A Drumbeat on Profit Takers
By ABIGAIL ZUGER, M.D.
CAMBRIDGE, Mass. — The old crusaders are getting just a little creaky: Dr. Arnold S. Relman, 88, has a hearing aid and the hint of a tremor; Dr. Marcia Angell, 72, osteoporosis and arthritic hands. But their voices are as strong as ever.
Colleagues for decades, late-life romantic partners, the pair has occasionally, wistfully, been called American medicine’s royal couple — as if that contentious Tower of Babel could ever support such a topper. In fact, controversy and some considerably less complimentary labels have dogged them as well.
From 1977 to 2000, one or both of them filled top editorial slots at The New England Journal of Medicine as it grew into perhaps the most influential medical publication in the world, with a voice echoing to Wall Street, Washington and beyond. Many of the urgent questions in the accelerating turmoil surrounding health care today were first articulated during their tenure.
Or, as Dr. Relman summarized one recent afternoon in their sunny condominium here, Dr. Angell nodding in agreement by his side: “I told you so.”
“I’ve allowed myself to believe that some of the things I predicted a long time ago are happening,” he said. “It’s clear that if we go on practicing medicine the way we are now, we’re headed for disaster.”
Hurray for Health Reform
By PAUL KRUGMAN
It’s said that you can judge a man by the quality of his enemies. If the same principle applies to legislation, the Affordable Care Act — which was signed into law two years ago, but for the most part has yet to take effect — sits in a place of high honor.
Now, the act — known to its foes as Obamacare, and to the cognoscenti as ObamaRomneycare — isn’t easy to love, since it’s very much a compromise, dictated by the perceived political need to change existing coverage and challenge entrenched interests as little as possible. But the perfect is the enemy of the good; for all its imperfections, this reform would do an enormous amount of good. And one indicator of just how good it is comes from the apparent inability of its opponents to make an honest case against it.
To understand the lies, you first have to understand the truth. How would ObamaRomneycare change American health care?
Gut Infections Are Growing More Lethal
By DENISE GRADY
Gastrointestinal infections are killing more and more people in the United States and have become a particular threat to the elderly, according to new data released last week.
Deaths from the infections more than doubled from 1999 to 2007, to more than 17,000 a year from 7,000 a year, the Centers for Disease Control and Prevention reported. Of those who died, 83 percent were over age 65.
Two thirds of the deaths were caused by a bacterium, Clostridium difficile, which people often contract in hospitals and nursing homes, particularly when they have been taking antibiotics. The bacteria have grown increasingly virulent and resistant to treatment in recent years.
Under Pressure, New York Moves to Soften Tough Medicaid Audits
By NINA BERNSTEIN
New York State was paying for the medical care of dead people when Gov. George E. Pataki and the State Legislature created the Office of the Medicaid Inspector General to curb billions of dollars in fraud and misspending by health care providers.
The turnaround was startling. Within four years the state had recouped $1.5 billion in Medicaid overpayments, the highest recovery rate in the nation. Other states rushed to create inspectors general like New York’s.
But a backlash from the politically powerful health care industry has erased broad support for the crackdown. Last year, amid a crescendo of provider complaints of overzealous, nitpicking audits and unfair tactics, Gov. Andrew M. Cuomo quietly dismissed the state’s first Medicaid inspector general, James G. Sheehan, and directed Mr. Sheehan’s successor, James C. Cox, to collaborate with providers on changes to the agency’s policies and auditing methods.
Gender Gap Persists in Cost of Health Insurance
By ROBERT PEAR
WASHINGTON — Women still pay more than men for the same health insurance coverage, according to new research and data from online brokers.
The new health care law will prohibit such “gender rating,” starting in 2014. But gaps persist in most states, with no evidence that insurers have taken steps to reduce them.
For a popular Blue Cross Blue Shield plan in Chicago, a 30-year-old woman pays $375 a month, which is 31 percent more than what a man of the same age pays for the same coverage, according toeHealthInsurance.com, a leading online source of health insurance.
In a report to be issued this week, the National Women’s Law Center, a research and advocacy group, says that in states that have not banned gender rating, more than 90 percent of the best-selling health plans charge women more than men.
Mary Beth Senkewicz, deputy insurance commissioner in Florida from 2007 to 2011, said the findings were consistent with her observations.
How Obama’s health care law affects the lives of 7 Americans
Posted March 19, 2012, at 9:03 a.m.
