http://www.a2u2.org/pictures/audio/s1_20130519ed.mp3
The Murky World of Hospital Prices
By THE EDITORIAL BOARD
Last week, the federal government made public a vast trove of information on the list prices charged by hospitals for a large array of procedures commonly performed on hospitalized patients. It was a good start toward providing greater transparency in hospital billing, which has long been shrouded in secrecy. But it fell short of providing full information that patients need to make informed decisions about which hospitals to use and which insurance to buy.
The data was compiled from hospital claims submitted to Medicare by more than 3,300 hospitals seeking fee-for-service reimbursements for the 100 most common inpatient treatments in fiscal-year 2011. The prices at issue — sometimes called “chargemaster” prices — are not what most people pay. They are far higher than what Medicare pays, which is close to the real cost of providing the service, and also higher than what private insurers pay because they negotiate for discounts.
The only patients likely to be charged the full listed prices are those with little or no insurance and no purchaser to bargain on their behalf. Many insured patients also face higher premiums or co-payments because their plans reimburse the hospitals based on discounts from the listed prices. The listed prices varied wildly from one part of the country to another and even within the same city or region, seemingly without any good reason or any relationship to the quality of care delivered.
For example, a Times analysis published Friday found that the Bayonne Medical Center in New Jersey typically charged $99,689 for treating each case of chronic lung disease, 17 times as much as Medicare paid in reimbursement. The price for a joint replacement with artificial hips or knees ranged from a low of $5,300 in a hospital in Ada, Okla., to a high of $223,000 at a hospital in Monterey Park, Calif., a 40-fold difference that cannot be explained by regional differences in wages, the sickness of the patients, or a hospital’s teaching responsibilities. The charge for treating heart failure patients in hospitals in Jackson, Miss., ranged from $9,000 to $51,000.
The huge differences in list prices have been posted on a government Web site. But for consumers to compare one hospital with another in a meaningful way, they need to know a lot more — including the rates that have been negotiated between hospitals and insurers, the listed prices for outpatient treatments, and the quality of care provided, a difficult measurement that is in its infancy.
Pills Tracked From Doctor to Patient to Aid Drug Marketing
By KATIE THOMAS
In the old days, sales representatives from drug companies would chat up local pharmacists to learn what drugs doctors were prescribing. Now such shoulder-rubbing is becoming a quaint memory — thanks to vast databases of patient and doctor information being used by pharmaceutical companies to market drugs.
The information allows drug makers to know which drugs a doctor is prescribing and how that compares to a colleague across town. They know whether patients are filling their prescriptions — and refilling them on time. They know details of patients’ medical conditions and lab tests, and sometimes even their age, income and ethnic backgrounds.
The result, said one marketing consultant, is what would happen if Arthur Miller’s Willy Loman met up with the data whizzes of Michael Lewis’s “Moneyball.” “There’s a group of geeks, if you will, who are running the numbers and helping the sales guys be much more efficient,” said Chris Wright, managing director of ZS Associates, which conducts such analyses for pharmaceutical companies.
Drug makers say they are putting the information to good use, by helping a doctor improve the chances that their patients take their medications as prescribed, or making sure they are prescribing the right drug to the right patients.
Some doctors, however, expressed discomfort with the idea of sensitive data being used to sell drugs, even though federal law requires that any personally identifiable information be removed. “I think the doctors tend not to be aware of the depths to which they are being analyzed and studied by people trying to sell them drugs and other medical products,” said Dr. Jerry Avorn, a professor of medicine at Harvard Medical School and a pioneer of programs for doctors aimed at counteracting the marketing efforts of drug makers. “Almost by definition, a lot of this stuff happens under the radar — there may be a sales pitch, but the doctor may not know that sales pitch is being informed by their own prescribing patterns.”
The research firm IMS Health has tracked information about which drugs doctors prescribe since the 1990s, and over the last decade, the list of available information has expanded to include insurance claims data, which yields a trove of intelligence about patients’ medical diagnoses and insurance coverage. Additional details about patients, including income, education and ethnicity, can also be available.
Medicaid, hospital debate rages on in Augusta
'To do one without the other would leave the job half done,' Democratic leader Mark Eves says, but Republicans are reluctant to expand Medicaid.
