Maine AllCare at the Movies: film and discussion in Portland
Posted Oct. 01, 2013, at 1:24 p.m.
PORTLAND, Maine — “The Healthcare Movie,” an award-winning documentary about how the Canadian and U.S. health systems
developed so differently, will be presented 7-9 p.m. on Oct. 24, at Nickelodeon Cinemas, 1 Temple St. Laurie Simons and Terry Sterrenberg, the creators of the film, will be on hand to answer questions from the audience. Dr. Phil Caper of Maine AllCare will serve as facilitator. This event is most timely as the federal Affordable Care Act is being rolled out. Admission is $7 for adults, $5 for students. Tickets may be purchased in advance or at the showing at the theater or online at patriotcinemas.com . A portion of the proceeds will go to the Portland Community Free Clinic. For more information about Maine AllCare, visit maineallcare.org or email Joe Lendvai at jlendvai@maineallcare.org. Maine AllCare is a non-profit, non-partisan organization that promotes quality, affordable health for all Maine people.
Some Key Job Sectors Turn Softer
Last year, restaurants and health care accounted for about a third of all the country’s job growth.
So some economists were concerned to see, deeper in Tuesday’s jobs report, a softening in those sectors. Health care posted a gain of only 6,800 jobs, compared with a monthly average this year of 22,000. And restaurants actually lost jobs, 7,100 of them, when they had been adding 25,000 a month.
“These were important sources of job creation, and if they’re fading we might be seeing a slower pace of growth” in the immediate future, said Dean Baker, the co-director of the Center for Economic and Policy Research in Washington.
Diane Swonk of Mesirow Financial said the health care sector had been slowing for some time, in keeping with a flattening of health care spending. Less spending on medical care may be good for the economy, but not so good for the fragile job market.
On the other hand, slowdowns in leisure and hospitality, a sector that includes restaurants and amusement parks, and in specialty construction, which includes home remodeling, point to a pullback in discretionary spending, as did a disappointing back-to-school shopping season.
“A month ahead of the shutdown, it’s particularly worrisome, because we knew that tourism would be hit hard when the government closed,” Ms. Swonk said of the September findings, adding that lower gasoline prices should have prompted more leisure and hospitality spending.
Of course, both economists cautioned against reading too much into just one month of data, noting that the trend could reverse in next month’s report.
The Obamacare Federal Health Insurance Exchanges––Week Three Status Report
I will be happy to have the Obama Administration do these status reports anytime they would like to takeover from me.If I were in the White House spinning, I could report to you that enrollment in states run by the federal exchanges jumped 50% in the last few days.
Health plans that might have told me last week that they had enrolled 400 people since October 1 are now telling me they had a "surge" in enrollment in recent days and are up to 600 people. I guess that takes us up to a trickle and a half.
Still, small health plans are generally reporting they have received dozens of enrollments and large health plans are no higher than in the hundreds.
The news from the backroom is mixed. Some plans are reporting some improvement in the error rates but still way too high for the automated processing of the thousands of enrollments per health plan that are ultimately expected. Others have said it is still a mess.
So, on a net basis, no material change after the federal exchange's weekend shutdown.
Sebelius Thrust Into Firestorm on Exchanges
By SHERYL GAY STOLBERG
WASHINGTON — The first, and perhaps most painful, call for Kathleen Sebelius to resign as President Obama’s health secretary came this month from an old family friend: Senator Pat Roberts, Republican of Kansas, who once boasted of a “special relationship” with Ms. Sebelius, forged when he worked for her father-in-law.
Now Ms. Sebelius, the former Kansas governor who is the public face of Mr. Obama’s health care overhaul, is facing a barrage of criticism over the problem-plagued rollout of its online insurance exchange. For Republicans, still reeling from their failed “defund Obamacare” strategy and government shutdown, she has proved an easy target.
Republicans insist the buck stops with the secretary. But although Ms. Sebelius runs the Department of Health and Human Services, the agency directly responsible for the health care law, there are questions about how deeply she was involved in the development of the troubled Web site.
“Kathleen has the title, but she doesn’t have the responsibility or in many respects the kind of wide authority and access to the president that she really needs to make a difference,” said one person close to Ms. Sebelius and the White House, who asked to remain anonymous to discuss internal decision-making. “Everybody thinks that she’s the driving force, but unfortunately she’s not.”
