It's time to focus on fixing the Affordable Care Act, not gutting it
Disinformation about Obamacare, now being broadcast in slick TV ads, is not the way to help enact and improve the program, which after all is the law of the land.
David Lazarus6:49 PM PDT, July 11, 2013
The woman in the TV commercial is identified as Julie, a mother of two. She's sitting on a bench in a nice yard containing a kids' play structure. A little boy swings in the background.
"Two years ago," Julie says, "my son Caleb began having seizures. The medical care he received meant the world to me. Now I'm paying more attention.
"I have some questions about Obamacare," she continues. "If we can't pick our own doctor, how do I know my family is going to get the care they need? And what am I getting in exchange for higher premiums and a smaller paycheck?"
Good questions. Just one thing: There's nothing in Obamacare, a.k.a. the Affordable Care Act, that prevents a patient from picking his or her own doctor. Nothing at all.
The ad is part of a $1-million ad campaign begun this week by Americans for Prosperity, a conservative group bankrolled by the billionaire Koch brothers, who are said to be a potential buyer for the Los Angeles Times and other Tribune Co. newspapers.
"The American people have serious questions and concerns about the negative impact of Obamacare," said Tim Phillips, president of the group. "They are waking up to higher premiums and fewer choices, but are being told by the White House and outside groups that everything is just fine.
"We feel it is important to provide education on the true consequences of government intrusion into the private healthcare decisions of families, and provide a counter to disinformation that's out there."
And that would be fine, if what the group is saying were true. But Americans for Prosperity, like many conservative critics of the reform law, is offering its own disinformation rather than constructive improvements.
Julie's concern about not being able to pick her own doctor simply isn't valid. As is the case now, people would be limited only by private insurers' own physician networks, not government rules.
http://www.latimes.com/business/la-fi-lazarus-20130712,0,5847707,print.column
Public Citizen's 'Road Map to State Single Payer'
By Healthcare-NOW's national staff
Healthcare-NOW, July 10, 2013
Healthcare-NOW, July 10, 2013
This year, some of our movement's most inspirational organizing has focused on state-level single-payer healthcare legislation. Consequently, our ally Public Citizen released a report today titled "A Road Map to 'Single Payer': How States Can Escape the Clutches of the Private Health Insurance System." The report aims to help state legislators and activists navigate the legal and legislative hurdles facing state-level single-payer efforts.
If you are active in a state single-payer campaign, we encourage you to download the report and share it with allies in your legislature.
Inspired by Vermont's law designed to move the state through a series of phases culminating in a single-payer system, many other states have impressed us this year. Oregon activists organized a 1,000-person rally that resulted in passing a bill that compares the costs of single-payer with other healthcare financing systems. New York activists delivered over 10,000 signatures for single payer to legislators that resulted in securing a majority of the state Assembly supporting their state single-payer bill. Colorado activists launched a statewide ballot initiative to make access to healthcare a constitutional right, and is in the process of collecting 100,000 signatures.
Many states, however, do not enjoy the luxury of a state legislature that offers hope for single-payer legislation. We hope state-level victories will inspire national activism for achieving a right to healthcare for all, regardless of geography, income, or other social identities.
We hope that this Road Map will serve as a helpful tool in states' organizing toolbox, and that you will share it with your network.
July 7, 2013
Supreme Court rules Drug Companies exempt from Lawsuits
July 7, 2013. Washington. In case readers missed it with all the coverage of the Trayvon Martin murder trial and the Supreme Court’s rulings on gay marriage and the Voting Rights Act, the US Supreme Court also made a ruling on lawsuits against drug companies for fraud, mislabeling, side effects and accidental death. From now on, 80 percent of all drugs are exempt from legal liability.
In a 5-4 vote, the US Supreme Court struck down a lower court’s ruling and award for the victim of a pharmaceutical drug’s adverse reaction. According to the victim and the state courts, the drug caused a flesh-eating side effect that left the patient permanently disfigured over most of her body. The adverse reaction was hidden by the drug maker and later forced to be included on all warning labels. But the highest court in the land ruled that the victim had no legal grounds to sue the corporation because its drugs are exempt from lawsuits.
Save Affordable Care Act by following Bush’s example
Posted July 13, 2013, at 7:40 a.m.
