Aaron

Sensory overload is defined as a condition in which one or more of the senses is so overloaded that it becomes difficult to focus on the task at hand. Those interested health policy may be excused if they display this disturbing condition. Health policy faces far-reaching, even fundamental, change through a bewildering variety of channels. Health policy analysts are heavily engaged in all of them. Meanwhile, they are neglecting the single policy debate that will more profoundly influence health policy than all of those now absorbing their attention: whether tax increases form a major part of any program to curb future federal budget deficits.

The distractions, though unfortunate, are understandable.

For starters, the Supreme Court is likely by mid-2012 to decide the constitutionality of the Affordable Care Act’s requirement that almost everyone must carry insurance. Yet, regardless of this decision, major campaigns are under way to repeal the law, or at least block its implementation.

In the background, the House has passed a bill to convert Medicaid into a block grant and to replace Medicare with vouchers linked to indices that for decades have grown more slowly than health costs. After the 2012 elections, supporters of these proposals are likely to control the Senate, and potentially the White House, too.

And, perhaps most consequential: When Congress raised the debt ceiling, it created a super committee to cut federal budget deficits. Congress endowed the committee with unlimited authority to recommend changes to any federal law and all government spending, and, as a result, proposals that could remake Medicaid and Medicare could pass before year-end with simple majorities in each house. Whether or not the special committee deals with the currently-scheduled 30-percent cuts in fees Medicare pays physicians, Congress will have to decide whether to let them take effect in early 2012 or once again to suspend them.

President Barack Obama has presented proposals of his own to cut federal health care spending. The cuts are small — just 3 percent over the next decade. Nonetheless, many groups are behaving as if vital interests are at stake and have protested so vociferously that the cuts seem unlikely to win congressional approval.

The outcome of these debates is obviously not without importance. But none of them will count for much, if deficit reduction plans exclude sizeable tax increases. To see why, consider what will happen if deficit reduction occurs exclusively through spending cuts.

Eventual deficit reduction is not an option; it is a necessity. Not immediately — cutting government spending or raising taxes in the midst of a recession is an extremely bad idea. But once economic recovery is well under way, it is vital to prevent the ratio of debt to gross domestic product from continuing to rise. The United States is widely regarded as a safe place in which to invest. But if the cost of servicing the national debt continues to outpace income growth, savers — foreign and domestic — will eventually come to doubt the willingness of the U.S. to service that debt. At that point, savers would demand sharply higher interest rates, raising the debt service burden still further and discouraging both private investment and consumption. The result would be chaos.

There is no magic debt/GDP ratio at which a crisis will occur. But currently, the prospect of a debt/GDP ratio of 0.9 after 10 years is triggering a widespread sense that it is necessary to do something to cut future deficits soon. To stabilize the ratio of debt to GDP it would take deficit reduction steps totaling between $4 trillion and $5 trillion over the next decade.

But it is impossible to cut spending this much without slashing Medicare, Medicaid and Social Security so deeply that it would become impossible to sustain the commitments of these programs, including the assurance of standard health care to the elderly, disabled and poor. The reason is that cutting the rest of government spending by so much would amount to a permanent shut-down of most of what government now does — to promote education, aid veterans, build highways, assure safe air travel and so on.

The special committee is charged to cut deficits ‘only’ $1.2 trillion over the next decade. Such cuts would put off the deficit problem for only about two years.

By 2013, looking two years farther into the future, projections indicate that, even with spending cuts of $1.2 trillion, deficits over the succeeding decade would be as large then as they are now. If in 2013 spending were cut by another $1.2 trillion over the succeeding decade, projected deficits would once again, two years later, be as bad as they are now. In brief, dealing with deficit by the age-old approach of “salami slicing” will make deficit crises a semi-permanent feature of the U.S. political debate and will guarantee that, sooner or later, health programs must be slashed. The old service station advertisement read: “you pay me now, or you pay me later.” The modern paraphrase would be that without sizeable tax increases in any deficit reduction plan, “you gut Medicare and Medicaid now, or you gut it later.”

