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AMA Says New Health Policy Must Maintain Coverage for All Currently Covered
The American Medical Association’s House of Delegates vowed Tuesday to work with the incoming Trump administration and Congress on health care reform, but said any new reforms shouldn’t result in people losing coverage.
“A core principle is that any new reform proposal should not cause individuals currently covered to become uninsured,” the group said in a statement. “We will also advance recommendations to support the delivery of high quality patient care. Policymakers have a notable opportunity to also reduce excessive regulatory burdens that diminish physicians’ time devoted to patient care and increase costs.”
The group added that it was committed to improving health insurance so patients can access high quality and affordable care. The group released a policy framework, noting they would advocate for expanding insurance coverage and choice.
Additionally, the group says it will also advocate to make sure policies offered through insurance exchanges, Medicare Advantage and Medicaid managed care offer wide provider networks. They’re also focused on encouraging prescription drug price and cost transparency.
“The new AMA policy acknowledges the carte blanche approach to drug pricing needs to change to align with the health system’s drive for high-quality care based on value,” AMA President Andrew Gurman said in a separate statement. “This transformation should support drug prices based on overall benefit to patients compared to alternatives for treating the same condition. We need to have the full picture to assess a drug’s true value to patients and the health care system.”
Expect Medicaid to Change, but Not Shrivel, Under Donald Trump
The expansion of Medicaid, a central pillar of the Affordable Care Act, faces immense uncertainty next year, with President-elect Donald J. Trump and top Republicans in Congress embracing proposals that could leave millions of poorer Americans without health insurance and jeopardize a major element of President Obama’s legacy.
But influential figures in surprising quarters of the new administration might balk at a broad rollback of Medicaid’s reach, favoring new conditions for access to the government insurance program for the poor but not wholesale cutbacks.
Mike Pence, the vice president-elect, is proud of the Medicaid expansion he engineered as governor of Indiana, one of 31 states that expanded eligibility under the Affordable Care Act. The Indiana program has conservative features that emphasize “personal responsibility” and require Medicaid beneficiaries to make monthly contributions to savings accounts earmarked for health care.
Another Trump adviser, Gov. Chris Christie of New Jersey, hails the expansion of Medicaid in his state, saying more than half a million people are receiving “more and better health care.” The federal government pays the full cost for newly eligible beneficiaries from 2014 through 2016 and at least 90 percent of the costs in later years under the health law.
It is hard to overstate the importance of Medicaid, which insures 77 million people, pays for more than half of all births in some states, covers about two-thirds of nursing home residents and provides treatment for many people addicted to opioids. Spending on Medicaid, by the federal government and states combined, exceeds $500 billion a year.
Of the 20 million people who have gained coverage under the Affordable Care Act, officials estimate, 12 million are insured by Medicaid — with few of the problems that have plagued the new insurance exchanges, or marketplaces.
But change is coming. In his campaign manifesto, Mr. Trump said Congress must repeal the Affordable Care Act and give each state a lump sum of federal money — a block grant — for Medicaid. Congress passed legislation in January to repeal the health law and roll back its Medicaid expansion. Mr. Obama vetoed the measure, but Speaker Paul D. Ryan of Wisconsin has vowed to put similar legislation on a Republican president’s desk.
The players who are set to influence Trump on health care
It’s customary in the nation’s capital to hail members of the incoming administration by telling everyone in town how close you are to them. So many in conservative Washington lobbying circles and elsewhere are busy touting their relationships with President-elect Donald Trump and his advisers.
There’s a benefit to proximity to power, especially now. At a time when nobody really knows how the Trump administration will regulate drugs and medical devices, fund scientific research, or repeal or replace the Affordable Care Act, relationships with the newcomers are viewed as critical to getting one’s issues on the table.
Donations don’t hurt, either.
Trump’s transition team is a moving train, so influencers are likely to jump aboard fast. Here’s STAT’s look at people and organizations in health care and science who are likely to have influence with a Trump presidency — and who else might benefit.
How Do You Recognize a Trustworthy Leader?
I’m hearing people talking about trustworthy leadership everywhere I go. We all crave it. We seek it out because trustworthy leadership allows us to be at our best so that we can make a meaningful contribution.
To recognize a trustworthy leader, look for all of these tell-tale signs:
- Values Centered – character, integrity and moral awareness are top priorities
- Full Congruence – behaves the same way in every context, and shows congruence between thoughts, words and deeds
- Genuinely Cares – treats people well – everybody, not just the inner circle
- Shows Respect – demonstrates respect for people and differences
- Other Focused – realizes that leadership is about bringing out the best in others – and it shows in every interaction and conversation
The best leaders strive to live out all five of these characteristics every day. They center themselves in positive ethical values like respect, care and trustworthiness.
