Americans are paying for health care with more than money
Posted Dec. 19, 2013, at 8:51 a.m.
Americans now spend close to $3 trillion a year for health care, around 18 percent of our GDP. That works out to almost $9,000 per person in Maine, almost twice as much per person as the average for other wealthy nations that provide health care for all their people.
Not only do we pay more, but we pay in far more ways than any other country. Some are obvious. They include health insurance premiums, “out of pocket” co-pays and deductibles, and payments for health care products and services that are not covered by insurance. Out-of-pocket payments are increasing every year as insurers shift more of the rising costs to their customers and employers to their employees.
We also pay in ways that are not so obvious. We all pay federal, state and local taxes to support programs such as Medicare and Medicaid, health care for federal, state and local employees, military personnel, the Veterans Affairs and many others. Since employment-related health insurance is tax exempt, we also pay around $250 billion a year in the form of lost tax revenues, that is then made up by higher taxes on all of us.
Other ways we pay are almost invisible, but we feel them anyway. Workers no longer bargain for increased wages or better working conditions. In a weak economy, any small gains they have made in total compensation have been more than consumed by increases in health care costs. As a result, real wages are declining.
At a recent national health care conference I attended, there was a panel discussion about the effects health care costs on a small central Maine town. Employee health care costs have risen dramatically over recent years. Benefits for the town’s 11 employees now total $18,000 each for a total of almost $200,000. This has forced severe cutbacks in other services such as road maintenance, public safety, libraries, education, and (ironically) emergency medical services. Diminished public services and a deteriorating quality of life is one more way we pay for our health care.
This should come as no surprise. During the past sixty years or so Americans have generously poured money into our health care system through thousands of channels that are individually difficult and collectively impossible to control.
Since Americans view health care as a business, we’ve allowed our health care system to become populated by thousands of profit seeking companies (some nominally nonprofit), each trying to maximize profits and competing for a larger share of an ever-growing pie. Many of these private businesses are heavily subsidized by tax-supported health care programs and tax breaks. So far, we have been unwilling to put any effective restraints around the growth of this huge pot of gold.
This is not a failure of capitalism or corporations, They are simply doing what they are supposed to do — create wealth for their owners. It’s a massive failure of public policy. It’s the fault of all of us, including our political leaders, for failing to put any meaningful constraints around our health care system to keep it affordable for everybody.
The result has been the creation of a gargantuan medical-industrial complex that has become the pac-man of public and private budgets. It is riddled with inefficiency and waste including unjustifiablyhigh prices and excessive use of lucrative services and products, many of them without demonstrated value or downright harmful,.
The Affordable Care Act begins to make some timid efforts at addressing this problem. Nobody I know thinks they will be sufficient. After seven years of “RomneyCare” (after which the Affordable Care Act was patterned), Massachusetts now has almost everybody insured, but it has the highest health care costs of any state in the country. Some public figures there are beginning to suggest moving toward a statewide single-payer system.
As I’ve written before, the market forces the ACA is trying to harness have not, will not and cannot solve this problem. As most other wealthy countries have done, we need to channel the many existing health care revenue streams together into a single funnel with a publicly managed flow-control valve, and then muster the political will to use it. That is what our neighbors in Vermont are now in the process of trying to do.
As one Canadian conference participant put it, “It breaks my heart to see Americans destroying your schools, libraries and public safety to pay for health care.”
It breaks my heart, too. We can do a lot better.
Americans now spend close to $3 trillion a year for health care, around 18 percent of our GDP. That works out to almost $9,000 per person in Maine, almost twice as much per person as the average for other wealthy nations that provide health care for all their people.
Not only do we pay more, but we pay in far more ways than any other country. Some are obvious. They include health insurance premiums, “out of pocket” co-pays and deductibles, and payments for health care products and services that are not covered by insurance. Out-of-pocket payments are increasing every year as insurers shift more of the rising costs to their customers and employers to their employees.
We also pay in ways that are not so obvious. We all pay federal, state and local taxes to support programs such as Medicare and Medicaid, health care for federal, state and local employees, military personnel, the Veterans Affairs and many others. Since employment-related health insurance is tax exempt, we also pay around $250 billion a year in the form of lost tax revenues, that is then made up by higher taxes on all of us.
