Pages

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.

Posted by at

No comments:

Post a Comment

Subscribe to: Post Comments (Atom)