Reasons for Outrage on Health Care
To the Editor:
Re “Diagnosis: Insufficient Outrage,” by H. Gilbert Welch (Op-Ed, July 5):
As medical “cost sharing” (read: “cost shifting”) grows, hidden costs will be revealed, and outrage, already simmering, can be counted on coming to a boil. We need to stop pretending that the rules of the market will provide us with high-quality, high-value health care and join the rest of the developed world with universal health insurance.
Medicare’s 48th birthday is coming up this month. Let’s expand and improve on this most successful and popular of American institutions with publicly financed and privately delivered single-payer health care for all.
LAURA S. BOYLAN
New York, July 5, 2013
New York, July 5, 2013
The writer is a clinical associate professor of neurology at New York University School of Medicine.
To the Editor:
We doctors should “rage” against a system so perverse that on any given day a physician may treat 15 patients with as many insurance plans requiring unproductive paperwork. It is a system so perverse that it forces us to hire clerks whose only role is to seek authorization for needed procedures.
It is a system so skewed against us that a letter from a lawyer sets our hearts racing. A system so out of control that chief executives of major insurance companies make salaries in the millions of dollars as we doctors struggle to meet payroll and pay the rent.
The excesses in the system may justifiably lead to outrage, but we doctors are likewise outraged at the blame heaped upon us for a failed system not of our creation.
MELVIN W. YOUNG
Dover, Vt., July 5, 2013
Dover, Vt., July 5, 2013
The writer is a cardiologist.
White House Has Known For Months Obamacare Implementation Wouldn't Work
If you've been reading all the Obamacare stories lately, you might get the impression that the administration has just realized it will not be able to implement the massivehealth reform as designed.
It has known for months.
As far back as March, a top IT official at the Department of Health and Human Services said the department's current ambition for the law's new online insurance marketplaces was that they not be "a Third-World experience." Several provisions had already been abandoned in an effort to simplify the administration's task and maximize the chances that the new systems would be ready to go live in October, when customers are supposed to start signing up for insurance.
(RELATED: Is 'Obamacare' In Trouble?)
At Restaurant, Delay Is Help on Health Law
By ABBY GOODNOUGH
ELLICOTT CITY, Md. — Eric King has worked diligently to keep his family’s 35-year-old seafood restaurant here viable, most recently by expanding the menu beyond its well-loved crab cakes and other traditional dishes to draw a younger, freer-spending crowd.
The restaurant, Shanty Grille, is on track to make a profit this year — about $80,000, Mr. King predicts — for the first time since the economic downturn. Yet the prospect of providing health insurance to every full-time worker or paying a penalty starting in January, a provision of the Obama health care law, has overshadowed the good news.
Businesses with the equivalent of more than 50 full-time employees are subject to the rule, and Shanty Grille hovers right around that threshold.
Then came last week’s announcement that the mandate would be delayed a year after business owners begged the Obama administration for more time. Mr. King, who had been fretting for three years about whether the restaurant would be subject to the mandate and how it would affect the bottom line, was thrilled.
“It gives us another year to plan,” he said Friday, sitting in the Grille’s sleek, newly expanded pub as customers cracked crabs at the bar. “If we fall below the 50, fantastic. If we’re above, then we’ll have another year to figure out how to offset these costs.”
Shanty Grille already provides health insurance to 9 of its 85 employees, paying part of the premium for each at a total cost of about $26,000 a year. The chosen group includes the restaurant’s managers and chefs — skilled workers, Mr. King said, whom “I really want to take care of and retain.”
Boehner, Cantor wax Orwellian on health care
Miller’s first law of political rhetoric holds that when one party in a Washington debate resorts to certifiably Orwellian language, they’re desperate, doomed or both.
Yet there’s no other way to view the latest Republican assault on Obamacare. The GOP sees blood in the water because the White House (sensibly) put off the employer mandate for a year. The truth is there shouldn’t have been an employer mandate at all — a point to which we’ll return in a future column — but Republicans have seized on the hook of this supposed “snafu” to hang their latest faux outrage.
“Is it fair for the president of the United States to give American businesses an exemption from his health-care law’s mandates, without giving the same exemption to the rest of America? Hell no, it’s not fair,” House Speaker John Boehner told his caucus Tuesday.
“I never thought I’d see the day when the White House, this president, came down on the side of big business, but left the American people out in the cold as far as this health-care mandate is concerned,” said a mock-shocked Eric Cantor.
“We agree with you that the burden was overwhelming for employers,” Republican leaders wrote to the president Tuesday, “but we also believe American families need the same relief.”
The same relief? How dumb do they think Americans are? “Relief” from the certainty that they’ll have access to group health coverage no matter their health status? “Relief” from income-based subsidies if they need help to buy a private health plan? “Relief” from finally knowing that they can never go broke from serious illness in one of the richest countries on earth? “Relief” from the job lock that binds countless Americans to large employers when they’d rather start a business or work on their own, but fear that if their family has any health issues they’d be left to fend for themselves? “Relief” from at last joining the community of advanced nations that view health coverage for all as an essential feature of a decent society, a view embraced decades ago even by conservative icons such as Margaret Thatcher?
War is peace. Freedom is slavery. Barack Obama is a tool of big business and an enemy of the people.
Our View: High hospital salaries send jarring message
Highly paid administrators should be judged more on quality of care than on revenue.
The health care system is in crisis, but compensation for top Maine hospital executives remains healthy.
Of the 10 highest-paid hospital administrators in Maine, all made at least $500,000 a year in 2011; the three highest-paid made $1 million or more. (These totals include not just base pay but also bonuses and other compensation.)