AUGUSTA – State lawmakers continued their war of words Thursday over Democrats' desire to expand Maine's health insurance program for the poor and Republicans' support for Gov. Paul LePage's plan to pay off the state's hospital debt.
The parties held dueling press conferences at the State House a day after Democratic leaders moved to join one of their highest priorities -- expanding Medicaid to cover an additional 60,000 Mainers -- with the Republican plan to pay the state's $181 million share of back payments to Maine's 39 hospitals.
The conflict mirrors debates that have occurred in other state legislatures over expanding Medicaid through the federal Affordable Care Act. The issue has highlighted entrenched ideologies and political positions on the federal health care law and one of its pillars, Medicaid, the publicly funded health insurance program for low-income Americans.
In Maine, Democratic leaders have insisted that expansion be approved in conjunction with LePage's hospital payback. The pairing, announced in late April and advanced through committee votes this week, sets up a showdown between Democrats, who have majorities in the Legislature, and LePage and Republican lawmakers.http://www.pressherald.com/politics/Democrats-Rpeublicans-duel-over-Medicaid-hospital-payback.html
Publicly funded health care reduces income gap
What:
May 14, 2013—Public funding of health care has a redistributive effect on the incomes of Canadians, but this is reduced when a life course perspective is considered, according to a new report from the Canadian Institute for Health Information (CIHI).
Lifetime Distributional Effects of Publicly Financed Health Care in Canada looks at estimated lifetime per capita health care costs in the public sector—including doctors, hospitals and some drugs—as well as the portion of household taxes that would be required to pay for these services.
The analysis found that average lifetime health care costs are $237,500 for Canadians in the lowest-income group and $206,000 for Canadians with the highest incomes. However, the difference is much larger when looking at only a single year (2011).
Similarly, while tax payments to finance health care are higher for more-affluent Canadians, differences between income groups are muted when examining costs over a lifetime, rather than in one specific year. The most-affluent Canadians contribute the equivalent of 8% of their average annual income toward publicly funded health care, and the least-affluent contribute 6% of theirs.
The report provides insight into what affluence and poverty would look like in Canada without the existence of publicly financed health care. For example, health care costs for members of the highest-income group are equivalent to 3% of their average income; however, costs for those in the lowest-income group are equivalent to 24% of their average income.
New Jersey Hospital Has Highest Billing Rates in the Nation
By JULIE CRESWELL, BARRY MEIER and JO CRAVEN McGINTY
BAYONNE, N.J. — The most expensive hospital in America is not set amid the swaying palm trees of Beverly Hills or the luxury townhouses of New York’s Upper East Side.
It is in a faded blue-collar town 11 miles from Midtown Manhattan.
Based on the bills it submits to Medicare, the Bayonne Medical Center charged the highest amounts in the country for nearly one-quarter of the most common hospital treatments, according to a New York Times analysis of 2011 data, the most recent available. No other hospital was at the top of the price list more often.
Bayonne Medical typically charged $99,689 for treating each case of chronic lung disease, 5.5 times as much as other hospitals and 17.5 times as much as Medicare paid in reimbursement. The hospital also charged on average of $120,040 to treat transient ischemia, a type of small stroke that has no lasting effect. That was 5.6 times the national average and 23.6 times what Medicare paid.
For those prices, the quality of care at Bayonne Medical is no better — or worse — than that at most other New Jersey hospitals. In a 2011 state hospital quality report, Bayonne Medical scored only in the top 50 percent.
But profits at the hospital, which was bankrupt in 2007, have soared in recent years, in part because it has found a way to turn some of those high billings into payments.
The increasingly contentious issue of hospital charges drew renewed attention last week when the federal government released Medicare data showing that facilities nationwide submitted widely divergent bills for the same treatments.
And while the unassuming, six-story brick hospital here holds a notable place in those rankings, others stand out as well. The midsize Crozer-Chester Medical Center in Upland, Pa., was the top biller in the country for urinary tract infections. One
prestigious Manhattan hospital, NYU Langone Medical Center, charged twice as much as the equally high-end NewYork-Presbyterian to implant a cardiac pacemaker. But Medicare considers the two New York hospitals so similar it pays them both about $20,000 for the procedure.
House Votes Again to Repeal Health Law
By JEREMY W. PETERS
WASHINGTON — One by one, they queued up in the aisles of the House of Representatives, eager for their one minute to unload on President Obama’s signature legislative achievement.