The White House kept close tabs on the creation of the online exchange, with particular attention to the Web site’s design, but managing the details of the software development was left to the Centers for Medicare and Medicaid Services, which Ms. Sebelius oversees. She testified on Capitol Hill this spring that the exchanges were “on track” to open on Oct. 1, but those close to her say she has been far more immersed in developing policy related to the health care law, and in traveling the country to promote it, than in its technical aspects.
Ms. Sebelius’s decision to leave Washington this week — she will speak at a gala at the John F. Kennedy Presidential Library and Museum in Boston on Wednesday night, then travel to promote the health care law in Phoenix; Austin, Tex.; and San Antonio — caused an uproar among Republicans who said she has not explained why the Web site failed and how the government plans to fix it.
House Republicans, including leaders of the Energy and Commerce Committee, which planned a hearing on Thursday to examine issues related to the technical failures of the Web site, have demanded that she testify. (She will do so next week.)
How to Fix the Glitches
By EZEKIEL J. EMANUEL
PHILADELPHIA — NOW that we are past the government shutdown and debt ceiling debacles, all eyes are on Obamacare. For the last three weeks, the rollout of the federal exchange Web site, a centerpiece of the law, has been riddled with problems, leaving millions of Americans frustrated and dismayed.
What went wrong? My diagnosis is that there were three big mistakes.
First, the Obama administration acted too slowly. It waited too long to release specific regulations and guidance on how the exchange would work. It also waited too long to begin building the physical Web site. These delays were largely because the administration wanted to avoid election-year controversy. This may have been a smart political move in the short term, but it left the administration scrambling to get the IT infrastructure together in time, robbing it of an opportunity to adequately consult with independent experts, test the site and fix any problems before it opened to the public.
Second, the ostensible quarterback of the federal health care exchanges, with responsibility for integrating all the various components, is the Centers for Medicare and Medicaid Services. While the agency has expertise in issuing reimbursement rules and overseeing large-scale claims-processing operations, it has little expertise in creating a complex e-commerce Web site. More important, there was no single senior person in the agency tasked with running the exchange rollout.
Finally, this was not the first health insurance exchange ever created. Massachusetts has had years of experience with its exchange, and there are private exchanges, like eHealth, where individuals can shop for insurance. In addition, many states, like California, Connecticut and Kentucky, had already spent around two years building their exchanges, gaining experience and proving it was possible to create a good customer shopping experience. It does not appear that the Centers for Medicare and Medicaid Services or its contractors spent much time reviewing these models and adopting best practices.
Now what should be done? On Monday, President Obama both criticized and defended the Web site. While he conveyed an all-hands-on-deck attitude and his commitment to solving the problems, he did not give sufficient specifics.
But there are five things we can do now to right the ship of Obamacare.
As Drug Costs Rise, Bending the Law Is One Remedy
By ELISABETH ROSENTHAL
Lee Higman, a 71-year-old artist from Bellevue, Idaho, who considers herself a law-abiding citizen, was shocked last month when she got a notice from the Food and Drug Administration telling her: “A mail shipment addressed to you from a foreign country is being held.”
The 90 tablets of Vagifem, prescribed by her physician, that she had ordered from a Canadian pharmacy had been impounded as an illegal drug at Los Angeles International Airport.
First marketed in 1988, Vagifem estrogen tablets are used by millions of women to relieve symptoms of menopause. There is no generic version available in the United States, and brand-name drugs are expensive here. So about five years ago, Mrs. Higman started ordering the tablets from Canada, where a year’s supply that would cost about $1,000 in the United States sells for under $100.
“The price went up. And we’d lost a lot on the stock market, and we’re living on fixed incomes,” Mrs. Higman, who is an artist, said in an interview. She and her husband, a writer, are covered by Medicare. In an e-mail to the Food and Drug Administration, she sought the release of the package, explaining, “When it became economically imperative I ordered it from Canada, a country with strict drug requirements.”
The high price of many prescription drugs in the United States has left millions of Americans telling white lies and committing fraud and other crimes to get their medicines. In response to a New York Times article about the costs, hundreds of readers shared their strategies, like having a physician prescribe twice the needed dose and cutting pills in half, or “borrowing” medicines from a friend or relative with better insurance coverage. But an increasingly popular — though generally illegal — route is buying the drugs from overseas.
