Health Care Reform Articles - January 31, 2012

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The New Health Law Needs to Be Repealed, Expanded, and Replaced—So Long As It Doesn’t Have a Mandate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http://healthpolicyandmarket.blogspot.com/2012/01/new-health-law-needs-to-be-repealed.html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. Coverscover@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

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

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

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

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

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

1. Harris Meyer1

1. 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