This past spring, Sen. Max Baucus, D-Mont., called the impending implementation of the Affordable Care Act “a huge train wreck.” His words caught my attention because the last time the federal government delivered a new health-care benefit to more than 40 million people, I drove the train.
As secretary of health and human services during President George W. Bush’s second term, I faced the daunting task of rolling out Medicare’s new prescription drug benefit. Commonly referred to as “Part D,” the program is considered a tremendous success: Premiums have remained low, the program operates well under its projected budget and 90 percent of seniors are satisfied with their plan.
But in early 2006, there were days when I thought we could crash at any moment. For several weeks, the rollout of Medicare Part D felt like a runaway train — bumpy, uncomfortable, unnerving. Fortunately, the ride ended safely.
I opposed the Affordable Care Act, and I still believe that big changes to the law are necessary. But I’m not hoping for a wreck. That outcome would hurt ordinary people, not just politicians. Avoiding a calamity will be a major test for the Obama administration. To succeed, it should learn from our experiences with Part D — what we did well and where we fell short.
Part D and the Affordable Care Act resulted from contentious negotiations and fierce legislative battles. Both charged the Department of Health and Human Services with creating an insurance marketplace where people could choose among competing private plans. Both involved new regulations and information-technology systems, approval of insurer bids and plans, coordination with federal departments and state governments, and the education of millions of Americans. However, the ACA’s challenges are even greater than those we faced, given the law’s complexity, size and scope.
The Obama administration assures us that it will be ready, but independent analyses and recent delays signal potential trouble. In particular, I see four risks that could cause this train to jump the tracks:
With the ACA’s initial enrollment period three months away, 78 percent of Americans lack awareness about the law and the changes it will bring. Four in 10 don’t even know the law is set to take effect. So it’s not surprising that 58 percent of the uninsured report that they don’t have enough information to answer the important question: What will the ACA mean for me?
With Part D, the education hurdles were also high. Before the program was implemented, only 21 percent of seniors had a favorable opinion of it, and 66 percent didn’t understand what the reform would mean for them.
Do Clinical Trials Work?
By CLIFTON LEAF
EVERY spring, some 30,000 oncologists, medical researchers and marketers gather in an American city to showcase the latest advances in cancer treatment.
But at the annual meeting of the American Society of Clinical Oncology last month, much of the buzz surrounded a study that was anything but a breakthrough. To a packed and whisper-quiet room at the McCormick Place convention center in Chicago, Mark R. Gilbert, a professor of neuro-oncology at the University of Texas M. D. Anderson Cancer Center in Houston, presented the results of a clinical trial testing the drug Avastin in patients newly diagnosed with glioblastoma multiforme, an aggressive brain cancer. In two earlier, smaller studies of patients with recurrent brain cancers, tumors shrank and the disease seemed to stall for several months when patients were given the drug, an antibody that targets the blood supply of these fast-growing masses of cancer cells.
But to the surprise of many, Dr. Gilbert’s study found no difference in survival between those who were given Avastin and those who were given a placebo.
Disappointing though its outcome was, the study represented a victory for science over guesswork, of hard data over hunches. As far as clinical trials went, Dr. Gilbert’s study was the gold standard. The earlier studies had each been “single-arm,” in the lingo of clinical trials, meaning there had been no comparison group. In Dr. Gilbert’s study, more than 600 brain cancer patients were randomly assigned to two evenly balanced groups: an intervention arm (those who got Avastin along with a standard treatment) and a control arm (those who got the latter and a placebo). What’s more, the study was “double-blind” — neither the patients nor the doctors knew who was in which group until after the results had been assessed.
The centerpiece of the country’s drug-testing system — the randomized, controlled trial — had worked.
Except in one respect: doctors had no more clarity after the trial about how to treat brain cancer patients than they had before. Some patients did do better on the drug, and indeed, doctors and patients insist that some who take Avastin significantly beat the average. But the trial was unable to discover these “responders” along the way, much less examine what might have accounted for the difference. (Dr. Gilbert is working to figure that out now.)
Indeed, even after some 400 completed clinical trials in various cancers, it’s not clear why Avastin works (or doesn’t work) in any single patient. “Despite looking at hundreds of potential predictive biomarkers, we do not currently have a way to predict who is most likely to respond to Avastin and who is not,” says a spokesperson for Genentech, a division of the Swiss pharmaceutical giant Roche, which makes the drug.
