Amazing Accomplishments in Global Health in 2015

We get so caught up in the Donald and Hillary and Ted and Bernie shows.  Yet there is so much else going on in the world about which most Americans never hear — such as global health.

Permit me to draw attention to This Week in Global Health (TWiGH) which has been producing weekly live online programming on global health topics since mid-2014.  Hosted by Dr. Greg Martin, editor of Globalization and Health, (an open access journal) it’s compelling and accessible.  Recently, the group asked its experts to identify big accomplishments in global health in 2015.  The list grabbed my attention, so here it is – see the YouTube video as well:

  1. Malaria: After 30 years and $565M, 2015 saw the development of the first-ever malaria vaccine; 50% of world population is at risk at risk and this development just might transform millions of lives for the better.
  1. HIV: The World Health Organization updated its guidelines for HIV treatment recommending that it be universal, and that everyone should be treated as soon as positive test result is made; those on treatment are far less likely to transmit the virus to another person.
  1. Climate change: The Paris Agreement on climate change puts in place the first international brakes on global warming, with 196 participating nations, and legally binding when signed by at least 35 countries.
  1. Bariatric Surgery: Though the spread of this treatment is controversial, it is considered the most important breakthrough in diabetes care since the discovery of insulin, with unrivaled health benefits.
  1. Ebola: We are seeing the beginning of the end of the West African Ebola Crisis – though the ordeal is far from over for 17,000 survivors.
  1. Polio: Last year we saw the elimination of polio from the African continent – the last cases were in Nigeria and in September the WHO said that polio is no longer endemic in Nigeria. Only Afghanistan and Pakistan remain as countries with polio.  Eradication is possible!


  1. Approval of the Sustainable Development Goals: 2015 saw the final approval of new international health and social development goals; compared with the earlier Millennium Development Goals, the SDGs are more comprehensive, more inclusive, and financed to encourage sustainable development.
  1. Research: A Nobel Prize was awarded to researchers for novel therapies for parasitic diseases and malaria, demonstrating the vital role and positive impact of research on global health.
  1. Ending Extreme Poverty: The number of people living in extreme poverty (defined as less than $1.90 per day) is down 10%, down from over 900m in 2012 to under 700 million now; a big MDG goal to end extreme poverty by 2030.
  1. Maternal & Child Health: Infant mortality is down to an all time low, down 54% since 1990 down by to 5.9 million, from 63 deaths per 1000 live births in 1990 to 32 in 2015; maternal mortality is down 44%.
  1. Water – In 2015, 91% of the world’s population had access to an improved drinking-water source, compared with 76% in 1990.

Well, wow!  I didn’t know that! Let’s notice and celebrate real progress for citizens of the world.  Let’s hope that 2016 brings other good news for the world.

Bernie Sanders and Hillary Clinton on Health Care – Who’s Got the Plan?

It’s funny how things turn out on the campaign trail. Since all Republican presidential candidates pledge to repeal the Affordable Care Act/ObamaCare, they have little to argue about. The fireworks are among Democrats as Hillary Clinton and Bernie Sanders argue the future of US health reform and, specifically, the merits of Sanders’ new single payer/Medicare for All scheme, released Sunday evening hours before the Democrats’ final pre-primary debate.

Clinton, fighting a Sanders surge in the Iowa and New Hampshire Democratic primaries, has been landing punches to throw his momentum off balance. Meanwhile, Sanders keeps humming the single payer tune that the Democratic base adores (see the Kaiser Poll below), offering some new melodies and riffs in his revised plan.

single payer 1

Sanders’ proposal matters because it shows how progressive thinking has shifted and because it calls into question whether Democrats have the staying power and political will to defend one of their principal accomplishments in the past 50 years, the ACA. Here are key points about the Sanders plan: Continue reading “Bernie Sanders and Hillary Clinton on Health Care – Who’s Got the Plan?”

