Health Care Reform Articles

Health Care Reform Articles - February 24, 2012

2012-02-24T06:39:00.002-08:00

A Shift From Nursing Homes to Managed Care at Home

By JOSEPH BERGER

Faced with soaring health care costs and shrinking Medicare and Medicaid financing, nursing home operators are closing some facilities and embracing an emerging model of care that allows many elderly patients to remain in their homes and still receive the medical and social services available in institutions.

The rapid expansion of this new type of care comes at a time when health care experts argue that for many aged patients, the nursing home model is no longer financially viable or medically justified.

In the newer model, a team of doctors, social workers, physical and occupational therapists and other specialists provides managed care for individual patients at home, at adult day-care centers and in visits to specialists. Studies suggest that it can be less expensive than traditional nursing homes while providing better medical outcomes.

The number of such programs has expanded rapidly, growing from 42 programs in 22 states in 2007 to 84 in 29 states today. In New York City, a program run by a division of CenterLight Health System, formerly known as the Beth Abraham Family of Health Services, has over 2,500 participants at 12 sites in the metropolitan area.http://www.nytimes.com/2012/02/24/nyregion/managed-care-keeps-the-frail-out-of-nursing-homes.html?_r=1&pagewanted=print

State to Close Program on Federal Health Law

By THANH TAN

A program created to help insurance-seekers in Texas cut through the complexities of federal health care reforms is shutting down in April, just 15 months after it opened its call center and years before the law goes into full effect.

Officials with the Texas Department of Insurance say they plan to help fill the gap, but it is unclear whether they can handle what some health experts call a beast of a policy change: millions of new patients will be required to acquire health insurance, and those first-time policy holders will need help understanding their rights and benefits.

When President Obama signed the Patient Protection and Affordable Care Act in 2010, a consumer education program was also created. That September, the federal government awarded the Texas Department of Insurance a $2.8 million grant to start the Consumer Health Assistance Program.

As of January, the department reported, the program had answered 8,900 calls and resolved nearly 5,600 cases statewide. A staff of nine employees had dispersed multilingual public service announcements, given field presentations, begun a Web site and staffed a hot line.

http://www.nytimes.com/2012/02/24/us/texas-to-shut-consumer-health-assistance-program.html?pagewanted=print

Austerity in Europe Puts Pressure on Drug Companies

By STEPHANIE NOVAK

PARIS —Profits at pharmaceutical companies have been declining or showing little growth for the last year as austerity measures across Europe lead to cuts in health care spending. Some analysts say this trend could continue until at least 2014.

Budget cuts mean that many European governments are not willing to pay as much for pills. But new laws in some countries are also putting pressure on companies to prove their drugs are effective or risk having them dropped from the coverage list, or covered at a lower rate.

And price reductions in Europe can have a ripple effect. Profits from sales in emerging markets may also fall, because governments in emerging markets refer to the prices set in Europe to determine their own.

That would particularly hurt European pharmaceutical companies, which have been quite successful in emerging markets in the last five years. American companies, by contrast, do not rely as much on overseas revenue because of their large domestic market.

http://www.nytimes.com/2012/02/24/business/austerity-in-europe-puts-pressure-on-drug-companies.html?pagewanted=print

A Cartoon That Cuts Through the Health Care Brambles

By CORNELIA DEAN

If you have been following the so-called debate over the Affordable Care Act of 2010 — often referred to by critics as Obamacare — you may be confused about what has changed so far and what it may mean in the future. You may even occasionally wish someone would draw you a diagram.

Now someone has done that, offering an easy-to-understand cartoon walk through the health care policy landscape. In “Health Care Reform,” readers see patients, workers, employers and others confront some of the legislation’s knotty issues, especially the mandate requiring everyone to have health insurance, the chief issue the Supreme Court will take up in March when justices hear challenges to the bill.

Prominent among the book’s comic characters is its author, Jonathan Gruber. Dr. Gruber, an economist at the Massachusetts Institute of Technology, consulted with the Obama administration and Congress as the legislation was drafted, and he was one of the architects of the plan on which it is based, the Massachusetts health care law that Mitt Romney pushed through when he was governor but seems ready to forget in his quest for the Republican presidential nomination.

For critics of either law, Dr. Gruber’s résumé offers reason enough to consign the book to the dustbin. But that would be a mistake.

http://www.nytimes.com/2012/02/13/health/views/health-care-reform-book-review-a-cartoon-to-cut-through-red-tape.html?pagewanted=print

The Internet has already changed how people shop for books, music, cars and a host of other consumer goods. Next up: prescription drugs.

Or so the founders of a Santa Monica start-up called GoodRx are hoping.

"There's no other site like it that we know of," said Scott Marlette, a former Facebook employee who's hoping to hit it big again with his new company. "We wanted to create a product where people can find the best pharmacy to go to."

http://www.latimes.com/business/la-fi-lazarus-20120224,0,3816088,print.column

Emergency budget for DHHS approved

Posted:Today
Updated: 8:16 AM

By Susan M. Cover scover@mainetoday.com
MaineToday Media State House Writer

AUGUSTA — A pared-down budget for the Department of Health and Human Services won final approval Thursday as four Democratic senators went from opposing the plan to supporting it, based on assurances that efforts will be made to help veterans maintain health insurance.
http://www.pressherald.com/news/Maine-Senate-passes-DHHS-budget.html

Health Care Reform Articles - February 23, 2012

2012-02-23T08:11:00.003-08:00

latimes.com

latimes.com/news/opinion/commentary/la-oe-dennehy-nurse-practitioners-20120222,0,7158283.story

Within the next two years, if federal healthcare reforms proceed as expected, roughly 30 million of the estimated 50 million uninsured people in the United States — 6.9 million in California — will be trying to find new healthcare providers.

It won't be easy. Primary care providers are already in short supply, both in California and nationwide. That's because doctors are increasingly leaving primary care for other types of practices, including higher paid specialties. As the demand increases, the squeeze on providers will worsen, leading to potentially lower standards of care in general and longer wait times for appointments for many of the rest of us.
http://www.latimes.com/news/opinion/commentary/la-oe-dennehy-nurse-practitioners-20120222,0,6779984,print.story

Doyle McManus: Future of Medicare looms as a campaign issue - latimes.com

Don't look now, but the 2012 election is turning into a national referendum on what to do about Medicare.

Democrats want to run on the issue — and to charge that Republican proposals to change Medicare into a voucher-based system would end the current guarantee of virtually unlimited healthcare for the elderly.

The chairman of their House campaign committee, Rep. Steve Israel (D-N.Y.), has told candidates to stress three issues: "Medicare, Medicare and Medicare."

At least some Republicans — such as Rep. Paul D. Ryan (R-Wis.), author of a leading GOP Medicare proposal — say they welcome that fight. "Medicare is the issue," Ryan told reporters last week.

http://www.latimes.com/news/opinion/commentary/la-oe-0219-mcmanus-medicare-20120219,0,946135.column?track=rss&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+latimes%2Fnews%2Fopinion%2Fcommentary+%28L.A.+Times+-+Commentary%29

Supreme Court lets providers continue suing to stop Medi-Cal cuts

Reporting from Washington and Sacramento—
A years-long legal fight over cuts in California's multibillion-dollar healthcare program for the poor took another twist Wednesday as the U.S. Supreme Court kicked the case back to a lower court.

The high court's 5-4 decision allows medical providers to continue suing to stop the cuts, which would lower reimbursement rates for doctors who participate in the state's Medi-Cal program.

http://www.latimes.com/news/local/la-me-medi-cal-20120223,0,7446743.story?track=rss&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+latimes%2Fnews%2Flocal+%28L.A.+Times+-+California+%7C+Local+News%29

California health insurers to raise rates 8% to 14% - latimes.com

California's largest health insurers are raising average rates by about 8% to 14% for hundreds of thousands of consumers with individual coverage, outpacing the costs of overall medical care.

The cost of goods and services associated with medical care grew just 3.6% over the last 12 months nationally, government figures show. But insurance premiums have kept climbing at a faster pace in California.

Insurers defended their rate hikes, saying they are based on their claims experience with the customers they insure and not just the broader rate of medical inflation. They also say that healthier members dropped out of the individual market as premiums rose and the economy worsened in recent years, leaving behind a group of policyholders who have higher average costs.
http://www.latimes.com/business/la-fi-0223-health-insurance-rate-hikes-20120223,0,7634380.story?track=rss&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+latimes%2Fbusiness+%28L.A.+Times+-+Business%29

Posted Feb. 22, 2012, at 7:55 p.m.
Last modified Feb. 23, 2012, at 8:35 a.m.

AUGUSTA, Maine — Maine’s Department of Health and Human Services will wait until the Legislature greenlights its budget before taking a federal official up on her offer to help Maine reform its Medicaid program, DHHS Commissioner Mary Mayhew said Wednesday.

Last week, U.S. Health and Human Services Commissioner Kathleen Sebelius said she would send a team of experts to Maine to help the state reduce its Medicaid costs. Sebelius was answering question from U.S. Sen. Olympia Snowe at a meeting of the Senate Finance Committee about how states can save money while preserving Medicaid coverage for residents.

http://bangordailynews.com/2012/02/22/politics/maine-needs-budget-in-place-before-getting-federal-help-dhhs-commissioner-says/

Health Care Reform Articles - February 22, 2012

2012-02-21T06:37:00.000-08:00

FEBRUARY 20, 2012, 11:18 AM

Rejecting Ritalin With the Power of Hindsight

By KJ DELL'ANTONIA

In The Art of Distraction on the Opinion Pages this weekend, Hanif Kureishi — a successful playwright, screenwriter, filmmaker, novelist and short-story writer — admits to being, as his title suggests, distracted. His son, too, suffers (or doesn’t, as you’ll gather from reading the whole of his piece) from a lack of focus — but, Mr. Kureishi argues, there is nothing “wrong” with his son. Or with him. Distraction, he suggests, is a gift, and focus overrated. From that point of view, he offers this indictment of Ritalin and other drugs designed to help those who can’t find it:

Ritalin and other forms of enforcement and psychological policing are the contemporary equivalent of the old practice of tying up children’s hands in bed, so they won’t touch their genitals. The parent stupefies the child for the parent’s good. There is more to this than keeping out the interesting: there is the fantasy and terror that someone here will become pleasure’s victim, disappearing into a spiral of enjoyment from which he or she will not return.
http://parenting.blogs.nytimes.com/2012/02/20/rejecting-ritalin-with-the-power-of-hindsight/?pagemode=print

MaineCare cuts would bring state in line with U.S. average

1:00 AM

Much of the debate for cutting funding to the state's Medicaid program focuses on its high cost compared to other states'.

By CLARKE CANFIELD/The Associated Press

PORTLAND — In his relentless demands for steep Medicaidcuts, Gov. Paul LePage has said Maine spends far more per capita than other states on Medicaid and is high above the national average.

