Gregg's Top Three Health Policy Articles

Health policy impacts everyone, but it can be hard to know what is important. If you can only read three things about health policy this week, I suggest...

The Top Three...

Bloomberg: US Health Insurance Premiums Now Cost $24,000 A Year, Survey Says Health insurance premiums jumped this year amid a post-pandemic spike in costs of care, adding to the burden on employers and workers as inflation erodes broader buying power. The average employer-sponsored health insurance premium for US families rose 7% to almost $24,000 this year, according to an annual KFF survey of more than 2,000 US companies, compared with a 1% increase last year. Premiums for individual employer coverage rose at the same rate. (LaPara, 10/18)

KFF Health News: Biden Pick To Lead NIH Finally Has Her Day, But Still Gets Caught Up In Drug Price Debate A Senate committee finally held a hearing Wednesday on President Joe Biden’s pick to lead the National Institutes of Health. But the panel’s chair, Sen. Bernie Sanders (I-Vt.), was focused on drug prices — an issue over which the NIH has very little control. After introducing the nominee, Monica Bertagnolli, at a hearing of the Health, Education, Labor and Pensions Committee, Sanders quickly pivoted to the high prices Americans pay for prescription drugs. (DeGuzman, 10/19)

Modern Healthcare: Medicare Advantage Marketing Faces Scrutiny After Senate Hearing Medicare Advantage brokers may face tougher restrictions from the Centers for Medicare and Medicaid after a highly critical Senate Finance Committee hearing Wednesday. The hearing, the topic of which was "cracking down on deceptive practices," catalogued a litany of alleged abuses by brokers—from providing false information and harassment to switching people out of plans without consent, all in a bid to boost increasingly opaque compensation from insurers. That includes "add-on" fees for administration. (McAuliff, 10/18)

For a Deeper Dive...

KFF Health News: Health Care ‘Game-Changer’? Feds Boost Care For Homeless Americans The Biden administration is making it easier for doctors and nurses to treat homeless people wherever they find them, from creekside encampments to freeway underpasses, marking a fundamental shift in how — and where — health care is delivered. As of Oct. 1, the Centers for Medicare & Medicaid Services began allowing public and private insurers to pay “street medicine” providers for medical services they deliver anyplace homeless people might be staying. (Hart, 10/19)

The New York Times: Rite Aid Files For Bankruptcy, Facing Slumping Sales And Opioid Suits Rite Aid, one of the largest pharmacy chains in the United States, filed for bankruptcy on Sunday, weighed down by billions of dollars in debt, declining sales and more than a thousand federal, state and local lawsuits claiming it filled thousands of illegal prescriptions for painkillers. The company filed for Chapter 11 bankruptcy protection in New Jersey. Its largest creditors include the pharmaceutical company McKesson Corporation and the insurer Humana Health. The pharmacy has raised $3.45 billion to fund its operations while it is in bankruptcy, during which it expects to continue to operate its stores and serve its customers. (Holman and Hirsch, 10/15)

Stat: NIH Confirmation Hearing Shows Politicization Of Research Monica Bertagnolli, President Biden’s nominee to lead the National Institutes of Health, spent her confirmation hearing Wednesday stuck in the middle of Republicans’ and Democrats’ bickering over her agency’s role in high drug costs, ultimately refusing to commit to either party’s approach. (Owermohle, 10/18)

Modern Healthcare: Healthcare Professionals Fleeing Industry, New Data Show More than 145,000 healthcare practitioners left the industry from 2021 through 2022, threatening access and quality, according to a report published Monday. Physicians accounted for roughly half of the healthcare workers who retired or changed professions over the two-year span, according to an analysis of all-payer claims data from Definitive Healthcare, a healthcare commercial intelligence company. More than 71,000 physicians left the workforce from 2021 to 2022. (Kacik, 10/16)

Modern Healthcare: Hospital Price Transparency Data Helping Employers Negotiate Costs Employers across the country are using price transparency data to tweak health plan benefits and push legislation to pressure hospitals to lower prices. Historically, employers have been reluctant to limit employees’ choice by cutting inefficient healthcare providers from their health plan networks. But that sentiment has changed as employers continue to see costs rise. (Kacik, 10/18)

