The following story is exceptionally long if you follow the hot-link, but it's very revealing about some of the practical barriers facing full implementation of the ACA. I suspect Mississippi is far from alone. Follow the link at the end of the excerpt for the full article.
-SPC
How Obamacare Went South In Mississippi
Oxfam
Issue Brief
January 19, 2015
Wealth: Having It All and Wanting More
By Deborah Hardoon
Global wealth is increasingly being concentrated in the hands of a small wealthy elite. These wealthy individuals have generated and sustained their vast riches through their interests and activities in a few important economic sectors, including finance and pharmaceuticals/healthcare. Companies from these sectors spend millions of dollars every year on lobbying to create a policy environment that protects and enhances their interests further.
* In 2014, the richest 1% of people in the world owned 48% of global wealth, leaving just 52% to be shared between the other 99% of adults on the planet.1 Almost all of that 52% is owned by those included in the richest 20%, leaving just 5.5% for the remaining 80% of people in the world.
* The very richest of the top 1%, the billionaires on the Forbes list, have seen their wealth accumulate even faster over this period. In 2010, the richest 80 people in the world had a net wealth of $1.3tn. By 2014, the 80 people who top the Forbes rich list had a collective wealth of $1.9tn; an increase of $600bn in just 4 years, or 50% in nominal terms. The wealth of these 80 individuals is now the same as that owned by the bottom 50% of the global population, such that 3.5 billion people share between them the same amount of wealth as that of these extremely wealthy 80 people. In 2010, it took 388 billionaires to equal the wealth of the bottom half of the world‟s population; by 2014, the figure had fallen to just 80 billionaires.
* In 2014 there were 1,645 people listed by Forbes as being billionaires. This group of people is far from being globally representative. Almost 30% of them (492 people) are citizens of the USA.
* Between 2013 and 2014 billionaires listed as having interests and activities in the pharmaceutical and healthcare sectors saw the biggest increase in their collective wealth. Twenty-nine individuals joined the ranks of the billionaires between March 2013 and March 2014 (five dropped off the list), increasing the total number from 66 billionaires to 90, in 2014 making up 5% of the total billionaires on the list. The collective wealth of billionaires with interests in this sector increased from $170bn to $250bn, a 47% increase and the largest percentage increase in wealth of the different sectors on the Forbes list.
* During 2013, the pharmaceutical and healthcare sectors spent more than $487m on lobbying in the USA alone. This was more than was spent by any other sector in the US, representing 15% of $3.2bn total lobbying expenditures in 2013. In addition, during the election cycle of 2012, $260m was spent by this sector on campaign contributions. Twenty-two of the 90 pharmaceutical and healthcare billionaires are US citizens.
Tracking Down Martin Luther King, Jr.'s Words on Health Care
"Of all the forms of inequality, injustice in health care is the most shocking and inhumane." -- Dr. Martin Luther King, Jr.
I first came across this powerful quotation in my role as a legal editor for Clearinghouse Review: Journal of Poverty Law and Policy. I was editing Gordon Bonnyman's important article in the current issue of the Review, "Helping Hope and History Rhyme: Why and How Every Advocate Can Help Realize Health Care Reform," in which he asserts that the Affordable Care Act is the "most important civil rights milestone" since the 1965 Voting Rights Act. In his article, Bonnyman, the executive director of the Tennessee Justice Center, predicts that the act "will close the racial gap in health coverage, which is a prerequisite for eliminating disparities in health care and health status."
As the Review's legal editors often do, I asked him to supply some sources to support his conclusion. He did so and elegantly introduced them with the above quotation from Dr. King. The quotation itself then needed a source, so I quickly searched for the speech or paper that included it.
Although the quotation was oft-repeated -- usually in connection with the debate over the Affordable Care Act or President Clinton's attempts at health care reform in the early 1990s -- it frequently appeared without further attribution. In the few times it was credited, it was listed as a statement Dr. King made in Chicago on March 25, 1966, to the second convention of the Medical Committee for Human Rights. I tried several online search tools to find a copy of Dr. King's speech to this convention and even sought help from my husband, an academic librarian, who searched newspapers from around the time of the speech, hoping to find a quote from Dr. King's remarks.
In spite of our best efforts, I could not locate the actual text of this speech anywhere.
http://www.huffingtonpost.com/amanda-moore/martin-luther-king-health-care_b_2506393.html
I first came across this powerful quotation in my role as a legal editor for Clearinghouse Review: Journal of Poverty Law and Policy. I was editing Gordon Bonnyman's important article in the current issue of the Review, "Helping Hope and History Rhyme: Why and How Every Advocate Can Help Realize Health Care Reform," in which he asserts that the Affordable Care Act is the "most important civil rights milestone" since the 1965 Voting Rights Act. In his article, Bonnyman, the executive director of the Tennessee Justice Center, predicts that the act "will close the racial gap in health coverage, which is a prerequisite for eliminating disparities in health care and health status."