Medicaid expansion

Whether you support or oppose LePage's cost-cutting proposals, he's right.
Maine had the nation's fifth-highest Medicaid coverage rate in fiscal year 2009, 27.8 percent, behind California, New Mexico, Louisiana and Vermont, according to the latest statistics for Maine from the Centers for Medicare and Medicaid Services. The national rate for the same period was 21 percent.
http://www.pressherald.com/news/cuts-would-bring-state-in-line-with-u_s_-average_2012-02-21.html

LePage’s claims that Maine’s Medicaid spending is above average are true

By CLARKE CANFIELD, The Associated Press

Posted Feb. 20, 2012, at 11:37 a.m.

PORTLAND, Maine — In his relentless demands for steep Medicaid cuts, Gov. Paul LePage has said Maine spends far more per capita than other states on Medicaid and is high above the national average.

Whether you support or oppose LePage’s cost-cutting proposals, he’s right.

Maine had the nation’s fifth-highest Medicaid coverage rate in fiscal year 2009, 27.8 percent, behind California, New Mexico, Louisiana and Vermont, according to the latest statistics for Maine from the Centers for Medicare and Medicaid Services. The national rate for the same period was 21 percent.

Maine’s Medicaid expenses for that year amounted to $1,890 per resident.

That’s 61 percent higher than the national average of $1,173 per person, according to CMMS statistics.

http://bangordailynews.com/2012/02/20/health/maine-medicaid-costs-above-average/print/

Seniors Need To Reevaluate Their Needs For Popular Medical Treatments: The KHN Interview

TOPICS: AGING

By JUDITH GRAHAM

FEB 21, 2012

This story was produced in collaboration with

Nortin Hadler, a professor of medicine and microbiology/immunology at the University of North Carolina at Chapel Hill, has been warning for years about the lack of evidence supporting many popular medical treatments and tests.

http://www.kaiserhealthnews.org/Stories/2012/February/21/nortin-hadler-q-and-a.aspx?p=1

February 21, 2012

A Real ‘Doc Fix’

In last week’s flurry of budget deals, Congress patched together yet another temporary fix for a flawed formula used to calculate the fees paid to doctors byMedicare. It will hold payments flat for the next 10 months instead of cutting them by 27 percent as the formula required, and the $18 billion to pay for it will be taken from other health care programs. But the fix only lasts until the end of the year. On Jan. 1, doctors will face another big cut unless Congress again steps in.

Congress now needs to devise a real fix that would be fair to doctors and make a serious effort to slow the rise of Medicare spending. In the near term, some doctors — highly paid specialists — should be required to accept some reduction in fees. That won’t be enough. Congress should also use this moment to wean doctors away from fee-for-service billing, a root cause of escalating costs, into better and cheaper forms of care.

http://www.nytimes.com/2012/02/22/opinion/a-real-doc-fix.html?_r=1&pagewanted=print

February 20, 2012

Catholic Hospitals Expand, Religious Strings Attached

By REED ABELSON

As Roman Catholic leaders and government officials clash over the proper role of religion and reproductive health, shifts in health care economics are magnifying the tension. Financially stronger Catholic-sponsored medical centers are increasingly joining with smaller secular hospitals, in some cases limiting access to treatments like contraception, abortion and sterilization.

In Seattle, Swedish Health Services has offered elective abortions for decades. But the hospital agreed to stop when it joined forces this month with Providence Health & Services, one of the nation’s largest Catholic systems.

In late December, Gov. Steve Beshear of Kentucky turned down a bid by Catholic Health Initiatives, another large system, to merge with a public hospital in Louisville, in part because of concern that some women would have less access to contraceptive services.

And in Rockford, Ill., there is resistance to a plan by OSF HealthCare, run by the Sisters of the Third Order of St. Francis, to buy a hospital because of new restrictions that would require women to go elsewhere if they wanted a tubal ligation after a Caesarean section.

http://www.nytimes.com/2012/02/21/health/policy/growth-of-catholic-hospitals-may-limit-access-to-reproductive-care.html?pagewanted=print

Universal: Medicare for all - Editorials - The Charleston Gazette - West Virginia News and Sports -

February 21, 2012

CHARLESTON, W.Va. -- Various Republicans are pressing the U.S. Supreme Court to rule the 2010 Affordable Care Act unconstitutional because it requires millions of "working poor" Americans to buy health insurance from commercial carriers.
Surprisingly, a crusading liberal Charleston reformer and activist has joined a Supreme Court brief demanding exactly the same thing.
http://wvgazette.com/Opinion/Editorials/201202210112

Health Care Reform Articles - February 20, 2012

2012-02-17T18:59:00.000-08:00

House passes, but Senate rejects DHHS budget — Politics — Bangor Daily News — BDN Maine
UGUSTA, Maine — Senate Democrats late Thursday blocked passage of a supplemental budget for the Department of Health and Human Service just hours after their counterparts in the House approved it.
The compromise budget bill, LD 1816, cuts approximately $120 million from the current fiscal year DHHS budget through a combination of changes to MaineCare eligibility and shifting funds from various accounts. It also includes an additional several million in savings across state government that were identified by a budget streamlining committee last fall.
The House vote was 109-27, well above the two-thirds majority needed for the budget to go into effect immediately.
When it came to the Senate, though, only three Democrats voted in favor, leaving the final tally well below the two-thirds threshold.

http://bangordailynews.com/2012/02/16/politics/house-approves-dhhs-budget-senate-up-next/

LePage: Democrats' vote was 'obstruction'

Posted: 11:28 AM
Updated: 9:28 PM

Senate Democrats say they are trying to find an alternative after rejecting a budget plan Thursday.

By Susan M. Cover scover@mainetoday.com
MaineToday Media State House Writer

AUGUSTA - Senate Democrats who voted Thursday night to reject a plan to close a budget shortfall in the Department of Health and Human Services "resorted to obstruction," Gov. Paul LePage said Friday.

http://www.pressherald.com/news/LePage-blasts-Senate-Democrats-for-obstruction.html

Our View: Governor should accept federal help to cut costs

Posted:Today

Updated: 1:25 AM

Maine may be missing out on less harmful ways to cut costs in the MaineCare program.

With all the problems Maine is facing in revising the state budget to account for shortfalls in the Medicaid program, you'd think that the governor's office would take all the help it could get. But that's not the case.

http://www.pressherald.com/opinion/governor-should-accept-federal-help-to-cut-costs_2012-02-17.html

Health and Human Services head offers to help Maine change Medicaid

Health and Human Services Secretary Kathleen Sebelius, accompanied by Attorney General Eric Holder, gestures during a news conference announcing the new Health Care Fraud and Abuse Control Program Report, Tuesday, Feb. 14, 2012, at HHS in Washington.

AUGUSTA, Maine — Health and Human Services Secretary Kathleen Sebelius told members of the U.S. Senate Finance Committee on Wednesday that she has told Maine Gov. Paul LePage what the state’s options are to change Medicaid and offered to send a team to help the state craft a plan that will pass federal muster.

“We again made it clear to him what was within the state’s discretion,” she said, addressing questions in Washington posed by Sen. Olympia Snowe, R-Maine, a member of the committee. “We volunteered to send a team in to look at their other choices, but we did not have a lot of paper from the Governor about what exactly was the proposal.”

http://bangordailynews.com/2012/02/15/news/state/health-and-human-services-head-offers-to-help-maine-change-medicaid/print/

Primary-care doctors critical — but relatively low-paid

By Sarah Kliff, The Washington Post

Posted Feb. 16, 2012, at 8:41 p.m.

On a chilly afternoon at a community clinic in Washington, three young doctors are busily laying the foundation for the health-care law’s success.

Jacob Edwards flips through a manual on skin conditions, diagnosing a rash that looks like chicken pox. Jessica O’Babatunde consults her supervisor on treating an adolescent’s obesity, which is literally off-the-charts. And Julie Krueger peppers 3-year-old Daphauni with questions at her physical: How do you spell your name? What did you eat for breakfast? What’s your favorite vegetable? (Cheese.)

They are primary-care residents at Children’s National Medical Center. A third of their class has more than $200,000 each in student loan debt. At the end of residency, they can stay in primary care and earn $29.58 an hour. Or they can specialize and make $74.45. Over a lifetime, a medical student who specializes can expect to earn $3.5 million more.

The Obama administration — and, arguably, the American health-care system — desperately needs them to choose primary care.

http://bangordailynews.com/2012/02/16/health/primary-care-doctors-critical-but-relatively-low-paid/print/

latimes.com

latimes.com/health/la-me-primarycare-20120219,0,250503.story
First-year medical student Hannah Segal sees the same patients and finds herself managing the same ailments during her frequent visits to a community health clinic on downtown Los Angeles' skid row.

It's not the most glamorous or desired duty among her USC classmates, many of whom aspire to prestigious, high-paying medical specialties. But her work on the front lines of patient care has helped Segal find her passion. "I'm always really excited to come here," she said. "I get to really problem-solve over time."
http://www.latimes.com/health/la-me-primarycare-20120219,0,3657471,print.story

Over 400,000 Mainers extended preventive health services

Posted Feb. 16, 2012, at 8:56 p.m.

The federal health reform law provided more than 400,000 Maine residents with preventive care last year, according to the U.S. Department of Health and Human Services.

About 226,000 Mainers were among 54 million Americans who were able to access at least one new preventive service for free in 2011 through their private health insurance as a result of the Affordable Care Act, according to a press release.

http://bangordailynews.com/2012/02/16/health/over-400000-mainers-extended-preventive-health-services/print/

Doctor says universal health care plan necessary

By Rich Hewitt, BDN Staff

Posted Oct. 28, 2009, at 11:31 p.m.

ELLSWORTH, Maine — You can forget about keeping government out of the health care business.

It’s already there, and it’s there to stay.

That was part of the message that Dr. Erik Steele brought Wednesday to the Eggs and Issues forum sponsored by the Ellsworth Area Chamber of Commerce. Steele is the chief medical officer for Eastern Maine Healthcare Systems and interim CEO at Blue Hill Memorial Hospital. He also writes a regular OpEd column for the Bangor Daily News.

“The federal government already insures between 60 [million] and 70 million people — federal employees, veterans, Medicare and Medicaid recipients,” Steele said. “The biggest insurance company in the country is the U.S. government — that is, you.”

The government may be the only entity that is “powerful enough to drive us all together.”

Health care is going to change, and as costs continue to escalate, people are going to demand that change, he said. Estimates are that by 2020, average Americans will spend half their income on health care.

http://bangordailynews.com/2009/10/28/news/doctor-says-universal-health-care-plan-necessary/print/

Shortages of critical prescription drugs hit Maine hard

Troy R. Bennett | BDN

Rhea Sanborn of Eliot stands in the insurance office she ran with her husband before her ovarian cancer came out of remission in November. Now, her cancer medication is in short supply, forcing her to take an alternative drug.

