care spending has risen dramatically since 1980, so has what families have to pay for it.

To put this in perspective, consider this. Since 1999 the US CPI has risen 54%, but, as the chart above shows, the cost of an employer offered family plan has risen 338%. If a family’s health care plan’s cost growth had been inflation-based, the total cost to employer and employee would be $8,898 in 2018, not $19,616. In 2018, the average family in an employer-based plan pays 30% of the plan’s cost ($6,850), plus a $2,000 deductible, plus co-pays that average $20 whenever health care is accessed, plus varying levels of co-pays for drugs.

On top of all that is the enormous difficulty people have in trying to navigate the dizzying health care system (if you can call it that). American health care is a dense forest of bewildering complexity, a many-headed Hydra that would make Hesiod proud, a labyrinthine geography in which even Theseus with his ball of string would find himself lost.

With wages and health care costs growing ever farther apart, America has a crisis of epic proportion. Yet all we can seem to do is shout at each other about it. When do you think that will end? When will we begin to answer the question that this post began with: What does a nation owe its citizens with respect to health care? When will our nation’s leaders realize we can actually learn from countries like Australia, the UK, Switzerland and all the other high performing, low cost members of the OECD? Continuing on the present course is no longer a viable option.

 

Note: You may be questioning The Commonwealth Fund’s research. To put your mind at ease about that, here are the study sources:

Our data come from a variety of sources. One is comparative survey research. Since 1998, The Commonwealth Fund, in collaboration with international partners, has supported surveys of patients and primary care physicians in advanced countries, collecting information for a standardized set of metrics on health system performance. Other comparative data are drawn from the most recent reports of the Organization for Economic Cooperation and Development (OECD), the European Observatory on Health Systems and Policies, and the World Health Organization (WHO).

 

 

Nurses, Nursing Assistants And Back Injuries: ‘Twas Ever Thus

Wednesday, October 3rd, 2018

“Occasionally the complaint is made that a nurse has injured her back … in moving a patient.”
Nursing: Its Principles And Practices; Robb, Isabel Adams, Mrs.; W.B.Saunders, Philadelphia, 1898.

Lynch Ryan’s very first client was a Massachusetts Community Hospital where the Experience Modification Factor was 2.77, primarily due to nursing and nursing assistant back injuries. The year was 1984, eighty-six years after Mrs. Robb’s observation, quoted above, and the Hospital had two problems: What to do about the employees who were suffering the back injuries and how to prevent them from happening in the future. Pulling a good-sized rabbit out of a small-sized hat, we were spectacularly successful at solving the first problem and pathetic failures when it came to the second. Oh, we knew what should be done. We had grand plans, but execution was beyond all our best efforts. And the problem continues to this day with no end in sight.

When we studied the problem of back injury prevention in the nursing industry back in 1984, these are the things that got in the way of a successful result then and where they stand today:

  • The vast preponderance of  back injuries happened while nurses and nursing assistants were trying to lift or move patients. That is still the primary problem;
  • In nearly all back injury cases, patient lifting or moving was being performed manually. It still is;
  • Although mechanical lifts were available for purchase, they were expensive and took time to set up and use, time that was often in short supply. Today, a Hoyer Manual Hydraulic Lift costs anywhere from $900 to $1,400; slings are about $370. Hospitals should have a couple units per floor. Employees need to be trained in how to use the equipment. A few hospitals, very few, have specially designated and trained teams. Although not a really big ticket item, the costs do add up, and the administrative logistics can be daunting;
  • There was no limit on how much a nurse or assistant would be required to lift, and more and more obese patients were turning up in the hospital. That issue is much worse now;
  • Many nurses and nursing assistants were themselves overweight or obese and, consequently, even more unable to lift overweight or obese patients. Today, in addition to the weight issue, which still remains (a 2012 University of Maryland study found 55% of nurses to be obese), the average age of nurses is higher than it was in the 1980s, and, because of budget constraints, there are fewer of them per patient.

While back injuries are the greatest source of loss with respect to nurses, the situation is even more problematic for nursing assistants, as this chart from the Bureau of Labor Statistics (BLS) shows.

As you can see, nursing assistants suffer more back injuries than any other occupation. And as America continues to age – baby boomers turn 65 at the rate of one every nine seconds – the problem is only going to get worse.

