If RAND’s latest report is accurate, the uninsured rate among 18-64 year old adults in the United States fell by 23 percent—from 20.5 percent to 15.8 percent—between September 2013 and March 2014. And if RAND is right, that’s big news—but it’s probably not the news we were expecting.CBPP:
How many uninsured people have gained health coverage since the Affordable Care Act’s major coverage expansions took effect January 1? While 2014 health coverage data from the major federal surveys won’t be available until mid-to-late next year, new data from three independent surveys suggest that health reform’s Medicaid expansion and subsidized marketplace coverage likely are already making substantial progress in reducing the ranks of the uninsured.The number of uninsured is dropping. The exact number is TBD, but it's beyond debate as to the direction of the trend.
More politics and policy below the fold.
According to new polling by Public Policy Poling conducted for MoveOn, in voters support Medicaid expansion in key states by wide margins: 52 to 35 percent in Kansas, 58 to 33 percent in Florida, 59 to 30 percent in Pennsylvania, 54 to 38 percent in Georgia. All are states where Medicaid expansion has been blocked by Republican politicians. In Virginia, where the GOP has also blocked Medicaid expansion, a previous poll found that even a majority of state Republican voters support extending coverage for the state’s low-income residents. And other polls show that three-out-of-four Americans nationwide, including a majority of Republicans, support Medicaid expansion.The next few pieces are on the Medicare (not Medicaid) reimbursement data dump.
Starting as early as today, CMS will publicly release comprehensive data on physician billing practices in Medicare, including information about specific, identifiable doctors. The move is controversial: the AMA, for one, is “concerned” that the data “will mislead the public into making inappropriate and potentially harmful treatment decisions and will result in unwarranted bias against physicians that can destroy careers.” And I’ll bet a few doctors in Miami, with its extraordinary rate of Medicare spending, are sweating bullets.WaPo:
CMS hopes the data will “help consumers compare the services provided and payments received by individual health care providers. Businesses and consumers alike can use these data to drive decision-making and reward quality, cost-effective care.” The word choice here—“consumers,” not “patients”—is a cue that CMS wants to enlist market forces to discipline errant physicians. Call it consumer-directed health care, Medicare-style.
There’s reason for skepticism, though. Information disclosure is a common regulatory tool. It’s been studied a lot. And in most settings, it just doesn’t work.
An analysis of government data released Wednesday shows that the cost of drugs administered by doctors accounts for a growing piece of Medicare’s spending and varies widely from region to region in the United States, raising questions about whether some physicians may be misusing the pharmaceuticals.For example, WSJ:
Most of the 4,000 doctors who received at least $1 million from Medicare in 2012 billed mainly for giving patients injections, infusions and other drug treatments, those records show.
Among the highest-reimbursed doctors in their fields were a Michigan oncologist with $10 million in 2012 payments and a Rhode Island anesthesiologist at $3.5 million, both of whom have been indicted for fraud in federal courts. Also among the highest reimbursed was Jean Malouin, a family-medicine doctor in Michigan, but that is because she reimburses other doctors in a special demonstration program backed by the agency that oversees Medicare. The Michigan oncologist has pleaded not guilty. An attorney for the anesthesiologist says his client is innocent.Jennifer Raff:
That diversity underscores crucial gaps in the new data. Medical groups and policy makers have asserted that the figures lack context needed to show which doctors may be abusing the system and which are simply hard workers and overseers of complicated medical practices, or those whose specialties involve high overhead costs, such as radiation oncology, that lead to bigger bills.
Dear parents,The above? A thing of beauty.
They say that measles isn’t a deadly disease.
But it is.
They say that chickenpox isn’t that big of a deal.
But it can be.
They say that the flu isn’t dangerous.
But it is.
They say that whooping cough isn’t so bad for kids to get.
But it is.
They say that vaccines aren’t that effective at preventing disease.
But 3 million children’s lives are saved every year by vaccination, and 2 million die every year from vaccine-preventable illnesses.
They say that “natural infection” is better than vaccination.
But they’re wrong.
Between Democrats who talk like Roosevelt or LBJ, but offer little or nothing to working-class whites not poor enough to qualify for means-tested welfare, and Republicans who sound like Ayn Rand but end up supporting Social Security and Medicare, the white working class has little to choose from. So non-racist, non-Southern members members tend to identify with the one of the two economically-conservative, plutocrat-funded parties that is dominant in their states and neighborhoods.Fact Tank/Pew:
The white working class has not rejected the party of pro-working-class economic progressivism, because in today’s America no such party exists. They can’t turn down a new New Deal that nobody offers them.
A greater share of mothers are not working outside the home than at any time in the past two decades, according to a new Pew Research Center report. After declining for several decades — bottoming out at 23% around the turn of the century — the share of stay-at-home mothers has risen in fits and starts over the past decade and a half, to 29% in 2012, according to the Pew Research analysis of census data.Charles M. Blow:
While there are many reasons driving this trend, one likely reason is the rising cost of child care. A 2010 Census paper (which focused on married stay-at-home mothers) commented that “[e]specially for mothers who have more than one child under 5, the cost of day care might be higher than she could support unless she has fairly high earnings.”
Voter apathy is a civic abdication. There is no other way to describe it.
If more Americans — particularly young people and less wealthy people — went to the polls, we would have a better functioning government that actually reflected the will of the citizenry.
But, that’s not the way it works. Voting in general skews older and wealthier, and in midterm elections that skew is even more severe.