For many Republicans, this was one of the major reasons for coming to Washington in the first place. And they were not going to miss their chance — whether it was their 37th time voting to repeal the 2010 health care overhaul, or their first.
“Obamacare is enforced by the I.R.S., probably the most feared federal agency in the United States government,” said Representative Michele Bachmann of Minnesota, offering one of the newest and more novel reasons Americans should fear the law. The dreaded Internal Revenue Service, she said, had just been caught targeting people from all walks of life: Christians, friends of Israel, people for less debt and more jobs, to name a few.
“We’re all sworn to protect and defend the Constitution, and that’s why today we have to end this horrible piece of legislation,” Mrs. Bachmann, the repeal act’s main sponsor, added.
Other Republicans — 40 of them in all spoke on Thursday — offered fresh explanations for why the law needed repealing, reasons that moved beyond the usual Republican opposition to it.
Representative Luke Messer, a freshman from Indiana, said that he could not possibly sum up in the minute allotted all that was wrong with such a wretched law.
So he stuck with a critique declaring it “the biggest assault on the 40-hour workweek in this country in a generation.” Employers, he said, were cutting employees’ hours in anticipation of the new policies’ costs.
Representative Robert Pittenger of North Carolina, another freshman, said the law was making medical students anxious about what awaits them upon graduation. Some undergraduates, he said, do not want to even go to medical school because of the law. (The Association of American Medical Colleges, however, has reported a steady increase in medical school enrollment every year since 2008.)
Cholesterol Levels No Longer Declining
By NICHOLAS BAKALAR
Average levels of LDL, the so-called bad cholesterol, declined significantly in Americans from 2001 to 2008, but have remained steady ever since. No one knows why.
Using the database of a medical testing company, researchers checked LDL values in the blood of almost 105 million men and women age 18 and older. After adjusting for age, they found that average LDL declined steadily at a rate of 2.05 milligrams per deciliter per year, to 104.7 in 2008 from 120 in 2001.
But the study, published in the May issue of PLoS One, found that over the next three years, there was almost no change, with levels in 2011 averaging 104.3. A reading under 100 is generally considered healthy, but some experts recommend getting to 70 or below, especially for people with heart disease.
The scientists offer three possible explanations. The recession that began in 2008 may have made people stop seeing doctors or buying cholesterol-lowering statins; the benefits of taking the drugs reached their maximum; or increasing obesity began to overwhelm the drugs’ beneficial effects.
“We’ve raised a red flag that something dramatic happened,” said the lead author, Dr. Harvey W. Kaufman, senior medical director at Quest Diagnostics, a medical testing company. “We laid out some theories, and it’s now up to investigators to determine why.”
N.H. insurance agents skeptical of new plans
By HOLLY RAMER The Associated Press
CONCORD, N.H. - In a recent survey, more than half of New Hampshire's insurance agents said they will sign up to sell plans through the new marketplaces required under the federal health overhaul law -- but how many actually follow through will depend on whether it's worth their while financially.
"I'm going to go through the steps and keep my options open, but right now, with the answers I have, I don't see a workable model," said Peter Gosselin of Gosselin Insurance in Hooksett. "No one's come up with a business model that makes this feasible."
The new insurance markets will offer individuals and their families a choice of private health plans resembling what workers at large companies already get. The government will help many middle-class households pay their premiums, while low-income people will be referred to safety-net programs for which they might qualify.
For many insurance agents, deciding whether to sell plans through the markets depends on what kind of commission they stand to earn. Rates will be set by insurance companies, but it's unclear how many will offer plans in New Hampshire. Gosselin said he believes those commissions could be half of what he currently earns.
Raymond White, a former state senator who founded Cornerstone Benefits and Retirement in Bedford, said he also is in a wait-and-see mode when it comes to selling health plans in the individual market through the marketplace. Like Gosselin, he worries about whether his small office would have the capacity to handle a large volume of customers in a compressed enrollment period, and whether commissions would be high enough to justify the effort.
New Hampshire could well end up with just one insurance company offering plans through the marketplace, he said.
"How much commission do you think they're going to pay if they're in that position? I wouldn't pay anything, quite candidly. That's not good for me, but if I'm the president of Anthem and I'm the only game in town, I'm going to pay extremely low commission because I don't have any competition," he said.