Bill Nemitz: ALS sufferer, husband in health care limbo
Life can't get much worse for Gail Kennett.
She's in the final stages of amyotrophic lateral sclerosis, or ALS, also known as Lou Gehrig's disease.
She's been a critical-care patient at Maine Medical Center in Portland since February 2012.
And her condition? Well, let's turn to Dr. Stephen Mette, chief of the hospital's critical care unit, for that one.
"She remains completely dependent on mechanical ventilation to sustain her life," wrote Mette in an update last month. "There are no attempts to wean her from mechanical ventilation and indeed she would not survive this given that she has essentially no respiratory muscle strength."
He continued, "She no longer has any motor function of her arms and hands. She uses a nurse call device triggered by small movement of her head. Communication has become more difficult over the past month. The care team now uses a system of eye deflection for yes or no answers only."
Beyond her life-or-death reliance on the ventilator, noted Mette, "Mrs. Kennett continues to be completely dependent for all aspects of her care including nutrition through a feeding tube, bathing and hygiene, positioning, tracheal suctioning. She continues to receive scheduled narcotics for control of pain and discomfort, anti-anxiety medications ..."
Heard enough?
So has Anthem Blue Cross and Blue Shield, which last September stopped paying for Kennett's care because, in the eyes of the health insurance company, none of the above is "medically necessary."
Rather, Anthem Utilization Management Services Inc. has decided, Gail's care is "custodial." And they don't cover that.
Scammers prey on confusion over ‘Obamacare’ terms
Posted July 11, 2013, at 8:27 a.m.
WASHINGTON — If a stranger claiming to be from the government calls to offer you an “Obamacare card” or threatens to throw you in jail unless you buy insurance, hang up the phone. It’s a scam.
Fraudsters are poised to take advantage of widespread confusion over the Affordable Care Act — also known as Obamacare — to steal Americans’ credit cards, Social Security numbers and other personal information, consumer advocates and government officials say.
“This is the huge, new government program. There’s no doubt in my mind that the fraudsters view it as an opportunity to rip people off,” said Lois Greisman, associate director for the Federal Trade Commission’s division of marketing practices.
The FTC already has issued a consumer alert about one telemarketing scheme, in which impostors claiming to be from Medicare told consumers they needed to hand over their personal or financial information in order to continue eligibility because “change is on the horizon.”
But nothing in the Affordable Care Act threatens existing benefits for Medicare enrollees, Greisman said. The official-sounding calls were just a ploy to steal consumers’ identities and money.
The FTC received more than 1,100 complaints about similar scams in May alone.
Another typical rip-off involves fraudsters who contact consumers by phone or email and say, “I’m with Obamacare. I need your information to send you your new Obamacare card,” said John Breyault, vice president of public policy for the National Consumers League, an advocacy group in Washington.
Some scammers try to sell consumers very poor coverage or coverage that isn’t even real.
The callers then request bank account routing numbers, or credit cards, or ask for cash directly through a wire transfer, he said.
“Scammers usually say you have to join. ‘It’s the law now, so you have to give us money,’ ” Breyault said. ” … It’s typically using scary language like ‘the government requires you to do this’ or ‘you’re going to lose your benefits unless you send us money.’ ”
Four in 10 don’t know Obamacare is law
Consumer groups first noticed a spike in complaints about Affordable Care Act swindles after Congress passed the 2010 law. Now, as the Oct. 1 deadline to open health care exchanges approaches, health care scams are on the rise again.
Problems with Affordable Care Act show need for single-payer system
By Toni Vafi
St. Louis Post-Dispatch, July 11, 2013
As promises of the Affordable Care Act continue to wither, the delay of the employer mandate is cause for more disappointment. Initially there was promise of average savings of $2,500 per family annually and visions of a public option. Universal coverage was assured and the oft-stated “if you like your employer based insurance, you can keep it” was evidence that we weren’t going socialist. These were a few of the goodies we expected under the Patient Protection and Affordable Care Act.
What happened? Gone are the $2,500 savings and the public option. Cost control wasn’t part of the ACA. The public option bothered insurance companies, so it was out. Of 60 million uninsured, the ACA will leave at least 30 million still without coverage, and the employer mandate delay will now surely increase the implementation burden on the exchanges, which might not be ready to go by Oct. 1.
