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Secretary of Health and Human Services Michael Leavitt addresses the media at an AEI event |
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Secretary of Health and Human Services Michael Leavitt gave a speech at AEI in April on "Promoting Health Insurance for Children and All Americans." He spoke about the stealth attempt to "crowd out" private insurance by dramatically increasing funding for and enrollment in the State Children's Health Insurance Program (SCHIP).
AEI's Studies on Medicare Reform started publishing in 2007. In the first book in the series, The Diagnosis and Treatment of Medicare, Andrew J. Rettenmaier and Thomas R. Saving propose financing the program by prepayment by each age cohort rather than the current transfer scheme. The forthcoming second volume in this series, Medicare and Markets, by AEI adjunct scholar and Wharton School professor Mark V. Pauly, will argue that market-based reform would be more effective in reconciling the rising demand for health care with the program's more limited resources.
An April event at AEI reviewed the recommendations of the Medicare Payment Advisory Commission on the perennial problem of the fees paid to physicians under Medicare. Mark Miller, executive director of the commission, spoke, and Joseph Antos moderated.
As they have done in past years, Mr. Antos and Robert B. Helms convened a session to review the annual Medicare trustees report the day after its release on April 23. Richard Foster, Medicare's chief actuary, discussed this year's findings with Mr. Saving and John Palmer, the two public trustees.
John E. Calfee, Scott Gottlieb, M.D., and Roger Bate have been studying prescription drugs this year. Mr. Calfee has focused on biotech drugs, writing a Health Policy Outlook on the subject of follow-on biologics in April. He argues that biologic innovators should enjoy data exclusivity for a number of years in order to protect their R&D investments and stimulate innovation. He also wrote a cover story for The American's March/April special report on health innovation. Mr. Calfee and Claude Barfield authored Biotechnology and the Patent System: Balancing Innovation and Property Rights (AEI Press, 2007), and they spoke at a forum on the subject in September when the Patent Reform Act of 2007 was pending in Congress.
Mr. Calfee and Dr. Gottlieb spoke at a conference in June on whether Congress should create a regulatory pathway for follow-on biologic drugs, which piggyback on R&D-intensive, complex drugs and thus present greater challenges to intellectual-property protection than simpler small-molecule drugs.
Dr. Gottlieb focuses on the approval process for new drugs. He wrote a series of op-eds in the Wall Street Journal exploring different ways the Food and Drug Administration (FDA) can improve the regulatory pathways for new medicines. He is also examining how the FDA regulates drugs after approval. In an article in Health Affairs, he criticized legislative proposals to require post-approval risk management.
The Health Policy Consensus Group, a task force of leading health economists, renewed its efforts this year to promote incentive-based and consumer-driven health care. Messrs. Antos and Helms and Thomas P. Miller contributed to policy fact sheets on Medicare Part D, SCHIP, Medicare Advantage, and other topics. Mr. Helms authored a Health Policy Outlook on SCHIP in August.
Mr. Antos and Alice M. Rivlin of the Brookings Institution edited Restoring Fiscal Sanity 2007: The Health Spending Challenge (Brookings Institution Press), which stresses the need for innovative approaches and cooperation between the private and public sectors.
Mr. Bate has been writing extensively about pharmaceuticals and global health. In nine Health Policy Outlooks since December 2006, he has addressed how corruption and tariffs reduce access to medicine in the developing world, how India and Thailand are weakening drug patents and endangering innovation, how counterfeit and copy drugs endanger patients, how the World Health Organization sets unrealistic targets, how price discrimination gets medicine to the poorest and preserves incentives for innovation, and how unhygienic health care hurts patients.
In his March Health Policy Outlook, Mr. Bate explored the murky medicine procurement process of the Global Fund for AIDS, Tuberculosis and Malaria. He examined the work of Senator Tom Coburn (R-Okla., see here) in attempting to impose transparency on the Global Fund.
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Resident Scholar
Robert B. Helms |
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Mr. Helms concluded his service on Secretary Leavitt's Medicaid Commission in December 2006. Although he voted for the commission's recommendation, Mr. Helms published a partial dissent as a January Health Policy Outlook, in which he argued that the formula for federal matching funds is flawed. It fails to target the poorest and neediest beneficiaries and states.
In a January Health Policy Outlook, Mr. Pauly outlined the strengths and weaknesses of the Massachusetts health plan to cover the uninsured. At an AEI event, Mr. Pauly and others examined whether the plan could be a model for other states.
In January, AEI hosted a panel to discuss whether the government should negotiate the prices of pharmaceuticals covered by the new Medicare Part D prescription drug benefit. Mr. Antos and Mark B. McClellan, M.D., spoke.
Bill Thomas gave the keynote address at a February conference on arguments pro and con for a White House proposal to replace the current tax break for employer-sponsored health insurance with a standard tax deduction available to anyone buying insurance. In August, Bryan E. Dowd of the University of Minnesota contributed a Health Policy Outlook on the president's proposal. Mr. Miller moderated a September panel on revving up consumer-driven health plans.
Sally Satel, M.D., continued her work on mental health policy, drug addiction, and organ markets.
In May, Mr. Pauly and Johns Hopkins University's Bradley Herring presented new findings on how insurance companies pool risk in the individual market and how various state regulations affect premiums and the degree of coverage. Their research provides a policy rationale for individual health insurance as a more effective tool to expand coverage.
At a session moderated by Mr. Miller, panels discussed a provocative article by health policy researchers Clark C. Havighurst and Barak D. Richman, in which they argue that there is "serious and systematic unfairness in the American way of financing, regulating, and dispensing health care."
The "retail revolution" in health care services was the subject of a July forum at which speakers addressed consumer-directed health plans, walk-in clinics, accessible medical records, and health care by nonphysicians.
Other sections within the Annual Report:
