A Model of Health
NOVEMBER 7, 2011
Friday, December 30, 2011
Thursday, December 29, 2011
Health Care Reform Articles - December 29, 2011
Steward Health Care chain quits Mass. hospital group
For-profit chain says it can better advocate for its unique interests
http://www.bostonglobe.com/business/2011/12/29/steward-health-care-chain-quits-mass-hospital-group/s5eDWPGjiW6SxawZlclFFP/story.html
Blue Shield to pay $2 million over dropping of policyholders
The settlement of a suit filed by L.A. ends a probe into more than 1,000 cases. The insurer was accused of dropping clients who got ill and needed expensive treatment. The city and county will split the money.
By Lisa Girion, Los Angeles TimesDecember 29, 2011
Blue Shield has agreed to pay $2 million to resolve accusations that the company improperly dropped policyholders after they got sick and needed expensive treatment.
The settlement, announced Wednesday by Los Angeles City Atty. Carmen Trutanich, ends an investigation into more than 1,000 so-called rescissions by Blue Shield, a San Francisco-based not-for-profit company.
Blue Shield spokesman Steve Shivinsky said the firm settled to avoid litigation.
http://www.latimes.com/news/nationworld/nation/la-me-blue-shield-20111229,0,7711606,print.story
Hospital is facing a bleak prognosis
A Victorville hospital has agreed to deals with Prime Healthcare, which has a record of stripping out low-margin or unprofitable medical services.
Michael HiltzikDecember 28, 2011
http://www.latimes.com/business/la-fi-hiltzik-20111228,0,3750553,print.column
Awards for health care reform wimpery and obfuscation
Created Wednesday, December 28, 2011
By Wendell Potter
iWatch News, Dec. 22, 2011
I'm sitting by the hospital bed of a grateful Medicare beneficiary — my mother. She seems to be making progress in her battle against pneumonia, and she doesn't have the worry that many other patients here have about how they are going to pay their medical bills. Because private insurance companies and employers have shifted so many Americans into high-deductible plans, many of the younger patients here will soon find out that they are terribly underinsured and thus will be on the hook for thousands of dollars not covered by their policies.
Earlier today I went to the gift shop to buy Mom a brush. Amid the Christmas candy, cards and cheap do-dads near the cash register was a basketful of something that brought back a painful holiday memory: little lacquered lumps of coal.
Several years ago, a friend who had been in the habit of giving me a biography of some long-dead politician or literary figure surprised me by giving me instead a Christmas stocking with nothing but a lump of coal in it. In her opinion, I had been such a jerk during the year I didn't deserve anything else.
That lump of coal was probably the best present I've ever received. I was so wounded I resolved to be a better, more thoughtful person. I’m still working on that.
So knowing from personal experience how beneficial lumps of coal can be at the holidays, I have decided to give out a few lumps of my own to folks whose recent actions make them deserving recipients.
http://www.pnhp.org/print/news/2011/december/awards-for-health-care-reform-wimpery-and-obfuscation
WWLP News, Channel 22 NBC, Dec. 15, 2011
BOSTON - Five years after redrawing the lines in the national health care debate, Beacon Hill is looking at new reforms, closely studying payment system plans to lower costs and examining a government controlled single-payer model.
“We will end up with a government option at some point. We will end up with a single-payer at some point, and wouldn’t it be wonderful if that point was now, and the place was Massachusetts?” said Sen. Dan Wolf (D-Harwich) at a Thursday afternoon legislative hearing.
http://www.pnhp.org/print/news/2011/december/advocates-push-for-public-health-care
iWatch News, Dec. 22, 2011
I'm sitting by the hospital bed of a grateful Medicare beneficiary — my mother. She seems to be making progress in her battle against pneumonia, and she doesn't have the worry that many other patients here have about how they are going to pay their medical bills. Because private insurance companies and employers have shifted so many Americans into high-deductible plans, many of the younger patients here will soon find out that they are terribly underinsured and thus will be on the hook for thousands of dollars not covered by their policies.
Earlier today I went to the gift shop to buy Mom a brush. Amid the Christmas candy, cards and cheap do-dads near the cash register was a basketful of something that brought back a painful holiday memory: little lacquered lumps of coal.
Several years ago, a friend who had been in the habit of giving me a biography of some long-dead politician or literary figure surprised me by giving me instead a Christmas stocking with nothing but a lump of coal in it. In her opinion, I had been such a jerk during the year I didn't deserve anything else.
That lump of coal was probably the best present I've ever received. I was so wounded I resolved to be a better, more thoughtful person. I’m still working on that.