By Jackie Farwell, BDN Staff

Posted Feb. 17, 2012, at 12:59 p.m.

Rhea Sanborn learned in November that her ovarian cancer had returned for the third time. After the Eliot woman’s oncologist at Maine Medical Center informed her of the devastating diagnosis, he dropped another bombshell.

Supplies of the medication that offered Sanborn the best shot at beating the disease had run out.

“He said the preferred treatment for you at this point in time would be Doxil” combined with another drug, she said. “But the Doxil isn’t available.”

Sanborn was shocked.

“When you find out your options are compromised, you’re surprised,” she said.

About a week ago, Sanborn, a mother to two grown sons, underwent her first chemotherapy treatment for this third round of cancer. She was injected with an alternative drug that’s more toxic, carries additional side effects and must be administered more frequently than Doxil.

http://bangordailynews.com/2012/02/17/health/shortages-of-critical-prescription-drugs-hits-maine-hard/print/

10 Big Lies (And A Free-Market "Death Panel") Driving the GOP's Plan to Destroy Medicare

By Richard (RJ) Eskow, Campaign for America\'s Future

There's a new "Medicare" proposal - sorta. It's really the same old bait-and-switch we've seen a dozen times. Still, you gotta hand it to 'em: Republican Sens. Tom Coburn and Richard Burr have taken the usual right-wing think-tank-designed buzzwords, deceptive packaging, and sleights of hand, and have taken them to new heights.

These foundation-forged assaults on the middle class may be old, battered ideas that have been debunked a dozen times, but still they just won't die. Like the old Terminators, they keep coming back with the same mission: Must. Kill. Medicare.

Coburn and Burr don't even pretend to show how their anti-Medicare plan - excuse me, "choice" plan - will save money. They just say this:

We do not yet have a concrete, specific amount of "savings" outlined, but we believe our proposal could save between $200 billion and $500 billion over a decade.

http://www.alternet.org/newsandviews/article/794275/10_big_lies_%28and_a_free-market_%22death_panel%22%29_driving_the_gop%27s_plan_to_destroy_medicare/#paragraph3

Our unrealistic attitudes about death, through a doctor’s eyes

By Craig Bowron, Published: February 17

I know where this phone call is going. I’m on the hospital wards, and a physician in the emergency room downstairs is talking to me about an elderly patient who needs to be admitted to the hospital. The patient is new to me, but the story is familiar: He has several chronic conditions — heart failure, weak kidneys, anemia, Parkinson’s and mild dementia — all tentatively held in check by a fistful of medications. He has been falling more frequently, and his appetite has fallen off, too. Now a stroke threatens to topple this house of cards.http://www.washingtonpost.com/opinions/our-unrealistic-views-of-death-through-a-doctors-eyes/2012/01/31/gIQAeaHpJR_print.html

Blue Shield of California vs. UCLA Medical Center - latimes.com

Blue Shield of California has suspended its relationship with UCLA Medical Center, one of the state's top hospitals, in adispute over the cost of treating patients there. It's a disturbing sign of things to come in the healthcare industry, as insurers become increasingly resistant to the cost increases that they routinely passed along in previous years. Although the standoff is hard on the patients who've lost access to UCLA, Blue Shield is right about one thing: The healthcare industry is on an unsustainable path, and every segment must start focusing on cost control.

http://www.latimes.com/news/opinion/opinionla/la-ed-blueshield-20120213,0,3668965.story

Health Care Reform Articles - February 16, 2012

2012-02-15T11:43:00.000-08:00

Four ways communities are turning health care delivery on its head - Bangor Daily News
Philip Caper, M.D.
When veteran print and TV journalist T.R. Reid visited Maine last fall, he claimed we could provide health care for everybody and do it for less money with better results. At 3:30 p.m. Sunday, MPBN will air his latest documentary, “U.S. Health Care: The Good News,” which shows how it can be done.
http://bangordailynews.com/2012/02/15/health/four-ways-communities-are-turning-health-care-delivery-on-its-head/print/

Universal Health Care: A Moral Obligation?

By Ronald Pies, MD

As a psychiatric physician for nearly thirty years, I am always surprised when I hear politicians claim that the U.S. health care system is “the best in the world.” To be sure, we are among the most advanced nations when it comes to medical technology, and we are second to none when it comes to the dedication of our doctors, nurses, and allied professionals. But if we examine indices of public health such as infant mortality and preventable deaths, we are far from having the best health care “system.” For example, according to a 2002 study by the Institute of Medicine, 18,000 Americans die every year because they don’t have health insurance. And in a 2008 Commonwealth Fund-supported study comparing “preventable deaths” in nineteen industrialized countries, the United States placed last.

http://www.hhropenforum.org/2012/02/universal-health-care-a-moral-obligation/

T.R. Reid talks about the good news in U.S. healthcare

Home > T.R. Reid talks about the good news in U.S. healthcare

NEW GLOUCESTER, ME – T.R. Reid, author of “The Healing of America” and documentary filmmaker, has once again joined forces with PBS to present a film looking at healthcare. “U.S. Health Care: The Good News,” a one-hour program scheduled to be broadcast nationwide on Feb. 16 on PBS (check local listings), examines communities in the United States that are providing high-quality care at lower costs. Reid spoke to Healthcare Finance News about his new documentary and healthcare issues facing the country.

http://www.healthcarefinancenews.com/print/41786

Self-Insured Complicate Health Deal

By KATIE THOMAS

The Obama administration thought it had found a way to ease mounting objections to a requirement in the new health care act that all employers — including religiously affiliated hospitals and universities — offer coverage for birth control to women free of charge.

It would make the insurers cover the costs, rather than the organizations themselves.

But the administration announced the compromise plan before it had figured out how to address one conspicuous point: Like most large employers, many religiously affiliated organizations choose to insure themselves rather than hire an outside company to assume the risk.

http://www.nytimes.com/2012/02/16/business/self-insured-complicate-health-deal.html?hpw=&pagewanted=print

Drowned girl's mom sought mental help, was rebuffed, relative says

A South Los Angeles mother who allegedly drowned her 1-year-old daughter and tried to drown her 5-year-old had sought psychiatric help but was rebuffed because she was an illegal immigrant, a relative said.
http://latimesblogs.latimes.com/lanow/2012/02/relative-says-mom-tried-seeking-psychiatric-help-but-was-rebuffed.html

Sebelius in L.A. to announce $9.1 million in aid to med students

http://latimesblogs.latimes.com/lanow/2012/02/sebelius-in-la-to-announce-91-million-in-aid-to-med-students.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+lanowblog+%28L.A.+Now%29

Health Care Reform Articles - February 15, 2012

2012-02-15T05:15:00.000-08:00

Chink in the dam

Published: February 14, 2012

Like a chink in a dam, Gov. Peter Shumlin’s concessions to the business community on participation in a new health benefits exchange threaten to open a chasm that could blow the dam wide open.

Shumlin announced last week that he was broadening the category of businesses that would not be required to purchase insurance from the exchange that state officials are now constructing to serve as a marketplace for health care policies. Creation of the exchange follows the requirements of the federal health care reform law and is meant to create a steppingstone to a new single-payer system for Vermont.

http://www.timesargus.com/article/20120214/OPINION01/702149967/1021/OPINION0

Conservatives Sowed Idea of Health Care Mandate, Only to Spurn It Later

It can be difficult to remember now, given the ferocity with which many Republicans assail it as an attack on freedom, but the provision in President Obama’s health care law requiring all Americans to buy health insurance has its roots in conservative thinking.

The concept that people should be required to buy health coverage was fleshed out more than two decades ago by a number of conservative economists, embraced by scholars at conservative research groups, including the Heritage Foundationand the American Enterprise Institute, and championed, for a time, by Republicans in the Senate.

http://www.nytimes.com/2012/02/15/health/policy/health-care-mandate-was-first-backed-by-conservatives.html?tntemail0=y&_r=1&emc=tnt&pagewanted=print

Hip Implants U.S. Rejected Sold Overseas

The health care products giant Johnson & Johnson continued to market an artificial hip in Europe and elsewhere overseas after the Food and Drug Administration rejected its sale in the United States based on a review of company safety studies.

During that period, the company also continued to sell in this country a related model, which earlier went on the market using a regulatory loophole that did not require a similar safety review.

http://www.nytimes.com/2012/02/15/business/hip-implant-the-fda-rejected-was-marketed-abroad.html?hpw=&pagewanted=print

Birth-control flap shows the need to abort employer-based healthcare

David Lazarus

February 14, 2012

It wasn't a retreat. Nor was it a compromise. It was an "accommodation."

That's how the White House spun President Obama's attempt last week to tamp down the political brush fire that had erupted over requiring all health insurance plans — including those offered by Roman Catholic universities and hospitals — to include free birth control for women.

http://www.latimes.com/business/la-fi-lazarus-20120214,0,3357335,print.column

ICD-10 To Be Delayed Indefinitely--Never Mind!

After years of telling us they are serious this time and everyone in the health care system had better be ready on time to implement the new disease coding system, CMS said today the whole project is going to be delayed indefinitely.

The new ICD-10 system requires payers and providers to convert from the old system of 13,000 codes to the new system of 68,000 codes.

http://healthpolicyandmarket.blogspot.com/2012/02/icd-10-delayed-indefinitely-never-mind.html

Toward an unhealthy Maine

Posted Feb. 13, 2012, at 10:29 p.m.

Depending on how the current struggles and compromises over the Maine budget come out, one of the big losers can be the Fund for a Healthy Maine, which receives the state’s annual share of a 1998 multibillion-dollar lawsuit settlement with the four largest cigarette companies.

Maine gets about $50 million a year “in perpetuity” from the tobacco settlement as reimbursement for past tobacco-related health costs. The settlement allowed the states to use the payments for any purpose. Some have used the payments chiefly to balance their state budgets.