As the Review's legal editors often do, I asked him to supply some sources to support his conclusion. He did so and elegantly introduced them with the above quotation from Dr. King. The quotation itself then needed a source, so I quickly searched for the speech or paper that included it.
Although the quotation was oft-repeated -- usually in connection with the debate over the Affordable Care Act or President Clinton's attempts at health care reform in the early 1990s -- it frequently appeared without further attribution. In the few times it was credited, it was listed as a statement Dr. King made in Chicago on March 25, 1966, to the second convention of the Medical Committee for Human Rights. I tried several online search tools to find a copy of Dr. King's speech to this convention and even sought help from my husband, an academic librarian, who searched newspapers from around the time of the speech, hoping to find a quote from Dr. King's remarks.
In spite of our best efforts, I could not locate the actual text of this speech anywhere.
http://www.huffingtonpost.com/amanda-moore/martin-luther-king-health-care_b_2506393.html
By Sandy Banks - LA Times
I've been lucky for the last 20 years. I could listen silently while friends complained about their medical care. My doctor was never too busy or too brusque. He always made time to listen. I never had to pay concierge fees for what I knew was uncommonly good and thorough care.
But my luck ran out last summer when my doctor unexpectedly retired — pushed by some of the forces that are supposed to make patient care better and more accessible for the masses.
He was working harder, earning less, frustrated by bureaucratic demands and feeling the weight of his own advancing age. The day he hesitated when writing a prescription because he couldn't recall the name of a familiar drug, he began thinking it might be time to move on.
His lapse lasted just seconds and probably wouldn't have troubled his patients. I'd have drawn comfort from the fact that, at 65, he's experiencing the same senior moments that I fret about.
Now my daughters are trying to console me. Maybe it's time, they say, to find a young doctor, one who's up on the latest research and armed with high-tech tools.
I prefer the experience of someone who doesn't have to consult an iPhone app to figure out what my symptoms mean. A doctor who will return my panicked phone call and assure me that my middle-of-the-night vertigo is probably fleeting and benign and the black spots fluttering through my field of vision don't mean that I'm going blind.
I intended to grow old with my health in the capable hands of a man I'd learned to trust. Instead I'm joining hordes of patients in California stranded by healthcare shake-ups and a looming doctor shortage.
The pool of internists and family practice physicians — the doctors we see for physicals and ordinary ailments — is shrinking faster than it can be replenished. Only about 20% of medical students in this country go into primary care. Most gravitate instead toward specialties that demand less and pay more.
Primary care doctors are supposed to be the linchpins of the Affordable Care system: They'll track our health, head off problems, school us on prevention and coordinate whatever specialist care we need. But a recent study of healthcare in California found that only 16 of the state's 58 counties had enough primary care physicians to meet residents' medical needs.
Those doctors are bearing the brunt of the system's growing pains. Their expenses are multiplying, their revenue shrinking and they feel burdened by government mandates and insurance company demands.
They're the pioneers in our national shift from paper patient files to electronic medical records — a skills challenge in a field where almost 30% of the physicians are nearing retirement age.
Many complain that cumbersome record-keeping cuts into time they used to spend talking with patients. It can take hours each week to transcribe notes, check the right boxes and click through online drop-down menus for the proper codes for every treatment and diagnosis.
That too influenced my doctor to hang up his stethoscope. He chose internal medicine because he wanted to build relationships with patients; to look at us and listen, not tap away on a keyboard while we talked.
On my final visit I asked my doctor if I could check in with him to see how retirement's going. We met for lunch in Pasadena this week.
He looked happy and well-rested. He's traveled to Spain with his wife, become an active member of her church and joined a tournament bridge club that meets twice a week.
Still, he misses his patients, he said; he'd been tending some for almost 40 years. We talked about the stresses of his profession: the middle-of-the-night calls, the failed treatments, the intractable illnesses. He never got accustomed to letting go, to watching patients he'd grown close to wither and die.
I wanted to tell him how much I'd appreciated him; how much he'd taught me over the years about taking care of myself. But I felt suddenly awkward, talking to him as Glenn, instead of as my doctor.
That didn't matter because what he wanted to talk about was how much his patients had taught him:
From the woman in her 90s, stressing about a son who was 72, he learned that parents never stop worrying about their children.
