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THE PROMISE OF BETTER HEALTH CARE FOR LESS FALLS SHORT AGAIN
Workers bear larger share of health premium costs
INDIANAPOLIS – Researchers say workers are paying a larger portion of health insurance costs as businesses, trying to ride out the economic downturn, shift more of the burden to their employees.
The average employee contribution toward premiums for family coverage climbed 14 percent this year to nearly $4,000, according to a report by the Kaiser Family Foundation and the Health Research and Educational Trust released Thursday. Contributions for single coverage grew 15 percent.
Total premiums rose a modest 3 percent for family coverage and 5 percent for single employees. But Kaiser Family Foundation CEO Drew Altman said companies passed most of those increases on to workers instead of absorbing them as they usually do.
The nonprofit Kaiser and the research trust surveyed more than 3,000 randomly selected companies from across the country earlier this year.
Researchers found that businesses still pay at least 70 percent of the total premium, on average, for their workers. But they're asking workers to chip in more, and that goes beyond increasing the premium contribution.
"The coverage that employees get is looking less and less like the coverage that their parents used to get," Altman said.
A growing percentage of workers are covered by health insurance that requires them to pay a deductible of $1,000 or more before most coverage starts. The increase is most striking with smaller companies, where 46 percent of workers are enrolled in high-deductible plans, up from 16 percent in 2006.
At companies with 200 or more employees, 17 percent of covered workers had high-deductible plans, up from 6 percent four years ago.
From The Director: While visiting other major nations in order to sudy their their healthcare systems,I came to the conclusion that we Americans expect/demand more care than people of other nations.
Patients waiting on line for care is the most visible, common and effective form of rationing. Those who can afford to buy private insurance policies, in addition to their government provided care, do so to avoid waiting.
We call this the two-tier model.as compared to the Single Payer System recently abandoned in some of the Canadian Provinces.
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AMERICANS HAVE TO EXPECT LESS AND TAKE BETTER CARE OF THEMSELVE IF THE COST IS TO GO DOWN
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NEW MEDICINE TO AVOID/END PREGNANCY RELEASED BY FDA
PROFESSION
5-day pill moves emergency contraception back to doctor's office
When ella is available...
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IS THIS BIRTH CONTROL OR VOLUNTARY ABORTION?
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THE ECONOMIC EFFECTS OF OUR AGING POPULATION
Volume 6 - Issue 32 John Mauldin Newsletter 8/2/2010August 2, 2010
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Demographics,...
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Approximately 60 MILLION ABORTIONS RECORDED/PERFORMED SINCE LAW MADE IT LEGAL
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PUBLIC URGED TO GET ANTI-VIRAL AND ANTI-BACTERIAL VACCINES
From the Sacramento Bee 8/31/2010
Feds recommend
this year's flu shot
for nearly everyone
Associated Press
WASHINGTON - It's flu- shot season already, and for the first time health authorities are urging nearly everyone to get vaccinated. There is even a new high-dose version for people 65 or older.
What a difference a year makes: Crowds lined up for hours for scarce shots during last fall's swine flu pandemic, when infections peaked well before enough vaccine could be produced. This year, a record vaccine supply is expected - an all-in-one inoculation that now promises protection against that swine flu strain plus two other kinds of influenza.
Shipments began so early that drugstores are offering vaccinations amid their backto-school sales.
But without last year's scare factor, the question is how many people will heed the new policy for near-universal vaccination. No more stopping to check if you're on a high-risk list: A yearly dose is recommended for virtually everyone except babies younger than 6 months - the shot isn't approved for tots that young -and people with severe allergies to the eggs used to brew it.
"Influenza is serious, and anyone, including healthy people, can get the flu and spread the flu," said Dr. Anne Schuchat of the Centers for Disease Control and Prevention. "Flu vaccines are the best way to protect yourself and those around you."
The CDC was moving toward that policy even before last year's pandemic brought home an inescapable fact: The flu virus doesn't just kill grandparents and babies and people with weak lungs or hearts, although they're particularly vulnerable. It also can kill healthy pregnant women and 30-somethings. And 5-year-olds.
'We were discussing how we were going to go get his 'Star Wars' Halloween costume after he got out of the hospital ... and all of a sudden his eyes lost their focus," said Serese Marotta of Dayton, Ohio, describing for reporters how her son Joseph, 5, died of swine flu last October before vaccine was available in her community, She urged families to make vaccination a priority.
From the Director: The decreasing ability of the currently available antibiotics to control bacterial infections that complicate viral infections increases our need to protect ourselves from viral infections such as Flu.
Consult with your Doctor as to what's best for you.
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DECREASING ABILITY TO TREAT BACTERIAL INFECTIONS CREATES A NEED TO SEEK PROTECTION FROM VIRUSES
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PUBLIC HOSPITALS CLOSING-PRIVATES FEELING THE STRAIN
Wall Street journal 8/30/2010
Cash-Poor Governments Ditching Public Hospitals
By SUZANNE...
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MANY HOSPITALS FACING BANKRUPTCY
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A SITUATION THAT REQUIRES IMMEDIATE CONCERN AND REPAIR
From SCRAMENTO BEE 8/21/2010
Medical tube errors tied to lax oversight
FDA'S APPROVAL PROCESS...
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HIGH QUALITY HEALTH CARE DELIVERY IS A COMPLESX PROCESS REQUIRING THE PROPER COORDINATION OF ALL INVOLVED
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CAT SCAN MAY BE BETTER THAN COLONOSCOPY TO SCREEN FOR COLON CANCER
From Sacramento Bee 8/21/2010
Virtual colonoscopy
touted in new study
BY SHARI ROAN
Los Angeles...
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THIS COULD MEAN SAVINGS OF MILLIONS OF DOLLARS FOR MEDICARE
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NEW INFECTION BROUGHT TO USA BY TRAVELLERS FROM INDIA [Updated 8/20/2010]
From Drudge Report 2010.com 2/1/2010 [see update below]
Reuters) - A new superbug from India...
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NO KNOWN ANTIBIOTIC IS EFFECTIVE IN TREATMENT
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ATTENTION DISORDERS IN CHILDREN LINKED TO PESTICIDES USED ON FOODS
From Sacramento Bee 8/20/2010
Pesticides cited in Attention Disorders in children
BY THOMAS H. MAUGH II Los Angeles Times
LOS ANGELES - A growing body of evidence is suggesting that exposure to organophosphate pesticides is a prime cause of attention deficit hyperactivity disorder.
The findings are considered plausible to many experts because the pesticides are designed to attack the nervous systems of insects. It is not surprising, then, that they should also impinge on the nervous systems of humans who are exposed to them.
Forty organophosphate pesticides are registered in the United States, with at least 73 million pounds used each year in agricultural and residential settings.
ADHD is thought to affect 3 percent to 7 percent of American children, with boys affected more heavily than girls. Many experts believe its incidcnce has increased sharply in recent decades, but critics attribute the increased incidence to overdiagnosis. Some attribute the increase to the greater use of pesticides.
The newest study, reported Thursday in the journal Environmental Health Perspectives, examines the effects of both prenatal and childhood exposure to the pesticides, which are widely used in the United States to control insects on food crops.
Epidemiologist Brenda Eskenazi of the University of California, Berkeley, and her colleagues have been studying more than 300 Mexican American children living in the heavily agricultural Salinas Valley.
Because they live in a farming community, the children are more likely than others to be exposed to the pesticides, but the problems resulting from environmental exposure are often first seen in those with the highest exposure.
Eskenazi and her team tested for levels of pesticide metabolites in urine in the mothers twice during their pregnancies and several times in the children after birth. They then tested the children at ages 31/2 years and 5 years for attention disorders and ADHD, using the mothers' reports, performance on standardized computer tests and behavior ratings from examiners.
After correcting the data to account for lead exposure and other confounders, they found that each tenfold increase in pesticide levels in the mothers' urine was associated with a fivefold increase in attention problems as measured by the assays. The effect was more pronounced in boys than in girls.
The study comes three months after a Harvard study, looking at much lower levels of malathion+ in urine, found that a tenfold increase in pesticide levels was associated with a 55 percent increase in ADHD. The researchers believe that most of the children in the study were exposed to the malathion through food.
"It's known that food is a significant source of pesticide exposure among the general population," Eskenazi said. "I would recommend thoroughly washing fruits and vegetables before eating them, especially if you are pregnant."
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"WASH FRUITS AND VEGETABLES THOROUGHLY BEFORE EATING"
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LISTEN TO AN ANALYSIS OF THE HIGH COST OF MEDICAL CARE
From THE AAPS NEWSLETTER 8/19/2010
AAPS President-Elect and Human Events columnist Lee...
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GOVERNMENT INVOLVEMENT INCREASES THE COST BUT LOWERS THE QUALITY OF HEALTH CARE
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"END OF LIFE" [EOL] COSTS-A MUST DISCUSS ISSUE
End-Of-Life Savings: The Fool's Gold Of Reform?
From Health Affairs Blog
July 28th, 2010
Just over 1 in 4 dollars spent by the Medicare program last year was spent on someone who was in their last year of their life. This is nothing new¨Cthe basic proportion has not changed since it was first noted in the 1970s. Other nations that spend much less on health care nevertheless spend a similar proportion of total system spending on persons in their last year of life.
Many believe that a health policy solution focused on reducing spending at end of life (EOL) is a practical cost-saving strategy for the United States, but this consistent proportion (across time and spending level) of total costs spent during the last year of life directly challenges the potential success of this approach.
A focus on EOL spending will likely receive increased attention over the coming months and years because the Medicare program is financially unsustainable, a fact that is exacerbated and made acute by the looming retirement of the baby boomers. In addition, cuts in planned future Medicare spending were used to finance insurance expansions in health care reform, and a means of absorbing such cuts in a manner that does not harm patients is a necessity.
Medicare, along with Medicaid, is the primary driver of the long-term structural federal deficit that exists and will exist in the foreseeable future unless changes are made. (See page 3, figure 1.1 of CBO's June 2009 Long-Term Budget Outlook, linked to earlier in the preceding sentence.) This fact makes further cuts in the future growth of Medicare spending needed if the system is to become sustainable, and there are no easy choices. The demographic effect of the baby boomers on Medicare was inevitable once they had fewer children than their parents; this reality can be lamented, but not altered. Slowing the rate of growth in program expenditures (payment cuts) and/or an increase in taxes are the only ways to make the program sustainable.Reducing End-Of-Life Spending: A Painless Solution?
This is where EOL spending comes in. Reducing wasteful, futile or even harmful EOL expenditures is an obvious place to start, and such reductions may offer the only "painless" cuts that could conceivably be imagined. The logic goes like this: Health care costs rise appreciably near death because most people are sick before they die, and medical care is expensive. According to the Census Bureau, 83 percent of all the deaths occurring in the U.S. occur among persons covered by Medicare, even though persons age 65 and older represent just 13 percent of the population.
We have anecdotal as well as empirical evidence that the experience of a loved one dying sometimes ends in regret at the medicalized nature of a person¡¯s last living days. This leads to the conclusion that EOL represents an opportunity to reduce spending in a manner that will not harm patients and which may actually improve quality of life. In fact, there is evidence that Medicare costs can be reduced slightly via expanded use of the hospice benefit in a manner that also improves quality of life. We know of nothing else that reduces overall spending and increases quality of life.
Thus, reducing EOL spending seems the last remaining painless way out of the box. Right?
Unfortunately, no. It is doubtful that a focus on reducing EOL spending per se will result in as much savings as is often assumed, for one simple reason: The concept of the last year of life is inherently retrospective. You do not know when the last year of someone¡¯s life started until it ends. The stylized fact that leads to the assumption of wasteful EOL spending., i.e., 1 in 4 dollars spent on care in the last year of life, is based on an inherently retrospective concept that does not translate easily into the prospective decision-making that would be needed to reduce wasteful, futile or harmful spending in the last year of life.
It is undoubtedly the case that the U.S. health care system is set up to "do everything medically possible" as a default, influenced by payment incentives embedded in how care is financed, how physicians are trained, and cultural norms and patient preferences that emphasize metaphors of "battle", "fight" and "victory" over disease. This orientation and the difficulty of accurate prognosis have led in part to the current financing conundrum.
However, changes are possible. The last 30 years have seen a cultural and professional dialogue about tradeoffs between expenditures and quality of life, leading to a general agreement that sometimes doing everything that is medically possible is not the best course, and that perhaps one could prolong a person¡¯s life in a medical condition that could be understood as being "worse than death." However, acknowledging that this state is conceptually possible is not the same thing as being able to identify such a state in the midst of the emotional intensity of a family losing a loved one, and leading them to alter their health care decisions prospectively. The Way Forward
Medicare is unsustainable. The only possible ways to change this are to increase the "in¡¯s" (taxes) or reduce the "out¡¯s" (care and/or payment rates). What is needed to achieve sustainability is a focus on purchasing value in the Medicare program across the board, not just with respect to end of life. It should be possible to reduce spending over the path implied by current Medicare policy while improving patient benefit and increasing value, but it will not be easy. Reorienting Medicare policy to value-based purchasing would mean that the following questions would be integrated into everything that Medicare pays for: "Does this extend life?" and "Does this improve quality of life?"
If the answer to both of these questions is no, then Medicare shouldn¡¯t be paying for it. If the answer to at least one of these questions is yes, then some means of asking the question "Is this benefit worth the cost?" needs to be developed and made a natural part of the policy-making process of running Medicare and of an honest cultural discussion of the costs and benefits of medicine. Obviously, there are value judgments and subjective assessments required to identify whether there are quality of life improvements, as well as to determine whether any improvements are "worth it." However, even agreeing that these questions are important, legitimate, and should be answered to inform Medicare policy would be a major step in the correct direction. That will not be easy.
The recently passed Patient Protection and Affordable Care Act (PPACA) has a variety of provisions that provide a chance for us to nudge Medicare toward an increased focus on purchasing value for seniors in a way that could begin to slow the rate of cost inflation in the program. History shows that changes in Medicare tend to filter into the health system as a whole.
There are a variety of payment and delivery experiments enabled in the law (Accountable Care Organizations, bundling, etc.) that could have a positive effect in altering incentives that now encourage more, but not necessarily high-value, care. Increased spending made available for comparative effectiveness research (which is now being called, patient-centered outcomes research) should help us to identify when commonly done interventions and clinical patterns do not seem consistent with purchasing value.
The Independent Medicare Advisory Commission should help force some difficult changes that could slow cost inflation. Finally, the Medicare Innovation Center has a chance to alter the culture of the Center for Medicare and Medicaid Services in the direction of experimentation and adopting new approaches in a more timely manner, which could revolutionize how Medicare benefit and payment policy is made.
There are numerous technical issues and problems related to practically operationalizing these new policy innovations into the functioning of the Medicare program, especially when it comes to the emotionally charged territory of the care of potentially vulnerable individuals who are near death. Moreover, if we seriously undertake a policy of seeking to reorient incentives and policies in Medicare, mistakes will inevitably be made. However, the technical barriers of moving toward purchasing value are dwarfed by the cultural and political ones. During the most recent health reform debate, a proposal for Medicare to pay for a modest palliative care consultation became "death panels." As anyone who has taken a glance at the financial situation of Medicare knows, there is nothing systematically limiting the amount of health care that elderly Americans are receiving. A Rorschach Test Measuring Perceptions Of The U.S. Health Care System
The real issue is whether there will be a revolution in how we will make medical financing decisions. Figure 1 below shows the per capita expenditure of the U.S. on health care along with a variety of other nations that are our trading and cultural partners. The figure in many ways is a Rorschach test for how one views the health care system in the U.S. In factual terms, it shows that the U.S. spends about two dollars each time many of our trading partners and other high income nations spend one dollar. However, U.S. life expectancy at birth is about the same, or a bit worse, and other measures paint a similar story.
When showing this information as a slide during numerous talks around North Carolina during the past year, there is a surprising reaction by the audience. Put simply, many responded by saying, "Yeah, but those other systems stink and ours is the greatest in the world." There are a variety of conclusions one could draw from the information in this slide, but we think that one is a stretch, unless you were predisposed to it in the first place. When we view this slide, our first thought is that "we aren¡¯t getting our money¡¯s worth for what we spend on health care."
The percent of GDP spent on health care in and of itself means very little. It is simply a signal of the relative value of health as compared to other items on which we could spend our money. However, the rate of increase in health care inflation has pushed our expenditures on health to a point of being unsustainable unless we undertake other changes in spending or taxation that we doubt are tenable. The real question is: why aren¡¯t we getting our money¡¯s worth? We believe what is needed in policy terms is more focus on purchasing value in health care, first in the Medicare program, and then throughout the system. Purchasing based upon quality/benefit or cost alone is bad policy; cost per quality/benefit improvement is the key to defining value.
Such a reorientation would likely reduce EOL spending ¨C along with spending across the rest of the life cycle. Since we cannot be sure when we are within the last year of life until it is over, the application of policies to change how we purchase care in the Medicare program must be applied across the illness trajectory and not just pigeon-holed as a last year of life issue. We are buying Fool¡¯s Gold if we think that EOL savings alone will provide the Medicare savings necessary to finance health reform, let alone the further cuts needed to make the program sustainable.
It will be very hard for our nation to make the changes necessary to render Medicare sustainable. But in one sense we are lucky: Our fiscal situation is so grave that we really don¡¯t have any choice but to try. Lets get started.
From the Director: No mention is made of the liability concerns of the care givers. That is, the likelyhood of lawsuits brought by angry family members who feel that all should have been done until the last breath/heart beat of their dear departed loved one.
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AUTHORS CALL IT "THE FOOL'S GOLD OF REFORM"
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FDA DECISION TO DROP "AVASTIN" FOR BREAST CANCER PATIENTS SUGGE$STS "DEATH PANEL" OPERATING
From THE Telegraph.co.uk 8/16/2010
US breast cancer drug decision 'marks start of death panels' ?
America's health watchdog is considering revoking its approval of the drug Avastin for use on women with advanced breast cancer, leading to accusations that it will mark the start of 'death panel' drug rationing.
Nick Allen in Los Angeles and Andrew Hough
Published: 10:07PM BST 16 Aug 2010
A decision to rescind endorsement of the drug would reignite the highly charged debate over US health care reform and how much the state should spend on new and expensive treatments.
It costs $8,000 (£5,000) a month and is given to about 17,500 women in the US a year. The drug was initially approved after a study found that, by preventing blood flow to tumours, it extended the amount of time until the disease worsened by more than five months. However, two new studies have shown that the drug may not even extend life by an extra month.
The FDA advisory panel has now voted 12-1 to drop the endorsement for breast cancer treatment. The panel unusually cited "effectiveness" grounds for the decision. But it has been claimed that "cost effectiveness" was the real reason ahead of reforms in which the government will extend health insurance to the poorest.
If the approval of the drug is revoked then US insurers would be likely to stop paying for Avastin.
The Avastin recommendation led to revived allegations that President Barack Obama’s overhaul of the US health care system would mean many would be denied treatments currently available.
During the debate, those opposed to the reforms cited Britain’s National Institute for Clinical Excellence, which decides whether new treatments should be made available on the NHS on the basis of cost effectiveness, as an example of the sort of drug rationing that amounted to a "death panel".
David Vitter, the Republican Senator for Louisiana, said the FDA decision amounted to rationing health care.
"I shudder at the thought of a government panel assigning a value to a day of a person’s life," he said. "It is sickening to think that care would be withheld from a patient simply because their life is not deemed valuable enough.
"I fear this is the beginning of a slippery slope leading to more and more rationing under the government takeover of health care that is being forced on the American people."
Avastin has been described as "the poster child for expensive anti-cancer drugs".
When reviewing drugs for approval the FDA is only charged with looking at their health risks and benefits, not cost effectiveness. It usually follows advisory panel recommendations. A final decision will be announced on Sept 17.
Avastin made $5.9 billion (£3.8 billion) in sales last year and is made by Genentech, a San Francisco-based unit of the Swiss drug maker Roche.
It is also approved for colon, lung, kidney and brain cancer, however, the FDA review and recommendation applies only to breast cancer.
An FDA spokeswoman said: "Avastin should be an option for patients with this incurable disease."
Breast cancer is the second most common cause of cancer death among US women, with 40,000 last year.
In the UK the National Institute for Clinical Excellence is reviewing whether Avastin should be available on the NHS for woman with breast cancer that has spread.
A spokeswoman said: "We will continue to investigate the treatment regardless of the FDA decision."
From the Director: The words "Not Cost Effective" beginning to be heard in America.
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LOSS OF FDA APPROVAL MAY ENCOURAGE PRIVATE INSURERS TO DO THE SAME
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61% OF DOCTORS SUED--5% WENT TO TRIAL--DOCTOR/DEFENDANT WON IN 90% OF THE CASES
PROFESSION
Medical liability: By late career, 61% of doctors have been sued
An AMA report on medical...