This is attention-grabbing news at a time when cost containment is a primary goal for health care. Maine hospitals are laying off employees and instituting hiring freezes. The state government has targeted public health programs for serious cutbacks. One of the most heated debates in Augusta this past legislative se
ssion centered on how and when to make several years' worth of overdue MaineCare payments to hospitals.
In this atmosphere of austerity, the high executive salaries are jarring. But they're also symptomatic of a larger problem. Our health care system fails to hold hospital administrators accountable for the quality of their institution's services, even as it rewards them for driving up revenues and keeping beds full. This undercuts nonprofit hospitals' public service mission, and the person who ultimately loses is the patient.
Portland approves $40 million expansion of hospital
By Randy Billings rbillings@mainetoday.com
Staff Writer
Staff Writer
PORTLAND – Despite experiencing financial challenges, the largest hospital in the state is about to get bigger.The Planning Board on Tuesday unanimously approved a $40 million expansion of Maine Medical Center's Bramhall Street campus. The 40,000-square-foot addition will be built on top of the Lower Bean Building, near the emergency room.
The project will add four operating rooms and associated patient prep and recovery areas. It will also allow the hospital to expand its existing operating rooms from an average of 400 square feet to 650 square feet.
Mark Harris, the hospital's vice president of planning and marketing, said its operating rooms currently run at 90 percent capacity, while the national average is in the "mid 80s."
"What this does is decompress that (operating room) activity and modernize the facility," Harris said.
Night terrors of the uninsured
For all of the promise of the Affordable Care Act, it has holes.
By Diana WagmanLos Angeles Times, July 6, 2013
It's 3:14 a.m.
I'm awake. Every night for the last six months, my eyes have opened just after 3. It's my personal witching hour when my demons come out of the closet and surround the bed whispering messages of doom. My husband sleeps on, oblivious. I've developed some tricks to keep the creatures at bay. I count backward, I count my blessings, I recite what little poetry I know by heart. If I start listening to the goblins, that's it, I'm up for the duration.
What am I worried about? I have smart, healthy children, one college graduate and one in college. I have a house and a husband and a car. What I don't have is a job. And because I'm unemployed, we don't have job-based health insurance. My husband works hard. He works a lot. But he's always been freelance, and he's hardly ever had insurance. That's what I get from my kind of work, teaching at the university level — never much in the way of salary, but benefits. Now the work has dried up and I'm benefit-less again.
I had a great one-year appointment teaching at a California State, with wonderful colleagues and interesting students. When the school decided to make the job a permanent position, I couldn't apply. I didn't have the required advanced degree. Twenty years working in my field, four published books and many published articles and stories, and I wasn't eligible to continue doing exactly what I'd been doing. I know it has to do with the school's accreditation. My department would have kept me if it could, but it couldn't. I looked into getting that advanced degree and was even accepted at a school nearby, but I wouldn't have been able to have the degree "in hand" by the time the permanent job started this fall.
So I'm out of work. Again. And because healthcare in this country is tied to employment, we are out of luck. Again. I had cancer. My daughter was hit by a car and got a concussion and a fractured ankle. I know bad things can happen to me, to my family. We have to have health insurance. And we have to pay for it ourselves. And that keeps me up at night.
http://www.pnhp.org/print/news/2013/july/night-terrors-of-the-uninsured
Community Health Centers plan – In Every State – Get Obamacare Outreach Funds
The nation’s community health centers — which treat the poor and uninsured– apparently know a good deal when they see one.
Nearly all 1,200 federally funded community health centers applied for and will be getting a piece of $150 million in federal health law money to enroll patients in new online health insurance marketplaces starting Oct.1.
Federal health officials on Wednesday said 1,159 centers will be getting the new money offered in May to provide in-person enrollment assistance to uninsured individuals across the nation. The centers, which operate nearly 9,000 service delivery sites nationwide and serve approximately 21 million patients each year, will each get from $59,000 to $500,000. Health centers in every state, even those that have governors opposing the health law, will be getting some of the funding. The money will allow health centers to hire an additional 2,900 outreach and eligibility assistance workers to assist millions of people nationwide with enrollment into the exchanges.
Health and Human Services Secretary Kathleen Sebelius said the funding will help the centers enroll 3.7 million people into the Obamacare exchanges as well as Medicaid and Children’s Health Insurace Program.
Repeal the health-care law
| |
| Business owners across America breathed a collective sigh of relief last week when the Obama administration announced it would grant them a one-year reprieve from some of Obamacare’s most onerous rules. It was cold comfort, though, to millions of individuals and families whose concerns about the impact of the Affordable Care Act continue to be ignored by the White House. Addressing the concerns of some while ignoring those of others won’t solve the problems ordinary Americans will face as a result of this law. It will magnify them. That’s why, ultimately, the only solution to the burdens of Obamacare is a permanent delay in the form of a full repeal, which would clear the path for reforms that actually lower costs and improve the quality of care. The good news is that while the administration hasn’t publicly admitted it yet, last week’s announcement is further proof that some of the law’s biggest backers are starting to realize how unworkable Obamacare truly is. A few months after one of the law’s chief architects in the Senate predicted an implementation “train wreck,” administration officials are now tacitly admitting as much by giving businesses — and Washington bureaucrats — another year to figure it all out. But the obvious problem with the band-aid approach is that without full repeal, there will never be an end to the number of problems that need to be fixed. That’s the nature of a law that runs 2,700 pages in length, has spawned more than 20,000 pages of regulations (so far) and has authorized the creation of, at last count, 159 bureaucratic agencies, boards and programs. http://dyn.politico.com/printstory.cfm?uuid=5404589F-E719-4CC3-A149-B609926DC7D5 |
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