The Canadian International Pharmacy Association, a 10-year-old group, said its members fill prescriptions for one million Americans each year. “It’s the Americans who are seeking us out,” said Tim Smith, the group’s general manager. “Clearly there’s a need.”
How Jon Stewart became President Obama’s biggest problem
By Chris Cillizza,
President Obama’s biggest problem when it comes to selling the American public on the so-far rocky rollout of his health-care law isn’t John Boehner or Mitch McConnell or even Ted Cruz. It’s Jon Stewart.
Stewart, the host of the wildly popular “Daily Show” on Comedy Central, has emerged as a harsh critic of healthcare.gov and the Obama Administration’s inability to fix it.
Stewart dedicated the entire first 10 minutes of his show — three full segments — on Monday to slashing hits on the Web site and the president’s handling of the problems. He compared Obama to “Gil”, the hapless salesman from “The Simpsons”, showed “Daily Show” correspondent John Oliver stuck in a computer after trying to sign up for Obamacare and expressed amazement that even the calculator on the healthcare.gov Web site doesn’t work. (And, remember, Stewart was heavily critical of Health and Human Services Secretary Kathleen Sebelius during an appearance on his show earlier this month.)
Here’s a clip from Monday that captures Stewart’s critique (it may not be safe to play at work for some of you):
Who cares what a late night comedian/talk show host thinks? President Obama should if viewership details on Stewart’s show are right.
According to a 2012 Pew Research Center poll, “The Daily Show” has the second largest share of young viewers — aged 18-29 — of any of the 24 media outlets tested. (The only one with a higher number of young viewers was the “Colbert Report”.)
President Obama and his administration have made it quite clear that one of the big beneficiaries of the law should be young people. “Already, millions of young adults have been able to stay on their parents’ plans until they turn 26,” Obama trumpeted in a speech defending the Affordable Care Act on Oct. 1. On Monday, in an address designed to calm worries about the problems with the healthcare.gov Web site, Obama specifically referenced three young people standing behind him who had been able to stay on their parents’ insurance until they were 26 and added: “Millions of other young people are currently benefiting from that part of the law.”
But, these same young people tend to get much of their news — and therefore have their opinions shaped — not by places like the Washington Post or the CBS Evening News but rather from Stewart. He is their Tom Brokaw, their David Brinkley. So, what Stewart says matters — a lot.
Democrats own health care
One was Paul Cox, who runs a North Carolina construction business and complained that the new law prevented him from hiring full-time employees because he would have to provide health insurance to anybody working more than 30 hours a week.
“We’ve had to keep them below 30 hours or we wouldn’t be able to . . . stay in business and pay it,” Cox said.
“It’s happening all the time,” Hannity contributed.
If by “it” Hannity meant “misinforming the American public,” then, yes, it is happening all the time.
Salon’s Eric Stern called Cox, and he found that Cox’s business has only four employees — and therefore is not affected by the new requirement, which applies to businesses with 50 or more workers. Stern reported that, after he asked Cox how this decision not to hire full-time workers was related to Obamacare, “There was a long pause, after which he said he’d call me back. He never did.” The others on Hannity’s program were similarly off-base.
This is perhaps the biggest problem facing Obamacare and probably will haunt it long after the technical problems at HealthCare.gov are fixed. Because of all the noise and disinformation, President Obama and the Democrats don’t just own Obamacare as a political issue. They own health care. Anytime something bad happens — premiums rise, or employers change plans or pare coverage — Obamacare will be blamed, even if the new law had nothing to do with the change.
Lack of quality ratings on Covered California site is criticized
Covered California, the state health insurance exchange, says it has reliable ratings on only four of the 12 participating insurers.
By Chad Terhune
7:00 PM PDT, October 22, 2013
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California's insurance exchange came under fire for its plan to withhold quality ratings of health plans until late 2015 while thousands of consumers shop for coverage under the federal healthcare law.
The state exchange, Covered California, said Tuesday that it had reliable ratings on only four of the 12 participating health insurers primarily because their networks of doctors and hospitals have changed so much for new policies available next year.