Maine has been a leader in restricting its use to health-related programs. In a 1999 law, Maine created the Fund for a Healthy Maine to receive the tobacco payments and specifies that “allocations are limited to the following health-related purposes.” It then lists eight programs starting with smoking prevention and winding up with school health and nutrition programs.

http://bangordailynews.com/2012/02/13/opinion/editorials/toward-an-unhealthy-maine/print/

Autoworkers’ Health Claims Offer Clues To Regional Spending Variations

Why does health care cost more in some areas of the country than others? It’s a question researchers have struggled with for decades, because the potential answers — unnecessary surgeries, generally bad health of patients or high prices charged by providers — each carry different prescriptions for how to hold down medical costs.
Now a new study from the Center for Studying Health System Change takes a novel approach by comparing claims among 218,000 autoworkers in 19 metropolitan areas. Because the autoworkers had the same private health plan through their union, the study didn’t have to worry about how different insurance benefits influenced health spending.
http://capsules.kaiserhealthnews.org/index.php/2012/02/autoworkers-health-claims-offer-clues-to-regional-spending-variations/

Health Care Reform Articles - February 13, 2012

2012-02-10T08:02:00.000-08:00

February 10, 2012
AHIP Hooray!
By Jacob Bor, Heather Lanthorn, and John Quattroch
If you were anywhere near Harvard Business School last Saturday you might have seen a 12-foot tall puppet dancing to accordion music while a merry band of “Congresspeople” and “health insurance executives” swilled champagne, showered each other in cash and sang round after round of “For She’s A Jolly Good Fellow.” If you weren’t near HBS, you missed a fantastic party. Here’s what happened:
Karen Ignagni, CEO of America's Health Insurance Plans, was greeted by this band of Occupy Harvard and Occupy Boston at the 9th Annual Healthcare Conference at HBS, where she was the keynote speaker. The merry band feted the insurance industry's lobbyist-in-chief with an impromptu gala, honoring Ms. Ignagni with an award for "Excellence in the Business of Denying People Medical Care." The revelers welcomed conference goers with cheers of "A-HIP-Hooray" and explained why Ms. Ignagni had been chosen for this ignominious award.
The award read: “Be it hereby known that Karen Ignagni has successfully upheld the interests of private insurance in the face of efforts to reduce the costs of administrative waste and to insure all Americans, preserving company rights to profit before the public’s right to health.”
http://www.thecrimson.com/article/2012/2/10/occupy-hbs-insurance/?print=1

February 12, 2012
Hospitals Flout Charity Aid Law
By NINA BERNSTEIN

For most of her life, Hope Rubel was a healthy woman with good medical insurance, an unblemished credit history and a solid career in graphic design. But on the day an ambulance rushed her to a Manhattan hospital emergency room shortly after her 48th birthday, she was jobless, uninsured and having a stroke.
Ms. Rubel’s medical problem was rare, a result of a benign tumor on her adrenal gland, but the financial consequences were not unusual. She depleted her savings to pay $17,000 for surgery to remove the tumor, and then watched, “emotionally paralyzed,” she said, as $88,000 in additional hospital bills poured in. Eventually the hospital sued her for the money.
http://www.nytimes.com/2012/02/13/nyregion/study-finds-new-york-hospitals-flout-charity-rules.html?hpw=&pagewanted=print

Our View: Compromise better than governor's proposal

1:00 AM

Lawmakers from both sides – and all of us – should be happy about the cuts not included.

It's a victory that no one will cheer. After weeks of around-the-clock struggle, the Legislature's Appropriations Committee has come up with a compromise that fixes the hole in theDepartment of Health and Human Services Budget while preserving key elements of the state's medical safety net.

http://www.pressherald.com/opinion/compromise-better-than-governors-proposal_2012-02-10.html

Bear witness to Medicaid misery

By Dr. Erik Steele

Posted Feb. 09, 2012, at 10:53 a.m.

To be poor and without health insurance in America is to walk largely out of sight in the dark alleys of health care waiting to get mugged by the thugs of ill health, inadequate care and societal indifference. So the suffering that will result when thousands of Maine’s poorest residents — many our friends and family members — are cut off from their Medicaid health insurance a few months from now will be invisible to most of us. We will not be present when and where the uninsured ill will suffer for want of adequate care.

But I don’t want any of us to be lucky enough to have all of that resulting misery hidden from our view, so I propose that some of us bear witness to that suffering and then tell that truth in a way that makes it impossible to ignore. I propose that Maine’s health care community, its social services community, its law enforcement community, its media community, its academic community and all others who do not wish to stand by band together and refuse to let that suffering be invisible. I propose we tell the stories of the avoidable suffering that will result from these cuts every chance we get, to anyone who will listen and especially those who will not, whenever the opportunity presents.

http://bangordailynews.com/2012/02/09/health/bear-witness-to-medicaid-misery/print/

Health Care In Massachusetts: 'Abject Failure' Or Work In Progress?

Voters are hearing a lot about health care this year. Republicans want to make the 2012 elections a referendum on the health care law that President Obama signed two years ago.
That law was largely based on one that then-governor Mitt Romney signed into law nearly six years ago in Massachusetts.
Romney is now a GOP presidential contender, and that's made the Massachusetts universal health care law a political football. Romney's rival Rick Santorum recently called it "an abject failure."
But "Romneycare," as Santorum and others call it, isn't controversial in its home state. And a lot of people here don't call it Romneycare, because it took the support of a lot of other people – Democratic legislators, business leaders, insurers, hospitals and doctors, consumer groups – to get it passed.
http://www.npr.org/blogs/health/2012/02/13/146701343/health-care-in-massachusetts-abject-failure-or-work-in-progress?ft=1&f=1001

From factory worker to orderly: health care jobs mixed bag for economy

On any weekday morning 50 years ago, men and women in cities and towns across Maine and the nation could be seen filing through factory gates or up the steps to a mill or plant. Manufacturing was king. Americans made things the rest of the world wanted. And blue collar workers and their paychecks were the foundation of American prosperity.
The popular perception is that this era is over, and more is the pity. Such a pronouncement misses the more complex story.
A statistical milestone noted in the news last week was an emblem that many seized upon to further lament the demise of our manufacturing glory days. For the first time, health care jobs exceeded manufacturing jobs. The trend lines are clear and unrelenting.
http://bangordailynews.com/2012/02/12/opinion/from-factory-worker-to-orderly-health-care-jobs-mixed-bag-for-economy/print/

Health Care Reform Articles - February 9, 2012

2012-02-08T06:00:00.000-08:00

Check out this Lawrence O"Donnell clip about Medicare-For-All vs. PPACA. You'll have to get through a 30 second commercial first.
http://www.msnbc.msn.com/id/45755883/vp/46320398#46321122

DeLeo’s success with health reform

IT’S A battle some doubted would ever be waged, let alone won.

But now, municipal health reform, which lets cities and towns bring local health care plans into line with state offerings, is paying big dividends.

All told, first-year savings attributable to the reform, which passed in July, should easily exceed $100 million, says the Massachusetts Taxpayers Foundation. Health plan changes put in place in nine cities and towns since the reform was enacted are projected to save $30 million, some of which will be shared with local employees. Add in savings negotiated in another dozen once it became clear the issue was finally on Beacon Hill’s agenda - concessions catalyzed by impending reform, in other words — and the tally of estimated first year results grows by another $30 million.

http://www.bostonglobe.com/opinion/2012/02/08/deleo-success-with-health-reform/NcSvTEHFNItLXXYhn0PyMM/story.html

FEBRUARY 3, 2012, 6:00 AM

Health Care Payers Push Back Against Costs

By UWE E. REINHARDT

Uwe E. Reinhardt is an economics professor at Princeton. He has some financial interests in the health care field.

In a paper, “Divide et Impera: Protecting the Growth of Health Care Incomes (Costs),” published this month in the British journalHealth Economics, I summarize themes touched on here and there in several earlier posts on this blog.

Today’s Economist

Perspectives from expert contributors.

My argument in the paper is that what is often called overuse of health care by what are often described as excessively insured Americans — especially their use of high-cost, high-tech procedures — is at best a partial explanation for the high cost of American health care.

Yet cost-containment initiatives like high deductibles and co-insurance have taken use of health care as their chief target. These efforts will be only partly successful in controlling national health spending.

Equally important contributors to our high health spending, and probably more so, have been two other factors.

http://economix.blogs.nytimes.com/2012/02/03/health-care-payers-push-back-against-costs/?pagemode=print

Lawmakers reach deal on DHHS budget

AUGUSTA, Maine — Lawmakers reached an early morning deal Wednesday on an alternative budget proposal for the Department of Health and Human Services — a move that likely will send the budget to the House and Senate for votes next week.
Members of the Legislature’s Appropriations Committee came to an agreement on two controversial items that had stalled the process in recent days.
As part of a bipartisan compromise, the budget proposal caps MaineCare funding for childless adults, or non-categoricals, at $40 million by freezing enrollment and through natural attrition.
http://bangordailynews.com/2012/02/08/politics/lawmakers-reach-deal-on-dhhs-budget/

Our View: More than money behind MaineCare cuts

Posted: February 8
Updated: Today at 7:42 AM

The governor's latest outburst shows this is about welfare policy, not balancing the budget.

We should thank Gov. Paul LePage for finally setting the record straight. His proposal to fill a $221 million shortfall in the Department of Health and Human Services budget is not an attempt to balance the books or preserve the social safety net for people who really need it.
http://www.pressherald.com/opinion/more-than-money-behind-mainecare-cuts_2012-02-08.html

Survey shows where doctors shade the truth

Most physicians paint overly optimistic prognoses for their patients, and many have told lies or withheld information concerning their medical mistakes and financial relationships with drug companies and device manufacturers, according to a national survey conducted by researchers at Massachusetts General Hospital.
The 2009 survey of nearly 1,900 doctors, published yesterday in the journal Health Affairs, shows that many doctors do not adhere to the standards of medical societies and accreditation groups, which have long required doctors to be open and honest with their patients.
http://www.bostonglobe.com/metro/2012/02/08/doctors-often-lie-patients-and-hide-mistakes-survey-reveals/9ks09asGrDp5cMxL3zKc4O/story.html

What a healthcare-for-all system could look like

In a five-part series provided by nonprofit, donor-funded Colorado Public News, investigative journalists examine how Grand Junction, Colo., has emerged as a model of low-cost, high-quality, near-universal healthcare.
http://www.latimes.com/news/health/grandjunction/la-he-grand-junction-healthcare-intro,0,6905836.story

Health providers gird for DHHS cuts under compromise deal

By Jackie Farwell, BDN Staff

Posted Feb. 08, 2012, at 6:05 p.m.

Lawmakers may have reached a bipartisan deal to close a budget gap at the Department of Health and Human Services, but health care providers are still bracing for deep cuts.

Members of the Legislature’s budget committee pushed back against Gov. Paul LePage’s proposal to drop coverage and tighten eligibility for some MaineCare beneficiaries, but left intact cuts to reimbursement rates for hospitals. Under the deal passed unanimously early Wednesday morning, hospitals will lose $10.1 million over the next two years on services they provide to MaineCare patients.

Hospitals also face a second hit from cuts outlined by a streamlining task force, which called for another $3.1 million drop in reimbursements.

The federal government kicks in roughly $2 for every $1 the state spends on MaineCare, the state’s version of Medicaid. So the proposed cuts for hospitals mean a loss of nearly $40 million in state and federal monies combined.