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FRIVOLOUS LAWSUITS CAUSING SEVERE INCREASES TO COST OF MEDICAL CARE
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NEW CPR PROCEDURE ELIMINATES MOUTH TO MOUTH CONTACT
See video describibg new CPR procedure http://tinyurl.com/2fx8r59
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MOUTH TO MOUTH CONTACT UNNECESSARY--BETTER RESULTS WITHOUT IT
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BE AWARE: WHOOPING COUGH RUNNING WILD AGAIN
Sacramento Bee 6/21/2010
EDITORIAL I Views of the editorial board
Whooping Cough
comes back to kill
Here's how California could save $12 million a year or more in state health care costs: require that kids entering middle school get a common vaccination against a nasty respiratory disease, whooping cough.
California long has been a leader in public health. But for no good reason, it is in the company of only 10 other states including Mississippi, South Dakota and West Virginia that don't require that kids receive booster vaccinations against whooping cough before entering middle school.
As it happens, California is in the midst of an epidemic of whooping cough, also known as pertussis.In the first five months of the year, there were at least 584 cases, including five deaths, all infants. There were deaths in Fresno and Stanislaus counties. During the same period in 2009, there were no deaths and 190 cases statewide, according to the California Department of Public Health.
We're heading into the worst time of year for the disease. The largest number of cases occurs in August and September each year.
The highly contagious disease is characterized by severe coughing spasms. It can last for several weeks or even for months, and is spread when the carrier coughs or sneezes. A vaccination has been available since the 1940s.
Babies routinely receive the vaccination, but it wears off by the time children enter junior high school. Infants too young to receive the vaccine are most vulnerable. Babies infected by the bacteria are vulnerable to pneumonia and brain damage as well aws death. All of it is preventable.
Assemblyman Juan Arambula of Fresno introduced legislation last year to require that middle school kids receive the vaccination.
The measure, Assembly Bill 354, has stalled in the Senate Appropriations Committee. It has run into the general and unfortunate resistance to vaccines.
There also would be an initial cost to the government. But the math makes clear that the bill makes sense. The cost to provide the vaccine to kids whose parents otherwise cannot afford it would be about $800,000, according to Arambula's staff. However, the Department of Public Health estimates the state Medi-Cal program would save $12 million related to treatment costs that no longer would be necessary.
The Senate needs to give this bill a boost. In the process, it will save money, but more importantly it will save lives
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SENIORS TAKE VACCINE? IF CLOSE TO SMALL CHILDREN TALK TO YOUR DOCTOR
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A NEW DRUG APPROVED BY FDA-- TO AVOID PREGNANCY
FDA Approves Ella Drug, Pro-Life Groups Say It's Untested, Causes AbortionsWashington, DC (LifeNews.com)...
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PRO LIFE GROUP SAYS NEW DRUG WILL CAUSE ABORTIONS
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EIGHT MILLION DISABLED {AGE 18-64] ON MEDICARE
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From Health Affairs
Nonelderly Medicare Beneficiaries: Access And Costs More Problematic |
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Bethesda, MD--A new study released today by Health Affairs focuses on an often-neglected segment of Medicare enrollees: people ages 18-64 with permanent disabilities, a group that currently numbers eight million, or roughly one-sixth of the total number of Americans in Medicare. The 2008 survey of a nationally representative survey of noninstitutionalized Medicare beneficiaries was designed and conducted by researchers at the Kaiser Family Foundation to assess how well Medicare is working for this group.
Medicare Doesn't Work As Well For Younger, Disabled Beneficiaries
As It Does For Older Enrollees
By Juliette Cubanski and Patricia Neuman
http://content.healthaffairs.org/cgi/content/abstract/hlthaff.2009.0962
Juliette Cubanski and Patricia Neuman are affiliated with the Medicare Policy Project at the Kaiser Family Foundation, in Washington, D.C.; Cubanski is the project's associate director, and Neuman is its director and a Foundation vice president.
The sample survey of 3,913 beneficiaries was drawn from administrative data provided by the Centers for Medicare and Medicaid Services (CMS) and included 2,288 people ages 18-64 with permanent disabilities and 1,625 respondents age 65 and older. The nonelderly disabled beneficiaries were twice as likely to have five or more chronic medical conditions, more than twice as likely to have felt sad or depressed during the previous year, and four times as likely to have experienced severe pain in the previous four weeks.
Some of the major findings:
• Half of the nonelderly beneficiaries reported problems paying for health care services in the previous twelve months, versus 18 percent of the elderly population. Similarly, 46 percent of the nonelderly group reported delaying or not getting health care services because of cost, compared to 16 percent of senior enrollees.
• Nearly one in three Medicare beneficiaries with disabilities reported that they were uninsured for at least part of the two-year waiting period before qualifying for Medicare.
• Nearly one in four nonelderly disabled beneficiaries lacked supplemental coverage, about twice the proportion of the elderly group.
• For nonelderly Medicare beneficiaries, Medicaid is the most likely supplemental coverage option; this group has nearly four times the rate of Medicaid supplemental coverage of the senior group.
• Nonelderly disabled enrollees in Medicare Part D drug plans were almost three times as likely to report difficulty in obtaining a medication because it was not covered by the plan (37 percent versus 13 percent of the elderly) and more than twice as likely to skip or take smaller doses because of the cost (26 percent versus 12 percent).
This year's health reform is likely to address some of the problems highlighted by this study. "One of the less-heralded but important aspects of the Affordable Care Act is its potential to help people with disabilities, including those in Medicare's waiting period, by broadening access to public and private health insurance coverage, improving Medicare Part D coverage, and introducing reforms designed to improve the coordination and quality of care," conclude the authors. "As policy makers focus their attention on reforms designed to increase insurance coverage and reduce health care costs, evaluating how well the implementation of the Affordable Care Act improves coverage and care for people with disabilities will provide an important test of its impacts." |
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"Medicare Doesn't Work As Well For Younger, Disabled Beneficiaries."
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HOSPITALS SEE LOWER INCIDENCE OF STAPH INFECTIONS
From Sacramento Bee 8/11/2010
Feds say staph infections declined
BY LINDSAY TANNER Associated...
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GOOD NEWS IN LIGHT OF INCREASING FAILURE OF ANTIBIOTCS TO CONTROL STAPH INFECTIONS
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RULES FOR COVERAGE OF THE UNINSURED WITH PRE-EXISTING CONDITIONS DEFINED
August 10, 2010
Sue DucatDirector of Communications(301) 841-9962sducat@projecthope.org
Adam...
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MONEY ALLOCATED FOR FOR THESE PATIENTS MAY NOT BE ENOUGH
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AN ANALYSIS OF FUTURE HEALTH CARE FOR AMERICANS
From the AAPS Newsletter 8/10/2010What to Expect Under the Reign of Berwick by Richard Amerling, M.D.CLICK...
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"...patients and physicians abandon this sinking ship and create a true free market for health care"
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BEWARE OF BOGUS STEM CELL CLINICS
Beware stem cell `cures,' Doctors sayby Carrie Peyton Dahlberg epeytondahlberg @sacbee.com September,...
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RESEARCH TO DETERMINE THE QUALITY OF THE CLINIC IS ESSENTIAL
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NEW LAW DESIGNED TO STOP FRAUD AND WASTE IN MEDICARE AND MEDICAID
Fraud crackdown mandated under new law
The president challenges federal agencies to reduce improper payments by $50 billion by 2012, including cutting improper Medicare fee-for-service pay in half.
By Chris Silva, amednews staff. Posted Aug. 4, 2010.
Washington -- President Obama on July 22 signed into law a bill that requires federal agencies to identify and recover improper payments and further cut down on waste, fraud and abuse in federal spending.
The bill was sponsored by Rep. Patrick Murphy (D, Pa.) and Sen. Tom Carper (D, Del.), who said the techniques and tools provided through the law were based partly on those used by Medicare on a limited basis in recent years. A three-year demonstration program that launched in California, Florida and New York in 2005 identified roughly $1 billion in Medicare overpayments, according to the Centers for Medicare & Medicaid Services.
The Improper Payments Elimination and Recovery Act requires federal agencies to identify and recover more of the estimated $98 billion of taxpayer dollars that are lost annually due to wasteful spending, Carper said. The law directs agencies to produce audited corrective action plans, mandates all agencies that spend more than $1 million to perform recovery audits on all programs and penalizes those that fail to comply with current accounting laws.
The administration in recent months has become more vocal about reducing improper payments. In fall 2009, a new executive order laid out a strategy to reduce improper payments by increasing transparency and boosting incentives for compliance. In March 2010, the president signed a memorandum directing all federal agencies to intensify their use of payment recapture audits. And on June 8, Obama announced that the administration would work to cut the improper payment rate in Medicare fee-for-service in half by 2012, a move that would eliminate more than $20 billion in payment errors.
Obama remarked after signing the bill that he's challenging federal agencies to reduce improper payments by $50 billion between now and 2012.
CMS currently is working to expand its recovery audit contractor program to all of Medicare and to Medicaid by the end of the year. RACs are third-party auditors hired by CMS to comb through Medicare claims from hospitals, physicians and others to identify improper payments.
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NEAR 100 BILLION DOLLARS A YEAR INVOLVED
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NEW BILL IN CONGRESS TO END FEDERAL FINANCIAL SUPPORT FOR ABORTIONS
Congressman Files New Pro-Life Bill to Cut All Federal Funding for AbortionsWashington, DC (LifeNews.com) ...
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"The beauty of the bill lies in its ability to make what are annual battles to stop abortion funding permanent federal law.
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SOME AMERICAN GIRLS REACHING PUBERTY AS YOUNG AS AGE 7
Growing up too soon? Puberty strikes 7-year-old girls
Study in 3 major cities finds precocious...
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OBESITY ONE OF THE CAUSES--OTHER POSSIBLE CAUSES UN DER STUDY
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20 STATES FILING SUIT AGAINST NEW HEALTH CARE MANDATES
States respond in health care overhaul lawsuit
By JENNIFER KAY, Associated Press Writer Jennifer Kay,...
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"The federal government does not have the authority to regulate an individual's decision to do nothing"
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DISPUTE OVER MEDICARE EXTENSION PROMISED IN NEW HEALTH CARE LAW [PPACA]
From Yahoo News Associated Press 8/5/2010Trustees: Medicare hospital fund extended...
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GOVERNMENT OFFICIALS DOUBT MONEY AVAILABLE FOR ANY EXTENSION
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AN ATTEMPT TO UNDERSTAND THE NEW HEALTH CARE REFORM LAW-PPACA
EDITORIAL FROM BLOOMBERG.COM
Obamacare Only Looks Worse Upon Further Review: Kevin Hassett
By Kevin Hassett -
Aug 1, 2010 6:00 PM PDT Mon Aug 02 01:00:06 UTC 2010
One of the more illuminating remarks during the health-care debate in Congress came when House Speaker Nancy Pelosi told an audience that Democrats would “pass the bill so you can find out what’s in it, away from the fog of controversy.”
That remark captured the truth that, while many Americans have a vague sense that something bad is happening to their health care, few if any understand exactly what the law does.
To fill this vacuum, Representative Kevin Brady of Texas, the top House Republican on the Joint Economic Committee, asked his staff to prepare a study of the law, including a flow chart that illustrates how the major provisions will work.
The result, made public July 28, provides citizens with a preview of the impact the health-care overhaul will have on their lives. It’s a terrifying road map that shows Democrats have launched America on the most reckless policy experiment in its history, the economic equivalent of the Bay of Pigs invasion.
Before discussing what the law means for you, we have to look at what it does to government. That’s where the chart comes in handy. It includes the new fees, bureaucracies and programs and connects them into an organizational chart that accounts for the existing structure. It’s so carefully documented that a line connecting two structures cites the legislative language that created the link.
Ornate System
This clearly is a candidate for most disorganized organizational chart ever. It shows that the health system is complex, yes, but also ornate. The new law creates 68 grant programs, 47 bureaucratic entities, 29 demonstration or pilot programs, six regulatory systems, six compliance standards and two entitlements.
Getting that massive enterprise up and running will be next to impossible. So Democrats streamlined the process by granting Health and Human Services Secretary Kathleen Sebelius the authority to make judgments that can’t be challenged either administratively or through the courts.
This monarchical protection from challenges is extended as well to the development of new patient-care models under Obama’s controversial recess appointment, Donald Berwick, whom Republicans are calling the rationer-in-chief. Berwick will run the Centers for Medicare and Medicaid Services, where he can experiment with ways to use administrative fiat to move our system toward the socialized medicine of Europe, which he has at times embraced.
Closer to Home
A sprawling, complex bureaucracy has been set up that will have almost absolute power to dictate terms for participating in the health-care system. That’s what the law does to government. What it does to you is worse.
Based on the administration’s own numbers, as many as 117 million people might have to change their health plans by 2013 as their employer-provided coverage loses its grandfathered status and becomes subject to the new Obamacare mandates.
Those mandates also might make your health care more expensive. The Congressional Budget Office predicts that premiums for a small number of families who buy their insurance privately will rise by as much as $2,100.
The central Obamacare mechanism for increasing insurance coverage is an expansion of the Medicaid program. Of the 30 million new people covered, 16 million will be enrolled in Medicaid. And you could end up in the program whether you want it or not. The bill states that people who apply for coverage through the new exchanges or who apply for premium-subsidy credits will automatically be enrolled in Medicaid if they qualify.
Hurting the Elderly
To pay for this expansion, the bill takes $529 billion from Medicare, with roughly 39 percent of the cut coming from the Medicare Advantage program. This represents a large transfer of resources, sacrificing the care of the elderly in order to increase the Medicaid rolls.
For all this supposed reform, you, the American taxpayer, can expect a bill to the tune of $569 billion.
Front and center among the new taxes is the 40 percent excise tax on those lucky people with so-called Cadillac health plans. The higher insurance costs that are driven by the government mandates will push many more ordinary plans into Cadillac territory.
If the idea of taxing people with coverage deemed too good doesn’t bother you, maybe the new 3.8 percent tax on investment income will. That will apply even to a small number of home sales, those that generate $250,000 in profit for an individual or $500,000 for a married couple.
In vivid color and detail, Congressman Brady’s chart captures the huge expansion of government coming under Obamacare. Harder to show on paper is the pain it will cause.
(Kevin Hassett, director of economic-policy studies at the American Enterprise Institute, is a Bloomberg News columnist. He was an adviser to Republican Senator John McCain in the 2008 presidential election. The opinions expressed are his own.)
To contact the writer of this column: Kevin Hassett at khassett@bloomberg.net
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MONEY FOR MEDICARE TO BE SUBSTANTIALLY REDUCED
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AAPS ASKS IF THE AMA IS IN THE PRESIDENT'S POCKET
From The American Association of Physicians and Surgeons [AAPS] NEWS LETTER 8/2/2019Is the AMA...
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"As stated in the Oath of Hippocrates, I will “follow the system of regimen which, according to my ability and judgment, I consider for the benefit of my patients.”
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NEW VAGINAL CREAM HELPFUL IN PREVENTING TRANSMISSION OF HIV VIRUS
From Sacrament Bee July/20/2010
GEL TO BATTLE HIV OFFERS HOPE TO AFRICAN WOMEN
By THOMAS...
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WHEN COMMERCIALLY AVAILABLE IT'S USE WILL BENEFIT ALL WOMEN
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"People are asking, Is the government doing us more harm than good?"
From drudgereport.com 7/31/2010
From Investors.comPowered by Investors Business DailyIBD EditorialsPerspective
Will...
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"The Wall Street Journal's steadfast Dorothy Rabinowitz wrote that Barack Obama is 'an alien in the White House'."
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NEW STATE LAW WILL PLACE RESRICTIONS ON VOLUNTARY ABORTIONS
From Scaramento Bee 7/30/2010
Elective abortion barred in new law
HIGH-RISK POOL RULES RELEASED
BY...
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"This new coverage will help all of us by reducing medical debt"
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DECLINE IN NUMBER OF DOCTOR OFFICE VISITS NOTED
HEALTH INDUSTRY JULY 29, 2010
Americans Cut Back on Visits to Doctor
By AVERY JOHNSON, JONATHAN...
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PEOPLE TAKING MORE/BETTER CARE OF THEMSELVES??
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ALL MEDICAL DOCTORS SHOULD TAKE "THE HIPPOCRATIC OATH"
From the AAPS News Letter 7/28/2010
A Plea to Medical Studentsfrom Truth Serum...
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"The majority of medical students take the Oath of Hippocrates (460?-377? B.C.). Called the “father of modern medicine,”*
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ENGLAND TO BREAK UP THEIR NATIONAL HEALTH SERVICE
From drudge report .com 7/24/2010
Britain Plans to Decentralize National Health Care
By SARAH LYALL Published: July 24, 2010 New York Times
The new British government’s plan to drastically reshape the socialized health care system would put local physicians like Dr. Marita Koumettou in north London in control of much of the national health budget.
Even as the new coalition government said it would make enormous cuts in the public sector, it initially promised to leave health care alone. But in one of its most surprising moves so far, it has done the opposite, proposing what would be the most radical reorganization of the National Health Service, as the system is called, since its inception in 1948.
Practical details of the plan are still sketchy. But its aim is clear: to shift control of England’s $160 billion annual health budget from a centralized bureaucracy to doctors at the local level. Under the plan, $100 billion to $125 billion a year would be meted out to general practitioners, who would use the money to buy services from hospitals and other health care providers.
The plan would also shrink the bureaucratic apparatus, in keeping with the government’s goal to effect $30 billion in “efficiency savings” in the health budget by 2014 and to reduce administrative costs by 45 percent. Tens of thousands of jobs would be lost because layers of bureaucracy would be abolished.
In a document, or white paper, outlining the plan, the government admitted that the changes would “cause significant disruption and loss of jobs.” But it said: “The current architecture of the health system has developed piecemeal, involves duplication and is unwieldy. Liberating the N.H.S., and putting power in the hands of patients and clinicians, means we will be able to effect a radical simplification, and remove layers of management.”
The health secretary, Andrew Lansley, also promised to put more power in the hands of patients. Currently, how and where patients are treated, and by whom, is largely determined by decisions made by 150 entities known as primary care trusts — all of which would be abolished under the plan, with some of those choices going to patients. It would also abolish many current government-set targets, like limits on how long patients have to wait for treatment.
The plan, with many elements that need legislative approval to be enacted, applies only to England; other parts of Britain have separate systems.
The government announced the proposals this month. Reactions to them range from pleased to highly skeptical.
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TURNING BACK TO REGIONAL DOCTOR CONTROL WILL SAVE BILLIONS
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ENGLAND DESCRIBES THE RATIONING PLANNED FOR THEIR NEW HEALTH CARE PLAN
Axe falls on NHS services
NHS bosses have drawn up secret plans for sweeping cuts to services, with...
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GENERAL PRACTITIONERS, NOT THE GOVERNMENT, WILL CONTROL THE METHOD OF HEALTH CARE DE$LIVERY
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COSTLY CANADIAN EXPERIENCE--GOVERNMENT HEALTH CARE
Soaring costs force Canada to reassess health model
By Claire Sibonney - Analysis Claire Sibonney - Analysis – Mon May 31, 2:38 pm ET
TORONTO (Reuters) – Pressured by an aging population and the need to rein in budget deficits, Canada's provinces are taking tough measures to curb healthcare costs, a trend that could erode the principles of the popular state-funded system.
Ontario, Canada's most populous province, kicked off a fierce battle with drug companies and pharmacies when it said earlier this year it would halve generic drug prices and eliminate "incentive fees" to generic drug manufacturers.
British Columbia is replacing block grants to hospitals with fee-for-procedure payments and Quebec has a new flat health tax and a proposal for payments on each medical visit -- an idea that critics say is an illegal user fee.
And a few provinces are also experimenting with private funding for procedures such as hip, knee and cataract surgery.
It's likely just a start as the provinces, responsible for delivering healthcare, cope with the demands of a retiring baby-boom generation. Official figures show that senior citizens will make up 25 percent of the population by 2036.
"There's got to be some change to the status quo whether it happens in three years or 10 years," said Derek Burleton, senior economist at Toronto-Dominion Bank.
"We can't continually see health spending growing above and beyond the growth rate in the economy because, at some point, it means crowding out of all the other government services.
"At some stage we're going to hit a breaking point."
MIRROR IMAGE DEBATE
In some ways the Canadian debate is the mirror image of discussions going on in the United States.
Canada, fretting over budget strains, wants to prune its system, while the United States, worrying about an army of uninsured, aims to create a state-backed safety net.
Healthcare in Canada is delivered through a publicly funded system, which covers all "medically necessary" hospital and physician care and curbs the role of private medicine. It ate up about 40 percent of provincial budgets, or some C$183 billion ($174 billion) last year.
