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Tuesday, July 26, 2016

The Clinton campaign health care policy position

Well, I posted about "The Trump campaign health care policy position" last week during the Republican National Convention in Cleveland. Now, as the Democrats convene in Philly, here's the Hillary position:
As president, Hillary will:
  • Defend and expand the Affordable Care Act, which covers 20 million people. Hillary will stand up to Republican-led attacks on this landmark law—and build on its success to bring the promise of affordable health care to more people and make a “public option” possible. She will also support letting people over 55 years old buy into Medicare.
  • Bring down out-of-pocket costs like copays and deductibles. American families are being squeezed by rising out-of-pocket health care costs. Hillary believes that workers should share in slower growth of national health care spending through lower costs.
  • Reduce the cost of prescription drugs. Prescription drug spending accelerated from 2.5 percent in 2013 to 12.6 percent in 2014. It’s no wonder that almost three-quarters of Americans believe prescription drug costs are unreasonable. Hillary believes we need to demand lower drug costs for hardworking families and seniors. Read more here. 
  • Fight for health insurance for the lowest-income Americans in every state by incentivizing states to expand Medicaid—and make enrollment through Medicaid and the Affordable Care Act easier.
  • Expand access to affordable health care to families regardless of immigration status. Hillary will expand access to affordable health care to families regardless of immigration status by allowing families to buy health insurance on the health exchanges regardless of their immigration status.
  • Expand access to rural Americans, who often have difficulty finding quality, affordable health care. Hillary will explore cost-effective ways to make more health care providers eligible for telehealth reimbursement under Medicare and other programs, including federally qualified health centers and rural health clinics.
  • Defend access to reproductive health care. Hillary will work to ensure that all women have access to preventive care, affordable contraception, and safe and legal abortion.
  • Double funding for community health centers, and support the healthcare workforce: As part of her comprehensive health care agenda, Hillary is committed to doubling the funding for primary-care services at community health centers over the next decade. Hillary also supports President Obama’s call for a near tripling of the size of the National Health Service Corp.
Strikingly different from the Trump stance. The entire 51 page Democratic Party 2016 platform paper health care section spans pages 34 - 39.

Noteworthy that Bernie Sanders has pushed Hillary leftward toward "universal health care." Trump, on the other hand, remains committed to the (totally beneficent, totally mythical) "free market."
"We will work with Congress to make sure we have a series of reforms ready for implementation that follow free market principles and that will restore economic freedom and certainty to everyone in this country. By following free market principles and working together to create sound public policy that will broaden healthcare access, make healthcare more affordable and improve the quality of the care available to all Americans."
And, as of yet, the Libertarian Johnson-Weld campaign remains silent on health care policy.

I guess I should also cite the Green Party Jill Stein Presidential campaign, notwithstanding that I continue to see her as a rounding error.
Health Care as a Right:
Establish an improved “Medicare For All” single-payer public health insurance program to provide everyone with quality health care, at huge savings.
That position has been pretty much co-opted by the Clinton campaign, who are now touting support for a Medicare "public option."

BTW, see my 2009 post "Public Optional" on another of my blogs. Seven years ago:
I am really sick of hearing about the "public option" wrangle 24/7 in the media these days. I am increasingly skeptical of its inclusion of any final legislation that may or may not reach the President's desk, and likewise skeptical that it would comprise much of an improvement even should it pass the Congress (and, it looks increasingly to me like a slickly orchestrated "misdirection" strategy). Without a "public option" (our having taken Single Payer off the table a priori), it is difficult to see what "health care reform" would truly amount to. But, then, "public option" as currently proffered (e.g., H.R. 3200) merely looks like -- as I've said before -- [1] corporate welfare ("Play or Pay" forcing everyone to buy health insurance policies under threat of tax penalty for non-compliance), and [2] outright "welfare" (means-tested government subsidy for health insurance "affordability").
Also, re: "Single Payer," I had a run at that in grad school in 1994 (pdf).