“It’s going to be a challenge to meet these cuts,” said Jeff Austin, a lobbyist for the Maine Hospital Association.

http://bangordailynews.com/2012/02/08/news/state/health-providers-gird-for-dhhs-cuts-under-compromise-deal/print/

Baby survives, problems remain

Mainers from all economic classes should be grateful to the legislators who toiled for untold hours and summoned a spirit of public service and compromise for a greater good to reach adeal on the Health and Human Services budget.
There’s no telling how Gov. Paul LePage will respond; if he is wise, he will thank legislators for their work. If he is convinced that structural problems remain in the department’s budget, he must work to explain them to legislators and the public and craft a plan to fix them.
http://bangordailynews.com/2012/02/08/opinion/editorials/baby-survives-problems-remain/print/

Health Care Reform Articles - February 7, 2012

2012-02-06T08:49:00.000-08:00

Critics say hospitals cherry pick best-paying patients

When the oversized postcard arrived last August from Provena St. Joseph Medical Center promoting a lung cancer screening for current or former smokers over 55, Steven Boyd wondered how the hospital had found him.

http://www.kaiserhealthnews.org/Stories/2012/February/06/Hospitals-Mine-Patient-Records.aspx

The Battle for Vermont’s Health

By Wendell Potter

You can’t see them. They’re hidden from view and probably always will be. But the health insurance industry’s big guns are in place and pointed directly at the citizens of Vermont.

Health insurers were not able to stop the state’s drive last year toward a single-payer health care system, which insurers have spent millions to scare Americans into believing would be the worst thing ever. Despite the ceaseless spin, Vermont lawmakers last May demonstrated they could not be bought nor intimidated when they became the first in the nation to pass a bill that will probably establish a single-payer beachhead in the U.S.

http://www.nationofchange.org/print/5891

Medicare Advantage Premiums Drop an Average of 7% and Enrollment up 10%—That Must Make Republicans Just Want to Cry

Medicare Advantage would appear to be a fantastic success—senior premiums are dropping and enrollment is increasing.

Listening to Health and Human Services Secretary Sebelius last week, you would think private Medicare plans were a Democratic idea and this is their success. Many industry observers, including me, have worried that Medicare Advantage benefits would shrink and premiums would rise because the new health care law reduced federal payments to the plans by $136 billion over the next decade.
http://healthpolicyandmarket.blogspot.com/2012/02/medicare-advantage-premiums-drop.html

LePage blasts lawmakers again on DHHS budget - Maine news, sports, obituaries, weather - Bangor Daily News

AUGUSTA, Maine — Gov. Paul LePage, in his strongest words to date, criticized lawmakers Monday for drastically altering his initial budget proposal to cut $220 million from the Department of Health and Human Services and for putting forward a new plan “full of gimmicks and built on false savings.”
“Quite frankly, I believe this represents an abdication of their responsibility to the Maine people,” LePage said in a Monday afternoon press conference, his second in less than a week. “This is the exact same approach the Legislature has taken for the past 40 years and it hasn’t worked yet.”
http://bangordailynews.com/2012/02/06/politics/lepage-blasts-lawmakers-again-on-dhhs-budget/print/

5Health Care Reform Articles - February 5, 2012

2012-02-02T07:45:00.000-08:00

July 25, 2011

Their Zeal Changed Lives, if Not the System

By ABIGAIL ZUGER, M.D.

“Man down in the men’s washroom!” This cry is not part of the usual hospital soundtrack, but when Dr. David A. Ansell heard it as he sped down a corridor in the old Cook County Hospital in Chicago, he barely broke stride. He veered into the men’s room, tried the locked door of the stall where a crumpled body lay, hoisted himself up over the fetid contents of the adjacent toilet, balanced on the metal divider and prepared to descend and administer CPR.

That was when the disheveled corpse on the floor roared to life, a lighted cigarette dangling from one hand, and requested with vigorous profanity that Dr. Ansell remove himself from the premises.

http://www.nytimes.com/2011/07/26/health/views/26zuger.html?pagewanted=print

WEDNESDAY, FEBRUARY 1, 2012

The Wyden-Ryan Plan Will Be the Foundation for Serious Medicare Reform—and Maybe More

In two companion articles in January’s New England Journal of Medicine, Henry Aaron with Austin Frakt, and Joe Antos critique the Wyden-Ryan Medicare reform proposal.

Senator Ron Wyden (D-OR) and Representative Paul Ryan (R-WI) are proposing a hybrid Medicare reform proposal combing both Republican defined contribution free market principles—a premium support scheme—with Democratic defined benefit principles—a baseline guaranteed plan and premium support.

http://healthpolicyandmarket.blogspot.com/2012/02/wyden-ryan-plan-will-be-foundation-for.html

Posted: February 2
Updated: Today at 10:50 PM

Our View: Pair of meetings rock LePage's plans

The governor hears that he won't get Medicaid waivers, but there are alternatives.

Gov. LePage held two meetings with southern Maine Democrats this week, and he's not talking about what went on. But the governor can't be happy about what he heard.

http://www.pressherald.com/opinion/pair-of-meetings-rock-lepages-plans_2012-02-02.html

Insuring contraception is preventive care

The weighty cost of health care is driving equally weighty political debates, both in Maine as state government struggles with a budget shortfall in the Department of Health and Human Services, and nationally as the Affordable Care Act emerges as a key issue in this year’s presidential campaigns.
Although the cost of health insurance has gotten top billing, since it has hamstrung businesses from investing in other activities which could create jobs, at the heart of the discussion is the cost of care. Programs that encourage avoiding unhealthy activities — smoking, eating fatty foods — and encourage healthy activities — regular exercise, preventive medicine — have the potential to lower costs.
http://bangordailynews.com/2012/02/01/opinion/editorials/insuring-contraception-is-preventive-care/print/

Health Care Reform Articles - February 1, 2012

2012-02-01T06:06:00.000-08:00

JANUARY 30, 2012, 9:00 PM

The End of Health Insurance Companies

By EZEKIEL J. EMANUEL and JEFFREY B. LIEBMAN

Ezekiel J. Emanuel on health policy and other topics.

Tags:

health care reform, Health insurance, Medicine and Health

Here’s a bold prediction for the new year. By 2020, the American health insurance industry will be extinct. Insurance companies will be replaced by accountable care organizations — groups of doctors, hospitals and other health care providers who come together to provide the full range of medical care for patients.

Already, most insurance companies barely function as insurers. Most non-elderly Americans — or 60 percent of Americans with employer-provided health insurance — work for companies that are self-insured. In these cases it is the employer, not the insurance company, that assumes most of the risk of paying for the medical care of employees and their families. All that insurance companies do is process billing claims.

http://opinionator.blogs.nytimes.com/2012/01/30/the-end-of-health-insurance-companies/?pagemode=print

Keeping It Clean: Maine’s Fight for Fair Elections

For more than a decade, a groundbreaking Clean Elections law has helped protect Maine politics from the influence of big money. But what’s happening now that big spenders have free rein to influence elections—and what does it mean for the rest of the country?

by Brooke Jarvis

http://www.yesmagazine.org/people-power/keeping-it-clean-maines-fight-for-fair-elections

January 31, 2012

Breast Cancer Surgery Rules Are Called Unclear

By DENISE GRADY

Nearly half of women who had lumpectomies for breast cancer had second operations they may not have needed because surgeons have been unable to agree on guidelines for the most common operation for breast cancer, a new study finds. It also hints that some women who might benefit from further surgery may be missing out on it.

Rates of repeat surgery can vary widely by doctor, from zero percent to 70 percent, according to the study.

http://www.nytimes.com/2012/02/01/health/repeat-breast-cancer-surgery-guidelines-found-unclear.html?hpw=&pagewanted=print

DHHS shortfall is budget problem, not welfare problem

Posted Jan. 31, 2012, at 4:21 p.m.

It’s a budget problem, not a DHHS problem.

That simple truth should guide members of the Legislature’s Appropriations Committee as they consider Gov. Paul LePage’s proposal to close a $220 million gap in the Department of Health and Human Services budget. Certainly the shortfall is real, and certainly the state can and should consider changing the level of health assistance it provides the needy.

But the governor has defined the problem in very narrow terms, ignoring about $150 million in tax cuts his first budget, signed last year, will provide. Those cuts include a reduction in the top income tax rate from 8.5 percent to 7.95 percent, and a bump in the threshold at which the estate tax kicks in from $1 million to $2 million. Some of the tax changes could be delayed.

http://bangordailynews.com/2012/01/31/opinion/editorials/dhhs-shortfall-is-budget-problem-not-welfare-problem/print/

January 31, 2012

Cancer Group Halts Financing to Planned Parenthood

By PAM BELLUCK

In a decision that is inflaming passions on both sides of the abortion debate, the world’s largest breast cancer organization, Susan G. Komen for the Cure, is cutting off its financing of breast cancer screening and education programs run by Planned Parenthood affiliates.

The move will halt financing to 19 of Planned Parenthood’s 83 affiliates, which received nearly $700,000 from the Komen foundation last year and have been receiving similar grants since at least 2005.

Planned Parenthood contends that the Komen foundation is yielding to longstanding pressure from anti-abortion groups, which Komen denies.

A spokeswoman for the Komen foundation, Leslie Aun, told The Associated Press that the main factor in the decision was a new rule adopted by Komen that prohibits grants to organizations being investigated by local, state or federal authorities. Ms. Aun told The A.P. that Planned Parenthood was therefore disqualified from financing because of an inquiry being conducted by Representative Cliff Stearns, Republican of Florida, who is looking at how Planned Parenthood spends and reports its money.

http://www.nytimes.com/2012/02/01/us/cancer-group-halts-financing-to-planned-parenthood.html?hpw=&pagewanted=print

Health Care Reform Articles - January 31, 2012

2012-01-30T07:56:00.000-08:00

JANUARY 26, 2012, 10:48 AM

Health Insurance Deductibles Doubled in 7 Years, Study Finds

By ANN CARRNS

Commonwealth Fund

1/27/12 | Updated Headline adjusted to more accurately reflect the article.

If you’ve seen your health insurance premiums increase along with your deductible, you’re not alone. A recent study by the Commonwealth Fund shows just how much more consumers are paying for employer-provided health insurance.

Total premiums — the amount paid by both employers and workers combined — for family coverage rose 50 percent from 2003 to 2010, to nearly $14,000 a year, the study found. (The fund is a private foundation that researches health policy issues. The report includes an interactive map showing premium increases by state.)

http://bucks.blogs.nytimes.com/2012/01/26/family-health-insurance-costs-doubled-in-7-years-study-finds/?pagemode=print

http://www.commonwealthfund.org/usr_doc/site_docs/slideshows/PremiumTrends2011/PremiumTrends2011.html

Another View: Market reforms will not result in health care for all in Maine

Yesterday at 12:00 AM

Federal and state programs will not achieve the savings promised by a single-payer system.

By JULIE PEASE, M.D.

