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Wednesday, August 29, 2012

Health Care Reform Articles - August 31, 2012

Sharp Cuts in Dental Coverage for Adults on Medicaid

By 


BOSTON — Banned from tightening Medicaid eligibility in recent years, many states have instead slashed optional benefits for millions of poor adults in the program. Teeth have suffered disproportionately.
 Republican- and Democratic-controlled states alike have reduced or largely eliminated dental coverage for adults on Medicaid, the shared state and federal health insurance program for poor people. The situation is not likely to improve under President Obama’s health care overhaul: it requires dental coverage for children only.
Illinois became the latest state to drastically cut dental benefits last month, when Gov. Pat Quinn, a Democrat, cut $1.6 billion out of its $15 billion Medicaid budget, reducing adult dental coverage to emergency tooth extractions. The state, whose Medicaid program was considered among the most generous, also cut vision benefits, eliminated chiropractic and podiatry coverage and started requiring co-payments for drugs.
In about half the states, Medicaid now covers dental care only for pain relief and emergencies, according to a recent report by the Kaiser Commission on Medicaid and the Uninsured, a national health research group. Other states cover preventive exams and cleanings but not restorative services, like fillings and root canals.
The federal health care law generally prohibits states from tightening eligibility for Medicaid before 2014, when a vast expansion of the program to cover people with incomes up to 133 percent of the federal poverty line is supposed to take effect. But states are still allowed to cut optional benefits, like vision, dental and drug coverage. Whether to seek broader cuts is part of a contentious debate between Mr. Obama and Mitt Romney over the future of Medicaid and Medicare, the government health care program for older Americans.



Blame the Poor

By DAVID FIRESTONE
TAMPA, Fla. - Talking about dismantling health care for the poor might seem to clash with balloons and funny hats, but this is a Republican convention, so it fits right in with the celebratory mood.
Many in the parade of governors scheduled to speak tonight have long complained about how much they are forced to spend to keep poor people healthy, and the Republican platform has an answer for them: They can stop worrying.
Medicaid is a "black hole," the platform says, and is too big and too flawed to be run out of Washington. By turning it into a block grant program and letting the states do what they want with it (i.e., as little as possible), those annoying federal regulations can be deleted.

"Excessive mandates on coverage should be eliminated," said a draft of the platform, a signal to statehouses that anything goes.
Both Mitt Romney and Paul Ryan favor a block-grant system, but the draft platform goes even further in explaining how spending can be squeezed from the program. It's done largely by blaming the patient. Because 80 percent of health care spending is because of "lifestyle," the platform says - specifically smoking, obesity, and substance abuse - it's time to put more emphasis on "personal responsibility."
There's no explanation for how the states will deal with those annoying, expensive lifestyle decisions of poor people to be fat or addicted, but the notion is rich coming from the party that regularly denounces "nanny state" suggestions from public health officials to cut back on fat and salt.
No explanation is really necessary; the line simply holds up a mirror to simmering conservative resentment at subsidizing the problems of the poor. (Of course, by allowing employers a tax deduction for regular health insurance, taxpayers also subsidize the health decisions of everyone else, but that never seems to come up.)


Medicare arguments key for both parties

By Michael Kranish

 |  GLOBE STAFF
  AUGUST 30, 2012
TAMPA — Elections are usually about change. But one of Mitt Romney’s most important messages at the Republican convention this week might be this: “Nothing changes for current seniors or those nearing retirement.”
That is the mantra that the Romney campaign has been emphasizing since the pick of Paul Ryan. It is an effort to counter charges from President Obama’s campaign that the Wisconsin congressman’s proposal to replace Medicare with a voucher system — an idea also embraced by Romney — would hurt senior citizens. Romney’s campaign is spreading its message, particularly in senior-heavy states such as Florida, that its plan would not affect those 55 years and older.