The Health Toll of Immigration
By SABRINA TAVERNISE
BROWNSVILLE, Tex. — Becoming an American can be bad for your health.
A growing body of mortality research on immigrants has shown that the longer they live in this country, the worse their rates of heart disease, high blood pressure and diabetes. And while their American-born children may have more money, they tend to live shorter lives than the parents.
The pattern goes against any notion that moving to America improves every aspect of life. It also demonstrates that at least in terms of health, worries about assimilation for the country’s 11 million illegal immigrants are mistaken. In fact, it is happening all too quickly.
“There’s something about life in the United States that is not conducive to good health across generations,” said Robert A. Hummer, a social demographer at the University of Texas at Austin.
For Hispanics, now the nation’s largest immigrant group, the foreign-born live about three years longer than their American-born counterparts, several studies have found.
Why does life in the United States — despite its sophisticated health care system and high per capita wages — lead to worse health? New research is showing that the immigrant advantage wears off with the adoption of American behaviors — smoking, drinking, high-calorie diets and sedentary lifestyles.
Here in Brownsville, a worn border city studded with fast-food restaurants, immigrants say that happens slowly, almost imperceptibly. In America, foods like ham and bread that are not supposed to be sweet are. And children lose their taste for traditional Mexican foods like cactus and beans.
For the recently arrived, the quantity and accessibility of food speaks to the boundless promise of the United States. Esther Angeles remembers being amazed at the size of hamburgers — as big as dinner plates — when she first came to the United States from Mexico 15 years ago.
“I thought, this is really a country of opportunity,” she said. “Look at the size of the food!”
Fast-food fare not only tasted good, but was also a sign of success, a family treat that new earnings put in reach.
“The crispiness was delicious,” said Juan Muniz, 62, recalling his first visit to Church’s Chicken with his family in the late 1970s. “I was proud and excited to eat out. I’d tell them: ‘Let’s go eat. We can afford it now.’ ”
For others, supersize deals appealed.
“You work so hard, you want to use your money in a smart way,” said Aris Ramirez, a community health worker in Brownsville, explaining the thinking. “So when they hear ‘twice the fries for an extra 49 cents,’ people think, ‘That’s economical.’ ”
Is the health-care spending slowdown for real?
“If something cannot go on forever, it will stop.”
— Stein’s Law , after economist Herbert Stein (1916-1999)
We all know that Stein’s Law will someday apply to health-care spending, which has risen from 5 percent of the economy (gross domestic product) in 1960 to almost 18 percent now. What we don’t know is how and when its share of the economy will stabilize. Will this result from spending controls imposed by Washington; or from delivery-system “reforms” that spontaneously cut “waste”; or from rationing, which limits spending by denying people treatment; or by some combination of these? As for when, could it be now?
Evidence of a spending slowdown is overwhelming. From 2009 to 2011, health spending remained at 17.9 percent of GDP, and actuaries at the Centers for Medicare and Medicaid Services (CMS) predict it will stay there in 2012 (final figures aren’t in) and 2013. If continued, this would have huge implications for the federal budget. Harvard economist David Cutler estimates the next decade’s savings at $770 billion. Health care’s stranglehold on other national priorities would loosen. Cutler is among those who think this is possible.
Writing in the journal Health Affairs — whose latest issue is devoted to costs — he and economist Nikhil Sahni argue that the slower spending reflects, at least partially, permanent changes. Drug costs are abating because there are “fewer new blockbusters,” and more drugs are “coming off patent” and can be replaced by cheaper generics. Hospitals are growing more efficient; since 2001, the University of Pittsburgh Medical Center has “reduced its rate of hospital-acquired infections by 85 percent,” they report. More cost-sharing (higher deductibles and co-payments) has curbed use, they say.
Some could have gaps in medical coverage under new law
Income fluctuations could interrupt coverage for 28 million low-income people who could bounce between Medicaid and insurance exchanges. The key will be ensuring people move smoothly between programs.
By Anna Gorman, Los Angeles Times
4:37 AM PDT, May 20, 2013
When the national healthcare law takes full effect next year, millions of Americans risk disrupted health coverage because of common life events: getting married or divorced, having children or taking on a second job.
As their family incomes change, so too will their eligibility for public insurance programs. And if nothing is done, policymakers warn, many low-income patients will lose access to their doctors and medications during this massive game of health coverage pingpong.
