On October 22, 2020, Richard Scheffler was named an editorial advisory board member of The Milbank Quarterly, a quarterly peer-reviewed healthcare journal covering healthcare policy. Their publications connect empirical research to practical policymaking. The 38 scholars on the board collectively offer multidisciplinary insight into social, economic, political, historical, legal, and ethical aspects of health and healthcare policy.
The Petris Center article, “What Does Senator Kamala Harris’ Record As California’s Attorney General Tell Us About Her Health Policy?” was cited in The New York Times on October 6, 2020. This analysis delves into her history in health policy as attorney general in three areas: antitrust (especially mergers and consolidation), pharmaceuticals, and support of the Affordable Care Act (ACA). Richard Scheffler was quoted in The New York Times on Harris prioritizing health care as an attorney general.
By Richard M. Scheffler and Surina A. Khurana | Published October 1, 2020 in Health Affairs Blog | Link to Full Article
Health policy, like most public policy, is autoregressive: The past is usually the best predictor of the future. Democratic vice presidential nominee Kamala Harris’ position on national health policy issues is well known from presidential debates and public statements; less is known about what she actually did while serving as the attorney general for the state of California from 2010 to 2017. Most of her record in health policy as attorney general was in three areas: antitrust (especially mergers and consolidation), pharmaceuticals, and support of the Affordable Care Act (ACA). It is fair to say that she has been very active and effective in all three areas.
By Richard M. Scheffler and Taylor L. Wang | Published September 21, 2020 in Milbank Quarterly Opinion | Link to Full Article
There is little doubt that the cost of health care and universal coverage will be a major topic discussed at the upcoming presidential debates. A key debate will likely center on the Biden-Sanders Unity Task Force’s recommendations released earlier this year proposing a public option to compete against existing private insurers. The recommendations only outline a public option framework, so the details, both logistical and financial, will be key to moving forward. While recent articles have assessed the state-level public options in Washington State and New Mexico, we look internationally to Germany and Australia to evaluate how their health care systems have achieved universal coverage by delivering public health insurance. Both countries have a private component in the health insurance system: Germany allows individuals to purchase substitutive private insurance based on income, and Australia takes it a step further by creating incentives for all citizens to enroll in supplemental private insurance. We examine the framework of each system, how the public-private insurance dichotomy is organized, and some key takeaways for the United States.
By Richard M. Scheffler and Taylor L. Wang | Published September 21, 2020 | Link to Full Article
Presidential candidate Joe Biden’s proposal for a public option is likely to be a major topic in the upcoming presidential debate. While the proposal certainly isn’t the first of its kind, in light of the recent COVID-19 pandemic it is especially significant due to the rapid increase in the number of people without insurance. To better understand the arguments for this proposal and other public option or opt out proposals, we discuss the following: (1) Jacob Hacker’s original ideas and arguments for a public option and why it was left out of the ACA, (2) A review of the cost and coverage impacts of various public option reforms conducted by the Urban Institute, (3) An examination of the only state-based public option passed by Washington State, (4) The current version of Biden’s public option, and (5) Final thoughts.
On Thursday, September 10, Professor Richard Scheffler served on an online panel discussing the topic: Antitrust Implications of Healthcare Provider Consolidation. Hosted by the California Lawyers Association, the webinar discussed antitrust issues that result from vertical integration, the impact of the COVID-19 pandemic on antitrust and economic analysis, and the ongoing Sutter case. The two other panelists were Laura Alexander (VP of Policy at the American Antitrust Institute) and Michelle Lowery (Partner at McDermott Will & Emery).
Healthy California for All Commission released a report, “An Environmental Analysis of Health Care Delivery, Coverage, and Financing in California” for California Governor Gavin Newsom, Senator Richard Pan, and California State Assemblymember Jim Wood. It examines the strengths and limitations of California’s current health care system, outlines potential designs to transition to unified financing, and describes health coverage expansion options.
In its analysis of provider consolidation, The Petris Center’s study “The Sky’s the Limit” is cited for trends of hospital market concentration. “A New Vision for California’s Healthcare system” is cited in discussing cost containment strategies, and “California Dreamin’: Integrating Health Care, Containing Costs, and Financing Universal” explores the role of integrated plans.
This research report titled “Preventing Anticompetitive Contracting Practices in Healthcare Markets” analyzes five specific clauses in healthcare contracts that have the potential for anticompetitive harm. In understanding the theory and empirics of pro- and anti-competitive effects in specific healthcare markets, we reviewed legal and economic literature, examined antitrust enforcement of contract terms, and surveyed all 50 states of proposed and enacted legislation restricting the use of these contract clauses. This report is the latest product from a joint project with The Petris Center and The Source on Healthcare Price and Competition supported by Arnold Ventures.
This project leverages the latest and most comprehensive data on state laws, healthcare markets, and healthcare prices in provider and insurer markets in the United States in the last ten years and presents evidence-based information and analyses on the most effective strategies for states to address rapidly consolidating healthcare markets. In the first published report in the series, “Preventing Anticompetitive Healthcare Consolidation: Lessons from Five States” identifies best practices that state policymakers should consider to enhance oversight of healthcare consolidation in their own state.
The Petris Center study, “The Distribution of Provider Relief Payments Among California Health Systems” was cited in The New York Times on July 10, 2020. The analysis estimated that a 24% reduction in net patient revenue was offset by direct CARES Act grants and varied widely by hospital. Hospitals with a larger share of net patient revenue from private insurers and hospitals residing in highly concentrated hospital markets received larger payments per adjusted patient day.