Health Care Finance - Bill of Health

Senior citizen woman in wheelchair in a nursing home.

The Barriers to Aging in Place

October 29, 2021October 29, 2021 The Petrie-Flom Center Staff Leave a comment

By Renu Thomas and John Roth

The COVID-19 pandemic has highlighted the risks associated with institutionalized care for the elderly, and has further shifted sentiments toward a preference for aging in place. But most seniors and their loved ones don’t realize the barriers that make aging in place a difficult proposition until a crisis occurs and they’re faced with finding services.

Take our family, for example. My father was diagnosed with Parkinson’s disease and it was after his first fall and discharge from the hospital that our family realized my parents’ independence was severely limited. We knew their house was not wheelchair or walker accessible, but we also needed to address other issues as well; neither of them could drive anymore, so how would we get them to appointments, how would their prescriptions and groceries get picked up, and how could we prevent them from being socially isolated? Like many families, we do not live nearby, let alone in the same state, which made coordinating these services even more challenging.

Glasses, case for contact lenses and eye test chart on mint background, top view

Medicare Poised to Expand Vision, Hearing, and Dental Benefits

October 26, 2021October 26, 2021 bkennedy Leave a comment

By Bailey Kennedy

Though Pres. Biden’s expansive infrastructure and social spending bills remain mired in Congress, it still seems likely that his administration will preside over one of the most dramatic revisions in America’s public safety net since the Great Society.

One of the most discussed provisions in the omnibus bill would expand Medicare benefits to include hearing, vision, and dental care. Currently, millions of Americans are forced to go without the types of care that the proposed Medicare expansion would address. And seniors, in particular, are likely to deal with vision and hearing-related health care issues, which pose a high financial burden.

While the proposed expansion has met pushback, including these aspects of health care in standard insurance plans is significantly overdue.

rear view of a dump truck loaded on the road laden with scrap metal

It’s Time for Biden to Scrap Trump-era Junk Plans

October 25, 2021October 25, 2021 czhang Leave a comment

By Cathy Zhang

Open enrollment for the health insurance marketplace begins on November 1.

Among the options available to consumers will be short-term, limited-duration insurance (STLDI), also known as junk insurance plans. The Trump administration facilitated the proliferation of these cheap, underprotective plans in an attempt to undermine the marketplace, and the Biden administration has yet to reverse that policy.

As part of the Biden administration’s public effort “to restore and strengthen Americans’ access to quality, affordable health care,” the administration needs to take executive action to protect consumers and eliminate junk plans.

Monthly Round-Up of What to Read on Pharma Law and Policy

October 20, 2021October 20, 2021 Ameet Sarpatwari Leave a comment

By Ameet Sarpatwari, Alexander Egilman, Aviva Wang, and Aaron S. Kesselheim

Each month, members of the Program On Regulation, Therapeutics, And Law (PORTAL) review the peer-reviewed medical literature to identify interesting empirical studies, policy analyses, and editorials on health law and policy issues.

Below are the citations for papers identified from the month of September. The selections feature topics ranging from an analysis of the regulatory outcomes of cancer drugs that received accelerated approval and had negative post-approval trials, to an evaluation of how federal public funding contributed to the development of Pregabalin (Lyrica), to a systematic literature review of the criticisms against the use of the quality-adjusted life-year (QALY) in health technology assessments. A full posting of abstracts/summaries of these articles may be found on our website.

Illustration of a family and large clipboard with items in a list checked off. All are underneath a large blue umbrella

Churning Point: Lessons from Medicaid Pandemic Policies

October 19, 2021April 12, 2022 czhang Leave a comment

By Cathy Zhang

During the COVID-19 pandemic, ensuring widespread health coverage took on a new sense of urgency, leading many states to implement policies to address the longstanding problem of Medicaid churn.

Churn is a persistent problem in the U.S. health care system. Changes in health insurance coverage disrupt care and worsen self-reported health at significant rates, even for individuals who go from one insurer to another with no gap in coverage. Legislation enacted as a stopgap measure during the pandemic may present a path forward for securing more durable Medicaid coverage beyond the public health emergency.

Doctor Holding Cell Phone. Cell phones and other kinds of mobile devices and communications technologies are of increasing importance in the delivery of health care. Photographer Daniel Sone.

Toward a Broader Telehealth Licensing Scheme

October 8, 2021October 20, 2021 The Petrie-Flom Center Staff Leave a comment

By Fazal Khan

Evidence generated during the first year the COVID-19 pandemic has called into question the need for many of the telehealth restrictions that were in effect prior to the pandemic.