Other ways we pay are almost invisible, but we feel them anyway. Workers no longer bargain for increased wages or better working conditions. In a weak economy, any small gains they have made in total compensation have been more than consumed by increases in health care costs. As a result, real wages are declining.
At a recent national health care conference I attended, there was a panel discussion about the effects health care costs on a small central Maine town. Employee health care costs have risen dramatically over recent years. Benefits for the town’s 11 employees now total $18,000 each for a total of almost $200,000. This has forced severe cutbacks in other services such as road maintenance, public safety, libraries, education, and (ironically) emergency medical services. Diminished public services and a deteriorating quality of life is one more way we pay for our health care.
This should come as no surprise. During the past sixty years or so Americans have generously poured money into our health care system through thousands of channels that are individually difficult and collectively impossible to control.
Since Americans view health care as a business, we’ve allowed our health care system to become populated by thousands of profit seeking companies (some nominally nonprofit), each trying to maximize profits and competing for a larger share of an ever-growing pie. Many of these private businesses are heavily subsidized by tax-supported health care programs and tax breaks. So far, we have been unwilling to put any effective restraints around the growth of this huge pot of gold.
This is not a failure of capitalism or corporations, They are simply doing what they are supposed to do — create wealth for their owners. It’s a massive failure of public policy. It’s the fault of all of us, including our political leaders, for failing to put any meaningful constraints around our health care system to keep it affordable for everybody.
The result has been the creation of a gargantuan medical-industrial complex that has become the pac-man of public and private budgets. It is riddled with inefficiency and waste including unjustifiablyhigh prices and excessive use of lucrative services and products, many of them without demonstrated value or downright harmful,.
The Affordable Care Act begins to make some timid efforts at addressing this problem. Nobody I know thinks they will be sufficient. After seven years of “RomneyCare” (after which the Affordable Care Act was patterned), Massachusetts now has almost everybody insured, but it has the highest health care costs of any state in the country. Some public figures there are beginning to suggest moving toward a statewide single-payer system.
As I’ve written before, the market forces the ACA is trying to harness have not, will not and cannot solve this problem. As most other wealthy countries have done, we need to channel the many existing health care revenue streams together into a single funnel with a publicly managed flow-control valve, and then muster the political will to use it. That is what our neighbors in Vermont are now in the process of trying to do.
As one Canadian conference participant put it, “It breaks my heart to see Americans destroying your schools, libraries and public safety to pay for health care.”
It breaks my heart, too. We can do a lot better.
The following is a very telling article. Think there are any lessons here?
- SPC
Baucus Still Fretting Over Health Law He Shepherded
By SHERYL GAY STOLBERG
WASHINGTON — Senator Max Baucus of Montana is the powerful — and, to many fellow Democrats, infuriating — chairman of the Senate Finance Committee. He is also the conflicted architect of President Obama’s health care law.
Eight months after warning of a “huge train wreck” if the administration did not do a better job explaining the law, Mr. Baucus said he had “a flash of anger” over its bungled rollout. In a wide-ranging conversation in his Capitol Hill office, he also said that the law did not do enough to control costs and that Kathleen Sebelius, Mr. Obama’s health secretary, and her top aides delivered only “platitudes” when he asked them for specifics on how they would carry out the health overhaul.
“The more I asked,” he said, “the more concerned I became.”
But in the unruly Washington blame game kicked off by the Affordable Care Act, no one is safe, including Mr. Baucus. As he laments the Obama administration’s bureaucratic ineptitude, Democrats still blame him for a protracted and fruitless courtship to get Republican support for the law, and for handing the G.O.P. the “train wreck” comment as a prime talking point. In 2009, it fell to Mr. Baucus to shepherd the measure through the Senate by dint of his committee chairmanship and the death of the chamber’s leading voice on health care, Edward M. Kennedy. Today the law is Mr. Baucus’s legacy as much as Mr. Obama’s.
But the act is hugely unpopular in Montana, and some analysts say it could have cost Mr. Baucus his re-election in 2014. After 35 years as Montana’s senator — its longest serving one — he is not running again. At 72 and newly remarried, he is building a house in Bozeman and says he is ready for “a whole new chapter.”
So he is liberated, free to speak his mind. He believes that Americans will ultimately embrace the health care law, although he said it might take as long as a decade.