A Looming Ballot Question May Upend Mass. Hospital Payments

Below is an article — Setting Hospital Prices by Ballot Initiative — just published in the winter edition of Commonwealth Magazine:

A LOOMING 2016 ballot initiative threatens to upend the foundations of hospital finance in Massachusetts, even if the measure never reaches the voters. The clash involves a fractured hospital community, insurers, a labor union, and state government in a controversy more than 25 years in the making.

For decades, savvy Massachusetts policy entrepreneurs have learned to use the threat of a statewide ballot initiative to compel legislative change that would never have happened absent the ultimatum.  I saw this up close in 1994 when Common Cause forced major campaign finance reform through a Legislature eager to avoid the group’s more punishing ballot proposal.  In 2000, health care advocates used this strategy to win passage of a managed care patient bill of rights. In 2014, the Massachusetts Nurses Association used the tool to score a new policy in their 20-year grudge match with the Massachusetts Hospital Association over state-mandated nurse/patient staffing ratios. Used well, the strategic ballot initiative is a proven and powerful public policy tool. Continue reading “A Looming Ballot Question May Upend Mass. Hospital Payments”

Please Remember This Number – 22 Million

22 million – that’s how many Americans would lose their health insurance, according to the U.S. Congressional Budget Office, if the reconciliation legislation approved by the U.S. House of Representative yesterday by a 240-181 vote were to become law.

The U.S. Senate approved the same bill in December and the House adopted it yesterday with no changes, so it is heading to the White House where President Obama is certain to veto the measure. The likelihood that House or Senate Republican leaders could summon the needed votes to override that veto is zero.

Recon 2016It’s easy to dive into the political games involved in this legislation because there are so many. Doing so, though, ignores our responsibility to recognize what this Congress has done – put itself on record to cancel health insurance for tens of millions of Americans and offer nothing, zero, to mitigate the harm to mostly low and lower middle income families.

Here are the bill’s key elements:

  • Eliminate the ACA Medicaid expansion
  • Eliminate the ACA’s premium and cost sharing subsidies to help lower middle income Americans buy private health insurance
  • Repeal the ACA’s individual mandate which helps to ensure a healthy risk pool of enrollees to keep premiums affordable
  • Cancel all federal funds to Planned Parenthood

Continue reading “Please Remember This Number – 22 Million”

Why Republicans Hate the ACA So Much

both increases literally reversed the majority of the last 20 years decline in the effective tax rate of America’s 400 wealthiest taxpayers!

This week, the US House of Representatives will take up reconciliation legislation, amended and approved in the US Senate last month, that would drill major, damaging holes in the Affordable Care Act.  Though the bill has zero chances of becoming law because of a certain veto by President Obama, it is – by the Democrats’ count – the 61st time the House has voted to repeal all or significant parts of the health reform law.

Why, people often ask me, do Republicans hate the ACA so much?

This past week’s New York Times Upshot article, I believe, provides a major part of the answer.  Briefly, “it’s the taxes on the wealthy, stupid.”  Specifically, it’s about two new Medicare taxes that went into effect in 2013 only on higher income Americans:

  1. ACA Medicare Part A Payroll Tax: Beginning in 2013, individuals with earnings above $200,000 and married couples making more than $250,000 got an increase in the Medicare part A payroll tax of 2.35%, up from 1.45% (a .9% increase), on adjusted income over the threshold. (2016-25 take = $123 billion)
  2. ACA Unearned Income Tax: This same group also now pays a new 3.8% unearned income (capital gains) tax on interest, dividends, annuities, royalties, rents, and gains on the sale of investments over the threshold. (2016-25 take = $222.8 billion)

It’s a lot of money and it’s a lot of money taken exclusively from the top 5% of America’s wealthiest, ($345.8 billion between 2016-25) and especially from the most wealthy as the chart below demonstrates: how-much-does-the-affordable-care-act-raise-taxes-really-01

As the Times article makes clear, these new taxes are so damn big (when combined with higher taxes from the 2012 American Taxpayer Relief Act) that both increases literally reversed the majority of the last 20 years decline in the effective tax rate of America’s 400 wealthiest taxpayers! Continue reading “Why Republicans Hate the ACA So Much”