Posts Tagged ‘healthcare reform’
Monday, January 10th, 2011
“We’re in this together, and the cost to taxpayers of treating anyone who seeks emergency care, with or without insurance, is far greater than the cost of requiring coverage for everyone,” writes David Lazarus, a business columnist for the Los Angeles Times. As proof of the foolishness of opposing healthcare reform, Lazarus cites the case of a California woman who underwent several rounds of chemotherapy after being diagnosed with ovarian cancer. The woman, who had been a Disney executive, is currently unemployed and is being financially squeezed in the same way as other people who carry individual insurance policies.
Shortly after her diagnosis, the woman’s insurer increased her monthly premiums by $91 because she had just celebrated her 55th birthday. In October, they rose an additional $83 because of “the growing cost of healthcare services.” The premium goes up an additional $44 in January because of “the new healthcare reform law,” according to the insurer.
According to Lazarus, “There rate hikes represent a 55 percent increase in premiums over just a few months – and not one of them is attributable to her cancer. As of January, she’ll be paying $613 a month for healthcare coverage and that is with a $5,000 deductible. In other words, the woman will be paying more than $7,000 a year for insurance and will still be responsible for the first $5,000 in annual costs.” As the woman says, “If I don’t get work, I don’t know how I’ll afford that. But I’m now uninsurable for individual coverage. I can’t switch to a different policy.”
Unless the courts overturn President Obama’s healthcare reform law, the woman will be able to shop for what potentially could be affordable coverage through the insurance exchanges where companies will not be able to turn down patients because of their medical histories. Lazarus notes that “Without the mandate, many healthcare experts say, premiums probably would skyrocket because most people would simply wait until they got sick before buying coverage. Health insurers, in turn, would probably stop offering individual policies because the marketplace would be rigged against them. If you believe that healthcare is a right and not a privilege, and that the mark of a decent and civilized society is how it looks after those in need, then it shouldn’t make any difference who’s knocking at a doctor’s or an insurer’s door. Healthcare should be there for all of us when we need it.”
Tags: chemotherapy, David Lazarus, Disney, healthcare reform, Individual insurance policies, Insurance exchange, Insurance mandates, Los Angeles Times, Ovarian cancer, Patient Protection and Affordable Care Act, President Barack Obama
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Tuesday, January 4th, 2011
Dr. Donald Berwick, Administrator of the Center for Medicare and Medicaid Services (CMS), “can’t imagine a worse idea” than repealing the Patient Protection and Affordable Care Act healthcare reform law. “Without the individual mandate, the intention to extend coverage, especially to people with chronic illnesses, would unravel,” Berwick said in a recent speech to the Commonwealth Club of California. According to Berwick, the requirement is “bearing your share of responsibility for your health.”
Berwick believes the new healthcare reform law “has got more resources in it and texture than I imagined.” One of the law’s biggest opportunities, Berwick said, is accountable-care organizations (ACOs); CMS is planning to release proposed ACO regulations in January. Berwick said that there is no single approach to creating an ACO because of differences between local resources, providers, and even geography. “I think we are going to see a rebirth of organizations able to make care a journey and not fragmentation. Organizations will have memories about patients, not amnesia,” Berwick said. “Withholding needed care is one of the worst plans you can imagine.”
Berwick warned that there will be two sides to the transformation that healthcare reform will bring. One will be “authentic, they will be the real partners on a great national expedition,” he said. Others “will become cloaks of the status quo.” The federal government has committed $10 billion over the next decade to the new Center for Medicare and Medicaid Innovation, a program that will test new approaches – as well as models of care and payment — that can improve health services.
