Workplace Wellness, Innovative Medicaid Expansion and Some Plain Ol’ Bad Ideas: A Healthcare News Catch-All
There is a great deal going on in the health policy world right now and, in the interest of efficiency, I’m going to highlight a number of the more noteworthy developments in one catch-all post. Let’s get started:
• It’s good to see that the efforts to repeal some of the more counterproductive provisions of the Patient Protection and Affordable Care Act, specifically the taxes on health sectors that will raise consumer prices and/or eliminate jobs, are still going strong and, in fact, may be picking up steam. The New York Times this week profiled the bipartisan drive to repeal the medical device tax that, because it’s assessed on revenues instead of profits, is particularly destructive to both jobs and innovation. And, Senators John Barrasso (R-WY) and Orrin Hatch (R-UT) have reintroduced their legislation to eliminate the tax on health insurance policies. At a time in which we’re trying to make health coverage more affordable, it makes little sense to impose a tax that will simply increase consumer costs.
• Staying on the subject of bad ideas, there are still legislative efforts underway to empower the federal government to “negotiate” drug prices in the Medicare Part D program. The arguments against this idea are plentiful. First, the Congressional Budget Office has already analyzed this notion and has found that the Department of Health and Human Services could not do a better job negotiating pharmaceutical prices than the private prescription drug plans in Part D are already doing. Second, the media needs to quit using the terminology that government would “negotiate” Part D prices. It’s not a negotiation when one side can simply impose its will on the other. We’re talking price controls, plain and simple. And, finally, the Part D program is already a huge success, achieving sky-high approval ratings among seniors and maintaining the same average monthly premium level for three consecutive years. Legislation to empower HHS “negotiations” is a dubious solution in search of a problem, as numerous patient groups are pointing out.
• An idea that bears watching is Arkansas’ approach to Medicaid expansion. The state’s Democratic governor, Mike Beebe, has received approval from HHS to take federal dollars intended to expand Medicaid eligibility and use those funds to purchase private health coverage for Medicaid beneficiaries through the state exchanges that will be established for all citizens under PPACA. Critics of this novel approach argue that it will cost taxpayers more money because private health plans pay hospitals and physicians more than comparably low conventional Medicaid rates. Health analyst Avik Roy has a compelling rebuttal to this criticism in Forbes. It will also be worth exploring to see if private coverage for Medicaid beneficiaries achieves the same higher quality of care as we see in private Medicare Advantage plans over conventional fee-for-service Medicare. Better care can equal lower long-term costs through improved disease prevention and reduced hospital readmissions.
• I think it’s just intuitive that employers can contain their healthcare costs by maintaining a healthier workforce. Some disagree. A study from a University of Arizona researcher suggests that workplace wellness programs are not cost savers because, among other reasons cited, they just encourage a shifting of costs from hospitalizations to outpatient care and pharmaceuticals. I joined with Dr. Kenneth Thorpe, the chairman of the Partnership to Fight Chronic Disease, in an op-ed in the Huffington Post pointing out that employers have indeed generated a significant return on investment from innovative wellness approaches. In fact, as we wage war against the chronic illnesses that account for the significant majority of the nation’s healthcare spending, we have no choice but to make the workplace, where so many Americans spend large portions of their lives, a primary battleground.
