Health-care dominoes
By Ruth Marcus,
Raising the eligibility age for Medicare sounds like a fiscal no-brainer.
After all, the Social Security retirement age is rising to 67. It would seem sensible for Medicare to have the same rule.
After all, life expectancy is growing. Today, the average 65-year-old can expect to live another 20 years — about five years longer than when Medicare started.
After all, federal health-care spending is on an unsustainable course. Something’s got to give.
Amid the entitlement mumbo jumbo, raising the eligibility age is attractive to politicians casting about for savings because it is tangible. It is at the top of the Republican wish list. It was part of the never-consummated deal that House Speaker John Boehner and President Obama crafted last year — although House Minority Leader Nancy Pelosi has declared her opposition.
Here’s the wrinkle: This no-brainer turns out to be exceedingly complicated. The savings aren’t as big as you might imagine, because costs to other government health programs would rise as a result. Meanwhile, the move could have an array of problematic effects, from leaving seniors uninsured to raising premium costs for many others.
The Congressional Budget Office (CBO) estimates that gradually increasing the eligibility age to 67 would save $113 billion over the next decade; the savings in the second 10 years, with the cuts fully implemented, would be larger. By 2035, Medicare spending would be 7 percent lower than otherwise expected, or 5 percent when taking into account higher spending on other programs. This isn’t chump change.
The Kaiser Family Foundation, calculating the effect of an immediate change, came up with a much smaller number: less than $6 billion in 2014. Kaiser found that raising the eligibility age would reduce Medicare spending on those seniors by $31 billion that year. But then Medicare premium receipts would drop by $7 billion because some seniors would not be paying into the program. Meanwhile, because some of the newly Medicare-less seniors would turn to the new health-insurance exchanges to obtain insurance, federal spending on the exchanges (premium and cost-sharing subsidies for lower-income seniors) would increase by $9.4 billion.
And federal spending on Medicaid, the health care program for the poor, would increase by $8.3 billion as the poorest seniors enroll in Medicaid under the new expanded-coverage part of the health care law.
http://www.washingtonpost.com/opinions/ruth-marcus-the-eligibility-age-conundrum/2012/12/06/cdb72e30-3fcb-11e2-ae43-cf491b837f7b_print.html
Heritage hackery, nationally and in Maine, is not good for anyone
In looking for a way forward, a number of Republicans and conservatives have argued that they need to be more grounded in the realities of America today.
Besides better grasping political and demographic realities, they should regain a concern with real policy solutions, based in authentic policy analysis.
Unfortunately, when it comes to some purported policy groups, they’re still off on the wrong track.
With Jim DeMint leaving the Senate to lead the Heritage Foundation, this think tank becomes even more political and less of an actual policy operation.
The Heritage Foundation was once a real policy shop.
Conservative analysts and researchers looked at policy problems and tried to figure out solutions. While guided by their values and commitment to market-based approaches, they used best practices in research methods,
Thus they developed core ideas behind Romneycare and Obamacare — maintaining private insurance companies, developing exchanges on which to buy insurance, and bringing everyone into the health insurance market via a mandate and subsidies to those who could not afford it.
Those days are gone. The Heritage Foundation tries to look like it does real analysis, but its presentations and studies are easily debunked, due to their lack of context and methodological problems.
Lewiston hospital announces job cuts, restructuring
Posted Dec. 07, 2012, at 6:25 a.m.
LEWISTON, Maine — Positions are being eliminated, departing employees are not being replaced and layoffs are expected as St. Mary’s Health System undergoes restructuring.
A source said as many as 25 people could be laid off at St. Mary’s Regional Medical Center, but a spokesman described that number as “fluid.”
Lee Myles, president and CEO of St. Mary’s Health System, released a statement late in the day Thursday to announce the restructuring.
“In order to prepare for health reform and make adjustments for reductions of MaineCare reimbursement, St. Mary’s Health System is undergoing a strategic restructuring,” Myles said in the statement. “As of today, the state owes St. Mary’s $23 million for services provided dating as far back as 2009. Given our current economy and changes in the national health-care structure, we can no longer absorb this outstanding debt. The purpose of restructuring is to reduce operating expenditures while optimizing patient care to meet the future needs of the community.”
According to the statement, hospital administrators are trying to find creative ways to ease the impact of lost jobs and eliminated positions.
Gonorrhea, now resistant to most drugs, on the rise in Maine
Posted Dec. 06, 2012, at 3:22 p.m.
An unusually high number of Mainers have been diagnosed this year with gonorrhea, a sexually transmitted disease that’s grown stubbornly resistant to treatment.
Through Oct. 31, Maine recorded 370 cases of gonorrhea, according to the Maine Center for Disease Control and Prevention. That’s a jump from 272 cases in all of last year and nearly four times the number of cases in 2008.
The incidence of gonorrhea has steadily risen in Maine over the last four years. It’s a troubling trend, coinciding with an ever-shrinking arsenal of drugs at doctors’ disposal to treat the increasingly drug-resistant disease.
Today, just one remaining antibiotic is reliably effective against the infection. Meanwhile, a “superbug” strain of gonorrhea that’s becoming untreatable has spread across Europe. One of the most common infectious diseases, gonorrhea is sounding public health alarms globally.
In 2012, most of the cases in Maine have arisen among those ages 20-29 in Cumberland, Androscoggin and York counties, particularly women, who are vulnerable to serious reproductive complications.
“We have noticed the uptick,” said Megan Hannan, Maine director of public affairs for Planned Parenthood of Northern New England.
Health care providers are required to report new cases of gonorrhea to health officials. The state CDC is exploring small pockets where the disease has spread to learn what factors correspond to higher risk this year, including race, gender and types of sexual partnerships.
