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Editorial

Whining about thousand-dollar pills

David Williams

David Williams's picture

When I saw Paying for the Thousand-Dollar Pill, an anti-Sovaldi op-ed in the Wall Street Journal, it brought back memories from my childhood when I toured the FBI headquarters in Washington, DC. The tour guide started off by showing us a wall with pictures of the 10 most wanted fugitives in the country and asked for our help in tracking them down.

What about the working class and middle class?

Robert Laszewski, Health Care Policy and Marketplace Review

Robert Laszewski's picture

Perhaps the biggest consumer problem Obamacare has is that the plans with high premiums even after the subsidy, big deductibles, and narrow networks are not attractive to working class and middle class families and individuals who don't qualify for the biggest tax credits.

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President Obama acknowledges the technical issues with HealthCare.gov, pledging his Administration will resolve them soon and asserting that the distressed web portal is not the only way to shop for affordable health insurance available through the ACA.

 

Three years after launching a 750-patient Medicare Advantage collaborative care pilot, Portland, Maine-based independent physician practice NovaHealth and insurer Aetna have shown concrete results in improving care quality and reducing costs. Technology and provider-payer cooperation played a large part in the program's success.

An insurance industry veteran who managed one of the few well-functioning state exchanges in the first open enrollment period is taking a key federal post.

While more payers and providers are trying to pursue value-based reimbursement models, some insurers are finding themselves fighting back against questionable fee-for-service schemes.

The federal government's employee advocate is trying to draw a line in the sand for wellness programs, and raising questions about the value and legality of some employers' incentive-based cost containment strategies.

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How much leeway do employers and insurers have in deciding whether they'll cover contraceptives without charge and in determining which methods make the cut? Not much, as it turns out, but that hasn't stopped some from trying.

What's in a name? When it comes to health plans sold on the individual market, these days it's often less than people think. The lines that distinguish HMOs, PPOs, EPOs and POS plans from one another have blurred, making it hard to know what you're buying by name alone -- assuming you're one of the few people who know what an EPO is in the first place.

The idea of a new "copper" tier of health plans is being pitched for the most healthy and cost-conscious consumers.

Oregon is mandating Medicaid coverage for gender dysphoria treatment, bringing it in parity with the state's progressive commercial market and also putting pressure on other states and insurers.

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