For two years, while great effort has been spent debating health care reforms, costs for health insurance have continued to spiral out of control. Contrary to the assertions of Sen. Deborah Sanderson in a Dec. 30 column ("Legislature is tackling the causes of Maine's high health care costs"), there is simply no evidence to suggest that increasing competition in the for-profit insurance market will control health care costs, just as there is no evidence to suggest that federal reforms will be able to bring costs under control.
http://www.pressherald.com/opinion/market-reforms-will-not-result-in-health-care-for-all-in-maine_2012-01-30.html?searchterm=pease

The New Health Law Needs to Be Repealed, Expanded, and Replaced—So Long As It Doesn’t Have a Mandate

Last week’s State of the Union speech was notable because the President hardly mentioned the new health care reform law.

Avoiding what is supposed to be the centerpiece domestic accomplishment of President Obama’s first term stuck out like a sore thumb.

He said almost nothing because the Obama team simply doesn’t know what to say.
http://healthpolicyandmarket.blogspot.com/2012/01/new-health-law-needs-to-be-repealed.html

LePage health care proposalis shortsighted and costly

Yesterday at 12:00 AM

Dr. Laurel Coleman
The proposal by Gov. Paul LePage to eliminate health care coverage for extremely poor adults is shortsighted, and will result in a significant shift of costs to our communities and hospitals. More importantly, it will lead to increased suffering and shorter lives.
http://www.kjonline.com/opinion/lepage-health-care-proposalis-shortsighted-and-costly_2012-01-29.html

A Spoonful of Sugar: On the Affordable Care Act

Bernard Avishai | January 25, 2012

It is hard to read Remedy and Reaction, Paul Starr’s remarkable chronicle of the hundred-year effort to legislate universal health insurance in the United States, without recalling Robert Gibbs’s tortured quip that Democrats who’ve denounced the Obama White House for having knuckled under to Republican principles or intimidation “ought to be drug-tested.” Nobody with a sense of history—that is, nobody who reads Starr’s book—could doubt how sensible and brave was the president’s effort to drive the Patient Protection and Affordable Care Act of 2010 through Congress. Nobody with a feel for the present moment should doubt how imminent is the threat to the act, how urgent it is for progressive Democrats to rally around Obama—and without all the condescending qualifications that “independents,” who flock away from allegedly weak or incompetent leaders, interpret as contempt.

http://www.thenation.com/print/article/165864/spoonful-sugar-affordable-care-act

Medical spas are booming

They offer a variety of spa services using medical devices, and they are growing in popularity. But it’s up to the client to ask the right questions.

http://www.bostonglobe.com/lifestyle/health-wellness/2012/01/30/medical-spas-are-booming/EN79O1cjxxgN07LOJeQCzI/story.html

Pingree: LePage's Medicaid proposal 'illegal'

Posted: 10:21 AM
Updated: 10:36 AM

By Susan M. Cover scover@mainetoday.com
MaineToday Media State House Writer

AUGUSTA — Gov. Paul LePage's proposal to ask the federal government to allow Maine to reduce eligibility forMedicaid is "illegal" and isn't the answer to Maine's budget crisis, U.S. Rep.Chellie Pingree, D-1st District, said this morning.

http://www.pressherald.com/news/Pingree-LePages-Medicaid-proposal-illegal.html

Health Care Reform Articles - January 30, 2012

2012-01-27T13:43:00.000-08:00

latimes.com

Karen Fairbank has cataracts and is scheduled for surgery in March at UCLA's Jules Stein Eye Institute. With her high-deductible Blue Shield of California policy, she was facing about $3,000 in out-of-pocket expenses.

But with a contract dispute between Blue Shield and UCLA showing no sign of resolution, Fairbank, 59, of Pacific Palisades found herself looking at more than $12,000 in costs because the insurer said it wouldn't cover the operation.
http://www.latimes.com/business/la-fi-lazarus-20120127,0,4471450,print.column

January 28, 2012

Ritalin Gone Wrong

By L. ALAN SROUFE

THREE million children in this country take drugs for problems in focusing. Toward the end of last year, many of their parents were deeply alarmed because there was a shortage of drugs like Ritalin and Adderall that they considered absolutely essential to their children’s functioning.

But are these drugs really helping children? Should we really keep expanding the number of prescriptions filled?

http://www.nytimes.com/2012/01/29/opinion/sunday/childrens-add-drugs-dont-work-long-term.html?_r=1&hpw=&pagewanted=print

Shocking injustice in health care

By Thomas Clairmont, M.D.
Letters, Portsmouth (N.H.) Herald, Jan. 27, 2012
Celebrating Martin Luther King Jr. Day should lead us to review some of what this great man said. Let's review three of his quotes:
"Of all the forms of inequality, injustice in health care is the most shocking and inhumane." With 65,000 Maine citizens about to be ejected from their Medicaid insurance, and 3,500 New Hampshire citizens with Medicaid eliminated from practices at Lakes Region Hospital, the time is long past to solve injustice in health care. You wouldn't know it from the recent primary, where the only "plan" to help you with health care was to repeal President Obama's Affordable Care Act and replace it with ... nothing.
"The time is always right to do the right thing."

http://www.pnhp.org/print/news/2012/january/shocking-injustice-in-health-care

Cost-controlled health coverage gaining ground

In just three years, a new way of paying for medical care has spread rapidly across Massachusetts, and now more than 1.2 million people are covered by plans that put providers on a budget in an effort to restrain health spending.
This means that about one in five Massachusetts residents are being treated by doctors working under these new cost-conscious arrangements, a Globe survey of insurers found - even before state lawmakers begin debating legislation to address soaring health insurance premiums by, in part, encouraging such plans.
http://www.bostonglobe.com/metro/2012/01/30/cost-controlled-health-coverage-gaining-ground-mass/awP5QMTXU5kzBULRMIYKiM/story.html

Health Care Reform Articles - January 27, 2012

2012-01-27T09:57:00.000-08:00

How the Health and Social Care Bill 2011 would end entitlement to comprehensive health care in England

By Allyson M. Pollock, et al.
The Lancet, Jan. 26, 2012

The National Health Service (NHS) in England has been a leading international model of tax-financed, universal health care. Legal analysis shows that the Health and Social Care Bill currently making its way through the UK Parliament[1] would abolish that model[2] and pave the way for the introduction of a US-style health system by eroding entitlement to equality of healthcare provision. The Bill severs the duty of the Secretary of State for Health to secure comprehensive health care throughout England and introduces competitive markets and structures consistent with greater inequality of provision, mixed funding, and widespread provision by private health corporations. The Bill has had a turbulent passage. Unusually, the legislative process was suspended for more than 2 months in 2011 because of the weight of public concern.[3] It was recommitted to Parliament largely unaltered after a “listening exercise”. These and more recent amendments to the Bill do not sufficiently address major concerns that continue to be raised by Peers and a Constitution Committee of the House of Lords,[4,5] where the Bill now faces one of its last parliamentary hurdles before becoming law.

http://www.pnhp.org/news/2012/january/how-the-health-and-social-care-bill-2011-would-end-entitlement-to-comprehensive-he

Top 5 percent of MaineCare recipients account for more than half the program’s cost - Maine news, sports, obituaries, weather - Bangor Daily News

Lillian Davis spends many of her nights at an Orono nursing home wide awake. Deceived by advanced dementia, the 83-year-old loses sleep for days on end tidying imagary messes in her room or talking to visitors who aren’t there. Sometimes, the nurses push her wheelchair under a table and lock the brakes so she can’t wander off, according to her daughter, Susan Davis.

http://bangordailynews.com/2012/01/27/health/top-5-percent-of-mainecare-recipients-account-for-more-than-half-the-programs-cost/print/

Debt, Deficit Denial: Why We Must Fix U.S. Health Care

By Glenn D. Braunstein, M.D.
The Huffington Post, Jan. 17, 2012
As partisans wrangle over fiscal matters like entitlements and taxes, what is getting overlooked is the more real and basic need to reform a huge and inefficient driver of America's economy: our health care delivery system. We spend far more than any other country on health care. Yet our citizens don't live as long as people in many other countries. Many of our health outcomes lag far behind other developed nations. The disparities in even basic care are too great between rich and poor. And too many Americans lack basic health insurance coverage.
The costs of providing health care in this country grow ever more painful and unsustainable. We spend $7,538 per person on health care, the highest rate in the industrialized world. That's more than twice the average amount spent by 15 countries analyzed by the Organization for Economic Cooperation and Development.
Even if you've still got a job with decent health insurance, skyrocketing costs affect you. Since 2001, the Kaiser Family Foundation reports, family health insurance premiums have increased 113 percent; annual premiums for employer-sponsored family health coverage grew to $15,073 this year, up 9 percent from last year.

http://www.pnhp.org/print/news/2012/january/debt-deficit-denial-why-we-must-fix-us-health-care

Health Care Reform Articles - January 26, 2012

2012-01-25T05:50:00.000-08:00

JANUARY 21, 2012, 5:41 PM
What We Give Up for Health Care
By EZEKIEL J. EMANUEL
Ezekiel J. Emanuel on health policy and other topics.
Tags:
Health insurance, Labor and Jobs, medicaid, Medicare, United States Economy
WHEN it comes to health care, most liberals are committed above all to ensuring that every American has insurance. In their view, the greatest achievement of the health care reform act passed under President Obama is to finally erase the moral stain of the United States’ being the only major developed country without universal coverage. But we also hold the questionable distinction of having the world’s most expensive health care system — what about cost control? For many liberals, that just sounds like a cover for heartless conservatives who care only about cutting benefits and not about helping people in need.
But liberals are wrong to ignore costs. The more we spend on health care, the less we can spend on other things we value. If liberals care about middle-class salaries, public education and other state-funded services, then they need to care about controlling health care costs every bit as much as conservatives do.
http://opinionator.blogs.nytimes.com/2012/01/21/what-we-give-up-for-health-care/?pagemode=print

Our for-profit health care system is broken

January 7

Last year, people woke up to the fact that corporate greed and injustice are hurting Americans.

We have a broken for-profit health care system. More than 50 million Americans are uninsured. Medicare and hospitals, along with other public programs like Medicaid, are under constant threat of new cuts by lawmakers. Meanwhile, last year, the nation's five largest for-profit health insurers netted $11.7 billion in profits, and their CEOs took $54.4 million in pay.

http://www.kjonline.com/opinion/letters/our-for-profit-health-care-system-is-broken_2012-01-06.html

January 24, 2012

Grief Could Join List of Disorders

By BENEDICT CAREY

When does a broken heart become a diagnosis?

In a bitter skirmish over the definition of depression, a new report contends that a proposed change to the diagnosis would characterize grieving as a disorder and greatly increase the number of people treated for it.