The Vacuum Behind the Slogans



The party that claims to have all the answers on Medicare seemed to have no interest in sharing them with the American people at its convention on Wednesday. The session, devoted to the theme of “We Can Change It,” never went any deeper than that slogan or a few others: Reform Medicare. Strengthen Medicare. Protect Medicare.
All without the slightest hint of how that supposed reform or strengthening would take place, regarding that program and many others. “We will not duck the tough issues; we will lead,” said Representative Paul Ryan, in his speech accepting the vice-presidential nomination. “We will not spend four years blaming others; we will take responsibility.”
Sounds great, except that the speech ducked the tough issues and blamed others for the problems.
Mr. Ryan, who rose to prominence on the Republican barricades with a plan to turn Medicare into a voucher system, never uttered the word “voucher” to the convention. He said Medicare was there for his grandmother and mother, but neglected to say that he considers it too generous to be there in the same form for future grandmothers (while firmly opposing the higher taxes on the rich that could keep it strong). He never mentioned his plan to abandon Medicaid on the doorstep of the states, or that his budget wouldn’t come close to a balance for 28 years.
The reasons for that are clear: Details are a turn-off, at a boisterous convention or apparently in a full campaign. A New York Times poll last week showed that the Medicare plan advocated by Mr. Ryan and Mitt Romney was highly unpopular in the swing states of Florida, Ohio and Wisconsin. As soon as voters find out that the Republicans plan to offer retirees a fixed amount, they disapprove, clearly preferring the existing system.

The Medicare Killers


By PAUL KRUGMAN


Paul Ryan’s speech Wednesday night may have accomplished one good thing: It finally may have dispelled the myth that he is a Serious, Honest Conservative. Indeed, Mr. Ryan’s brazen dishonesty left even his critics breathless.
Some of his fibs were trivial but telling, like his suggestion that President Obama is responsible for a closed auto plant in his hometown, even though the plant closed before Mr. Obama took office. Others were infuriating, like his sanctimonious declaration that “the truest measure of any society is how it treats those who cannot defend or care for themselves.” This from a man proposing savage cuts in Medicaid, which would cause tens of millions of vulnerable Americans to lose health coverage.
And Mr. Ryan — who has proposed $4.3 trillion in tax cuts over the next decade, versus only about $1.7 trillion in specific spending cuts — is still posing as a deficit hawk.
But Mr. Ryan’s big lie — and, yes, it deserves that designation — was his claim that “a Romney-Ryan administration will protect and strengthen Medicare.” Actually, it would kill the program.
Before I get there, let me just mention that Mr. Ryan has now gone all-in on the party line that the president’s plan to trim Medicare expenses by around $700 billion over the next decade — savings achieved by paying less to insurance companies and hospitals, not by reducing benefits — is a terrible, terrible thing. Yet, just a few days ago, Mr. Ryan was still touting his own budget plan, which included those very same savings.
But back to the big lie. The Republican Party is now firmly committed to replacing Medicare with what we might call Vouchercare. The government would no longer pay your major medical bills; instead, it would give you a voucher that could be applied to the purchase of private insurance. And, if the voucher proved insufficient to buy decent coverage, hey, that would be your problem.


Plan to take over Brunswick hospital draws opposition from competion

By Christopher Cousins, BDN Staff
Posted Aug. 30, 2012, at 5:58 p.m.
BRUNSWICK, Maine — Central Maine Healthcare moved forward with plans to take over Parkview Adventist Medical Center in Brunswick with a filing Wednesday to the Department of Health and Human Services, though neighboring Mid Coast Hospital said Thursday that it will oppose the move with a counter-proposal.
Chuck Gill, vice president for public affairs for Central Maine Healthcare, which is the parent organization of Central Maine Medical Center in Lewiston as well as Bridgton and Rumford hospitals, said Thursday that he filed a Certificate of Need application with the state on Wednesday. He said he expects it will take up to three months for the state to approve or reject the application, which would give CMHC overarching administrative control of Parkview, though Parkview’s local board of directors would remain in place.
“There’s no money changing hands and we’re not buying anything,” said Gill. “This is a change of control application that’s been done multiple times in Maine and across the country.”
Lois Skillings, president and CEO of Mid Coast Hospital, which is located just a few miles from Parkview in Brunswick, said Mid Coast opposes Parkview’s merger with CMHC because the board of directors believes that control of a local hospital should remain in local hands. Furthermore, she said a Parkview/Mid Coast merger would reduce health care costs in the community by $22 million.
She told the Bangor Daily News during a recent interview that Mid Coast would file a competing application in the event that CMHC and Parkview moved forward with their proposal. Stephen Trockman, a spokesman for Mid Coast Health Services, said Thursday that an application would be filed “very soon.”
“We feel that it is time for our hospitals to work together to improve health care in our community,” said Skillings. “We feel very strongly that Central Maine Healthcare should not be allowed to take over Parkview. To me it’s like a lobsterman in Rockland putting traps around Bailey Island.”

