Here is another link to a You-Tube video about pizza and healthcare costs. It's pretty good!
- SPC
http://www.youtube.com/watch?v=R7LF5Vj2n64&feature=c4-overview&list=UUGaVdbSav8xWuFWTadK6loA
House Nears Vote To Fund Government, Defund Obamacare
The Republican-controlled House is set to vote Friday on a stopgap spending bill to keep the government open for business through the middle of December. And the White House has already said if it makes it to the president's desk, he'll veto it. That's because the bill also would defund the Affordable Care Act.
Congress has 10 days to get this worked out. If not there will be a government shutdown. Passing what's known as a continuing resolution — a temporary bill to keep the lights on — should be routine. But this is turning into a huge fight that's likely to go right down to the wire.
And it's all because of Obamacare. Or more accurately, the determination of congressional Republicans to destroy President Obama's signature legislative achievement.
At the insistence of the most conservative wing of the House GOP conference, Speaker John Boehner is moving forward with a must-pass spending bill that also would defund the health care law.
Of course, the Senate is controlled by Democrats, and Majority Leader Harry Reid says any measure to defund Obamacare is "dead" and a "waste of time."
The Public and the Conflict over Future Medicare Spending
House Nears Vote To Fund Government, Defund Obamacare
The Republican-controlled House is set to vote Friday on a stopgap spending bill to keep the government open for business through the middle of December. And the White House has already said if it makes it to the president's desk, he'll veto it. That's because the bill also would defund the Affordable Care Act.
Congress has 10 days to get this worked out. If not there will be a government shutdown. Passing what's known as a continuing resolution — a temporary bill to keep the lights on — should be routine. But this is turning into a huge fight that's likely to go right down to the wire.
And it's all because of Obamacare. Or more accurately, the determination of congressional Republicans to destroy President Obama's signature legislative achievement.
At the insistence of the most conservative wing of the House GOP conference, Speaker John Boehner is moving forward with a must-pass spending bill that also would defund the health care law.
Of course, the Senate is controlled by Democrats, and Majority Leader Harry Reid says any measure to defund Obamacare is "dead" and a "waste of time."
The Public and the Conflict over Future Medicare Spending
- Article
- References
- Two recent government reports show substantial short-term improvements in the financial outlook for Medicare and in the federal budget deficit.1,2 However, these forecasts also suggest the need for further action brought about by a worsening of the financial situation after 2015 as the number of Medicare recipients increases from 52 million to 73 million in the decade following.1-3 This issue is likely to receive considerable attention in the upcoming debate about the federal budget deficit and the national debt.As we reported in the Journal in 2011, there has been little public support for major policy changes aimed at reducing Medicare spending to lower the federal deficit.4 This article goes further and seeks to document the underlying beliefs that may shape the public response to future efforts to substantially slow projected Medicare spending. Our thesis is that there exists today a wide gap in beliefs between experts on the financial state of Medicare and the public at large. Because of the potential electoral consequences, these differences in perception are likely to have ramifications for policymakers addressing this issue.We examine this thesis by analyzing data from six public opinion polls conducted in 2013 with 1013 to 2017 U.S. adults, plus historical data, in a project supported by the Robert Wood Johnson Foundation (see Opinion Polls on the Conflict over Medicare Spending). We also compare public-opinion data to published reports on the status of Medicare today. The findings are presented around five issues: public views about Medicare spending and the budget deficit; perceptions of the performance of Medicare; reasons seen for the rising costs of Medicare; views about the future of Medicare; and implications of these beliefs for future elections. Because of the possibility that generational views may differ greatly, most of the data are presented for the total adult population and for four commonly used age groups. For comparisons between age groups, a P value of less than 0.05 was considered to indicate statistical significance. All P values are two-sided. Sampling variation and weights are accounted for in the calculation of statistical significance.
What’s superbugging you?
