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Highlights of the important and the interesting from the world of health care:
Where’s the health insurance competition? In a country seemingly founded on the idea that competition is a universally Good Thing, you’d think the U.S. would have a decent amount of competition in our health insurance markets. Not so much. In 24 of 43 states surveyed, just two insurers control 70 percent of the market, according to a report from the American Medical Association. Apparently, the AMA has decided to pile on insurance companies in the hopes that they’ll get more of the blame for the ridiculously high costs of health care in the U.S. In the wake of the outrage of Wellpoint’s 30-plus percent premium hikes in California (and elsewhere), it’s a good strategy and may work. (Wellpoint has a 57 percent market share in California’s individual-insurance market, by the way.)
With the Rise of AI, What IP Disputes in Healthcare Are Likely to Emerge?
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
The AMA is urging the federal government to to more vigorously review mergers for potential antitrust law violations. The trade group that represents health insurers shot back at the AMA, claiming that the physicians’ group is focusing on wrong kind of competition and consolidation. “To the extent that research has raised the question of competition as a factor in rising health care costs, it has pointed to consolidation among providers, not health plans,” the insurers’ group said. While many freemarketeers decry attempts to set price controls on health insurers–and there are clearly some risks involved–some extra pressure on insurers to control cost seems overall to be beneficial to the American people.
The olive branch of malpractice reform: There’s plenty of convincing evidencethat tort reform (or malpractice reform or capping jury awards, whatever you call it) wouldn’t do anything to control America’s runaway health costs. Nonetheless, The New Republic’s Jon Cohn still advocates such reformbecause “the system is clearly broken.” In a piece that does an excellent job examining the issue, Cohn offers several potential solutions to improve the malpractice system.
One suggestion is to simply have doctors report medical errors to hospital administrators, who would then notify patients and begin negotiations. Another is to create special “health courts” that would have expertise in dealing with malpractice matters. The option Cohn labels the “most intriguing” would tie malpractice to quality incentives by offering some sort of legal protection to physicians who demonstrate they have followed accepted clinical guidelines. If Democrats want to see if Republicans really have any desire to engage in health reform, they could extend a malpractice olive branch and see if there are any GOP takers. Don’t bet on it.
What’s so liberal about the Senate health reform bill? To get an idea of how health policy ideas have changed over the last 15 to 20 years, take a look at this chart from Kaiser Health News. The chart compares the Senate reform bill, a Republican health reform proposal and a 1993 Republican proposal that was pushed as an alternative to President Clinton’s plan. The takeaway? The Senate bill is very close to the ’93 Republican proposal. Credit to Ezra Klein for one of the best lines I’ve read about health reform:
A Personalized Approach to Medication Nonadherence
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
We’ve got a situation in which Democrats are essentially pushing moderate Republican ideas while Republicans push extremely conservative ideas, but because neither the press nor the voters know very much about health-care policy, the fact that Republicans refuse to admit that Democrats have massively compromised their vision is enough to convince people that Democrats aren’t compromising.
The pain of medical school debt: Since there’s always room to add another issue to the health-overhaul debate, let’s throw another on the pile: medical school debts. DB’s Medical Rants shares the story of one med student who will graduate with nearly $300,00 in debt, and interest charges will push that amount up in the future. Worse yet, this student is going into primary care, the lowest-paid form of medicine and not coincidentally the one in shortest supply in America. Those huge debt loads clearly push lots of students away from primary care and into better-paying specialties that aren’t going through such a shortage. It would indeed be a wise move if reform efforts incorporate some sort of significant debt-relief measures for doctors who choose the tough road of primary care.