Steward still waiting to close R.I. medical center deal

By Steven Syre

 |  GLOBE COLUMNIST
  AUGUST 31, 2012
Steward Health Care System turned heads when it managed to build a big system of hospitals across Massachusetts in no time flat.
Steward and its private equity owners assembled a network of 10 community hospitals in what passes for a blink of an eye in the pokey world of big health care. It moved like an Acela hurtling down the milk-train track and never felt so much as a bump.
Then Steward struck a deal more than 18 months ago to acquire a hospital in Rhode Island, its first foray outside Massachusetts, and things changed. The process of adding Landmark Medical Center of Woonsocket to the Steward portfolio moved a lot slower and got much nastier.

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Monday, August 27, 2012

Health Care Reform Articles - August 28, 2012

Massachusetts leads on health care while Maine regresses

By Philip Caper, M.D.
Bangor Daily News, Aug. 23, 2012

Massachusetts, the first state that attempted to offer health care to all its residents and provided the template for national health reform, recently took the inevitable and much more difficult next step.

It passed a law intended to restrain future growth in total statewide health care costs. Once government has adopted a policy of achieving universal health care, it must then take steps to maintain affordability.
 http://www.pnhp.org/news/2012/august/massachusetts-leads-on-health-care-while-maine-regresses


Why ObamaCare is Not Enough: Turning off the Demand for Health Care

by 

n the run up to the presidential election, the political debate is heating up around health care.  Recently the Supreme Court upheld the Affordable Care Act and the individual mandate, but the single biggest question is hauntingly absent from the campaign discourse.
How do we stop and turn back the tsunami of chronic disease, in particular, diabesity – the continuum of obesity, pre-diabetes, and diabetes that is the major driver of 21st century suffering and costs?
Diabesity is the hidden cause of most heart disease, hypertension, high cholesterol, stroke, dementia, many cancers (breast, colon, prostate, pancreas, liver, and kidney) and even depression. Yet is it almost never treated directly because there is no good drug for it.
In short, health care reform addressed the supply side of health care, making it more accessible and improving processes and systems to reduce inefficiencies and medical errors.
http://www.bostonglobe.com/lifestyle/health-wellness/2012/08/26/for-physicians-and-patients-time-best-medicine/ABqZSk3BogpFmfmF31EwyM/story.html?camp=newsletter


For $83, a sling and no simple answers

Patient’s complaint shows intricacies of medical purchasing

By Liz Kowalczyk

James Dichter awoke from elbow surgery in May and went home with a simple navy-blue cloth sling. When the bill for that sling arrived a month later, Dichter’s jaw dropped.
He discovered that his insurer had paid Surgi-Care, a Waltham medical equipment supplier, $83 for providing the item, which consists of two panels of thin cloth sewn together and a shoulder strap. His share was $25. Dichter, 59, a consultant with an MBA from the University of California Berkeley, suspected something was wrong with that price. He searched online and found a similar basic sling for $7.
He wondered why any insurer would pay nearly 12 times that amount. “Somewhere in our health care system,’’ he said, “common sense has left the building.’’

