Friday, December 30, 2011

Health Care Reform Articles - January 1, 2012

A Model of Health

Thursday, December 29, 2011

Health Care Reform Articles - December 29, 2011

Steward Health Care chain quits Mass. hospital group

For-profit chain says it can better advocate for its unique interests

Steward Health Care System, the fast-growing company that operates 10 Massachusetts hospitals, has abruptly resigned from the state’s leading hospital association in the midst of a roiling political debate over the future of health care reform.

Blue Shield to pay $2 million over dropping of policyholders

The settlement of a suit filed by L.A. ends a probe into more than 1,000 cases. The insurer was accused of dropping clients who got ill and needed expensive treatment. The city and county will split the money.

By Lisa Girion, Los Angeles Times
December 29, 2011

More than a year after the healthcare reform law sought to prevent sick patients from losing medical coverage, insurers are still paying for their alleged abuses.

Blue Shield has agreed to pay $2 million to resolve accusations that the company improperly dropped policyholders after they got sick and needed expensive treatment.

The settlement, announced Wednesday by Los Angeles City Atty. Carmen Trutanich, ends an investigation into more than 1,000 so-called rescissions by Blue Shield, a San Francisco-based not-for-profit company.

Blue Shield spokesman Steve Shivinsky said the firm settled to avoid litigation.,0,7711606,print.story

Hospital is facing a bleak prognosis

A Victorville hospital has agreed to deals with Prime Healthcare, which has a record of stripping out low-margin or unprofitable medical services.

Michael Hiltzik
December 28, 2011,0,3750553,print.column

Awards for health care reform wimpery and obfuscation

Tuesday, December 27, 2011

Health Care Reform Articles - December 28, 2011

Our View: MaineCare cuts may bring on federal fines

Posted: December 27
Updated: Today at 6:57 PM

The governor is confident that Maine can get waivers, but the Legislature should ask for proof.

Gov. LePage says he is "absolutely confident" that he can get the federal waivers needed to make his proposed human services cuts legal under federal law, but we hope the Legislature requires more than the governor's say-so

DECEMBER 23, 2011, 6:00 AM

The Wyden-Ryan Plan: Déjà Vu All Over Again

Uwe E. Reinhardt is an economics professor at Princeton. He has some financial interests in the health care field.
After wrestling for decades and in futility with the triple problems facing health care in the United States – unsustainable spending growth, lack of timely access to health care for millions of uninsured Americans and highly varied quality of care – any new proposal to address these problems is likely to be a recycled old idea.
Today’s Economist
Perspectives from expert contributors.
The widely discussed new proposal from Senator Ron Wyden, Democrat of Oregon, and Representative Paul D. Ryan, Republican of Wisconsin, to restructure the federal Medicare program for the elderly is no exception.

Can Occupy and Labor Unite on Health Care?
The Bi-Partisan Attack on Medicare
Politicians are attacking Medicare and Medicaid on all sides–Democrats and Republicans alike. Obama’s national health care bill will slash hundreds of billions from Medicare over the next decade, an act supported by so-called “progressive” Democrats. Soon after this “victory” Obama created the Super Committee to balance the budget, which included automatic  “triggers”– if no decision was reached – that are now slated to cut $600 billion more from Medicare.
On a state-by-state basis, Medicaid – a program that provides health care to the poor –  is being cut in virtually every state, where they are using their manufactured budget crises as an excuse. This under-funding of Medicaid has created a lack of doctors for patients, according to USA today:  ”With a shortage of doctors…[Medicaid] patients have little choice but to use hospital emergency rooms for more routine care.” (July 5th, 2011).

The High Cost of Failing Artificial Hips

The most widespread medical implant failure in decades — involving thousands of all-metal artificial hips that need to be replaced prematurely — has entered the money phase.
Medical and legal experts estimate the hip failures may cost taxpayers, insurers, employers and others billions of dollars in coming years, contributing to the soaring cost of health care. The financial fallout is expected to be unusually large and complex because the episode involves a class of products, not a single device or just one company.

Highmark looks to expand hospital and physician ownership

The Pittsburgh-based insurer, in a dispute with the area's largest hospital system, wants to occupy what it calls the "provider space."

By EMILY BERRY, amednews staff. Posted Dec. 26, 2011.

Sunday, December 25, 2011

Health Care Reform Articles - December 26, 2011

Full Circle America: An elder care alternative

Posted: December 25
Updated: Today at 7:37 PM

Combining surveillance with a support network and lower costs, the company's services appeal to seniors who want to stay at home.

ROCKLAND - Framed needlepoints cover the walls of Patty Gardner's living room, where she and Marian White sit and work on their embroidery every Monday.

