From The Archives: Medicare Means Testing - Test the Deductible, Not the Premiums

Many conservatives believe that increasing means testing for Medicare would be a good solution. Some would even go so far as to eliminate Medicare benefits for very rich people (like Warren Buffett).

But this is not consistent with principles of limited government. I have recently dug up an article I wrote on the issue from 2008. While the figures are out of date, the argument remains the same.

Read it here.

From the Archives: Heart Transplants to Hairpieces - The Questionable Benefit of State Benefit Mandates

This is a long study I wrote in 2008, which addresses the costs and benefits of state benefit mandates. At the time, a movement to mandate coverage of a controversial therapy for autism was sweeping through the states.

In it, I concluded that an additional mandated benefit increased the number of uninsured residents of a state by about one quarter of one percent. However, I was very tentative in this conclusion. This is why you don't find me in the conservative chorus calling for selling health insurance "across state lines" (whatever that means) to escape mandated benefits.

I had not posted it here previously because I could not find it on the Internet. Well, we have it now! The link is here.

The $35 Billion Windfall From Delaying Obamacare's Individual Mandate By One Year Could Restore National Institutes of Health Funding For A Decade

Delaying Obamacare's individual mandate by just one year would reduce the federal deficit by over $35 billion, according to the Congressional Budget Office (CBO). Freed from fear of the individual mandate, Americans would be less likely to buy expensive health insurance on the Obamacare exchanges (which have suffered embarrassing glitches during their first week of operation). This would stop the hemorrhaging of about $28 billion of subsidies through the exchanges. Further, because Americans would keep more of their wages as taxable income, income and payroll tax receipts would increase by about $8 billion.

If more Americans appreciated this fiscal windfall, the mandate would surely become even more unpopular. Although many Americans would like to reduce the deficit, others might prefer to spend the revenue on other government activities. If House Republicans were willing to pass a new version of the CR that spent some of this revenue, it would surely increase the odds of passage in the Senate.

Read the rest of this article at Forbes.com, The Apothecary.

The Medicare "Doc Fix" Will Never Get Fixed Like This

Earlier this month, the Congressional Budget Office (CBO) scored the cost of a Republican-led bill to permanently “fix” the Medicare fee schedule for physicians. The cost to taxpayers? $175 billion over ten years. To put that in perspective, according to the Congressional Budget Office’s bishopx-largeMay 2013 budget outlook, the ObamaCare’s effect on health spending is that it will cost $1.8 trillion over ten years. So, this so-called permanent doc fix would cost almost one tenth the entire cost of ObamaCare.

How can anyone possibly call that a “fix?

Read and comment on the rest of this article at John Goodman's Health Policy Blog.

Obamacare's Medical-Device Excise Tax: Early Evidence Suggests Significant Harm

The medical-device industry’s primary lobbying goal this year is to repeal Obamacare’s 2.3 percent excise tax on medical devices. Device makers have been collecting and remitting this new tax since the beginning of 2013.

Now that we are in the second half of 2013, we can inquire whether the early evidence confirms these predictions. Preliminary research on the financial results for the first half of the year suggests that the excise tax is causing significant harm.

Read this entire article at Forbes.com's The Apothecary here.

Health Technology Forum Launches a Branch in Washington, DC: Kick Off September 19

Before moving to DC in August 2012, I was involved in the Health Technology Forum. The Forum started about three years ago, meeting about once a month in either San Francisco or Silicon Valley.

According to the vision statement, "Health Technology Forum promotes the intersection of health care and technology by connecting people worldwide who have common interest in making health care better, more accessible and affordable for everyone." What it looks like in practice is networking events after work, attended by about one hundred people, where three or so entrepreneurs present their businesses. Sometimes, government officials (from, e.g. FDA or ONC HIT) will present.

For example, one of the San Francisco events I attended featured a presentation by PillJogger, a software solution for medication adherence, which was founded by an MD trained at Johns Hopkins and Stanford. I (and everyone else) was able to engage the entrepreneurs close up. It's a rare and great experience.

In the last couple of years, chapters have been founded in many North American cities. The community has decided to found a chapter in the DC area, and the kick off event will be on September 19 at Troutman Sanders, 401 9th St, NW, Washington, DC.

So far we have two speakers confirmed:

• Damon Sanders, Director of the Health Data Initiative at the Office of the Chief Technology Officer at U.S. Department of Health & Human Services
• Nancy Hall, Chief Information Officer of MedAmerica, a leading medical-practice management service provider.

For more information and registration, please see this Meet Up page. The more the merrier, so please forward this invitation to anyone you think might be interested in the Health Technology Forum. I hope to see you there.

How Congress Encourages Shortages of Cancer Drugs

2011 and 2012 saw a quickening of interest in the deadly problem of acute shortages of injected drugs, especially those targeting cancer. Drugs defined as being in “short supply” by the Food and Drug Administration (FDA) increased from 61 in 2005 to more than 250 in 2011. Since reforms passed Congress thirteen months ago, the problem has gotten 20 percent worse.

The fundamental reason for Congress' failure is that it increased the power of the FDA, when it should have decreased it.

Read the entire article at Forbes.com The Apothecary.