New Taxes to Take Effect to Fund Health Care Law
By ROBERT PEAR
WASHINGTON — For more than a year, politicians have been fighting over whether to raise taxes on high-income people. They rarely mention that affluent Americans will soon be hit with new taxes adopted as part of the 2010 health care law.
The new levies, which take effect in January, include an increase in the payroll tax on wages and a tax on investment income, including interest, dividends and capital gains. The Obama administration proposed rules to enforce both last week.
Affluent people are much more likely than low-income people to have health insurance, and now they will, in effect, help pay for coverage for many lower-income families. Among the most affluent fifth of households, those affected will see tax increases averaging $6,000 next year, economists estimate.
To help finance Medicare, employees and employers each now pay a hospital insurance tax equal to 1.45 percent on all wages. Starting in January, the health care law will require workers to pay an additional tax equal to 0.9 percent of any wages over $200,000 for single taxpayers and $250,000 for married couples filing jointly.
The new taxes on wages and investment income are expected to raise $318 billion over 10 years, or about half of all the new revenue collected under the health care law.
Ruth M. Wimer, a tax lawyer at McDermott Will & Emery, said the taxes came with “a shockingly inequitable marriage penalty.” If a single man and a single woman each earn $200,000, she said, neither would owe any additional Medicare payroll tax. But, she said, if they are married, they would owe $1,350. The extra tax is 0.9 percent of their earnings over the $250,000 threshold.
Since the creation of Social Security in the 1930s, payroll taxes have been levied on the wages of each worker as an individual. The new Medicare payroll is different. It will be imposed on the combined earnings of a married couple.
Employers are required to withhold Social Security and Medicare payroll taxes from wages paid to employees. But employers do not necessarily know how much a worker’s spouse earns and may not withhold enough to cover a couple’s Medicare tax liability. Indeed, the new rules say employers may disregard a spouse’s earnings in calculating how much to withhold.
A miracle story that needs just one more
If your kid is sick, if your child is dying, you believe in miracles.
Shohreh Moldenhauer believes in miracles. She and her husband, Bob, have just one child, a son named Robert. Two weeks after he was born, 14 years ago, Robert underwent a heart transplant.
The good news was that he lived; the bad news was that the antirejection drugs eventually ruined his kidneys. In June 2011, the Moldenhauers were told that Robert needed a new heart and new kidneys.
They live in Wisconsin and their first stop was at a hospital in Milwaukee. The doctors there said there was nothing they could do. They went to a hospital in New York and got the same answer. A hospital in California raised their hopes, only to dash them three weeks later. They went to Columbus, Ohio. They went to Chicago. The Moldenhauers criss-crossed the country and when they were done eight different hospitals had said the same thing: they were sorry, there was nothing they could do. It was time to let Robert go. But Shohreh Moldenhauer believes in miracles. “He’s my only child. I am not going to give up. I am not going to let him die,” she says. “No mother would give up.”
Changes to the psychiatrists' bible, DSM: Some reactions
That big fat bible of psychiatric diagnosis — the DSM — is one step closer to its overhaul, a task that has taken more than a decade. On Dec. 1, the board of trustees of the American Psychiatric Assn. voted to approve the fifth edition of the book, which psychiatrists use to diagnose patients. The final edition is due out in May.
Among the changes:
Asperger’s disorder will no longer be classed as a separate condition but will be folded into an umbrella category called autism spectrum disorder. Hoarding disorder is added to the book. “Disruptive mood dysregulation disorder” is a new psychiatric category for children and adolescents who exhibit “persistent irritability and frequent episodes of behavior outbursts three or more times a week for more than a year.” Many such kids are today diagnosed with — and then medicated for — bipolar disorder, which is an issue of concern to many who work in mental health. Identifying as transgender will no longer be listed as “gender identity disorder.” The term is replaced by “gender dysphoria,” which would refer to “emotional distress over a marked incongruence between one's experienced/expressed gender and assigned gender.” The distress is the focus, in other words, not the state of being. Many within the transgender community support this de-pathologizing, though some note it might make it harder for people who identify as transgender to receive medical services,as this article discusses. People suffering grief had in the past been excluded for a diagnosis of depression during a certain window of time: Grief, after all, is a natural reaction to loss. That "grief exclusion" is out. The change “reflects the recognition that bereavement is a severe psychosocial stressor that can precipitate and major depressive episode beginning soon after the loss of a loved on,” the APA statement explains. Hypersexual disorder — what’s popularly termed sex addiction — did not make it into DSM-5, though its inclusion had been debated.Maine medical records going high-tech
For the 1.5 million patients in Maine Med's index, the Internet-accessible system will centralize their health-care history.
