tag:blogger.com,1999:blog-39909889807710116862024-02-07T16:57:30.629-05:00Mitchell on Health CareMitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comBlogger115125tag:blogger.com,1999:blog-3990988980771011686.post-50491443215878894582020-09-18T09:38:00.000-04:002020-09-18T09:38:00.336-04:00Curated COVID related articles for the week ending 9-18-2020For the past several months, I've been preparing weekly emails for a Doctor I know who (especially at the beginning) has not had time to keep up with the news.I thought this week I would share and see if anyone else finds it useful. Let me know what you think - should I share these every week?Note this is NOT an attempt to do a recap of the week - it's a curated collection of articles I found Mitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-54688405373489006112018-09-05T04:53:00.000-04:002018-09-05T04:53:02.318-04:00What’s a small state to do? (A health care agenda for Maine’s next governor)
Here in Maine, we’ll have a new governor come January. That combined with federal action that has undermined the Affordable Care Act (ACA) makes this a good time to ask what we, as a small, poor, mostly rural state, can do to improve health care for our residents.
In case you’ve been distracted by all the other news; in addition to the Administration’s sabotage over the past two years, there Mitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-61290214495734658822018-05-13T11:17:00.001-04:002018-05-13T11:17:59.575-04:00The President’s Drug Price Address: Smoke and Mirrors With a Dash of PolicyI wanted to believe something would come of this speech-- I really did. As a candidate, the President talked about doing something material about drug pricing including having the government (through Medicare) directly negotiate prices as well as other substantive changes. Sadly the speech given by the President and the accompanying “plan” released by HHS (American Patients First: The Trump Mitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-7341969973316470392017-12-28T15:40:00.000-05:002017-12-28T15:40:51.230-05:00Reports of the ACA's Death Have Been Greatly Exaggerated
A new survey out this week tells us that “31 percent believe Trump has repealed the Affordable Care Act, 49 percent say he hasn’t, and 21 percent are unsure.” To paraphrase Mark Twain: reports of the ACA’s death have been greatly exaggerated.
While the penalty for not having health coverage (the mandate) has been zeroed out starting in 2019, despite the constant attack, most of the law Mitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-52040562547947989122017-11-15T05:15:00.000-05:002017-11-15T05:30:47.774-05:00Once more unto the breach, dear friends
A new insidious threat reared its head yesterday when a provision eliminating the individual mandate was added to the Senate version of the tax bill.
Fellow Mainers, please let Senator Collins know this is unacceptable.
As many of you know, the mandate works to bring everyone into the system. Without it, the CBO estimates 13 million fewer people would be covered and premiums Mitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-35159305134052154352017-11-02T11:11:00.000-04:002017-11-02T11:11:24.581-04:00Evidence and Empathy – Two Reasons to Vote Yes on 2
On Thursday night November 2, I'll be speaking at "A Faith-Based Perspective on the Need for Medicaid Expansion in Maine" taking place at Woodfords UCC Church at 7 PM. Below are my remarks.
I have spent my career working on various parts of our health care system. I started working for MetLife on long-term care insurance in 1991 and then spent over 15 years at Mercer Consulting Mitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-79846887031981160032017-10-18T06:18:00.000-04:002017-10-18T06:18:58.114-04:00Can the Senate Function as Intended?
Yesterday afternoon it was announced that Senator Murray and Senator Alexander had reached a bipartisan agreement to provide funding for cost-sharing reduction subsidies and make other minor changes to how the ACA is currently being administered.
This is how the Senate is supposed to work, two sides meet and hash out a compromise. However, questions remain as to if the compromise will Mitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-12826036259383105942017-10-13T05:17:00.001-04:002017-10-13T05:19:22.508-04:00Waking up to ACA chaos
Yesterday morning, the President signed an executive order instructing
several federal agencies to consider actions which will further undermine the
ACA.
As I said to the Press Herald yesterday (Trump’s
executive order could alter Maine insurance market) :
“As of the signing of the
executive order, absolutely nothing changes,” said Mitchell Stein, an
independent insurance industry Mitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-33125067149623452972017-09-25T08:01:00.000-04:002017-09-25T08:01:08.592-04:00Yes, they managed to make it even worse
Late last night, revised text was released for the Graham Cassidy repeal and replace legislation.
