What The Health Law Will Bring In 2013
by JULIE ROVNER
Most of the really big changes made by the 2010 health law don't start for another year. That includes things like a ban on restricting pre-existing conditions, and required insurance coverage for most Americans. But Jan. 1, 2013, will nevertheless mark some major changes.
One of those changes that will affect everyone with private health insurance actually took effect last September. But most people won't see it until they renew or apply for new health insurance. It's calleda summary of benefits and coverage. The idea is to help people actually understand what's in their insurance policies.
"One of the big complaints of people in polls or focus groups is that they just ... don't understand either the coverage or the price," said Jay Angoff, a former official at the U.S. Department of Health and Human Services who worked on implementing the health law.
"One of the big complaints of people in polls or focus groups is that they just ... don't understand either the coverage or the price," said Jay Angoff, a former official at the U.S. Department of Health and Human Services who worked on implementing the health law.
But with the new document, he says, "there's a standard format that allows people to compare benefits to make apples-to-apples comparisons, not just on price, but on benefits."
Health plans will also have to provide consumers a glossary of insurance terms if they ask for it.
"It's still harder than some people would want," Angoff says. "It's still a complicated area. But I think HHS has really done a very good job in making it as simple and as meaningful as possible."
Later in 2013 will also bring a key launch date for the law, says Angoff: "Oct. 1, 2013, is when open enrollment begins."http://www.npr.org/blogs/health/2013/01/01/168344168/what-the-health-law-will-bring-in-2013?ft=1&f=1001
Fixing Our Food Problem
By MARK BITTMAN
Nothing affects public health in the United States more than food. Gun violence kills tens of thousands of Americans a year. Heart disease, cancer, stroke and diabetes kill more than a million people a year - nearly half of all deaths - and diet is a root cause of many of those diseases.
And the root of that dangerous diet is our system of hyper-industrial agriculture, the kind that uses 10 times as much energy as it produces.
We must figure out a way to un-invent this food system. It's been a major contributor to climate change, spawned the obesity crisis, poisoned countless volumes of land and water, wasted energy, tortured billions of animals... I could go on. The point is that "sustainability" is not only possible but essential: only by saving the earth can we save ourselves, and vice versa.
How do we do that?
This seems like a good day to step back a bit and suggest something that's sometimes difficult to accept.
Patience.
We can only dismantle this system little by little, and slowly. Change takes time. Often - usually - that time exceeds the life span of its pioneers. And when it comes to sustainable food for billions, we're the pioneers of a food movement that's just beginning to take shape. The abolition movement began at least a century before the Civil War, 200 years before the civil rights movement. The struggle to gain the right to vote for women in the United States was active for 75 years before an amendment was passed. The gay rights struggle has made tremendous strides over the last 40 years, but equal treatment under the law is hardly established.
Activists who took on these issues had in common a clear series of demands and a sense that the work was ongoing. They had a large and ever-growing public following and a willingness to sacrifice time, energy and even life for the benefit not only of contemporaries but for subsequent generations.
New Year brings tax increases to pay for health care law
By Tony Pugh, McClatchy Newspapers
Posted Jan. 02, 2013, at 10:12 a.m.
WASHINGTON — The tax man is coming in 2013. And he’s wearing surgical scrubs and has a stethoscope around his neck.
Five new tax increases take effect on Jan. 1 to help pay for the nation’s health care overhaul.
New provisions of the Affordable Care Act require affluent taxpayers to pay more for Medicare and, for the first time, have their investment income subject to Medicare taxes as well. Also, people who use flexible spending accounts for health care expenses will pay higher taxes. And taxpayers who spend a lot out of pocket on their health care will find it harder to deduct those expenses from their taxable income, raising their tax bill.
Individual consumers won’t be the only ones paying higher taxes. Importers and manufacturers of certain medical devices will face a 2.3 percent excise tax on U.S. sales in 2013.
The new measures are slated to raise $24.2 billion next year and more than $258 billion through the year 2019, according to the Joint Committee on Taxation.