Spending has been rising 6 percent a year under a deal that added C$41.3 billion of federal funding over 10 years.
But that deal ends in 2013, and the federal government is unlikely to be as generous in future, especially for one-off projects.
"As Ottawa looks to repair its budget balance ... one could see these one-time allocations to specific health projects might be curtailed," said Mary Webb, senior economist at Scotia Capital.
Brian Golden, a professor at University of Toronto's Rotman School of Business, said provinces are weighing new sources of funding, including "means-testing" and moving toward evidence-based and pay-for-performance models.
"Why are we paying more or the same for cataract surgery when it costs substantially less today than it did 10 years ago? There's going to be a finer look at what we're paying for and, more importantly, what we're getting for it," he said.
Other problems include trying to control independently set salaries for top hospital executives and doctors and rein in spiraling costs for new medical technologies and drugs.
Ontario says healthcare could eat up 70 percent of its budget in 12 years, if all these costs are left unchecked.
"Our objective is to preserve the quality healthcare system we have and indeed to enhance it. But there are difficult decisions ahead and we will continue to make them," Ontario Finance Minister Dwight Duncan told Reuters.
The province has introduced legislation that ties hospital chief executive pay with the quality of patient care and says it wants to put more physicians on salary to save money.
In a report released last week, TD Bank said Ontario should consider other proposals to help cut costs, including scaling back drug coverage for affluent seniors and paying doctors according to quality and efficiency of care.
WINNERS AND LOSERS
The losers could be drug companies and pharmacies, both of which are getting increasingly nervous.
"Many of the advances in healthcare and life expectancy are due to the pharmaceutical industry so we should never demonize them," said U of T's Golden. "We need to ensure that they maintain a profitable business but our ability to make it very very profitable is constrained right now."
Scotia Capital's Webb said one cost-saving idea may be to make patients aware of how much it costs each time they visit a healthcare professional. "(The public) will use the services more wisely if they know how much it's costing," she said.
"If it's absolutely free with no information on the cost and the information of an alternative that would be have been more practical, then how can we expect the public to wisely use the service?"
But change may come slowly. Universal healthcare is central to Canada's national identity, and decisions are made as much on politics as economics.
"It's an area that Canadians don't want to see touched," said TD's Burleton. "Essentially it boils down the wishes of the population. But I think, from an economist's standpoint, we point to the fact that sometimes Canadians in the short term may not realize the cost."
($1=$1.05 Canadian)
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COSTS RISING--PUTS STRAIN ON CANADIAN TREASURY
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CANADIAN HEALTH CARE SYSTEM REVIEWED IN THE AAPS JOURNAL
a brief summary of an editorial in the AAPS journal, summer 2010
Canadian Power PlayLawrence...
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SOME CANADIAN PROVINCES NOW ALLOW THE SALE OF PRIVATE HEALTH INSURANCER [ENDING THE SINGLE PAYER PLAN}
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RECENT REPORT OF MEDICAL CARE IN GERMANY
From Greg Scandlen Newsletter #225 6/10/2010
Germany
Speaking of one standard for the Feds and another for everybody else, Ron Bachman writes up the results of his trip to Germany where he dug deep into the German system. He writes, "We listened to federal and state officials, doctors, hospital executives, members of the Bundestag, a health journalist, and German policy experts. They told us that the German system is the fourth most expensive system in the world. Their costs are rising rapidly and are unsustainable." He says he pressed these people on what were the three best characteristics of the German system, and they could come up with only two - Solidarity and Progressive Financing. "Quality, access, cost effectiveness, choice, and convenience were never mentioned."
He goes on to say that, 90% of the population is in "compulsory statutory social health insurance through 170 plans (where) there are waiting times for office visits, delays for elective hospital care, and postponed care if quarterly medical budgets are exceeded. Choice of physicians/surgeons is limited and private hospital rooms are not available."
Ten percent of the population is "covered by 50 private insurance plans. Those with private coverage get to the head of the line for appointments, have access to private hospital rooms, and use of 'master' surgeons and leading specialists for care." Ron writes, "I asked, who are those individuals and how many Germans get the private coverage as complimentary? The response was that federal government employees, state employees, professors, and others are defined as civil servants." They make up 80% of those enrolled in these private plans.
Not all pigs are equal on this plantation.
SOURCE:
Daily Caller
For more information www.greg@chcchoices.org
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THE TWO TIER SYSTEM WORKS IF YOU CAN AFFORD IT
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ANOTHER SINGLE PAYER HEALTH PLAN FAILS
N.KOREA HEALTH CARE IN COLLAPSE
MISERY ABOUNDS, GROUP REPORTS
BY BARBARA DEMICK Los Angeles Times
BEIJING - North Korea's health care system is unable to provide sterilized needles, clean water, food and medicine, and patients are forced to undergo agonizing surgery without anesthesia.,Amnesty International reported Thursday.
The human rights group, citing World Health Organization statistics, found that North Korea spent under $1 per capita on health care, the lowest in the world. The global average was $716 per capita.
The collapse of the health care system compounds the misery of a population that is chronically malnourished and suffering from digestive problems caused by eating weeds, tree bark, roots, corn husks, cobs and other "substitute" foods. The poor diet also weakens the immune system, making people susceptible to diseases such as tuberculosis, which afflicts at least 5 percent of the population, according to the report. Meanwhile, about 45 percent of children under the age of 5 suffer stunted growth because of malnutrition.
"In view of the enormity of the food crisis in North Korea, health issues cannot be separated from the food insecurity that has gripped the country for almost two decades," the report stated. "The people of North Korea suffer significant deprivation in their enjoyment of the right to adequate health care, in large part due to failed or counterproductive government policies."
Amnesty International interviewed 40 people who had escaped North Korea, most of them between 2004 and 2009. They told harrowing stories about their experiences in the medical system. I was screaming so much from the pain, I thought I was going to die. They had tied my hands and legs to prevent me from moving," said a 56-year- old woman from Musan whose appendectomy was performed without anesthesia.
In keeping with its socialist ideology, North Korea once boasted of providing free, universal health care with a network of more than 44,000 general practitioners who would even make house calls. Although hospitalization remains free, the facilities are unsanitary and have no food, bandages or medicine.
"Hospitals in North Korea no longer have medicines. Medical personnel don't receive any, or if they do, they sell them in the market," said a 47-year-old man interviewed by Amnesty International who also described paying a doctor treating his son for tuberculosis with 10 packs of cigarettes. Others told of providing bottles of liquor or cooked meals to the doctors, who themselves were receiving almost no salary.
The Amnesty International report was consistent with the description of North Korea in Los Angeles Times stories on the city of Chongjin in 2005. A doctor, Kim Ji Eun, said then that her patients had to bring their own bottles if they needed intravenous fluid. Beer bottles were preferred. "If they would bring in one beer bottle, they'd get one IV. If they'd bring two bottles, they would get two," said the doctor, who defected in 1998 and lives in South Korea.
More recent defectors say there has been no improvement in the health care situation. A 17-year-old girl from Musan who defected in February said people often used illegal drugs, particularly "ice," a highly addictive methamphetamine that is manufactured in North Korea.
"You do drugs if you have a cold, a stomach ache, for whatever is wrong," said the girl, who was interviewed in march by the Times. The Amnesty International report also said N. Koreans were using Morphine and Opium derivatives to medicate themselvers for lack of proper pharmaceuticals
From Sacramento Bee 7/16/2010
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N.KOREA SPENDS LESS ON HEALTH CARE THAN ANY OTHER NATION
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GREECE EXPERIENCING NATIONAL PROTEST OVER HEALTH CARE
From AAPS News Letter 6/8/2010
ObamaCare, Tried in Greece, Leads to Bankruptcy, Rioting &...
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"LEADS TO BANKRUPTCY,RIOTING AND BLOODSHED"
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MASSACHUSETTS HEALTH CARE REFORM PLAN IN TROUBLE
From Greg Scandlen News Letter #231, 7/20/2010
Once More to Massachusetts
Writing in the Wall Street Journal on July 7, Joseph Rago looks at how the Bay State is doing as a model for ObamaCare and concludes, "the Massachusetts plan couldn't be a more damning indictment of ObamaCare." He begins with the arbitrary price controls on insurance premiums that ignored the advice of the state's professional insurance regulators, and were eventually reversed by a state appeals board. Still, he says, "the five major state insurers have so far collectively lost $116 million due to the rate cap. Three of them are now under administrative oversight because of concerns about their financial viability."
Now, the governor "wants to export the rate review beyond the insurers to hospitals, physician groups and specialty providers-presumably to set medical prices as well as insurance prices," and a state senator "has introduced a new bill that will make physician participation in government health programs a condition of medical licensure."
SOURCE:
Wall Street Journal
Robert Samuelson takes a similar view in The Washington Post and decides that the Massachusetts experience is "not encouraging." He says, "The state did the easy part: expanding state-subsidized insurance coverage. It evaded the hard part: controlling costs and ensuring that spending improves people's health."
He acknowledges that the state reduced the numbers of uninsured and slightly improved access, "But much didn't change. Emergency rooms remain as crowded as ever (and) state leaders have proved powerless to control costs." He adds that state spending on health care has risen from 16% of its budget in 1990, to 22% in 2000, and 35% this year. Health care is squeezing out everything else the state is expected to do.
He says, "A year ago, a state commission urged another approach: Scrap the present "fee-for-service" system," in favor of a "global budget." "But the commission offered no blueprint, and efforts to craft consensus among providers, consumer groups and insurers have failed. State Senate President Therese Murray, an advocate of payment change, has given up for this year. 'Nobody is in agreement on anything,' she told the Boston Globe."
He concludes, "What's occurring in Massachusetts is the plausible future: Unchecked health spending shapes government priorities and inflates budget deficits and taxes, with small health gains. And they call this "reform"?
SOURCE:
Washington Post
For more information greg@chcchoices.org
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"the Massachusetts plan couldn't be a more damning indictment of ObamaCare."
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NEW MEDICARE DIRECTOR WANTS TO REDISTRIBUTE THE WEALTH
Flashback: Donald Berwick “We Must Redistribute Wealth”
Today, President Obama officially made Donald Berwick his recess appointment to be the administrator of the Centers for Medicare and Medicaid Services.
In 2008 while speaking on the British health care system in the UK, Berwick said wealthy individuals must redistribute their wealth to those less fortunate for health care funding. Also during this speech, he told those in attendance that he opposes free markets.
“Any health care funding plan that is just equitable civilized and humane must, must redistribute wealth from the richer among us to the poorer and the less fortunate. Excellent health care is by definition redistributional.”
Posted by Joe Schoffstall
This entry was posted on Wednesday, July 7th, 2010 at 11:42 am and is filed under Capitol Hill, Liberals Behaving Badly, Media, Online Video, Politics. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
Tags: Donald Berwick, free markets, health care, Obama, Recess Appointment, redistribution of wealth
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WHO WILL CONTROL WHAT'S DONE WITH THAT "FREE MONEY"
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NEW MEDICARE DIRECTOR WANTS "RATIONING" OF HEALTH CARE
President Obama to Make Recess Appointment of CMS Administrator Republicans Attacking as 'Expert on Rationing'
July...
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LIMITED MONEY AND RESOURCES WILL RULE IN THIS ISSUE
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SENATE MEMBERS OPPOSE PRESIDENT'S APPOINTMENT OF DR BERWICK TO RUN HEALTH CARE REFORM-PPACA
Senate Republicans Respond to Berwick Appointment, Seek Hearing, Block Judges
 Washington, DC (LifeNews.com) -- If President Barack Obama thought he would get away with appointing rationing advocate Donald Berwick as the head of Medicare and Medicaid and not see a response from Senate Republicans, he should think again. They have responded aggressively by blocking judges and demanding a hearing.
Berwick is the new director of the Center for Medicare and Medicaid Services who has praised British programs that ration care.
The position is important because it will oversee implementation of the massive government-run health care plan that pro-life advocates say will foster rationing and also contains taxpayer funding of abortions.
Senate Republican lawmakers are upset that Berwick never received a hearing or vote before Obama went around the Senate and used a recess appointment to allow him to head the agency through the end of next year.
In response, Senate Republican Leader Mitch McConnell blocked a request Wednesday from Democrats to approve two Obama nominees to the U.S. Court of Appeals for the Fourth Circuit.
Also, Wednesday evening, Republican members of the Senate Finance Committee demanded a public hearing on Berwick and his controversial rationing views. Full story at LifeNews.com
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HIS ADMIRATION OF THE FAILING BRITISH NATIONAL HEALTH SERVICE IS PUZZLING
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MEDICAL PROFESSION OVERWHELMED BY NEW REGULATIONS AND RESPONSIBILITIES
HEALTH CARE INDUSTRY CAN'T COPE
From The Director:
In my opinion:
Our Nation's Life Style and Expectations are Unrealistic
More than Seven hundred thousand Physicians and the American health care delivery system are held responsible for the care of approximately 300 million Americans including several million illegal aliens, despite many who abuse tobacco products, alcohol and illegal drugs; whose poor nutritional habits can lead to Diabetes, Arteriosclerosis, Asthma and morbid Obesity while reckless driving together with an unwillingness to comply with safe-sexual conduct lead to early death, long term disability, chronic illness and Infertility [unable to have children].
Despite their life-style, many Americans feel that prompt and proper health care is their right and should be provided at little or no cost [including the medicines their illness requires]. Their belief is so firm as to expect to return, in good health, to their previous life-style as quickly as possible and, If disappointed, will demand [and expect] monetary compensation, through legal means, from any one in the system who did not meet their expectations.
While ignoring world history, which teaches that It cannot and will not work that way, their demands and expectations are causing serious damage to their health care system.which is without dispute,and despite its faults, the finest the world has ever witnessed.
Many articles in this section serve to demonstrate examples of that damage. [see new problems below]
FDA investigations lead to the arrest and conviction of Doctors who prescribe too much pain relieving medicines while other Doctors are accused of medical malpractice for prescribing too little.
A 70 year old patient died following a necessary surgical procedure. There was no evidence of Malpractice. The family sued the Doctor for "Battery" for failing to inform the patient of that possibility, The Jury awarded the family $150,000.
Needed Doctors are retiring early or curbing services, such as delivering babies, because of malpractice insurance premiums that can reach as high as two hundred thousand dollars per year.
There will be fewer new Doctors since medical school applicants are declining, as well.
NB: NEWS REPORTS INDICATE AN INCREASE IN MEDICAL SCHOOL APPLICATIONS. BE AWARE, STUDENTS MAY APPLY TO MORE THAN ONE MEDICAL SCHOOL. [I know of one who applied to 14 -he was counted 14 times ].
MANY STUDENTS APPLY TO MORE THAN ONE.
Our FDA is being severely criticized for approving drugs that can harm some patients while the majority who use the same drug receive great relief of their illness.
I would remind you that Penicillin and Aspirin have been known to cause deaths. In my many years of practice experience I have not heard of a medicine that didn't hurt someone.
Two plus two doesn't always add up to four in the health care business. Sometimes it's three, four or five depending on your family history, weight, age, blood pressure, Genes, eating and drinking habits and whether or not you use tobacco products etc.
We'll know after we've had a chance to check those things out.
THE ANSWER WON'T BE FOUND IN A BOOK
Vincent W Cangello MD
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MEDICAL DISEASE SETS ITS OWN RULES AND REGULATIONS--GOOD DOCTORS LEARN FROM EXPERIENCE
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FEWER PROFESSIONALS AVAILABLE TO CARE FOR MORE PEOPLE IN NEED
Proposal would shorten
days for hospital interns
BY LINDSEY TANNER Associated Press [from Sacrament...
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IS THE LIABILITY FEAR CHAMGING THE LANDSCAPE?
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EMERGENCY ROOM VISITS INCREASE WITH GOVERNMENT CONTROL HEALTH CARE
Emergency department visits increase in Massachusetts
Emergency physicians warn that the national...
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DOCTOR OFFICE APPOINTMENTS HARDER TO GET WHEN GOVERNMENT INSURES EVERYONE
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AAPS FILES LAWSUIT AGAINST THE OBAMA HEALTH CARE BILL [PPACA]
From the AAPS MEDICAL JOURNAL Summer 2010
ObamaCare: Not What the Doctor Ordered
Andrew...
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MANY STATES HAVE JOINED THE AAPS LAWSUIT
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ARIZONA HEALTH CARE FREEDOM ACT DRAWING ATTENTION
Health Care Freedom Acts
Spreading Across the United States
"In 2006, physicians Eric Novack, M.D. and Jeff Singer, M.D. (who are also AAPS members) laid the foundation for the Arizona Health Care Freedom Act which will be on the Arizona ballot in November 2010. It is the prototype for other such acts now being considered across the United States."
"The US Health Freedom Coalition is supporting efforts to enact Health Care Freedom Acts in all 50 states..."
"...The Health Care Freedom Act protects 2 rights:
1) The right to choose NOT to participate in any health care system or plan WITHOUT a penalty, fine, or tax. Because it is not what you GET when you join, but it is the FINE PRINT you are now subject to: ALL the rules, regulations and restrictions.
2) The right to spend your own money to get access to any lawful health care service. Because NO BUREAUCRAT, public or private, should be able to take that right away."
From: www,aapsonline.org
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"The right to choose NOT to participate" in any health care system or plan WITHOUT a penalty, fine, or tax"
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LAW CENTER FILES SUIT AGAINST NEW OBAMA HEALTH CARE REFORM LAW
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Thomas More Law Center Files Detailed Reply to Government’s Defense of Obamacare
 ANN ARBOR, MI – The Thomas More Law Center (TMLC), a national, public interest law firm based in Ann Arbor, Michigan, filed a reply brief this past Friday in support of their motion for a preliminary injunction against President Obama’s health care legislation. [Click here to read Brief].
The reply brief was drafted by Robert Muise, TMLC Senior Trial Counsel, and David Yerushalmi, an associated private attorney with law offices in New York, Washington D.C., and Arizona. The brief was filed in support of TMLC’s previously filed motion for a preliminary injunction, in which TMLC is requesting the court to immediately enjoin the enforcement of the individual mandate provision of the health care law.
Muise commented: “Our lengthy and detailed reply to the government’s defense of the Health Care Reform Act demonstrates the weakness of the government’s superficial arguments. As evidenced in our brief, we certainly like our chances that the court will strike down this unconstitutional act of Congress.”
The Thomas More Law Center defends and promotes America’s Christian heritage and moral values, including the religious freedom of Christians, time-honored family values, and the sanctity of human life. It supports a strong national defense and an independent and sovereign United States of America. The Law Center accomplishes its mission through litigation, education, and related activities. It does not charge for its services. The Law Center is supported by contributions from individuals, corporations and foundations, and is recognized by the IRS as a section 501(c)(3) organization. You may reach the Thomas More Law Center at (734) 827-2001 or visit our website at www.thomasmore.org. | | |
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"AGAINST THE INDIVIDUAL MANDATE PROVISION oF THE HEALTH CARE LAW"
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A VIEW FROM THE PAST [1998] BEARS REPEATING--WHY DIDN'T WE FIX WHAT WE HAVE?
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FROM THE DIRECTOR
TURNING BACK TO FIND THE FUTURE |
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A majority of the American people are outraged by the "immoral conduct" in the corporate world, the "excessive" profits in the Pharmaceutical Industry and the "rising costs" and salaries reported by "privately operated" Managed Health Care Plans--as they watch their retirement plans "vanish"; find it "impossible" to afford life-preserving medicines and are expected to settle for a "diminishing quality "and quantity of the health care "provided" when they are in need.
Truth is, they supported the growth of a "private enterprise" managed health care system. The promise of "better health care at a lower cost" failed to materialize. In short, the new system put into place failed to deliver, They know they must look for an alternative.
With polls showing a majority [70%?] of Americans favor a Single Payer Health Care System [such as exists in Canada?] the federal government could take control of health care delivery with the formation of a new bureaucracy or with the current system in place but financed and controlled by government regulation..
In the event that a National Health Service is their choice, State Governments could function in an essential but subsidiary role. Quality Control issues would then be returned to Physicians now that it is apparent that cost control can only be achieved by a reduction in the utilization of services, the quality of the Providers who deliver that service and of the materials made available to them. In other words through "Rationing of goods and services".
A national health service might choose to function by expanding the existing Medicare structure to cover all age groups while using the State Agencies in place or the facilities of the private health Insurance Industry as it currently exists. Delivery of care, at the community level, would be under the direction of regional and local committees composed of consumers and provider who would be guided by federal regulation and a limited budget.