By Dana Milbank,
You may be worried about a government shutdown, but I’m not.I’m not worried about a shutdown because we’re all about to die anyway. Superbugs are going to kill us.“Drug-resistant bacteria pose potential catastrophe, CDC warns” was The Post’s headline this week about a Centers for Disease Control and Prevention report that did indeed use words such as “nightmare” and “catastrophic threat.”“We’re just getting closer and closer to the cliff,” CDC official Michael Bell cautioned reporters in a conference call.CDC Director Tom Frieden warned of being “thrust back to a time before we had effective drugs.”They spoke of the infamous “flesh-eating bacteria,” but even that horrid streptococcus is a minor problem compared to the “urgent health threat” posed by Clostridium difficile, carbapenem-resistant Enterobacteriaceae and other nasties you most definitely don’t want to meet. There’s now even a superfungus — fluconazole-resistant Candida — that can kill you.I reacted as I usually do to such reports. I covered myself head to toe in Purell, donned a respirator and hid under my bed. I was so concerned about the superbugs that I temporarily forgot to worry about avian flu and the deadly coronavirus coming from Saudi Arabia.To help me keep track of these threats, my Post colleague Alan Sipress, author of a book on pandemic flu, suggested that I subscribe to ProMED, a daily e-mail update from the International Society for Infectious Diseases. This week, ProMED informs me that there have been four new cases of MERS (the Middle East respiratory syndrome), and that there’s a potentially problematic development with H7N9 influenza in China (not to be confused with H7N7 in Italy or H5N1 in Cambodia).The trouble is, ProMED also introduces me to all kinds of threats I never thought to worry about. As I write this, the daily bulletin includes news of a paralytic shellfish poisoning in Australia, E. coli in Canadian cheese, waterborne diarrhea in Armenia, a superbug in Brazil, hemorrhagic fever in Uganda, hemorrhagic fever with renal syndrome in Russia, cholera and dysentery in Africa, something called “Meloidogyne enterolobii root knot” involving South African potatoes, and the dread “lumpy skin disease” related to bovines in Turkey.Lest you think these are other countries’ problems, ProMED has word of salmonellosis at a North Carolina church barbecue, toxic algae in Ohio drinking water, people catching the flu from pigs in Arkansas and equine encephalitis from mosquitoes in Maine. There are contaminated oysters in Massachusetts and the bubonic plague in New Mexico. Still, I’d take those over the case in Bangladesh involving monkey-to-human transmission of “simian foamy virus.”ProMED is a must-read for a hypochondriac like me, and I intend to keep reading about these exotic contagions until I succumb to the ravages of mad cow disease, which the government seems to think I have. (Regulations prohibit me and anybody else who lived in Britain between 1980 and 1996 from giving blood, out of concern that we may be carrying the mind-wasting illness.)Reading about all the infectious threats actually eases the symptoms of germaphobia because you realize that, though there are lots of things out there that can kill you, they rarely do. Beneath the headlines about the CDC superbug catastrophe, for example, you learn in smaller print that only about 1 in 14,000 Americans will be killed by them in a year, and these people often have other health problems.You also realize there’s not a whole lot an individual can do about all the infectious threats, other than washing your hands, cooking your food, getting vaccinated, using antibiotics properly and not kissing sick chickens.Beyond that, we should all push our government to accelerate and expand what it’s already doing: getting antibiotics out of the food chain, by restricting their use in animals, and researching new drugs. As the CDC report notes, bacteria will inevitably evolve to resist antibiotics; the best we can do is slow down the evolution so scientists can stay one step ahead of the superbugs.This is some of the most important work the federal government does, mostly through the National Institutes of Health: spurring the development of new antibiotics, vaccines for pandemic flu and treatments for all kinds of diseases. It saves and lengthens millions of lives, and it’s a public good that only government can provide — and only if government is up and running.Come to think of it, maybe I should be worried about a government shutdown. It’s at least as much of a threat to my health as simian foamy virus.With new Augusta hospital about to open, MaineGeneral surprised with downgraded credit rating
Posted Sept. 19, 2013, at 4:15 p.m.AUGUSTA, Maine — Moody’s Investors Service on Wednesday reduced MaineGeneral Medical Center’s credit rating, citing a downturn in its financial performance and worries that those challenges will persist as the organization prepares to open its new hospital in November.Moody’s downgraded the nearly $281 million in bonds the hospital sold in 2011 to fund the construction of its new Augusta hospital, and revised its outlook from stable to negative. The ratings agency downgraded the bonds from Baa3, considered “investment-grade,” to Ba1, considered “speculative-grade.”Wednesday also happened to be the day Maine paid its share of overdue Medicaid bills to nearly 40 hospitals.Moody’s attributed the hospital’s financial downturn to low revenue growth due to Medicare and Medicaid cuts, rising bad debt and charity care and lower inpatient volumes. It also mentioned demographic challenges, as an aging population increases the hospital’s exposure to Medicare.The downgrade “absolutely” came as a surprise, according to Michael Koziol, the hospital’s chief financial officer.