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As another data point in the trend of mounting frustration about rising healthcare costs, KFF Health News published an article about the growing momentum behind "Medicare for All", a movement "to bring universal healthcare to every American," even though the specific mechanisms can vary. The article notes that "nearly 60% of Americans favor a system of Medicare for All, while 85% of Democrats support it." Perhaps more surprising is that "According to one survey, more than half of all physicians have said they'd prefer some sort of single-payer system. ... The American College of Physicians, the nation's second-largest physician group, also supports Medicare for All." While Medicare for All would likely streamline paperwork for doctors, Medicare for All likely would not leave room for negotiation for rates, potentially limiting physicians' overall compensation over time. Already, many physicians refuse to accept Medicare plans because of the lower reimbursements.

As the article points out, translating this general sentiment into actual legislation still takes many steps and would still need to overcome many entrenched interests. Even still, it seems clear that decades of marketplace dysfunction has helped shape public sentiment. Perhaps the momentum will continue to grow enough to actually shape public policy.

KFF Health News published an article highlighting politicians in at least four states pushing for "single-payer, universal healthcare systems": Oregon, California, New York, and Washington. Oregon is the furthest along, with their Universal Health Plan Governance Board trying to establish "medical, vision, dental, and mental health benefits for every state resident from cradle to grave — with no premiums, deductibles, or copayments" starting in 2032. The article also noted that "In California, Democratic candidates for governor are not debating whether to implement single-payer but how. New York lawmakers are debating a single-payer bill called the New York Health Act. And in Washington, state legislators have created a commission to design a universal healthcare plan."

The surge of interest in universal healthcare is a response to the long-running frustration at the rise in healthcare premiums and dissatisfaction with the status quo (including denials). However, the article also highlights how difficult it can be to enact legislation to this effect, with health insurers funding opposition, and even the medical community being unsure. Even if a state successfully enacts legislation, executing the plan can be very difficult, as Vermont's previous effort shows.

For the case of Oregon, the plan to provide all of those benefits ("from cradle to grave") without deductibles and premiums seems quite ambitious and probably naive. Given free health care, patients are more likely to consume more, and the cost to support such a system might rise unsustainably.

This week, we released a feature that we have been working for the better part of this year: improving our search interface. Instead of submitting an entire query out to find out what our parser understood, the new interface interactively offers tags as users type. The tags are also categorized (e.g. name or location or specialty) so that users can more easily confirm a match.

Please try out this new feature and let us know what you think. Similarly, if you have ideas for new features, please let us know.

There is some debate as to how Medicaid funds should be spent. One core question is whether Medicaid funds should be restricted to medical care, or if they should be allowed to pay for activities that improve health and reduce the need for medical care. KFF Health News highlighted one study showing that patients who received "medically tailored meals for at least three months needed less medical care." Among the findings: "The Massachusetts researchers found that the meals — at a cost of $125 per person per week [about $3,250 for six months] — essentially paid for themselves. Patients with heart disease used about $10,000 less in healthcare services over six months, and patients with kidney disease used $12,000 less in healthcare. There were also savings for people with diabetes, depression, and anxiety." Yet, on the other side, are those who "believe federal health spending is too high and riddled with fraud. Sen. John Kennedy... , for example, has accused California of 'outrageous fraud' for using Medicaid dollars to fund housing and nutrition programs." The article notes that "Some companies have been accused of billing Medicaid for meals that were neither healthy nor nutritious, raising concerns about lax regulation of these programs."

It seems that in the best cases, "food as medicine" can lead to better outcomes and more savings. However, the possibility of fraud or even ineffective programs should not be ignored.

As hospitals buy up nearby practices, they exert more control over patients. KFF Health News profiled one patient who ended up paying roughly double of the initial estimate she was given because a hospital had bought her physician's practice and they mandated that her procedure be done in a surgery center. The hospital's mandate contradicts the guidelines of a relevant professional organization. The article notes that "while the stated purpose [of acquisitions in the healthcare industry] is generally greater efficiency, studies have shown that for patients the net result has been higher prices and no benefit, or worse health outcomes." Some might be surprised that "82% of physicians are employed by hospitals, other corporate entities (like insurers), or private equity firms," leaving a much smaller percentage of physicians who work in private practice.

Understandably, hospitals and health systems are trying to increase their revenues, similar to many businesses. However, these extra costs make the entire system more expensive (for example, higher insurance premiums). It would be interesting to know how much of growth in healthcare spending over the last ten years has been due to mergers and acquisitions.