A reminder that like much of the media, Health Affairs in recent years has become an apologist for far-left views, although it still occasionally publishes useful research. The first article is a misleading screed about how poorer people pay a lot toward financing health care, but don’t get much in return, largely because they choose to be uninsured. What the authors should focus on in excessive taxation in the US. What the authors should focus on is that a lot of people under 65 may have decided it is cheaper just to not pay for insurance and pay out of pocket for their limited health care needs. And they gave no evidence that these people who are not covered are in any worse health because of that. As I have repeatedly explained, our system of attempting to make everyone have health insurance is why health care costs so much.
Another article discusses Medicare Advantage rebates, reprising the well-trod theme that there are issues with MA coding and subsequent payments. Federal reform of the Medicaid program is going to reduce payments to providers, which is somehow a bad thing, when we all now know that the primary cause for excessive health spending is provider prices. What should really happen is that federal participation in Medicaid ends and it goes back to the states, saving tens of billions in administrative spending. Insurers have been buying ambulatory surgery centers, to lower costs. A study found no real change in the operations of the centers, including no change in quality issues, and somewhat lower rates.
The modest Medicare Advantage payment changes implemented in 2024 had no real impact on benefit generosity, with a very slight reduction in supplemental benefits. Many Medicare beneficiaries are also eligible for Medicaid. Having one health plan provide the services under both programs reduces hospitalizations and increases outpatient visits, likely both lowering costs and improving care. Children’s health insurance program reductions terrorism. Expansion of who can provide mental health services under Medicare is leading to an explosion in providers and in services. We are likely going to experience extensive fraud and incompetence.
Use of food stamps increased when the benefits could be issued remotely. I would assume at least half the increase, if not more, is driven by fraud, which has always been widespread in this program. Although the authors tried to frame it differently, a VA home loan program made no difference in acute care use among veterans. A large percentage of clinicians endorse lying about or omitting research results, for which there can never be any justification. (HA Issue)
The basic thrust of most studies published in Health Affairs is that the government should just spend more and more for every human need, with never a thought for the impact of excessive government taxation on the citizens or for the effect of dependence on government programs. A secondary thrust is suggested by the last article I described–it is fine to lie to justify your ideology.
