Health Care Experts

What Can Congress Learn from the FDA User Fee Bills?

Mon, 14 May 2012 16:34:21 GMT

Unlike so much else in the 112th Congress, the package of legislation to authorize Food and Drug Administration user fee agreements is humming along. At a House markup last week, Rep. Henry Waxman, D-Calif., was one of many members who commended his colleagues for their ability to collaborate and compromise: "Consideration of this bill should be a model for legislative action," he said. The "UFA" legislation, as it's known, is nearly identical on the House and Senate sides, has passed through markups with nary a complaint, and looks set to pass months before the programs it reauthorizes are set to expire at the end of September.

In a session marked by so much partisan rancor, why are the UFA bills different? What can Congress learn from this process?

Should Americans Get Insurance From Their Employers?

Mon, 07 May 2012 18:20:19 GMT

What role should employer-sponsored health insurance plans play in U.S. health care?

House Republicans have bashed the health reform law as the beginning of the end of the employer-sponsored health insurance market, since it would be less expensive for some employers to drop their plans and pay a fine to the federal government. The House Ways and Means committee released a report last week finding 71 of Fortune 100 companies could save $422 billion by simply paying fines for their employees, instead of the insurance plans they offer now.

But Republicans haven't been huge fans of employers dictating health insurance coverage for individuals in the past. Sen. John McCain, R-Ariz., proposed getting rid of the employer-sponsored health insurance tax exclusion in his failed 2008 presidential campaign, which could incentivize people to buy their own plans. Gov. Mitt Romney, the presumptive Republican presidential nominee for 2012, hasn't gone that far yet. But he does want to "equalize" the tax treatment of health insurance, giving individual buyers the same tax breaks that employees get on their employer health insurance.

Should people get their health insurance through their employers? What considerations should lawmakers take into account when writing policies that shape insurance coverage?

Are ACOs Already Over?

Mon, 16 Apr 2012 18:52:16 GMT

Last week the federal government announced it had signed up 27 hospital and doctor groups to participate as accountable care organizations, one of the health reform law's great cost-saving hopes.

The number is well under federal projections from October, which predicted up to 270 groups would sign up to become Medicare accountable care organizations, or ACOs. The ACO program pays bonuses to doctor and hospital groups if they successfully coordinate care and improve health outcomes for certain Medicare patients. The groups can eventually lose money from the federal government if they don't meet those standards.

Does the low turnout mean ACOs are over? Or is the program just off to a slow start? Why?

Missing Ways To Salvage Health Reform?

Mon, 02 Apr 2012 18:01:09 GMT

After tougher-than-expected questioning for the Obama administration at last week's historic Supreme Court arguments on the health reform law, figuring out how to make the law work if the court strikes down the insurance coverage requirement has become a fulltime hobby.

Several options have been floated-- like auto-enrolling people in health insurance plans or restricting enrollment to certain times of the year--but so far no formal strategy has emerged.

Are there any ways to salvage the health care law that have been missed? What programs do you see surviving if the Supreme Court decides the insurance requirement is unconstitutional?

Doug Peddicord responded to Missing Ways To Salvage Health Reform? on April 16, 2012 02:17 PM

Mon, 02 Apr 2012 18:01:09 GMT

The Supreme Court and Biosimilars As the Supreme Court deliberates the constitutionality of the Affordable Care Act, there are several key provisions unrelated to the individual mandate or the commerce clause that hang in the balance. One such provision can be found in the subtitle of the law known as the Biologics Price Competition and Innovation Act or BPCIA. This provision granted the U.S. Food and Drug Administration (FDA) the authority to approve imitative versions of biologic drugs, known as biosimilars, that would be less costly than the innovator biologic they attempt to replicate. Generic forms of many standard, chemically produced drugs...

Two Years of Health Reform: What Would You Change?

Mon, 19 Mar 2012 12:00:00 GMT

Friday marks the second anniversary of the health reform law. Just three days later, what Republicans like to deride as "Obamacare" will face the biggest challenge it has ever seen: oral arguments at the Supreme Court on whether the law is constitutional. Democrats are spending the week telling voters just how they've benefited from the law, and what they'd lose if it is overturned. Republicans are keeping on their message that the law is an unprecedented government intrusion into Americans' health care. In the meantime, states are scrambling to get insurance exchanges up and running while every facet of the health industry--from insurance companies to doctors to hospitals--are making significant changes to their businesses to adhere to the law's new rules.

If you were implementing the law, what would you have done differently? What would you keep the same? In the battle for public opinion, who is winning: Democrats or Republicans?

Doug Peddicord responded to Two Years of Health Reform: What Would You Change? on March 23, 2012 12:43 PM

Mon, 19 Mar 2012 12:00:00 GMT

The Real Cost of ‘Sunshine’ The goal of any health care reform legislation should be to expand access, increase quality and lower costs. For the most part, the landmark health reform bill signed into law by President Obama does just that. For example, it contains provisions that prohibit the use of “pre-existing conditions” to deny coverage and create health insurance exchanges that will encourage a more competitive marketplace. But at least one part of this law represents serious government overreach and begs for significant rethinking or perhaps even repeal. Section 6002, the Physician Payments Sunshine Act, is intended to...

Gene Steuerle responded to Two Years of Health Reform: What Would You Change? on March 20, 2012 03:26 PM

Mon, 19 Mar 2012 12:00:00 GMT

The Supreme Court Case That Shouldn’t Be There really is no excuse for the case now before the Supreme Court on individual mandates. I am not speaking to the legal merits of each side but to the inability of Republicans and Democrats to come together to fix anything. The individual mandate is really a penalty for not buying insurance. As one of those writing on individual mandates over the years, I had suggested before and during the health reform debate that it be assessed simply as a condition for receiving certain other government benefits. If done that simpler way, there would be no...