FHI's Week in Review

Volume V, Issue 32

Aug. 6, 2018

Does Medicare for All Make Sense?

Jeffrey Sachs, a professor and director of the Center for Sustainable Development at Columbia University, lays out the argument for Medicare for All (M4A) in an opinion piece posted to CNN.com on August 4.

WIM

Dr. Sachs' analysis is flawed. In his idealized description of a Single Payer healthcare system, he overlooks several problems associated with such a scheme including: lack of innovation, lack of capital investment and unmet demand (resulting in long waiting times for healthcare services). That said, Dr. Sachs does highlight several issues that hamper our current health system:

The health care lobby is the biggest one in the country, with lobbying outlays of a whopping $557 million in 2017, including $280 million by pharmaceutical and health products companies, $103 million by hospitals and nursing homes, $92 million by health professionals and $82 million by health services and HMOs, according to the Center for Responsive Politics.

U.S. health care is not a competitive marketplace. It is rife with monopoly power.

U.S. health care prices are sky-high compared with the prices paid in other high-income countries, while US health outcomes are worse.

Just two weeks' inactivity can trigger diabetic symptoms in vulnerable patients

A July 31 article in MedicalXpress describes research recently published in The Journals of Gerontology:

Just two weeks without much activity can have a dramatic impact on health from which it is difficult to recover, according to researchers who studied overweight older adults at risk of developing Type 2 diabetes. Not only did an abrupt, brief period of inactivity hasten the onset of the disease and elevate blood sugar levels among pre-diabetic patients, but researchers reported that some study participants did not fully recover when they returned to normal activity for two weeks.

WIM

This research illustrates the critical importance of exercise for the maintenance of good health. Too often, we get caught up in the marvels of prescription medications and cutting-edge surgical procedures and we overlook the basics. A sedentary lifestyle can be a death sentence.

ACOs skittish over MSSP rule delay as CMS silence creates mounting uncertainty

Evan Sweeney reports, for Fierce Healthcare on July 30th, that Accountable Care Organizations (ACOs) are growing increasingly worried about an extended delay of the Medicare Shared Savings Program (MSSP) and a lack of communication from the Trump administration. Meanwhile, ACOs still don't have applications for the 2019 participation year and they've received no guidance on the application process, which typically kicks off in early spring.

WIM

According to Mr. Sweeney:

For new ACOs looking to join the program, and those up for renewal, the delay creates a difficult time crunch for an extensive application process that "typically takes months," according to Allison Brennan, the VP of Policy at the National Association of ACOs. ACOs use that time to select which ACO track to participate in and calibrate a budget, as well as add new practices and skilled nursing facilities based on ongoing negotiations with providers.