Pages

Wednesday, March 6, 2013

Health Care Reform Articles - March 6, 2013


Deadly Bacteria That Resist Strongest Drugs Are Spreading


By 

Deadly infections with bacteria that resist even the strongest antibiotics are on the rise in hospitals in the United States, and there is only a “limited window of opportunity” to halt their spread, health officials warned Tuesday.
The bacteria, normally found in the gut, have acquired a lethal trait: they are unscathed by antibiotics, including carbapenems, a group of drugs that are generally considered a last resort. When these resistant germs invade parts of the body where they do not belong, like the bloodstream, lungs or urinary tract, the illness may be untreatable. The death rate from bloodstream infections can reach 50 percent.
Dr. Thomas R. Frieden, director of the Centers for Disease Control and Prevention, called the organisms “nightmare bacteria” during a telephone news conference, and noted that they could pass their trait for drug resistance — encoded in a scrap of genetic material called a plasmid — along to other bacteria.
Most people who contract these infections already have other serious illnesses that require complicated treatment and lengthy stays in hospitals, nursing homes or long-term care facilities. One bit of good news, Dr. Frieden said, is that the infections do not seem to have spread beyond hospitals into the community at large. But that could easily happen, he warned.

Anger and Kudos as Florida Governor Tacks Left


By 

MIAMI — A few days after Gov. Rick Scott of Florida endorsed a Medicaid expansion, a U-turn so sharply executed that it flabbergasted his supporters, the head of a local Tea Party group typed up a “breakup note.”
“I’m trying to determine how the Medicaid expansion is going to pay for the surgery to remove the knife planted in my back,” Henry Kelley, the Tea Party leader and an early supporter of Mr. Scott, wrote on his blog.
“This was his issue, his singular core issue,” Mr. Kelley said later in an interview. “This is why we rallied around him.”
Mr. Scott, 60, a former health care executive who won the governorship by calling for deep budget cuts and fiercely criticizing President Obama’s health care bill, has, in his third year in office, marched toward the political center, a necessity in this diverse swing state.
Facing stubbornly low approval ratings, Mr. Scott has crisscrossed the state advertising his enthusiasm for education, state workers, highways, commuter rails, early voting, the disabled, environmental protection and jobs. With Florida’s economy slowly burbling to life and a tiny budget surplus, the governor’s proposed budget of $74.2 billion is one of the largest in Florida history and includes a $2,500 across-the-board pay increase for teachers.
Along the way, Mr. Scott has danced in a music class, hugged teachers, quipped about his bald head and sprinkled cartoon-size checks around the state like a reborn Ebenezer Scrooge.
Democrats are as puzzled as Republicans. “Medicaid expansion, Obamacare, teacher bonuses — who is this guy?” Chris Smith, the State Senate minority leader, asked on Twitter.
In a recent interview at Wynnebrook Elementary School in West Palm Beach, Mr. Scott, wearing black cowboy boots emblazoned with an alligator and Florida flags, defended his new pragmatism, saying re-election concerns played no role in them. He did not change, he said, so much as Florida’s economy and deficit changed, freeing him to spend some money.

This board knows best

By Mark Rogers

ALLOW ME to congratulate the board of directors of Blue Cross Blue Shield of Massachusetts for its part in continuing to support the public’s mistrust of all things that emanate from the boardroom. Board members have voted to reinstate their own compensation. The move comes nearly two years after the state’s largest health insurer suspended board compensation in response to Attorney General Martha Coakley’s push for health care nonprofits to end pay for board members.
But don’t worry — Blue Cross’s board did not make this move on a whim. According to spokesperson Jay McQuaide, the board did this only after undertaking a two-year process to strengthen its “governance practices to make sure they are in line with best practices.” I feel better now. That completely erases the fact that these are many of the same people that voted in 2010 to reward the insurer’s outgoing CEO an $11 million golden parachute after the company posted a $149 million loss.
Furthermore, board members have taken a huge pay cut compared to the level they were back in 2011. Their annual cash retainer is down from $40,000 to $30,000, and their stipend for attendance at each committee meeting has shrunk to a measly $1,000 (down from $1,200).

Panel rejects LePage-nominated Dirigo Health critic along party lines; governor vows to keep seat vacant

By Matthew Stone, BDN Staff
Posted March 05, 2013, at 12:55 p.m.
AUGUSTA, Maine — A legislative committee voted along party lines Tuesday to oppose Gov. Paul LePage’s nomination of a vocal and longtime Dirigo Health critic to the program’s board.
LePage said late Tuesday he would keep the board seat open because of the committee opposition, rather than nominate another candidate.
In an 8-5 vote, the Legislature’s Insurance and Financial Services Committee opposed the nomination of former Rep. Jon McKane to the Dirigo Health board. The vote followed a hearing dominated by discussion of McKane’s past comments that have been critical of both the Dirigo Health program and the people who support it.
McKane, a Republican from Newcastle, served four terms as a state representative and couldn’t run for re-election last year due to Maine’s term limits law. His nomination now goes to the full Senate, where two-thirds of senators would have to override the committee vote to approve the nomination.
It’s rare for a legislative committee to oppose a gubernatorial nomination, and it’s customary for a governor to withdraw a nomination a committee has rejected.
“It’s clear, Democrats chose to deny a highly qualified individual because of partisan politics,” LePage said in a statement. “If legislators don’t want to approve McKane then I’ll choose to keep that seat vacant.”
The Insurance and Financial Services Committee on Tuesday unanimously supported two other LePage nominations to the Dirigo board: former Republican Reps. Gary Reed of Falmouth and Wes Richardson of Warren. LePage had nominated Reed to serve another term on the board.
During McKane’s hearing, Democrats on the committee pointed to comments he made online and in opinion columns about supporters of the Dirigo program, male and female, whom he and others have called “Dirigirls,” and his description of a series of pro-Dirigo editorials in the Portland Press Herald in 2005 as an “all out jihad against any Dirigo health non-believers.”
“Do you think you can be a productive member of the board after those comments?” asked Rep. Henry Beck, D-Waterville.