"We don't think providing partial information is helpful, and it might be more harmful," said Dr. Jeffrey Rideout, senior medical advisor at Covered California. "History is sometimes a good predictor of future performance, but in this case it's not."
Rideout said the earliest that quality ratings would appear on the exchange is October 2015, after the state has time to survey patients and examine claims data.
Another state agency, the Office of the Patient Advocate, already publishes annual ratings of the largest HMO and PPO plans, handing out one to four stars in a variety of categories. The report card looks at whether insurers are meeting national standards for recommended care, and it asks patients to rate their own experience.
Both consumer advocates and HMO giant Kaiser Permanente criticized Covered California's move and said they would try to persuade the exchange's five-member board to reconsider at a meeting Thursday. Critics said the delay rewards lower-performing insurers and forces consumers to focus on price alone.
"It's disappointing because consumers care about this information," said Betsy Imholz, special projects director for Consumers Union. "Other states are going forward with these ratings. I don't think we should require it to be perfect."
Kaiser Permanente and two other insurers — Sharp Health Plan in San Diego and Western Health Advantage in Sacramento — complained in a letter to the exchange this week that "there has never been a compelling reason to deny this information to consumers.... On this issue, Covered California has surrendered its 'pace car' status."
http://www.latimes.com/business/la-fi-exchange-health-insurers-20131023,0,4398046,print.story
LePage holds firm in opposition to Medicaid expansion, but GOP senator says negotiations continue
Posted Oct. 22, 2013, at 5:28 p.m.
AUGUSTA, Maine — Gov. Paul LePage is watching closely as Republican governors in other states find ways to expand their Medicaid programs under the Affordable Care Act, but so far LePage is not ready to propose anything that would lead to an expansion in Maine.
However, Assistant Senate Minority Leader Roger Katz, R-Augusta, said his push toward an expansion model acceptable to his GOP colleagues and the executive branch continues. Katz said he’s trying to craft a compromise that would help poor people afford health insurance while addressing concerns that a culture of entitlement arises if people don’t pay a portion of their health care costs.
LePage spokeswoman Adrienne Bennett said Tuesday morning that the governor’s stance on expanding Medicaid under the federal Affordable Care Act has not changed: he wants a better deal from the federal government than the one that is currently proposed. But federal officials have said they can’t sweeten the deal.
“A one-size-fits-all approach is not acceptable and we hope the Obama administration continues to be open to creative solutions that states develop for themselves,” said Bennett in a written statement. “Gov. LePage has consistently advocated for flexibility from the federal government because the current system is broken and financially unsustainable. The LePage administration will continue to evaluate these models and explore options for ensuring quality health care and fiscal responsibility.”
Bennett said Tuesday that her comments do not mean LePage has moved any closer to accepting any form of Medicaid expansion. She repeated often-used arguments that the Medicaid program is already too big — with one in three Mainers participating — and too expensive.
At issue is the federal government’s offer to states to pay 100 percent of the cost of expanding Medicaid programs for three years, ramping down to 90 percent support thereafter. The expansion would cover able-bodied parents and adults without children who earn up to 133 percent of the federal poverty level, which is $20,628 of income per year for a two-person household.
LePage and his Republican allies in the Legislature have argued that accepting the federal offer could lead to out-of-control cost increases in the future that would cannibalize the state’s budget. Some, most notably LePage, have also argued that they don’t trust the federal government to keep its promises.
LePage and Republicans deflected several attempts by Democrats in the Legislature earlier this year to move ahead with the Medicaid expansion. While LePage hasn’t budged much on the issue, Democrats insist that the expansion remains one of their priorities.
Meanwhile, several Republican governors, including those in Florida, Pennsylvania, Michigan, New Jersey, Arizona and Iowa, have either accepted the expansion or at least softened their opposition to it. The Toledo Blade newspaper reported Tuesday that Ohio is moving toward accepting the federal money, despite Ohio Gov. John Kasich’s early opposition.
Posted Oct. 21, 2013, at 10:38 a.m.
AUGUSTA, Maine — A committee designed to advise state government on the roll-out of the federal Affordable Care Act met for the second time on Monday but ended up generating far more questions than answers.
One of the questions everyone on the Health Exchange Advisory Committee had is how many Mainers have signed up for health insurance under the new health care law and given the widespread and disastrous technical problems in the federal government’s online sign-up tool, how many have tried and failed.
