Archive for the ‘Healthcare Village’ Category

Republican Senators Trying to Derail One Provision of Healthcare Reform

Wednesday, August 11th, 2010

Senate Republicans want to fast-track an amendment that repeals a portion of the new healthcare reform law. Whether or not they will be able to accomplish this is another question.Republicans make first attempt at scuttling healthcare reform legislation.

Senator Mike Johanns (R-NE) has proposed legislation to rescind a provision in the new law that requires businesses to report purchases of $600 or more to the Internal Revenue Service (IRS).  Business lobbyists such as the U.S. Chamber of Commerce and the National Federation of Independent Business (NFIB) both support the legislation.  Republicans want to attach the repeal provision to a broader bill intended to help small businesses.  According to the Chamber and the NFIB, the provision places a burdensome obligation on the nation’s 40 million small businesses.  Under this provision of the healthcare reform bill, businesses are required to file an IRS 1099 form for non-credit card purchases totaling $600 or more.  Johanns says that rule is “overly burdensome.”

To make up for the $17 billion that the provision would raise, Johanns has proposed reducing the individual mandate threshold and defer $16 billion in funding for wellness programs.  Senator John Cornyn (R-TX) and other Republicans have introduced legislation that would kill the Independent Payment Advisory Board that the healthcare reform law created.  Democratic Senators who wrote the legislation counter that the board is needed to reduce consistently increasing healthcare costs.

Americans Aging, Gracefully

Tuesday, August 3rd, 2010

By 2030, an estimated 72 million baby boomers will make up 20 percent of the population.  Americans are aging and living longer than ever, according to a report entitled “Older Americans 2010:  Key Indicators of Well-Being” compiled by 15 federal agencies.

The full report, which details demographics, economics, health status, health risks and healthcare can be found at a dedicated website.  According to the report, Americans who live to 65 can expected to survive approximately 18.5 additional years, four more years than in 1960. Women who live to 85 can expect to live 6.8 more years and men 5.7 years.  As impressive as those life expectancies are, people living in most of Europe, Australia, New Zealand, Japan, Singapore, Hong Kong, Costa Rica – and even Cuba — can expect to live longer.

An estimated 39 million Americans were 65 or older in 2008 – approximately 13 percent of the population.  In 2030 – when the entire baby boomer generation will be 65 or older – there will be 72 million senior citizens or approximately 20 percent of the population.  By 2050, the over-85 population is expected to grow from 5.8 million to 19 million.  Healthcare costs for the average senior, adjusted for inflation, rose from $9,224 in 1992 to $15,081 in 2006.  Heart disease remains the leading cause of death for people 65 and older, though at half the rate recorded in 1981 – just 1,297 per 100,000.  Strokes, cancer, respiratory diseases and Alzheimer’s are the next leading causes of death.  Healthcare ate up 28 percent of out-of-pocket spending among the poor and nearly poor in 2006; that compares to 12 percent in 1977.

High-Risk Pool Healthcare Has Hefty Premiums

Monday, July 19th, 2010

“High-risk pool” healthcare coverage comes at a steep price.  Healthcare coverage for uninsured Americans with pre-existing conditions won’t come cheaply. Premiums in the new “high-risk” pool could average $300 to $600 a month in certain states, according to a new government website.   The Department of Health and Human Services says that the premiums could range from $140 to as much as $900 a month.

According to Richard Popper, deputy director of the Office of Consumer Information and Insurance Oversight, “There are going to be meaningful premiums that are going to be required to stay in this plan…in the hundreds of dollars.”  HealthCare.gov estimates show that monthly premiums for a 50-year-old Floridian would be $552 to $675; for a New Yorker, the average cost would be $400 to $600; $491 to $600 for a Texan; and only $283 for a Pennsylvanian.  Coverage under the Pre-Existing Condition Insurance Plan begins on August 1.

Consumer advocates are advising the uninsured who have health problems to sign up quickly – despite the cost – because they cannot be turned down for coverage.  The high-risk pool is a temporary solution for at-risk individuals who cannot get healthcare insurance because of a medical condition.  The pool will be available until 2014 when healthcare reform takes full effect.  At that point, insurance companies will not be allowed to turn down people in poor health.  Low- and middle-income individuals will receive subsidized coverage.

Remote Area Medical Brings Healthcare Services to Needy Locales – Including Chicago

Wednesday, June 30th, 2010

New Illinois law lets doctors cross state lines to take care of the uninsured.  A prime example of why access to quality healthcare needs to be expanded is an ambitious effort to hold an enormous, free medical event in Chicago.  The proposed event, sponsored by Remote Area Medical (R.A.M.), can move ahead now that Governor Pat Quinn has signed a law making Illinois the second state to allow healthcare professionals licensed in other states to volunteer their services without obtaining official authorization. This change to Illinois’ Good Samaritan laws, which applies to out-of-state physicians providing charity care at free clinics, will directly help the 1.6 million Illinois residents who lack healthcare insurance.

