|THIS WEEK IN HEALTHCARE
What happened in healthcare this week—and what we think about it.
Healthcare? She’ll have a plan for that.
Facing a growing chorus of attacks from rival Democratic presidential candidates, Sen. Elizabeth Warren (D-MA) pledged this week that her campaign would soon deliver details on how she plans to pay for “Medicare for All” (M4A). Warren has not proposed a healthcare plan of her own but has expressed support for Sen. Bernie Sanders’s (I-VT) single-payer plan, which would replace the nation’s existing insurance system with a new, government-run program. Sanders has been clear that his proposal would entail higher taxes for many Americans, in exchange for eliminating the burden of premiums, deductibles and copays. Warren, however, has been reluctant to say whether she would also raise taxes on middle-income Americans to pay for M4A. Having earmarked all of the revenue from her proposed 2 percent wealth tax on those with more than $50M in assets to pay for her education plans, Warren must find other ways to pay for the estimated $30T in increased spending over ten years that M4A would entail. “This is something I’ve been working on for months and months,” Warren said at a town hall on Sunday, “and it’s got just a little more work until it’s finished.” Several ideas are being considered inside the Warren camp, according to the Washington Post, including a tiered sales tax, lowering the threshold for those subject to a wealth tax, and increasing taxes on businesses. As moderate candidates continue to criticize Warren for her vagueness on the topic, it’s clear she will need to be more explicit about her healthcare plans, or risk losing the momentum that has propelled her to front-runner status in the primary race. As is usually the case with healthcare reform, the devil is in the details.
Healthcare? They have a plan for that.
This week the Republican Study Committee (RSC), a group of 145 GOP lawmakers in the House of Representatives, released a healthcare plan intended to serve as a counterweight to the ongoing discussion of M4A among Democratic presidential candidates. The plan provides a framework for how the largest caucus of conservatives in Congress would approach healthcare legislation should their party win back the House and retain the Senate and White House. It largely mirrors legislative proposals considered by Congress in 2017, including transforming Medicaid into a block-grant system, increasing the use of health savings accounts, dismantling the essential health benefits provisions of the Affordable Care Act (ACA), and relying on high-risk pools to stabilize the individual insurance market. In a nod to the Trump administration’s efforts to encourage states to implement work requirements for Medicaid enrollees, the RSC proposal includes a new “flex grant” option for Medicaid block grants that would provide greater funding to states that implement such rules. The plan also allows greater flexibility for short-term insurance plans, health sharing ministries, association health plans, and other less-expensive alternatives to plans currently offered in the insurance marketplace. In a press release accompanying the framework, the RSC said, “With the introduction of our plan today, we are beginning a desperately needed conversation on how to save our country’s broken health care system.” With nearly a decade’s worth of contentious political battles over “repeal and replace” behind us, and in the midst of yet another election cycle in which healthcare reform is the central issue, House Republicans are scarcely “beginning a conversation”, but rather adding to the seemingly endless cacophony of partisan shouting about healthcare.
Amazon adds to its new healthcare platform
This week Amazon confirmed a CNBC report that it had agreed to acquire Health Navigator, an online symptom checker and virtual triage service. The acquisition is the second healthcare-related pickup for the e-commerce giant, which bought online pharmacy PillPack last year. Health Navigator is a much smaller acquisition and will become part of the newly launched Amazon Care, the company’s virtual care platform for its own employees. Health Navigator was founded in 2014 by David Thompson, an emergency medicine physician who is best known for helping to develop the triage protocols now widely used by nurse navigators at many insurer and provider call centers. The company works with a range of telemedicine, electronic health record, and call center companies, providing clinical content and a diagnosis engine that enables virtual triage of patients based on symptoms, using a natural language processing tool to capture patient complaints and match them to clinical conditions. Amazon is likely to incorporate the Health Navigator platform into Amazon Care’s virtual care services, helping connect employees to the appropriate care provider through virtual visits or home-based care. While initially offered only as a benefit for its Seattle-based workers, Amazon Care generated widespread buzz upon launch, with many speculating that it will become the basis for a broader consumer health offering in the future. Whether that’s true remains to be seen—for now, Amazon appears to be in the R&D phase of its healthcare play, using its own employees as a proving ground for new delivery approaches.