Christie Hager, a regional director for the U.S. Department of Health and Human Services, who joined the committee meeting by telephone, was unable to answer either of those questions.
“We do not have state-specific enrollment data,” said Hager. “We’re expecting we’ll have that roughly around the middle of next month.”
Sen. Margaret Craven, D-Lewiston, who chairs the committee, asked another popular question: How long until the federal online health insurance exchange is fixed?
“There’s no date certain for repairs,” said Hagar.
The deadline for signing up for health insurance that will kick in on Jan. 1, 2014, is Dec. 15 of this year. Rep. Sharon Treat, D-Hallowell, said the timeline for the release of data and repairs to the online system as stated by Hagar are problematic for health care advocates in Maine who want to help people choose an insurance plan and enroll in but don’t know where to start.
“It’s really important that we get that data on the street level as soon as possible,” said Treat to Hager. “We don’t have a lot of people beating the bushes out there to sign up. … If November 15 is when data will be available, that only leaves one month between then and when the deadline is to sign up. I strongly encourage you to get us state-level data. It would be very helpful for us to have a sense of what’s going on out there.”
That conversation led to another concern: If the sign-up system isn’t working and might not for another month, does the federal government plan to push back the sign-up deadlines?
“We don’t have any information about the moving of deadlines,” said Hager.
So where does that leave uninsured Mainers who want to enroll but have been frustrated by the computer problems. Wait a couple of weeks and try again, say the experts, such as Emily Brostek of Consumers for Affordable Health Care, who is fielding hundreds of calls from Mainers with questions about how to sign up and which plan to buy.
“We’ve been encouraging people to just wait a couple of weeks and be patient,” she said outside the meeting. “It’s a concern of ours that people might be turned off by the process but we’ve heard from people that they’re so excited to have affordable health care options that it’s not a concern for them.”
Why Kathleen Sebelius is safe
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| Kathleen Sebelius may be irreplaceable — in that she cannot be replaced. Not because President Barack Obama wouldn’t be able to find someone else to do the job, or that anyone’s too pleased with the launch of the Obamacare website. But the White House and Democrats on the Hill know a potential confirmation fight would be so torturous and difficult that they’re better off sticking with the Health and Human Services secretary they’ve got, despite all that’s gone wrong on her watch. Rep. Paul Ryan (R-Wis.) on Tuesday afternoon became the highest-ranking lawmaker to call for Sebelius’s resignation — part of a movement that picked up steam after she declined to appear at a scheduled House hearing Thursday, though she has committed to one next week. But even before the shutdown and debt ceiling standoff ended, the Republican National Committee launched its “Fire Sebelius” campaign, trying to use holding her responsible for the problem-plagued rollout as a way of redirecting the conversation back to doubts about the Affordable Care Act. (PHOTOS: HealthCare.gov: 10 Sebelius quotes) Those politics are exactly why Obama likely couldn’t and wouldn’t get rid of Sebelius, even if he wanted to: Democrats know the people opposed to the law would never let another person who backed the law through unscathed and would instead use the confirmation hearings to relitigate the Affordable Care Act — to subpoena reams of information, chase headline-grabbing leads and, overall, do whatever they could to delay or derail it. Sebelius was originally picked for the job less because she was viewed as a visionary than as a competent manager who would be able to oversee the complex process with minimal hitches. Even so, the White House says the president doesn’t want her to go now, that he continues to have full confidence in her — and that despite the disappointments and the palpable fury in the West Wing, they’re working with her to set things right. In fact, administration officials cite the success she’s had at implementing other parts of the law besides the website as reasons to keep supporting her. (Understanding Obamacare: POLITICO's guide to the Affordable Care Act) Asked Tuesday on CNN if she’d talked with Obama about resigning, Sebelius said, “What I talked about is doing the job that I came here to do. … I think my job is to get this fully implemented and to get the website working right. And that’s what I’m focused on.” The feeling inside the West Wing is that the new focus on Sebelius is transparent, just another angle of attack from the same people who’ve been behind every other effort to resist the law. http://dyn.politico.com/printstory.cfm?uuid=6421144D-7B6A-42E7-9224-8A79D628EB7E
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