THE HEALTH REFORM “PARADIGM”

Slides:

Advertisements

Similar presentations

Changes in the U.S. Healthcare System Gary Claxton Vice President and Director of the Health Care Marketplace Project.

Advertisements

Sample insurance constraints

Ana Malinow, MD Associate Professor Pediatrics, BCM Co-founder, Health Care for All Texas September 22, 2009.

Among Firms Offering Health Benefits, Percentage of Firms That Report They Made the Following Changes as a Result of the Economic Downturn, by Firm Size,

Health Benefits 2007: A USA and California Update Jon R. Gabel Senior Fellow National Opinion Research Center.

Employer Health Benefits KFF/HRET 2008 Survey Health Benefits in 2008: Premiums Increase Modestly as CDHP Grows and Deductibles Rise Sharply Jon Gabel.

Employer-Sponsored Health Coverage Release Slides Tuesday, September 11, 2012 March 15, 2013.

Jon R. Gabel Senior Fellow National Opinion Research Center at the University of Chicago.

Employer Health Benefit Survey Release Slides Tuesday, August 20, 2013.

Robert B. Helms Resident Scholar American Enterprise Institute ARIA Annual Meeting The Capital Hilton August 7, 2006 Tax Policy and Health Insurance: History.

Affordable Healthcare Act (ACA) By Suzan, Scott, and Pat.

Obama Administration Outline/Proposal Broad Outline Only Would retain employer based health insurance system Includes a “play or pay” model Creates a.

Evolution of Managed Care. Introduction What is Managed Care? Brief History.

Employer Health Benefit Survey 2015

-AND Findings from the Kaiser/HRET and Kaiser/Hewitt Employer Surveys.

Employer Health Benefits Survey Release Slides September 10, 2014.

The Kaiser/HRET 2002 National Survey of Employers: What Are Its Implications for Health Insurance? Jon Gabel Vice President, Health System Studies Health.

Average Annual Premium Increases for Family Coverage,

Web Briefing for Media: 2015 Kaiser/HRET Employer Health Benefits Survey Tuesday, September 22, 2015 Presented by the Kaiser Family Foundation and Health.

Trends in Employer-Based Health Insurance Jon Gabel Senior Fellow, NORC.

Employer Health Benefits Survey 2017

Web Briefing for Media: Kaiser/HRET Employer Health Benefits Survey

Employer Health Benefit Survey 2016

Exhibit 1.16 Average Premium Increases for Covered Workers with Family Coverage, * Percentage change in family premium is statistically different.

Gathered Wednesday, 25 April 2012

Omar M. Lattouf, MD, PhD, FACC, FACS

Exhibit 8.1 Among Firms Offering Health Benefits, Percentage of Firms that Offer an HDHP/HRA and/or an HSA-Qualified HDHP, * Estimate is statistically.

Average Premium Increases for Covered Workers with Family Coverage,

Exhibit 14.5 Among Firms Offering Health Benefits, Percentage of Firms Whose Largest Plan Includes a High-Performance or Tiered Provider Network, by Firm.

Exhibit Among Firms Offering Health Benefits with 50 or More Employees, Percentage of Covered Workers Enrolled at a Firm That Offers Benefits Through.

Exhibit 8.5 Percentage of Covered Workers Enrolled in an HDHP/HRA or an HSA-Qualified HDHP, * Estimate is statistically different from estimate.

Exhibit 12.8 Among Firms Offering Health Benefits, Percentage of Firms that Offer Employees an Opportunity to Complete a Biometric Screening, by Firm Size,

Exhibit 7.8 Percentage of Covered Workers Enrolled in a Plan with a High General Annual Deductible for Single Coverage, by Firm Size, 2016 * Estimate is.

Exhibit 8.18 Among Firms Offering Family Coverage and an HSA-Qualified HDHP, Percentage of Firms That Vary Their HSA Contribution for Family Coverage on.