“Max has always made some Democrats nervous — his fateful words about the Obamacare train wreck have turned out to be very true,” said John E. Sununu, the Republican former senator from New Hampshire. “And given that for the next year, he’s going to be telling it like it is, he’s going to put a lot of them in a tough position.”
Mr. Baucus frets that the health care law had no Republican support in either the Senate or the House. “It is my belief that for major legislation to be durable, sustainable, it has to be bipartisan,” Mr. Baucus said in the interview, sounding more like a Republican than a Democrat. “I mean, one party can’t jam legislation down the other party’s throat. It leaves a bitter taste.”
http://www.nytimes.com/2013/12/19/us/politics/baucus-still-fretting-over-health-law-he-shepherded.html?pagewanted=2&tntemail0=y&emc=edit_tnt_20131218&pagewanted=print
How to Revive the Fight for Single-Payer
When the media frenzy subsides and Republicans run out of scare stories, the country will be faced with the most important question about Obamacare: Can it deliver what it promised? Thanks to the Affordable Care Act, a new business model is rapidly emerging in the medical-industrial complex that, in theory, can dramatically reduce the inflated costs of healthcare while serving everyone—rich and poor, healthy and sick. But the reformed system will also still rely on the market competition of profit-making enterprises, including insurance companies. A lot of liberal Democrats, though they voted for Obama’s bill, remain skeptical.
“In the long arc of healthcare reform, I think [the ACA] will ultimately fail, because we are trying to put business-model methods into the healthcare system,” said Washington Representative Jim McDermott. “We’re not making refrigerators. We’re dealing with human beings, who are way more complicated than refrigerators on an assembly line.” I turned to the Seattle congressman for a candid assessment because he’s the third-ranking Democrat on the House Ways and Means Committee and has been an advocate of single-payer healthcare for decades. Plus, he’s a doctor.
The business transformation under way in healthcare involves the consolidation of hospitals, doctors and insurance companies in freestanding “integrated delivery systems”—nonprofit and profit-seeking—that will have the operating scope and power to eliminate duplications and waste and hold down costs, especially the incomes of primary-care doctors. Major hospitals are buying up other hospitals and private practices, and they’re hiring younger doctors as salaried employees. An American Medical Association survey in 2012 found that a majority of doctors under 40 are employees, no longer independent practitioners.
“The medical-industrial complex is putting itself together so that the docs will be the least of our problem,” McDermott said. “They will simply be serfs working for the system.” The AMA’s market research reports that “hospitals focus on employing primary-care physicians in order to maintain a strong referral base for high-margin specialty service lines.” Big hospitals need a feeder system of salaried doctors, McDermott explained, to keep sending them patients in need of surgery or other expensive procedures.
Why the Left Should Defend Obamacare
The Affordable Care Act began life as a compromise—a complicated and frustrating political calculation—and it is never easy to defend a compromise. But failure to do so at this critical stage in the rollout of the ACA will create a crisis not just for healthcare in America but for the notion that government can and should repair the breaches that threaten civil and humane society.
When President Obama and Democratic leaders in Congress decided to expend political capital to address the absolute failure of the free market to provide affordable, readily available healthcare to tens of millions of working Americans, they took off the table the right response to the crisis—a single-payer, “Medicare for All” system. They believed the best reform was politically unachievable, so they cobbled together a hybrid of public regulation and private insurance that has come back to haunt them. Now, as the peddlers of junk insurance game the system to defend their profiteering, and as Republicans gleefully spin incoherent “told you so” fantasies, some Democrats are going weak in the knees. Thirty-nine of them in the House simply threw in with the Republicans on November 15 to back an attack on the basic premises of “Obamacare.”
There is no question that the drafting and design of the Affordable Care Act was flawed (the administration should not have sacrificed the public option, for example). Nor is there any question that the rollout of the government ACA website was disastrous. These problems, of course, must be addressed. But the “fixes” now on offer from Congressional Republicans are, at best, a mangling of the initial plan and, at worst, acts of sabotage that will fatally undermine the promise of quality coverage for the uninsured and underinsured.
Tackling a Racial Gap in Breast Cancer Survival
By TARA PARKER-POPE
MEMPHIS — After her doctor told her two months ago that she had breast cancer, Debrah Reid, a 58-year-old dance teacher, drove straight to a funeral home. She began planning a burial with the funeral director and his wife, even requesting a pink coffin.
