Monday, April 28, 2008

The State of Employer-Sponsored Health Coverage

First published on THCB.
New data make it clear that America's employer-based health coverage system is increasingly in shambles, providing adequate coverage to a rapidly diminishing percentage of the population. We can fix it or replace it but, for the good of the nation, we need to do one or the other. To let it languish causes enormous unnecessary suffering and cost.


A detailed new study from the Economics Policy Institute confirms what many of us suspect but haven't had the data to easily nail down. This weightily titled report by Jared Bernstein and Heidi Shierholz - A Decade of Decline: The Erosion of Employer-Provided Health Care in the United States and California, 1995-2006 - provides more granular information about the enrollment dynamics over time in employer-sponsored health coverage than we've seen in a while. Based on an analysis of the March 2007 Current Population Survey, the numbers reported here are mostly in sync with (but deeper than) similar studies that have attempted to size the enrollment and erosion characteristics of the employer-sponsored coverage market. Strap yourself in; this isn't pretty.

Tuesday, April 22, 2008

An Open Response To HHS Secretary Michael Leavitt

First published on THCB.
hhsUnder the Bush Administration, HHS officials keep telling us how they support health care pricing and performance transparency. But in withholding Medicare physician data from public scrutiny - they have followed the AMA's advice that doctors have a right to privacy - they demonstrate that their interest in transparency is selective.

A few months ago, the two of us – both long-time advocates for transparency and accountability – posted separate comments on
Secretary Mike Leavitt’s blogBrian asked Secretary Leavitt to square his support of "Chartered Value Exchanges” with the attempt to block release of physician-specific Medicare claims data to Consumers’ Checkbook, which wants to rate doctors. After a court ruled that the data should be provided to the group, HHS appealed. Michael urged the secretary to go beyond supporting Consumers’ Checkbook and use his “bully pulpit” to promote sophisticated data analysis that could be used to create national quality comparisons.