ACCESS: AFFORDABLE CARE

Increases in Health Insurance Premiums Compared with Other Indicators, 1988–2007 Percent * Premiums are growing at rates more than twice that of other.

Exhibit 7.12 Percentage of Covered Workers Enrolled in a Plan with a General Annual Deductible of $2,000 or More for Single Coverage, by Firm Size,

Projected Savings and Effectiveness of System Reform Provisions in House and Senate Reform Bills 2010–2019 (in billions) CBO Estimate of Budget Savings,

Exhibit 5.1 Distribution of Health Plan Enrollment for Covered Workers, by Plan Type, NOTE: Information was not obtained for POS plans in 1988.

Exhibit 7.9 Percentage of Covered Workers Enrolled in a Plan with a General Annual Deductible of $1,000 or More for Single Coverage, By Firm Size,

Exhibit 9.1 Distribution of Covered Workers Facing Different Cost-Sharing Formulas for Prescription Drug Benefits, * Distribution is statistically.

Trends in Insurance Coverage

Exhibit 11.1 Among All Large Firms (200 or More Workers) Offering Health Benefits to Active Workers, Percentage of Firms Offering Retiree Health Benefits,

Percentage of Individuals Covered by Employment-Based Health Benefits With a Choice of Health Plan, by Type of Health Plan, 2005–2007 Comprehensive =

Exhibit 1.7 Distribution of Annual Premiums for Single and Family Coverage Relative to the Average Annual Single or Family Premium, 2016 Percentages.

Exhibit 11.1 Among All Large Firms (200 or More Workers) Offering Health Benefits to Active Workers, Percentage of Firms Offering Retiree Health Benefits,

Exhibit E: Distribution of Health Plan Enrollment for Covered Workers, by Plan Type, NOTE: Information was not obtained for POS plans in 1988.

Exhibit 11.4 Among All Large Firms (200 or More Workers) Offering Health Benefits to Active Workers and Offering Retiree Coverage, Percentage of Firms.

Grandfathering Under the Affordable Care Act (ACA),

Exhibit 12.7 Among Firms That Offer Health Benefits and Provide Employees the Opportunity to Complete a Health Risk Assessment, The Percentage of Firms.

Exhibit 6.20 Distribution of the Percentage of Total Premium Paid by Covered Workers for Single and Family Coverage, by Firm Wage Level, 2016 SINGLE COVERAGE.

Exhibit 7.11 Percentage of Covered Workers Enrolled in a Plan with a General Annual Deductible of $1,000 or More for Single Coverage After Any HRA/HSA.

Exhibit 7.13 Percentage of Covered Workers Enrolled in a Plan with a General Annual Deductible of $2,000 or More for Single Coverage After Any HRA/HSA.

Exhibit 2.9 Among Firms Offering Health Benefits, Percentage of Firms That Offer to Part-Time Workers, by Firm Size, 1999–2016 * Estimate is statistically.

Exhibit 3.5 Among Workers in Firms Offering Health Benefits, Percentage of Workers Covered by Health Benefits Offered by Their Firm, by Firm Characteristics,

Exhibit 2.10 Among Firms Offering Health Benefits, Percentage That Offer Health Benefits to Temporary Workers, by Firm Size, 1999–2015 * Estimate is statistically.

Exhibit 10.2 Percentage of Covered Workers in Partially or Completely Self-Funded Plans, by Firm Size, * Estimate is statistically different.

Exhibit 9.10 Percentage of Covered Workers with Drug Coverage Who Face a Separate Prescription Drug Deductible, by Plan Type, NOTE: Tests found.

Exhibit 8.3 Among Firms Offering Health Benefits, Percentage That Offer an HDHP/SO, by Firm Size, * Estimate is statistically different from.

Exhibit 2.9 Among Firms Offering Health Benefits, Percentage That Offer Health Benefits to Part-Time Workers, by Firm Size, 1999–2015 * Estimate is statistically.