“When we went to the bond market two years ago, the No. 1 concern was construction risk,” because construction projects are notorious for finishing late and blowing their budget, Koziol told the Bangor Daily News on Thursday.But MaineGeneral Medical Center is on the verge of completing its construction project ahead of schedule and on budget. The planned 640,000-square-foot hospital, which will replace three smaller, aging MaineGeneral facilities in the region, is slated to open Nov. 9.“We took care of that risk,” Koziol said.The financial challenges, Koziol readily admits, are real, but it’s not just MaineGeneral feeling the pinch.“We‘re disappointed Moody’s didn’t see it our way,” he said. “They’re negative on the entire industry.”In its 2013 fiscal year, which ended June 30, MaineGeneral budgeted to make $16 million, but only made $10.7 million, Koziol said. Projections were off by roughly $5 million, he said, because Medicare cuts were above and beyond what the hospital anticipated, and it faced higher amounts of charity care and bad debt — “all stories that are not unique to MaineGeneral.”How LePage proved smokers, drinkers should get Medicaid
Gov. Paul LePage on Monday continued his broadside against an expansion of Medicaid under the federal Affordable Care Act, issuing a news release claiming that expanding the public health insurance program for low-income people “will mainly benefit younger men, smokers and drinkers.”The policy battle over Medicaid expansion is finished, for now, and LePage was able to claim victory when he vetoed an expansion bill that passed the Democrat-controlled Legislature. But the public relations war is not over, and that’s why neither opponents nor supporters of the expansion can let the topic go.His Monday news release cited a study in the latest issue of the Annals of Family Medicine that predicts the health characteristics of those most likely to gain Medicaid coverage. Indeed, those likely to gain Medicaid eligibility on Jan. 1 are more likely to smoke, more likely to drink heavily and more likely to be young and male than the current crop of Medicaid recipients.By highlighting those findings, LePage is playing to a natural aversion among taxpayers to providing a government service to those who are able-bodied and make irresponsible life choices. But the study he cites actually makes the case that covering this newly eligible population is a wise investment.Some 49.2 percent of new enrollees are likely to be smokers, and 16.5 percent are likely to describe themselves as heavier drinkers. Among current Medicaid recipients, those numbers are 38 percent and 9.8 percent respectively. Medicaid recipients are about 50 percent more likely to smoke than the general population, according to the U.S. Centers for Disease Control and Prevention.A closer look at the study’s projections provides a clearer picture of the health of newly eligible Medicaid recipients. They’re more likely to be in good and excellent health than the current Medicaid population, less likely to be obese, less likely to suffer from depression and about as likely to suffer from hypertension and diabetes.The study concludes Medicaid will likely spend less per recipient in the short term to cover this new population, and it actually recommends providing them with coverage. “Given the higher prevalence of tobacco smoking and alcohol use,” the study’s authors write, “broad enrollment and engagement of this potentially eligible population is needed to address their higher prevalence of modifiable risk factors for future chronic disease.”As lawmakers this past spring debated whether Maine should expand Medicaid, GOP legislators often argued Maine should tend first to elderly and disabled residents placed on waitlists for services such as group homes, in-home care and work support before extending coverage to low-income but able-bodied residents.LePage made the same argument Monday. But in pointing to a reason why Maine shouldn’t extend Medicaid coverage to about 50,000 adults without children — the expansion would also prevent about 25,000 other low-income parents and childless adults from losing coverage on Jan. 1 — he actually pointed out why Maine should expand Medicaid.Medicaid researcher: LePage missed point of study he used to oppose expansion
Posted Sept. 18, 2013, at 6:14 a.m.AUGUSTA, Maine — One of the two researchers who wrote a study cited Monday by Gov. Paul LePage as new grounds to oppose Medicaid expansion took issue Tuesday night with the governor’s contention that increasing access to eligibility would lead to a “sharp increase” in the number of smokers and heavy drinkers on the program.