Here’s a look at the changes:
Agreement makes social programs more vulnerable
By Bryan Bender
WASHINGTON — The lack of spending cuts in legislation that averted the fiscal cliff will place enormous pressure on entitlement programs such as Social Security, Medicare, Medicaid, and even the president’s new heath insurance plan when negotiations begin in coming weeks to reduce the deficit, analysts said Wednesday.
The legislation passed this week delayed by two months the implementation of automatic across-the-board cuts in discretionary spending. Now President Obama and Republicans are hoping to use that breathing room to come up with specific cuts, which could affect an array of social programs that are vital to many lower and middle-income Americans.
With Congress having finished work on income tax rates this week — raising taxes for families earning more than $450,000 and keeping George W. Bush-era rates for those earning less — Democrats will probably have less leverage against GOP leaders who insist the only way to improve the government’s financial health is to find savings in entitlement and other safety net programs.
“Decades from now, Jan. 1, 2013, will be remembered as sealing the fate of Medicare — as well as Medicaid, food stamps, and perhaps even Social Security,” James Kwak, a professor at the University of Connecticut School of Law and a specialist on government spending, wrote in an analysis published Wednesday.
Making a Case for the Medical Checkup
By DANIELLE OFRI, M.D.
How does it feel to learn that the bread-and-butter of what you do for patients might not actually help them?
Unsettled, to say the least. A recent analysis from The Cochrane Collaboration, an international group that reviews scientific evidence, concluded that general health checkups for adults did not help patients live longer or healthier lives.
I thought about that the other day as I worked my way through the morning appointments. Some patients were there for management of their ongoing diseases, like diabetes and hypertension. But many were there for a general checkup, often prompted by minor symptoms.
One 43-year-old man came because of shoulder pain. It took just a few minutes of questions and physical exam to attribute the pain to muscle strain from lifting weights, with the simple prescription to lay off the weights for a few weeks.
For an internist, though, this is a golden opportunity - a minor symptom gets a patient into my office, which becomes a prime opportunity to address general health. Like many healthy people, he hadn't been to a doctor in years, so there was lots to do.
I checked his blood pressure to screen for the "silent killer" of hypertension. I noticed that he hadn't had a tetanus booster in 10 years, not to mention an annual flu shot. I ordered a blood test for cholesterol. I went through his family medical history in case there were any particular diseases we should be on the lookout for.
We discussed a healthy diet and exercise. I screened for H.I.V., depression, domestic violence, smoking, and drug and alcohol abuse.
It was a lot to pack in for a visit about shoulder pain, but screening is where we get the most bang for the buck, or so we've been told. If our detailed interview uncovered one serious illness in the making, we'd be poised to treat it earlier, not later. This is the essence of primary care medicine.
Our Absurd Fear of Fat
By PAUL CAMPOS
ACCORDING to the United States government, nearly 7 out of 10 American adults weigh too much. (In 2010, the Centers for Disease Control and Preventioncategorized 74 percent of men and 65 percent of women as either overweight or obese.)
But a new meta-analysis of the relationship between weight and mortality risk, involving nearly three million subjects from more than a dozen countries, illustrates just how exaggerated and unscientific that claim is.
The meta-analysis, published this week in The Journal of the American Medical Association, reviewed data from nearly a hundred large epidemiological studies to determine the correlation between body mass and mortality risk. The results ought to stun anyone who assumes the definition of “normal” or “healthy” weight used by our public health authorities is actually supported by the medical literature.
The study, by Katherine M. Flegal and her associates at the C.D.C. and the National Institutes of Health, found that all adults categorized as overweight and most of those categorized as obese have a lower mortality risk than so-called normal-weight individuals. If the government were to redefine normal weight as one that doesn’t increase the risk of death, then about 130 million of the 165 million American adults currently categorized as overweight and obese would be re-categorized as normal weight instead.
To put some flesh on these statistical bones, the study found a 6 percent decrease in mortality risk among people classified as overweight and a 5 percent decrease in people classified as Grade 1 obese, the lowest level (most of the obese fall in this category). This means that average-height women — 5 feet 4 inches — who weigh between 108 and 145 pounds have a higher mortality risk than average-height women who weigh between 146 and 203 pounds. For average-height men — 5 feet 10 inches — those who weigh between 129 and 174 pounds have a higher mortality risk than those who weigh between 175 and 243 pounds.
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