The Last Bipartisan


By 


WHEN I first encountered Ron Wyden in 1974, he was setting up the Oregon outpost of the Gray Panthers, a lobby group founded by the liberal activist Maggie Kuhn with a broad agenda but an emphasis on empowering the elderly. Wyden, who was 25, seemed improbably boyish to be a champion of senior citizens. But he radiated a winning, wonky exuberance. He was clearly bound for a life in politics. He won an insurgent campaign for a House seat in 1980, graduated to the Senate in 1996 — and now, at age 63, has spent almost exactly half his life on Capitol Hill.
If the name rings a bell, it’s probably because Senator Wyden — without really deserving it — has become a bumper sticker in the Republican presidential campaign. Wyden, an Obama Democrat, co-authored a Medicare reform proposal with Paul Ryan last year, a precursor to the Ryan budget plan that Democrats have pilloried as a heartless effort to throw grandma and grandpa off the train. When Romney and Ryan refer to their Medicare thinking as “bipartisan,” as they do ceaselessly, they mean Ron Wyden. In truth, Wyden never subscribed to the most draconian aspects of the Ryan blueprint, but the fact that the Romney-Ryan ticket uses his name as cover has not endeared Wyden to his own party. Charles Pope, the Washington correspondent for Wyden’s hometown paper, The Oregonian, began a thoughtful analysis of the senator’s predicament this way: “Trail blazer or traitor?”
We’ll get back to Medicare in a moment, but let’s linger a bit on what this episode tells us about the decline of the honorable craft of lawmaking.
AUGUST 27, 2012, 2:37 PM

Overtreatment Is Taking a Harmful Toll

By TARA PARKER-POPE
When it comes to medical care, many patients and doctors believe more is better.
But an epidemic of overtreatment - too many scans, too many blood tests, too many procedures - is costing the nation's health care system at least $210 billion a year, according to the Institute of Medicine, and taking a human toll in pain, emotional suffering, severe complications and even death.
"What people are not realizing is that sometimes the test poses harm," said Shannon Brownlee, acting director of the health policy program at the New America Foundation and the author of "Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer."
"Sometimes the test leads you down a path, a therapeutic cascade, where you start to tumble downstream to more and more testing, and more and more invasive testing, and possibly even treatment for things that should be left well enough alone."
Have you experienced too much medicine? As part of The New York Times's online series The Agenda, I asked readers to share their stories. More than 1,000 responded, with examples big and small.
Some complained that when they switch doctors they are required to undergo duplicate blood work, scans or other tests that their previous doctor had only recently ordered. Others told of being caught in a unending maze of testing and specialists who seem to forget the patient's original complaint. I heard from doctors and nurses, too - health professionals frustrated by a system that encourages these excesses.

Many Bone Tests for Some, and Too Few for Others

By RONI CARYN RABIN
Though Riva Schwartz, who manages a law office in Garden City, N.Y., has never broken a bone, she began receiving bone-density scans almost 10 years ago, when she turned 50. Eventually she was given a diagnosis of osteoporosis and started treatment. But every bone-building medication she took had side effects.
The bisphosphonate drugs often used to treat bone loss caused a severe flulike reaction that landed her in bed with fever and chills. When Mrs. Schwartz switched to a different drug, which she had to inject herself, she developed painful kidney stones.
Now she is taking a third medication. "I'm glad I'm getting treatment," said Mrs. Schwartz, 59, "but I'm the first one to say I'm a guinea pig."
Fractures in old age, and broken hips in particular, are a serious health problem. One in every two women will experience a fracture after the age of 50, and for those who break a hip, the injury can be life-altering, making a woman up to four times as likely to die within a year of the injury as she would be otherwise.
"People don't understand how serious it is to experience fractures late in life," said Dr. Ethel Siris, who heads the Toni Stabile Osteoporosis Center at Columbia University Medical Center and who was involved in osteoporosis studies funded by Merck. "When you break a hip at 80, it can be a life-ending experience."
About 7 percent of postmenopausal women will experience a hip fracture. A broken hip can lead to isolation and depression in addition to increasing the risk of dying, and many elderly people who break a hip will require nursing home care.
But recent reports suggest that too many younger women are being evaluated and treated for bone loss when they should not be.