Sensing something was amiss, the funeral director, Edmund Ford, paused. “Who is this for?” he asked. Ms. Reid replied quietly, “It’s for me.”
Aghast, Mr. Ford’s wife, Myrna, quickly put a stop to the purchase. “Get on out of here,” she said, urging Ms. Reid to return to her doctor and seek treatment. Despondent, Ms. Reid instead headed to her church to talk to her pastor.
“I was just going to sit down and die,” she says.
Like many other African-American women in Memphis and around the country, Ms. Reid learned about her breast cancer after it had already reached an advanced stage, making it difficult to treat and reducing her odds of survival. Her story reflects one of the most troubling disparities in American health care. Despite 20 years of pink ribbon awareness campaigns and numerous advances in medical treatment that have sharply improved survival rates for women with breast cancer in the United States, the vast majority of those gains have largely bypassed black women.
The cancer divide between black women and white women in the United States is as entrenched as it is startling. In the 1980s, breast cancer survival rates for the two were nearly identical. But since 1991, as improvements in screening and treatment came into use, the gap has widened, with no signs of abating. Although breast cancer is diagnosed in far more white women, black women are far more likely to die of the disease.
And Memphis is the deadliest major American city for African-American women with breast cancer. Black women with the disease here are more than twice as likely to die of it than white women.
European Agency Warns of Risk to Humans in Pesticides Tied to Bee Deaths
By DANNY HAKIM
LONDON — European food regulators said on Tuesday that a class of pesticides linked to the deaths of large numbers of honey bees might also harm human health, and they recommended that the European Commission further restrict their use.
The commission, which requested the review, has already taken a tougher stance than regulators in other parts of the world against neonicotinoids, a relatively new nicotine-derived class of pesticide. Earlier this year, some were temporarily banned for use on many flowering crops in Europe that attract honey bees, an action that the pesticides’ makers are opposing in court.
Now European Union regulators say the same class of pesticides “may affect the developing human nervous system” of children. They focused on two specific versions of the pesticide, acetamiprid and imidacloprid, saying they were safe to use only in smaller amounts than currently allowed. Imidacloprid was one of the pesticides placed under a two-year ban this year.
The review was prompted by a Japanese study that raised similar concerns last year.
Imidacloprid is one of the most popular insecticides, and is used in agricultural and consumer products. It was developed by Bayer, the German chemicals giant, and is the active ingredient in products like Bayer Advanced Fruit, Citrus & Vegetable Insect Control, which can be purchased at stores internationally, including Home Depot in the United States.
Acetamiprid is sold by Nisso Chemical, a German branch of a Japanese company, though it was developed with Bayer’s help. It is used in consumer products like Ortho Flower, Fruit & Vegetable Insect Killer.
Early figures suggest startup insurer outpacing Anthem on Obamacare enrollment
Posted Dec. 19, 2013, at 3:15 p.m.
A local startup health insurer appears to be outpacing market leader Anthem in signing Mainers up for coverage under the Affordable Care Act.
Early numbers, still subject to change, indicate the nonprofit Maine Community Health Options, or MCHO, based in Lewiston, has captured nearly 73 percent of the Maine residents who have chosen a health plan through healthcare.gov, the federal government’s gateway for the marketplaces in Maine and 35 other states.
Last week, the U.S. Department of Health and Human Services released updated enrollment information showing that 1,747 Mainers chose a plan through the website from its launch on Oct. 1 through Nov 30. Kevin Lewis, CEO of MCHO, said 1,268 people enrolled in his nonprofit’s plans during those two months, based on data it has received from the federal government.
Anthem Blue Cross and Blue Shield in Maine, the only other insurer in the state selling plans through healthcare.gov, declined to release enrollment figures. In Maine, Anthem has been the largest player in the market healthcare.gov targets, people who buy their own insurance rather than get coverage through work or government programs such as Medicaid and Medicare.
With the balky healthcare.gov improving day by day, more Mainers are signing up for health insurance, Lewis said.
“We’re seeing vastly accelerated pace of enrollment now relative to the first couple of months,” he said. “It definitely seems to be working, we’ll see what the rest of December brings, but we’re well on our way to getting lots of people into coverage.”
Lewis expressed confidence in the enrollment figures, despite data errors that have plagued healthcare.gov behind the scenes, preventing the website from properly alerting insurers when a new member enrolls in their plans. The faulty transmissions have led to insurers receiving some flawed or duplicate enrollment records.