The question many policymakers are asking now is: which of the telehealth regulatory waivers enacted during the pandemic should become permanent?

My forthcoming article proposes that the federal government use its spending power to incentivize states to adopt a de facto national telehealth licensing scheme through state-based mutual recognition of licensing and scope of practice reforms through a Medicaid program funding “bonus.”

A patient is seen in the intensive care unit for the coronavirus disease (COVID-19) in Thoracic Diseases Hospital of Athens in Greece on November 8, 2020.

Financial Burden of COVID-19 Shifts from Insurance to Patients

October 5, 2021October 5, 2021 bkennedy Leave a comment

By Bailey Kennedy

It’s no secret that health care in America sometimes leaves those without means struggling to pay for their care. However, for the last year and a half, COVID has been an exception to the rule: many insurance companies have stepped up to foot the bills for hospitalized COVID patients. Now insurance companies seem to be returning to the status quo ante COVID by expecting patients to cover a portion of their COVID-19 care.

These attempts to penalize those who become sick with COVID-19 — a disproportionate number of whom are unvaccinated — are not necessarily out of line with other attempts to punish Americans for their perceived poor health.

Congress Should Act to Fund Medical-Legal Partnerships

September 30, 2021September 30, 2021 The Petrie-Flom Center Staff Leave a comment

By Emily Rock and James Bhandary-Alexander

On August 9, legislators introduced a new bill in Congress that allocates funding to the development of Medical-Legal Partnerships (MLPs), in recognition of the important role MLPs can play in the lives of older Americans.

As attorneys with the Medical-Legal Partnership program at the Solomon Center for Health Law and Policy at Yale Law School, we strongly encourage Congress to act quickly to pass this legislation.

Symbol of law and justice, banknote of one dollar and United States Flag.

Saving Lives and Decreasing Costs: The Economic Case for Health Justice

September 22, 2021September 22, 2021 wepstein Leave a comment

By Wendy Netter Epstein

Most proponents of health justice will tell you that health is a fundamental human right. They will say that there is a moral imperative to eliminate health inequities and to give all people equal opportunity to lead a healthy life. And they will be correct. Health justice as a framework is driven by this narrative — the laudable goals of health equity and social justice.

What you aren’t as likely to hear from health justice advocates, however, is that health justice is economically efficient. To the contrary, most health justice advocates see its framework as an alternative to the markets, efficiency, autonomy, and individual responsibility that are the hallmarks of conservative ideology.

Yet, there is no question that health inequities are costly to the individuals that bear them, in higher health care expenses, missed days of work, and fewer years lived. There are also significant costs to society — both direct and indirect. According to one analysis, disparities lead to $93 billion in excess medical care costs and $42 billion in lost productivity per year.

Making the economic case for health justice, and noting how it is inextricably linked to the moral case, is crucial. Because not only is the framework bolstered by notions of both fairness and efficiency, but also, as a practical matter, getting legislative and regulatory buy-in to fund initiatives to address health inequities requires making the economic case.

If health inequities could be ameliorated, government health spending and other safety net spending would be drastically reduced, workforce productivity would increase, and even healthy and wealthy Americans — who are the most likely to oppose the health justice framework — would benefit.

Envelope from U.S. Citizenship and Immigration Services with the American flag on top/U.S. immigration concept.

Health Justice for Immigrants, Revisited

September 17, 2021September 17, 2021 The Petrie-Flom Center Staff Leave a comment

By Medha D. Makhlouf

A major contribution of health justice is that it provides a framework for understanding how universal access to health care protects collective, as well as individual, interests. The pandemic has underscored the collective nature of the health and wellbeing of every person living in the United States, regardless of immigration status.

In a 2019 article, Health Justice for Immigrants, I adopted and adapted the health justice framework to the problem of disparities in immigrant access to subsidized health coverage. I argued that, in future health care reforms, health justice requires that immigrants be included in the “universe” of universal access to health care. In this blog post, I revisit this argument in light of the COVID-19 pandemic.

This blog post applies the health justice lens to inequities in immigrant health and access to health care, drawing out lessons for the pandemic and post-pandemic eras. It describes three examples illustrating the utility of health justice for catalyzing cross-sector initiatives to improve health, reducing the role of bias in the design of interventions to address health disparities, and ensuring that such efforts are serving the needs of historically subordinated communities.

Category: Health Care Finance