Health care

Why Hospitals Never Have Enough Nurses: The Explanatory Power of “Prasad’s Law” of Wealth Concentration

Published by Anonymous (not verified) on Fri, 06/12/2019 - 9:18pm in

Nurses, or more accurately, nurse staffing levels demonstrate a central bad incentive in American medicine.

‘Dark Waters’ Tells the Origin Story of a Public Health Nightmare. We’re Still Living It.

Published by Anonymous (not verified) on Fri, 06/12/2019 - 1:55am in

On a docu-drama that recounts the first major suit against toxic "forever chemicals" and what's being done about them now.

Opening of Formerly Secret FDA Database Exposes Medical Device Failures, Spurring Lawsuits

Published by Anonymous (not verified) on Wed, 04/12/2019 - 8:16pm in

The FDA kept a database of medical device malfunctions secret for decades.

Leaked US Trade Talks Show How Trump Is Dictating Johnson’s Approach to a Hard Brexit

Published by Anonymous (not verified) on Thu, 28/11/2019 - 9:00pm in

Far from Brexit letting the UK takw back control, it has entered into a relationship where it holds none of the cards.

Federal Prosecutors Initiate Criminal Probe of Six Opioid Manufacturers and Distributors

Published by Anonymous (not verified) on Thu, 28/11/2019 - 5:25am in

Federal prosecutors in Brooklyn have initiated an investigation that could lead to criminal charges against at least six opiods companies.

New Evidence on The Broad Reach of Pharmaceutical Payments

Published by Anonymous (not verified) on Tue, 26/11/2019 - 1:55am in

Our results add to a growing body of evidence linking pharmaceutical payments to changes in prescribing behaviour

Health Care Dysfunction Makes It to the Presidential Debate

Published by Anonymous (not verified) on Sat, 23/11/2019 - 8:25pm in

A damning compendium of what ails the US health care industry.

US Medical Data Security Gets Worse 2 Months After Expose of Hundreds of Millions of Images, Related Patient Info Open on the Internet

Published by Anonymous (not verified) on Fri, 22/11/2019 - 9:42pm in

Another medical data horrorshow.

Why Affordable Student Health Insurance Matters: A Look Back on Care for GW

Published by Anonymous (not verified) on Thu, 21/11/2019 - 6:21am in

In the wake of President Trump’s election in 2016, my friends and I at the George Washington University (GW) were anxious about health insurance. We worried that Trump and a Republican legislature might overturn the entire Affordable Care Act. A loss of protections allowing young people to stay on their parents’ health insurance until age 26 would leave many uninsured and unable to afford insurance. It didn’t take long to realize that many of our peers shared these fears. Our concerns were only compounded by the shockingly high price of the student health insurance plan (SHIP) at GW, which would leave many of us with few options for affordable insurance.

As a 2017 Roosevelt Network summer fellow, I researched and advocated for changes to SHIP. At the time, SHIP premiums at GW cost an astounding $4,103 per year for domestic undergraduates. I worked with a team of students to secure affordable health care at GW and bring student voices into health-related decisions on campus.

When my team asked students about their experiences with health care at GW, we heard stories of health anxiety. Many uninsured students were afraid and unable to seek care unless their conditions were unbearable, often landing them in the emergency room and costing hundreds of dollars. 

My team worked throughout 2017 to build coalitions and advocate for lower costs before university officials. We advocated for a mandatory hard waiver to SHIP, under which students would need to opt out of SHIP by proving that they had other insurance. This system is in place at most other colleges and, as we argued, would lower costs by shifting the insurance risk pool for the plan and guaranteeing that all students had insurance. We also pushed the university to provide more assistance to low-income students to help them afford insurance coverage. Finally, we advocated for the creation of a Student Health Advisory Council (SHAC) to bring students and administrators together to address campus health issues. We published these recommendations in the policy paper I wrote as part of my Roosevelt summer fellowship.

In April 2018, after over a year of advocacy, GW announced changes to SHIP and health services, which were in line with our recommendations. The changes reduced premiums by over $1,400 with no change in the quality of coverage. We also officially established SHAC and began meeting on a regular basis. Other changes made at this time included an electronic health records system and increased free mental health sessions. 

The reduction in health insurance costs is remarkable. Many students expressed happiness that an affordable plan was there if they needed it. According to a recent article in the GW Hatchet, students are still content with this affordable option, with fewer students electing to waive the plan in 2019 compared to 2018 (8,800 students waived in 2019 compared to 9,600 in 2018). The article includes an interview with a sophomore who purchased SHIP after her parents divorced and she was left uninsured. Although this student intends to join one of her parents’ plans soon for in-network coverage with her health care providers at home, the affordable coverage allowed her to stay insured during a period of change in her family.

Just weeks ago, GW officials announced additional positive changes, including expanded clinic hours and a new clinic location. Students at GW have long complained about the university’s focus on profit over student health and wellness. In a promising quote for the GW Hatchet last month, Vice President for Student Affairs and Dean of Students Cissy Petty said, “What happens sometimes is that, if students don’t use a facility often enough, then we say, ‘Well, it’s inefficient,’ instead of that safety and care are more important than the efficiency . . . I’m going to work to put safety and care first, and I’m not going to worry about the revenue.” 