So knowing from personal experience how beneficial lumps of coal can be at the holidays, I have decided to give out a few lumps of my own to folks whose recent actions make them deserving recipients.
http://www.pnhp.org/print/news/2011/december/awards-for-health-care-reform-wimpery-and-obfuscation
Want government-run single-payer system
By Andy Metzger, State House News ServiceWWLP News, Channel 22 NBC, Dec. 15, 2011
BOSTON - Five years after redrawing the lines in the national health care debate, Beacon Hill is looking at new reforms, closely studying payment system plans to lower costs and examining a government controlled single-payer model.
“We will end up with a government option at some point. We will end up with a single-payer at some point, and wouldn’t it be wonderful if that point was now, and the place was Massachusetts?” said Sen. Dan Wolf (D-Harwich) at a Thursday afternoon legislative hearing.
http://www.pnhp.org/print/news/2011/december/advocates-push-for-public-health-care
Tuesday, December 27, 2011
Health Care Reform Articles - December 28, 2011
Our View: MaineCare cuts may bring on federal fines
Posted: December 27Updated: Today at 6:57 PM
The governor is confident that Maine can get waivers, but the Legislature should ask for proof.
Gov. LePage says he is "absolutely confident" that he can get the federal waivers needed to make his proposed human services cuts legal under federal law, but we hope the Legislature requires more than the governor's say-so
The Wyden-Ryan Plan: Déjà Vu All Over Again
By UWE E. REINHARDTUwe E. Reinhardt is an economics professor at Princeton. He has some financial interests in the health care field.
After wrestling for decades and in futility with the triple problems facing health care in the United States – unsustainable spending growth, lack of timely access to health care for millions of uninsured Americans and highly varied quality of care – any new proposal to address these problems is likely to be a recycled old idea.
The widely discussed new proposal from Senator Ron Wyden, Democrat of Oregon, and Representative Paul D. Ryan, Republican of Wisconsin, to restructure the federal Medicare program for the elderly is no exception.
DECEMBER 26, 2011
Can Occupy and Labor Unite on Health Care?
The Bi-Partisan Attack on Medicare
Politicians are attacking Medicare and Medicaid on all sides–Democrats and Republicans alike. Obama’s national health care bill will slash hundreds of billions from Medicare over the next decade, an act supported by so-called “progressive” Democrats. Soon after this “victory” Obama created the Super Committee to balance the budget, which included automatic “triggers”– if no decision was reached – that are now slated to cut $600 billion more from Medicare.
On a state-by-state basis, Medicaid – a program that provides health care to the poor – is being cut in virtually every state, where they are using their manufactured budget crises as an excuse. This under-funding of Medicaid has created a lack of doctors for patients, according to USA today: ”With a shortage of doctors…[Medicaid] patients have little choice but to use hospital emergency rooms for more routine care.” (July 5th, 2011).
The High Cost of Failing Artificial Hips
By BARRY MEIER
The most widespread medical implant failure in decades — involving thousands of all-metal artificial hips that need to be replaced prematurely — has entered the money phase.
Medical and legal experts estimate the hip failures may cost taxpayers, insurers, employers and others billions of dollars in coming years, contributing to the soaring cost of health care. The financial fallout is expected to be unusually large and complex because the episode involves a class of products, not a single device or just one company.
BUSINESSHighmark looks to expand hospital and physician ownershipThe Pittsburgh-based insurer, in a dispute with the area's largest hospital system, wants to occupy what it calls the "provider space."By EMILY BERRY, amednews staff. Posted Dec. 26, 2011. |
Sunday, December 25, 2011
Health Care Reform Articles - December 26, 2011
Full Circle America: An elder care alternative
Posted: December 25Updated: Today at 7:37 PM
Combining surveillance with a support network and lower costs, the company's services appeal to seniors who want to stay at home.
ROCKLAND - Framed needlepoints cover the walls of Patty Gardner's living room, where she and Marian White sit and work on their embroidery every Monday.
Health care
Periods of dramatic change can create new opportunities, and this is especially true in the health care sector. Composed of companies that make or deliver health-related products and services, this sector is generally less sensitive to swings in the economy than other, more cyclical sectors. While even health care faces secular headwinds, the potential solutions to these problems offer opportunities for investors.
- Theme 1: Increased health care utilization
- Theme 2: Deflationary business models
- Theme 3: Personalized medicine
https://guidance.fidelity.com/viewpoints/healthcare-sectors-2012?print=true
For GOP, ‘repeal and replace’ has been nothing but a mantra on health-care law
By David A. Fahrenthold,
More than a year after Republicans first pledged to “repeal and replace” President Obama’s new health-care law, the GOP is still struggling to answer a basic question.