The headlines are saying that Maine (among a few other states) will benefit from the new language in an attempt to convince Senator Collins to vote for the bill.
Take those headlines with a huge grain of salt. The estimates being used are from the bill’s authors – the authors whose estimates forMitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-91566178440107900682017-09-02T15:31:00.000-04:002017-09-02T15:31:30.782-04:00Learning about our health care system from the inside
It was a dark and stormy night – actually it was another beautiful summer day here in Maine, Tuesday, August 29th. I had been experiencing a little shortness of breath when walking my dog Beau, so I made an appointment with my primary care doctor. Three days, two hospitals, and an ambulance transfer later, I was the proud container for two stents and had three daily medications I’ll be taking Mitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-57400559935902489492017-07-20T15:50:00.000-04:002017-07-20T15:50:01.313-04:00Next steps – as of Thursday, July 20
Given the pace of developments, I felt compelled to put today’s date in the title. I hope the contents will continue to be relevant and helpful, but as I’ve said before – I know nothing ¯\_(ツ)_/¯
With that in mind, I’m writing under the assumption that “repeal & replace” and “repeal & delay” are both dead. Of course, that may yet prove to be false, but if the vote Mitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-40060332314803473282017-06-26T07:32:00.000-04:002017-06-26T07:32:15.223-04:00The Senate Bill and Pre-existing condition protections. A response to Senator Johnson
In today's New York Times, Ron Johnson, Republican senator from Wisconsin argues against the Senate health care bill because it DOES NOT remove the protections for coverage of pre-existing conditions (https://www.nytimes.com/2017/06/26/opinion/senate-health-care-bill.htmlhttps://www.nytimes.com/2017/06/26/opinion/senate-health-care-bill.html)
Guess what, it already does. I've put Mitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-91431309376174538072017-06-23T10:00:00.000-04:002017-06-23T10:00:20.583-04:00Better Care Reconciliation Act – No, the bill title is not a joke, just another sign that irony is dead
Did anyone really think the Senate bill would be better? It’s not. In many ways, it’s very similar to the House bill, but it also manages to find new creative ways to be horrible.
I wanted to write a moderate post, talking about the good and the bad in the bill, finding places that might be the start of negotiation. But I can’t. Perhaps President Obama summed it up Mitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-63999585710793632952017-05-17T07:31:00.000-04:002017-05-17T18:28:58.364-04:00Comments on Maine’s 1115 Medicaid Waiver Application - Evidence and Empathy
DHHS is holding a public hearing on its Medicaid waiver application. Below are the comments I will either read or submit (based on turnout at the hearing).
Good morning. My name is Mitchell Stein, and I am an independent health policy consultant. I offer these comments on Maine’s 1115 Medicaid waiver application as a private individual, no client is paying for my time, and Mitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-24065199737839068762017-05-05T05:15:00.002-04:002017-05-05T05:25:11.571-04:00Time to take a deep breath and then get back to work
OK, let’s all take a deep breath. I don’t want to stifle the outrage, believe me, I’m pissed, but we have a long road ahead. No one’s coverage has changed (yet). The ACA has not been repealed or replaced (yet). Passage in the House was only the first step so let’s all take a deep breath, maybe have a drink to drown our sorrows, and then get back to work.
At the end of this tweet is a summary Mitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-74202004803294090552017-05-05T05:12:00.002-04:002017-05-05T05:12:20.455-04:00Speaking truth to power
24 hrs, 3 stories
Portland Press Herald May 2, 2017
LePage administration program inspires key component of ACA replacement plan
Stein said there’s nothing wrong with the structure of a reinsurance program like MGARA, but the key is how well it’s funded.
“In the end, it all comes down to how much money is put in,” Stein said.
MPBN May 2, 2017
GOP’s Revised Health Mitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-61834459269376135942017-03-25T12:33:00.000-04:002017-03-25T12:34:00.328-04:00What just happened, and what happens next?
I think it’s safe to say that over the last few days we saw an unprecedented defeat for the party in power. Despite having majorities in both houses of Congress and the Presidency, they were unable to fulfill a promise seven years in the making – instead, as put by Bill Gardner, The ACA Won.