The errors in enrollment files MCHO has received actually suggest the nonprofit’s sign-ups might rise further for the October-November period, Lewis said.
But Emily Cooke, an attorney at Pierce Atwood in Portland with expertise in the Affordable Care Act, said it’s too soon to draw any conclusions. Along with the data errors, possible differences in data-collection methods and the small sample size make the figures unreliable at this early stage, she said.
Consumers also still have three more months, until March 31, to sign up for health insurance during healthcare.gov’s open enrollment period. Many are expected to wait until the last minute.
“We know it’s very likely that we’ll see enrollment creep up, so it certainly could shift that balance [between MCHO and Anthem],” she said.
Another Rule in Health Law Is Scaled Back
By ROBERT PEAR
WASHINGTON — Millions of people facing the cancellation of health insurance policies will be allowed to buy catastrophic coverage and will be exempt from penalties if they go without insurance next year, the White House said Thursday night.
Kathleen Sebelius, the secretary of health and human services, disclosed the sudden policy shift in a letter to Senator Mark Warner, Democrat of Virginia, and five other senators.
It was another effort by President Obama to cushion the impact of the health care law and minimize political damage to himself and Democrats in Congress who adopted the law in 2010 over solid Republican opposition.
In recent weeks, insurers have told many people that their insurance policies were being canceled because they did not comply with the minimum coverage requirements of the law. Insurers usually offer to replace the coverage with new policies that do comply, providing more benefits at higher cost.
The Department of Health and Human Services issued a bulletin on Thursday advising consumers, “If you have been notified that your individual market policy will not be renewed, you will be eligible for a hardship exemption and will be able to enroll in catastrophic coverage.”
The help for people with canceled policies was offered late Thursday, just four days before the deadline for people to sign up for coverage that starts on Jan. 1.
Ms. Sebelius said the goal was to ensure “the smoothest possible transition” for people seeking new coverage after cancellation of their policies.
Mr. Obama initially tried to address a furor over the cancellations by asking carriers to reinstate the policies. But some insurers and some state officials did not go along with his request, so the White House looked for other ways to address the problem.
Hypertension Guide May Affect 7.4 Million
By GINA KOLATA
With two-thirds of Americans over 60 experiencing high blood pressure, new treatment guidelines released on Wednesday might mean fewer medications, lower doses or even none at all for millions of people.
But the committee that released the guidelines did not have data to answer one fundamental question: How many people are affected by the change?
On Thursday, Dr. Paul Munter, a professor of epidemiology at the University of Alabama at Birmingham, came up with an answer: 7.4 million Americans out of the 51 million over 60 are in the newly defined safe range, which is blood pressure of between 140/90 and 149/90.
The old guidelines urge treatment if the systolic blood pressure — the top number — is 140 or higher. The new guidelines state that the goal for people over 60 is a systolic pressure of less than 150. In both cases the recommended diastolic pressure — the bottom number — should be lower than 90.
Dr. Munter’s figure was derived in response to an inquiry on Wednesday from a reporter. It was based on his analysis of data from the National Health and Nutrition Survey, a federal study that combines interviews and health exams to gather information on the health of Americans.
More than half of those 7.4 million people — 4.2 million — are currently taking medications to lower their blood pressure, yet still remain over 140/90. Under the old guidelines, that often led to more treatment, with doctors urging additional medications or higher doses to bring systolic pressure down. Under the new guidelines, that is no longer recommended.
The other 3.2 million can continue without treatment, though in the past they were often warned that no treatment would put them at risk of a stroke or heart attack. The committee said that anyone over 60 with pressure below 140/90 after treatment can stay on the medications, as long as there are no side effects.
An Epidemic of Attention Deficit Disorder
By THE EDITORIAL BOARD
The hard-sell campaign by drug companies to drive up diagnoses of attention deficit hyperactivity disorder, or A.D.H.D., and sales of drugs to treat it is disturbing. The campaign focused initially on children but is now turning toward adults, who provide a potentially larger market.
There is no doubt that a small percentage of children, perhaps 5 percent, have the disorder and that medication can alleviate the symptoms, such as inability to concentrate, that can impede success in school or in life. Some studies have shown that medications helped elementary schoolchildren who had been carefully evaluated for A.D.H.D. improve their concentration and their scores on reading and math tests.