For everyone interested in health care policy, therefore, the most important issue on the current policy agenda is not whether to cut physician fees, change Medicaid matching percentages, cut drug payments for dual eligibles, and so on. How these debates turn out will matter little in the end if sizeable tax increases are not part of any deficit reduction plan. If taxes go up, there will be fiscal room to sustain the nation’s current commitments to the aged, disabled and poor. If they don’t, those commitments will end. For those who want those commitments sustained, job one is fighting to ensure that taxes are increased at least as much as spending is cut.

Henry J. Aaron is the Bruce and Virginia MacLaury Senior Fellow at The Brookings Institution. The views expressed here are his own and do not necessarily represent those of the trustees, officers or other staff of the Brookings Institution.

This <a target="_blank" href="/medicaid/different-takes-henry-aaron/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

The health reform debate, they say, is between those who would use government regulation to try to control growth of health care spending and those who would rely on cost-conscious consumers operating in a competitive market place. The right way to reform health care, they say, is not government regulation but rather by shifting to a defined-contribution system in which people would bear the full marginal costs of insurance they buy. Medicare beneficiaries and Medicaid recipients should be given vouchers for the purchase of health insurance. Employers should do the same with private employees. The recently enacted health reform legislation, they say, extends fee-for-service medicine. For that reason, it should be replaced.

This critique is based on multiple fictions-about what the Affordable Care Act does, about what any plausible alternative would do, and about what the real issues in the current debate really are.

First, the federal health law clearly moves the health care system in the very directions that Capretta and Miller urge-toward a defined contribution system.

• That is true for most of the 16 million people who would be covered through the newly created health insurance exchanges. Subsidized clients in the health insurance exchange will receive vouchers to reduce the net cost of a moderate health insurance plan to a fraction of their income. If people want more generous coverage, they will have to pay for it themselves. That is what defined-contribution coverage does.

• Medicaid also is moving fast away from fee-for-service care toward services provided by managed care organizations operating under negotiated contracts with states. That is how most of those newly covered by Medicaid will be served.

• The law will impose a modest tax on high-cost private health plans starting in 2018. This tax will discourage the provision of highly generous insurance plans that accommodate inefficient fee-for-service care.

Like Capretta and Miller, I wish that tax applied to more plans and started sooner. That it does not results from the refusal of Republicans in the course of the reform debate to do anything else than vote “no.” The first president to embrace limits on the tax breaks for employer-financed health insurance was Ronald Reagan. Republicans have long embraced such reforms. Had they been true to their tradition and participated actively and constructively in this debate, as a previous generation of Republicans did in the debate leading up to the enactment of Medicare and Medicaid, and as Democrats did in the process leading up to the passage of the Medicare Modernization Act in 2003, there is little doubt that coverage of the tax on high-cost plans would have been broader and it would have started sooner.

The next fiction is the idea that there exists some market-based reform that would operate immaculately free of intrusive government regulation. If consumers are to exercise real leverage on insurance vendors, they have to understand the choices they face. That demands that the range of plans be limited to a manageable number, that marketing of insurance plans be highly regulated and that objective literature written in plain English must be available to customers. It also demands extensive risk adjustment of premiums and subsidies for those who cannot afford the full cost of health insurance. All of this will require heavy government involvement. Come to think of it, each of those steps is part of the health law. If a well-functioning private market place is what Capretta and Miller want, they should be celebrating the bill, not joining calls for its repeal.

No, the health reform debate is not about a fictional war between market-based health insurance and government regulation. It is about whether to provide adequate subsidies to cover the uninsured and whether to begin a process of leveraging change in the delivery and payment systems through which one-sixth of the U.S. economy is devoted to health care. Under this administration’s leadership, the last Congress laboriously and narrowly pushed through legislation ending the crippling stasis that virtually all observers of the U.S. health care system deplore. Their handiwork is not perfect, nor can its full effects be anticipated. Further legislation will unquestionably be necessary-to fix provisions that don’t work well and to deal with unanticipated consequences of the legislation. Making that legislation work as well as possible now and figuring out what legislation will make it work better in the future should occupy the nation now, rather than a sterile debate based on a false issue and misrepresentation. 