Aspirin May Aid Cancer Recovery


By 


Men treated for prostate cancer who took aspirin regularly for other medical conditions were less likely to die of their cancer than patients who weren’t taking aspirin, according to a new study published on Tuesday in The Journal of Clinical Oncology.
The new report is not a randomized controlled clinical trial of the kind considered the gold standard in medicine, but it adds to an intriguing and growing body of evidence suggesting that aspirin may play a beneficial role in the treatment and possibly the prevention of a variety of cancers. Much of the earlier research on aspirin focused oncolon cancer.
“This is another piece of evidence suggesting aspirin does seem to have this effect against cancer across different body sites,” said Dr. Andrew T. Chan, an associate professor of medicine at Harvard Medical School, who studies the role of aspirin in preventing colorectal cancer but was not involved the new research.
In the new study, researchers used the national database of a project known as CaPSURE, for Cancer of the Prostate Strategic Urologic Research Endeavor, to look at nearly 6,000 men who had localized prostate cancer and were treated with surgery or radiotherapy. Just over one-third of the men, or 2,175 of the 5,955, were taking anticoagulants, mostly aspirin.
Those taking aspirin were less than half as likely as those who were not to die of prostate cancer over a 10-year period, researchers calculated; the prostate cancer death rate for those taking aspirin was 3 percent, the researchers found, compared with 8 percent for those who did not.

Republicans steal Medicare from the Democrats

By , Published: August 27

TAMPA
Who knew? In the hall-of-mirrors parallel universe where the Republican National Convention is taking place, the GOP stands tall and proud as the party of Medicare.
I’m still a little confused about the historical timeline in this alternate reality. Was it President Goldwater who signed into law the nation’s health-care guarantee for seniors? Was it President Dole who made sure the program remained solvent? Did John McCain win in 2008?
It must be that in RNC World, the past simply doesn’t exist. There is no other explanation for all the Great Society rhetoric coming from Republicans who once claimed to favor small government, limited entitlements and a balanced budget.
At a breakfast hosted by Bloomberg News on Monday morning, Mitt Romney’s campaign brain trust claimed to welcome a fight with President Obama over the future of Medicare. I say “claimed” because the Romney team surely recognizes that putting Rep. Paul Ryan (R-Wis.) on the ticket means not being able to run away from Ryan’s plan — endorsed by House Republicans — to transform Medicare into a voucher program.
This radical change would, as Democrats claim, “end Medicare as we know it.” Instead of the current guarantee that the program pays for medical costs, Ryan’s plan would give seniors a set amount of money each year to buy private health insurance. If that sum isn’t enough to pay for the necessary coverage — or to pay for traditional Medicare — seniors would have to make up the difference.
“I think we’re winning the Medicare battle because the facts are on our side,” said Eric Fehrnstrom, Romney’s communications chief. “It’s not usual that Republicans have the upper hand in this argument.”
To say the least.

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Friday, August 24, 2012

Health Care Reform Articles - August 26, 2012

Unhealthy Competition
Paul Ryans Plans to Reduce Health Care Costs by Using Competition Wont Work
by Peter Orzag

https://dl.dropbox.com/u/77156032/Unhealthy%20competition%20-%20Honolulu%20Star%20Advertiser-22%20Aug%202012%20-%20Page%20%2312.pdf


Controlling Health Care Costs in Massachusetts With a Global Spending Target FREE ONLINE FIRST

Robert Steinbrook, MD
JAMA. Published online August 22, 2012. doi:10.1001/2012.jama.11322



A Glitch in Health Care Reform



Confusing language in the health care reform law has raised the possibility that millions of Americans living on modest incomes may be unable to afford their employers’ family policies and yet fail to qualify for government subsidies to buy their own insurance. This is a bizarre development that undercuts the basic goal of health care reform — to expand the number of insured people and make their coverage affordable.
The people left in the lurch would be those who had lower incomes but were not poor enough to qualify for Medicaid. They would either have to pay more than they could afford for an employer’s family plan or go without health insurance. The problem arises because the reform law quite properly tries to keep people from dropping affordable employment-based coverage and turning to taxpayer-subsidized coverage on new insurance exchanges, starting in 2014. Only those with coverage deemed “unaffordable” by the health care act would be allowed to receive subsidies.
As Robert Pear reported in The Times recently, the law considers a worker’s share of the insurance premium unaffordable when it exceeds 9.5 percent of the worker’s household income. But that calculation is based on individual coverage for the worker alone, not family coverage, which is much more expensive. That is how the wording of the law has been interpreted by the Internal Revenue Service and the Congressional Joint Committee on Taxation.