Health care

Three themes for health care:

Periods of dramatic change can create new opportunities, and this is especially true in the health care sector. Composed of companies that make or deliver health-related products and services, this sector is generally less sensitive to swings in the economy than other, more cyclical sectors. While even health care faces secular headwinds, the potential solutions to these problems offer opportunities for investors.

For GOP, ‘repeal and replace’ has been nothing but a mantra on health-care law

By Published: December 24

More than a year after Republicans first pledged to “repeal and replace” President Obama’s new health-care law, the GOP is still struggling to answer a basic question.
Replace it . . . with what?

The Haves’ Children Are Healthier Than the Have-Nots’

Every Monday, Sycamore Valley Elementary in Danville challenges its students to run a “Smile Mile” together after school. Some parents even run with their children. Photos of the student joggers’ grinning faces are posted in the cafeteria. On a recent Monday afternoon, there were 41 smiling faces on the wall.
Students at Sycamore Valley have a lot to be happy about when it comes to their physical fitness. Fifth graders there got the best scores among all of their Bay Area peers on the 2011 statewide Physical Fitness Test.
Eighty-three percent of the fifth graders tested at Sycamore Valley aced the test by receiving healthy scores on all six different measurements — of aerobic capacity, abdominal strength, upper body strength, trunk strength, body composition and flexibility, most of them gauged through physical activity. One part of the Physical Fitness Test measures a child’s body composition, usually through body mass index, which is calculated using weight and height and is used to determine who is overweight.
Statewide, only 31 percent of public school students performed as well, according to the California Department of Education.

Robert Ader, Who Linked Stress and Illness, Dies at 79

Dr. Robert Ader, an experimental psychologist who was among the first scientists to show how mental processes influence the body’s immune system, a finding that changed modern medicine, died on Tuesday in Pittsford, N.Y. He was 79.

Providers accepting moderate increases

By Robert Weisman

Massachusetts insurers, taking a tougher line in bargaining with health care providers under pressure from financially strained customers and government regulators, have held payment increases to the lowest level in years.
Contracts negotiated in 2011 gave hospitals and doctors groups average fee increases of 2 to 3 percent, roughly half those given in 2010 and less than in any year since 2005, according to estimates by executives of the state’s three largest health insurers.

He speaks his mind on health

Dr. Salah D. Salman
Dr. Salah D. Salman

Salman, a former Lebanese cabinet minister and former surgeon at the Massachusetts Eye and Ear Infirmary, recently wrote a critique of the American medical system, ‘‘Scrubbed Out: Reviving the Doctor’s Role in Patient Care.’’
Q. You raise a lot of questions in your book about the quality of the American medical system. Is our system worse than we think it is?

When Medicare Isn't Medicare

Let's say you have a Ford and decide to replace everything under the hood with Hyundai parts, including the engine and transmission. Could you still honestly market your car as a Ford?
That question gets at the heart of the controversy over who is being more forthright about GOP Rep. Paul Ryan's plan to "save" Medicare, Republicans or Democrats.
If you overhaul the Medicare system like you did your Ford and tell the public it's still Medicare, are you doing so honestly?

Saturday, December 24, 2011

Health Care Reform Articles - December 24, 2011

Medicaid Cuts Are Part of a Larger Battle in Maine

AUGUSTA, Me. — At a town hall meeting in the rural western part of the state last week, a woman asked Gov. Paul R. LePage if he could confirm a worrying rumor she had heard: that poor out-of-staters flock here because the public benefits are so generous.
Yes, he could. “If you come across from New Hampshire at 8 o’clock in the morning, by 4 o’clock in the afternoon you will have subsidized housing in the state of Maine,” the governor declared. “We need to change the rules.”
Mr. LePage, a first-term Republican whose destitute childhood is a well-known piece of his biography, is seeking to do just that. Calling the state’s entitlement system “a runaway train,” he has proposed contentious changes, including some of the most drasticMedicaid cuts in the nation.


The state’s big Medicare experiment

It’s hard to imagine the Boston area’s medical establishment and the federal government - two of the most entrenched institutions on the planet - working together as change agents.

Hospitals Adopt Drug Industry Sales Strategy

In northwest Indiana, Carrie Sota visits five or six doctors' offices every work day as part of her new sales job.

Carrie Sota, of the University of Chicago Medical Center, pays a "sales call" to Dr. Amit Joshi, a family doctor in Orland Park, Ill. (Photo by John Zich/USA Today)
But Sota isn't selling the physicians on a prescription drug or a medical device. She's promoting her hospital — the University of Chicago Medical Center.
Sota is one of four employees the academic medical center has hired in recent months to make "sales calls" on physicians in the hope that they will refer more patients to the hospital.  "We are trying to build meaningful relationships," said Sota, who was previously a saleswoman for a small medical device company.

Insurer to reward patients for finding cheaper care

Harvard Pilgrim plan seeks to reduce costs