This <a target="_blank" href="/news/011911aaron/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

To be more precise, the HELP Committee released fragments of a bill; it did not include extensions of Medicaid or mandates on employers that everyone anticipates it will add, nor did it specify how the added costs would be paid for. And CBO’s estimates referred only to fragments of the incomplete draft bill that was actually released.

But even that low degree of specificity was enough to send tremors through the health policy community. Then came a large after-shock–Chairman Max Baucus of the Senate Finance Committee announced a delay in issuing the committee’s bill because initial cost estimates were even higher–$1.6 trillion over 10 years.

After months of trading in generalities-high-flown goals and policy changes so vague that no one could possibly understand who would be required to do what differently from what they do now-the legislative language hit the table and the cost estimates hit the fan.

The estimates for the HELP bill were shocking. The $1 trillion estimate was bad enough. Worse was the spending rate at the end of the decade. The initial costs of any bill are close to zilch, because it takes a couple of years to get a plan going and a couple more before it is running full blast. For those reasons, the cost of the $1 trillion HELP bill translates into $200 billion in 2019. The $1.6 trillion estimate for the Finance bill implies outlays in the 10th year approaching $300 billion.

The Center on Budget and Policy Priorities points out that the initial estimate of the HELP bill was misleading because it ignored several important provisions in the bill and assumed that the individual mandate would be backed up by penalties so weak that enrollment in an insurance plan would be virtually voluntary. There is no reason to think that estimates of the Finance Committee were incomplete (they have not been released).

The combination of specific legislative language and CBO scoring is bringing into high relief two important aspects of the health reform debate.

The first is a reminder of how complex and nasty the tradeoffs are that have to be made if coverage is to be universal or close to it. The best estimate is that the system-wide cost today of a fully implemented universal coverage would be $125 billion to $150 billion a year. But that cost grows as the cost of health care increases. At the end of 10 years, the cost would be $200 billion a year. But that is system cost–added national health care spending, not budget cost–added spending by the federal government. Unless a draft bill finds a way of keeping every dollar of non-budget health care spending ‘in the game’ or forcing some increases in what businesses spend, the budget costs could be larger than the system costs.

The draft HELP bill was silent on how to pay for these added outlays. Sen. Baucus pledges that his proposal, when published, will be paid for. The hostile reactions of members of Congress, Democrats as well as Republicans, to the tax increases and spending cuts the president proposed as a reserve to pay for health reform suggest that paying for the bill is the biggest challenge. President Obama has said that health reform must be paid for. Where is the money to come from? Keep in mind that all those savings promised by drug companies, hospitals, and doctors through private actions will not count. CBO has made explicit that it will count only savings resulting from federal legislation.

The second aspect of current developments is a reminder that the administration’s calculated decision NOT to present a bill to the Hill has risks as well as benefits. So far, the administration has contented itself with enunciating broad principles in public and leaving the drafting of the final bill to lawmakers. This strategy has a large advantage. It avoids the result that befell the Clinton administration which drafted a detailed bill, complete to the last comma; those who had to vote on it had no stake in it whatsoever (except, of course, electorally, as they learned in 1994).

At some point, however, the administration must decide whether it is prepared to be more directive about what it wants and doesn’t want. It is not likely, for example, that the split among Democrats on whether to curb the exclusion of employer-financed health insurance from income and payroll taxes can be resolved without heavy White House involvement. This issue and others will not be resolved unless the president weighs in-and weighs in hard, twisting arms and using every bit of political leverage that the White House can muster.

Henry J. Aaron is the Bruce and Virginia MacLaury Senior Fellow at The Brookings Institution.