Policymakers and healthcare industry leaders across the nation are paying close attention to the issue and working to close the coverage gaps before Jan. 1, said Alan Weil, executive director of the National Academy for State Health Policy.
Life changes are unavoidable, Weil said, but the key will be ensuring that people can move between programs without mountains of paperwork or interruptions in healthcare. "If we fail to effectively move people across programs as their circumstances change, that will be a big problem," he said.
Nationwide, income fluctuations are estimated to interrupt coverage for as many as 28 million people expected to bounce between Medicaid and the federally subsidized health insurance exchanges that states are working to create, according to an article in the journal Health Affairs. Among those most at risk are seasonal and hourly workers and young adults who lack coverage through their parents or jobs, experts said.
Patients who can't see their doctors or get their medication will either avoid care or end up in publicly subsidized emergency rooms, pushing healthcare costs even higher, experts said. And insurance premiums will rise if young, healthy people get fed up with the transitions and opt out of health coverage altogether.
"I was devastated," said Hill, who lives in Alhambra. "I thought, 'Oh my God. What are we gonna do?'"
The family couldn't afford to buy private insurance, so they went without. But just a few months later, her fiance got laid off and the family reapplied for Medi-Cal. "I had to do the process all over again," she said.
Jasmine Barajas, 20, also got dropped from Medi-Cal because her job selling cellphones and her husband's job making jeans put them above the income limit. Their young daughter remained on a public plan, but Barajas and her husband couldn't pay for their own coverage.
"We need something permanent," she said. "Everything is a hassle."
The Affordable Care Act will improve access for many low-income workers who currently become uninsured if they are no longer eligible for Medicaid, said Benjamin Sommers, assistant professor of health policy and economics at the Harvard School of Public Health. Beginning in January, those workers will be able to buy private insurance with federal subsidies.
But policymakers must figure out a way to make that coverage affordable and to ease the transition between Medicaid and the state exchanges to prevent more emergency room visits and hospitalizations, he said. "These significant disruptions … can make it hard for people to get high-quality, stable healthcare."
http://www.latimes.com/news/local/la-me-medi-cal-churn-20130520,0,5531630,print.story
Medicaid opposition underscores states' healthcare disparities
In states where Republican leaders are rejecting expansion of the government health plan for the poor, residents already have lower rates of coverage.
By Noam N. Levey, Washington Bureau10:06 PM PDT, May 18, 2013
WASHINGTON — Republican opposition in many statehouses to expanding Medicaid next year under President Obama's healthcare law — opposition that could leave millions of the nation's poorest residents without insurance coverage — will likely widen the divide between the nation's healthiest and sickest states.
With nearly every GOP-leaning state on track to reject an expansion of the government health plan for the poor, the healthcare law's goal of guaranteed insurance will become a reality next year mostly in traditionally liberal and moderate states. These states already have higher rates of health coverage.
Residents of these states — concentrated in the Northeast, upper Midwest and West Coast — also have better access to doctors and are less likely to die from preventable illnesses.
Colon cancer deaths in states opposing Medicaid expansion, for example, are an average of 16% higher than in pro-expansion states, according to a Los Angeles Times analysis of state health data.
Deaths from breast cancer are 8% higher on average in anti-expansion states. And adults under 65 are 40% more likely on average to have lost six or more teeth from decay, infection or gum disease.
Medicaid by itself may not close those gaps, which also reflect income and education disparities. And the program's conservative critics, who contend it could ultimately sap state budgets, say poor Americans would be better helped by alternative strategies, including limits on government medical aid to encourage people to take responsibility for their own healthcare.
"Government assistance should not be an entitlement. Government assistance should not be a lifestyle," said Michigan House Speaker Jase Bolger, a Republican who has called for a complete overhaul of the state's Medicaid program, including a four-year limit on benefits for nondisabled adults. "Government assistance should be a temporary hand up. It should be a way to improve people's lives, not trap them in dependency."
Yet most state leaders who are fighting the Medicaid expansion have advanced few alternative plans to tackle their states' health shortfalls. That means that, at least in the short term, America's unhealthiest states could fall even further behind as the Affordable Care Act is implemented.
http://www.latimes.com/news/nationworld/nation/la-na-medicaid-expansion-20130519,0,1745430,print.story
Gov. LePage silenced in visit to panel
His surprise request to speak is rebuffed in order to keep ‘politics’ out of talks to deal with his MaineCare cutoff warning.
