California’s largest health care system is a single-payer system (“Medi-Cal”) that covers the state’s 13 million poorest residents, a population greater than all but four states. Service is terrible. Despite spending of $100 billion per year, appointments are hard to get, emergency room visits are up, there’s little indication of greater healthiness, and there’s even […]
California counties are sitting on money from a special tax on millionaires that should be spent on mental health programs, but the state isn’t moving fast enough to reclaim the funds, according to a state audit released on Tuesday. California State Auditor Elaine Howle found that county mental health programs had stashed $231 million from […]
“National healthcare spending trends are unsustainable in the long term,” President Donald Trump’s budget acknowledges. An article published earlier this month in the medical policy journal Health Affairs buttresses this simple point. Medical inflation stands to outpace both economic growth and actual inflation. Our spending — government, individual, business, etc. — on healthcare, projected to […]
When the authors of the Affordable Care Act promised to “bend the cost curve” in health care, it was typical Washington doublespeak. Voters likely heard those words as a promise that costs would go down, but the intended meaning was merely that they would rise more slowly than before. Yet even by that meager standard, ObamaCare is a failure. Costs are rising faster than before, and there’s no real prospect of a reversal. The key provisions of the law that were supposed to produce savings and efficiencies either haven’t worked or will never be implemented. ObamaCare’s Failed Cost Controls Photo: iStock/Getty Images America’s health-care spending rose 4.3% in 2016, according to federal data released earlier this month. That is the third straight year it outpaced economic growth. Total health spending last year was 17.9% of gross domestic product, up from 17.2% in 2013.
When the Legislature reconvenes and the campaigns for governor heat up next year, Californians will be hearing a lot – and a lot of hot air – about universal health care. Making California the first state to guarantee health care for every resident has become a touchstone issue – and a divisive one – for the state’s dominant Democrats. . . .It’s not necessary for the state to seize control of California’s entire medical care system if the real bottom line goal is covering those undocumented immigrants. It could be done for about $10 billion a year, which is a lot less than $100 billion. However, advocates would have to publicly acknowledge that covering them is what this conflict is all about and take whatever political heat it generates.
The Los Angeles City Council voted Wednesday to impose a new fee on development to raise millions of dollars a year for affordable housing as the city copes with rising rents and surging homelessness
Major health insurers in some states are seeking increases as high as 30% or more for premiums on 2018 Affordable Care Act plans, according to new federal data that provide the broadest view so far of the turmoil across exchanges as companies try to anticipate Trump administration policies. Big insurers in Idaho, West Virginia, South Carolina, Iowa and Wyoming are seeking to raise premiums by averages close to 30% or more, according to preliminary rate requests published by the U.S. Department of Health and Human Services. Insurers face a mid-August deadline for completing their rates. The companies have until late September to sign federal agreements to offer plans in 2018.
California consumers buying insurance for 2018 through the state’s insurance exchange will see average premiums increases of 12.5 percent, but by comparison pricing, many could limit their premium hikes to 3.3 percent, Covered California officials announced Tuesday.
The increase was a little lower than the average 13.2 Covered California premium hike implemented this year, despite uncertainty over the future of the Affordable Care Act amid Republican attempts to repeal the law.
. . . That “ongoing uncertainty” could mean that roughly 650,000 consumers who buy Covered California’s most popular insurance plans, those in the silver tier, will face a double whammy on their premium prices. The exchange said it may have to add a 12.4 percent surcharge to premiums in that tier because insurers are worried about continued federal funding that lowers out-of-pocket costs for enrollees.
