The United States has the largest economy in the world, with the health care sector representing nearly 19% of it. Given the steady growth in older age cohorts and the likelihood that members of those groups will have one or more chronic ailments, the percentage is destined to continue increasing. Clinicians and the services they provide to patients constitute major focal points in the professional literature. Somewhat less visible is an important personnel sub-group that has a significant impact on the development of health policy. As their careers progress, a revolving door aspect is apparent based on an investigation by the University of Southern California Schaeffer Center for Health Policy & Economics and Harvard University reported in the September 2023 issue of the journal Health Affairs. The study is the first to quantify personnel movement between health-care industries and the government agencies that regulate them. Although there are understandable reasons for movement to occur between the public and private sectors, the study notes that such a revolving door could make government agencies more vulnerable to pro-industry bias.
Among individuals appointed to the Department of Health and Human Services (HHS) between 2004 and 2020, 15% had been employed in private industry immediately before their appointment. At the end of their tenure, 32% exited to industry, with the greatest net exits occurring from the Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services. A revolving door between government and industry may pose a problem for regulatory agencies, such as the Department of Health and Human Services. The exit of government employees to industry may lead to pro-industry bias. Employees considering a departure from government service may be inclined to make decisions favorable to private firms where they are hoping to obtain jobs. It also is possible that government appointees who come from industry may be more sympathetic to industry interests and could create work environments more open to industry contact and influence.
Mental Health Parity And Addiction Equity Act
The Departments of Labor; Health and Human Services; and the Treasury announced an important step in addressing the nation’s mental health crisis by proposing new rules to improve access to care for mental and substance use disorders. Enacted in 2008, the Mental Health Parity and Addiction Equity Act aims to make sure patients seeking mental health and substance use disorder care do not face greater barriers to treatment than those faced by individuals seeking treatment under their insurance plans for other types of care for physical ailments. Generally, the act prohibits private health insurance companies from imposing copayments, prior authorization, and other requirements on mental health or substance use disorder benefits that are more restrictive than those imposed on medical and surgical benefits. Despite the law’s existence, greater barriers are faced when seeking coverage for mental health and substance use disorder care. The proposed rules can be viewed here. Comments on the proposal are due no later than October 2, 2023.
Public Knowledge About The Social Security Program
An average of almost 67 million Americans per month in 2023 will receive a Social Security payment, totaling about $1.4 trillion paid during the year. Beneficiaries include 49.4 million retired workers and their 2.6 million dependents; 7.5 million disabled workers and their 1.2 million dependents; and 5.8 million survivors. Nearly nine out of ten individuals age 65 and older were receiving a benefit as of June 30, 2023. Among elderly beneficiaries, 37% of men and 42% of women receive 50% or more of their income from Social Security. Among that elderly group, 12% of men and 15% of women rely on Social Security for 90% or more of their income. Regardless of income level, it can be expected that some of it must be used for health care expenses involving insurance premiums, co-payments, and uncovered services. According to a report published on August 1, 2023 in the Social Security Bulletin, people of color tend to have fewer resources than non-Hispanic White people when they reach retirement age. Consequently, Social Security benefits play an even greater role in retirement security for them. Moreover, study results show that people of color have significantly lower levels of Social Security retirement program knowledge than non-Hispanic Whites. Program knowledge disparities persist across age and education levels and are compounded for women of color. Knowledge about the Social Security retirement program plays an important role in retirement security by helping individuals make optimal decisions about saving and the timing of benefit claiming.