“We did find that individuals newly eligible for Medicaid under the Affordable Care Act are more likely than current Medicaid beneficiaries to smoke (49 percent vs 33 percent) and to have heavy alcohol use (17 percent vs 10 percent),” Dr. Matthew Davis wrote in an email to the Bangor Daily News. “However, these findings illustrate that this is not about a ‘sharp increase’: there are already clinically concerning levels of smoking and heavy drinking among people who currently benefit from Medicaid. As a primary care physician, I would say that Medicaid expansion under the Affordable Care Act has the potential to bring more people in for medical care who could really benefit from having insurance coverage and having their health needs addressed.”Davis collaborated with Dr. Tammy Chang on the study, which was published in a recent edition of the Annals of Family Medicine. Their research focused on who would receive health insurance through Medicaid if every state accepts the federal government’s eligibility expansion offer next year.The study analyzed information found in a survey by the Centers for Disease Control and Prevention. LePage focused on its findings that higher percentages of young men, smokers and heavy drinkers would qualify for publicly funded health care if all states accepted the federal government’s proposal for expanded Medicaid eligibilityIn addition to projecting increased percentages of smokers and heavy drinkers, as LePage highlighted, the study showed that the average age of Medicaid recipients under the ACA expansion would go from 39 to 36 and there would be an increase in the number of male recipients from 33 percent to 49 percent of total enrollees.The same study estimated that the number of obese people on Medicaid would drop from 43 percent to 35 percent and the number diagnosed with clinical depression would drop from 22 percent to 16 percent.“This study illustrates why we oppose a very costly Medicaid expansion,” LePage said in a release issued Monday. “This expansion of welfare would provide services to a younger population, while depleting scarce resources that are critical to care for those who desperately need assistance. We must ensure our neediest Mainers, the elderly and disabled, are put at the front of the line.”Davis disagreed.“Seniors and the disabled remain at the front of the line in Maine and in the United States, through the Medicare program and its connection to Medicaid for poor and low-income seniors, and those who have disabling conditions,” he wrote in the email to the BDN. “It is important for readers to know that the Affordable Care Act does not undermine or unravel the safety net for seniors and the disabled that has existed for the last several generations. Instead, the Affordable Care Act attempts to extend the types of benefits that Medicaid offers to a broader set of individuals who are currently uninsured.”Eastern Maine Medical Center to acquire Sunbury Medical Associates, including 4 clinics
Posted Sept. 17, 2013, at 6:28 p.m.BANGOR, Maine — Eastern Maine Medical Center and Sunbury Medical Associates have struck a deal under which the hospital will buy the private family medical practice and its four clinics.The terms of the sale were not immediately released.EMMC spokeswoman Jill McDonald confirmed Tuesday that the purchase is taking place but declined to discuss specifics.“We really want to communicate with patients first,” McDonald said, adding that the hospital will send letters out this week to inform Sunbury patients of the change in ownership and to reassure them that they will continue to have access to quality medical care after the ownership change.Sunbury’s family medical sites in Bangor, Brewer, Hermon and Winterport serve roughly 35,000 patients, Sunbury CEO David Savell said Tuesday.In March, Sunbury sold its practice in Corinth to Mayo Regional Hospital in Dover-Foxcroft, according to published reports.Last year, Sunbury opened a walk-in care facility at its headquarters in Bangor. It also closed its facilities in Hampden and Orono and transferred its medical providers and patients to its Winterport and Bangor locations.Though the number of employees has fluctuated over the years, Savell said that the company employed about 210 at its peak and now employs about 140.Whether those employees will be retained was not clear this week. Savell said that was EMMC’s decision to make.“They have their own strategic plan,” he said, adding that EMMC officials have been very respectful to Sunbury employees throughout the negotiations process.Savell said that Sunbury and EMMC reached agreement on the terms of the sale on Monday and that the deal will be closed on Sept. 30.Savell said the arrangement will be good for the community.“We’re excited,” he said. “They clearly are a good partner to sell this practice to. Eastern Maine clearly has more resources than Sunbury could bring to bear. I just cannot say enough how the community will benefit.”Savell said the move is good for the community because private practices like Sunbury have disadvantages in the marketplace, which make it hard to compete with nonprofits like EMMC that have access to grants and better reimbursement rates.On health care, ‘party of no’ should focus on ‘getting to yes’
Posted Sept. 19, 2013, at 1:29 p.m.Last week, Republicans in the House voted for the 41st time to repeal or dismantle parts of the Patient Protection and Affordable Care Act. And no, the 42nd time is not going to be the charm.What exactly is the Republican endgame? Initially, it may have been about what House Speaker John Boehner calls the “optics”: allowing newly elected members to cast a symbolic vote on the law. Now they just look like spoilers.Back in May, the New York Times calculated that since Republicans took power in 2011, they have devoted “no less than 15 percent of their time” on the House floor to repealing or modifying the law. Lawmakers might just as well meet biennially if this is how they are going to spend their time.The health care act is the law of the land. It survived a Supreme Court challenge. That should appeal to the libertarian wing of the Republican Party.Whether you’re a fan of Obamacare or think it’s the worst thing since socialized medicine (or that it is socialized medicine), you have to wonder what on earth the