Pages

Wednesday, February 15, 2012

Health Care Reform Articles - February 15, 2012

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.



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.


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

David Lazarus
February 14, 2012
advertisement

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.

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.

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.



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/


Posted by at No comments:

Friday, February 10, 2012

Health Care Reform Articles - February 13, 2012

February 10, 2012

AHIP Hooray!

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.”




February 12, 2012

Hospitals Flout Charity Aid Law

By 

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.

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.




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.



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/




Posted by at No comments:

Wednesday, February 8, 2012

Health Care Reform Articles - February 9, 2012

Check out this Lawrence O"Donnell clip about Medicare-For-All vs. PPACA.   You'll have to get through a 30 second commercial first.


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.

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.


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.


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/







Posted by at No comments:

Monday, February 6, 2012

Health Care Reform Articles - February 7, 2012

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.


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.


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/


Posted by at No comments:

Thursday, February 2, 2012

5Health Care Reform Articles - February 5, 2012

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.


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.



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/
Posted by at No comments:

Wednesday, February 1, 2012

Health Care Reform Articles - February 1, 2012

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:

, , 
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.


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?




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 


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.

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.

January 31, 2012

Cancer Group Halts Financing to Planned Parenthood

By 
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.


Posted by at No comments:
Subscribe to: Posts (Atom)