This <a target="_blank" href="/news/061809aaron/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

Aaron

Sensory overload is defined as a condition in which one or more of the senses is so overloaded that it becomes difficult to focus on the task at hand. Those interested health policy may be excused if they display this disturbing condition. Health policy faces far-reaching, even fundamental, change through a bewildering variety of channels. Health policy analysts are heavily engaged in all of them. Meanwhile, they are neglecting the single policy debate that will more profoundly influence health policy than all of those now absorbing their attention: whether tax increases form a major part of any program to curb future federal budget deficits.

The distractions, though unfortunate, are understandable.

For starters, the Supreme Court is likely by mid-2012 to decide the constitutionality of the Affordable Care Act’s requirement that almost everyone must carry insurance. Yet, regardless of this decision, major campaigns are under way to repeal the law, or at least block its implementation.

In the background, the House has passed a bill to convert Medicaid into a block grant and to replace Medicare with vouchers linked to indices that for decades have grown more slowly than health costs. After the 2012 elections, supporters of these proposals are likely to control the Senate, and potentially the White House, too.

And, perhaps most consequential: When Congress raised the debt ceiling, it created a super committee to cut federal budget deficits. Congress endowed the committee with unlimited authority to recommend changes to any federal law and all government spending, and, as a result, proposals that could remake Medicaid and Medicare could pass before year-end with simple majorities in each house. Whether or not the special committee deals with the currently-scheduled 30-percent cuts in fees Medicare pays physicians, Congress will have to decide whether to let them take effect in early 2012 or once again to suspend them.

President Barack Obama has presented proposals of his own to cut federal health care spending. The cuts are small — just 3 percent over the next decade. Nonetheless, many groups are behaving as if vital interests are at stake and have protested so vociferously that the cuts seem unlikely to win congressional approval.

The outcome of these debates is obviously not without importance. But none of them will count for much, if deficit reduction plans exclude sizeable tax increases. To see why, consider what will happen if deficit reduction occurs exclusively through spending cuts.

Eventual deficit reduction is not an option; it is a necessity. Not immediately — cutting government spending or raising taxes in the midst of a recession is an extremely bad idea. But once economic recovery is well under way, it is vital to prevent the ratio of debt to gross domestic product from continuing to rise. The United States is widely regarded as a safe place in which to invest. But if the cost of servicing the national debt continues to outpace income growth, savers — foreign and domestic — will eventually come to doubt the willingness of the U.S. to service that debt. At that point, savers would demand sharply higher interest rates, raising the debt service burden still further and discouraging both private investment and consumption. The result would be chaos.

There is no magic debt/GDP ratio at which a crisis will occur. But currently, the prospect of a debt/GDP ratio of 0.9 after 10 years is triggering a widespread sense that it is necessary to do something to cut future deficits soon. To stabilize the ratio of debt to GDP it would take deficit reduction steps totaling between $4 trillion and $5 trillion over the next decade.

But it is impossible to cut spending this much without slashing Medicare, Medicaid and Social Security so deeply that it would become impossible to sustain the commitments of these programs, including the assurance of standard health care to the elderly, disabled and poor. The reason is that cutting the rest of government spending by so much would amount to a permanent shut-down of most of what government now does — to promote education, aid veterans, build highways, assure safe air travel and so on.

The special committee is charged to cut deficits ‘only’ $1.2 trillion over the next decade. Such cuts would put off the deficit problem for only about two years.

By 2013, looking two years farther into the future, projections indicate that, even with spending cuts of $1.2 trillion, deficits over the succeeding decade would be as large then as they are now. If in 2013 spending were cut by another $1.2 trillion over the succeeding decade, projected deficits would once again, two years later, be as bad as they are now. In brief, dealing with deficit by the age-old approach of “salami slicing” will make deficit crises a semi-permanent feature of the U.S. political debate and will guarantee that, sooner or later, health programs must be slashed. The old service station advertisement read: “you pay me now, or you pay me later.” The modern paraphrase would be that without sizeable tax increases in any deficit reduction plan, “you gut Medicare and Medicaid now, or you gut it later.”