This horrendoma that nobody seems to want to address is so severe that injuries in the health care sector dwarf any other industry, as another BLS chart shows for 2016, the most recent year for which there is data.

As we careen, helter skelter, down the Make America Great Again pothole-pockmarked highway, you’d think some genius would finally figure out how to fix the problem Mrs. Robb identified back in 1898. Then again, maybe not.

The waning days of summer Health Wonk Review

Thursday, August 23rd, 2018

 

Through vacations, heat waves, and days on the beach, our health policy wonks are still on the job. As we eke out the remaining days of summer and slouch toward the interim election, they continue their relentless focus on opining about the issues of the day. Check our August edition entries.

  • First up, Joe Paduda unpacks the generic term to uncover the varied approaches to universal coverage currently operating at far lower cost and far better outcomes than our “multi-payer” “system” in his post What exactly is single payer at Managed Care Matters.
  • Louise Norris tells us that the Trump administration has finalized rules that will make it easier for many Americans to buy short-term health insurance plans that may be less expensive – but aren’t as comprehensive as ACA-compliant plans. She explains the rules and how they’ll affect consumers in her post at healthInsurance.org Blog: ‘So long’ to limits on short-term plans.
  • At InsureBlog, Patrick Paule puts paid to the notion that Medicare4All is any great deal or panacea. he makes his case in his post On BernieCare.
  • What’s worse than needing help with gait, mobility and balance? Being told you need a walker. No wonder, when the typical walker basically screams “frail elderly,” and is difficult to use as well. At Health Business Blog, David Williams talks with neurologist Patricia Kavanagh about how she teamed up with a design and production team to a modern device that is more functional and stylish in an effort to get her patients with Parkinson’s and other movement disorders to use a walker.
  • Vincent Grippi pf the CareCentrix’s Homefront Blog submits this month’s episode of #CareTalk, in which David Williams (Health Business Group) and John Driscoll (CareCentrix) discuss Trump’s fight with Pfizer over drug pricing, and more.

 

Next issue: September 20 – Andrew Sprung – xpostfactoid

 

Quo Vadis, Kentucky?

Tuesday, July 10th, 2018

June 29, 2018. Thirteen days ago. I’m sitting in the Grand Ballroom of the Capital Hilton Hotel in Washington, DC, soaking in the presentations at the Annual Conference and CEO Summit of the Association for Community Affiliated Plans (ACAP). ACAP has grown to be quite the force for Medicare Advantage and Medicaid health plans around the country. So, the conference is an important event for Medicare and Medicaid professionals.

I’m looking forward to the 3:30 p.m. session, Plans Involvement in the New World of Work Requirements, because Mark Carter and Carl Felix, CEO and COO, respectively, of Kentucky’s Passport Health Plan, are going to describe their efforts to implement the Bluegrass State’s Medicaid work requirements.

In early January, 2018, Kentucky became the first state to win CMS approval to institute work requirements for its Medicaid beneficiaries. As I sit in the Hilton’s ballroom, its new  Medicaid work requirement program, Kentucky HEALTH, is slated to go live in two days (state government is only outdone by the US Army in its genius-like ability to create acronyms; this one stands for Helping to Engage and Achieve Long Term Health; catchy, eh?). There’s a pesky lawsuit lurking in the wings aimed at getting the Court to declare the program unconstitutional, but on June 29 Kentucky bureaucrats are ready to drop the hammer.

So, I am really interested in learning about the looming work requirement program, because three other states have won approval and are putting their programs together, and more are waiting in the wings.

Unfortunately, at the last minute, Mark and Carl (remember them?) have to cancel, because in the mad dash to the finish line for Kentucky HEALTH’s launch, they actually can’t leave the office. But, not to worry. Kentucky HEALTH’s Chief Marketing Officer is here to fill us in.