Comments that suggest "the Government doesn’t want it" should be dismissed. Federal Bureau records expressing the belief that Government control is needed to solve the nation’s health care delivery problems have been heard since 1972. [ref: Forward Plan Of Health, FY 1978-82, US Department of HEW, page 1, publ. August 1976
Providers [Doctors, Hospital Workers and other health care professionals] who would have resisted a takeover, then, are more likely to welcome it, now, as they become increasingly concerned with their financial survival rather than the provision of quality patient care.
This new health care system would try to avoid the errors committed by existing national systems, but if history is to be our guide, it's not likely that we would fare any better. The reality is that blood is red no matter where it’s spilled and pain is the same no matter when you get it or how you say it. All sick people are the same and so too is the help they require.
After visiting several nations to study their health care delivery systems, those in existence are very much alike as are the problems they encounter/create. The outstanding similarity in all is promptly delivered, non-emergency care of good quality is available, only, outside of the system, in private offices or hospitals, for cash or supplemental private health insurance. Formerly,this service was readily avaiable in all but one nation I visited, Canada. However, in 2006. a Canadian Provincial Supreme Court Ruling mandates that Canadian Citizens be allowed to purchase private health insurance, in addition to taxes, if they wish.
Wherever private health insurance is available the result is the creation of the "two tier system of health care that was expected to become unnecessary. One for the poor who cannot afford anything else and another for those who will pay additional money [beyond taxes] for better care. Should we expect it to be any different here in America?
"Corporate Care", now dominating our health care scene is proving to be unacceptable because of its primary concern with profit on the provider side competing with the demand for prompt and total care on the consumer side. In America, delivering health care with profit in mind or withholding needed services for budgetary reasons is unpalatable when dealing with sickness and dying ---even more so today when so many American feel that immediate access to high quality health care is their right.
Health care costs would continue to increase during a transition to any new system as patient enrollment increases and more sophisticated methods of diagnosis and treatments are discovered. In addition, under a National Health Service more administrative levels become necessary, some nations have nine, and each requires a budget that can be expected to increase every year. As a result, less money becomes available for patient care, "waiting lines begin to form." This, the most visible form of rationing, is accompanied by other less visible forms of rationing currently in use by the, only twenty years old, "Corporate Care" model. Examples are longer waiting periods for necessary care by requiring pre-authorization or possible denial of necessary medicines and surgery, shorter hospital stays and, in the not too distant future, the likely denial of services because of unhealthy life styles, obesity, smoking and substance abuse].
Points for discussion
Traditionally, a "fee for service" system flourishes in a democratic society that is economically sound. Today, as both individual and corporate economic security decline demand for less costly health care intensifies without any less intensity in the belief that access to total health care is a right that should be guaranteed to all regardless of ability to pay. It is precisely this concept, "equal care for all regardless of ability to pay" that is causing many hospitals to close their doors, for lack of funds. It's effecting physicians as well. Many have been forced to look for salaried positions rather than continue in, or open an office for, the private practice of medicine.
A return to the era of the private practice of medicine, as I knew it, is unlikely in the near future, if at all, in light of the massive changes in Hospital and Medical Clinic design; reimbursement schedules that discourage solo private practice and the greater understanding of the cause and treatments of many diseases. Today, diagnosric procedures are better, yet more expensive to provide and treatment of disease more promising, yet more expensive to obtain. With this knowledge in mind, no matter what health care delivery system we choose slogans that suggest "Something for nothing" or "It will be better and cheaper" should be ignored.
I believe that American citizens cannot swallow the idea of RATIONING or PROFIT when it comes to health care. To support my position I read in this morning’s paper that a major hospital chain has agreed to treat two children with a rare immune disease. The only known treatment is experimental, will cost 600,000 dollars and will not cure the disease. The treatment carries a 30+ % mortality rate. In the same issue, an editorial writer argues that Medicaid [welfare] patients should have access to name brand medicines despite the increased cost. News obtained on the Internet reported a 13 percent increase in premiums, for employer-provided health care insurance, which will force some employers to discontinue providing that insurance unless they can demand that their employees pay more, such as a higher co-pay, when they use the insurance .
Traditionally, extra money made by hospitals, was used to guarantee their ability to make available to all of their occupants, "regardless of ability to pay", the very best care, when needed. Doctors were allowed to charge a generous fee for their effort to deliver "up to date and high quality care" to all of their patients, regardless of race, creed or religion, at any time of day or night when it was needed. In recent years, however, the Doctors and the Hospitals are portrayed as outrageously profit oriented.
The public demanded that changes be made and they are taking place. Fortunately or unfortunately, depending on your point of view, changes in such significant social services, as a nation's health care delivery system, are slow in their development. Our traditional system had been functioning, as such, for near one century. It cannot be changed overnight. Researchers who study such social phenomena tell us that three decades of trial and error are needed to place a new system. They describe an 80+ year cycles to find, use and then discard a total system. Interestingly, the USA and Great Britain are at a similar place but on different sides of a cycle [circle]. They, from my observation, are moving away from a National Health Service as we appear to be moving toward one.]
My Conclusions:
1. As the years pass, the public's demand for quality health care for all, regardless of one's ability to pay, diminishes as the rising cost coupled with an oppressive tax structure weakens their concern for the needs of the poor.
2. National health care systems employ a large number of citizens, estimated to be more than 5 million people in Great Britain. Though this may appear attractive, at first glance, it can later become the obstacle that makes the system impossible to change or remove when proven unsatisfactory [where else would you employ all those people?].
3. As the tax burden enlarges should the efficiency of the system decline, the private fee for service, practice of medicine returns [that's paying twice for the same thing]. For example, despite a U.S. Postal Service, UPS, Federal Express and other delivery services have become profitable..
4. Great societies reinvent the wheel when enough time passes for us to forget what a wheel looked like. For example: new "Corporate" health Planners are hiring Doctors and Hospitals to cover subscribers despite the fact that Blue Cross/Blue Shield and others were performing that function. Why didn't we fix what was in place, then, by demanding a reduction in premiums with a guarantee of coverage for everyone.
5. We are/were not spending more for health care than other major nations. They spend it differently and some had fewer Seniors, for many years, as a result of lives lost during WWII. Germany, Japan and Great Britain report that health care costs are rising rapidly.
6. I see an irony in the fact that many Americans act as if the Medical Profession invented the concept of greater personal satisfaction and financial reward for hard work and intellectual achievement. These rules of achievement have always been, and will never cease to be amongst the basic foundation stones of a free society operating in a free enterprise system. If such a nation chooses to abandon such principles it will be only a short period of time before they reappear.
Finally, the American public did enjoy the benefits of the greatest health care system that man has ever devised. Too many, however, have lost sight of that fact and are demanding that changes be made, and quickly. This is occurring despite the realization, by many health care professionals,that inordinate demands will soon be placed upon any new system we choose. Many of our younger citizens seem bent on their own destruction through poor nutritional habits, cigarettes, abuse of drugs and alcohol, and failure to protect themselves from deadly sexually transmitted diseases.
Ignoring these developments our nation continues to be more concerned with reducing the cost of health care and getting rid of incompetent, greedy and dishonest Doctors. Pity if it doesn't turn out that way. For if we don't do it right, we will pay more, get less, and bad Doctors like bad people, won't go away either.
I believe "He who fails to learn from history is doomed to repeat it".
Why, then, do so many of us who hear those words think "they were meant for someone else.?"
From :Chapter 10, "Health Care Reform--Facts and Fiction"
by: Vincent W. Cangello, M.D.,FACS,FACOG,FRSM, [Publ.1998]
Formerlly, Clinical Professor of Health and Medical Sciences,
University of California, Berkeley .
In Private Medical Practice 1959-2003,
For HCREI BOOKS see. Contact Us
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IT'S THE BEST IN THE WORLD---LET'S HANG ON TO IT FOR DEAR LIFE
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OBAMA'S HEALTH CARE REFORM LAW GOES TO WORK
By RICARDO ALONSO-ZALDIVAR, Associated Press Writer 2 hrs 54 mins ago 7/5/2010 ...
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LONGER WAITING TIMES/LINES SHOULD BE EXPECTED
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ADMINISTRATION ADMITS NEW HEALTH CARE LAW IS A TAX
Changing Stance, Administration Now Defends Insurance Mandate as a Tax
By ROBERT PEAR Published: July 16, 2010, New York Times
WASHINGTON — When Congress required most Americans to obtain health insurance or pay a penalty, Democrats denied that they were creating a new tax. But in court, the Obama administration and its allies now defend the requirement as an exercise of the government’s “power to lay and collect taxes.”
And that power, they say, is even more sweeping than the federal power to regulate interstate commerce.
Administration officials say the tax argument is a linchpin of their legal case in defense of the health care overhaul and its individual mandate, now being challenged in court by more than 20 states and several private organizations.
Under the legislation signed by President Obama in March, most Americans will have to maintain “minimum essential coverage” starting in 2014. Many people will be eligible for federal subsidies to help them pay premiums.
In a brief defending the law, the Justice Department says the requirement for people to carry insurance or pay the penalty is “a valid exercise” of Congress’s power to impose taxes.
Congress can use its taxing power “even for purposes that would exceed its powers under other provisions” of the Constitution, the department said. For more than a century, it added, the Supreme Court has held that Congress can tax activities that it could not reach by using its power to regulate commerce.
While Congress was working on the health care legislation, Mr. Obama refused to accept the argument that a mandate to buy insurance, enforced by financial penalties, was equivalent to a tax.
“For us to say that you’ve got to take a responsibility to get health insurance is absolutely not a tax increase,” the president said last September, in a spirited exchange with George Stephanopoulos on the ABC News program “This Week.”
When Mr. Stephanopoulos said the penalty appeared to fit the dictionary definition of a tax, Mr. Obama replied, “I absolutely reject that notion.”
Congress anticipated a constitutional challenge to the individual mandate. Accordingly, the law includes 10 detailed findings meant to show that the mandate regulates commercial activity important to the nation’s economy. Nowhere does Congress cite its taxing power as a source of authority.
Under the Constitution, Congress can exercise its taxing power to provide for the “general welfare.” It is for Congress, not courts, to decide which taxes are “conducive to the general welfare,” the Supreme Court said 73 years ago in upholding the Social Security Act.
Dan Pfeiffer, the White House communications director, described the tax power as an alternative source of authority.
“The Commerce Clause supplies sufficient authority for the shared-responsibility requirements in the new health reform law,” Mr. Pfeiffer said. “To the extent that there is any question of additional authority — and we don’t believe there is — it would be available through the General Welfare Clause.”
The law describes the levy on the uninsured as a “penalty” rather than a tax. The Justice Department brushes aside the distinction, saying “the statutory label” does not matter. The constitutionality of a tax law depends on “its practical operation,” not the precise form of words used to describe it, the department says, citing a long line of Supreme Court cases.
Moreover, the department says the penalty is a tax because it will raise substantial revenue: $4 billion a year by 2017, according to the Congressional Budget Office.
In addition, the department notes, the penalty is imposed and collected under the Internal Revenue Code, and people must report it on their tax returns “as an addition to income tax liability.”
Because the penalty is a tax, the department says, no one can challenge it in court before paying it and seeking a refund.
Jack M. Balkin, a professor at Yale Law School who supports the new law, said, “The tax argument is the strongest argument for upholding” the individual-coverage requirement.
Mr. Obama “has not been honest with the American people about the nature of this bill,” Mr. Balkin said last month at a meeting of the American Constitution Society, a progressive legal organization. “This bill is a tax. Because it’s a tax, it’s completely constitutional.”
Mr. Balkin and other law professors pressed that argument in a friend-of-the-court brief filed in one of the pending cases.
Opponents contend that the “minimum coverage provision” is unconstitutional because it exceeds Congress’s power to regulate commerce.
“This is the first time that Congress has ever ordered Americans to use their own money to purchase a particular good or service,” said Senator Orrin G. Hatch, Republican of Utah.
In their lawsuit, Florida and other states say: “Congress is attempting to regulate and penalize Americans for choosing not to engage in economic activity. If Congress can do this much, there will be virtually no sphere of private decision-making beyond the reach of federal power.”
In reply, the administration and its allies say that a person who goes without insurance is simply choosing to pay for health care out of pocket at a later date. In the aggregate, they say, these decisions have a substantial effect on the interstate market for health care and health insurance.
In its legal briefs, the Obama administration points to a famous New Deal case, Wickard v. Filburn, in which the Supreme Court upheld a penalty imposed on an Ohio farmer who had grown a small amount of wheat, in excess of his production quota, purely for his own use.
The wheat grown by Roscoe Filburn “may be trivial by itself,” the court said, but when combined with the output of other small farmers, it significantly affected interstate commerce and could therefore be regulated by the government as part of a broad scheme regulating interstate commerce.
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EVERYONE MUST HAVE HEALTH INSURANCE BY 2014
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SENIORS BEWARE OF SCAMS NOW THAT REFORM BILL IS LAW
State battles scams
by Medicare brokers
FOLSOM AGENT ACCUSED OF DEFRAUDING 12 ELDERLY CLIENTS
BY...
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PROCEED CAUTIOUSLY--REGULATIONS FOR THE LAW NOT YET PUBLISHED
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WORKERS HEALTH INSURANCE PREMIUMS AND CO PAY HIGHER
Health: Unions pressed to accept bigger co-pays
"We can't afford to continue to pay double-digit...
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THE BITE OF "PAY MORE GET LESS" IS BEGINNING TO HURT
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AAPS COMMENTS re:DR BERWICK--THE NEW MEDICAL DIRECTOR OF OUR HEALTH CARE
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How Dr. Berwick Will Control
Your Doctor AND YOU
July 18th, 2010
By Richard Amerling, MD
Barack Obama’s recess appointment of Dr. Donald Berwick as head of the Center for Medicare and Medicaid Services (CMS) marks a new low in his destructive presidency, and that is saying something!
After forcing the Orwellian Patient Protection and Affordable Care Act (PPACA) onto an unwilling populace and through a reluctant Congress, he installs an elitist who admits to being “in love” with Britain’s National Health Service into a position of incredible power without so much as a hearing.
This is an affront to the American people, and to Constitutional government. It also completely confirms our predictions regarding the true nature of ObamaCare. It will be modeled after the NHS with rigid budgets, income redistribution, command-and-control structure, “death panels” (The National Institute for Clinical Excellence, or NICE), and a weighty bureaucracy. Ironically, this comes at a time when the British are struggling with the bureaucratic morass of the NHS authority.
How does Dr. Berwick hope to control the billions of decisions made by practicing physicians every day? Daniel Henniger, in his Wonder Land column, has some revealing, and frightening, quotations:
“The unaided human mind, and the acts of the individual, cannot assure excellence. Health care is a system, and its performance is a systemic property.”
“I would place a commitment to excellence—standardization to the best-known method—above clinician autonomy as a rule for care.”
“Young doctors and nurses should emerge from training understanding the values of standardization and the risks of too great an emphasis on individual autonomy.”
The mechanisms for this are already in place. A central board, our version of the NICE, was already legislated into existence by the stimulus bill. Payment-for-performance (P4P) is already being used in certain areas to enforce compliance with clinical practice guidelines. Language in PPACA gives the secretary of Health and Human Services (which oversees CMS) authority to bar from participation doctors who do not comply with certain quality standards, i.e. conform to guidelines.
Physicians are currently being bribed by CMS to purchase electronic health records, which will be used to insert algorithms to “guide” the physician to the “correct” plan of care. Where do practice guidelines come from?
Practice guidelines are a recent fad and have proliferated to cover virtually all areas of medicine. They are funded either by government, insurance and pharmaceutical cartels, or medical organizations such as the American Medical Association. While billed as “evidence-based,” for the most part they are consensus opinions of a panel of “experts.” These experts invariably have extensive financial ties to industry. This may explain why practice guidelines are almost always biased towards greater levels of drug treatment targeting ever-wider patient populations.
Guidelines are sluggishly produced and often superseded by new information when finally published. As an example, tight control of blood sugar has been pushed by guidelines for Type II diabetes for years. Four studies published in 2008 showed either no benefit or increased death rates with this approach. Guidelines discourage innovative thinking and encourage the “one-size-fits-all” approach so loved by Dr. Berwick. If practice guidelines were in existence in the 18th century, bloodletting might still be the standard of care!
The problem with trying to implement guidelines as public policy is that we are all unique individuals and individual differences really do matter. Only a personal physician has the local knowledge of the patient that permits tailoring of treatment for maximum benefit at lowest risk.
Central control of medical care, which is the predictable endpoint of centralized payment for care, will wreak havoc on the medical profession and harm thousands, if not millions, of patients. Since PPACA effectively nationalizes the private health insurance industry, the Berwick appointment affects everyone.
Patients need to seize control of their medical destinies by setting up Health Savings Accounts and paying for their medical care themselves. Seniors should strongly consider opting out of Medicare Part B. For doctors, it has never been more urgent to sign the Physicians’ Declaration of Independence and sever third party relationships. The future of an independent medical profession is at stake.
 Richard Amerling, MD, is a nephrologist practicing in New York City. He is an Associate Professor of at Albert Einstein College of Medicine in New York, and the Director of Outpatient Dialysis at the Beth Israel Medical Center. Dr. Amerling studied medicine at the Catholic University of Louvain in Belgium, graduating cum laude in 1981. He completed a medical residency at the New York Hospital Queens and a nephrology fellowship at the Hospital of the University of Pennsylvania. He has written and lectured extensively on health care issues and is a Director of the Association of American Physicians and Surgeons. Dr. Amerling is the author of the Physicians’ Declaration of Independence (http://www.aapsonline.org/medicare/doi.htm). | |
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"The future of an independent medical profession is at stake."
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SOME HEALTH INSURERS WILL STOP WRITING NEW POLICIES FOR CHILDREN
From Drudge Report 7/24/2010 "Some major health insurance companies will no longer...
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NEW RULES ALLOW PARENTS TO DELAY "APPLYING FOR" UNTIL CHILD IS ILL
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FINANCIAL CRISIS OCCURRING IN HIV/AIDS PREVENTION/TREATMENT
Analysis: Frustration grows as AIDS science and politics clash
VIENNA | Fri Jul 23, 2010 10:08am EDT...
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33 MILLION HIV CASES WORLWIDE and 7500 NEW CASES EVERY DAY
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WHO WILL BENEFIT-WHO WILL LOSE WITH PPACA
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From Health Affairs
Who stands to gain from health reform? |
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Bethesda, MD - As the United States begins implementing health reform, many aspects of the new law will be experienced differently depending on an individual’s current health insurance status. Joseph P. Newhouse, an internationally renowned economist, assessed health reform from the perspective of four different groups. He warns that although the new law will probably reduce the number of uninsured Americans, it is unlikely that the steady rate of growth of health care costs will be successfully curtailed unless further efforts are made to streamline payment rates.
Assessing Health Reform’s Impact On Four Key Groups Of Americans
By Joseph P. Newhouse
http://content.healthaffairs.org/cgi/content/abstract/hlthaff.2010.0595
Newhouse is a professor of health policy and management at Harvard University in Boston. This paper is adapted from his May 2010 Eisenberg Legacy Lecture, a program funded by the California HealthCare Foundation.
The four groups Newhouse identified were: (1) those who are uninsured or eligible for Medicaid or the Children’s Health Insurance Plan (CHIP); (2) purchasers of individual health policies and those insured through a small business employer; (3) employees of midsize or large employers offering benefits; and (4) Medicare enrollees. Newhouse predicts that although we can expect significant issues to arise concerning financing and administration, and perhaps the capacity of the delivery system, individuals in the first group will benefit greatly from the new guidelines. So will the second group, which he estimates could grow to become one-sixth or more of the population. Those belonging to the third group, says Newhouse, are generally unaffected by health reform at the moment. Medicare enrollees will gain from the new benefits (especially concerning long-term care and the closing of the doughnut hole). But they also may find their access to care diminished, as reduced reimbursement to providers could cause some physicians to turn away Medicare patients who lack supplemental insurance or other means of making additional payments.
Ultimately, Newhouse observes, there is no panacea—and the continually increasing costs of health care and Medicare, coupled with the lack of political will to increase taxes, will mean that the nation remains in a fiscal hole. “Despite all of the substantive and political problems of price setting, some sort of all-payer regulatory regime may be the only feasible alternative,” Newhouse concludes. “Health reform will accomplish many good things for a great many people. But it is doubtful that the steps included in the Affordable Care Act to reduce the steady rate of growth of health care costs will suffice.” |
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NEW HEALTH CARE REFORM LAW WILL NOT CONTAIN COSTS
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CALIFORNIA STATE INSURANCE DEPARTMENT WILL CHECK INCREASE IN HEALTH INSURANCE RATES
Anthem CEO Resigns
1. Anthem, Aetna submit new rate requests in California The California...
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CEO OF ANTHEM BLUE CROSS STEPS DOWN
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CALIFORNIA HEALTH DEPARTMENT WARNS OF EPIDEMIC
STATE URGES WHOOPING COUGH SHOTS
NEARLY 1,500 CASES. UP FIVEFOLD
BY BOBBY CALVAN AND JACQUELINE Baylon Sacramento Bee 7/20/2010
California is experiencing what could be its most severe epidemic of whooping cough in a half century, says the state Department of Public Health.
