A He
alth Policy Checkup
Supreme Court schedule for federal health care law case: For those who are interested in following the litigation regarding the federal Patient Protection and Affordable Care Act, here is a link to the timetable between now and the end of oral argument before the U.S. Supreme Court on March 28: http://tinyurl.com/6r9cdzf.
There are four distinct questions before the Court:
1. Individual mandate: Whether Congress went too far in requiring all Americans to purchase and maintain individual health insurance.
2. Severability: The Severability Clause, language that describes the right to remove a line or portion of a bill without changing the rest, was not included in this legislation, so that if any part of the law is declared unconstitutional, the entire law could be invalid.
3. Anti-Injunction Act. This particular rule says that private individuals are barred from challenging the constitutionality or legality of taxes until after a tax is collected. In other words, must the Court first wait for the tax to be imposed on those who don’t want to buy individual insurance, after which they can sue to not pay it? This means that a decision on the constitutionality of the individual mandate may have to be delayed until 2015.
4. Medicaid: Whether the Medicaid expansion by Congress usurps the authority of the states.
What is the impact of regulation and the new health care law? Fewer jobs, according to a U.S. Chamber of Commerce Small Business Study . Of the small businesses surveyed in the study released January 18, 78 percent report the taxation, regulation and legislation from Washington make it harder for their business to hire more employees. And 74 percent say the recent health care law makes it harder for their business to hire more employees. Only 19 percent of small business owners say their business has added employees over the last year and an additional 63 percent say they will keep the same number of employees over the next year. Why aren’t they hiring? As one would expect, 52 percent say economic uncertainty is among the top reasons they are not hiring. Additionally roughly one-third cites lack of sales as part of their hesitation. Many say Washington is part of the problem, as well. Thirty-six percent say uncertainty about what Washington will do next is one of the top two reasons they are not hiring and 30 percent say they are not hiring because of the requirements in the health care bill.
The high cost of the individual mandate: In a January 23 Wall Street Journal op-ed, the Cato Institute’s Michael Cannon agrees that the new federal health care law will force insurers to reduce premiums for the sick, and the mandate will magnify that effect. The caveat? “But those same government price controls will increase premiums for healthier customers – and the mandate will magnify that effect, too. (Economist Jonathan Gruber, one of the law’s biggest proponents, projects that for some who buy policies in the individual market, premiums will more than double.) At best, those two effects cancel each other out. But these provisions also create incentives for healthy people to drop coverage, driving average premiums higher still.” Read more at http://www.cato.org/pub_display.php?pub_id=14037.
The Doctor Trap, Part II: In his blog, John Goodman of the National Center for Policy Analysis continues to explain how physicians are trapped . For one, they aren’t paid for telephone consultations. “Medicare has a list of about 7,500 tasks it pays physicians to perform. And talking by phone isn’t on the list – at least in a way that makes it practical. Private insurance tends to pay the way Medicare pays. So do most employers.” He points out, too that electronic medical record (EMR) systems have the capacity to improve quality and greatly reduce medical errors. “Yet only about half of physicians have electronic medical record (EMR) systems and most of those are not connected to other physicians’ offices and hospitals, do not allow electronic prescribing, etc. The same is true for hospitals. One study concluded that “information systems in more than 90 percent of U.S. hospitals do not even meet the requirement for a basic electronic-records system.”