From the patients clinging to hope through devastating terminal illnesses, he realized that for all our talk of dying with dignity, no one is really ever ready to go.
From the family marking a matriarch's demise with a joyful "home-going" celebration in her hospital room, he was introduced to the sustaining joy and power of faith.
Watching his patients grow old taught him to appreciate the natural aging process that is bound to hobble and humble us all. "Most of my older patients, no matter the obstacles, were still optimistic, still enjoying life," he said.
They were his teachers, and he became mine.
I remember our first visit in 1994. I was newly widowed and my youngest child was a toddler. Your job, I told him then, is to keep me alive for 18 years, until all three of my children are grown.
I realize now that he must have sensed the fear beneath my banter. But he never pitied or patronized me.
He understood I was more than a collection of ailments or a data set of test results. He let me ramble, cry, complain. He advised, but didn't judge. His most frequent prescription was "exercise," no matter what the problem.
And what I'm most grateful for has nothing to do with high bone density or lowered cholesterol. He made me feel less like a patient and more like a partner.
Twitter: @SandyBanksLAT
http://www.latimes.com/local/california/la-me-0117-banks-doctor-shortage-20150117-column.html
Sure You Can Track Your Health Data, But Can Your Doctor Use It?
Dr. Paul Abramson is no technophobe. He works at a hydraulic standing desk made in Denmark and his stethoscope boasts a data screen. "I'm an engineer and I'm in health care," he says. "I like gadgets." Still, the proliferation of gadgets that collect health data are giving him pause.
Abramson is a primary care doctor in San Francisco and lots of his patients work in the tech industry. So it's not surprising that more and more of them are coming in with information collected from consumer medical devices — you know, those wristbands and phone apps that measure how much exercise you're getting or how many calories you're eating.
The "wearables" market is growing fast. Credit Suisseestimates it's already worth between $3 billion and $5 billion. Add to that nearly 50,000 health apps, and you have a booming new digital health industry aiming to transform health care in the same way Amazon took on publishing.
Abramson says all the information these devices collect can be overwhelming. One of his patients arrived with pages and pages of Excel spread sheets full of data — everything from heart rate to symptoms to medications. Abramson says he didn't know what to do with it all.
"Going through it and trying to analyze and extract meaning from it was not really feasible," he says.
To Anderson, the spreadsheets just didn't say all that much. "I get information from watching people's body language, tics and tone of voice," he says. "Subtleties you just can't get from a Fitbit or some kind of health app."
How big a sham is the case seeking to gut Obamacare subsidies?
http://pollways.bangordailynews.com/2015/01/16/national/how-big-a-sham-is-the-case-seeking-to-gut-obamacare-subsidies/
Hating Good Government
JAN. 18, 2015 by Paul Krugman
It’s now official: 2014 was the warmest year on record. You might expect this to be a politically important milestone. After all, climate change deniers have long used the blip of 1998 — an unusually hot year, mainly due to an upwelling of warm water in the Pacific — to claim that the planet has stopped warming. This claim involves a complete misunderstanding of how one goes about identifying underlying trends. (Hint: Don’t cherry-pick your observations.) But now even that bogus argument has collapsed. So will the deniers now concede that climate change is real?
Of course not. Evidence doesn’t matter for the “debate” over climate policy, where I put scare quotes around “debate” because, given the obvious irrelevance of logic and evidence, it’s not really a debate in any normal sense. And this situation is by no means unique. Indeed, at this point it’s hard to think of a major policy dispute where facts actually do matter; it’s unshakable dogma, across the board. And the real question is why.
Before I get into that, let me remind you of some other news that won’t matter.
First, consider the Kansas experiment. Back in 2012 Sam Brownback, the state’s right-wing governor, went all in on supply-side economics: He drastically cut taxes, assuring everyone that the resulting boom would make up for the initial loss in revenues. Unfortunately for his constituents, his experiment has been a resounding failure. The economy of Kansas, far from booming, has lagged the economies of neighboring states, and Kansas is now in fiscal crisis.
So will we see conservatives scaling back their claims about the magical efficacy of tax cuts as a form of economic stimulus? Of course not. If evidence mattered, supply-side economics would have faded into obscurity decades ago. Instead, it has only strengthened its grip on the Republican Party.
Meanwhile, the news on health reform keeps coming in, and it keeps being more favorable than even the supporters expected. We already knew that the number of Americans without insurance is dropping fast, even as the growth in health care costs moderates. Now we have evidence that the number of Americans experiencing financial distress due to medical expenses is also dropping fast.
Single-payer system would free $375 billion for health care
By Isaiah J. Poole
Campaign for America's Future, Jan. 15, 2015
A new study has put a price tag on how much more the United States pays in health care costs because it has chosen not to adopt a single-payer system: $375 billion.