AUGUSTA — The Senate chairwoman of the Legislature’s budget-writing committee blocked Gov. Paul LePage’s surprise attempt to speak Sunday during an emergency meeting called to address the governor’s recent claim that the Department of Health and Human Services won’t be able to pay MaineCare providers come May 28.
Democratic leaders, skeptical of the timing and motive behind the claim, made a letter that LePage sent to them late Friday the subject of Sunday’s emergency meeting to question DHHS Commissioner Mary Mayhew about the finances of her department.
LePage asked to address the Appropriations and Financial Affairs Committee as it was preparing to recess. Sen. Dawn Hill, D-Cape Neddick, told the governor that she didn’t want to inject politics into a meeting during which lawmakers had agreed that the shortfall could be fixed by the end of the week.
“I mean no disrespect to you, but ... I know there’s a lot of politics at play here,” Hill said.
“No,” LePage interrupted. “There’s no politics. I’m a pragmatic person. I do not play politics.”
The exchange went on for about two minutes. At one point, LePage rose to leave the room. He then stopped and returned to the dais, saying the committee was denying him the chance to speak.
“It’s unfortunate that the people of the state of Maine are being played for patsies,” he said.
The exchange followed an emergency session during which Democrats grilled LePage administration officials over the letter the governor sent to legislative leaders Friday evening. LePage claimed that the Legislature needed to approve the state’s next two-year budget by the end of this week or risk delaying MaineCare reimbursement payments.
Silenced by legislators at budget talks, LePage says Mainers are being played for ‘patsies’
Posted May 19, 2013, at 4:07 p.m.
AUGUSTA, Maine — The Senate chairwoman of the budget-writing committee on Sunday declined to allow Gov. Paul LePage to address the panel about a fast-approaching deadline the Legislature faces so the Department of Health and Human Services doesn’t run out of money for payments to care providers.
The exchange between LePage and Sen. Dawn Hill, D-York, happened at the end of a rare Sunday session that Appropriations Committee members used to question Health and Human Services Commissioner Mary Mayhew about a Friday letter she wrote to LePage alerting him that her department has enough money to pay its bills to providers through June 10 — 20 days before the end of this fiscal year.
In the letter to LePage, Mayhew said lawmakers need to pass a budget by May 28 so her department can make its payments.
LePage approached the microphone to address the committee after members questioned Mayhew and Finance Commissioner Sawin Millett, and Hill declined to allow the governor to speak.
“I think there are a lot of politics around this committee,” Hill said. “I think what happened here today was good and we ended on a very good note.”
“Are you saying that the governor of the state of Maine is not welcome to address the Appropriations Committee?” LePage asked.
“We hadn’t expected you, and what we had to accomplish was accomplished,” Hill said, adding that she would be open to speaking with LePage outside committee meetings. “It’s best to end it on a high note, and I think that’s where we were.”
“Outside this committee won’t happen unless I have a way to speak,” LePage responded. “I want to get on the record, and this committee is not allowing it. The people of the state of Maine are being played for patsies.”
Mayhew’s letter Friday prompted a more terse letter from LePage to legislative leaders in which he called on Democrats to propose an alternative to his unpopular budget proposal. He also criticized them for pursuing an expansion of Medicaid under the Affordable Care Act while the state struggles to afford its current Medicaid program.
In two committee votes last week, Democrats voted to tie repaying the state’s $484 million debt to its hospitals to an expansion of Medicaid, a link LePage and many other Republicans have opposed.
Medicare for All?
By Chuck Thompson
PhillyBurbs.com, May 16, 2013
Nearly two years ago, I turned 65 and signed up for Medicare. I was actually dreading this move as one often fears change, particularly when it relates to health care plans. For nearly 16 years, my wife and I operated our own consulting company and paid in excess of $14,000 a year in health care premiums. When the cost threatened to bury us, my wife got a job with a private company that provided health care coverage for her and me. With her company’s plan acting as the supplement for Medicare when I turned 65, I soon learned that I would be receiving basically the same kind of coverage that I had for decades before on private plans.
