John R. Graham Archive

John R. Graham is a Senior Fellow at The Independent Institute.
Full biography and recent publications

Obamacare Tax Merry-Go-Round



Get a load of how Obamacare health-insurance premium taxes work. According to Medicaid Health Plans of America: “This situation results in the federal government taxing itself and taxing state governments to fund the higher Medicaid managed care payments required to fund the ACA health insurer fee.” It look me a few times to get...
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Can Taxpayers Recover Hundreds of Millions of Dollars from Obamacare Exchanges?



The Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services has just released a report on the contracts issued to private vendors to set up the federal pieces of Obamacare’s disastrous health-insurance exchanges. This is only the first of a series of reports, and it limits itself to describing the...
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Medicare Fees: The RUC Is Bad, but There’s No Point in Regulating It



Politico recently ran an interesting story on the Relative Value Scale Update Committee—the “RUC”—a body convened by the American Medical Association that fixes the fees that Medicare pays physicians. It describes the absurdity of a committee of physicians fixing fees that the government pays physicians, and demonstrates how the RUC pays primary-care practitioners much...
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Price Transparency Lowers Healthcare Costs



A study recently published in Health Affairs describes how price transparency drove down the cost of MRIs by almost twenty percent from 2010 to 2012. Compared to patients who did not have the advantage of transparent pricing, patients who knew what their MRI procedure would cost saw a cost reduction of $220 per procedure. Further, price transparency...
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There Is a Market for Human Organs, Whether You Like It or Not



The buying and selling of human organs was in the news this weekend, via an investigative report in the New York Times. People tend to be moved when they learn about someone donating an organ to someone else who needs it, but they also tend to be disgusted by the notion of a market where people...
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Walmart Shakes Up Primary Care—and the Whole System



Walmart has a new take on retail clinics. These newly launched clinics will charge patients $40 for a visit—but only $4 for Walmart associates. Anybody, with or without insurance, can go into one of these clinics and be seen by a qualified health professional, without the usual paperwork. Although the mega-retailer has operated clinics...
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What Is to Be Done with Health-Insurance Exchanges, Post-Obamacare?



Any time a Republican politician suggests that there is anything positive in Obamacare, the media are eager to declare that this means the Republican establishment is backing away from repealing the Affordable Care Act and wants to “fix” it instead. This, of course, is what most businesses and their lobbyists would prefer take place....
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Obamacare Threatens Free Clinics



Obamacare’s most significant effect is an expansion in the number of people dependent on Medicaid, the joint state-federal welfare program for low-income people. Kaiser Health News points out that this expansion is threatening the existence of free clinics. Some clinics are signing up for Medicaid, while others are closing: “We used to say ......
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Medicaid’s Financing Merry-Go-Round



Medicaid, which provides health-related welfare benefits to low-income individuals, is jointly financed by the federal and state governments. Before Obamacare, the split was 50/50 for rich states, but low-income states got more dollars. This mechanism is called the Federal Medicaid Assistance Percentage (FMAP). So, if California spent $50 on Medicaid, the federal taxpayer would...
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Gross Domestic Product: Is Health Spending Figured Out?



Relying on a government agency to tell us the value of goods and services produced in our nation may not be the best way to estimate Gross Domestic Product. Nevertheless, it is widely accepted. Health spending was a non-issue in the Department of Commerce’s release of the advanced estimate of second-quarter GDP, which came...
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