Exhibit 6.18 Distribution of the Percentage of Total Premium Paid by Covered Workers for Single and Family Coverage, by Wage Level, 2013 SINGLE COVERAGE.

Average Annual Change Adjusted for Inflation is 5.3%

Exhibit 2.5 Percentage of Firms Offering Health Benefits to At Least Some of their Workers, by Firm Size, 2015 NOTE: Estimates presented in this exhibit.

Exhibit 8.3 Among Firms Offering Health Benefits, Percentage of Firms That Offer an HDHP/SO, by Firm Size, * Estimate is statistically different.

Exhibit 3.5 Among Workers in Firms Offering Health Benefits, Percentage of Workers Covered by Health Benefits Offered by Their Firm, by Firm Characteristics,

Exhibit 7.15 Distribution of General Annual Deductibles for Single Coverage After any HRA/HSA Contributions, By Firm Size, NOTES: Testing found.

Exhibit 11.4 Among Large Firms (200 or More Workers) Offering Health Benefits to Active Workers and Offering Retiree Coverage, Percentage of Firms Offering.

Exhibit 14.4 Among Firms Offering Health Benefits, Percentage of Firms Whose Largest Plan Includes a High-Performance or Tiered Provider Network by Firm.

Exhibit 2.4 Percentage of Firms Offering Health Benefits to At Least Some of Their Workers, by Firm Size, 2016 * Estimate is statistically different from.

Exhibit 6.19 Distribution of the Percentage of Total Premium Paid by Covered Workers for Single and Family Coverage, by Wage Level, 2014 SINGLE COVERAGE.

Presentation transcript:

THE HEALTH REFORM “PARADIGM” (I don’t think that’s a real word.)

“PARADIGM” “A set of assumptions, concepts, values, and practices that constitutes a way of viewing reality for the community that shares them, especially in an intellectual discipline.” In heath care, there’s no such thing. Which is rather the problem.

What is health reform? Health Care: Cost, access, quality. Politics: The act of getting a bill passed.

The paradox of health reform Access reform. Obama and Massachusetts. Cost reform.

Average Percentage Increase in Health Insurance Premiums Compared to Other Indicators, 1988-2007 3.7% 2.6% *Estimate is statistically different from estimate for the previous year shown (p<.05). No statistical tests are conducted for years prior to 1999. Note: Data on premium increases reflect the cost of health insurance premiums for a family of four. The average premium increase is weighted by covered workers. Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2007; KPMG Survey of Employer-Sponsored Health Benefits, 1993, 1996; The Health Insurance Association of America (HIAA), 1988, 1989, 1990; Bureau of Labor Statistics, Consumer Price Index, U.S. City Average of Annual Inflation (April to April), 1988-2007; Bureau of Labor Statistics, Seasonally Adjusted Data from the Current Employment Statistics Survey, 1988-2007 (April to April).

Ezra Klein’s First Rule of Health Reform Do Not Screw With What People Have. The first rule of cost reform: Screw with what people have

POLITICS! Insurers are not the enemy. Nor are pharmaceutical companies, doctors, device manufacturers, etc. The Senate in the enemy. Obstruction. A system designed to ensure nothing gets done.

THE PROBLEM OF THE PRESIDENT. Mandates. Max Baucus. FDR, Truman, Johnson, Nixon, Carter, Clinton.

The Problem of Plans Obama, Clinton, Clinton 1994, Edwards, McCain, Wyden-Bennett, Langevin, New America, CAP, CAF, Hacker, Ezekiel-Fuchs, Massachusetts, EPI, Bush, Cato, Heritage, Ezra Klein, France, Kennedy. We got plans.

Approach Policy dogmatists and political agnostics. We need to be, within reason, political dogmatists and policy agnostics.

The Budget Picture Health care and the bail out, the deficit, etc. Access alone becomes tougher. CBO and Wyden Back to the paradox. Which brings us back to the politics.

The “Paradigm.” Politics.