Nearly 1,500 cases have already been reported this year statewide - a fivefold increase from last year.
State health officials Monday urged people, including the elderly who care for small children, to get vaccinated.
At least five children, all under 3 months old, have died this year from the disease, and another case is under investigation, state officials said.
"We are facing what could be the worst year for pertussis that this state has seen in more than 50 years," said Dr. Gilberto Chavez, the chief of the state's Center for Infectious Disease. ' I
In 2005, eight people died from whooping cough, with 3,182 reported cases, according to state public health officials. Not since 1958, when there were 15 deaths and more than 3,800 cases, has there been a worse epidemic.
Placer County reported 23 cases of the disease so far this year - a marked increase from the three cases it recorded during the same period last year.
Sacramento County also reported 23 cases, up from nine.
Most pertussis infections happen during the summer months, and health officials are urging Californians to heed warnings.In particular, pregnant women, those planning a pregnancv....
Three-fourths of infants who get the disease get it from somebody within their household, said Dr. Dean Blumberg, associate professor of pediatrics at the UC Davis School of Medicine. Because immunity eventually fades, most people are advised to ask their doctor if they should get a booster shot The pertussis vaccine can be administered in a single shot also containing vaccines for diptheria and tetanus. rI ,
Vaccination is the most, effective way to prevent whooping cough, according to the Centers for Disease Control and Prevention. ?
Marin County has the state's highest -number of cases with 195 - far more than 43 in Los Angeles or the. 32 in nearby San Francisco. '
State officials attributed Mann County's high numbers to parents who choose not to vaccinate their children.
Dr. Kburam Arif, chair, of the department of pediatrics for Mercy Medical Group, said some parents may not realize how dangerous pertussis 'can be to their infants. While adults usually recover quickly from whooping cough, infants have more difficulty battling an infection because of their delicate airways.
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NUMBER OF WHOOPING COUGH INFECTIONS INCREASING
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FLU VACCINE IN THE FUTURE--A SKIN PATCH
Vaccine comes in a patch,
you won't feel a thing,
RESEARCHERS SAY IT COULD BE IN USE IN 5 YEARS
BY...
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ADULTS AND CHILDREN WHO DON'T LIKE NEEDLES WILL APRRECIATE THIS
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MAJOR HEALTH INSURERS ARE DESIGNING LOWER COST HEALTH CARE POLICIES
Big health insurers
test cheaper plans
that limit choices
BY REED ABELSON New York Times
As the...
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"Big health insurers test cheaper plans that limit choices"
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NEW HEALTH CARE LAW WILL COVER ABORTION
Obama Administration OKs First Tax-Funded Abortions Under Health Care Law
 Washington, DC (LifeNews.com) - 7/18/2010- The Obama administration has officially approved the first instance of taxpayer funded abortions under the new national government-run health care program. This is the kind of abortion funding the pro-life movement warned about when Congress considered the bill.
The Obama Administration will give Pennsylvania $160 million to set up a new "high-risk" insurance program under a provision of the federal health care legislation enacted in March.
It has quietly approved a plan submitted by an appointee of pro-abortion Governor Edward Rendell under which the new program will cover any abortion that is legal in Pennsylvania.
The high-risk pool program is one of the new programs created by the sweeping health care legislation, Patient Protection and Affordable Care Act, President Obama signed into law on March 23. The law authorizes $5 billion in federal funds for the program, which will cover as many as 400,000 people when it is implemented nationwide.
"The Obama Administration will give Pennsylvania $160 million in federal tax funds, which we've discovered will pay for insurance plans that cover any legal abortion," said Douglas Johnson, legislative director for the National Right to Life Committee.
Johnson told LifeNews.com: "This is just the first proof of the phoniness of President Obama's assurances that federal funds would not subsidize abortion -- but it will not be the last."
"President Obama successfully opposed including language in the bill to prevent federal subsidies for abortions, and now the Administration is quietly advancing its abortion-expanding agenda through administrative decisions such as this, which they hope will escape broad public attention," Johnson said. Full story at LifeNews.com
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HEALTH CARE TAXES WILL BE AVAILABLE TO COVER VOLUNTARY ABORTIONS
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MANY MILLIONS AWARDED TO SETTLE NURSING HOME DEATH
Judge rejects appeal in death of nursing home patient
EVIDENCE BACKS $29 MILLION JURY AWARD, HE SAYS
BY...
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JUDGE CALLS IT--"a classic demonstration of how well the jury system works."
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GOP PURSUES ROLLBACK OF HEALTH CARE LAW
CALIFORNIA FOCUS "GOP pursues rollback of health care law"Sunday, July 11, 2010
AREA'S HOUSE MEMBERS...
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"This is politics at its worst," Thompson said. "People in This country wants health care that works."
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NEW BILL IN STATE LEGISLATURE WOULD ALLOW HOSPITALS TO EMPLOY PHYSICIANS
3. Legislation allowing hospitals to hire physicians moves to Senate release 7/12/2010
The California...
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PHYSICIANS MUST BE RESPONSIBLE TO THE PATENT'S NEED--NOT TO THE HOSPITAL
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CATHOLIC BISHOPS TAKE A POSITION ON MILITATY ABORTIONS
Bishops Urge Senate to Remove Abortion Amendment from Defense Bill
A Senate committee amendment that would authorize the performance of elective abortions at military hospitals in this country and around the world is "misguided" and should be removed from the National Defense Authorization Act (S. 3454), said the Chairman of the U.S. bishops' Committee on Pro-Life Activities. In a June 29 letter, Cardinal Daniel DiNardo of Galveston-Houston urged Senators to remove this amendment on the grounds that it breaks with longstanding federal and military policies on government promotion of abortion.
Cardinal DiNardo said it was disingenuous to suggest, as the amendment's proponents have, that the amendment is "moderate" in requiring patients at military facilities to pay for their abortions. "Which is a more direct governmental involvement in abortion: That the government reimburses someone else for having done an abortion, or that the government performs the abortion itself and accepts payment for doing so?" the Cardinal wrote. He cited a 1989 ruling by the U.S. Supreme Court saying that "the State need not commit any resources to facilitating abortions, even if it can turn a profit by doing so."
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"it breaks with longstanding federal and military policies on government promotion of abortion."
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SOCIAL SECURITY AND MEDICARE HAVE MONEY PROBLEMS
Investors.com - Powered by Investors Business Daily
Are Overdue Reports Concealing ObamaCare Impact...
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DELAYED CBO REPORT ON SOCIAL SECURITY AND MEDICARE FUNDING TROUBLE SOME
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A STEP CLOSER TO A VACCINE TO CONTROL AIDS
- Antibody Discovered for 91% of HIV Strains
MARK SCHOOFS Wall Street Journal 7/8/2010
U.S. government scientists have discovered three powerful antibodies, the strongest of which neutralizes 91% of HIV strains, more than any AIDS antibody yet discovered.
Looking closely at the strongest antibody, they have detailed exactly what part of the virus it targets and how it attacks that site. Together with recent research into how to make animals produce antibodies, the new findings constitute a significant step toward an AIDS vaccine.
Mark Schoofs discusses a significant step toward an AIDS vaccine, U.S. government scientists have discovered three powerful antibodies, the strongest of which neutralizes 91% of HIV strains, more than any AIDS antibody yet discovered.
The antibodies were discovered in the cells of a 60-year-old African-American gay man, known in the scientific literature as Donor 45, whose body made the antibodies naturally. Researchers screened 25 million of his cells to find 12 that produced the antibodies.
Now the trick will be for scientists to develop a vaccine or other methods to make anyone's body produce them.
That effort "will require work," said Gary Nabel, director of the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases, who was a leader of the research. "We're going to be at this for a while" before any benefit is seen in the clinic, he said.
The research was published Thursday in two papers in the online edition of the journal Science, 10 days before the opening of the large International AIDS Conference in Vienna, where prevention science is expected to take center stage.
More than 33 million people were living with HIV at the end of 2008, and about 2.7 million contracted the virus that year, according to United Nations estimates. Vaccines, which are believed to work by activating the body's ability to produce antibodies, eliminated or curtailed smallpox, polio and other once-feared viral diseases, so they have been the holy grail of AIDS research.
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THREE ANTIBODIES DISCPVERED THAT ATTACK AIDS VIRUS
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HEALTH CARE FOR LAW BREAKERS CONFOUNDING THE SYSTEM
Immigrants, Mr. President, It’s The System Set Up to Distribute Benefits of Lawbreaking
By Arizona Physician, Jane M. Orient, M.D.
CLICK HERE to read article online and comment.
On July 1, Barack Obama spoke of the immigrants who helped build our country—such as my great-grandparents. They passed through public health screening, obeyed the law, worked hard, and never got welfare benefits. They learned the English language and American history. Some even carried the Constitution of their beloved adopted homeland in their pocket throughout their lives. They asked only for the opportunity to contribute.
Should we, as Obama suggested, break down the bureaucratic barriers that hinder such people? Absolutely. That is not what the controversy is about.
The issue is illegal immigration—lawbreaking. Controversy is inflamed by marches of angry people, aggressively waving a foreign flag, insulting Americans in a foreign language, and demanding to “take back” the property and earnings of Americans.
Illegals circumvent public health screening, bringing once banished foreign organisms with them. The most serious one is probably multi-drug resistant tuberculosis, which one can catch on a bus. Head lice are far more common than previously in schools. Dengue has reached the continental U.S. and the parasite that causes Chagas disease now infests more than 40 percent of the kissing bugs found near Tucson, compared with only 4 percent in 1964.
Then there’s property and environmental destruction in the Arizona desert. Ranchers’ land is trampled, and strewn with tons of garbage and human excrement.
Worse, there are guns—including military assault rifles. Americans are warned to stay out of the Buenos Aires National Wildlife Refuge because it is occupied by heavily armed invaders, who smuggle drugs and humans. Phoenix, Arizona, is perhaps the kidnapping capital of the world, with heavily armed contingents invading homes and carrying off people for ransom.
While proclaiming that we are “a nation of laws,” Obama didn’t mention how the U.S. federal government encourages lawlessness. One way is by forcing the private sector to care for illegals free of charge, through the Emergency Medical Treatment and Active Labor Act (EMTALA). Physicians on a hospital staff are required to serve these patients immediately—even if they have scheduled surgeries or an office full of waiting patients.
When hospitals in border states complained that this unfunded mandate could cause them to close (as many actually have), the federal government offered some reimbursement for services provided under EMTALA to illegals. Hospitals, however, could not inquire about immigration status—they had to somehow divine it without asking, and file a claim without telling.
Doctors owe a duty of confidentiality to their patients. The Oath of Hippocrates states: “All that may come to my knowledge in the exercise of my profession or outside of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and never reveal.”
Some things, however, ought to be revealed, and by law physicians must report them. These include certain infectious diseases, gunshot wounds, suspected abuse, and evidence of an impending crime. While the government demands access to more and more sensitive information about citizens from their health records, including illegal drug use, sexual preference, psychiatric history, and gun ownership, one is not allowed to ask basic questions about immigration status. This is a double standard.
Doctors are not law enforcement agents. Their duty is simply to treat patients—even known enemy combatants or criminals. They may not, however, help people evade the law.
Federal law may actually encourage them to do so. According to anonymous reports, “community health centers,” which are generously funded by federal tax dollars, not only provide treatment to illegals but also may help them obtain many other welfare benefits to which they are not entitled. Bending or violating the law might keep enrollments expanding and the federal dollars flowing and the staff paid. Immigration officials look the other way, and anyone who dared to raise questions would likely be branded as a “racist.” (“ObamaCare,” by the way, will expand the reach of such centers from about 5 percent to 10 percent of the population.)
In contrast to Obama’s examples, like Jews fleeing Eastern Europe, this time we’re not facing just a migration, but an influx having many hallmarks of a foreign invasion.
Individual illegal residents may be oppressed refugees or simply, as Obama says, people seeking a better life. Sympathy for individuals—some of whom might even be hostages or human shields— must not, however, blind us to the threat to our country from harboring at least 11 million “entrants” who have defied our laws.
The system is set up to distribute benefits of lawbreaking. Not just to Obama’s “unscrupulous businesses” but also to politicians who expect to get the immigrant vote, and to bureaucrats, medical professionals, and other citizens who draw taxpayers’ money from the welfare state.
If the United States cannot or does not enforce its laws, Lady Liberty’s lamp will no longer beckon to the people throughout the world who are “yearning to breathe free.”
 Jane M. Orient, M.D., Executive Director of Association of American Physicians and Surgeons, has been in solo practice of general internal medicine since 1981 and is a clinical lecturer in medicine at the University of Arizona College of Medicine. She received her undergraduate degrees in chemistry and mathematics from the University of Arizona, and her M.D. from Columbia University College of Physicians and Surgeons. She is the author of Sapira’s Art and Science of Bedside Diagnosis; the fourth edition has just been published by Lippincott, Williams & Wilkins. She also authored YOUR Doctor Is Not In: Healthy Skepticism about National Health Care, published by Crown. She is the executive director of the Association of American Physicians and Surgeons, a voice for patients’ and physicians’ independence since 1943. Complete curriculum vitae posted at www.drjaneorient.com.
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HEALTH CARE FOR ILLEGALS CREATING HAVOC
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SERIOUSLY ILL SENIORS MAY BE UNABLE TO GET CARE?
Health law risks turning away sick
By Julian Pecquet - 07/01/10 07:13 PM ET from THE HILL NEWSPAPER
"The Obama administration has not ruled out turning sick people away from an insurance program created by the new healthcare law to provide coverage for the uninsured.
Critics of the $5 billion high-risk pool program insist it will run out of money before Jan. 1, 2014. That’s when the program sunsets and health plans can no longer discriminate against people with pre-existing conditions.
Administration officials insist they can make changes to the program to ensure it lasts until 2014, and that it may not have to turn away sick people. Officials said the administration could also consider reducing benefits under the program, or redistributing funds between state pools. But they acknowledged turning some people away was also a possibility.
"There’s a certain amount of money authorized in the statute, and we will do our best to make sure that that amount of money insures as many people as possible and does as much good as possible," said Jay Angoff, director of the Office of Consumer Information and Insurance Oversight at the Department of Health and Human Services (HHS). "I think it’s premature to say [what happens] when it’s gone."
The administration has not discussed asking Congress for more money down the line if the $5 billion runs out before Jan. 1, 2014. Uninsured sick people could start applying for participation in the high-risk insurance pools on Thursday.
Healthcare experts of all stripes warned during the healthcare debate that $5 billion would likely not last until 2014. Millions of Americans cannot find affordable healthcare because of their pre-existing conditions, and that amount would only cover a couple hundred thousand people, according to a recent study by the chief Medicare actuary.
Republicans continued to hammer that point on Thursday, asking HHS officials to brief them about the program...."
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WILL THE MONEY ALLOTTED FOR SICK SENIORS LAST TILL 2014?
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"CBS INVESTIGATES" REPORTS CONTROL OF INTERNET NEWS
From Drudge report 7/6/2010
(Credit: CBS News) T THE Transportation Security Administration (TSA)...
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"CBS INVESTIGATES" WILL NOT ACCEPT CALLS CONCERNING THIS REPOPRT
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PROOF THAT MOST EMERGENCY ROOM VISITS ARE MADE BY INSURED PATIENTS
Uninsured not driving increase in EMERGENCY ROOM visits
The elderly and those on Medicaid are among the most likely to use emergency departments.
By Christine S. Moyer, amednews staff. Posted June 9, 2010.
A new report finds that the uninsured are no more likely to go to an emergency department for care than are those with insurance.
About one in five people went to an ED at least once in 2007, according to a report issued in May by the Centers for Disease Control and Prevention's National Center for Health Statistics. Most of the patients had some type of health insurance and considered themselves to be in poor health (www.cdc.gov/nchs/data/databriefs/db38.htm).
"The reason we did this particular short little report was to lay out exactly who does go to the emergency department. ...There seems to be a lot of misperceptions," said Amy Bernstein, ScD, an author of the report and chief of the Analytic Studies Branch in the Office of Analysis and Epidemiology at the NCHS.
In 2007, there were 116.8 million ED visits nationwide, up 23% from 1997.
Angela Gardner, MD, president of the American College of Emergency Physicians, said visits likely jumped during the recession, which began at the end of 2007, when waves of people lost their jobs and health insurance.
"We've heard from doctors that [ED volume] is going up everywhere," said Dr. Gardner, associate professor of emergency medicine at the University of Texas Southwestern Medical Center.
For the CDC report, researchers examined 2007 data from the National Health Interview Survey and the National Hospital Ambulatory Medical Care Survey. They found that as family income increased, the likelihood of ED visits in the previous year decreased. Adults age 75 and older, blacks, and people with Medicaid coverage sought emergency care most frequently.
Uninsured children and adults age 45 to 64 were no more likely than those with private insurance to have visited the ED at least once during the year.
Researchers found that having a usual source of medical care did not affect the number of times people younger than 65 went to the ED in a 12-month period. But ED visits were more likely among adults 65 and older who had a usual source of care.
"Often, primary care providers send patients to the emergency department because they know we'll take care of a problem expeditiously," Dr. Gardner said.
Similar findings on ED use were reported in a March Annals of Emergency Medicine study. Researchers found that people who visited EDs at least four times a year generally are white, insured and have a primary care physician (www.annemergmed.com/webfiles/images/journals/
ymem/elacalle.pdf).
The ACEP has called on the CDC to release a more comprehensive report so health professionals have greater insight into the condition of the nation's EDs as health care system reforms are implemented.
This content was published online only.
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ARE THE UNINSURED ACCUSED IN ORDER TO CONVINCE US THAT GOVERNMENT CONTROLLED HEALTH CARE IS NEEDED?
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WHAT WILL THEY THINK OF NEXT?
From Sacramento Bee 6/14/2010HEALTH COSTS
Some getting paid to take their meds
MONEY...
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SOLUTIONS OF THIS NATURE COULD LEAD TO GREATER IRRESPONSABILITY
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GENES IMPORTANT FOR LONG AND HEALTHY LIFE
Genes linked to healthy aging identified in study
Washington Post 7/2/2010
WASHINGTON - Scientists...
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STUDY AFFIRMS THAT 2 PLUS 2 DOESN'T ALWAYSD ADD UP TO 4 IN THE HEALTH CARE BUSINESS
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IMPORTANT RESEARCH FINDINGS ABOUT HIV/AIDS INFECTIONS
Extracts from Journal of American Physicians and Surgeons
IATROGENIC HARM FOLLOWING "HIV" TESTING
BY...
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MANY PEOPLE WITH HIV VIRUS UNLIKELY TO GET AIDS
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FINALLY A PLEASANT SURPRISE IN HEALTH CARE REFORM
From the Sac Bee 7/1/2010
ANTHEM RATE HIKE CUT TO 14%
HEALTH INSURER SAYS THIRD PARTY CHECKED ITS DATA AFTER ERRORS IN EARLIER 39% RISE
BY MATT KAWAHARA rnkawahara@sacbee.com
Facing continued scrutiny over rising premiums, Anthem Blue Cross on Wednesday submitted revised rate increases that are substantially lower than the controversial rate hikes it proposed six months ago.
But it wasn't enough to appease consumer health advocates, who said the average increase of 14 percent remained too high for 700,000 Californians who buy insurance on their own. A spokeswoman for WellPoint, Anthem's parent company, said the new rates, while still substantial for policyholders, are necessary to keep the company sustainable.
"We'd acknowledge that the rates are high," said the spokeswoman, Kristin Binns. "But we are concerned that medical costs are rising and we don't see that subsiding." The insurer came under fire for an earlier plan to increase rates by as much as 39 percent. The steep hike stoked debate over the rising cost of health insurance and helped revive the national effort to overhaul health care.
The company withdrew its rate filing in April when anactuary hired by the Department of Insurance to review it found numerous math errors.
This time, Anthem officials said, the company took "multiple steps" to ensure its filing was accurate, including bringing in a third party to review the numbers, a practice it intends to follow in the future.
"We put extra care, time and commitment into really scrubbing all our data to ensure that we've done this thoroughly and it's been well-reviewed," Binns said.Consumer advocates were hardly satisfied by the company's revised rates. They argue that regulators need the authority to reject what they deem as exorbitant increases.
"Clearly what the reduced rate increases show is that public scrutiny matters," said Anthony Wright, executive director of Health Access California.
The Department of Insurance announced in April that an actuary found flaws in Blue Cross' original rate filing. Blue Cross withdrew the proposal, which came under political and public fire.