Recently I took some time to read volumes of material on the development of Medicare. Basically it was part of the general discussion of the need for universal health care in the United States that dated back to 1911 when the British National Health Insurance program was enacted. A concerted effort to pass medical care for the elderly – which led to the enactment of the program known as Medicare – took more than two decades to come to fruition. It was opposed by the usual gang of conservatives employing their typical scare tactics, with a heavy dose of the money needed to employ an army of lobbyists coming from the American Medicine Association, the doctors’ NRA.
Was Medicare immediately hailed as a major tool in the improvement of medical care in America? Not quite. According to a column written by the Washington Post’s Ezra Klein, after Lyndon Johnson was elected and started the final push for Medicare, a Harris poll found only a minority of Americans, 46%, supported a federal plan to extend health care to the aged. “Today, of course,” Klein points out, “Medicare is overwhelmingly popular.” And it has proved to be a major boon to the very doctors who fought against it for so many years. It has also proved, in my estimation, that government can do a much better job regulating and providing quality, affordable medical care than can private industry.
Medicare may have been a major leap forward, but the U.S. continued to stand almost entirely alone among developed nations that lack universal health care. The Affordable Care Act, passed in 2010 and still in the implementation phase, will go a long way in meeting the needs of the rest of the people, without affecting people who are happy with the plans they currently have.
In the final analysis, however, I wonder how long people will be happy with their current health care plans. Flash back to my wife obtaining medical coverage from her employer. Initially, we were very content with the Blue Cross/Blue Shield Personal Choice plan with limited co-pays and the ability to go to any doctor or specialist of our choice. Ultimately, that plan became too expensive for her employer and last year it evolved into a plan with a $4,000 deductible that had to be met before it started to pick up any of the costs for hospitalization, doctors or prescriptions. I learned from my pharmacist that this is becoming very commonplace among employer health care plans. They should be called insurance for catastrophic illnesses and not much else.
http://www.pnhp.org/print/news/2013/may/medicare-for-all
PhillyBurbs.com, May 16, 2013
Nearly two years ago, I turned 65 and signed up for Medicare. I was actually dreading this move as one often fears change, particularly when it relates to health care plans. For nearly 16 years, my wife and I operated our own consulting company and paid in excess of $14,000 a year in health care premiums. When the cost threatened to bury us, my wife got a job with a private company that provided health care coverage for her and me. With her company’s plan acting as the supplement for Medicare when I turned 65, I soon learned that I would be receiving basically the same kind of coverage that I had for decades before on private plans.
Recently I took some time to read volumes of material on the development of Medicare. Basically it was part of the general discussion of the need for universal health care in the United States that dated back to 1911 when the British National Health Insurance program was enacted. A concerted effort to pass medical care for the elderly – which led to the enactment of the program known as Medicare – took more than two decades to come to fruition. It was opposed by the usual gang of conservatives employing their typical scare tactics, with a heavy dose of the money needed to employ an army of lobbyists coming from the American Medicine Association, the doctors’ NRA.
Was Medicare immediately hailed as a major tool in the improvement of medical care in America? Not quite. According to a column written by the Washington Post’s Ezra Klein, after Lyndon Johnson was elected and started the final push for Medicare, a Harris poll found only a minority of Americans, 46%, supported a federal plan to extend health care to the aged. “Today, of course,” Klein points out, “Medicare is overwhelmingly popular.” And it has proved to be a major boon to the very doctors who fought against it for so many years. It has also proved, in my estimation, that government can do a much better job regulating and providing quality, affordable medical care than can private industry.
Medicare may have been a major leap forward, but the U.S. continued to stand almost entirely alone among developed nations that lack universal health care. The Affordable Care Act, passed in 2010 and still in the implementation phase, will go a long way in meeting the needs of the rest of the people, without affecting people who are happy with the plans they currently have.
In the final analysis, however, I wonder how long people will be happy with their current health care plans. Flash back to my wife obtaining medical coverage from her employer. Initially, we were very content with the Blue Cross/Blue Shield Personal Choice plan with limited co-pays and the ability to go to any doctor or specialist of our choice. Ultimately, that plan became too expensive for her employer and last year it evolved into a plan with a $4,000 deductible that had to be met before it started to pick up any of the costs for hospitalization, doctors or prescriptions. I learned from my pharmacist that this is becoming very commonplace among employer health care plans. They should be called insurance for catastrophic illnesses and not much else.
http://www.pnhp.org/print/news/2013/may/medicare-for-all
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