Choosing the “Best” Plan in a Health Insurance Exchange: Actuarial Value Tells Only Part of the Story
Ryan LoRe, Jon R. GabeL, RoLand Mcdevitt, and MichaeL SLoveR
ABSTRACT: In the health insurance exchanges that will come online in 2014, consumers will be able to compare health plans with respect to actuarial value, or the percentage of health care costs that a plan would pay for a standard population. This analysis illustrates the out-of-pocket costs that might result from plans with various plan designs and actuarial values. We find that average out-of-pocket expense declines as actuarial values rise, but two plans with similar actuarial values can produce very different outcomes for a given person. The overall affordability of a plan also will be influenced by age rating, income- related premium subsidies, and out-of-pocket subsidies. Actuarial value is a useful starting point for selecting a plan, but it does not pinpoint which plan will produce the best overall value for a particular person.
http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2012/Aug/1626_Lore_choosing_best_plan_HIE_actuarial_ib_v2.pdf

Cuba squeezed by health care costs

1:00 AM 

Cuba's health sector has had millions of dollars in budget cuts and tens of thousands of layoffs.

The Associated Press
HAVANA - Cuba's system of free medical care, long considered a birthright by its citizens and trumpeted as one of the communist government's great successes, is not immune to cutbacks under Raul Castro's drive for efficiency.
http://www.pressherald.com/news/nationworld/cuba-squeezed-by-health-care-costs_2012-08-26.html


Pen Bay Medical Center working to cut down high readmission rates after Medicare penalty

By Stephen Betts, BDN Staff
Posted Aug. 25, 2012, at 11:27 a.m.
ROCKPORT, Maine — The new head of Pen Bay Healthcare said steps have been taken to address the high rate of patients who are readmitted to Pen Bay Medical Center after being treated there.
Pen Bay is one of 10 hospitals in Maine being penalized by Medicare for the high rate of readmissions. The Rockport hospital’s penalty is the highest in the state in terms of percentage of payments being withheld by the federally funded health care program.
The monetary penalty for Pen Bay will be $77,590 in 2012-2013, less than one-tenth of 1 percent of revenues received by the hospital.
Medicare is imposing penalties of up to 1 percent starting Oct. 1 for hospitals with greater than acceptable rates for patients who are admitted to the hospital within 30 days of being discharged. The penalty increases to a maximum of 2 percent in October 2013 and up to 3 percent in October 2014.
Wade Johnson, the president and chief executive officer of Pen Bay Healthcare, said Thursday that reducing the readmission rate is one of the priorities. Johnson was hired in February to oversee the health care system that includes Pen Bay Medical Center in Rockport, Quarry Hill retirement village in Camden, the Knox Center for Long Term Care in Rockland, Kno-Wal-Lin Home Health Care, and the majority of physician offices in the area.
“There’s no question that Pen Bay sticks out,” Johnson said of the readmission rates.


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Health Care Reform Articles - August 24, 2012

Massachusetts leads on health care while Maine regresses

By Philip Caper, Special to the BDN
Posted Aug. 23, 2012, at 4:43 p.m.
Massachusetts, the first state that attempted to offer health care to all its residents and provided the template for national health reform, recently took the inevitable and much more difficult next step.
It passed a law intended to restrain future growth in total statewide health care costs. Once government has adopted a policy of achieving universal health care, it must then take steps to maintain affordability.
For the past 50 years, our national health care policy has been one of relentlessly expanding our system’s capacity. In the mid-1950s, the Internal Revenue Service made employer-provided health benefits tax exempt. In 1965, building on the legacies of Presidents Roosevelt, Truman and Kennedy, President Johnson prodded the Congress into enacting Medicare and Medicaid, thereby infusing billions of public dollars into our health care system for direct care of the poor and elderly.
During the following decades, under both Democratic and Republican administrations, Congress further expanded our health care system, creating community health and mental health centers, the national health service corps and expanding health benefits for federal workers, the military and their dependents, as well as veterans and Native Americans.
Congress also provided support to increase the numbers of doctors, nurses and other health care professionals and to construct hospitals and other health care facilities. Federal support for basic biomedical research was massively expanded through the National Institutes of Health.
That support subsequently spurred unprecedented innovation through the conversion of publicly funded scientific knowledge into commercially viable products and the capability to use them. With the help of sophisticated marketing techniques, these products and services are now being relentlessly promoted in an effort to increase demand.
So our public policy regarding health care has been to spend trillions of dollars to expand our capacity to provide services, personnel, facilities and innovation. These efforts have been hugely successful. Per-capita health care spending (in constant dollars) has increased by about six times since 1966, when Medicare was implemented, and we’re now at about twice the spending level of other wealthy countries.
But despite our high spending, we have the highest percentage of population without adequate access to health care, the poorest health outcomes and the least popular health care system of any advanced country.