Pieter Pastoor, an Anthem customer from Davis, welcomed the rate adjustment, saying that "14 percent is certainly a lot better than 30."
But Pastoor and his wife are still paying over $20,000 a year for coverage, he said, a number that will rise even with the reduced increase.
"Whatever they do or however they want to raise it, there's nowhere else for me to go," said Pastoor, age 64.
Greater government oversight is crucial to protecting consumers, said Jamie Court, president of Consumer Watchdog, a left-leaning Santa Monica-based advocacy group.`The problem is we don't have a standard that sets out what is excessive and what is not," Court said. He argues the state should have the ability to deny rate increases it determines are too high. "We should let the regulators determine what's excessive," Court said.
In the uproar over Blue Cross' original filing, Insurance Commissioner Steve Poizner pledged that the Department of Insurance would closely analyze the rate filings of the state's largest individual-policy insurers.
On Wednesday, the department released rate filings for Anthem, Aetna and Blue Shield. Aetna filed for an average 19 percent hike, and Blue Shield filed for an average IS percent increase.
For more information call the Sac Bee's Matt Kawahara [916-321-1015]
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HEALTH CARE INSURERS WILL RESPOND TO COMPETITION AND REVIEW
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A PRIVATE PRACTICING DOCTOR TELL US HOW HEALTH CARE MONEY IS SPENT
From the AAAPS New Letter 6/29/2010
Why the Government Cannot Control Medical CostsClick here...
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YOU WON'T SAVE MONEY WITH GOVERNMENT CONTROLLED HEALTH CARE
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CAREER DEDICATED WOMEN DECIDING NOT TO HAVE CHILDREN
More American women not having children: report by Daniel Lippman Daniel Lippman Jun 25,3:17 pm ET ...
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LOWER BIRTH RATE IN MANY NATIONS THREATINING THE PRESERVATION OF THEIR CULTUREs
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THE NEW HEALTH BILL [PPACA] WILL CAUSE MANY SENIORS/RETIREES TO LOSE SOME HEALTH CARE COVERAGE
Sent: Thursday, June 24, 2010 1:15 PM
Subject: Enduring ObamaCare - Week 13
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Dear Policy Patriots -
It's Official: More than Half Won't Be Able to Stay in Their Employer Health Plan. If you listened to the campaign rhetoric during the 2008 election, you could be forgiven for thinking that health reform would mainly mean insuring people who cannot afford insurance on their own; in the process there would be no tax increases or benefit cuts for the middle class; and, as President Obama repeatedly stated, "If you like the plan you are in, you can keep it!"
Turns out, the reality is 180 degrees different. Things are likely to change least for low-income people. About 18 million of them will be herded into Medicaid. But with no new doctors or nurses, they will find it more difficult to access care than ever before and, according to a new NCPA brief analysis, will likely show up at hospital rooms in increasing numbers.
Middle-class families who already have insurance will see the biggest change:
- Within the next few months, senior citizens will begin receiving notices that their Medicare Advantage plans are being cancelled, and for those who continue in Medicare Advantage, they will see premium increases and benefit cuts. Over the next decade, 7.4 million Medicare Advantage enrollees will lose coverage they would have otherwise had.
- By September, between one and two million Americans with limited benefit insurance will lose coverage because their insurance doesn't comply with the "no lifetime limit on benefits" regulation in ObamaCare.
What about "Grandfathered" Health Plans? According to the Administration, health reform would grandfather some health plans and, therefore, spare them from onerous, cost-increasing regulatory burdens. Unfortunately, the news isn't good on that front. Under a "mid-range" estimate, more than half of all workers will not be in grandfathered within three years.
Under the most likely scenario, 87 million Americans will no longer be able to retain their current health plan. In fact, the number could be as high as 117 million. Small businesses will be especially hard hit and as many as 80 percent will lose their grandfathered status by 2013.
From the Administration's own statements, it now appears that "grandfathering" was never intended to be a long-term phenomenon. Eventually, all firms will lose their grandfathered status and, in turn, employees will lose the plans they liked.
...And You Could Be Dropped Anyway. As NCPA President John C. Goodman's recent editorial in The Wall Street Journal made clear, even if you are in a grandfathered plan, your employer could drop your coverage anyway. Although estimates vary, the number of workers estimated to lose their employer-provided insurance is incredible. Consider:
- The Congressional Budget Office (CBO) predicts that between nine and ten million workers will lose their coverage.
- The Medicare Chief Actuary predicts that fourteen million employees will be dropped.
- Former CBO Director Douglas Holtz-Eakin estimates the number at thirty-five million.
So, what's the bottom line? Because of ObamaCare, the United States could experience a complete restructuring of the economy, with firms dissolving and emerging solely based on government subsidies. Of course, that will means that millions of American workers won't be able to keep the plan they have now.
Educate Your Friends & Family! ObamaCare isn't just a health care bill. It's a law that increases deficit spending, constricts your access to care, destroys your private health insurance coverage and fundamentally changes your relationship with your doctor. Fight ObamaCare through education. Forward this email to your friends and family and encourage them to sign up for the Policy Patriot Weekly Letter. It's important to you. It'll be important to them, too.
The NCPA Needs You! The work of the National Center for Policy (NCPA) comes at a price. We need your help in order to continue the valuable policy work that we do.
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National Center for Policy Analysis
P.O. Box 650098
Dallas, Texas 75265-0098 |
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OTHERS WILL SEE LARGE INCREASES IN THEIR CARE INSURANCE PREMIUMS
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PRESIDENT STATES BENEFITS OF HIS NEW HEALTH LAW {PPACA]
White House releases 'patient bill of rights'
By RICARDO ALONSO-ZALDIVAR, Associated Press Writer...
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THESE PROMISES ARE SUBJECT TO CHANGE WHEN THE REGULATIONS FOR ADMINISTERING THE LAW ARE PUBLISHED
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MEDICARE PLANS FOR 20% CUT IN DOCTOR'S Fees
From AAPS NEWS 6/23/2010
Congress “Solves” Medicare Cost Problem by Not Paying for Doctors
By Jane M. Orient, M.D. She is the Executive Director of the Association of American Physicians and Surgeons, a voice for patients’ and physicians’ independence since 1943.
Nine times in the past eight years, Congress has, at the last second, delayed the automatic cuts in doctors’ Medicare fees that it decreed some 13 years ago to prevent Medicare spending from outpacing other consumer expenditures.
The AMA threatens that doctors, especially primary care doctors, will stop accepting Medicare patients if the cuts go through. Congress cites the impending bankruptcy of the program.
Every time cuts are postponed, the next scheduled cut gets deeper. It’s like a balloon mortgage payment in reverse.
And the controversy gives columnists another occasion to rail against those greedy overpaid doctors, unwilling to assume a bit of shared sacrifice despite the economic downturn.
As Steven Pearlstein writes in The Washington Post, Congress and the President should not accede to these “un-Hippocratic ransoms.” So what if Medicare physician fees haven’t quite kept up with the costs of running the office? What he calls a “modest gap” has been “more than offset” by physicians’ working harder.
What’s a little 21 percent pay cut to someone who already makes much more than the average patient does? Of course, Mr. Pearlstein doesn’t seem to recognize that when overhead is 50 percent or more, a 21 percent cut in revenue means a cut of 42 percent or more in the physician’s actual pay. And if one is losing $23 per patient visit, it is impossible to “make it up on volume.”
Unlike the AMA, the Association of American Physicians and Surgeons (AAPS) has repeatedly said: Let the cuts go through. But don’t cut off benefits to seniors who see the doctors of their choice.
Both Congress and the AMA appear to be in deep denial about several basic facts:
First, Medicare is insolvent. Expenditures will be cut because the government doesn’t have any money.
Second, the access problem is not caused by the “sustained growth rate” (SGR) formula, but by price controls. If doctors can’t collect enough to keep their doors open, they close, like any other business.
Third, physicians could make more money while charging less, if it were not for the costs of filing claims and complying with Medicare rules.
Fourth, more doctors would do primary care if they could charge a fair price—that the patient was willing to pay—and organize their work in the most efficient way. If they could charge $100 for one long enough visit, instead of churning five patients through frantic $20 visits to bring in $100 without being accused of “upcoding,” doctors would find primary care much more attractive.
We are warned that more doctors will “opt out” if the cuts go through, as up to 200 Texas doctors are already doing each year. Exactly. We need more opted-out physicians to take care of seniors who can’t find a physician willing to work under Medicare’s constraints and threats—or who want a non-government physician.
Congress, however, punishes seniors who choose such a doctor by denying them any reimbursement at all for services they receive from opted-out doctors— or that are ordered by such doctors, even if performed by Medicare providers.
While Pearlstein might be shocked to hear it, doctors opt out of Medicare not because they want more money—many stay in just because they fear a serious drop in income—but because they want to be able to do their job. They want to be able to order what a patient needs, not what a Medicare bureaucrat decides he may have.
Congress apparently intends to cut costs by simply not paying them. Then, if doctors see fewer patients, there are fewer bills for tests or procedures. The government not only saves the $15 it might have paid the doctor, but hundreds or thousands of dollars on tests or drugs.
Fixing the SGR may top the AMA’s agenda. But for seniors, the problem is draconian cuts in care. These can be averted only by restoring patients’ freedom to choose an independent doctor, not by a slight easing of their captive doctor’s shackles.
For more information: www.aapsonline.org
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MANY DOCTORS PLAN EARLY RETIREMENT OR REDUCING THE NUMBER OF MEDICARE PATIENTS THEY WILL CARE FOR
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CONFIDENCE IN PRESIDENT OBAMA FALLING
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MANY AMERICAN WANT NEW PEOPLE IN CONGRESS
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UC MEDICAL SCHOOLS SEE MORE MINORITY GROUP APPLICANTS
From Sacramento Bee 6/14/2010
UCD med school boosts minority ratio
BY BOBBY CAINA CALVAN bcalvan@sacbee.com
At...
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A GROWING PERCENTAGE OF GRADUATES SEEKING PRIMARY CARE TRAINING
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NEW RULES AND REGULATIONS ARE INTERFERING WITH THE PRIVATE PRACTICE OF MEDICINE
From the AAPS News Letter 6/19/2010
Pecos Bill
from Truth Serum Blog by Joseph Scherzer, M.D. current President of AAPS
Pecos Bill is a mythical figure of American Folklore. I first learned of him in my doctor’s office. I was 7 years old, suffering from severe asthma, and Dr. Aaron Horland, an EENT (Eye, Ear, Nose, Throat) specialist in my home town of Newark, N.J., had agreed to reduce his fees so my mother could afford to provide me with the allergy shots that may well have saved my life.
Dr. Horland’s paneled waiting room displayed about half a dozen prints of larger-than-life figures from American Folklore, such as Paul Bunyan. Pecos Bill was among them, riding a wild Tornado. Realizing it could not throw him, the tornado ‘rained itself out’ over Arizona, creating the Grand Canyon in the wake of its flood waters, finally crashing into California to form Death Valley.
These days, most doctors feel as if they are riding a wild tornado each day of the week. (I would imagine that most well informed Americans feel the same way this year.) There is hardly a week that goes by without some new concern or demand, none of which have to do with learning about Medicine. We are caught up in a torrential whirlwind of bureaucratic regulations admixed with a flood of threats.
On June 14, the Maricopa County Medical Society of Arizona informed its members that The Centers for Medicare and Medicaid Services (CMS) are requiring doctors to enroll in a program called PECOS (the Provider, Enrollment, Chain and Ownership System) 6 months sooner than expected. Not only that, but CMS suddenly decided to change the rules of the game, and is not backing down even though the AMA (for once) and 40 other medical organizations contend that it is going “beyond what is called for in the health reform statute. According to the legislation…only physicians who order and refer durable medical equipment, prosthetics, orthotics and supplies, or home health services are required to be enrolled with Medicare through PECOS by July 1. However, CMS also is requiring that doctors who order or refer imaging, laboratory and specialist services be enrolled by July 6.”*
If I, as a dermatologist, do not enroll, and send a biopsy of a malignant melanoma to a trusted pathologist, that pathologist will not be paid. Ipso facto, that doctor will not provide his service to my patient.
The AAD contact person made it sound as if enrolling in PECOS just takes 5 minutes: ‘Filling out the form is not a problem at all – it is just a way to be sure that no fraud or abuse occurs.’
BUT - if one comma is different between the Pecos form, the NPI form, and the IRS forms, I may not get paid!!
As Dr. Jane Orient wrote two days ago, “Containment efforts in new Medicare rules include requiring doctors to “revalidate” their billing privileges periodically. They’ll have to show that their name, address, identifying numbers, and organizational status are exactly as registered. They’ll have to give Medicare access to their checking account by electronic funds transfer (EFT) so that it can make immediate “adjustments” in case of overpayment.
The Patient Protections and Affordable Care Act (“ObamaCare”) imposes additional screening requirements; some providers will have to be fingerprinted. Ever-more aggressive private bounty hunters called Recovery Audit Contractors (RACs) are descending on doctors’ offices, dissecting claims and patients’ records, looking for a missing “bullet point” in the documentation, or an inaccurate digit in the billing code. ObamaCare increases the penalties for errors from $11,000 per item to $50,000. The government’s burden of proof, already light, has been further decreased. There is no need to prove any intent to defraud, or even to show that any money was ever collected. Also, the definition of “fraud” is expanded to include “unnecessary” services, “ineffective” services, or those that don’t comply with Medicare requirements. “
Twila Brase, President of CitizensCouncilonHealthCare (www.healthcarefreedom.us) just visited Capitol Hill, where, to her surprise, she learned that 1) “no national physician organizations except for a national neurologist's group, are asking for a repeal of the [Obama Health Care] bill, which is frustrating to certain GOP Members of Congress, and 2) There is disagreement among Republicans over a straight REPEAL of ObamaCare or the proposed "REPEAL AND REPLACE" plan. She was told that if there is not agreement on a straight repeal, the law will likely stand intact and un-repealed. Keep this in mind when you next talk to your Members of Congress.”
[In addition, Ms. Brase discussed] “EHR [Electronic Health Records] - Tool for Control of Doctors. The Economic Stimulus law (ARRA), according to the Obama Administration, is the foundation for national health care. The bill requires every doctor and hospital to have an interoperable (online accessible/linkable) electronic health record system by 2015 if they want to avoid reduced Medicare payments.
It also envisions a single online medical record for all citizens, and provides $20 billion for the creation of a National Health Information Network (NHIN), which CCHC calls an InfoTRUSION network.”**
My own internist left his group practice when his partners decided to implement EHR. They went bankrupt in the process, but his practice is thriving.
THEN there is the Doctor ‘FIX.’ “ The Hill (5/21, Pecquet) notes, "Without the [Fix], payments to doctors under Medicare were scheduled to receive a 21.3 percent cut in June. Under the deal crafted by House Ways and Means Committee Chairman Sandy Levin (D-MI) and Senate Finance Committee Chairman Max Baucus (D-MT), the payment will increase by 1.3 percent through the end of the year." Doctors "would get an additional one percent increase in 2011, and further increases would be offered in 2012 and 2013 based on the growth in Medicare health spending." Kaiser Health News (5/20, Villegas) also covered the story.”
Fees have not kept up with inflation since the payment ‘system’ was introduced circa 1990, when they were actually rolled back to fees charged in the 70’s. Of course, expenses (staff salaries, rent, etc,. etc) are not Price-‘FIXED.’
"Kaiser Health News (6/15, Marcy, Villegas, Weaver) GOP Unwilling To Pass "Doc Fix" Because AMA Supported Health Reform. Roll Call (6/16, Pierce, Roth) reports, "It's not that Senate Republicans aren't sympathetic to doctors' desire to get paid for their services; it's just that they aren't willing to bend over backward anymore to help the American Medical Association get the legislative remedy that it wants." The GOP "and the AMA used to be like peas in a pod -- such as in the early 2000s when the GOP had control of Congress and repeatedly pushed payout limits for medical malpractice lawsuits." In 2009, however, "the AMA did the unthinkable in Republican eyes and endorsed the Democrats' massive healthcare reform bill. So, as the Democratic-controlled Senate now debates a bill that would prevent physicians from taking a 21 percent cut in Medicare payments, Republicans are turning the other way."
I think you get the picture. We need to treat our patients. We should not make the practice of medicine subservient to, and secondary, to compliance with a non-stop flood of bureaucratic regulations. Practicing quality medicine should not place us at risk for fines, bankruptcy, and even potential imprisonment, for failing to ride the whirlwind - or by making a numerical error on a government form.
I think the time to say ‘NO’ is way overdue. A strike (excluding emergencies) may well be the only answer - a vaccination causing a little, short-lived pain in order to prevent a fatal disease.
Joseph M. Scherzer, M.D.
* News from Maricopa County Medical Society – Physician Deadline for Medicare PECOS enrollment moved up to July.”** CCHC Health Care News - 6/15/10
From the Director: I
In my opinion, the historically strong independent will of Private Practicng Physicians is being constantly eroded by a barrage of new rules and regulations, together with repeated reductions in reimbursements received for their services.
The goal may be to cause Private Physicians to accept increasing/total government control of America's health care.
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YOUR DOCTOR IS LOSING HIS ABILITY TO GIVE YOU THE CARE HE FEELS YOU NEED
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ARE MEDICARE PHYSICIAN'S PAY CUTS CHANGING THE CARE OF CANCER PATIENTS?
From Health Affairs
6/17/2010 Medicare Physician"s Payment...
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THE REGULATIONS FOR ADMINISTERING THE NEW HEALTH CARE LAW ARE YET TO BE PUBLISHED
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"Stopping the Medicare Fraud Gusher is Crucial"
From AAPS News Letter 6/14/2010While All Eyes Are On BP, Stopping the Medicare Fraud Gusher is...
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"Prison doesn't stop leaks"
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EMPLOYERS WILL SEE INCREASE IN HEALTH INSURANCE COSTS NEXT YEAR
Jun 14, 2:36 AM (ET)By TOM MURPHY
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CHANGES DESIGNED TO INFLUENCE WORKERS TO SEEK LESS HEALTH CARE
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GENOME [GENETIC] RESEARCH MORE DIFFICULT THAN EXPECTEDED
From The New YorkTimes 6/13/2010
"Ten years after President Bill Clinton announced that the first...
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RESEARCH TO CONTINUE DESPITE DISAPPOINTMENT
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RULES FOR "LIFE SAVING" MAMMOGRAPHY IN DISPUTE
HHS urged to pull controversial mammography advice
Radiologists back a lawmaker's demand that the department cease promoting recommendations issued last fall.
By Chris Silva, amednews staff. Posted May 31, 2010.
Washington -- Lawmakers have directed the Obama administration to set aside revised breast cancer screening recommendations issued last November by the U.S. Preventive Services Task Force after the advice was met with strong criticism by some physicians and women's groups. However, the Dept. of Health and Human Services still lists the revised recommendations as the most current ones, and the lawmaker who authored the provision wants that changed.
On May 12, Sen. David Vitter (R, La.) sent a letter to HHS asking it to remove from its website and cease all promotion of the task force recommendations related to breast cancer screening and mammography. The task force guidelines, published in the Nov. 17, 2009, Annals of Internal Medicine, said women younger than age 50 do not need routine mammography screening and that women ages 50 to 74 should get a mammogram every two years. The guidelines also recommended against teaching women to do breast self-examination.
The revisions marked a shift from the task force's previous recommendations, issued in 2002, that called for a mammography every one to two years for all women older than 40. The task force later clarified that the decision to obtain the screening for a woman younger than age 50 should be an individual one that takes specific patient circumstances into account.
Vitter called the recommendations "ill-conceived" and said they were offered without transparency and input from those with experience and expertise in the field. He successfully amended the health system reform law to say that the November 2009 recommendations should not be considered the most current ones.
The Agency for Healthcare Research and Quality, the branch of HHS that lists the revised recommendations on its website, did not return calls requesting comment.
Physicians on both sides
Although many have distanced themselves from the revised mammography recommendations, not all physicians have given up on them.
Christine Laine, MD, MPH, an internist in the Philadelphia area, said the recommendations are a practical, effective reworking of outdated policies that make them more in line with how doctors practice globally. She had recommended annual mammograms for her patients ages 50 to 70 but has been following the revised guidelines since they were issued.
"I find it curious that [Vitter's] reasons for removal are that they were developed without transparency and expertise," Dr. Laine said. "When you compare the methodologies of the task force compared to some others, you see that they're clearly specified."
She noted that the disputed language is simply a set of recommendations that don't have to be followed to the letter for every patient. Because there's no evidence that screening women in their 40s decreases mortality rates, heeding the guidelines could avoid unnecessarily exposing women to the adverse effects of chemotherapy and surgery if excessive testing leads to more false positives, she said.
