Dr. Troyen Brennan Discusses His Just-Published Book, "The Transformation of American Health Insurance, On the Path to Medicare for All"
The Healthcare Policy Podcast ® Produced by David IntrocasoShow Notes
Harvard Chan School of Public Health’s Dr. Troy Brennan argues in sum that because government Medicare, Medicaid and ACA marketplaces have grown and evolved, meaning the feds have improved their ability to competently regulate the healthcare market, employer-sponsored commercial plan coverage has become both comparatively unaffordable and increasingly irrelevant. Primarily for these reasons Dr. Brennan argues the US is headed toward or on the path to federally-sponsored and regulated healthcare administered by private or commercial payers. That is it appears increasingly likely the US will finally realize universal, socialized, single payer healthcare insurance or what he defines as Medicare For All, or more specifically Medicare Advantage for All in which commercial insurance plans serve a strictly administrative role. Dr. Brennan’s book can be found at: https://www.press.jhu.edu/books/title/53759/transformation-american-health-insurance.
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More from The Healthcare Policy Podcast ® Produced by David Introcaso
In a world of unbridled self-interest or where self-interest becomes the basis for reason, where integrity is abandoned, where there exists a striking absence of and/or contempt for moral analysis, virtue and empathy and where cynicism becomes inevitable, power compromises the law and evil no longer needs to be justified. These realities, for example, help explain a projected 14+ million deaths by 2030 via US AID funding cuts, the US quitting the WHO and the Paris accord, cutting Medicaid funding by ~$1 trillion, reducing projected ACA enrollment by nearly 50%, disappearing AHRQ, crippling the CDC and dismantling the EPA. As Prof Neiman argues, “In all the words written in an attempt to understand the present crisis, what’s striking is the scarcity of moral analysis.” “Trump and his ilk could never have come to power without one belief: Moral concepts are for suckers who don’t know they’re being conned.” Professor Susan Neiman bios are at: https://www.susan-neiman.com/ and at: https://en.wikipedia.org/wiki/Susan_Neiman. Info on “Call It Evil” is at: https://wwnorton.com/books/9781324131045.
On July 30 Senate Finance Committee Democrats issued an 86-page Request for Information (RFI) titled, “Health Coverage That Works for Everyone.” As Ranking Democratic Member Ron Wyden explained, much like the Finance Committee’s 2008 white papers that laid the groundwork for the ACA, this RFI constitutes an essential blueprint for necessary and immediate federal healthcare reform. Surprisingly - or not, beyond a limited number of trade publications and policy shops the RFI has to date been ignored. The authors 167-page paper make essentially two arguments: while the Ds diagnosis is correct in that part of the problem is how commercial insurers (termed “Big Insurance”) make money (and how much), nearly half of the RFI’s 71 propose reforms will likely cause payers to move money to unregulated subsidiaries or affiliates instead of saving it or applying the savings to actual care spending; and, by ignoring hospital prices, that substantially are responsible for both health care spending and inflation (once again think: “It’s the Prices, Stupid”), the Senate Finance Ds are ignoring over $300 billion in potential annual savings. E.g., they write, “squeeze insurer margin perfectly and the hospital price base is exactly where it was,” and “you cannot audit the pricing power of the party [hospitals] you have just cast as the injured one.” The report deserves the attention of all serious healthcare policy students. The authors’ work, published as INET working paper, is at: Alvelda-Ferguson-Wyden-RFI-Critique-Brainworks-INET-final.pdf. INET is at: https://www.ineteconomics.org/. Professor Ferguson’s bio is at: https://www.ineteconomics.org/research/experts/tferguson. Dr. Alvelda’s bio is at: https://www.ineteconomics.org/research/experts/pAlvelda and at: https://brainworks.ai/about-us/.
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