Elizabeth Warren on health care and religion

By E.J. Dionne
In my column today, I noted that I had interviewed Elizabeth Warren, the Democratic candidate for the U.S. Senate in Massachusetts. In the course of the interview, Warren offered what I thought were particularly interesting thoughts about the Affordable Care Act, and also about the role of her religious faith in her public engagement. I share a partial transcript of the interview here.


Medicare takes over as main issue in congressional races

Both Democrats and Republicans see their path to the congressional majority through Paul Ryan's vision for Medicare.

By Lisa Mascaro, Washington Bureau
August 22, 2012, 4:00 a.m.
WASHINGTON — The addition of Rep. Paul D. Ryan to theGOP presidential ticket has upended the congressional campaigns as the battle for the House and Senate swiftly focused on one main issue: Medicare.
As the architect of the GOP's Medicare overhaul hit the campaign trail alongside presumed presidential nominee Mitt Romney, the complicated policy issue was catapulted into the national spotlight.
Suddenly, Americans began hearing Ryan's vision to change the healthcare safety net for the next generation of seniors at a volume that had not been reached before — despite multiple House and Senate votes on the budget proposal.



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Wednesday, August 22, 2012

Health Care Reform Articles - August 23, 2012

Turning Medicare into vouchers won't work

By THEODORE R. MARMOR


Before Medicare began in 1965, many American senior citizens — and their children — struggled to pay for their doctor bills. Ever since, Medicare's been an American success story.
Why, then, do so many Beltway pundits and members of Congress — including Mitt Romney's new running mate, Rep. Paul Ryan, R-Wis. — go after it?
Some of its critics claim that slashing Medicare is the only way to control the deficit. Like most attacks on Medicare, this one is based on ideology, not evidence. Medicare's critics often claim that rising federal health care spending is America's biggest fiscal challenge. In fact, the federal deficit is bloated today primarily due to the Bush administration's irresponsible tax cuts, economic mismanagement, costly wars and increased defense spending.
Of course large numbers of retiring boomers mean Medicare will need more revenue. But Medicare costs won't need to spiral out of control. The new Affordable Care Act includes steps to limit per-person health care price hikes. It's already saving Medicare money. Yet Romney and Ryan promise they would work to repeal it.
What's their alternative? The Ryan Budget Plan calls for extremely deep cuts to Medicare, while promising more and longer-lasting tax cuts for a few very wealthy Americans. Most House Republicans have already voted for that. It would end Medicare as we know it, and instead force seniors to buy private insurance with vouchers that would cover less of their healthcare costs each year.
These vouchers would reduce seniors' choices, not their costs. Why? Republican voucher plans assume that if government ends Medicare, private insurance companies will start to deliver cheaper, more efficient plans. But what's their evidence?
http://www2.tbo.com/member-center/share-this/print/?content=ar467518