The criteria for depression are being reviewed by the American Psychiatric Association, which is finishing work on the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders, or D.S.M., the first since 1994. The manual is the standard reference for the field, shaping treatment and insurance decisions, and its revisions will affect the lives of millions of people for years to come.

http://www.nytimes.com/2012/01/25/health/depressions-criteria-may-be-changed-to-include-grieving.html?tntemail1=y&emc=tnt&pagewanted=print

Long-term-care insurance: Right for some, but not all

By Caroline E. Mayer, Kaiser Health News

Posted Jan. 25, 2012, at 8:08 a.m.

In the last years of Martin Privot’s life, his family had to start selling his assets to pay for his nursing home costs. “He needed 24-hour care and couldn’t be left alone,” recalls his daughter Toni Footer. “My biggest fear was we would run [through his money] and wouldn’t be able to provide the care that he needed.”

Privot died in 2008, from post-surgical complications and other ailments, before all his assets were depleted. Yet Footer, 61, says her dad’s experience “reinforced my already strong feelings that long-term-care (insurance) is a necessity.” The Rockville, Md., resident says she pays about $2,500 every year for such coverage for herself. “It’s expensive — in fact, it’s gone up twice — but it’s worth every penny. It provides a peace of mind that my family won’t have to struggle to find money to pay for my care.”

http://bangordailynews.com/2012/01/25/health/long-term-care-insurance-right-for-some-but-not-all/print/

JANUARY 25, 2012, 4:36 PM

Despite Generic Rivals, Branded Drugs Still Sell Well

By BRUCE JAPSEN

Though the loss of patent protection on a brand-name prescription drug tends to lead to a sharp drop in sales for that product in the United States, such older medicines have become a booming business for the pharmaceutical industry in emerging markets.

Take Abbott Laboratories, which on Wednesday, reported that one of its fastest growing business lines last year was that of established pharmaceuticals, or “branded generics” as they are known in the industry. Sales of such products, which include branded generics outside the United States, were up nearly 20 percent to $5.4 billion last year, the company said in a news release.

http://prescriptions.blogs.nytimes.com/2012/01/25/despite-generic-rivals-branded-drugs-still-sell-well/?pagemode=print

State releases report on single-payer plan

By CHRIS GAROFOLO / Reformer Staff

Posted: 01/24/2012 03:00:00 AM EST

Updated: 01/24/2012 07:23:43 AM EST

Tuesday January 24, 2012

BRATTLEBORO -- Officials in the process of overhauling Vermont's "unsustainable" health care system released a 21-page report on how the state will implement a single-payer plan within the next three to five years.

http://www.reformer.com/ci_19803543?IADID=Search-www.reformer.com-www.reformer.com

JANUARY 23, 2012, 4:16 PM

Doctors Refer More Patients to Specialists

By REED ABELSON

The specialist will see you now — and it’s one of the reasons that medical care has become more expensive.

In a study published Monday in Archives of Internal Medicine, an academic journal, researchers from Harvard Medical School found that the likelihood that a doctor referred a patient to another doctor, often a specialist, nearly doubled from 1999 to 2009.

http://prescriptions.blogs.nytimes.com/2012/01/23/doctors-refer-more-patients-to-specialists/?pagemode=print

Patient-Centered Care: What It Means And How To Get There

At a recent symposium concerning both saving money and improving patient care, Health Affairs Editor-in Chief Susan Dentzer stated, “It is well established now that one can in fact improve the quality of health care and reduce the costs at the same time.” This is exactly the principle behind the growing movement toward patient-centered care. Physicians practicing patient-centered care improve their patients’ clinical outcomes and satisfaction rates by improving the quality of the doctor-patient relationship, while at the same time decreasing the utilization of diagnostic testing, prescriptions, hospitalizations, and referrals. Patient-centered practitioners focus on improving different aspects of the patient-physician interaction by employing measurable skills and behaviors. This type of care can be employed by physicians in any specialty, and it is effective across disease types.
http://healthaffairs.org/blog/2012/01/24/patient-centered-care-what-it-means-and-how-to-get-there/

Progressive groups offer alternatives to LePage’s DHHS cuts

By Jackie Farwell, BDN Staff

Posted Jan. 25, 2012, at 3:27 p.m.

AUGUSTA, Maine — Opponents of Gov. Paul LePage’s plan to close a $220 million shortfall at the Department of Health and Human Services pitched alternatives Wednesday in the wake of the governor’s State of the State address.

Engage Maine, a coalition of progressive groups, proposed reforming MaineCare without dropping any recipients from the rolls and ending tax breaks for Maine’s wealthiest residents. The coalition said it hoped to spark conversation about responsible ways to address the shortfall without sacrificing services to Maine’s elderly, disabled, children and the poor.

“What Gov. LePage has presented is dangerous and irresponsible, which is really why we presented these alternatives,” Ben Dudley, executive director of Engage Maine, said by phone after a noontime press conference.

http://bangordailynews.com/2012/01/25/health/progressive-groups-offer-alternatives-to-lepages-dhhs-cuts/print/

Health Care Reform Articles - January 24, 2012

2012-01-23T19:27:00.000-08:00

Remington: ‘Sorry for your loss — here’s your bill’

With the family of deceased Canadian skier Sarah Burke facing a U.S. medical bill topping the value of an average Calgary home, I was reminded Friday of a quote by the late Justice Emmett Hall, a crusader for Canada’s public health-care system.

“We as a society are aware that the trauma of illness, the pain of surgery, the slow decline to death are burdens enough for the human being to bear without the added burden of medical or hospital bills penalizing the patient at the moment of vulnerability,” Hall wrote in a 1979 review of publicly funded health insurance.

To help Burke’s husband Rory Bushfield pay an expected $550,000 medical bill for nine days of intensive care in Utah, a website was set up by Burke’s agent asking for donations. The site had reached nearly $200,000 as of this writing Friday afternoon, prompting the Canadian Freestyle Ski Association to announce that the amount was enough that her family “will not have any financial burden related to her care.”

http://www.calgaryherald.com/opinion/Remington+Sorry+your+loss+here+your+bill/6029293/story.html

Park City Vantage Point Puts Tragedy of American Health Care in Vivid Relief

Grieving family of fallen Canadian skier Sarah Burke faces massive hospital bill it wouldn’t face at home.
PARK CITY, Utah — The journey I embarked on when I made the decision to leave a successful career in the health insurance business was a spiritual one. I can trace the decision to a true epiphany, to the very moment I saw hundreds of people standing, soaking wet, in long, slow-moving lines, waiting to get medical care that was being provided in animal stalls at a fairground in Wise County, Virginia.
It hit me immediately that had my circumstances been a little different when I was growing up near there, I could have been one of those people. It also hit me that the work I was doing as a spokesman for the insurance industry was making it necessary, at least in part, for those people to resort to such humiliation to get basic medical care. One of my responsibilities was to persuade Americans of the lie that most of the uninsured are that way by choice, that they have shirked their responsibility to themselves and their families. Nothing could have been further from the truth. Our so-called health care “system” had simply left them behind.
http://wendellpotter.com/2012/01/park-city-vantage-point-puts-tragedy-of-american-health-care-in-vivid-relief/

Santorum says Obama pushes doctors from Medicare

LADY LAKE, Fla. (AP) — Republican presidential candidate Rick Santorum on Monday warned Florida's seniors that the Democrats' health law would limit their access to doctors and dollars and criticized his main rivals for backing its requirement that younger Americans buy health insurance.
Santorum tried to draw a connection between Medicareand a key provision of the health care law, the so-calledindividual mandate, which doesn't affect older Americans because virtually all of them are already covered through the government program.
http://news.yahoo.com/santorum-says-obama-pushes-doctors-medicare-193527342.html

Attorney general warns of supplemental insurance scams

Posted Jan. 20, 2012, at 7:14 p.m.

AUGUSTA, Maine — Attorney General William J. Schneider is warning consumers about recent reports of calls from people claiming to represent supplemental health insurance offers.

Schneider said he has learned that Maine seniors have received phone calls from individuals claiming to be from Medicare or from the “health office.”

http://bangordailynews.com/2012/01/20/news/state/attorney-general-warns-of-supplemental-insurance-scams/print/

Health Care Reform Articles - January 23, 2012

2012-01-21T11:43:00.000-08:00

January 21, 2012

Chefs, Butlers, Marble Baths: Hospitals Vie for the Affluent

By NINA BERNSTEIN

The feverish patient had spent hours in a crowded emergency room. When she opened her eyes in her Manhattan hospital room last winter, she recalled later, she wondered if she could be hallucinating: “This is like the Four Seasons — where am I?”

The bed linens were by Frette, Italian purveyors of high-thread-count sheets to popes and princes. The bathroom gleamed with polished marble. Huge windows displayed panoramic East River views. And in the hush of her $2,400 suite, a man in a black vest and tie proffered an elaborate menu and told her, “I’ll be your butler.”

http://www.nytimes.com/2012/01/22/nyregion/chefs-butlers-and-marble-baths-not-your-average-hospital-room.html?hpw=&pagewanted=print

Published on Friday, January 20, 2012 by Common Dreams

Maine's Tea Party Governor: 'Slash Health and Human Services or I'll Close Schools'

- Common Dreams staff

Republican Governor of Maine and Tea Party favorite, Paul LePage, angered many residents of the northeast state Thursday when he said that if the legislature did not pass his proposed cuts to the Department of Health and Human Services' budget, he would order a statewide closure of public schools on May 1 of this year.

The Portland Press Herald reports:

The governor on Thursday held a town hall meeting in Lewiston after a day touring the region as part of his 12th Capitol for a Day event.

The Sun Journal reports that LePage, describing the DHHS budget gap as a "runaway train," told the audience that if the Legislature didn't ratify his proposed budget he would be forced to close the state's schools. It's unclear what authority he has to take such a measure.http://www.commondreams.org/headline/2012/01/20-3?print

Now Departed From The Centers For Medicare And Medicaid Services, Berwick Receives High Marks For His Tenure At Agency

Harris Meyer1

http://content.healthaffairs.org/content/early/2011/11/29/hlthaff.2011.1243

JANUARY 20, 2012, 6:00 AM

Is U.S. Health Spending Finally Under Control?

By UWE E. REINHARDT

9:36 a.m. | Updated to correct reference to lines in Chart 3.

Uwe E. Reinhardt is an economics professor at Princeton. He has some financial interests in the health care field.

“Growth in U.S. health spending remains slow in 2010” was the headline of a news release on Jan. 9 by the Centers for Medicare and Medicaid Services, part of the Department of Health and Human Services. At an increase of 3.9 percent over national health spending in 2009, “the rates of health spending growth in 2009 and 2010 marked the lowest rate in the 51-year history of the National Health Expenditure Accounts,” the release said.

Today’s Economist

Perspectives from expert contributors.

The news was quickly picked up and disseminated by news organizations, including The New York Times.

What is one to make of this development? Is it evidence that we have finally “broken the back of the health care inflation monster,” as former Secretary of Health and Human Services Margaret Heckler famously put it in 1984. That was just after the Reagan administration had introduced the current prospective case-based payments for hospital inpatient care but two years before the health care inflation monster returned with a vengeance.

