Health Care Reform Articles - January 25, 2013

Americans Want Deficit Addressed Without Medicare Cuts, Poll Finds

By Mary Agnes Carey

Most Americans want quick action to reduce the deficit, but almost six in 10 oppose cutting Medicare spending to achieve that goal, according to a new poll released today.

Lawmakers should examine other alternatives, including requiring drug makers to give the government “a better deal” on medications for low-income seniors (85 percent) and making higher-income seniors pay more for coverage (59 percent), according to the survey conducted by the Kaiser Family Foundation, the Robert Wood Johnson Foundation and the Harvard School of Public Health. (KHN is an editorially independent program of the Kaiser Family Foundation.)

More than seven in 10 Democrats, independents and Republicans say that if the President Barack Obama and Congress made the “right changes,” they could reduce the deficit without making major cuts to Medicare.  Just over half (51 percent) oppose raising the Medicare eligibility age from 65 to 67, an idea discussed by both parties on Capitol Hill, and 85 percent oppose requiring all seniors to pay higher Medicare premiums.

Forty-six percent of those surveyed said they would not accept any reductions to Medicaid, the federal-state insurance program for the poor which has been a big target of Republican lawmakers.  Those percentages are largely unchanged from two years ago, “suggesting the past year of debate over the need to make cuts had not greatly altered the general shape of public opinion,” the survey found.

http://capsules.kaiserhealthnews.org/index.php/2013/01/americans-want-deficit-addressed-without-medicare-cuts-poll-finds/

Medicare paid $120m in illegal care

By Kelli Kennedy

MIAMI — The taxpayer-funded Medicare program paid more than $120 million from 2009 to 2011 in violation of federal law for medical services for inmates and illegal immigrants, according to two reports issued Thursday by federal health officials.

By law, Medicare generally does not pay for services for either group of patients. But the program was billed for more than $33 million in inmate care and more than $91 million for illegal immigrant care over that period, according to the reports from the Department of Health and Human Services inspector general.

In 2011, Medicare expenditures were $549 billion, making Thursday’s figures a fraction of the program’s annual budget. But the reports come as the Obama administration and Congress look for savings in a lean budget year. Putting a dent in Medicare fraud, estimated at $60 billion a year, has the potential for major savings. The reports recommend that officials establish a better system to automatically flag charges for inmates and illegal immigrants.

http://www.bostonglobe.com/news/nation/2013/01/25/reports-medicare-paid-illegal-care/uVamkYTEqvnmmSEYZBrsYP/story.html?camp=newsletter

New health care law could hit smokers' wallets

The Affordable Care Act allows health insurers to charge smokers buying individual policies up to 50 percent higher premiums starting next Jan. 1.

The Associated Press

WASHINGTON — Millions of smokers could be priced out of health insurance because of tobacco penalties in President Barack Obama's health care law, according to experts who are just now teasing out the potential impact of a little-noted provision in the massive legislation.

The Affordable Care Act – often referred to as "Obamacare" – allows health insurers to charge smokers buying individual policies up to 50 percent higher premiums starting next Jan. 1.

For a 55-year-old smoker, the penalty could reach nearly $4,250 a year. A 60-year-old could wind up paying nearly $5,100 on top of premiums.

Younger smokers could be charged lower penalties under rules proposed last fall by the Obama administration. But older smokers could face a heavy hit on their household budgets at a time in life when smoking-related illnesses may emerge.

Workers covered on the job would be able to avoid tobacco penalties by joining smoking cessation programs, because employer plans operate under different rules. But experts say that option is not guaranteed to smokers trying to purchase coverage individually.

Nearly one of every five U.S. adults smokes. That share is higher among lower-income people, who also are more likely to work in jobs that don't come with health insurance and would therefore depend on the new federal health care law. Smoking increases the risk of developing heart disease, lung problems and cancer, contributing to nearly 450,000 deaths a year.

http://www.pressherald.com/news/new-health-care-law-could-hit-smokers-wallets_2013-01-25.html

F.D.A. Panel to Vote on Restricting Drugs Like Vicodin

By SABRINA TAVERNISE

Trying to stem the scourge of prescription drug abuse in the United States, an advisory panel of experts to the Food and Drug Administration plans to vote Friday on whether to toughen restrictions on hydrocodone products like Vicodin, the most widely used narcotic painkillers in the country.

The recommendation, which the F.D.A. would likely follow, would limit access to the drugs by making them harder to prescribe, a major policy change that advocates said could help ease the growing problem of addiction to painkillers.

The change would have sweeping consequences for doctors, pharmacists and patients. Under the new rules, refills without a new prescription would be forbidden, as would faxed prescriptions and those called in by phone. Only written prescriptions from a doctor would be allowed and pharmacists and distributors would be required to store the drugs in special vaults. The vote comes after similar legislation in Congress failed last year, after intense lobbying by pharmacists and drugstores.

Prescription drugs account for about three-quarters of all drug overdoses in the United States, with the number of deaths more than tripling since 1999, according to federal data. Since 2008, deaths from overdoses have outpaced deaths from car accidents.

The F.D.A. convened the panel, made up of scientists and other experts, after a request by the Drug Enforcement Administration, which contends that the drugs are among the most frequently abused painkillers in the country.

“This is the federal government saying, ‘we need to tighten the reins on this drug,'” said Scott R. Drab, associate professor of pharmacy and therapeutics at the University of Pittsburgh. “Pulling in the rope is a way to rein in abuse, and consequently, addiction.”

http://www.nytimes.com/2013/01/26/health/fda-vote-on-restricting-hydrocodone-products-vicodin.html?hpw&pagewanted=print

The Affordable Care Act: What to Expect in 2013

By John Geyman, M.D.
The Huffington Post, Jan. 24, 2013
The Affordable Care Act (ACA), crafted in large part by corporate stakeholders who are themselves responsible for the high costs of U.S. health care, is more secure with President Obama's win last November. But regrettably, the law will fail to control costs or prices, will not provide universal access to care, and at best will provide low-value, high-premium "insurance" that will still make essential health care unaffordable for many millions of patients and families.
The ACA's fundamental flaw is that it props up an inefficient and exploitative private health insurance industry while not recognizing that deregulated markets can't fix systemic problems of access, costs, quality, equity, accountability and sustainability.
President Obama gained an impressive victory, and Democrats have held control of the Senate. Most importantly, corporate money, power, lies and deception on the right have not prevailed. But of course, the Republican-controlled House is likely to bring continued political gridlock. Overemphasis on austerity and deficit control threaten Medicare, Medicaid and safety net programs.
Going forward, we can expect to see wild battles across the health care landscape, including these examples:
* Continued mergers among the major players, including insurance companies, hospital systems, medical groups and others, which will end up increasing costs and prices while limiting patients' choices of physician and hospital.
* Continued lobbying by the insurance industry to mold accountable care organizations and insurance exchanges in their interests (i.e. cherry-pick enrollees and pass along sicker patients to public programs).
* Further privatization and exploitation of Medicare and Medicaid.
* Efforts by insurers to limit definitions of minimal essential benefits.
* Further fragmentation and increasing bureaucracy of our market-based health care system with worse health outcomes.
Under this onslaught, the ACA will not hold up. Health care reform needs to be more progressive than how it ended up with the ACA. The only real fix for our problems is single-payer, improved Medicare for All, a proposal introduced by Rep. John Conyers (D-Mich.), H.R. 676, coupled with a private delivery system.
http://www.pnhp.org/print/news/2013/january/the-affordable-care-act-what-to-expect-in-2013