In Poll, Obama Is Given Trust Over Medicare


By  and DALIA SUSSMAN


The Romney-Ryan proposal to reshape Medicare by giving future beneficiaries fixed amounts of money to buy health coverage is deeply unpopular in Florida, Ohio and Wisconsin, according to new polls that found that more likely voters in each state trust President Obama to handle Medicare.
The Medicare debate was catapulted to the forefront of the presidential campaign this month when Mitt Romney announced that his running mate would be Representative Paul D. Ryan of Wisconsin, who is perhaps best known for proposing a budget plan, supported by Mr. Romney, to overhaul Medicare to rein in its costs.
After more than a week of frenzied campaigning on the issue, Medicare ranks as the third-most crucial issue to likely voters in Florida, Ohio and Wisconsin — behind the economy and health care, according to new Quinnipiac University/New York Times/CBS News polls of the three swing states. The Republican proposal to retool the program a decade from now is widely disliked.
Roughly 6 in 10 likely voters in each state want Medicare to continue providing health insurance to older Americans the way it does today; fewer than a third of those polled said Medicare should be changed in the future to a system in which the government gives the elderly fixed amounts of money to buy health insurance or Medicare insurance, as Mr. Romney has proposed. And Medicare is widely seen as a good value: about three-quarters of the likely voters in each state said the benefits of Medicare are worth the cost to taxpayers.
“On Medicare, I don’t like the Paul Ryan plan,” said Beverly McLaren, 72, an independent from St. Petersburg, Fla., who said in a follow-up interview that Medicare worked well for her and that she planned to vote to re-elect Mr. Obama. “I can’t see how it will help at all, and we’ll have more out-of-pocket expenses, and I’m not really clear how it will work.”

The politics of health care

By Sara Stalman, Special to the BDN
Posted Aug. 22, 2012, at 6:47 p.m.
To write about health care and politics is to write about the sacred and the profane.
Our word “health” has the same etymological root as our words “whole” and “holy.” It reflects ancient awareness that we are designed and guided by forces — sacred forces — that, although beyond human comprehension, we know to be greater than ourselves and to be good. “Health” has “the Sacred” at its very root.
“Politics,” on the other hand, refers to activities related to governance. Our present political realities foster the greatest disparity of wealth between rich and poor that our country has ever known. One in five Mainers do not seek medical care because they cannot afford it. Many have health insurance but, with high monthly payments and high deductibles, they see doctors only in emergencies. At the same time Maine is hemorrhaging health care dollars to out-of-state insurance profiteers. In 2002, between 38 cents and 50 cents of every dollar spent on health insurance left Maine, never to return. It’s only gotten worse. Working people pay for everybody’s health care. That’s the reality. In a single-payer health insurance system those monies would go into a single “pot” directly paying all healthcare costs: minimal overhead, no insurance company profiteers, direct purchase of medications for the cheapest negotiated price. Our Veterans receive health care through a single-payer system. Minus the prescription-drug nonsense, Medicare, too, is a single-payer system.
In 2001, Maine was the first state to be standing within a hair’s breadth of legislatively passing a single-payer health insurance system. By a vote of 76-54, “single-payer” passed with strong bipartisan support in the House. With the Senate set to vote in favor along party lines (18-16) then-Gov. Angus King vowed to veto the bill. The final senate vote of 15-17 precluded the governor’s veto but in no way changed the fact of his position.

Romney/Ryan would nuke $4.1 billion (and counting) in Medicare prescription drug savings

byJoan McCarterFollow


http://www.dailykos.com/story/2012/08/21/1122728/-Romney-Ryan-would-nuke-4-1-billion-and-counting-in-Medicare-prescription-drug-savings


For patients or for profits?

By Helen Redmond
Socialist Worker, Aug. 22, 2012
Helen Redmond reports on a series of scandals hitting for-profit health care giant HCA--and looks at how the quality of care patients receive has suffered, with sometimes deadly results.
In the last 20 years, as the health care crisis has accelerated and the number of uninsured has soared to over 50 million, publicly funded, not-for-profit hospitals have been transformed into ruthless, investor-owned, profit-generating businesses. Corporations have bought up not only hospitals, but dialysis clinics, outpatient surgical centers, home care agencies and physician practices with the singular goal of making money.
Hospitals are the nexus of profit-making for medical equipment and supply companies, the pharmaceutical industry, medical device makers, doctors who charge exorbitant fees and, increasingly, private investors. The health care sector has grown exponentially and now comprises one-sixth of the national economy.
No single company has been more successful in the hijacking of health care resources to Wall Street than the Hospital Corporation of America (HCA), which is currently facing a series of scandals. The industry giant's insatiable greed for profits has resulted in numerous, ongoing federal and state investigations and hefty fines.
Over the years, nurses and doctors at HCA facilities have consistently blown the whistle on unethical medical practices that have maimed and killed patients.
http://www.pnhp.org/print/news/2012/august/for-patients-or-for-profits




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