That figure, in a report published this week in the online journal BMC Health Services Research, represents the excess administrative costs imposed by our private billing and insurance system in 2012. It would have been enough, the report said, to provide every uninsured American with health coverage and upgrade coverage for millions of others who are carrying inadequate, bare-bones policies.
“We could provide everyone with good care and remove the complex and onerous cost-sharing that we have in the current system,” said James G. Kahn, senior author of the study and a researcher at the Philip R. Lee Institute for Health Policy Studies at University of California at San Francisco, in an interview with OurFuture.org.
“Not to put too fine a point on it, but by spending this money on health care, we could save lives,” he said.
The report, which also includes input from physicians and health policy researchers from the City University of New York School of Public Health and Harvard Medical School, said that the United States spent a total of $471 billion in medical billing paperwork and insurance-related red tape.
A single-payer system, they estimate, would eliminate 80 percent of that cost.
The finding not only serves to underscore the extent to which the Affordable Care Act has only tinkered around the edges of the health care system, when in fact a full rethinking of how we deliver health care is needed, but it is fodder for a rebuke of the conservative “repeal and replace” mantra, which would double down on the Rube Goldberg private insurance system and leave patients even more vulnerable to its complexities and costs.
Giving patients more “skin in the game” by requiring them to shoulder more of the health care cost burden would simply prompt people to not get the health care they need at those times when they are in a position to make a decision, Kahn said. Especially during emergencies, when health care costs are typically highest, “there is no evidence at all that the skin-in-the-game strategy is a way to control health care costs.”
Kahn points out that there is “a critical mass” of Americans who support movement toward a single-payer system, and there are groups of health care experts who are working to educate the public about the remaining work that needs to be done to offer Americans a health care system that provides universal coverage and is cost-efficient.
“If I and my colleagues can document in stark terms the ways we are wasting money – that is more than $1 trillion over three years – that will convince people that we really need to achieve that change, even though at the moment it seems tough,” he said.
For more, including an audio of the interview described above, click here: http://ourfuture.org/20150115/single-payer-system-would-free-375-billion...
http://www.pnhp.org/print/news/2015/january/single-payer-system-would-free-375-billion-for-health-care
Campaign for America's Future, Jan. 15, 2015
A new study has put a price tag on how much more the United States pays in health care costs because it has chosen not to adopt a single-payer system: $375 billion.
That figure, in a report published this week in the online journal BMC Health Services Research, represents the excess administrative costs imposed by our private billing and insurance system in 2012. It would have been enough, the report said, to provide every uninsured American with health coverage and upgrade coverage for millions of others who are carrying inadequate, bare-bones policies.
“We could provide everyone with good care and remove the complex and onerous cost-sharing that we have in the current system,” said James G. Kahn, senior author of the study and a researcher at the Philip R. Lee Institute for Health Policy Studies at University of California at San Francisco, in an interview with OurFuture.org.
“Not to put too fine a point on it, but by spending this money on health care, we could save lives,” he said.
The report, which also includes input from physicians and health policy researchers from the City University of New York School of Public Health and Harvard Medical School, said that the United States spent a total of $471 billion in medical billing paperwork and insurance-related red tape.
A single-payer system, they estimate, would eliminate 80 percent of that cost.
The finding not only serves to underscore the extent to which the Affordable Care Act has only tinkered around the edges of the health care system, when in fact a full rethinking of how we deliver health care is needed, but it is fodder for a rebuke of the conservative “repeal and replace” mantra, which would double down on the Rube Goldberg private insurance system and leave patients even more vulnerable to its complexities and costs.
Giving patients more “skin in the game” by requiring them to shoulder more of the health care cost burden would simply prompt people to not get the health care they need at those times when they are in a position to make a decision, Kahn said. Especially during emergencies, when health care costs are typically highest, “there is no evidence at all that the skin-in-the-game strategy is a way to control health care costs.”
Kahn points out that there is “a critical mass” of Americans who support movement toward a single-payer system, and there are groups of health care experts who are working to educate the public about the remaining work that needs to be done to offer Americans a health care system that provides universal coverage and is cost-efficient.
“If I and my colleagues can document in stark terms the ways we are wasting money – that is more than $1 trillion over three years – that will convince people that we really need to achieve that change, even though at the moment it seems tough,” he said.
For more, including an audio of the interview described above, click here: http://ourfuture.org/20150115/single-payer-system-would-free-375-billion...
http://www.pnhp.org/print/news/2015/january/single-payer-system-would-free-375-billion-for-health-care
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