TWO STATES, Rhode Island and Indiana, have been able to make major changes to the traditional Medicaid programs, which allowed them to curb costs and enhance their recipients’ quality of care. Patient satisfaction went up sharply. In 2009 Rhode Island sought and won an unprecedented waiver from Washington. . . As Alexander noted, “These reforms, in turn, gave patients greater independence and better outcomes, and their satisfaction soared. . . . The imaginative remedies we implemented were so responsive and customized to our patients’ needs that their experiences and health improved even as we spent less.” . . . Indiana instituted even better Medicaid reform. The Hoosier State has long pushed the idea of health savings accounts (HSAs) coupled with high-deductible health insurance that covers catastrophic medical expenses. As the state has observed: “About 96% of [the state’s] employees have voluntarily elected to enroll in a consumer-driven health plan option. In its first four years of offering [such options] to state employees, the state saved 10.7% annually, as employees used hospital emergency departments at lower rates, had fewer physician office visits, lower prescription costs and a higher generic-medication dispensing rate.” . . .Now the Hoosier State is expanding this state-employees concept and applying it to its Medicaid recipients.
Assembly Speaker Anthony Rendon put the brakes on a sweeping plan to overhaul the health care market in California Friday, calling the bill “woefully incomplete.” Rendon announced plans to park the bill to create a government-run universal health care system in Assembly Rules Committee “until further notice” and give senators time to fill in holes that the bill does not currently address. “Even senators who voted for Senate Bill 562 noted there are potentially fatal flaws in the bill, including the fact it does not address many serious issues, such as financing, delivery of care, cost controls, or the realities of needed action by the Trump administration and voters to make SB 562 a genuine piece of legislation,” Rendon said.
It wouldn’t be the first time that a high price tag torpedoed a government takeover of health care. In 2014, Vermont’s attempt at single-payer ended abruptly when Gov. Peter Shumlin rejected the 11.5% payroll tax hike and 9.5% individual tax hike required to fund the program. Yet the financial costs of single-payer are practically negligible compared with the human costs.
Consider the Department of Veterans Affairs’ scandal-plagued single-payer health program. Last month, the agency’s inspector general found that more than 100 veterans died while waiting for care at a Los Angeles VA facility between October 2014 and August 2015.
There will be two sources of financing for Healthy California. The first is the same public health care revenue sources that are presently providing about 71 percent of all health care funding in the state. These include Medicare and MediCal, which together provide nearly 50 percent of all health care funding in California at present. It also includes tax subsidies for health care expenditures by individuals and households in the state, which provide about 9 percent of the state’s total health care funding. The Healthy California bill is explicit in stating that the State will work to obtain waivers in all of the present areas of public health funding, so that these present funding sources will continue to finance Healthy California. Assum ing the state is successful in obtaining these waivers, these funds will provide $225 billion in funding for the state’s single -payer program. That means that the remaining $106 billion to fund Healthy California will need to be provided by new revenue sources in the state.
California’s uninsured rate has declined dramatically in the past few years. Much of the increase in health coverage has been the result of the state’s decision to expand Medi-Cal, its Medicaid program, under the Affordable Care Act. While the federal government has funded a large share of program growth, state costs have also risen. This cost growth, combined with major policy shifts still conceivable at the federal level, has created additional uncertainty about the future of Medi-Cal financing. As state lawmakers and other stakeholders plan for the future of the program, it is important to understand how Medi-Cal is currently financed and how it fits into California’s overall budget.
The top 1 percent of health-care spenders use more resources, collectively, than the bottom 75 percent, according to a new study based on national surveys. Slice the data a different way, and the bottom half of spenders all together rack up only about 3 percent of overall health care spending — a pattern that hasn’t budged for decades. This creates a fundamental inequality in the country’s health spending that is the crux of the challenge policymakers face: They need a system that works for people who are ill, but is attractive to those who are healthy and spend little on health care.
An ambitious proposal to create a single statewide insurance plan for every Californian — including undocumented residents, seniors on Medicare and people who now get their health coverage through work — began to take shape on Thursday when two legislators released details about what services would be covered and who would run the giant program. Still missing, however, are the details that have bedeviled universal health care advocates for decades: how much it would cost taxpayers. And the plan will be difficult, if not impossible, to execute without permission from Washington to steer billions of federal Medicare and Medicaid dollars into a trust fund that covers everyone.