Maine Medical Association comes out in support of Medicaid expansion

By Matthew Stone, BDN Staff
Posted March 05, 2013, at 7:25 p.m.
AUGUSTA, Maine — The chief lobbyist for Maine’s doctors said Tuesday that his organization would support an expansion of Maine’s Medicaid program next year as part of the Affordable Care Act, the Obama administration’s landmark health care reform law.
Gordon Smith, executive vice president of the Maine Medical Association, told members of the Legislature’s budget-writing Appropriations Committee an expansion of the state’s Medicaid rolls would translate into more insured patients who seek medical care routinely rather than seeking care in more expensive hospital emergency rooms.
He also said a Medicaid expansion could support the creation of about 2,000 health care jobs.
“Every day [doctors] do see problems associated with people who have no insurance,” Smith told lawmakers. “The data is compelling, whether the studies are from Maine or the nation. We know the people who have Medicaid coverage are healthier. They are more likely to get medical care and are more likely to get it on a timely basis.”
Gov. Paul LePage has remained opposed to Maine’s participation in the national Medicaid expansion, which takes effect next year for states that decide to participate. LePage and members of his administration have continually said Maine already has a generous Medicaid program it can’t afford and the state can’t count on a promise from the federal government to stick to increased Medicaid funding rates.
Smith acknowledged the program’s fiscal troubles, but said doctors are encouraged by reforms underway in Maine’s Medicaid program to reduce the cost of providing care to the most expensive patients. Those reforms include shifting to an approach that reimburses health care providers for positive outcomes among patients rather than reimbursing them for the procedures they administer.
Much of that work will be supported by a $33 million federal grant Maine recently received along with five other states to foster state-level innovations.
Maine Medical Association’s support for the Medicaid expansion, Smith said, “is predicated on what we think will be a different Medicaid program than it was in the past.”
Another major medical lobbying organization in Maine, the Maine Hospital Association, hasn’t taken a public position yet on the Medicaid expansion.

Even with penalties, many US workers still may refuse to buy health insurance

By Sarah Kliff, The Washington Post
Posted March 05, 2013, at 8:24 p.m.
WASHINGTON — Millions of lower-income workers who gain access to employer-sponsored health insurance under the Affordable Care Act may still choose not to purchase coverage, according to a new study.
Most of the lowest-income workers offered health benefits elect not to enroll, according to a study from the ADP Research Institute released Monday. While the Affordable Care Act requires large employers to offer coverage, this study raises the possibility that many Americans may still decide to forgo the option.
“In 2014, there are going to be a number of people who are eligible for benefits for the first time,” said Christopher Ryan, vice president of ADP Strategic Advisory Services. “These additional people are primarily lower-income, and the critical question is: To what extent, if they have the opportunity to purchase benefits, will they participate?”
ADP, a payroll services company, studied the enrollment rate for health benefits offered at 300 companies with more than 1,000 employees. The majority of workers, 81 percent, who earned more than $50,000 elected to buy into health insurance benefits, according to the survey.
Lower-income Americans, by contrast, were less likely to purchase health benefits. Among full-time employees earning $15,000 to $20,000, 37 percent elected to purchase health benefits when they were made available. Among those earning $20,000 to $25,000, participation increased to 58 percent.
“For them, it’s an affordability issue,” Ryan said, noting that lower-income employees generally have to dedicate a larger share of their salary to purchasing health benefits than high-income earners do.
The health care overhaul attempts to address the question of affordability. It requires employers with 50 or more employees to offer their workers a benefit plan that costs less than 9.5 percent of their income. If they do not, the companies will face thousands of dollars in federal penalties.
There are also penalties for workers who do not purchase coverage. Next year, workers who decline their employer-sponsored health insurance will face a $95 tax penalty, which will rise to $695 by 2016.
Still, it’s unclear whether those penalties will be enough to encourage lower-income workers to purchase insurance coverage.
Most workers with health benefits already spend less than the Obama administration’s affordability threshold on their plan. The ADP study found that only 8.6 percent of employees spent more than 9.5 percent of their income on health benefits.
Also, the $95 financial penalty for not purchasing coverage is probably cheaper than purchasing employer-sponsored health insurance.

The mysteries held within hospital bills

On Election Day last year, I was working as the communications director for the statewide campaign to allow same-sex couples to receive a marriage license.
I was also shuttling back and forth (mostly just back) between campaign headquarters and the hospital where my wife was waiting for emergency gallbladder surgery.
I would describe the surgery as minor, but I know better. The only surgical procedure that anyone ever describes as minor is the one someone else is having.
Being generous in my interpretation, that day I did not find the appropriate balance between home life and work.
I might have even asked my wife, while she was in the emergency room nearly incapacitated, if she’d voted. The answer was “yes,” thank goodness. It would have been challenging to sneak her out of the hospital to vote.
Needless to say, I vacated my chances of winning any “husband of the year” honors for the next decade.
My wife recovered quickly.
It’s taken longer to sort out the bills.
Posted by at

No comments:

Post a Comment

Subscribe to: Post Comments (Atom)