As she takes us through Kentucky HEALTH’s creation, I have to say that I, and the three or four hundred other people in the room are absolutely astonished at the time, money, manpower and all-around effort involved in giving birth to this behemoth. In terms of planning and implementation preparation, Kentucky HEALTH may perhaps only be exceeded by Operation Overlord (look it up). Some highlights:

  • For the first time EVER, Kentucky’s Medicaid beneficiaries will have to pay premiums. The premiums aren’t a lot (to you and me), ranging from $1 to $15 per month. Pregnant women and children are exempt.
  • Individuals with income above the poverty level ($12,060) who do not pay their premiums in 60 days will be kicked out of coverage for six months. Enrollees can return to the program earlier if they pay two months of missed premiums and make one new premium payment. They also must complete a financial or health literacy course.
  • Individuals must either work, volunteer, be enrolled in schooling or do some kind of “qualified community engagement” for at least 80 hours per month.
  • Beneficiaries must report their work activity each month; failure to do so will cause Medicaid disenrollment for six months.
  • Healthcare providers will have to certify to the Commonwealth the health status of those individuals they deem physically unable to work.

Regarding that last bullet – Kentucky HEALTH created a seven page form providers must complete. Knowing how busy healthcare providers are, I ask, “What’s been the feedback from your providers about this seven page form, and, by the way, are you paying them to do it?” Answer: “We haven’t communicated with the providers about this. We consider it all part of an office visit.”

For a moment, put aside why Kentucky is going to all this trouble. The bottom line question is: What does it get for going to all this trouble? In its need to get freeloaders off Medicaid rolls, just how many people would Kentucky’s work requirements actually put to work?

The nonprofit Kaiser Family Foundation provides some answers. Let’s check the numbers. Nationally:

  • About 10% of Medicaid recipients are elderly, age 65 and older, and many of them are in nursing homes.
  • About 48% are children, age 18 and younger.
  • That leaves about 42% who are of working age and potentially subject to the requirements.
  • Of that 42% who could be subject to the rules, 42% of them are already working full-time, and 18% are working part-time.
  • Another 14% are not working due to illness or disability.
  • Six percent are in school.
  • Twelve percent are caregivers for family members.
  • All of the above would be exempt from Kentucky’s rules.

That leaves about 1% of all Medicaid beneficiaries who would qualify for a work requirement program like Kentucky’s. That’s about 740,000 people nationally and around 12,000 in Kentucky (Since 2014, when Kentucky accepted Medicaid expansion, its Medicaid population has about doubled, rising from around 650,000 to 1.2 million) .

Kentucky HEALTH’s CMO wouldn’t (or couldn’t) say how much the state has spent on putting the program together or how many people have been devoted to it. But its best case scenario is that out of 1.2 million current beneficiaries about 95,000 may be off the rolls in five years, because either they no longer qualify for Medicaid because they either make too much money due to full-time work or they fail to comply with work requirements.

The day after the Kentucky HEALTH presentation at the ACAP conference District court Judge James Boasberg ruled Kentucky’s plan unlawful, because the federal government is obligated under federal law to consider whether a Medicaid proposal advances the program’s objectives, the judge wrote, and the Trump administration failed to meet that standard before approving Kentucky’s plan.

One final thought. When he announced the Trump administration’s approval of Kentucky’s work requirement plan, Governor Matt Bevin said, “I was raised by a father who said, ‘Don’t take something that is not earned.’” So, here’s the question: Unlike the entirety of the rest of the developed world, in America is basic health care something that has to be “earned?”

 

 

Bulletin: Dog Catches Bus! Now What?

Tuesday, June 12th, 2018

We’re goin’ right straight back to 2010
To start the health care war all over again!

It took time, but the GOP has finally learned a thing or two about fighting the Affordable Care Act, or, as they insist on calling it: Obamacare. You will recall that in 2017, after achieving control of all three branches of government, the party of Abraham Lincoln launched, in another Ground Hog Day moment, its biggest ever attack on the ACA, only to see its troops repulsed and annihilated once again by the turned down thumb of a war hero.

And then, after so many defeats there was a “light dawning over Marblehead” moment that would have made Prince Talleyrand proud.  In what the army calls a “triple flank,” republicans:

  1. In their humongously big 2017 tax cut law, zeroed out the penalty for not having health insurance;
  2. In February, 2018, got 20 states to sue the federal government contending that repeal of the penalty obviates the individual mandate making the entirety of the ACA unconstitutional.
  3. In May, 2018, somehow convinced the Justice Department not to defend the government in the suit.

Wow! A trifecta!

