A New Edition of Health Wonk Review—Does Barack Obama Remind You of Richard Nixon? . . . Will Most States Expand Medicaid? Do All Non-Profit Hospitals Deserve a Tax Exemption? Why Didn’t Anyone From J&J Go to Jail?

Brad Wright has hosted the most recent edition of Health Wonk Review http://www.healthpolicyanalysis.com/2013/11/07/if-you-like-the-health-wonk-review-you-currently-have-you-can-keep-it/, a round-up of some of the best recent healthcare posts in the blogosphere. It’s an excellent read.

Wright begins with a post by John Goodman, published at the NCPOA Health Policy Blog, and titled “The Selling of Obamacare.” There, Goodman acknowledges, “As for the president himself, he is a complete enigma to me. I’ve never felt that I understood him.’  Goodman goes on to prove his point by comparing Barack Obama to Richard Nixon.

According to Goodman, when “the President suggested that most people will be completely unaffected by the new health law . . . he was lying.” After all millions who buy their own insurance in the individual market place are now getting cancellation notices. The President “looked directly into the TV camera and said something that was blatantly untrue . . . over and over and over and over again. You have to go all the way back to Richard Nixon to find something comparable.”

That’s one way of looking at things,” Wright observes, “but it’s certainly not the only way. Over at the Colorado Health Insurance Insider,/ Louise Norris counters with these words:

“Much has been said recently about how the ACA is causing a tidal wave of policy cancellations, and resulting in people losing coverage that they would prefer to keep.  The frustrating part about this – as has generally been the case with every big uproar about the ACA – is that we’re not really getting a complete picture of what’s going on, and it’s hard to see the reality through all the hype and hysteria.

I agree.

Here is the larger picture: in fact, most Americans will not be affected by Obamacare. The vast majority are insured by their employers. Medicare, Medicaid or the military. Of the 311 million people who now live in the U.S., just 15 million purchase their own insurance. They represent 5% of the population. And only some of the 5% who buy their own coverage are getting those cancellation letters,

We are talking about less than 3% of the population –far from “most people.” 

The folks I worry about most are those who should qualify for Medicaid under the Affordable Care Act, but live in states that have refused to expand the program. (Often they are not eligible for Medicaid simply because they don’t have children, no matter how poor they are.)

Wright offers hope by spotlighting Joe Paduda’s post on Managed Care Matters. There, he asks: “What’s happening with Medicaid Coverage?”


Here is Paduda’s answer:As of now, there are 26 states moving forward with Medicaid, with Ohio just joining this week.”  (Paduda offers a useful map showing state status.)  “Among the states that may consider expansion in the future “NH may do this in November in a special legislative session, PA may be moving in this direction as well.

“Interestingly, the map looks just like it did in 1965 when states originally could decide to adopt Medicaid or not,” Paduda adds. “About half adopted Medicaid that first year, and most of the rest did within a few years . . .I would expect more states to accept Medicaid expansion  over the next few years.”

Wright agrees because “the financial” reasons to expand are so compelling, though he thinks “the timing of that decision will remain a political issue. As soon as the coast is clear for red states to take the money without looking like they are flip-flopping, they’ll opt-in.”

One of the many things I like about this edition of HWR is that it doesn’t focus solely on Health Care Reform.  Wright highlights posts that look at some of the problems in our health care system that the Affordable Care Act doesn’t reach.

I believe that Obamacare does a very good job of addressing the fact that today, millions of low-income and middle-income people cannot afford insurance. The ACA’s subsidies give them the access they need to comprehensive affordable care. Reform also has done a surprisingly good  (although not perfect) job of regulating for-profit insurers in the private sector.

But the ACA represents just the beginning of health care reform in this country. There is much more to be done.

For example, not all “non-profit hospitals” deserve their tax exemption. Many just don’t deliver the services to their communities that would justify their tax-free status. On Health Care Renewal Roy Poses points out that last spring, “the Mayor of Pittsburgh initiated a lawsuit that challenged the tax-exempt, non-profit status of giant hospital system UPMC. The suit charged that UPMC functions more like a for-profit corporation based on its large surplus (recently $1 billion), larger reserves ($3 billion), minimal commitment to charitable care, and generous executive pay (recently $5.9 million  to CEO Jeffrey Romoff, 19 executives paid more than $1 million, and ownership of a jet aircraft).”

Poses reports that in its response to the suit, UPMC has claimed that it shouldn’t have to fork over payroll taxes because: it really “doesn’t have employees.” (Are all of those nurses, lab technicians and pharmacists running around UPMC  imaginary people!)  No, the hospital claims that it is just a holding company: the employees belong to its subsidiaries.

This response is not only absurd– it displays what Poses describes as total “contempt for the truth.”
Read the rest of what Poses has to say. It’s an excellent post.

While you’re on his website, you might want to take a  look at his recent post on Johnson & Johnson’s $2.2 billion dollar settlement with the government.   There is still much corruption in our money-driven health care system. I agree with Poses: if we’re going to root out that corruption, those who are responsible will have to go to jail.

These are just two highlights from this edition of Health Wonk Review.  The entire post is well worth reading. 




7 thoughts on “A New Edition of Health Wonk Review—Does Barack Obama Remind You of Richard Nixon? . . . Will Most States Expand Medicaid? Do All Non-Profit Hospitals Deserve a Tax Exemption? Why Didn’t Anyone From J&J Go to Jail?

  1. Thanks for the J&J link and comment – Fines and bad publicity are not working. I and others have called for jail time for criminal behavior by some Big PhRMA excutives for more than 5 years

    • Dr Rick–
      Thanks for our comment.

      I agree that companies will not take these fines seriously unless executives who over aw the
      white collar crimes go to jail.

      • Maggie:
        Good to see you here. I was beginning to wonder. Just back from Thailand and China trip.

  2. Maggie:

    Good to see you here. I was beginning to wonder. Just back from Thailand and China trip.