For everyone interested in health care policy, therefore, the most important issue on the current policy agenda is not whether to cut physician fees, change Medicaid matching percentages, cut drug payments for dual eligibles, and so on. How these debates turn out will matter little in the end if sizeable tax increases are not part of any deficit reduction plan. If taxes go up, there will be fiscal room to sustain the nation’s current commitments to the aged, disabled and poor. If they don’t, those commitments will end. For those who want those commitments sustained, job one is fighting to ensure that taxes are increased at least as much as spending is cut.

Henry J. Aaron is the Bruce and Virginia MacLaury Senior Fellow at The Brookings Institution. The views expressed here are his own and do not necessarily represent those of the trustees, officers or other staff of the Brookings Institution.

This <a target="_blank" href="/medicaid/different-takes-henry-aaron/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

The health reform debate, they say, is between those who would use government regulation to try to control growth of health care spending and those who would rely on cost-conscious consumers operating in a competitive market place. The right way to reform health care, they say, is not government regulation but rather by shifting to a defined-contribution system in which people would bear the full marginal costs of insurance they buy. Medicare beneficiaries and Medicaid recipients should be given vouchers for the purchase of health insurance. Employers should do the same with private employees. The recently enacted health reform legislation, they say, extends fee-for-service medicine. For that reason, it should be replaced.

This critique is based on multiple fictions-about what the Affordable Care Act does, about what any plausible alternative would do, and about what the real issues in the current debate really are.

First, the federal health law clearly moves the health care system in the very directions that Capretta and Miller urge-toward a defined contribution system.

• That is true for most of the 16 million people who would be covered through the newly created health insurance exchanges. Subsidized clients in the health insurance exchange will receive vouchers to reduce the net cost of a moderate health insurance plan to a fraction of their income. If people want more generous coverage, they will have to pay for it themselves. That is what defined-contribution coverage does.

• Medicaid also is moving fast away from fee-for-service care toward services provided by managed care organizations operating under negotiated contracts with states. That is how most of those newly covered by Medicaid will be served.

• The law will impose a modest tax on high-cost private health plans starting in 2018. This tax will discourage the provision of highly generous insurance plans that accommodate inefficient fee-for-service care.

Like Capretta and Miller, I wish that tax applied to more plans and started sooner. That it does not results from the refusal of Republicans in the course of the reform debate to do anything else than vote “no.” The first president to embrace limits on the tax breaks for employer-financed health insurance was Ronald Reagan. Republicans have long embraced such reforms. Had they been true to their tradition and participated actively and constructively in this debate, as a previous generation of Republicans did in the debate leading up to the enactment of Medicare and Medicaid, and as Democrats did in the process leading up to the passage of the Medicare Modernization Act in 2003, there is little doubt that coverage of the tax on high-cost plans would have been broader and it would have started sooner.

The next fiction is the idea that there exists some market-based reform that would operate immaculately free of intrusive government regulation. If consumers are to exercise real leverage on insurance vendors, they have to understand the choices they face. That demands that the range of plans be limited to a manageable number, that marketing of insurance plans be highly regulated and that objective literature written in plain English must be available to customers. It also demands extensive risk adjustment of premiums and subsidies for those who cannot afford the full cost of health insurance. All of this will require heavy government involvement. Come to think of it, each of those steps is part of the health law. If a well-functioning private market place is what Capretta and Miller want, they should be celebrating the bill, not joining calls for its repeal.

No, the health reform debate is not about a fictional war between market-based health insurance and government regulation. It is about whether to provide adequate subsidies to cover the uninsured and whether to begin a process of leveraging change in the delivery and payment systems through which one-sixth of the U.S. economy is devoted to health care. Under this administration’s leadership, the last Congress laboriously and narrowly pushed through legislation ending the crippling stasis that virtually all observers of the U.S. health care system deplore. Their handiwork is not perfect, nor can its full effects be anticipated. Further legislation will unquestionably be necessary-to fix provisions that don’t work well and to deal with unanticipated consequences of the legislation. Making that legislation work as well as possible now and figuring out what legislation will make it work better in the future should occupy the nation now, rather than a sterile debate based on a false issue and misrepresentation. 