CHICAGO — A father lost his job at a medical device company that is facing a new tax. A young woman got back on her parents’ insurance and was able to get surgery for an injury that could have hobbled her. A part-time sales woman stopped putting off a colonoscopy and cancer screenings and saved nearly $3,000 because health plans now must pay for preventive care without co-pays. A business owner received a tax rebate for providing health coverage to her employees.
As the U.S. Supreme Court prepares to hear arguments on President Barack Obama’s health care overhaul, The Associated Press spoke with a variety of people to hear their experiences so far with the landmark legislation, whose major provisions don’t take effect until 2014. Reporters asked: How has the health care law affected your life?
Here are snapshots of seven Americans:
Riley defends Obama health-care law
Posted Jan. 21, 2011, at 6:52 a.m.
LEWISTON, Maine – Health care costs are too high, but Americans aren’t healthier for it, according to the former director of the Governor’s Office of Health Policy and Finance.
She told a crowd at the Great Falls Forum Thursday that the federal government’s controversial health care reform law is the best way to change that.
“It’s taken a lifetime to pass health reform in this country,” Trish Riley said. “It is not perfect, no law ever is. But one choice would be, let’s take it — it doesn’t (fully) go into effect until 2014 — let’s take it as it goes, let’s see how it works, let’s fix what needs to be fixed as we go.”
Her comments came one day after the House of Representatives voted to repeal the health care reform law. The repeal effort is not expected to last through the Democrat-controlled Senate.
At Heart of Health Law Clash, a 1942 Case of a Farmer’s Wheat
By ADAM LIPTAK
WASHINGTON — If the Obama administration persuades the Supreme Court to uphold its health care overhaul law, it will be in large part thanks to a 70-year-old precedent involving an Ohio farmer named Roscoe C. Filburn.
Mr. Filburn sued to overturn a 1938 federal law that told him how much wheat he could grow on his family farm and made him pay a penalty for every extra bushel.
The 1942 decision against him, Wickard v. Filburn, is the basis for the Supreme Court’s modern understanding of the scope of federal power. It is the contested ground on which the health care case has been fought in the lower courts and in the parties’ briefs. And it is likely to be crucial to the votes of Justices Anthony M. Kennedy and Antonin Scalia, who are widely seen as open to persuasion by either side.
Publicity Push as Health Law’s Court Date Nears
By JENNIFER STEINHAUER and ROBERT PEAR
WASHINGTON — Republicans on Capitol Hill have put together a highly coordinated two-week renewed assault on the health care law, seizing on the legislation’s second anniversary and the next week’s oral arguments before the Supreme Court concerning its constitutionality.
On Monday, Congressional Republicans took to the floor of both chambers to denounce the law, presaging a vote in the House this week to dismantle the law’s payment advisory board, the 26th legislative attack on the law in the Republican-controlled House in the 112th Congress.
Daily news conferences are planned on the Hill next week, featuring state attorneys general, lawmakers who are physicians and others.
Republican members are also holding sessions on Twitter, making videos and scheduling television interviews day and night, with one veteran lawmaker, Senator Roy Blunt of Missouri, appearing on Fox News on Monday.
The States Get a Poor Report Card
State governments have long been accused of backroom dealing, cozy relationships with moneyed lobbyists, and disconnection from ordinary citizens. A new study suggests those accusations barely scratch the surface.
The study, issued Monday by a consortium led by the Center for Public Integrity, a nonpartisan watchdog group, found that most states shy away from public scrutiny, fail to enact or enforce ethics laws, and allow corporations and the wealthy a dominant voice in elections and policy decisions. The study gave virtually every state a mediocre to poor grade on a wide range of government conduct, including ethics enforcement, transparency, auditing and campaign finance reform. No state got an A; five received B’s, and the rest grades of C, D or F.
Major Trends in the U.S. Health Economy since 1950
N Engl J Med 2012; 366:973-977March 15, 2012
Comments open through December 31, 2012- Article
- Rapid advances in medical science and technology, substantial gains in health outcomes attributable to medical care, and budget-busting increases in health care expenditures fueled by private and public insurance have marked the past six decades of health care in the United States. As the country struggles to emerge from a multiyear financial and economic crisis, policymakers and the public have increasingly homed in on those skyrocketing health care expenditures. What lessons can be drawn from the evolution, since 1950, in the sources of payment and objects of expenditures in the health care arena?
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