Friday News Dump: Wonkbites

by Galen Benshoof

Yes, the government re-opened, but other news happened, too!

  1. Shutdown strikeout. Republicans closed the government in order to cripple the ACA, believing that President Obama would relinquish part of his signature policy achievement. After two weeks of tantrums, and billions of dollars of destruction, their great policy victory turned out to be…. nothing. Well, it wasn’t technically “nothing,” but a small amount of additional reporting on income verification procedures that were already in the law. Sarah Kliff calls the concession “meaningless.” ACA boosters seem to agree.
  2. Pay up front or go away. As deductibles rise, some providers are requiring up-front payment from consumers. The phenomenon isn’t confined to the individual market, either—rising cost-sharing among employer-sponsored plans means workers with coverage may find themselves in similar straits. Providers claim that higher deductibles result in more bad debt, which they want to avoid. On one hand, the policy makes business sense for them. But how many people will it keep from getting the care they need?
  3. Fewer barriers to preventive drugs. In better news for consumers, insurance companies are expanding their coverage of preventive medicine. With the goal of increasing compliance, a few prominent insurers have dropped or reduced deductibles, copayments, and coinsurance for prescription drugs aimed at treating conditions like asthma. Millions of Americans, including those profiled in a recent New York Times article, will benefit from the the reductions. It’s not hyperbole to say that lower costs will save lives.
  4. High earnings and high techA new study in JAMA shows no connection between nonprofit hospital executive pay and two critical indicators: quality of care and patient outcomes. By contrast, the authors found a positive association between CEO compensation and use of technology, as well as patient satisfaction. The causal mechanism remains murky. Does increased use of medical gadgetry somehow lead to higher pay, or do executives who are more likely to embrace new technologies earn above-average salaries for other reasons? Regardless of the answer, the lack of relationship between compensation and outcomes is most troubling. Hospitals exist to care for sick people, and their executives should be paid based on how well they do the job.
  5. ACApalypse Now. Obamacare opponents have a penchant for hyperbole. Can you tell doomsaying political quotes apart from alien invasion movie lines?


Galen is a Master in Public Affairs candidate at Princeton University’s Woodrow Wilson School, where he focuses on health policy. Find him on Twitter: @benshoof.


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