If the 20 states prevail, collateral damage abounds. First and foremost, the ACA’s provision that insurers not discriminate against people with pre-existing conditions. There are about 133 million Americans, under the age of 65, who fall into that health care Punji Pit. Prior to the ACA these family members, friends or neighbors of ours could be either denied coverage relating to their conditions, or charged exorbitant premiums. Beginning in 2014, the ACA forbade that. If the states win their suit, that meaty provision of the law, which a Kaiser tracking poll shows 70% of the population supports, gets torn up into little pieces and fed to the crows.

You might ask, “What do insurance companies think about all this?” Well, they do not like it one bit. America’s Health Insurance Plans, the trade association for health insurance companies, supports the pre-existing condition protections under the ACA. “Removing those provisions will result in renewed uncertainty in the individual market, create a patchwork of requirements in the states, cause rates to go even higher for older Americans and sicker patients, and make it challenging to introduce products and rates for 2019,” AHIP said in a statement.

So, here’s the question: If the 20 states actually win their suit, what happens then? Among many groups, the 1.25 million Americans with Type 1 diabetes who need to inject costly insulin every day to stay alive are waiting for an answer.

Health Wonk Review – Instagram Style

Thursday, May 17th, 2018

A picture’s worth a thousand words, and today Jason Shafrin proves it at Healthcare Economist. Jason has a photo, a chart, a graph and even a cartoon (for you Sponge Bob lovers) to illustrate what Health Wonk Review authors are posting.

We’re heading toward summer, although you’d never know it from the weather we’ve been gifted here in Massachusetts. Regardless, grab a mug of whatever you like, sit back, put your feet up and take a stroll through a Wonk garden filled with some excellent health care policy thinking.

It’s The Zip Code, Stupid! Update

Thursday, May 10th, 2018

At the end of February 2018, we wrote about a May 2017 study in JAMA Internal Medicine that concluded that where one lives is a bigger factor in health care outcomes than actual health care. This from our February post:

Geography is the biggest X-Factor in today’s American Hellzapoppin version of health care. The study analyzed every US county using data from deidentified death records from the National Center for Health Statistics (NCHS), and population counts from the US Census Bureau, NCHS, and the Human Mortality Databas and found striking differences in life expectancy. The gap between counties from lowest to highest life expectancy at birth was 20.1 years.

And, surpirse, surprise, it turns out if you live in a wealthy county with excellent access to high level health care, like Summit County, Colorado (life expectancy: 86.83), you’re likely to live about 15 years longer than if you live, say, in Humphries County, Mississippi, where life expectancy at birth is 71.9 years.  So, yes, Zip Code matters.

The concept of  zip code influence seems to be gaining traction. Today, from AIS Health Daily, we learn  a number of Blues Plans are planning on targeting the “where you live” problem with innovative strategies. Here is the AIS Daily release:

Blues Plans Work to Combat “ZIP Code Effect”
The Blue Cross and Blue Shield Association (BCBSA) recently launched the Blue Cross Blue Shield Institute, a subsidiary of BCBSA created to address social and environmental issues, as evidence mounts that health outcomes may be affected as much or more by social determinants of health as they are by actual medical care.
The Blue Cross Blue Shield Institute says it will address what it calls the “ZIP code effect,” which encompasses transportation, pharmacy, nutrition and fitness deserts in specific neighborhoods. It is partnering with Lyft, Inc., CVS Health Corp. and Walgreens Boots Alliance to address transportation and pharmacy deserts. The institute says it plans to deal with fitness and nutrition deserts in 2019.
Meanwhile, Highmark Inc. will launch a transportation initiative this summer to provide rides for members with chronic health conditions who live in a transportation desert. The service will begin in Pittsburgh as a pilot.
On April 17, Highmark’s Allegheny Health Network opened its Health Food Center, which acts as a “food pharmacy” where patients who lack access to food can receive nutritious food items, education on disease-specific diets and additional services for other social challenges they may face.
Other Blues plans also are addressing social determinants of health. For instance, Blue Cross and Blue Shield of North Carolina intends to invest part of its savings from the Tax Cuts and Jobs Act of 2017 into community health programs.
At Independence Blue Cross, the Independence Blue Cross Foundation’s Blue Safety Net Program offers “mobilized services” to medically underserved communities. The IBC Foundation sponsors the Philadelphia Eagles Youth Partnership’s Eagles Eye Mobile to conduct free vision screenings and eye exams and provide prescription glasses to under-insured and uninsured children.
We salute the Blues for recognizing the problem and trying to do something productive about it.
Final thought: If you do not subscribe to AIS Health Daily, you should.