Knoxville, TN-based R.A.M. brings free health, dental and vision care to geographically isolated areas around the world.  Last year, the organization broadened its scope to include large U.S. cities by holding a clinic in Los Angeles where more than 6,000 people received treatment.  Now, a group of Chicago physicians want to have a similar event in Chicago.  “Any time you can take a speed bump out, take away borders from healthcare, it helps,” said Dr. Ken Nelson, medical director at the Community Nurse Adult Clinic in LaGrange, IL.  “Not everybody is going to get insurance.”  One in six of Illinoisians under the age of 65 is uninsured.  Of those, 80 percent are in working families and 25 percent are children.

“The greatest impediment to what R.A.M. does, except here in Tennessee where they had the good sense to change the law back in 1995, is that for some extraordinary reason, a doctor, dentist – even nurses who are licensed to the same standards – are not allowed to cross state lines to provide free care for people in another state,” said Stan Brock, R.A.M.’s founder.  Ending these restrictions leads to “a quantum leap in volunteerism in this country.”

“Barely Hanging On”

Tuesday, May 11th, 2010

Study finds that middle-class Americans are losing their healthcare coverage.  Middle-class Americans are losing their healthcare insurance at a faster rate than other income earners. This finding was reported in “Barely Hanging On”, prepared by the University of Minnesota’s State Health Access Data Assistance Center.  The report was commissioned by the Robert Wood Johnson Foundation as part of its yearly Cover the Uninsured Week and analyzed data from the U.S. Census Bureau and the Department of Health and Human Services.

According to the study, three million fewer middle-income Americans had healthcare insurance provided by their employers in 2008 when compared with 2000.  Two-thirds of families earning between $45,000 and $85,000 a year were insured by their employers in 2008, a seven percent drop from 2000.

The study also found that costs had risen 81 percent between 2000 and 2008.  During the same timeframe, household incomes fell 2.5 percent.  Additionally, fewer workers were offered or could afford employer-provided coverage.

“America’s uninsured crisis means that hard-working people with average incomes are being squeezed,” said Risa Lavizzo-Mourey, the Robert Wood Johnson Foundation’s president and CEO.  “The fallout from rising health insurance costs hits everyone.”

Yawn….

Thursday, March 18th, 2010

People who are bored at work found to be 2 ½ times more likely to die early.  The term “bored to death” might not be too far from the truth.

An article that will be published in the April issue of the International Journal of Epidemiology reports that a study has found that people who bore easily are more likely to die early.  University College London researchers found that boredom on its own is unlikely to kill, but that it is a symptom of other risky behaviors such as drinking, smoking, using drugs or having psychological problems.

The researchers studied questionnaires completed between 1985 and 1988 by government employees living in London aged 35 to 55 to determine if they were bored at work.  Next, the researchers tracked the number of participants who had died by April of 2009.  Respondents who said they were very bored at work were found to be 2 ½ times more likely to die of heart conditions than those who said that they were not bored.

“Someone who is bored may not be motivated to eat well, exercise and have a heart-healthy lifestyle.  That may make them more likely to have a cardiovascular event,” noted Dr. Christopher Cannon, an associate professor of medicine at Harvard University and the American College of Cardiology’s spokesperson.

Cannon added that boredom can be linked to depression, which would make the person more susceptible to heart attacks.  Additionally, it is possible that when someone is bored, the body releases dangerous hormones that stress the heart.

Left and Right Give Thumbs Down to Health Insurance Mandate

Thursday, January 14th, 2010

The left, right and insurance industry are unhappy with the healthcare insurance mandate.  There’s one element of healthcare reform legislation on which many liberals and conservatives agree – the mandate.  Both the Senate and House versions of the healthcare reform bill contain a mandate requiring that all Americans be insured – whether it is through their job, the government or the private market.

From the right, there’s criticism from Michael Cannon, a health policy analyst at the libertarian Cato Institute, who says “The federal government does not have the power to force you to purchase a private product.”  From the left, Jim Dean, chairman of Democracy for America, notes that “We’d like to see the individual mandate stripped.  It was fair given the presence of a government entity that could provide competition and control the cost.  It’s not fair if people are required to buy insurance from the same insurance industry that caused this problem.”

The reasoning behind the mandate reflects the basic concept that underlies all insurance.  A large pool of people pays fairly small premiums to create a fund large enough to take care of people who need help.  The idea that people of all ages participate is of particular importance in healthcare, because costly medical conditions are found primarily in Americans who are middle-aged or older.  When younger and healthier people don’t have insurance, the others pay higher premiums.

The insurance industry has a totally different reason for disliking the mandate – they think it’s too mild.  Robert Zirkelbach, spokesman for America’s Health Insurance Plans, believes that “We think there’s more that (the bill) needs to do.  There’s still a strong incentive for people to wait until they are sick to purchase insurance.”  Zirkelbach is referring to one of the legislation’s hallmark features – the requirement that insurers treat those with pre-existing conditions the same as all other patients and bans denying coverage.