Tags: Accountable care organizations, Center for Medicare and Medicaid Innovation, Center for Medicare and Medicaid Services, Commonwealth Club of California, Dr Donald Berwick, healthcare reform, Individual mandate, Patient Protection and Affordable Care Act
Posted in Healthcare, Hospital Systems | 1 Comment »
Monday, December 20th, 2010
A conservative federal judge in Virginia has ruled that a key provision of the Patient Protection and Affordable Care Act is unconstitutional. Specifically, U.S. District Judge Henry Hudson overturned the section of the healthcare reform law that requires all Americans to purchase healthcare insurance starting in 2014. The Obama administration will appeal the decision, which is likely to end up before the United States Supreme Court. Previous lawsuits in Michigan and Florida have been dismissed and additional cases are pending, including one filed by 20 other states. Hudson agreed with Virginia Attorney General Kenneth Cuccinelli in saying the mandate overstepped the Constitution.
Hudson, who was appointed to the federal bench by George W. Bush, explained his decision this way. “Neither the Supreme Court nor any federal circuit court of appeals has extended Commerce Clause powers to compel an individual to involuntarily enter the stream of commerce by purchasing a commodity in the private market,” he wrote. “In doing so, enactment of the (individual mandate) exceeds the Commerce Clause powers vested in Congress under Article I (of the Constitution). The outcome of this case has significant public policy implications. And the final word will undoubtedly reside with a higher court. At its core, this dispute is not simply about regulating the business of insurance — or crafting a scheme of universal health insurance coverage — it’s about an individual’s right to choose to participate.”
“We are confident that this law is constitutional, and we are confident that the Supreme Court when, and if, it hears this case will agree that it’s constitutional,” an Obama administration official said. White House healthcare reform director Nancy-Ann DeParle said the administration is encouraged by the two other judges who have upheld the law. She noted that the Justice Department is presently reviewing Hudson’s ruling.
Tags: Commerce Clause, George W Bush, Health insurance industry, healthcare reform, Individual mandate, Justice Department, Nancy-Ann DeParle, Patient Protection and Affordable Care Act, President Barack Obama, U.S. District Judge Henry Hudson, U.S. Supreme Court, Unconstitutional, Virginia, Virginia Attorney General Kenneth Cuccinelli
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Monday, December 13th, 2010
The Department of Health and Human Services (HHS) has announced that approximately $8 million in federal funding will be made available to community health centers that have cooperative agreements to provide training and technical assistance to local organizations. The agency’s Health Resources and Services Administration (HRSA) noted that the funding is courtesy of the Patient Protection and Affordable Care Act. The health centers will use the funding to promote community development, plan expansions, create patient-centered medical homes and support the adoption of electronic health records. Additionally, the Affordable Care Act will invest $11 billion to fund the operation, expansion and construction of community health centers across the country. Of that, $9.5 billion will be used to construct community health centers in regions that are medically underserved.
“These Health Center Cooperative Agreements help build on the Affordable Care Act’s investments in community health centers,” said HHS Secretary Kathleen Sebelius. http://www.hhs.gov/news/press/2010pres/11/20101119b.html “These funds will provide assistance to community health centers to help them improve access to healthcare services, especially for those who are uninsured, isolated or medically vulnerable.”
Community health centers serve nearly 19 million patients, approximately 40 percent of whom lack health insurance. These centers deliver preventive and primary care services at more than 7,900 service delivery sites around the country to, regardless of patients’ ability to pay. Charges for services are set according to income.
“The funding the Secretary announced will ensure that health centers who need it have the ability to plan for their futures,” said HRSA Administrator Mary K. Wakefield, Ph.D., R.N. “Community health centers provide high quality health care to anyone who needs it, these funds make continuing that care possible.”
Tags: Community development, community health centers, Department of Health and Human Services, Electronic health records, Health Resources and Services Administration, healthcare reform, Kathleen Sebelius, Mary K. Wakefield, medical homes, Medically underserved areas, Patient Protection and Affordable Care Act
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Monday, November 29th, 2010
Americans are divided on their perceptions of the Patient Protection and Affordable Care Act’s ability to increase insurance access and control healthcare costs, according to a recent survey by the Deloitte Center for Health Solutions. Approximately 59 percent of respondents believe the law will positively impact Americans’ access to affordable insurance. Another 20 percent said the law’s impact on insurance access will be negative. Respondents generally believe that the law will reduce insurance, hospital, physician, hospital and drugs costs.