But the American College of Radiology applauded Vitter's letter. According to the college, the task force ignored direct scientific evidence from large clinical trials and based the recommendations on conflicting computer models and the concept that the parameters of mammography screening change abruptly at age 50.
"These recommendations ... have undoubtedly confused many women to the point that they have refused needed care," said James H. Thrall, MD, chair of the ACR's board of chancellors. "Breast cancer screening policy decisions based on faulty recommendations may result in the unnecessary loss of thousands of lives."
Dr. Thrall also noted that 2008 legislation gave HHS the authority to consider task force recommendations in making Medicare coverage determinations. "Allowing a small group of people, who may or may not have an expertise in the field on which they are making recommendations ... and have those serve as health coverage policy is unacceptable and potentially dangerous," he said.
The American College of Obstetricians and Gynecologists and the American Cancer Society are among the groups that said they would continue to recommend annual screening using mammography and clinical breast examination for all women beginning at age 40.
The print version of this content appeared in the June 7 issue of American Medical News.
From the Director:
Statement below taken from:
"Marching Toward A Single Payer With Politicians Regulating Your Healthcare" by Vincent W Cangello MD, FACS ,FACOG, FRSM, page22, Publ. 1999.
"My morning paper reported the difference of opinion between the AMA, The American College of Surgeons and the College of Obstetricians and Gynecologists concerning the value of Mammograms for women in the age group 40-50. In this article the term "NOT COST EFFECTIVE" caught my eye. That means the number of women whose lives are saved by performing this test, in the 40 to 50 age groups, are so few it isn't worth the cost.
That expression "Not Cost Effective" is commonly used in Nations with National Health Care, but it's new in America. It was sure to be used one day as managed care became more popular. It's purpose is to justify Rationing and I don't think American women will stand for it. "
For HCREI BOOKS see. Contact Us
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WOMEN IN NATIONS WITH MORE RESTRICTIVE LIMITS ON THE USE OF MAMMOGRAPHY HAVE A HIGHER DEATH RATE FROM BREAST CANCER
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DISPUTE OVER NEW PILL TO PREVENT PREGNANCY
Panel to weigh new 'Morning after' drug
SIMILARITY TO ABORTION PILL MAY BE AN ISSUE
BY ROB STEIN- Washington...
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IS IT AN ABORTION IF THE EGG IS FERTILIZED BUT NOT ALLOWED TO GROW IN THE UTERUS?
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NEW AND OLD HEALTH CARE POLICIES WILL CHANGE
washingtonpost.com > Nation
Health-care rules may force some to change coverage, leaked document suggests
by Associted Press
Saturday, June 12, 2010
President Obama said repeatedly during the health-care debate that people who like their current coverage would be able to keep it. But an early draft of an administration regulation estimates that many employers will be forced to change their health plans under the new law.
In just three years, a majority of workers -- 51 percent -- will be in plans subject to new federal requirements, according to midrange projections in the draft.
Plans that predate the health-care law are exempt from many, but not all, of its consumer protections. Types of changes could include offering preventive care without co-payments and instituting an appeals process for disputed claims that follows new federal guidelines. The law already requires all health plans to extend coverage to young-adult children until they turn 26.
"What we are getting here is a clear indication that most plans will have to change," said James Gelfand, health policy director for the U.S. Chamber of Commerce. "From an employer's point of view, that's a bad thing. These changes, whether or not they're good for consumers, are most certainly accompanied by a cost."
The Obama administration said the draft regulation is an early version undergoing revision, but the leaked document was drawing wide interest Friday.
Senate Minority Leader Mitch McConnell (R-Ky.) said it showed that Obama's assurance that Americans would be able to keep existing plans was "a myth."
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"ASSURANCE THAT AMERICANS WOULD KEEP...EXISTING PLANS WAS A MYTH"
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FED FUNDS IFFY FOR MEDICAID IN MIDTERM ELECTION YEAR
From Sacramento Bee 6/8/2010
States count iffy on funds for Medicaid to plug gaps
CALIFORNIA,...
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"FEDERAL AID SHOULD NO LONGER BE TAKEN FOR GRANTED>"
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NURSES STRIKE--WILL THEY HAVE PUBLIC SUPPORT?
From Scaramento Bee 6/8/2010
Nurses call for one-day walkout
UNION CITES SAFETY, STAFFING;...
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DECREASE OF HOSPITAL REIMBURSEMENT AND NURSING SHORTAGE LIKELY TO EFFECT THE OUTCOME?
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HERE'S A MIXED SALAD OF THOUGHTS/DISCUSSION OF THE NEEDS-PROBLEMS-CHALLENGES TO BE FOUND IN THE HEALTH REFORM EFFORT
HEALTH AFFAIRS JUNE 2010 Issue
Significant Challenges--and Opportunities--in Implementing...
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MANY PLANNERS WHO BELIEVE 2 PLUS 2 ALWAYS EQUALS 4 ARE IN THE HEALTH CARE REFORM BUSINESS
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PRESIDENT WANTS TO ASSURE ALL AMERICANS OF THE BENEFITS IN HEALTH CARE REFORM
From Sacramento Bee 6/72010
Obama, allies launch a major PR blitz on health careNew...
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PLAN Will NOT BE FULLY IMPLIMENTED UNTIL 2014
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ARIZONA MEDICAL PROFESSIONALS STATE THEIR CASE
From AAPS News Letter * 6/1/2010
What do Arizona physicians think about the illegal immigration...
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20% TO 40% OF THE STATE'S BUDGET FOR NEEDS OF ILLEGAL ALIENS
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Reports accuse WHO of exaggerating H1N1 threat, possible ties to drug makers
Reports accuse WHO of exaggerating H1N1 threat, possible ties to drug makers
By Rob SteinWashington Post Staff Writer
Friday, June 4, 2010; 3:52 PM
"European criticism of the World Health Organization's handling of the H1N1 pandemic intensified Friday with the release of two reports that accused the agency of exaggerating the threat posed by the virus and failing to disclose possible influence by the pharmaceutical industry on its recommendations for how countries should respond.
The WHO's response caused widespread, unnecessary fear and prompted countries around the world to waste millions of dollars, according to one report. At the same time, the Geneva-based arm of the United Nations relied on advice from experts with ties to drug makers in developing the guidelines it used to encourage countries to stockpile millions of doses of antiviral medications, according to the second report.
The reports outlined the drumbeat of criticism that has arisen, primarily in Europe, of how the world's leading health organization responded to the first influenza pandemic in more than four decades.
"For WHO, its credibility has been badly damaged," wrote Fiona Godlee, the editor of the BMJ, a prominent British medical journal, that published one of the reports. "WHO must act now to restore its credibility."
A spokesman for the WHO, along with several independent experts, however, strongly disputed the reports, saying they misrepresented the seriousness of the pandemic and the WHO's response, which was carefully formulated and necessary given the potential threat...."
From the Director; SEARCH earlier discussions on this website of the H1N1 Flu epidemic
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"For WHO, its credibility has been badly damaged,"
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A PRIVATE PRACTICING PRIMARY CARE DOCTORS SPEAKS OUT
From AAPS NEWS BULLETIN 6/2/2010
AAPS member and director, Juliette Madrigal-Dersch, M.D., was featured in a spot on her local NBC news yesterday talking about her decision to opt-out of Medicare. The 21% cut in Medicare reimbursement that again went in to effect on June 1 is leading a growing number of physicians to consider this option.
However many doctors who opt out say it is not because of the money; Dr. Madrigal's fees are less than the price of a haircut and she sees patients over 90 for free. She once again has the freedom to see her senior patients without the Medicare bureaucracy looming over her shoulder. Her patients are happier and so is she.
Dr. Madrigal will be a featured speaker at the June 25th AAPS workshop, "Building a Healthy, Independent Practice" to be held in Atlanta. Visit www.aapsonline.org/atlanta for more details.
Watch the video clip at: http://www.aapsonline.org/newsoftheday/001053
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SOME DOCTORS DROP MEDICARE MEMBERSHIP AND WORK FOR LESS
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RETAIL MEDICAL CLINICS WILL NEED MORE EXAMINERS--WHO WILL THEY BE?
From American Medical News
Retail clinics look to health reform to boost business
With more patients...
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QUALITY OF CARE RECEIVED WILL DEPEND ON THE SOURCE AND TRAINING OF THE CLINIC PERSONELL
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HIGH SCHOOL STUDENTS PLAN A CAREER IN HEALTH CARE
From the Sacramento Bee 6/6/2010ANTHONY EVARISTO AN ASPIRING HEALTH professional...
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"Health care is one of California's fastest growing..."
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TRANSPARENCY OF HEALTH CARE COST MAY BE IMPOSSIBLE
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From the Director:
This article, written and presented on this website a few years ago, may help explain the difficulty facing the health care industry as it attempts to provide the transparency concerning costs that is expected, today.
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THE MEDICAL PROFESSION CAN'T COPE
In My Opinion: A Dilemma
Nation's Life Style and Expectations are Unrealistic
Seven hundred thousand Physicians and the American health care delivery system are held responsible for the care of approximately 300 million Americans including several million illegal aliens, despite many who abuse tobacco products, alcohol and illegal drugs; whose poor nutritional habits can lead to Diabetes, Arteriosclerosis, Asthma and morbid Obesity while reckless driving together with an unwillingness to comply with safe-sexual conduct lead to early death, long term disability, chronic illness and Infertility [unable to have children].
Despite their life-style, many Americans feel that prompt and proper health care is their right and should be provided at little or no cost [including the medicines their illness requires]. Their belief is so firm as to expect to return, in good health, to their previous life-style as quickly as possible and, If disappointed, will demand [and expect] monetary compensation, through legal means, from any one in the system who did not meet their expectations.
While ignoring world history, which teaches that it cannot and will not work that way, their demands and expectations are causing serious damage to their health care system which is without dispute and despite its faults, the finest the world has ever witnessed.
Many articles in our Media demonstrate examples of that damage:
FDA investigations lead to the arrest and conviction of Doctors who prescribe too much pain relieving medicines while other Doctors are accused of medical malpractice for prescribing too little.
A 70 year old patient died following a necessary surgical procedure. There was no evidence of Malpractice. The family sued the Doctor for "Battery" for failing to inform the patient of that possibility; The Jury awarded the family $150,000.
Needed Doctors are retiring early or curbing services, such as delivering babies, because of malpractice insurance premiums that can reach as high as two hundred thousand dollars per year.
Our FDA is being severely criticized for approving drugs that can harm some patients while the majorities who use the same drug receive great relief of their illness.
Be aware, Penicillin and Aspirin have been known to cause deaths. In my many years of practice experience I have not heard of a medicine that didn't hurt someone.
Two plus two doesn't always add up to four in the health care business. Sometimes it's three, four or five depending on your family history, weight, age, blood pressure, Genes, eating and drinking habits and whether or not you use tobacco products etc.
Each of you is different.
PREDICTING THE COST OF YOUR CARE WILL BE DIFFICULT IF NOT IMPOSSIBLE
Vincent W Cangello MD, Medical Director, Health Care Reform Educational Institute,. |
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TWO PLUS TWO DOESN'T ALWAYS ADD UP TO FOUR IN THIS BUSINESS
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A NEW AND DIFFERENT ANALYSIS OF GOVERNMENT RUN HEALTH CARE
Outside the Box
John Mauldin, Editor Vol. 6, Issue 24, 6/1/2010 johnmauldin@investorinsight.comFrom...
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THE FUTURE WILL SEE SENIORS LIVING LONGER
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MASSACHUSETTS HEALTH PLAN RUNNING OUT OF MONEY
GOVERNMENT
No economic hardship exception in Mass. health law
A recent court decision leaves workers...
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"they are optimistic that the federal reform law eventually will close that gap."
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HOSPITAL READMISSION STUDY RAISES QUESTIONS
Hospital return visits at 25%, study shows
BY BOBBY CAINA CALVAN bcalvan@acbee.com 5/22/2010
More than a fourth of all hospital patients were readmitted within two years for the same conditions that prompted their initial hospitalization, according to a new federal study.
The study released Wednesday by the U.S. Agency for Healthcare Research and Quality adds to a growing body of research suggesting that revolving-door admissions are adding billions of dollars, perhaps unnecessarily, to the country's growing health care costs.
Last week, California's Office of Statewide Health Planning and Development issued its own study saying that more than a third of patients hospitalized in California are readmitted within a year.
But unlike the state's study, which did not distinguish the reasons for repeat hospital visits, the federal study looked at readmissions based on the originating ailment.
The federal study analyzed data on 15 million patients in 12 states, including California in 2006 and 2007. The study focused particularly on chronic ailments, such as asthma, diabetes, high blood pressure and hardening of the arteries.
"High rates of repeat patient visits to the hospital," the report states, "may indicate deficiencies in the health care delivery system."
Both state and federal researchers found that patients on the government's two biggest insurance programs -Medicare and Medicaid, referred to as Medi-Cal in California - had the highest rates of readmission.
Also, the federal study showed that the poor also had higher readmission rates.
From the Director: many factors need explanation.
For examples: Were the patients diagnosed and admitted too late or discharged too early.? Was there proper followup for such patients with these chronic diseases?
Is the money being spent properly? Are the patients being cooperative and the professionals doing all they can/should.?
We need to know to render a proper judgement.
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MANY QUESTIONS NEED ANSWERS BEFORE THE PROBLEMS CAN BE RESOLVED
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A DOCTOR WITH EXPERIENCE TALKS ABOUT HOSPITAL READMISSIONS
From AMMED NEWS 5/31/20110
Medicare shouldn't be surprised by readmission rate it helped to create
Regarding...
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T^HE HEALTH CARE DELIVERY BUSINESS IS COMPLEX WITH FEW EASY ANSWERS
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TIME TABLE SET FOR NEW HEALTH REFORM LAW
LONG BUT WORTH READING
Health reform questions: Your patients will ask, here are some answersBy David...
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LAWSUITS-SHORTAGE OF PROFESSIONALS-SHORTAGE OF FUNDS WILL DELAY IMPLEMENTATION
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BEST ANTIBIOTICS AVAILABLE NOT EFFECTIVE IN SEVERE BACTERIAL INFECTION
Phoenix-area hospitals fight highly toxic 'supergerm'
by Ginger Rough - May. 29, 2010 12:00 AM ...
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CALL FOR NEW ANTIOTICS--NOT YET AVAILABLE
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IRS OVERSIGHT OF NEW HEALTH CARE LAW WILL BE DIFFICULT
From Greg Scandlen News letter #2235/28/2010
NFIB Sees the Light Small wonder, then, that...
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GROWING DISLIKE OF NEW HEALTH CARE LAW VERIFIED BY POLLS
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DOCTORS HAVE A NO PAY DAY
BUSINESS
Physicians ask patients: What is this visit worth?
Doctors held pay-what-you-can days to...
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GOOD FOR THE COMMUNITY AND FOR THE PROFESSION
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IMPENDING 20% CUT IN DOCTOR'S FEES CAUSING MANY TO LIMIT AVAILABILITY
MY WAY NEWS 5/27/2010 By Ricardo-Alonso-ZaldivarUNCERTAINTY OVER...
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THIS UNCERTAINTY NEEDS TO BE RESOLVED
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A PRIVATE PRACTICING PHYSICIAN PREDICTS THE FAILURE OF THE MEDICARE INSURANCE PROGRAM
Health Reform by Cloward and Pivenby Richard Amerling, M.D.Richard A. Cloward and Frances Fox Piven were...
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MANY DOCTORS ARE NOW EMPLOYED--OTHERS REMAIN IN PRIVATE PRACTICE THAT LIMITs GOVERNMENT INSURED PATIENTS
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MAJORITY OF AMERICANS SUPPORT REPEAL OF THE NEW HEALTH CARE LAW
"...The survey of 1,000 Likely Voters was conducted on May 22-23, 2010 by Rasmussen Reports. The margin of sampling error is +/- 3 percentage points with a 95% level of confidence. Field work for all Rasmussen Reports surveys is conducted by Pulse Opinion Research, LLC. See methodology.
Sixty-three percent (63%) of all voters expect the health care plan to increase the federal deficit. Just 12% expect the bill to push the deficit down, while 13% say it will have no impact.
Fifty-five percent (55%) say the plan will make the quality of health care in the country worse. Twenty percent (20%) expect it to improve the quality of health care, and 18% think quality will stay about the same.
Fifty-five percent (55%) also expect the health care plan to drive up the cost of health care rather than achieve its stated goal of causing those costs to go down. Only 18% believe health care costs will indeed go down because of the plan’s passage. Another 16% expect costs to stay about the same.
Male voters remain more critical of the health care plan than female voters.
While sizable majorities of Republicans and voters not affiliated with either major party continue to favor repeal of the plan, most Democrats remain supportive. "
For more information on this repoprt: www.rasmussenreports.com/public
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55% SAY NEW HEALTH CARE LAW WILL MAKE HEALTH CARE WORSE
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WELLPOINT PREMIUM INCREASE UNDER QUESTION---DELAYED
WellPoint rate hike proposal ignites second political firestorm
After California finds errors in the...
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NEW BILL IN CONGRESS WILL EFFECT ABILITY TO RAISE PREMIUMS
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MODERN MEDICINES ARE REDUCING THE CHILD DEATH RATE THROUGHOUT THE WORLD
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WORLD |
sacbee.com
For latest breaking news |
Child death rates fall global work hailed
BY DENISE GRADY New York Times 5/28/2010
Death rates in children younger than 5 are dropping in many countries at a surprisingly fast pace, according to a new report based on data from 187 countries from 1970 to 2010.
Worldwide, 7.7 million children are expected to die this year - still an enormous number, but a vast improvement over the 1990 figure of 11.9 million.
On average, death rates have dropped by about 2 percent a year from 1990 to 2010, and in many regions, even some of the poorest in Africa, the declines have started to accelerate, according to the report, which is being published online Sunday by the Lancet, a medical journal.
Some parts of Latin America, North Africa and the Middle East have had declines as steep as 6 percent a year.
Other reports in recent years have found similar trends. But the new article, based on more detailed information and what its authors say are improved statistical methods, paints the most optimistic picture yet.
Health experts say the figures mean that global efforts to save children's lives have started working better and faster than expected. Vaccines, AIDS medicines, vitamin A supplements, better, treatment of diarrhea and pneumonia, insecticide-treated bed nets to prevent malaria and more education for women are among the factors that have helped lower death rates, said Dr. Christopher J.L. Murray, an author of the report and the director of the Institute for Health Metrics and Evaluation at the University of Washington. He said the improvements in Africa were especially encouraging.
"The very slow progress in Africa has led some people in global health to argue there should be more emphasis on tackling child mortality outside of Africa, especially India," Murray said.
"We think it's important to call out this accelerated progress. The last thing we'd like to see, when at last something is happening, is to pull the plug and move elsewhere."
The United Nations has set a goal of reducing death rates in children younger than 5 by two-thirds from 1990 to 2015, but not many countries seem on track to reach it.
A third of all deaths in children occur in south Asia, and half in sub-Saharan Africa. Newborns account for 41 percent of those who die.
The lowest death rates, per 1,000 births, are in Singapore (2.5) and Iceland (2.6); the highest are in Equatorial Guinea (180.1) and Chad (168.7). In rich countries, some of the worst rates are in the United States (6.7) and Britain (5.3)...."
From the Drector; It was reported in an earlier HCREI Bulletin on Birth rates and Aborton that the number of Voluntary Abortions performed in the United States totaled 57 million since it was made legal. The number of private Abortions performed here is not known.
A recent government bulletin reported the average age in the USA had reached 50 years. This of course will have an impact on our future economy and on the life style of retired seniors
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BIRTH RATES IN THE USA AND EUROPE HAVE DROPPED SIGNIFICANTLY AS A RESULT OF BIRTH RATE CONTROL AND CHILDHOOD DISEASE
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CHILDREN WITH PRE-EXISTING CONDITION WILL COST MORE
Insurance costs may still shut kids out of care
BY RICARDO ALONSO-ZALDIVAR Associated Press...
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"WHAT INSURERS CHARGE IS STILL AN OPEN QUESTION"
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WELLPOINT DENIES DROPPING PATIENTS BECAUSE OF BREAST CANCER
BUSINESS
Health plan responds angrily to Obama mention of rescission
WellPoint CEO denies the insurer...
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ONLY 4 OF 200,000 LOST COVERAGE--REASON?
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HOSPITAL FORCED TO REDUCE STAFF DURING LAST TWO YEARS
Hospital mass layoffs keep steady pace
The trend mirrors the economy as a whole, although health care traditionally recovers from downturns later than do other industries.
By Victoria Stagg Elliott, amednews staff. Posted May 13, 2010.
Hospitals are continuing to have as many mass layoffs as they did in 2009, though the number of employees laid off was lower in the first three months of 2010, according to numbers released April 23 by the Bureau of Labor Statistics.