GW administrators rarely speak openly about valuing student wellness over revenue. This shift in tone is notable, though GW administrators have historically issued empty promises to students fighting for change. Nevertheless, it is doubtful that health administrators at GW would have shifted their tone so drastically without pressure from students, both within and outside of SHAC. Many of these changes are thanks to the GW Student Association, which now runs SHAC. I am thankful for every member of the student association who has pushed for student-focused changes to health services at GW. 

Although these changes have been beneficial, there is still room for improvement at GW and many other schools. Students at GW are currently pushing back against clauses in SHIP regarding self-harm and gender-affirming surgeries, which the plan does not cover. In hindsight, I wish my team had fought back against these clauses during our advocacy. I am hopeful that SHAC will be effective in helping students advocate and find solutions to remove these clauses from the plan.

I hope that my team’s successful advocacy will encourage students who are frustrated with health care on their campuses to take on similar projects. Health issues present a unique opportunity for students to build coalitions with campus officials to create a healthier environment for everyone. I hope that Medicare for All will soon be a reality, so that students won’t need to fight for change on a case-by-case basis. Until then, students deserve universities that prioritize their health through affordable student health insurance.

The post Why Affordable Student Health Insurance Matters: A Look Back on Care for GW appeared first on Roosevelt Institute.

The Best Option: Why the Public Option Won’t Be Universal

Published by Anonymous (not verified) on Wed, 20/11/2019 - 3:18am in

Health care—and the prospect of a single-payer system—has gotten a lot of attention at the national level and in presidential debates this year. And for good reason: The costs of health care are consistently rising faster than the economy overall, and households are bearing those increased costs through growing premiums and deductibles. That means many Americans—even those who are insured—still aren’t able to get all of the health care they need.

Momentum against the current system is building, and the state of New York may soon grant the movement its biggest win yet: the New York Health Act, a comprehensive single-payer bill and the subject of a hearing I testified at late last month

Upon passage of the bill, New York residents would have no deductibles, no co-pays—no payments at all at the point of health care service. All residents would be covered under the bill, which would prohibit the sale of private insurance covering the same major medical care covered under the legislation. As a result, there would be no narrow networks, no eligibility rules, no “churning” in and out of coverage when you change jobs—just 100 percent progressively tax-financed universal single-payer coverage.

From a political standpoint, the bill is surprisingly close to passage. It passes the assembly annually and has one senator short of a majority as cosponsors. Governor Cuomo has said that he would not veto the bill if passed. With high turnout expected for the 2020 elections, Democratic senators in New York are relatively safe to pass such a sweeping reform. Hearing the compelling testimonies of state residents and leaders who have sacrificed to get health care for themselves, their families, and their employees, one can begin to grasp the urgency of the moment.

The idea of a public option, however, remains a popular alternative among more moderate candidates. The idea behind the public option would be to introduce a new alternative for consumers who find the private market unaffordable. In most states considering this kind of legislation, the public option would work by allowing consumers the option of buying into a narrow-network Medicaid policy alongside other options in the private insurance marketplace. As I testified before the legislature, there are several reasons the public option cannot bring the kind of large-scale relief that the public seeks.

Consumers won’t be clamoring for a public option.

Under a public option, policies would retain the high deductibles of the Affordable Care Act (ACA) private insurance markets, which average $4,000 this year for benchmark coverage and draw few consumers out. 

The public option would combine high deductibles with very narrow networks of doctors from which to choose. The bright side would be about a 15 percent discount in the monthly premium, since doctors would get paid less. And that brings up the second point.

Medical providers won’t be stoked about a public option either. 

Consider this: Medicaid pays about 56 percent of what Medicare pays in the state of New York. Most providers’ offices can’t and won’t operate at that level. But if provider fees are the only source of savings, as is the case in each of the states currently considering a public option, we face a steep tradeoff between savings and access. (Alternatively, the New York Health Act maintains the average reimbursement rate and generates savings through other avenues, including through the elimination of private insurance companies.)

Finally, private insurance companies won’t want to contract with the states to offer a very widespread public-option alternative.

We would be mistaken to expect private insurers to create a low-cost, high-quality alternative that wholly dominates their private product. It would be irrational. 

Instead, the state-insurance partnerships considering the public option are designing limited-eligibility programs for people who are unable to get coverage through an employer, Medicaid, or marketplace subsidies from the ACA. This limited scope leaves little room for major competitive pressure in the market because consumers won’t be choosing between alternatives; they’ll only have one option.

What the public cares about is whether they will see relief—whether their deductibles can be eliminated without their premiums going up, whether they can find doctors near their home to choose from, and whether they can freely tend to their own well-being. The public option conveniently leaves these questions largely unanswered. The best option for truly universal health care is a single-payer system.

The post The Best Option: Why the Public Option Won’t Be Universal appeared first on Roosevelt Institute.