Medicare Already Limiting Seniors' Access to Care, As Will Obamacare

The Washington Post reports on physicians' reducing the number of appointments they'll give to seniors enrolled in the traditional Medicare monopoly.

What is needed is rigorous measurement of this phenomenon – like the Canadian Fraser Institute’s measurement of waiting times for specialist and hospital care under the government monopoly up there. Obviously, the U.S. government would never fund such research.

December 7 Speech: Alternatives to Obamacare in Contra Costa County, Northern California

I'll be speaking in Contra Costa County on December 7, 6-8 p.m., on alternatives to Obamacare.  It's free and there'll be plenty of time for Q&A.  Round up your friends and neighbors. Register here.

Thanksgiving Break Until Next Monday

Enjoy your vacation!

Health IT and Airport Scanners

Greg Scandlen has sounded a warning about government-dictated health IT.  He points to a scholarly article which demonstrates that health IT can make delivering medical care more dangerous than otherwise.  Mr. Scandlen points out that vendors of health IT are hungry for government hand-outs, which will be significant under Obamacare.

Will Health Reform Save Lives?

Over at the John Goodman Health Policy Blog, Mr. Goodman points out the absurdity of thinking that "uninsurance" is a useful predictor of health status.  Because most uninsured people are uninsured for only a few months, it's not a useful explanatory variable.  Frictional uninsurance is linked to unemployment.  If individuals owned their own health insurance, the problem would be a lot smaller.

One commenter believes that Obamacare's exchanges will help, because people will own their own policies as long as they're in an exchange.  However, you only get the subsidy if you choose your plan from whatever set is available through the state-based exchange.

Competition in Hospitals

I'm involved in an interesting discussion on hospital mortality and the perverse nature of competition amongst hospitals over at John Goodman's Health Policy Blog.

What's Wrong with Long-Term-Care Insurance? Medicaid is one Answer

Medicaid is the single largest payer for long-term-care (LTC) insurance.  That's an important part of the explanation for difficulties in the private market, as I discuss at John Goodman's Health Policy Blog.

Restoring Obamacare's Medicare Cuts

I was thinking of writing this but Ron Bachman of PricewaterhouseCoopers beat me to it.  Mr. Bachman advocates restoring Obamacare's cuts to Medicare by taking the money from the state-based exchanges, which come online in 2014.

It's a great idea.Although the exchanges don’t start running until 2014, it is critical that those who would profit from them (health-IT vendors and consultants, dominant insurers, etc.) do not invest business-development resources in them. Unfortunately, this is already happening.

Changes in Survival: The US in International Comparison

Linda Gorman dissects a study published in Health Affairs, which asserts (among other things), that U.S. health outcomes suffer from a lack of government spending!

I really enjoyed the straw man that Ms. Gorman quoted: “The findings undercut critics who might argue that the US health care system is not in need of major changes.”

Debunking Richard Cohen: How Does the U.S. Health-Care System Stack Up?

Richard Cohen had an extremely ill-informed column in the Washington Post, which Tom Miller of the American Enterprise Institute handily demolishes: Debunking Richard Cohen: How Does the U.S. Health-Care System Stack Up?

Why Don't Doctors Help Patients Shop for Drugs?

Because they don't know themselves how much drugs cost. And health plans don't pay them to know this information or do anything about it.

Although the health plans don’t pay doctors to help patients “shop for medicines,” I have learned that they will pay doctors to switch their prescriptions from branded to generic. Of course, this entire struggle between health plan and brand-name drugmaker is entirely invisible to the patient, and, therefore, likely results in perverse outcomes.

I participate in the discussion over at John Goodman's Health Policy Blog.

Who Killed Primary-Care Practice?

It wasn't just Medicare and private health plans, as I note at John Goodman's Health Policy Blog.

O-Day is January 1, 2014

That's the date Obamacare really sinks its teeth into American health care.  What are the tactics for repeal until then?

I pitch into the debate at National Review Online.

American Health Care & American Productivity

One of the great myths about American society is that our lack of a “universal” health plan harms our competitiveness. Even Lee Scott, former CEO of Wal-Mart, a company that has introduced some headline-making innovations in health benefits for its workforce and customers, bemoans the cost of U.S. health care as a burden on the economy.

On the other hand, we don’t hear Mark Zuckerberg complaining that Facebook’s health care costs are preventing him from competing against foreign social-media businesses.

Prices of Medical Goods and Services

Dr. John Goodman is discussing the policy community's failure to appreciate the role of prices in health care.  I've pitched in, over at his blog.

On the Republican "Alternatives"

With the glow of victory still fresh, it’s a little unseemly to start criticizing the Republicans already on their proposals to replace Obamacare.

But we would not be in the fix we are today if a previous Republican regime had reformed (or eliminated) the employer-based exclusion of health benefits from taxable income. Or, to put it in other words: The federal government should give the American people the health-care dollars that it currently gives our employers.

Republican leaders really muddy this issue.  To wit: Karl Rove's advice in yesterday's Wall Street Journal.

Read the entire post at National Review Online.

San Francisco Bans Toys in Restaurant Meals

In a purported attempt to reduce childhood obesity, San Francisco's Board of Supervisors has voted to ban toys and similar inducements that restaurants use to promote kids' menus.

This is the result of lobbying by the city's bloated and ambitious public-health bureaucracy, and a completely wrong-headed investment of political energy, as I wrote in the local newspaper back in September, when the ban was first proposed.

Health Care Freedom: 2 Out of 3 Ain't Bad

The Freedom of Choice in Health Care Act was on the ballot in three states. This is the model legislation that asserts the unconstitutionality of Obamacare's individual mandate. Before last night, it had already passed as statute or constitutional amendment in six states.

Yesterday's victory in Arizona (55% to 45%) "upgrades" the previously passed statute to a constitutional amendment. Yesterday's victory in Oklahoma (65% to 35%) overides the incumbent governor's previous veto. The measure was defeated in Colorado, but by a narrower margin of 47% to 53%.


All in all, yesterday was a great day for health freedom.

Election Gives States Momentum to Defeat Obamacare

Yesterday’s election resulted in a resounding setback for Obamacare. The federal government takeover of Americans’ access to medical services will suffer significant setbacks in the new Congress. While Congress works towards repeal, states have to choose whether to enable or obstruct Obamacare, which will further pummel states’ fiscal situations.

On Interstate Sales of Health Insurance

I'm involved (over at John Goodman's Health Policy Blog) in a discussion on interstate sales of health insurance.

I’ve been ambivalent about this before, but I square the circle by proposing that states negotiate an interstate compact for health insurance. Others have explained to me that there is no prohibition on their doing so. Plus, there is enough collaboration via National Association of Insurance Commissioners (NAIC) and NCOIL (National Conference of Insurance Legislators) that they could figure this out (if they wanted to) without explicit Congressional permission.

Read more here.