“It’s not just Maine,” said state epidemiologist Dr. Stephen Sears. “There’s been an increase in sexually transmitted diseases in many parts of the country. I’m not sure if I know all of the reasons. Usually we find subpopulations that the disease is propagating in.”
In August, the federal Centers for Disease Control and Prevention issued new guidelines for how doctors should treat gonorrhea, scrambling to keep pace with the increasingly drug-resistant disease. The guidelines were an update to recommendations issued in 2010.
Caused by the Neisseria gonorrhoeae bacterium, gonorrhea was, for years, treated with common antibiotics including penicillin and tetracycline. Wide use of those drugs for a variety of infections, coupled with the rapid mutation of some strains, has over time rendered those antibiotics ineffective for warding off gonorrhea.
Mass. firm poised to buy Mercy hospital says other losses part of refurb plan
Posted Dec. 05, 2012, at 7:19 p.m.
Last modified Dec. 06, 2012, at 9:16 a.m.
Last modified Dec. 06, 2012, at 9:16 a.m.
PORTLAND, Maine — As Steward Health Care System moves ahead with its planned purchase of Mercy Health System of Maine, most of the Massachusetts company’s hospitals are losing money.
That’s not surprising, given Steward’s strategy for Mercy and the other hospitals it has scooped up since forming in 2010. The for-profit company invests millions of dollars in financially struggling facilities, shoring up buildings and infrastructure and giving hospitals the resources to change how they’re paid for taking care of patients.
Mercy has never faced bankruptcy, but it has lost money for the last three years. Its revenues totaled $190 million in 2010, a drop from $196 million in 2009, according to its most recent tax filing.
Mercy has signed a letter of intent to sell the system to Boston-based Steward. If the sale goes through, Mercy would become the first hospital in Maine to be owned by a for-profit company.
A member of Pennsylvania-based Catholic Health East, which operates 35 acute care hospitals across the eastern seaboard, Mercy includes two flagship hospitals in Portland and several health care facilities in southern Maine.
In Massachusetts, all but two of Steward’s 10 hospitals are in the red, according to a Novemberreport by the Massachusetts Center for Health Information and Analysis, an independent state agency tasked with tracking medical spending. In the second quarter of fiscal year 2012, Steward’s Norwood Hospital in Norwood posted losses of more than $7 million and its Carney Hospital in Dorchester showed losses of $6.5 million, according to the report.
http://bangordailynews.com/2012/12/05/health/mass-firm-poised-to-buy-mercy-hospital-says-other-losses-part-of-refurb-plan/
Steward’s bid for Maine hospital group falls through
Steward Health Care System and Mercy Health System of Portland, Maine, have terminated a letter of intent signed last August under which Boston-based Steward would have bought the financially struggling Catholic hospital group in its first out-of-state acquisition.
In a terse statement issued late Friday afternoon, Steward said it had “entered into a period of exclusive negotiations but (was) unable to come to a definitive agreement” with Mercy Health. “As a result,” Steward said, “the letter of intent is terminated.”
No reason was given for why the nonbinding merger agreement had fallen through, and a Steward spokesman, Chris Murphy, would not elaborate on what went wrong. Susan Rouillard, a Mercy Hospital spokeswoman, declined to comment.
Mercy later released a statement saying it entered into a letter of intent to be acquired by Eastern Maine Healthcare Systems in Brewer, Maine.
Mercy Health System, EMHS seek merger
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Last modified Dec. 07, 2012, at 9:39 p.m.
PORTLAND, Maine — Mercy Health System of Maine, based in Portland, has scrapped its plan to merge with a for-profit health care company in Boston and has instead signed a letter of intent to merge with Eastern Maine Healthcare Systems of Brewer.
The two health care systems have begun the due diligence necessary to ensure a good fit between the organizations, Susan Rouillard, Mercy’s chief development and communications officer, told the Bangor Daily News on Friday evening.
Terms of the potential deal are not being disclosed, Rouillard said.
“I can tell you that Eastern Maine is a very good fit for Mercy, and Mercy is a very good fit for Eastern Maine,” she said. “[EMHS] is one of the pioneer accountable care organizations — it’s one of only 32 in the nation. That ties in very well with Mercy’s effort to provide higher value care at lower cost.”
Mercy, which is a member of Pennsylvania-based Catholic Health East, includes two flagship hospitals in Portland and several health care facilities in southern Maine. If it merged with EMHS, Mercy would retain its Catholic identity, legacy and nonprofit status, according to a media release.
Mercy plans to merge with Eastern Maine Health System
The Portland hospital walks away from a deal that would have made it the first for-profit hospital in the state.
The nonprofit health care organization that includes Mercy Hospital abruptly dropped its plan to be acquired by a for-profit Massachusetts company Friday and signed a letter of intent to merge with the nonprofit Eastern Maine Healthcare Systems.
Mercy Health System of Maine did not say what went wrong in its negotiations with the Boston-based Steward Health Care System, issuing only a terse statement saying that the two sides had engaged in exclusive negotiations since August "but were unable to come to a definitive agreement. As a result the Letter of Intent is terminated."
Steward Health Care System was negotiating to buy the two Mercy Hospital campuses in Portland and nine primary care facilities in Greater Portland.
Steward is a for-profit chain of 10 hospitals that is, in turn, owned by Cerebus Capital Management, a private equity firm.
A Mercy spokesman said the Catholic organization felt a strong sense of kinship with Eastern Maine Healthcare Systems, which operates seven hospitals including Eastern Maine Medical Center in Bangor and nine nursing homes and retirement communities in northern and eastern Maine
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