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Health Care blog
High-Risk Pools Covered the Sick Before 2014, and They Could Do It Again Funded high-risk pools protect people with costly conditions without raising premiums for everyone else, and the states have tested the model for decades. Six Things People Believe About Health Insurance That Are Simply Not So Six common beliefs about health insurance, from who pays the premium to preexisting conditions and price shopping, tested one at a time with a verdict on each. Read the Medicare for All Bill and You Will Find Your Insurance Abolished The slogan promises to extend a popular program, but the Medicare for All Act of 2019 bars private coverage that duplicates the government plan. Veterans Should Carry Their Health Care Dollars the Way They Carry the GI Bill The GI Bill trusted veterans to pick their own college; the same trust argues for letting them take their care elsewhere when the VA cannot serve them. The VA MISSION Act Let Veterans See Private Doctors, What It Changed After the Phoenix wait-list scandal, Congress let veterans see private doctors, and the 2018 MISSION Act made that choice permanent. Here are the rules. Phoenix 2014 and the Secret Wait Lists That Changed Veterans' Health Care Phoenix VA staff kept unofficial wait lists to hit their numbers, and the scandal produced three laws that gave veterans a way out of the line. The Church Amendments of 1973 and a Doctor's Right to Say No Conscience protection for doctors and nurses began in Congress in 1973 as a bipartisan settlement, and the history shows it was never a new demand. A Certificate of Need for Pizza Shops, a Thought Experiment in Planning A labelled satire that applies hospital-style certificate-of-need rules to pizza, to show what the real laws do to clinics, scanners and surgery centers. Certificate-of-Need Laws Make a New Clinic Ask Its Rivals for Permission Certificate-of-need laws make anyone who wants to build a hospital wing or buy a scanner prove "need" to a board that rivals can lobby; repeal them. How Direct Primary Care Works and How to Find a Practice That Offers It Direct primary care swaps the insurer for a flat monthly fee, and this step-by-step guide shows how to test whether it fits your family in a single afternoon. What California's 1975 Malpractice Law and Texas's 2003 Reform Taught Us California capped pain-and-suffering damages in 1975 and Texas followed in 2003, and the record shows what caps can and cannot do. The Right to Try Law of 2018 and the Families Who Pushed It Through A dying patient should not need Washington's permission to try an unapproved drug, and families made that case state by state until Congress listened. Medicare Advantage Proves Seniors Will Choose Private Plans When Allowed Medicare Advantage grew because seniors kept picking it. Its history, its bidding system and its flaws point toward premium support. John Roberts Called the Mandate a Tax, and Conservatives Still Argue About Why Roberts's 2012 vote in NFIB v. Sebelius rested on the saving construction, and conservatives split over whether that was restraint or rewriting. The Biggest Tax Break in America Hides in Your Paycheck Stub The unlimited tax exclusion for employer health coverage favors the best-paid, hides the cost of care and locks people into jobs; equal treatment is the fix. How World War II Wage Controls Tied Your Health Insurance to Your Job Employer-based health insurance was an accident of wartime wage controls that the tax code froze in place, and it still costs workers when they change jobs. Four Conservative Health Plans Side by Side, From Tax Credits to Block Grants Four real conservative health bills compared on credits, Medicaid, preexisting conditions and state flexibility, with a verdict on which suits which goal. King v. Burwell and the Four Words the Supreme Court Chose to Rewrite In King v. Burwell (2015) the Court read "established by the State" to include federal exchanges, and what the case teaches about Congress, agencies and courts. Seven Promises Made for the Affordable Care Act, Tested Against the Record Seven selling points of the Affordable Care Act, each stated fairly and checked against what the law and the courts actually did, with a verdict on every one. The Affordable Care Act From the 2009 Town Halls to a Zero-Dollar Penalty A dated timeline of the Affordable Care Act, from the 2009 town halls to a zero-dollar mandate penalty, and why the law never won the country over. A Shopper's Playbook for Getting a Real Price Before a Medical Procedure Ten numbered steps for getting a price before planned care, from the billing office call to the Good Faith Estimate to a dispute if the bill runs over. Hospitals Went to Court to Keep Their Prices Secret, and They Lost The hospital industry sued to block the federal price transparency rule, lost in two courts, and the case shows who benefits when prices are hidden. Eleven Questions About Health Savings Accounts, Answered for Working Families How a health savings account works, where it came from, what it costs, and why conservatives should explain it to families never offered the choice. Death Panels, the Coverage, and the Board Congress Quietly Repealed The press mocked "death panels" in 2009 while a real ACA board with power over Medicare spending never seated a member and was repealed in 2018. What the Social Security and Medicare trust funds hold, and depletion day The trust funds hold Treasury IOUs, and when they run out benefits fall automatically to what payroll taxes bring in. Here is the arithmetic. Asking Able-Bodied Adults to Work for Medicaid Is Not Cruelty, It Is Dignity The cruelty charge against Medicaid work requirements fails against the 1996 welfare law and the court record, though the paperwork critique is real. The Medicaid Match That Pays States More for Adults Than for Disabled Kids The Affordable Care Act paid states a richer Medicaid match for able-bodied adults than for the disabled, and the arithmetic shows how that bends priorities. GAO's High-Risk List Has Named Some of the Same Programs Since 1990 GAO has listed federal programs most vulnerable to waste, fraud and mismanagement since 1990, and some never come off. That argues for structural reform. What the Medicare Debate of 1965 Promised and What the Program Became Conservatives offered a targeted alternative to Medicare in the 1960s and warned of open-ended costs, and the program's later history shows why. Medicare's Two Trust Funds and the 45 Percent Warning Congress Keeps Ignoring Medicare is two funds with two different bills, and a 2003 alarm bell that was written into law has been ringing for years without an answer. Frances Kelsey, Thalidomide and the 1962 Law That Slowed Every New Drug Frances Kelsey was right to hold the line on thalidomide, but the 1962 law passed in her wake went far beyond safety, and its cost deserves an honest count. How a New Drug Gets Through the FDA and Why the Trip Takes So Long The FDA's approval path is a chain of safety rules that also carries a cost few count: patients who wait while a useful drug sits in review. Pharmacy Benefit Managers, the Middlemen You Never Hired, Explained How rebates, formularies and spread pricing work, why a list price can rise while someone else pockets the gap, and why transparency beats a price board. Should America Stop Paying for the World's Medicines? Conservatives Split Two conservative answers to foreign drug price controls, importing their prices or pressing them through trade, and why the second is the better one. Price Controls on Medicines Today Mean Fewer New Medicines Tomorrow Government price setting for drugs buys a visible saving now and costs cures that are never invented, and the patent bargain explains why. When a Health Agency Decided It Could Freeze Every Eviction in America The CDC stretched a 1944 quarantine statute to freeze evictions nationwide, and the Supreme Court rulings that followed show where agency power stops. What Jacobson v. Massachusetts Actually Held About State Health Powers Jacobson v. Massachusetts is cited as a blank check for health orders, but a close reading shows it limits state power and never mentions federal agencies. The case against assisted suicide that does not depend on religion Legal assisted suicide pressures the vulnerable, and that holds without faith. Autonomy at its strongest, then the enacted laws of Oregon, Canada and the Dutch.