Replace it . . . with what?
The Haves’ Children Are Healthier Than the Have-Nots’
By KATHARINE MIESZKOWSKI
Every Monday, Sycamore Valley Elementary in Danville challenges its students to run a “Smile Mile” together after school. Some parents even run with their children. Photos of the student joggers’ grinning faces are posted in the cafeteria. On a recent Monday afternoon, there were 41 smiling faces on the wall.
Students at Sycamore Valley have a lot to be happy about when it comes to their physical fitness. Fifth graders there got the best scores among all of their Bay Area peers on the 2011 statewide Physical Fitness Test.
Eighty-three percent of the fifth graders tested at Sycamore Valley aced the test by receiving healthy scores on all six different measurements — of aerobic capacity, abdominal strength, upper body strength, trunk strength, body composition and flexibility, most of them gauged through physical activity. One part of the Physical Fitness Test measures a child’s body composition, usually through body mass index, which is calculated using weight and height and is used to determine who is overweight.
Statewide, only 31 percent of public school students performed as well, according to the California Department of Education.
Robert Ader, Who Linked Stress and Illness, Dies at 79
By PAUL VITELLO
Dr. Robert Ader, an experimental psychologist who was among the first scientists to show how mental processes influence the body’s immune system, a finding that changed modern medicine, died on Tuesday in Pittsford, N.Y. He was 79.
Providers accepting moderate increases
By Robert WeismanMassachusetts insurers, taking a tougher line in bargaining with health care providers under pressure from financially strained customers and government regulators, have held payment increases to the lowest level in years.
Contracts negotiated in 2011 gave hospitals and doctors groups average fee increases of 2 to 3 percent, roughly half those given in 2010 and less than in any year since 2005, according to estimates by executives of the state’s three largest health insurers.
http://www.bostonglobe.com/business/2011/12/26/health-insurers-curtail-rise-fees/oLGI1RexwZNwigWLIHBruJ/story.html
He speaks his mind on health
Dr. Salah D. Salman
Dr. Salah D. Salman
WHAT
Q. You raise a lot of questions in your book about the quality of the American medical system. Is our system worse than we think it is?
http://www.bostonglobe.com/lifestyle/health-wellness/2011/12/26/speaks-his-mind-health/e6G1OPTRmg2bZA71iPwf8J/story.html
Let's say you have a Ford and decide to replace everything under the hood with Hyundai parts, including the engine and transmission. Could you still honestly market your car as a Ford?
That question gets at the heart of the controversy over who is being more forthright about GOP Rep. Paul Ryan's plan to "save" Medicare, Republicans or Democrats.
If you overhaul the Medicare system like you did your Ford and tell the public it's still Medicare, are you doing so honestly?
Saturday, December 24, 2011
Health Care Reform Articles - December 24, 2011
Medicaid Cuts Are Part of a Larger Battle in Maine
By ABBY GOODNOUGH
AUGUSTA, Me. — At a town hall meeting in the rural western part of the state last week, a woman asked Gov. Paul R. LePage if he could confirm a worrying rumor she had heard: that poor out-of-staters flock here because the public benefits are so generous.
Yes, he could. “If you come across from New Hampshire at 8 o’clock in the morning, by 4 o’clock in the afternoon you will have subsidized housing in the state of Maine,” the governor declared. “We need to change the rules.”
Mr. LePage, a first-term Republican whose destitute childhood is a well-known piece of his biography, is seeking to do just that. Calling the state’s entitlement system “a runaway train,” he has proposed contentious changes, including some of the most drasticMedicaid cuts in the nation.
BOSTON CAPITAL
The state’s big Medicare experiment
Hospitals Adopt Drug Industry Sales Strategy
In northwest Indiana, Carrie Sota visits five or six doctors' offices every work day as part of her new sales job.
Carrie Sota, of the University of Chicago Medical Center, pays a "sales call" to Dr. Amit Joshi, a family doctor in Orland Park, Ill. (Photo by John Zich/USA Today)
But Sota isn't selling the physicians on a prescription drug or a medical device. She's promoting her hospital — the University of Chicago Medical Center.
Sota is one of four employees the academic medical center has hired in recent months to make "sales calls" on physicians in the hope that they will refer more patients to the hospital. "We are trying to build meaningful relationships," said Sota, who was previously a saleswoman for a small medical device company.
Insurer to reward patients for finding cheaper care
Harvard Pilgrim plan seeks to reduce costs
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