PORTLAND – Maine Medical Center has launched a totally integrated electronic health records system that promises to benefit patients and employees.
This week's roll-out of the "one patient, one record" system at Maine's largest hospital is part of a seven-year, $150 million technology upgrade that is the largest capital investment ever in health care in Maine.
By the end of 2013, the system will be adopted by seven other MaineHealth hospitals and their affiliated clinics, labs and physician practices.
"It's a big leap forward for us," said Dr. Barry Blumenfeld, senior vice president and chief information officer for MaineHealth, the state's largest health care organization. "It's one of the best things we can do to improve the quality and safety of the care we provide."
For the 1.5 million people in Maine Med's patient index, the secure, Internet-accessible system means all information about an individual's doctor visits, hospital stays, prescriptions, lab work, X-rays, outpatient therapies, billing and scheduling will be in one place.
Medicare Fraud
A newspaper investigation shows that fraudsters can easily obtain ID numbers without having an office.
By M.B. Pell, The Atlanta Journal-Constitution
ATLANTA - Dorsey Med Group is conveniently located for patients near Atlanta's Buckhead district who are looking for a good internist. On paper, the clinic is headed by a respected physician with 39 years of experience.
The medical office could easily hold a box of sterilized latex gloves, but not much more.
It's located at 2625 Piedmont Road Northeast, Suite 56-331 -- a UPS Store mailbox.
And the doctor who is the clinic's namesake didn't know he was the CEO, as federal records show. He certainly never made the 192-mile drive from his Albany practice to Buckhead to see patients or review medical records.
Federal officials probably should have grown suspicious two years ago when someone using the name Olga Teplukhina incorporated the fictitious medical practice, applied for a National Provider Identification number and claimed a UPS mailbox as the practice location.
Then again, the box is the largest size UPS offers.
"So have they been billing stuff?" Dr. Harry Dorsey asked when the Atlanta Journal-Constitution told him the suspicious provider number was still active. "That's identity fraud, and that really ticks me off."
For years, officials at the agency that administers Medicare have known that fraudsters sign up as health care providers using UPS Store mailboxes and other post office box like addresses as their location. But the Centers for Medicare and Medicaid Services says it lacks the technology to identify these locations because they look like legitimate street addresses, not like the easily identified post office box addresses.
http://www.printthis.clickability.com/pt/cpt?expire=&title=Mailbox%3A+Only+thing+scammers+need+for+Medicare+fraud&urlID=497879742&action=cpt&partnerID=606322&cid=182692581&fb=Y&url=http%3A%2F%2Fwww.pressherald.com%2Fnews%2Fnationworld%2Fin-focus-medicare-fraud_2012-12-09.html
Inland, Sebasticook Valley hospitals credit culture, computers for high ratings
Central Maine hospitals rated in top 13 rural medical centers in America, according to nonprofit group
Two small hospitals 25 miles from each other made a list of the 13 best rural hospitals in the nation and adminstrators said it has a lot to do with workplace culture and computers.
Infections and other preventable errors are becoming less common at Inland Hospital of Waterville and Sebasticook Valley Health of Pittsfield, two of the top 13 rural hospitals in the nation, according to an independent nonprofit group dedicated to improving health care.
The group, Leapfrog, released the list after an analysis of public data on more than 200 hospitals showed that Inland and Sebasticook minimize hospital errors that hurt patients and increased health care costs.
Statistics from the national Centers for Disease Control show that hospitals give infections to 1.7 million patients a year, costing more than $30 billion.
Inland President John Dalton and Sebasticook President Victoria Alexander-Lane said workplace culture and computers are behind their success.
Our View: Too many mental health crises end with force
Better training and outside review could better equip officers to handle tough situations.
When a person trapped in a mental health crisis threatens to hurt himself or someone else, a police officer is the last line of defense.
But what happens when the last line becomes the front line? What happens when the deadly force police use to keep us safe is the only tool available when our most troubled friends, neighbors and family members are out of control?
These are the questions posed today in "Deadly Force," a series beginning in today's newspaper, and the lack of good answers is troubling. Systems set up to protect officers and police departments from lawsuits could be putting officers in avoidable situations where deadly force is the only option.
So little information is available about these encounters that it's hard for the public to know if the best practices are being used. Lawmakers are failing to show proper oversight, treating these shootings as strictly a police matter and not what they really are: a matter of public health.
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