This Can’t Go On Forever, Right?

Monday, April 23rd, 2018

The ratio of wages to the cost of living is what the economist calls real wages; the desirability of having real wages as high as possible, consistent with high employment, is a social objective. Rises in real wages do for the most part come about in fact as a consequence of rises in productivity. In a modern economy, what has [sic] normally to be expected  is rising productivity. – J. R. Hicks: Unions, Management and the Public; New York, Harcourt, Brace, and Co., 1960

What Hicks wrote 58 years ago had been true for more than 100 years. But 13 years later, in 1973, his economic model crashed. Productivity and real wage growth, which had been so tightly bound for so many years, parted company.

The consequences have been enormous. Hourly paid workers comprise about 60 percent of wage and salary workers. In Hicks’s day, nearly a third of all  workers were unionized. In 2017, however, the union membership rate had fallen to 10.7 percent, according to the U.S. Bureau of Labor Statistics. It’s only that high because of public sector participation. The union membership rate of public sector workers (34.4 percent) is more than five times higher than that of private sector workers (6.5 percent). Ponder that for just a moment. Only 6.5% of private sector workers are unionized today. This, despite union members having median weekly earnings about 25 percent higher than earnings for nonunion workers in comparable jobs ($1,041 versus $829).

This presents us with a befuddling paradox:

  1. Since 1973, the year when hourly wages and productivity waved goodbye to each other, real wages have been essentially flat, rising about 4% in the intervening 45 years;
  2. But in the same period, the CPI has risen 586%. That’s right. What you bought for $1.00 in 1973 will cost you $5.86 as of one month ago.
  3. Yet throughout this period, union participation and membership has declined by roughly 50%, despite union membership resulting in considerably higher wages for workers.

In Massachusetts, my home state, union membership was 12.4% in 2017, but 70% of that was in the public sector. At the recent Workers’ Compensation Research Institute’s annual conference I asked Steve Tolman, President of the Massachusetts AFL-CIO, why union membership hasn’t risen like a rocket to the moon given the persistent stagnant growth of real wages. He said he thought legislatures and employers had made it increasingly more difficult to win a union campaign. So, I then asked Keynote Speaker Erica Groshen, Ph.D., former Commissioner of the U.S. Bureau of Labor Statistics, her opinion. She wasn’t sure if there was a link between lack of union membership and stagnant real wage growth and suggested more research should be done. And in yesterday’s New York Times Louis Uchitelle suggested that American manufacturers relentlessly moving manufacturing jobs offshore has led to a steady decline in union membership – you can’t be in a union if you don’t have a job. The title of Uchitelle’s piece was, “How Labor’s Decline Hurt American Manufacturing.” Could have just as easily been titled, “How American Manufacturing’s Decline Hurt Labor.”

Regardless, what we’re left with is this (as I’ve written before): The 60% of the American workforce that is paid hourly resembles a swimmer trying to catch up to a battleship; with every stroke he falls farther and farther behind.

One highly illustrative area where meager wage growth has impacted the American family can be found in the cost of health care.

In 1989, Herb Stein (father of Ben), former Chairman of President Nixon’s Council of Economic Advisors, coined Stein’s Law*, which says, “If something cannot go on forever, it will stop.”

Do you think this can go on forever? What are the societal and political consequences if we see continued flat wage growth, the accelerating decline of private-sector unions, a rising CPI and an increasingly costly health care burden for families? Do you think today’s polarized American society is capable of addressing, let alone reversing, these decades old trends? What will it take for that to happen? I wish I knew.

But here is something I do know. If employers do not begin to do their best to address these issues – wage stagnation and ever rising health care costs that come with ever increasing deductibles – then unions and people like Steve Tolman, dormant for so long, will, and they’ll come with all guns blazing.

 

* Stein’s Law appeared on Page One of the June 1989 issue of the “AEI Economist” under the headline “Problems and Not-Problems of the American Economy.”

 

It’s The Zip Code, Stupid!