Democrats Taking On Healthcare Insurers’ Antitrust Immunity

Wednesday, November 18th, 2009

If Democrats get their way, healthcare insurers will lose their immunity from antitrust laws.  Democrats in the House and Senate are trying to strip the insurance industry of its decades-old exemption from federal antitrust laws, in the fight to overhaul the way healthcare is delivered in the United States.  If the legislation is passed, it will end the “price-fixing, bid-rigging and market allocation in the health and medical malpractice” insurance areas, according to Senator Patrick Leahy (D-VT), chairman of the Senate Judiciary Committee.  Leahy’s statement coincided with the House Judiciary Committee’s 20 – 9 vote to end the industry exemption.

Health insurers are fighting back, with Karen Ignagni, president and CEO of America’s Health Insurance Plans (AHIP) claiming that “We believe that health insurers have not been engaging in anti-competitive conduct and that McCarran – Ferguson does not provide a shield for such conduct” in a letter to Representative John Conyers (D-MI), who chairs the House Judiciary Committee.  The McCarran – Ferguson Act of 1945 gives states the ability to regulate the insurance industry for antitrust matters.  As a result, insurance companies currently are exempt from federal jurisdiction.

The moves to revoke healthcare insurers’ long-term immunity from antitrust laws reflect the Democrats’ anger in response to the industry’s attempts to shape reform legislation.  The action came shortly after AHIP issued a report asserting that a measure in the Senate Finance Committee would result in significantly higher premiums for people who current have healthcare insurance.  Democrats and President Obama attacked the study as flawed and motivated by politics.  According to the president, insurers are earning “profits and bonuses while enjoying a privileged exemption from our antitrust laws, a matter that Congress is rightfully reviewing.”

Edward Eckenhoff on Improving a Major Healthcare System

Monday, November 2nd, 2009

Edward EckenhoffI once asked legendary healthcare publisher and speaker Chuck Lauer who the most inspiring figure he met in healthcare was.  He answered Eddie Eckenhoff.  It’s easy to see why.

Eckenhoff is founder and president of the National Rehabilitation Hospital (NRH) in Washington, D.C.  A paraplegic since a 1963 auto accident, Eckenhoff is at the forefront of efforts to enhance the quality of care provided to patients undergoing rehabilitation.  He led the creation of the New Value Process, a loyalty program that draws inspiration from Disney’s model customer relations efforts.  By creating a culture of excellence at the NRH, Eckenhoff and his team members are cutting the average length of stay, making the rehabilitation process seamless for patients and their families and delivering optimal outcomes at discharge.

Consider this:  The average length of stay in a rehabilitation hospital has changed from as long as four months to an average of 30 days.  A lot of activity is now packed into that short time period, including three to 4 ½ hours of intensive therapy every day.  Within 24 hours of arrival, the patient’s team – including the physician, rehab nurse, physical therapist, occupational therapist, speech/language pathologist when needed, rehabilitation engineer and neuropsychologist – is in place and a discharge date established.  That is the culture of patient care he has created.

In a recent interview for the Alter+Care Podcasts on Healthcare, Edward Eckenhoff says that a patient arriving at the NRH likely will have been assured by the staff of the acute-care hospital that “everything will be fine”.  The rehabilitation hospital staff’s job is to break the reality to the patient from day one by assuring the patient that they will teach him to live with reasonable independence and functionality – especially when a spinal injury is involved.

Since opening in 1986, the NRH has grown into the NRH Medical Rehabilitation Network, which operates in 34 locations, and serves thousands of patients with disabilities ranging from spinal cord injuries to traumatic brain injury, stroke, arthritis, amputation and other neurological and orthopedic conditions.  Recognized as one of “America’s Best Hospitals” by U.S. News & World Report, the NRH has more than 1,500 staff members, including over 200 physicians.

 
icon for podpress  Edward Eckenhoff on Improving a Major Healthcare System: Play Now | Play in Popup | Download

Illinois Should Improve Healthcare Delivery Quality: Study

Thursday, October 22nd, 2009

flu_seniors_480Illinois medical providers rank among the nation’s most ineffectual when it comes to providing cost-effective treatment and avoiding unnecessary hospitalizations.

According to the nonprofit Commonwealth Fund’s report, Illinois ranks 49th among 50 states and the District of Columbia in terms of “avoidable hospital use and costs.” The study measures how often Medicare patients with chronic conditions such as heart disease are admitted to the hospital or how frequently nursing home patients shuttle in and out of hospitals.  New York came in 50th, with Louisiana occupying the last place.

Illinois also placed 44th in terms of how effectively hospitals deliver basic care that avoids complications.  Healthcare costs and volumes of tests and treatments were found to be unusually high, especially in metropolitan Chicago.

There was some good news for Illinois in the Commonwealth Fund’s study.  The state ranked 20th in access to care, quality in terms of income, race and ethnic background; 29th in quality-of-life measures such as infant mortality; and 32nd in death rates for colon and breast cancer.  The study places Illinois in 42nd place in terms of the quality of overall healthcare delivery.

Cathy Schoen, Senior Vice President of the Commonwealth Fund and a co-author of the study, noted that the findings underscore the need for wide-ranging healthcare reform.  “We need payment reforms with incentives to do well on outcomes and efficiency of care,” she said.