The healthcare bill drafted by House Republicans was finally unveiled and is now making its way through House committees at an accelerated pace. It is doing so without benefit of estimates from the non-partisan Congressional Budget Office as to cost and the number of persons who will be covered. The White House has attempted to[…]
In our last blog, we were critical of the format and the performance of the moderators at the debate conducted by CNBC. Since that time there has been extensive discussion and “debate about the debate.” While numerous suggestions have been made by the candidates and various observers, most of them have been little more than tweaking. We have something a bit more radical (or “modest” in the Swiftian sense). […]
A couple of years ago, Jeff Bauer and I and our wives shared a nightly dinner on a transatlantic crossing and became friends. Jeff and I stayed in touch and exchanged thoughts on various subject, including healthcare, a subject on which he is an expert and I am not. I was impressed by his expertise and intrigued by his perspectives on that challenging issue and I talked him into doing a guest blog. I believe that readers of RINOcracy.com will find it both informative and thought-provoking. ~ DMP.
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Redirecting Health Reform: A Real Republican Opportunity
By Jeffrey C. Bauer, Ph.D.
The intensely partisan debate over repairing or repealing the Affordable Care Act (ACA) is a waste of everyone’s time. Democrats begrudgingly admit that Obamacare is flawed, but they refuse to modify its core goal of reducing the number of uninsured Americans. Meanwhile, Republicans keep voting to repeal the law without offering a viable alternative for solving the serious problems of our medical care system.
Expanding access to a dysfunctional system will only make the situation worse, but returning to the pre-ACA marketplace will not make things any better. As I argue in Paradox and Imperatives in Health Care: Redirecting Reform for Efficiency and Effectiveness (CRC Press, 2015), it’s time to start from scratch. A new approach to reform is sorely needed to extract us from today’s lose-lose confrontation between defenders of a poorly crafted law and opponents who would return us to the failed marketplace that Obamacare attempted to address. […]
“Most people envision their own death as a peaceful and an ideally rapid transition. But with the exception of accidents or trauma or of a few illnesses that almost invariably result in death weeks or months after diagnosis, death comes at the end of a chronic illness or the frailty accompanying old age. Few people really have the opportunity to know when their death will occur.”
That unsurprising but sobering observation was included in the Preface to a report issued on September 14 by the Institute of Medicine (IOM), “Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life.” The IOM is an affiliate of the National Academy of Science and the report was prepared by a nonpartisan committee that included physicians, nurses, insurers, lawyers, and gerontologists. The goal of the report was to offer a road map to providing care at the end of life that is “person-centered, family-oriented, and evidence-based.” To that end, the report proposed sweeping reforms to end of life care, including the nature of care provided, how the government and insurers compensate for medical service, and the focus of medical education. It is a lengthy report, some 507 pages, that reflects the complexity of the issues and the care that went in to the study of them by the IOM committee. It is a document that deserves the attention of the medical community, patients and their families, political leaders, and the public at large. […]
On June 30, The Supreme Court issued an opinion in Sebelius v. Hobby Lobby Stores and Conestoga Wood Specialties v. Sebelius (collectively Hobby Lobby) invalidating regulations under the Affordable Care Act (ACA) that require that insurance provided by employers cover a broad range of contraceptive medications and devices. The employers in each case objected to coverage for four specific types of contraceptives that they consider to be abortifacients, i.e., causing an abortion. The employers claimed that the requirement to provide that coverage infringed their rights under the Religious Freedom Restoration Act (RFRA). A five-justice majority of the Court agreed in an opinion by Justice Alito. The immediate controversy over the decision was quickly heightened when, three days later,the Court entered a preliminary stay in Wheaton College v. Burwell relieving Wheaton, a Christian college, of complying with an alternative procedure that the Court had appeared to endorse in Hobby Lobby. […]
Schadenfreude: a feeling of enjoyment that comes from seeing or hearing about the troubles of other people.
Republicans may be forgiven if they have indulged themselves in a bit of Schadenfreude over the continuing debacle of Obamacare. To be sure, that debacle could hardly have come at a more opportune time. The furies unleashed by the website failures and the cancellation of insurance policies served to soften, if not erase, the public disdain for the Republicans’ recent antics: the ill-advised gambits with the government shutdown and the debt ceiling. Nevertheless, those furies, and the agonies they have produced in Democrats, may prove to be ephemeral. A diet of Schadenfreude does not provide much nutrition, and it surely is not a policy. […]
Rinocracy.com was among the first to call attention to the fact that Obamacare had led to the cancellation of hundreds of thousands of health insurance policies with millions more cancellations likely to follow. We pointed out, as others had, that such cancellations appeared to make a mockery of President Obama’s oft-repeated pledge that “If you like your health insurance, you can keep it.” (Special Bulletin, October 27, 2013, “What did the President know and when did he know it (or Who’s minding the store?).” Indeed, Glenn Kessler, Fact Checker for The Washington Post has now given the President his highest “award:” Four Pinocchios.
The Special Bulletin of October 27 pointed out that HHS had adopted regulations that eviscerated the President’s promise that “If you like your health insurance you can keep it.” A lengthy and informative report by NBC News indicates that “the Administration” knew of that fact three years ago. The report also give useful examples of[…]