Did you ever think you would hear Paul Ryan say, “Obamacare is the law of the land”?
Mitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-67978532269484895182017-02-26T16:25:00.000-05:002017-02-26T19:18:30.811-05:00A tumultuous 48 hours for the future of the ACA
Friday and Saturday (2/24-2/25) saw several developments concerning the future of the ACA. We now know more directionally about the “replacement” plans, where this is will all end up is still anyone’s guess.
Let’s look at what happened and what it might mean. Here’s the timeline:
Fri AM - First analysis of the net financial impact on Americans of the proposed Republican Mitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-63134788662754592582017-02-14T16:07:00.006-05:002017-02-14T16:07:55.312-05:00Rep Poliquin and the ACA - slogans are easy, policy is hardHi, it's been a while since I've posted on this blog. However, now that I'm back on my own, it's a good place to park some of my longer musings on healthcare.
Representative Poliquin of Maine’s second district has prepared a handy form letter to send to constituents who write or call his office expressing support for the ACA. I thought it would be helpful to walk through some of his Mitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-20200030193706940092015-06-08T19:32:00.001-04:002015-06-08T19:32:40.816-04:00Sometimes I just can’t help myself…
While I’ve started my new job at ICER, I can't help but continue to pay attention to the ACA J
This morning the Supreme Court rejected Maine's challenge to the constitutionality of an ACA provision governing Medicaid. This was the administration's attempt to drop 19 and 20-year-olds from Medicaid, claiming that the Maintenance of Effort provision of the original law was unconstitutional.&Mitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-35932928883488166392015-03-21T08:14:00.000-04:002015-03-21T08:14:39.375-04:00An Appreciation of Atul Gawande’s Being Mortal: Medicine and What Matters in the End
This is not a book review. If I were to write a review it
would be very short: This is a great book, go read it. Instead below I share my
appreciation for the book through excerpts that resonated most with me. They
probably won’t be the same for you, but that’s OK, diversity of perspectives
helps make life interesting
For me, there were three main points that stood out. None of
them are newMitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-29966149912519067892015-03-13T10:10:00.001-04:002015-03-13T11:09:22.095-04:00That Was The Week That Was - Issue 52 (Final Edition)
This is it, the final issue of “That Was The Week That
Was”. I've been thinking a lot about
what I want to say, I thought about last lines of novels, movie quotes and
more. But in the end, it’s very simple,
what I want to say is thank you. Thank
you for reading, thank you for sharing this time with me, and most of all thank
you for caring enough about health care (both your ownMitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-33629014984220837082015-03-08T17:53:00.001-04:002015-03-08T17:53:17.163-04:00How to be a health policy wonk
Wondering how you'll keep up with health policy news now
that my newsletter is ending? Below I
outline some of what I do to keep up.
Through a combination of email subscriptions, checking
websites and following twitter feeds I manage to stay abreast of current
events.
Email subscriptions
Here are some of my email subscriptions, and yes, I know, it’s
a lot. You will probably Mitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-70051789578546616332015-03-05T15:53:00.000-05:002015-03-05T15:55:07.540-05:00That Was The Week That Was - Issue 51
A look back at the week's health policy news with a
focus on ACA implementation
Welcome to the penultimate edition of this newsletter. No
news yet on what I’ll be doing next, so if anyone is looking for a health
policy expert who has been told he knows how to string words together to form
meaningful sentences, let me know.
This week we'll talk about the Supreme Court subsidy case
Mitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.comtag:blogger.com,1999:blog-3990988980771011686.post-37791070438201070872015-02-26T18:56:00.001-05:002015-02-26T18:56:07.043-05:00That Was The Week That Was - Issue 50
A look back at the week's health policy news with a
focus on ACA implementation
Only two issues of this blog to come after this one, so
treasure these while you can. I’m still figuring out what’s next after the blog
ends, so stay tuned.
You might have heard a little something about another ACA
case headed to the Supreme Court regarding the subsidies. With oral arguments scheduled
for next Mitchellhttp://www.blogger.com/profile/06501281477707010061noreply@blogger.com