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Romney says uninsured have access to health care
Antibiotic Prescription? It May Depend on Where You Live
By ANAHAD O'CONNOR
A new study has found that older men and women in the South are more often prescribed antibiotics than older Americans elsewhere, even though there is no evidence that the South has higher rates of pneumonia and other diseases for which antibiotics are necessary. The findings suggest there are greater rates of antibiotic overuse in that part of the country.
Many experts have expressed concerns that antibiotics are being overprescribed and overused, leading to unnecessary spending on prescription medicines as well as more widespread bacterial resistance to the drugs. In the elderly, who are more likely to suffer adverse side effects and reactions from antibiotics, the health consequences can be amplified.
Despite this vulnerability, antibiotic use among seniors has not been as closely studied as it has been among younger Americans. So a team of researchers looked at prescribing patterns among men and women over 65 across the country, comparing rates over a period of several years and doing breakdowns quarterly. Their research, published in Archives of Internal Medicine, showed that during a typical three-month period, about 21.4 percent of older Americans in the South used an antibiotic, compared with about 17.4 percent in the West. The rate in the Midwest was 19.2 percent, and in the Northeast it was 18.2 percent.
Redistributing wealth upward
By Harold Meyerson,
Which is the more redistributionist of our two parties? In recent decades, as Republicans have devoted themselves with laser-like intensity to redistributing America’s wealth and income upward, the evidence suggests the answer is the GOP.
The most obvious way that Republicans have robbed from the middle to give to the rich has been the changes they wrought in the tax code — reducing income taxes for the wealthy in the Reagan and George W. Bush tax cuts, and cutting the tax rate on capital gains to less than half the rate on the top income of upper-middle-class employees.
The less widely understood way that Republicans have helped redistribute wealth to the already wealthy is by changing the rules. Markets don’t function without rules, and the rules that Republican policymakers have made since Ronald Reagan became president have consistently depressed the share of the nation’s income that the middle class can claim.
Part of the intellectual sleight-of-hand that Republicans employ in discussions of redistribution is to reserve that term solely for government intervention in the market that redistributes income downward. But markets redistribute wealth continuously. In recent decades, markets have redistributed wealth from manufacturing to finance, from Main Street to Wall Street, from workers to shareholders. Rules made by “pro-market” governments (including those of “pro-market” Democrats) have enabled these epochal shifts. Free trade with China helped hollow out manufacturing; the failure to regulate finance enabled Wall Street to swell; the opposition to labor’s efforts to reestablish an even playing field during organizing campaigns has all but eliminated collective bargaining in the private sector.
Maine not alone in hunt for Medicaid savings
The Associated Press
AUGUSTA — Maine is not alone among the states that have reduced spending for Medicaid programs, a health care spending consultant on Tuesday told a panel that's looking to add to cuts that already have been imposed.
Cuts elsewhere range from eyeglasses and eye exams to hearing aids, dental care, chiropractic services and mental health services, according to a summary prepared by Seema Verma of SVC Inc. for the MaineCare Redesign Task Force.
"A lot of the states are in a similar situation where they're looking for cost-containment strategies," Verma, of the Indiana-based consultancy, told the task force. "There are no easy answers to this. Any decisions you make will have advantages, will also have some disadvantages."
Medicaid already has undergone major cuts in Maine, notably coverage for 19- and 20-year-olds, reduced access for elderly people already eligible for Medicare and increased eligibility requirements for non-disabled, non-pregnant adults on Medicaid. But even while the Legislature is adjourned, the search for more cuts continues.
Gov. Paul LePage says the costs of Medicaid, known in the state as MaineCare, are unsustainable over the long term. As part of the state budget update that was passed in May, the Legislature created the nine-member task force, whose members have expertise in health policy and health care finance.
The panel must find $5.25 million in savings this fiscal year, then formulate longer-term strategies. Among the first approaches taken by other states is increased cost sharing through larger co-pays, a strategy some states see as an incentive for people receiving benefits to take more personal responsibility, Verma said.
But she warned that the states may not be able to change standing cost-sharing rules because of national Affordable Care Act restrictions on such changes. She also said increased cost sharing may have a downside in the form of reduced access to care.
Finding healing: How to reduce hospital readmission rates
When a patient is treated at a hospital and released she should know exactly what medications and continued care she’ll need. If she’s underinsured or uninsured, she should be connected to nearby free clinics and drug assistance programs. These are just a few ways to help prevent her from having to return to the hospital with complications.
As political leaders discuss how to make the $486 billion Medicare program more efficient, they have and will continue to press hospitals to reduce readmissions — both to cut costs and improve people’s health. As Maine hospitals work to lower their readmission rates, they can learn from what has worked at other hospitals.
Affordable health care — invented by Republicans
Posted Sept. 24, 2012, at 1:02 p.m.
There are only three ways this country could move toward universal health care. We could extend Medicare to the entire population, having the government pay for it; we could require employers to insure their workers, with government picking up the bill for the rest, or we could have an individual mandate. The individual mandate is the most politically conservative plan, and it is the plan Obama and Congress chose when they enacted The Affordable Care Act.
The plan was first proposed in 1989 by the conservative Heritage Foundation. In 1993, a similar bill was proposed by prominent Republican senators. In 2005, another such bill was proposed by Mitt Romney as governor of Massachusetts, which became law the next year. All these reforms included an individual mandate, which somehow was never a big issue. Romney even said, in a 2008 Republican primary debate, “I like mandates.”
Now Romney calls the Affordable Care Act “an assault on freedom.” You explain this; I can’t.
The Massachusetts bill became the model for Obama’s Affordable Care Act, passed in 2009. From what I’ve heard, the Massachusetts bill has been fairly successful, although a little more expensive than hoped. Massachusetts is the only state in the Union where the individual mandate is NOT a big issue, because they already have it.
Pay off the hospitals, then collect the cash
Posted Sept. 24, 2012, at 1:01 p.m.
Since there is apparently a pot of gold at the end of Maine’s liquor contract rainbow, it’s not too early to begin thinking about how that money should be handled.
Maine Gov. Paul LePage is rumored to have his own plan, and we can only hope it’s different from the one offered in the early years of the John Baldacci administration.
In 2003, the newly elected governor was looking at a biennial budget with a $1.2 billion structural gap. That meant the budget needs for the next two years were $1.2 billion larger than projected revenues.
So Baldacci and the Legislature began looking for ways of closing that gap. There are only two ways of doing that without resorting to gimmickry: either raise more revenue or cut expenses.
Baldacci was adamantly opposed to increasing any broad-based taxes, so his administration focused mostly on cutting expenses and, to a lesser extent, increasing fees.
And, according to several sources, Maine lobbyist Severin Beliveau approached Baldacci with an idea: Sell off the state’s liquor control business, which at the time earned the state about $26 million a year.
That was the first plan, but state Sen. Peter Mills, now executive director of the Maine Turnpike Authority, was shocked by the suggestion.
The idea of selling off a reliable, monopolistic revenue stream struck him as “crazy” and “obscene,” he told the Sun Journal last week.
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