Monday, February 26th, 2018

“Sixty-percent of life expectancy, which has gone down two years in a row, is determined by where you live, 30% by your genetic code and 10% by the clinical care you get. Zip code matters more than genetic code.”

That was the sobering message delivered by AETNA CEO Mark Bertolini during an interview on CBS this morning. And he’s right. A May 2017 study from JAMA Internal Medicine concluded that geography is the biggest X-Factor in today’s American Hellzapoppin version of health care. The study analyzed every US county using data from deidentified death records from the National Center for Health Statistics (NCHS), and population counts from the US Census Bureau, NCHS, and the Human Mortality Databas and found striking differences in life expectancy. The gap between counties from lowest to highest life expectancy at birth was 20.1 years.

And, surpirse, surprise, it turns out if you live in a wealthy county with excellent access to high level health care, like Summit County, Colorado (life expectancy: 86.83), you’re likely to live about 15 years longer than if you live, say, in Humphries County, Mississippi, where life expectancy at birth is 71.9 years.  So, yes, Zip Code matters. According to the study:

In this population-based analysis, inequalities in life expectancy among counties are large and growing, and much of the variation in life expectancy can be explained by differences in socioeconomic and race/ethnicity factors, behavioral and metabolic risk factors, and health care factors.

On the whole, though, US life expectancy at birth increased by 5.3 years for both men and women — from 73.8 years to 79.1 years — between 1980 and 2014. But the county-by-county magnitude of the increase was determined by where one lives. That is, wealthy counties showed significantly greater increases in life expectancy than poor counties.

What is even more alarming is that some counties have experienced declines in life expectancy since 1980.

The JAMA study is another view from a different angle of inequality in America. According to Bertolini, CVS’s pending acquisition of AETNA, the third largest health insurer in the nation, will be a positive step in leveling the health care field when fully rolled out. He believes CVS’s 10,000 stores will evolve into much more than the Minute Clinics a lot of them are now. Time will tell, but CVS may be on to something here. In an op-ed in today’s New York Times, Ezekiel Emanuel pointed out that since 1981:

The population has increased by 40 percent, but hospitalizations have decreased by more than 10 percent. There is now a lower rate of hospitalizations than in 1946. As a result, the number of hospitals has declined to 5,534 this year from 6,933 in 1981.

People are apparently trying their mightiest to get health care anywhere except a hospital. According to Ezekiel, hospitals now seem less therapeutic; more life-threatening. Also, and this is where CVS is heading, complex care can now be provided somewhere else.

Another red flag from Mark Bertolini’s CBS interview was his reference to life expectancy dropping two years in a row. He’s right about that, too. In 2015 and 2016, life expectancy declined by a statistically significant 0.2 and 0.1 years, respectively.¹ Until now, life expectancy in America hadn’t declined since 1993.

All this is happening while our modern-day Tower of Babel – the US government – remains unwilling, unable, or both, to do anything constructive to improve the situation. Our more than 30-year health care train wreck needs serious attention, not partisan bloviation. To paraphrase Winston Churchill, ” That is a situation up with which we must no longer put.”

The men and women of Humphries County deserve nothing less.

 

¹ 2015’s drop was originally put at 0.1 year by the CDC, but was revised to 0.2 years after Medicare data were re-evaluated.

Going for the gold: An Olympic edition of Health Wonk Review

Friday, February 16th, 2018

Steve Anderson has posted the Health Wonk Review for February 15, 2018: Going for the Gold Edition at HealthInsurance.org blog. It’s an entertaining and wide-ranging smorgasbord of health policy topics of the day.

Here are a few of the topics d’jour:

  • Amazon/Bershire Hathaway/PMorgan’s foray into healthcare
  • Unexpected ER bills
  • CMS attack on freedom of the press
  • Predictions about Alex Azar, newly appointed HHS Secretary
  • The ACA
  • Peruvian healthcare
  • A different kind of hospital coverage
  • A recap of Health Action 2018, Families USA’s annual meet for healthcare activists.

If you aren’t familiar with healthinsurance.org, you should be. Check out the impressive roster of contributing authors and the excellent state health guides.

And just a heads up: In 2018, Health Wonks are on a once-per month schedule so catch this issue – you won’t have a chance for more wonkery until March.