Republicans are up to. If Obamacare is so unworkable — if the inherent structure is so flawed as to increase demand for health care, reduce supply and send costs soaring — why not allow the law to be fully implemented and watch it implode? Wouldn’t that better serve their purposes, whatever they may be?It is popular among conspiracy theorists to claim that Obamacare is a Trojan horse, a surreptitious way to introduce a single-payer system of universal health care. If you buy that argument, it follows that you have to kill it before it morphs into something else.If you aren’t partial to tinfoil hats, a better argument would be that time is running out. On Oct. 1, the state health-insurance exchanges will open for business. (The insurance purchased doesn’t take effect until Jan. 1.) Once the subsidies start flowing in January to low- and middle-income families, the law will be very hard to reverse.As Ronald Reagan put it: “The nearest thing to eternal life we will ever see on this earth is a government program.”The latest Republican gambit is an attempt to link a vote on a continuing resolution to fund the government after Sept. 30 to a rider that defunds Obamacare for a year. President Barack Obama chose to delay selective portions of the law, including the employer mandate, for a year. And Congress has already passed seven bills, which were signed into law, to repeal or delay parts of the health care act. Under the circumstances, delaying the funding for a year makes perfect sense.There is no chance of such a measure winning Senate approval. If it did, Obama would veto it. He’s already started to blame the Republicans for shutting down the government — two weeks hence.Republicans do have a plan, even though you may not have heard about it. Rep. Tom Price, R-Ga., has introduced H.R. 2300, the Empowering Patients First Act, just as he did in the 111th and 112th Congresses. Price, a physician, says the goal of his patient-centric proposal is to ensure access to health coverage for all Americans, control costs, solve the problems of portability and pre-existing conditions, and improve the health care delivery structure. Under Price’s plan, Americans would own their coverage, taking it with them when they change jobs. It would level the playing field by offering individuals a tax deduction, in addition to a refundable tax credit, for purchasing insurance. It would save billions of dollars by addressing lawsuit abuse, freeing doctors from practicing defensive medicine. And yes, it would repeal Obamacare. The American public needs to hear more about the alternatives, about “replace” rather than “repeal.”FAQ: Obamacare And Coverage For Immigrants - Kaiser Health News
The U.S. is home to more than 21 million immigrants who are not citizens, and for many of them, health coverage is a concern. That is partly because so many of them--both those who came here legally and those who do not have permission to live in the United States--work in low wage jobs that don’t include health coverage.As a result, non-citizens are three times more likely to be uninsured than U.S.-born residents, although they represent only 20 percent of the total uninsured.The health law will help some gain coverage, although those in the country illegally will not get access to federal subsidies or to insurance sold through new state-based exchanges. That decision by the Obama administration brought complaints from immigration advocates. Hispanic groups complained about the Obama administration's decision in 2012 to not extend the health law’s coverage to young adults who are accepted into a new program granting temporary amnesty to some who were brought to the U.S. as children.But for those who are not exempt, the health law is expected to boost coverage, either through private insurers or in Medicaid, the state-federal health program for low-income residents. Here are five questions about the health law, immigrants and the medical providers who care for them.Expect Snags As The Affordable Care Act Rolls Out
This story comes from our partner Stateline, the daily news service of the Pew Charitable Trusts.There will be glitches when the major provisions of the Affordable Care Act are implemented starting Oct. 1. Huge glitches. Many glitches. Bet on it.That is a prediction not only from those resolutely opposed to the ACA. Even those quite excited about President Barack Obama’s federal health law have the same expectation: The rollout of the biggest new social program in nearly 50 years is not going to be pretty.“When you’re dealing with tens of millions of new clients, mistakes are inevitable,” said Henry Aaron, a health economist at the Brookings Institution. “You’re going to have thousands of mistakes.”Health Spending Over The Coming Decade Expected To Exceed Economic Growth
The nation’s total health spending will bump up next year as the health law expands insurance coverage to more Americans, and then will grow by an average of 6.2 percent a year over the next decade, according to projections released Wednesday by government actuaries.That estimate is lower than typical annual increases before the recession hit. Still, the actuaries forecast that in a decade, the health care segment of the nation’s economy will be larger than it is today, amounting to a fifth of the gross domestic product in 2022.They attributed that to the rising number of baby boomers moving into Medicare and the actuaries’ expectation that the economy will improve, according to their findings published in the journal Health Affairs.
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