Politics and Policy

Sponsors of Part D legislation believe private Medicare Part D plans have been less effective than the government could be in negotiating price concessions.

Absent regulatory reform prompts Michigan Blues to make some hard business decisions while groups such as Put Michigan People First say BCBSM wasn't able to get individual insurance reform legislation passed because it failed to compromise with key stakeholders.

Consultants speculate on who President Obama will tap to fill the HHS, FDA and IT Coordinator posts after Tom Daschle announces his withdrawal from the HHS appointment.

MCO execs should be looking at payment changes that are win-win for the payer, consumer

Pick your poison. Even with the grand number of proposals on the table, healthcare will still cost the nation trillions.

As a compromise effort for individual insurance reform dies in Michigan, BCBSM is left with tough options.

Healthcare leaders are concerned about future public programs under the new administration that simply shift costs

Most consumers and healthcare experts want to see a reduction in costs or coverage expansion in 2009

New political leaders and intense economic woes set the stage for a new day in healthcare reform. No one disagrees with the need, just the means for getting there.

Congress is looking to reign in excessive payment to MA plans, especially PFSS, in order to bring them closer to FFS rates

The economy trumps all for President-elect Obama, so healthcare spending must be re-examined if programs stand any chance of succeeding

President-elect Obama selects former Senate majority leader Tom Daschle as HHS secretary

Ambitious new efforts to expand healthcare coverage may be ruled out in the near future.

In the midst of current financial turmoil, the industry entrusted with the greatest accumulation of funds is the insurance industry. MCOs and HMOs should expect greater scrutiny of their finances.

The candidates are generally in agreement that the next administration should work toward reducing healthcare costs, delivering high-quality patient care, placing an increased emphasis on prevention, and providing coverage for an estimated 46 million uninsured Americans, but their proposals differ dramatically.

As goes the national economy, so goes healthcare. Unemployment will cause a rise in uninsured and Medicaid enrollment with higher spending ahead.

Plans can no longer charge higher copays or limit the number of visits for behavioral or mental health benefits, thanks to a new law

Coverage expansion is taking a back seat as costly medical advances and the burden of obesity chew up more of the healthcare spending pie

Even though the Medicare prescription drug benefit has provided access to medicines at less-than-anticipated cost to the government - and lower out-of-pocket spending for seniors - Democrats and consumer advocates are gearing up for a battle to overhaul the program.

While it appears as if healthcare has taken a back seat to current economic and global issues, 25.9% of nearly 500 MHE readers surveyed see health plans as being the agents of change in reform.

Health policy experts have been debating how to obtain more reliable, unbiased information on which drugs and medical procedures are most effective.

As far back as 1971, Mickey Herbert has believed that a market-based system of healthcare delivery is the only option for America. Now president and CEO of ConnectiCare, a commercial and Medicare Advantage insurer, Herbert still believes in the market-based system.

Congress has joined states and consumer groups taking action against health insurers for revoking coverage for thousands of individual policy holders.

In enacting legislation to delay a reduction to Medicare physician fees, Capitol Hill Democrats demonstrated their intent to undermine the role of private insurers in providing care to seniors. Although all sides agreed to avoid a big cut in Medicare payments to doctors, Republicans fought efforts to fund the fees by reducing payments to Medicare Advantage plans.

Although there is strong interest in providing universal coverage for Americans, there is a growing sense that any coverage mandate must follow other changes so insurance is made more affordable first.