What should you do if you can’t find a trustworthy leader? Keep looking. They’re out there.
Keeping tabs on a potential ACA repeal: Three questions to watch
In the days since the surprise election of Donald Trump to the presidency, substantial attention has been paid to the possibility that congressional Republicans will take advantage of a Republican president’s pen to repeal all or part of the Affordable Care Act, possibly as soon as January. Doing so will almost certainly involve a special budgetary process known as budget reconciliation, which, thanks to a limit on time for debate, eliminates the possibility of a filibuster. Reconciliation and other similar procedures for limiting debate in the Senate (which I’ve written on elsewhere) are often described as “arcane,” and certainly, the coming weeks are likely to bring several procedural twists, likely with big policy implications, worth watching. Given the centrality of the law’s repeal to Republican messaging—the House has voted on repeal more than 60 times—the political implications of the foregoing debate are large as well. Here are three key questions I’ll be watching for the answers to as the debate unfolds, as they’ll tell us much about the both the policy and political implications of Republicans’ repeal efforts.
The ”New Normal” For The C-Suite – Learning Agile Leaders
What are CEOs looking for in the next generation of C-Suite leaders? Let’s look at three real-world examples:
1. Growth Leaders – The CEO of a multi-billion dollar industrial products company boldly sets an ambitious growth goal of growing revenue by 40% over a three-year period. He has a Board-approved strategy, a solid operating plan with targets, and a newly developed business unit organization structure to implement it.
But he also knows that this is the easy part. What’s the hard part? It’s building a cadre of leaders who can grow the company at a rapid clip. No one has asked them to do anything like this before. They have good managers, but do they have growth leaders?
2. Champions of the Greater Good – The CEO of a large, global educational services company is reorganizing to increase its impact in the company’s areas of focus. The new organizational model will enable linkages across the company, connecting people from various disciplines together to innovate and drive marketplace success.
The CEO needs to staff several newly defined senior executive roles with leaders who will drive collaboration across former fiefdoms and make decisions that put the company, not their unit, first. Which leaders will have not only domain expertise but also the ability to wear an “Enterprise Hat”?
3. Transformational Leaders – A well-respected publishing company is transforming its brand. It must reach new audiences with ever more impactful content and diversify its traditional sources of revenue. The CEO came on board with a change imperative and is heading into the third year of a multi-year transformation process.
After collaboratively developing a strategy with her Board and engaging all employees in the change process, the time is now to see the changes implemented flawlessly. She needs her leadership team to collaborate across silos, make difficult strategic and operational decisions and lead with a more integrated “One Company” mindset. Who will help her lead this transformation?
Ryan now has the muscle to phase out Medicare — within months
House Speaker Paul Ryan’s plan to phase out Medicare is nothing new. But now, under a Trump presidency and with both houses of Congress in Republican hands, it looks like he could finally make it happen, possibly within months.
Back in 2011, as a U.S. representative for Wisconsin’s 1st Congressional District, Ryan floated a plan to turn Medicare into a “premium support” program. The “premium support” would be a payment that would let you buy insurance from private insurers. But you won’t get full coverage.
As Josh Marshall acidly noted Sunday in a blog for TPM, “In any case, rather than Medicare you’ll have insurance from an insurance company, which everybody should love because haven’t you heard from your parents and grandparents how bummed they were when they had to give up their private insurance for Medicare?
“You’ll hear lots of people calling this ‘reform’ and other catchwords. But Medicare is a single payer, universal health care system. Replacing it with private insurance means getting rid of it. Even calling it ‘privatization’ masks what is really afoot.”
On Fox News Special Report on Thursday, Ryan was asked about entitlement reform. His answer:
“You have to remember, when Obamacare became Obamacare, Obamacare rewrote Medicare, rewrote Medicaid. If you are going to repeal and replace Obamacare, you have to address those issues as well. What a lot of folks don’t realize is this 21-person board called the IPAP is about to kick in with price controls on Medicare. What people don’t realize is because of Obamacare, Medicare is going broke, Medicare is going to have price controls because of Obamacare, Medicaid is in fiscal straits. You have to deal with those issues if you are going to repeal and replace Obamacare. Medicare has serious problems [because of] Obamacare. Those are part of our plan.”
Marshall says that’s false, and Ryan knows it. Instead of putting Medicare under deeper financial stress, the Affordable Care Act has had the opposite effect and actually extended Medicare’s solvency by over 10 years, he says.
According to Medicare’s trustees, the “Part A” trust fund — the costliest component of Medicare, covering hospitalization — is set to become insolvent in 2028. In 2009, before the passage of the Affordable Care Act, it was projected that fund would go broke in 2017.