The Wall Street Journal: Health Inflation’s Big Hike This Year, In Charts
Inflation came for your healthcare this year. Next year is looking to be just as bad. The cost of employer health insurance rose this year at the fastest clip since 2011, according to an annual survey from KFF, a healthcare research nonprofit. The 7% jump in the cost of a family plan brought the average tab to nearly $24,000—more than the price for some small cars. Workers’ average payment of $6,575 for those plans was nearly $500 more than last year. (Mathews and Ulick, 10/18)

The Washington Post: Primary Care Saves Lives. Here’s Why It’s Failing Americans Without patients having access to primary care, minor complaints evolve into chronic illnesses that demand complex long-term treatment plans. Addressing basic patient problems in the emergency room costs up to 12 times what it would in a primary-care office, resulting in billions of additional dollars each year. But even as evidence mounts that access to primary care improves population health, reduces health disparities and saves health-care dollars, the field is attracting fewer and fewer medical students. The remaining small-group medical practices are being replaced by concierge offices with steep annual membership fees. (Sellers, 10/17)

AP: California Gov. Newsom Signs Law To Slowly Raise Health Care Workers’ Minimum Wage To $25 Per Hour Several city councils in California had already passed local laws to raise the minimum wage for health care workers. The health care industry then qualified referendums asking voters to block those increases. Labor unions responded by qualifying a ballot initiative in Los Angeles that would limit the maximum salaries for hospital executives. The law Newsom signed Friday would preempt those local minimum wage increases. (Beam, 10/13)

Axios: Medicare Advantage Star Ratings Fall Again Medicare Advantage plans' average star ratings have fallen for the second straight year, according to data from the Centers for Medicare and Medicaid Services. The ratings are a closely watched metric intended to help seniors pick better-performing plans, based on up to 40 quality measures. The scores also determine if insurers qualify for bonuses from Medicare, and consumers can switch into the highest-scoring plans year-round. (Goldman, 10/16)

Vox: The Mental Health Crisis Among Doctors Is A Problem For Patients Twice a week, Boston-area psychiatrist Elissa Ely volunteers at a US anonymous help line for physicians in crisis. The calls she takes are often from people in deep distress — physicians having panic attacks, abusing substances or alcohol, facing divorce or alienation from family and friends. A typical call, she said, could be from “an ER doctor who vomits before she goes in for her shifts; despair and depression; suicidality.” But despite her callers’ high levels of mental distress, they’re often very resistant to her suggestions that they seek mental health care, said Ely. When she suggests doctors consider even just a “tincture” of an antidepressant or anti-anxiety medication, or find a therapist, she inevitably gets the same response, a long pause followed by a question: “Is this call really anonymous?” (Landman, 10/18)

Stat: Is There Really A Nursing Shortage In The U.S.? Hospitals are frustrated with a nationwide nursing shortage that’s only gotten worse since the pandemic. In 2022, the American Hospital Association quoted an estimate that half a million nurses would leave the field by the end of that year, bringing the total shortage to 1.1 million. At the same time, National Nurses United insists there isn’t a nurse shortage at all. There are plenty enough nurses for the country, they say — merely a shortage of nurses who want to work under current conditions. (Trang, 10/16)

Axios: Life Expectancy Gap In America Widens Depending On College Education The U.S. is failing less-educated people given the dismal life expectancy prospects they face compared to their more educated peers, researchers said. While the U.S. economy outperforms other countries by metrics such as economic growth and inflation rates, two prominent economists argue the life expectancy gap says otherwise. (Rubin, 10/16)

For the Visual Among Us...

A few years ago I started a weekly e-mail for friends and colleagues who want to keep up on major federal health policy developments but did not have time to plod through all the minutiae--they were busy doing important things like running organizations and taking care of patients! Much to my surprise, it became pretty popular. I have now converted to a weekly newsletter format so you can manage your own subscription preferences and forward to others that might be interested.

These summaries represent my judgement on health policy issues that may not on the front pages, but are relevant to clinicians, administrators, and educators. I monitor many news sources and clipping services to identify content for this newsletter and I try hard to be as factual, balanced, and non-partisan as possible. While the articles are written by others (with credit attributed), the choice of what to include is entirely mine. If you are interested in receiving a daily summary of health policy news, you might consider signing up for the KHN Morning Briefing. If you enjoy podcasts, I suggest What the Health? and Tradeoffs.

-Gregg S. Margolis, PhD