In March, the latest month tracked by the BLS, 12 mass layoffs occurred at hospitals, affecting 798 employees. A mass layoff is defined as one that affects 50 or more workers. In March 2009, there also were 12 mass layoffs, but 1,062 people filed for unemployment insurance after those incidents.
There were 36 hospital mass layoffs during the first three months of 2010, only one less than the 37 during the first three months of 2009, according to the BLS. In 2009, however, 3,003 employees were affected, while in 2010 that number was down to 2,516.
These trends mirror those of the economy as a whole, although health care is traditionally a lagging indicator affected by and recovering from downturns later than other industries, analysts said. Hospitals have been struggling because of increasing demand for charity care and reductions in elective procedures. Cuts in reimbursements from government-run health care programs have added to the strain, analysts said.
The BLS has not tracked April statistics yet, although the numbers are sure to include two major hospital layoffs.
On April 6, Saint Vincent Catholic Medical Centers in New York announced the closure of St. Vincent's Hospital Manhattan's inpatient services, resulting in more than 1,000 layoffs. On April 23, Jackson Health System in Miami announced the cutting of 613 positions, with 511 people losing jobs.
Ambulatory care centers, including physician offices, have been touched by the recent downturn as well, although mass layoffs are far less common in this setting.
Data for March 2009 were not recorded because they did not meet agency standards, but 16 mass layoff events were noted in January and February of 2009, with 2,252 people losing jobs. Only 14 mass layoff events occurred during the first quarter of 2010, with 789 jobs eliminated.
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"Hospitals have been struggling because of increasing demand for charity care and reductions in elective procedures"
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FEDERAL AGENCY NOT DEMANDING PROPER IDENTIFICATION FROM SUPPLIERS
GOVERNMENT
Medicare fraud risk created by billing loophole
A temporary rule allows equipment claims...
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MEDICARE SPENDS APPROX.100 BILLION DOLLARS A YEAR FOR MEDICAL SUPPLIES--ID OF SUPPLIER IS CRITICAL
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DOES UNDERSTANDING HOSPITAL COST HAVE TO BE DIFFICULT?
Hospitals exchange of cost data clears antitrust hurdle
The California program to publicize how much...
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"The Hospital Value Initiative in California received a green light from the Justice Dept. to promote transparency in hospital cost data..."
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HIV [AIDS] TREATMENT INCREASES RISK OF CANCER
From Sacramento Bee 5/22/2010
HIV patients face higher cancer risk
REPORT REVEALS NON-AIDS CANCER MORE PREVALENT
BY DARRYL FEARS Washington Post
WASHINGTON - When science turned AIDS several years ago from a fatal disease to a chronic illness that often can be managed with drugs, patients and doctors breathed a sigh of relief.
Now they have a new worry. As people live longer with the virus, they are becoming far more likely than the rest of the population to develop cancers that were not previously associated with AIDS, research has found.
"We're seeing high rates of head and neck cancer, lung cancer, kidney cancer, liver cancer and anal cancer," said John Deeken, director of head and neck oncology at Georgetown University Medical Center.
Researchers have detected the trend for years in separate studies around the world, but their findings were not widely publicized or known. On Thursday, the American Society of Clinical Oncology released an abstract by Deeken outlining a clinical trial by the AIDS Malignancy Consortium to study the effects and safety of a chemotherapy drug to treat non-AIDS-related cancers in HIV-positive patients, Deeken said he hopes the presentation of his research at ASCO's June 4 national conference will call attention to a growing cancer threat and the need to address it. Thousands of oncologists from around the world attend the annual conference to discuss new approaches to cancer treatment.
"Even when we control for smoking, we see a higher rate than the general population," Deeken said. "We don't know why this is happening. We need to figure that out."
The development of nonAIDS-related cancers in HIV-infected people could change the way people who are at a greater risk of contracting the virus have come to view the disease. AIDS activists say that advances in HIV drug therapy have led some young gay men to think of the disease as a chronic condition that can be easily managed if they became infected.
Robert Yarchoan, chief of the HIV and AIDS Malignancy Branch of the National Cancer Institute, said that medical advances have saved lives but noted that people with HfV "have to take pills the rest of their lives."
"The pills have side effects he said, "there's premature aging and heart attacks. And now, there are these cancers."
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"Even when we control for smoking, we see a higher rate than the general population,"
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MALE INFERTILITY INCREASING AS WELL AS FEMALE INFERTILITY
The infertility timebomb: Are men facing rapid extinction?
By Tamara Sturtz Last updated at 1:32 AM...
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HIGH PERCENTAGE OF ABNORMAL SPERM FOUND IN YOUNG MEN
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OUR WORLD IS AGING AS BIRTH RATE DECLINES
World death rate plunges since 1970
BY DAVID BROWN Washington Post
WASHINGTON - The global...
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MEDICAL BIRTH CONTROL-ABORTIONS-SEXUALLY TRANSMITTED DISEASES COULD CAUSE OUR EXTINCTION
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PRO LIFE GROUPS USING NEW HEALTH LAW TO LIMIT ABORTION COVERAGE
Health overhaul now used to restrict abortions
BY Ricardo ALONSO-ZALDiVAR
Associated Press
WASHINGTON - Abortion opponents fought passage of President Barack Obama's health care overhaul to the bitter end, but now that it's the law, they're using it to limit coverage by private insurers.
An obscure part of the law allows states to restrict abortion coverage by private plans operating in new insurance markets. Capitalizing on that language, abortion foes have succeeded in passing bans that, in some cases, go beyond federal statutes.
"We don't consider elective abortion to be health care, so we don't think it's a bad thing for fewer private insurance companies to cover it," said Mary Harned, attorney for Americans United for Life, a national organization that wrote a model law for the states.
Abortion rights supporters are dismayed. "Implementation of this reform should be about increasing access to health care and increasing choices, not taking them away," said Sen. Patty Murray, D-Wash., a member of the Senate leadership. "Health care reform is not an excuse to take rights away from women."
Since Obama signed the legislation March 23, Arizona and Tennessee have enacted laws restricting abortion coverage by health plans in new insurance markets, called exchanges. About 30 million people will get their coverage through exchanges, which will open in 2014 to serve individuals and small businesses.
In Florida, Mississippi and Missouri, lawmakers have passed bans and sent them to their governors. Most of the states allow exceptions in cases of rape, incest or to save the life of the mother. Insurers still could offer separate policies to specifically cover abortion. Three other states may act this year - Louisiana, Ohio and Oklahoma. Overall, there are 29 states where lawmakers or public policy groups expressed serious interest, Harned said.
Before the overhaul became law, five states had limits on. private insurance coverage of abortion - Idaho, Kentucky, Missouri, North Dakota and Oklahoma. Abortion rights supporters are concerned that the list is growing as a result of the new federal law. It's really going to be a patchwork of state laws by the time these exchanges are set up," said Jessica Arons, director of women's health at the Center for American Progress, a liberal public policy institute.
Most private health insurance plans cover abortion as a legal medical procedure, but research indicates many women opt to pay directly.
The federal law allows private insurance plans in the exchanges to cover abortion as long as they collect a separate premium. That money must remain apart from public subsidies available to help pay insurance premiums for most customers in the exchanges.
From the Director: That Fact "research indicates many women opt to pay directly" is the reason why the number of Voluntary abortions performed in the United States cannot be completely known.
Our data therefore is unreliable and cannot be compared with other nations.
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"ABORTION FOES HAVE SUCCEDED IN PASSING BANS,THAT IN SOME CASES,GO BEYOND FEDERAL STATUTES."
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SUTTER HOSPITAL GROUP TRAINING NURSING STUDENTS TO ALLEVIATE SHORTAGE
From the Sacramento Bee 5/17/2010
Nursing students receive a head start
SUTTER PROGRAM SAYS...
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NURSING OPORTUNITIES WILL INCREASE BECAUSE OF "BABY BOOMERS" AND AN INCREASE IN RETIREMENTS
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FUNDING FOR BREAST CANCER SCREENING MUST BE MAINTAINED
JEANNE CONRY and DONNA SANDERSON I Special to The Bee
Breast cancer tests save money, lives
Coming on the heels of Mother's Day and during Women's Health Month, the California Legislature has the opportunity to make a very large statement to the women of this state - you do count, and your health will not be ignored.
Over the next few weeks, the Legislature will consider whether to restore funding to the state's Every Woman Counts program, which provides lifesaving breast cancer screening to women in need.
Assembly member Noreen Evans, D-Santa Rosa, and Sen. Jenny Oropeza, D-Long Beach, have also proposed legislation that, if signed, will restore the Every Woman Counts program, resolving the crisis and bringing tens of thousands of women back under protection of this vital program.
Every Woman Counts is a joint program by the state Department of Public Health and the Centers for Disease Control and Prevention's National Breast and Cervical Cancer Early Detection Program that provides mammograms for low-income women who are either uninsured or underinsured, but do not qualify for Medicaid.
These measures are needed to fix the mess left by the severe cuts to the program made earlier this year by the governor, which effectively shut the doors to breast cancer screening services for low-income and uninsured women for the first six months of 2010, and closed access to the program for women age 40 to 49 altogether. Since one-fourth to one-third of the 300,000 women who are typically screened by the program are in their 40s, limiting it to women 50 and above amounts to a significant reduction.
Dr. Jeanne Conry is a practicing ob/gyn at Kaiser Roseville. Donna Sanderson, a breast cancer survivor, is the executive director of Susan G. Komen for the Cure Sacramento ValleyAffiliate.
the state's general fund and is instead funded by three sources: Proposition 99, its main source of funding; the Breast Cancer Control Account, the secondary 2-cent tobacco tax; and a federal CDC grant.
The current monies can sustain the program; however, the governor's recent proposal to siphon money out of the Proposition 99 fund is creating this quagmire. The program cost $54 million in 2009, serving 300,000 women, and the proposed cuts will save $16 million this year. However, since the program is not funded through the general fund, the costs and savings will not affect the current budget crisis.
Every Woman Counts is a safety net to ensure that women who fall through the gaps in our health care system get the screenings that may save their lives. Unless these funds are restored and eligibility is returned to its previous level, we will find out what happens when there is no safety net - the cost will be felt when taxpayers are paying for costly treatment for later-stage cancers for these women who did not receive screening in their 40s.
Why is screening important? If we have learned anything over the years it is that early detection of
the disease. When breast cancer is detected early, the five-year relative survival rate is 98 percent, but declines to 23 percent if it has spread to other parts of the body. In California, more than 21,700 women are diagnosed with breast cancer each year and more than 4,000 lose their battle with the disease.
It is also worth noting that the changes to Every Woman Counts came not long after new mammography screening recommendations were unveiled by the U.S. Preventive Services Task Force, which generated significant controversy and confusion. Some have interpreted the guidelines as a recommendation against mammography for women age 40 to 49. In fact, the task force actually intended to encourage women to talk with their providers and assess their personal risk factors in deciding whether to have a mammogram.
Since then, the U.S. Department of Health and Human Services issued statements suggesting that women, in consultation with their doctor, continue to receive annual mammograms starting at age 40. Susan G. Komen for the Cure and medical professional groups continue to recommend annual mammograms for women age 40 and above.
Thankfully, as the yearlong national debate over health reform reached its ultimate conclusion, an amendment sponsored by U.S. Sen. Barbara Mikulski, D-Md., to ensure access to mammography and other early detection tools for women age 40 and above was approved by a bipartisan vote. In other words, the nation has spoken to say access to breast cancer screenings needs to be increased and protected, not cut or denied. Only California has staked that position. That must change. This week it can.
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MANY LIVE WILL BE LOST IF FUNDING IS WITHDRAWN
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NEW HEALTH LAW TO FACE DIFFICULTIES IN FUNDING
STATE HEALTH CARE STRAIN SEEN
Many to remain uninsured, panels told
bcalvan@sacbee.com Sacramento Bee 5/13/2010
Even after the federal health care overhaul is in place, 2 million Californians could still be left uninsured, and the budget-strapped state may find it difficult to absorb millions of others who will wisuddenly have coverage, experts told lawmakers Wednesday.
California has the nation's largest population of the uninsured - 7 million people.
Many of the people without health coverage will choose not to buy it -despite penalties - or are in the state illegally and will not be eligible for subsidies and other government assistance, said Marian Mulkey, a senior program officer with the California Healthcare Foundation, during testimony before a joint session of the state Senate and Assembly health committees.
In addition to the 2 million people Mulkey estimated would continue to lack coverage, another 2 million poor Californians would likely receive it under an expansion of Medi-Cal eligibility
While the federal government will pick up the tab for the 2 million additional enrollees, the state will nevertheless find itself financially stressed to pay for its share of existing enrollees, Mulkey said.
"We face ongoing challenges of maintaining the public programs that we have under the difficult budget challenges that we have," Mulkey said in an interview.
Medi-Cal has been much maligned by health care providers and consumer advocates who say the program is inadequately funded.
Federal health care reform will help extend coverage to more people, Mulkey said, "but it builds on a pretty shaky financial foundation."
On Friday, the Governor's Office is scheduled to unveil its updated budget proposal, and health care advocates are bracing themselves for severe cuts to the state's health care system.
Already, some experts say, California may lack the health care infrastructure - including doctors and clinics - needed to serve millions more people.
"Our health care system will be hard-pressed to deliver that care," said David Maxwell-Jolly, director of the state's Department of Health Care Services.
Insurers are scrambling to comply with key requirements of the federal legislation, including putting in place new insurance coverage standards.
Starting in September, insurers will no longer be able to rescind coverage or withhold coverage because of preexisting conditions.
"We intend to be a constructive voice," said Charles Bacchi Executive vice president of the California Association of Health Plans, "but will be warning you when policies have unintended consequences."
Call The Bee's Bobby Caina Calvan, (916) 321-1067
From the Director: The reformed health care system was near a century in the making, both the good and the bad of it. The new law is attempting to cover everyone in a few years . History would support this comment "Not likely to happen-Be prepared for disappointment"
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"HURRY UP" REFORM EFFORT WILL BE DISAPPOINTING
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BETTER PAY FOR BETTER PERFORMANCE MAY NOT BE WHAT IT SEEMS
From the AAPS NEWS 4/11/2010
Pay for PerformanceClick here to read this article and others like it (and submit...
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THIS DOCTOR REWARD MAY NOT BE IN THE BEST INTEREST OF THE PATIENT
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NEW HEALTH BILL-PPACA-WILL COST MORE THAN PROMISED
COST OF HEALTH CARE REFORM WILL BE MUCH HIGHER THAN EXPECTED SAYS OUR CBO
By...
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AN INCREASE IN TAXES WILL LIKELY BE NECESSARY
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A STORY ABOUT HEALTH CARE FOR ILLEGAL ALIENS
From the AAPS Newsletter 5/12/2010
As Illegals Take,
Are Americans Free?
By Alieta Eck, MD
We do not have "universal health care." We have mandatory free “health care for the universe."
A middle-aged woman came to our local emergency room, suitcase in tow, complaining of a severe headache and diminished vision. A CT scan of the head showed a brain tumor. The neurosurgeon on call was summoned and within days the patient had surgery to preserve her vision. An inspiring story giving tribute to the wonderful ingenuity, generosity, and high standards in our country?
There’s more.
This woman knew about her brain tumor and had already had an unsuccessful attempt at surgery in her home country. She booked a flight as a tourist, and her extended family took her directly from the airport to the emergency room. None of them had the slightest intention of paying any part of her bill. American patients, insurance subscribers, and taxpayers will subsidize the hospital, albeit inadequately. The neurosurgeon will not get paid, but will still be fully liable for any adverse outcome in our medical malpractice environment.
For foreigners, it appears that dishonesty pays. But those who are completely honest have a harder time. The headmaster of a Christian grammar school in Liberia had an abdominal tumor the size of a football. No one in Liberia felt capable of handling such surgery so our church arranged for him to come to that same hospital in New Jersey. Since US government officials knew this man needed medical attention, he was asked to supply letters from the church guaranteeing payment for his surgery. Only then, would the US embassy give him a visa. The church, here, will fulfill its promise and pay a fair price as this is the honorable thing to do. The surgeon will be paid unless he voluntarily chooses to perform the procedure for free, and everyone is uplifted.
There will be those who say they would do anything to get medical care for a loved one. Does this mean they would steal for it? And does their need make stealing right?
Charity is a noble thing, but it cannot be mandated. Our government’s requiring physicians and hospitals to provide free services to whomever walks into the ER does not represent true charity, but a taking of the services from those with valuable skills. The more that is taken, the less charity can be freely given, and all patients suffer as services become less available. Many hospitals now lack neurosurgery coverage for any patient, insured or not.
The proper channels would be for the needy to appeal to those in a position to provide charity, with a culture of generosity arising to meet the need. We learned quickly that we could not provide access to the United States for every Haitian that needed help. Instead, armies of volunteers have traveled there to help.
While illegal immigrants are not the only ones taking advantage of the “free” services here in the US, the situation attracts those who are willing lie to get something for nothing. Hospitals near the border are especially hard hit, especially by women who forgo prenatal care and show up at the ER in the second stage of labor. An added attraction is automatic American citizenship for the child. Births to illegal alien mothers constitute nearly 40% of all births paid for by Medi-Cal. Dozens of hospitals along the border in California, Arizona, New Mexico, and Texas have been forced to close or go bankrupt because of the unfunded federal mandate to provide free care to Illegals.
The Arizona state government has passed a law making it a state offense to cross the border illegally. It is already a federal offense. How else should Arizona respond when the federal government does not take seriously its constitutional obligation to protect the US borders?
Our forefathers came to this country with only the shirts on their backs, expecting nothing but an opportunity to work in freedom. They did not demand free services but worked alongside hardworking Americans to build their own American dream. That was always the promise of America and we need to be vigilant lest we lose it.
Dr. Alieta Eck, MD graduated from the Rutgers College of Pharmacy in NJ and the St. Louis School of Medicine in St. Louis, MO. She studied Internal Medicine at Robert Wood Johnson University Hospital in New Brunswick, NJ and has been in private practice with her husband, Dr. John Eck, MD in Piscataway, NJ
www.aapsonline .org
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CAN WE AFFORD TO GO ON LIKE THIS AS HOSPITALS FACE BANKRUPTCY?
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PROPOSED TIME TABLE FOR NEW HEALTH LAW [PPACA]
www.healthaffairs.org April 30 2010
Near-Term Changes In Health Insurance: Newly enacted...
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REGULATIONS STILL TO BE PUBLISHED FOR THE ADMINISTERING OF THE NEW LAW
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COVERING YOUNG ADULTS TO AGE 26 WILL RAISE PREMIUM COST
Reuters – A supporter of the health care reform holds a sign outside a health care...
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MANY INSURERS ARE ALREADY OFFERING THIS EXTENDED COVERAGE TO FAMILIES THEY INSURE DIRECTLY
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CONSUMER CONTROLLED HEALTH CARE-HSA-UP 27%
Consumer-directed health plans grew 27% in 2009
Although the growth rate was slower than for the previous year, these plans were still the only insurance products to show enrollment gains.
By Victoria Stagg Elliott, amednews staff. Posted May 5, 2010. More people in 2009 than in 2008 signed up for high-deductible health insurance combined with some form of health savings or reimbursement account, and much of this growth is due to the increasing number of small businesses offering employees this option.
This is according to an analysis of Mercer's National Survey of Employer-Sponsored Health Plans released April 14 by the American Assn. of Preferred Provider Organizations.
"At a time when employers are faced with the difficult choice of limiting benefits or raising health care costs to their employees, they are turning to [consumer-directed health plans], given the cost savings inherent in these plans," said Karen Greenrose, RN, AAPPO's president and CEO.
An estimated 23 million people signed up for consumer-directed health plans in 2009, a 27% increase from the 18 million who did so in 2008. This is the only type of health insurance to show enrollment growth in 2009, so 9% of those covered by employer-sponsored health insurance now have this kind of plan.
The proportion of small employers offering this option grew from 9% to 15%, while participation by large employers held steady at 20%.
"This is actually a product that small employers continue to embrace," Greenrose said.
Growth also differed by region, with this form of coverage becoming much more common in the South and Midwest than elsewhere.
The increase nationally, however, was less than for the year before. According to data released by the PPO group in April 2009, CDHP enrollment went up 44%, from 12.5 million people in 2007 to the 18 million noted for 2008. About 6.5 million new people enrolled in the plans in 2008, and 5 million did so in 2009.
The latest research did not indicate why the rate of growth declined.
According to the survey, within the next five years, 11% of companies intend to offer a consumer-directed health plan as the only health insurance option, and 34% said they would offer it alongside others.
Those working on this issue, however, said it is unclear how consumer-directed health plans will fit in with recently passed health system reform legislation.
This content was published online only.
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