Recent data from the Centers for Disease Control and Prevention showed that 15 percent of high-school-age children had been diagnosed with the disorder and that the number of children taking medication for it had soared to 3.5 million, up from 600,000 in 1990. Many of these children, it appears, had been diagnosed by unskilled doctors based on dubious symptoms.
A two-decade campaign by pharmaceutical companies promoting the pills to doctors, educators and parents was described by Alan Schwarz in The Times on Sunday. The tactics were brazen, often misleading and sometimes deceitful. Shire, an Irish company that makes Adderall and other A.D.H.D. medications, recently subsidized 50,000 copies of a comic book in which superheroes tell children that “Medicines may make it easier to pay attention and control your behavior!” Advertising on television and in popular magazines has sought to persuade mothers that Adderall cannot only unleash a child’s innate intelligence but make the child more amenable to chores like taking out the garbage.
The potential dangers should not be ignored. The drugs can lead to addiction, and, in rare cases, psychosis, suicidal thoughts and hallucinations, as well as anxiety, difficulty sleeping and loss of appetite. On Tuesday, the Food and Drug Administration warned that some A.D.H.D. medications, including Ritalin, Concerta, and Strattera, may, in rare instances, cause prolonged and sometimes painful erections known as priapism in males of any age, including children, teens and adults.
So many medical professionals benefit from overprescribing that it is difficult to find a neutral source of information. Prominent doctors get paid by drug companies to deliver upbeat messages to their colleagues at forums where they typically exaggerate the effectiveness of the drugs and downplay their side effects. Organizations that advocate on behalf of patients often do so with money supplied by drug companies, including the makers of A.D.H.D. stimulants. Medical researchers paid by drug companies have published studies on the benefits of the drugs, and medical journals in a position to question their findings profit greatly from advertising of A.D.H.D. drugs.
Minnesota Becomes Fourth State to Lose Chief of Exchange
By STEVEN YACCINO
The director of Minnesota’s health insurance exchange, April Todd-Malmlov, abruptly resigned this week, making the exchange the fourth state program to see a leadership change in the midst of mounting criticism over the rollout of President Obama’s new health care law.
At a news conference on Wednesday, Ms. Todd-Malmlov’s successor was quick to promise fixes to problems still plaguing consumers, many of whom are worried about getting coverage by Jan. 1, when new policies under the law are set to take effect.
“There is no doubt that this process will improve moving forward,” said Scott Leitz, who was named the interim chief executive of MNsure, Minnesota’s state-run marketplace. “It will be a much better process than it is now, and it will be much easier to enroll.”
Ms. Todd-Malmlov had been in damage-control mode for weeks, but calls for her removal grew after she took a tropical vacation in November — a trip seen as politically unwise at a moment of crisis for the fledgling marketplace, while frustrated residents encountered issues with the website and call center.
While critics and even some supporters of the Affordable Care Act have complained that the White House has yet to hold anyone accountable for the botched rollout of the federal health care exchange on Oct. 1, the resignation in Minnesota just days before a Dec. 23 registration deadline for consumers to receive coverage is the latest in a series of top-level departures from state-run online exchanges around the country. By most accounts, the federal exchange is operating far more smoothly.
The head of Hawaii’s health care marketplace resigned last month after delays in getting that state’s online portal up and running. During the first week of December, the director of Oregon’s troubled insurance exchange went on an unexplained medical leave. And the executive director of the program in Maryland, where the health care website was so sluggish and erratic that the state allowed insurers to handle payments directly, resigned this month. Fourteen states run their own health care exchanges; the remaining 36 rely on the federal exchange.
Health Insurers Extend Deadline for First Premiums
By REED ABELSON
Insurance companies, worried about potential chaos next month as people begin seeking coverage under the federal health care law without completing the necessary paperwork, have agreed to give consumers an extra 10 days to pay their first-month premiums, according to a statement from the companies’ trade group on Wednesday.
While some state regulators or individual companies could set different deadlines, nearly all the major insurers have agreed to cover their customers retroactively if they go to the emergency room or doctor’s office after Jan. 1, but send in their payment by Jan. 10.
The Obama administration has been urging flexibility on the part of insurers, in part because of problems with the federal government’s health insurance website,healthcare.gov. But the companies said they made the decision voluntarily.