Not to worry. Employers that have been unable to come up with a plan over the past four years are mainly employers of lower wage and temporary workers. These workers might receive subsidized plans on the exchanges. According to the Post-Dispatch ("Delay in health care law raises questions," July 4), some employers expect to save millions during this one-year delay, millions to be picked up by the taxpayers. Most of the 30 million newly insured will be exchange or Medicaid clients, also to be funded in full or subsidized by the federal government. While I never begrudge the use of federal funds for health care, I do begrudge this elaborate plan giving insurance companies a third of those federal funds to shuffle paper and deny care, while earning huge profits for themselves.
If medical care is to be funded by tax dollars, let’s skip the hogwash and go directly to a single-payer system, which saves billions and provides equitable care for all.
http://www.pnhp.org/print/news/2013/july/problems-with-affordable-care-act-show-need-for-single-payer-system
St. Louis Post-Dispatch, July 11, 2013
As promises of the Affordable Care Act continue to wither, the delay of the employer mandate is cause for more disappointment. Initially there was promise of average savings of $2,500 per family annually and visions of a public option. Universal coverage was assured and the oft-stated “if you like your employer based insurance, you can keep it” was evidence that we weren’t going socialist. These were a few of the goodies we expected under the Patient Protection and Affordable Care Act.
What happened? Gone are the $2,500 savings and the public option. Cost control wasn’t part of the ACA. The public option bothered insurance companies, so it was out. Of 60 million uninsured, the ACA will leave at least 30 million still without coverage, and the employer mandate delay will now surely increase the implementation burden on the exchanges, which might not be ready to go by Oct. 1.
Not to worry. Employers that have been unable to come up with a plan over the past four years are mainly employers of lower wage and temporary workers. These workers might receive subsidized plans on the exchanges. According to the Post-Dispatch ("Delay in health care law raises questions," July 4), some employers expect to save millions during this one-year delay, millions to be picked up by the taxpayers. Most of the 30 million newly insured will be exchange or Medicaid clients, also to be funded in full or subsidized by the federal government. While I never begrudge the use of federal funds for health care, I do begrudge this elaborate plan giving insurance companies a third of those federal funds to shuffle paper and deny care, while earning huge profits for themselves.
If medical care is to be funded by tax dollars, let’s skip the hogwash and go directly to a single-payer system, which saves billions and provides equitable care for all.
http://www.pnhp.org/print/news/2013/july/problems-with-affordable-care-act-show-need-for-single-payer-system
Obamacare’s missing mandate
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| The massive coast-to-coast campaign to get people to sign up for Obamacare is light on mentions of one central element: the widely disliked individual mandate. Poll after poll has found that Americans don’t like being told they have to get insurance or face a penalty. So the groups doing outreach don’t plan to draw much attention to it. “For the most part no, because [the mandate] doesn’t apply to very many people at all,” said Ethan Rome, executive director of Health Care for America Now, citing government estimates that only a small proportion of uninsured Americans would actually face a penalty by 2016. (PHOTOS: The eight GOP governors who said yes to Medicaid expansion) The early stages of the enrollment push has been all honey and no vinegar. Organizing for Action, President Barack Obama’s advocacy group, has released two ads focusing on the law’s benefits. Other advocates are counting on Mom to get their adult kids to sign up. Oregon’s exchange released its first ads this week, featuring – what else? – indie musicians strumming on guitars for the “Live Long Oregonians” campaign. No mention of the “m” word. The GOP has no such compunctions. Republicans reclaimed the individual mandate as an attack line this month, vowing to put it on hold for at least a year now that the White House has delayed until 2015 a parallel requirement for businesses. Putting off one set of rules while forging ahead with another just isn’t fair, say Republican lawmakers, who’ll force House votes on each mandate Wednesday. (Also on POLITICO: Appeals court tosses Obamacare suit) The Obama administration staked its health care law on a politically sensitive requirement that individuals get covered or pay a fine and it fought all the way to the Supreme Court to keep the mandate in place. The court kept the mandate alive last year by ruling that it was a tax – which didn’t exactly help its popularity problem. With all that baggage in the background, don’t count on Obamacare supporters to bring a “sign up or else” mandate message as they strive to enroll millions in the health insurance system just a few months from now. The penalty for not having insurance the first year is only $95, although that will rise in the future. |
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