Relatedly, from PNHP:

Government funds nearly two-thirds of U.S. health care costs: American Journal of Public Health study
Contrary to popular perceptions, taxpayers fund 64 percent of U.S. health care, more public dollars per capita than the citizens of other nations – including those with universal health programs

January 21, 2016

Tax-funded expenditures accounted for 64.3 percent of U.S. health spending – about $1.9 trillion – in 2013, according to new data published today [Thursday, Jan. 21] in the American Journal of Public Health. The Affordable Care Act will push that figure even higher by 2024, when government’s share of U.S. health spending is expected to rise to 67.3 percent.

At $5,960 per capita, government spending on health care costs in the U.S. was the highest of any nation in 2013, including countries with universal health programs such as Canada, Sweden and the United Kingdom. (Estimated total U.S. health spending for 2013 was $9,267 per capita, with government’s share being $5,960.) Indeed, government health spending in the United States exceeded total health spending (government plus private) in every other country except Switzerland.

The finding that Americans pay the world’s highest health-related taxes conflicts with popular perceptions that the U.S. health care financing system is predominantly private, write Drs. David U. Himmelstein and Steffie Woolhandler, the authors of the study. Himmelstein and Woolhandler are professors at the City University of New York School of Public Health and lecturers in medicine at Harvard Medical School.

Direct government payments for such programs as Medicare, Medicaid and the Veterans Administration accounted for 47.8 percent of overall health spending. The analysis also identified two commonly overlooked tax-funded health expenditures – government outlays for public employees’ private health insurance coverage ($188 billion, or 6.4 percent of total spending) and tax subsidies to health care ($294.9 billion, or 10.1 percent of the total). Together, these public expenditures put the U.S. in first place for health care taxes.

Using another yardstick, the researchers note that tax-funded health expenditures in the U.S. accounted for a larger share of the gross domestic product (11.2 percent in 2013) than did the total health expenditures of any other nation...
Nearly 20% of GDP, more than half of it already publicly financed. And -- going all too frequently unreported -- the vast bulk of that publicly-funded expenditure going to private sector entities.

But, hey, the future of health care?
The future of health care? "Flawlessly run by AI-enabled robots, and 'essentially' free?"

A physician and a well-known "liberal" health care consultant argue their cases for electing Donald Trump.


Interesting series up at the excellent STATnews. All three "seasons" now posted.

Season 1
Episode 1: Man inside the hard drive
Episode 2: A code is broken
Episode 3: BAM reveals all
Episode 4: Rosetta Stones
Episode 5: Individual Z dissected
Season 2
Episode 6: A Jedi in the wastelands
Episode 7: Duplicate and delete
Episode 8: The variants of protection
Season 3
Episode 9: Ancient paths of Y and X
Episode 10: Echoes of pre-human ancestors
Episode 11: The Neanderthal inside
Episode 12: Host to viruses and selfish genes
Episode 13: Answers and questions

I was particularly interested given my most recent books on the "omics" topics.

I continue to closely (and guardedly) study "omics" issues.

UPDATE: Just in from the National Academies of Science, Engineering, and Medicine.

Research on gene drive systems is rapidly advancing. Many proposed applications of gene drive research aim to solve environmental and public health challenges, including the reduction of poverty and the burden of vector-borne diseases, such as malaria and dengue, which disproportionately impact low and middle income countries. However, due to their intrinsic qualities of rapid spread and irreversibility, gene drive systems raise many questions with respect to their safety relative to public and environmental health. Because gene drive systems are designed to alter the environments we share in ways that will be hard to anticipate and impossible to completely roll back, questions about the ethics surrounding use of this research are complex and will require very careful exploration...
Free PDF download, if you don't want ot spend $79 for a bound copy.


I've been covering Health 2.0 events for years (including WinterTech).

Mercifully, this year I won't be in the middle of radiation tx for prostate cancer. See here, here, here, and here as well.


Friday update: As the GOP and DNC conventions enter the history books, one utterly true headline this morning.


More to come...

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