“Our community is taking an important step to give consumers greater peace of mind about their health care coverage,” Karen Ignagni, the chief executive of the trade association America’s Health Insurance Plans, said in the statement.
Despite the extra cushion for making payments, customers who want coverage to begin by Jan. 1 will still be required, in most places, to enroll by Dec. 23. Some states, like Maryland, have pushed that deadline to Dec. 27. A bigger deadline looms on March 31, the last day for most people to obtain coverage for all of 2014 through the federal and state exchanges.
WellPoint, one of the nation’s largest insurers, said in a separate statement on the payment extension that it would also offer more help to consumers trying to sign up for coverage. “Our call centers will be staffed throughout the holidays, and teams of employees will be working to process applications quickly in this compressed time frame,” the company said. Enrollment has been climbing quickly as the technological problems that have plagued healthcare.gov are being solved, and the Obama administration has been urging insurers to be as flexible as possible in helping people who want to begin coverage next month.
Franklin Community Health Network opts to join MaineHealth
Posted Dec. 19, 2013, at 5:23 p.m.
FARMINGTON, Maine — Franklin Community Health Network, which includes Franklin Memorial Hospital in Farmington, has decided to seek a merger with MaineHealth, the largest health care system in the state.
The Franklin Community Health Network board of directors voted earlier this week to seek the necessary approvals to join MaineHealth’s network, which includes Maine Medical Center in Portland, Pen Bay Medical Center in Rockport and Waldo County General Hospital in Belfast.
Franklin Community Health Network includes the 65-bed Franklin Memorial Hospital; Evergreen Behavioral Services, an emergency mental health service; NorthStar, the region’s ambulance service; Healthy Community Coalition of Greater Franklin County; and medical practices that represent more than 50 physicians and other clinicians who provide the vast majority of the region’s primary care and specialty services.
The health network’s board spent six months analyzing its options for the future and concluded that membership in the MaineHealth system would be its best option, Joseph Bujold, who chairs the board, said in a statement.
“This decision best positions our organization to assure health-care services for our communities for the next generation,” Bujold said.
Fewer than 15 percent of all hospitals nationally remain independent, and with the downturn in the economy and health care reform, many independent hospitals are in merger discussions, according to a news release from the Farmington-based health care organization.
“The changing landscape of government reimbursement, the increasing costs to deliver health care, increasing regulation and a drive to improve quality is paving the way for many small hospitals to seek membership in larger systems,” Rebecca Arsenault, CEO of Franklin Community Health Network, said in a statement.
“By coordinating resources and collaborating on health care delivery, we’ll be able to deploy resources more effectively and better serve our community today, and well into the future,” added Arsenault. “MaineHealth’s access to technology and specialists will help our hospital to more fully develop quality health care models. We’re thrilled to be bringing the resources of Maine’s premier health system to our community.”
A vote to join MaineHealth is not all that is required. Both organizations will prepare an application to the state’s Certificate of Need unit and request an antitrust review. Assuming no issues are found, the merger is expected to be complete by late 2014, according to the release.
Medicaid Estate Recovery + ACA: Unintended Consequences?
Affordable Care Act of 2010. Estate recovery will be forced on millions of people who might have otherwise gone without insurance. Why? Because the plan is that millions more Americans have health insurance. That would be accomplished by expanding Medicaid and implementing premium assistance (subsidies). When a person is found to be eligible for Medicaid, they will be automatically enrolled into their state's Medicaid program. Those forced into Medicaid will, due to the federal law, also be forced into estate recovery. Their estates will be partly or fully taken over by the federal or state government when they die.http://www.dailykos.com/story/2013/10/17/1248425/-Medicaid-Estate-Recovery-ACA-Unintended-Consequences#
Administration reports 25% error rate on Obamacare forms from October, November
Obama administration officials announced Friday that the enrollment records for an estimated one in four Americans who chose health plans through the online federal marketplace in October and November had computer-generated errors that complicated their ability to finish buying coverage. Officials said that such errors have now become less common.
Currently, the Web site, HealthCare.gov, is making mistakes in the records of an estimated one in 10 people signing up for a health plan, according to Julie Bataille, director of communications for the Center for Medicare and Medicaid Services, the agency that oversees the federal health-insurance exchange.
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