The charts below provide a longer-run perspective on health spending in the United States. They are all based on the rich data tables released annually by the Office of the Actuary of the Centers for Medicare and Medicare Services.

http://economix.blogs.nytimes.com/2012/01/20/is-u-s-health-spending-finally-under-control/

A doctor to watch over you

In the new system of ‘global payments,’ patients will have more contact with their primary providers — like it or not

http://www.bostonglobe.com/lifestyle/health-wellness/2012/01/23/doctor-watch-over-you/u51KXNIHZPnlS3W3rFFCUK/story.html

Health Care Reform Articles - January 20, 2012

2012-01-19T05:55:00.000-08:00

Do we need to gut MaineCare?
By Philip Caper, Special to the BDN
Posted Jan. 19, 2012, at 1:30 p.m.
For more than a month, the Legislature has been focused on the governor’s proposal to cut $221 million from the Department of Health and Human Services budget by revoking Medicaid eligibility for about 65,000 low-income and disabled Mainers. His proposal has generated controversy, including marathon hearings, state house rallies, articles in many of Maine’s papers as well as a petition that garnered more than 8,000 signatures in less than two weeks, all opposing the cuts.
I hope our legislators are enjoying this exercise in democracy because, even if they are able to satisfactorily resolve the immediate crisis, they can look forward to a repeat performance in a year or two unless they have the courage, wisdom and bipartisanship to attack the fundamental flaws in the ways we finance and deliver health care services. Maine’s very real problems with MaineCare are only symptoms of defects in our overall health care system. The most visible signs are out-of-control costs and diminishing access to quality health care.
For the past few decades, insurance companies have been systematically pushing the least healthy off their rolls. As a result, many people have been forced to turn to public programs such as Medicaid, swelling its roles, or to their own inadequate resources. Predictably, the amount of uncompensated care facing hospitals and other providers is growing. The Maine Hospital Association recently sounded the alarm, warning that layoffs and further reductions in service would result from the proposed MaineCare cutbacks.

http://bangordailynews.com/2012/01/19/health/do-we-need-to-gut-mainecare/print/

MAINE COMPASS: Our health care system needs to stop being an illness care system

January 17

Thomas G. Bartol

Maine's Department of Health and Human Services is in crisis, and it has been proposed that health care coverage be cut to some 65,000 people in Maine.

Cutting services is an easy solution but one that is short-sighted. It's as if you have a hole in your car's gas tank and you decide to fill your tank less often to save money. The hole is still there draining precious fuel.

http://www.kjonline.com/opinion/columnists/our-health-care-system-needs-to-stop-being-an-illness-care-system_2012-01-16.html

JANUARY 19, 2012, 12:01 AM

Why Doctors Can’t Predict How Long a Patient Will Live

By PAULINE W. CHEN, M.D.

Constantini/Getty ImagesIs it possible to predict when a patient will die?

Slender, in her 60s and possessing the stoicism of someone who had single-handedly raised children in the toughest section of the city, our patient faced a difficult challenge of the medical kind. She had diabetes and such severe peripheral vascular disease that even the strongest antibiotics could not heal a long-standing foot infection. She needed an operation.

This grandmother who regularly held court in her hospital room with her extended brood also suffered from high blood pressure and heart disease, and all of us on the surgical team knew that operating would be no easy feat. We could amputate her infected foot, a relatively quick operation that would carry few risks, but she would never walk again. Or we could do an arterial bypass, a more complex operation that would save her leg but that might disable or even kill her before her surgical scars ever healed.

http://well.blogs.nytimes.com/2012/01/19/why-doctors-cant-predict-how-long-a-patient-will-live/?pagemode=print

baltimoresun.com

Four years ago, doctors at Chesapeake Urology Associates started ordering the most expensive kind of prostate-cancer therapy for many more of their patients.
Before 2007, the large, multi-office practice was prescribing the treatment, known as intensity modulated radiation therapy, for 12 percent of its prostate-cancer patients covered by Medicare, according to data compiled by a Georgetown University researcher. But starting in mid-2007, Chesapeake Urology's referral rate for IMRT more than tripled, rising to 43 percent of the Medicare cases.
http://www.baltimoresun.com/health/bs-bz-hancock-chesapeake-urology-20120114,0,4241674,print.column

DHHS cuts painful, but necessary, Commissioner Mayhew tells Husson crowd

By Jackie Farwell, BDN Staff

Posted Jan. 19, 2012, at 2:39 p.m.

BANGOR, Maine — Department of Health and Human Services Commissioner Mary Mayhew took a break from Augusta Thursday to defend controversial cuts to her agency’s budget in Bangor.

Mayhew has spent many hours in recent days before lawmakers, explaining Gov. Paul LePage’s plan to close an estimated $220 million shortfall in the DHHS budget by overhauling MaineCare. On Thursday, attendees at a breakfast event at Husson University quizzed Mayhew on many of the cuts also drawing attention in Augusta.

“As I’ve said about so many of the proposals that we have within the supplemental budget, these are painful decisions; there are consequences,” Mayhew said.

http://bangordailynews.com/2012/01/19/health/dhhs-cuts-painful-but-necessary-commissioner-mayhew-tells-husson-crowd/print/

Republican lawmakers urge action on LePage’s MaineCare cuts

By Jackie Farwell, BDN Staff

Posted Jan. 19, 2012, at 7:21 p.m.

AUGUSTA, Maine — Lawmakers sparred Thursday over Gov. Paul LePage’s plan to close an estimated $220 million budget gap at the Department of Health and Human Services.

Some Republicans lamented what they called an unwillingness by Democrats to nail down savings, while Democrats bristled at the prospect of cutting services for the needy while tax cuts are on the table.

“We have to start looking for how we’re going to pay for this,” said Rep. Kenneth Fredette, R-Newport. “Quite frankly, I think it’s time you step up to the table to address that.”

http://bangordailynews.com/2012/01/19/health/republican-lawmakers-urge-action-on-lepages-mainecare-cuts/print/

Patients With Normal Bone Density Can Delay Retests, Study Suggests

By GINA KOLATA

Bone loss and osteoporosis develop so slowly in most women whose bones test normal at age 65 that many can safely wait as long as 15 years before having a second bone density test, researchers report in a new study.

The study, published in Thursday’s issue of The New England Journal of Medicine, is part of a broad rethinking of how to diagnose and treat the potentially debilitating bone disease that can lead to broken hips and collapsing spines.

http://www.nytimes.com/2012/01/19/health/bone-density-tests-for-osteoporosis-can-wait-study-says.html?hpw=&pagewanted=print

Health Care Reform Articles - January 18, 2012

2012-01-18T06:55:00.000-08:00

In Dire Health
By Arnold Relman
The American Prospect, Jan. 13, 2012
Most people assume that insurance is an essential part of the health-care system. Some think it should be provided through public programs like Medicare, while others prefer to see it purchased from private insurance companies, but the majority believe that insurance is needed to help pay the unpredictable and often catastrophic expenses of medical care. That is why so much public policy focuses on extending coverage to as many people as possible and controlling its cost. I think this emphasis on insurance is mistaken. We would have a much better and more affordable health-care system if the reimbursement of medical expenses through public or private insurance plans was replaced by tax-supported universal access to comprehensive care, without bills for specific services and without insurance plans to pay those bills.

http://www.pnhp.org/print/news/2012/january/in-dire-health

Our for-profit health care system is broken

By John Benziger, M.D.Letters, Kennebec Journal (Augusta, Maine), Jan. 7, 2012
Last year, people woke up to the fact that corporate greed and injustice are hurting Americans.
We have a broken for-profit health care system. More than 50 million Americans are uninsured. Medicare and hospitals, along with other public programs like Medicaid, are under constant threat of new cuts by lawmakers. Meanwhile, last year, the nation's five largest for-profit health insurers netted $11.7 billion in profits, and their CEOs took $54.4 million in pay.
Private insurers succeed not by offering better healthcare. They maximize profits by charging high premiums, avoiding high-risk individuals, limiting services for those they do cover, and, whenever possible, shifting costs to other payers or to individuals in the form of high deductibles and co-payments.
http://www.pnhp.org/print/news/2012/january/our-for-profit-health-care-system-is-broken

Hospitals say LePage’s DHHS budget ignores debt owed them

By Jackie Farwell, BDN Staff

Posted Jan. 17, 2012, at 6:32 p.m.

AUGUSTA, Maine — As lawmakers grapple with the governor’s proposal to close a more than $120 million shortfall in the Department of Health and Human Services budget for the next six months, the funding gap could be twice as big.

The state owes hospitals $125 million through the remainder of this fiscal year, debt that has accumulated since 2009 as hospitals continue to serve Medicaid patients without being fully reimbursed by the state.

“The hospital debt has masked the true size of the problem, I think for a long time,” Jeff Austin, a lobbyist for the Maine Hospital Association, told lawmakers last week.

http://bangordailynews.com/2012/01/17/health/hospitals-say-lepages-dhhs-budget-ignores-debt-owed-them/print/

latimes.com

latimes.com/business/la-fi-get-thin-whistleblower-20120118,0,2725024.story
Workers at weight-loss surgery centers affiliated with the 1-800-GET-THIN ad campaign persuaded patients to have medically unnecessary surgeries and billed insurance companies for procedures that were never performed, a new lawsuit alleges.

Two women who formerly worked at surgery centers associated with the Lap-Band ad campaign also alleged that executives covered up mistakes that contributed to the Sept. 8 death of Paula Rojeski, a Lap-Band patient from Orange County.

The new lawsuit seeks damages from eight people, including brothers Michael and Julian Omidi, who the lawsuit says run the weight-loss business from offices in Beverly Hills. The lawsuit, filed Tuesday in Los Angeles County Superior Court, also seeks damages from 13 companies it says are controlled by the Omidis.
http://bangordailynews.com/2012/01/17/health/hospitals-say-lepages-dhhs-budget-ignores-debt-owed-them/print/

'Tiered' Insurance Confounds Consumers, Docs In Mass.

This story is part of a reporting partnership that includes WBUR, and Kaiser Health News.BOSTON — Sarah Bechta, a wife, mother and physician from Northborough, Mass. sat down at her kitchen table with a folder full of brochures, pages from insurance websites and a hand-drawn spreadsheet to try to find out if a new "tiered" health plan would be the cheapest option for her family.
A tiered plan would cut Bechta’s premium in half and "would save about $1,400 a year. It made me stop and think," she said.She started by comparing her premium for traditional insurance and a tiered plan. Tiered insurance is being offered by various companies in Massachusetts as a way to meet employers’ demands for cheaper insurance premiums.
http://www.kaiserhealthnews.org/Stories/2012/January/17/Mass-Tiered-Insurance.aspx

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