This <a target="_blank" href="/news/011911aaron/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

To be more precise, the HELP Committee released fragments of a bill; it did not include extensions of Medicaid or mandates on employers that everyone anticipates it will add, nor did it specify how the added costs would be paid for. And CBO’s estimates referred only to fragments of the incomplete draft bill that was actually released.

But even that low degree of specificity was enough to send tremors through the health policy community. Then came a large after-shock–Chairman Max Baucus of the Senate Finance Committee announced a delay in issuing the committee’s bill because initial cost estimates were even higher–$1.6 trillion over 10 years.

After months of trading in generalities-high-flown goals and policy changes so vague that no one could possibly understand who would be required to do what differently from what they do now-the legislative language hit the table and the cost estimates hit the fan.

The estimates for the HELP bill were shocking. The $1 trillion estimate was bad enough. Worse was the spending rate at the end of the decade. The initial costs of any bill are close to zilch, because it takes a couple of years to get a plan going and a couple more before it is running full blast. For those reasons, the cost of the $1 trillion HELP bill translates into $200 billion in 2019. The $1.6 trillion estimate for the Finance bill implies outlays in the 10th year approaching $300 billion.

The Center on Budget and Policy Priorities points out that the initial estimate of the HELP bill was misleading because it ignored several important provisions in the bill and assumed that the individual mandate would be backed up by penalties so weak that enrollment in an insurance plan would be virtually voluntary. There is no reason to think that estimates of the Finance Committee were incomplete (they have not been released).

The combination of specific legislative language and CBO scoring is bringing into high relief two important aspects of the health reform debate.

The first is a reminder of how complex and nasty the tradeoffs are that have to be made if coverage is to be universal or close to it. The best estimate is that the system-wide cost today of a fully implemented universal coverage would be $125 billion to $150 billion a year. But that cost grows as the cost of health care increases. At the end of 10 years, the cost would be $200 billion a year. But that is system cost–added national health care spending, not budget cost–added spending by the federal government. Unless a draft bill finds a way of keeping every dollar of non-budget health care spending ‘in the game’ or forcing some increases in what businesses spend, the budget costs could be larger than the system costs.

The draft HELP bill was silent on how to pay for these added outlays. Sen. Baucus pledges that his proposal, when published, will be paid for. The hostile reactions of members of Congress, Democrats as well as Republicans, to the tax increases and spending cuts the president proposed as a reserve to pay for health reform suggest that paying for the bill is the biggest challenge. President Obama has said that health reform must be paid for. Where is the money to come from? Keep in mind that all those savings promised by drug companies, hospitals, and doctors through private actions will not count. CBO has made explicit that it will count only savings resulting from federal legislation.

The second aspect of current developments is a reminder that the administration’s calculated decision NOT to present a bill to the Hill has risks as well as benefits. So far, the administration has contented itself with enunciating broad principles in public and leaving the drafting of the final bill to lawmakers. This strategy has a large advantage. It avoids the result that befell the Clinton administration which drafted a detailed bill, complete to the last comma; those who had to vote on it had no stake in it whatsoever (except, of course, electorally, as they learned in 1994).

At some point, however, the administration must decide whether it is prepared to be more directive about what it wants and doesn’t want. It is not likely, for example, that the split among Democrats on whether to curb the exclusion of employer-financed health insurance from income and payroll taxes can be resolved without heavy White House involvement. This issue and others will not be resolved unless the president weighs in-and weighs in hard, twisting arms and using every bit of political leverage that the White House can muster.

Henry J. Aaron is the Bruce and Virginia MacLaury Senior Fellow at The Brookings Institution.

This <a target="_blank" href="/news/061809aaron/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">