“Since 2008, we have surveyed consumers about their assessment of the U.S. health care system,” said Paul Keckley, Ph.D., executive director of the Deloitte Center for Health Solutions. “Consumers remain mixed in their assessment of the system’s performance, concerned about costs, and supportive of changes that improve its value. Our survey findings indicate that the views of respondents are dramatically different based on age,” added Keckley. “Younger adults tend to be more optimistic about the impact of health reform, while older adults tend to be more skeptical.”
Healthcare costs continue to be an issue. More than one-third (36 percent) of respondents said they are financially prepared to handle future healthcare costs, compared with 17 percent who say they are unprepared. Just five percent of young adults 18-24 say they are financially unprepared. This is likely due to the fact that, under the new law, they can remain on their parents’ coverage until they reach their 26th birthdays. Consumers think health insurance company costs (70 percent), hospital costs (69 percent) and prescription drugs (61 percent) are major influences on driving overall healthcare system costs.
Tags: healthcare costs, healthcare reform, Patient Protection and Affordable Care Act
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Tuesday, November 23rd, 2010
The Food and Drug Administration (FDA) has concluded that years of warnings about the dangers of smoking cigarettes, the availability of nicotine patches and gum has not worked. Instead, the FDA is proposing to put gruesome images on cigarette packs that warn of the consequences of smoking. Tobacco is the leading cause of early and preventable deaths in the United States, accounting for 433,000 annual deaths and approximately 33 percent of all cancer deaths. The healthcare reform law provides free access to anti-smoking therapies; the stimulus bill included $225 million to support local, state and national anti-smoking programs.
The proposed images, which include one of a man suffering a heart attack and another of a mother blowing smoke in her baby’s face, would cover half the front and back of each pack if adopted. “When the rule takes effect, the health consequences of smoking will be obvious every time someone picks up a pack of cigarettes,” said Margaret A. Hamburg, FDA Commissioner. The FDA plans to choose nine images by June 22. After October 22, 2012, cigarette manufacturers who refuse to put the new warnings on their product will be banned from selling their brands in the United States. Anti-tobacco activists applauded the move. “In implementing the new warnings, the United States is catching up to scientific best practices,” said Matthew Myers of the Campaign for Tobacco-Free Kids.
Not surprisingly, some tobacco companies are not thrilled. R. J. Reynolds Tobacco Company, which is already suing the government over tobacco regulations, is reviewing the proposed warnings. “It is worth noting that the legality of requiring larger and graphic warnings is part of our lawsuit that is currently pending,” said company spokesman David Howard. Philip Morris USA, on the other hand, has been supportive of FDA regulations; the company “has actively participated in the FDA’s rule-making and public comment process and plans to do the same on this proposal.”
Canada, which has used graphic warnings since 2000, has seen a significant reduction in smoking. “It’s always difficult to point to a particular policy and say it’s due to that,” said David Hammond, a researcher of the University of Waterloo in Ontario. In fact, smoking rates in Canada have fallen approximately 20 percent since 1985. “But all the evidence does point to the fact that these things do help. The bottom line is that there’s no magic bullet. But about one-third of smokers say this increases their motivation to quit, and about the same proportion of former smokers say they remind them why they quit.”
Tags: Food and Drug Administration, healthcare reform, Margaret Hamburg, smoking, stimulus bill
Posted in Economics, Healthcare, Healthcare Village, Hospital Systems | No Comments »
Tuesday, November 16th, 2010
The healthcare system in the United States significantly under performs every other industrialized nation, with the result that too many Americans either die or are harmed every year. This is the opinion of Louise Probst, Executive Director of the St. Louis Area Business Health Coalition. Writing for the Commonwealth Fund, Probst says that “Since the Institute of Medicine’s (IOM) executive summary to its landmark report To Err is Human was published in the Journal of the American Medical Association, the IOM estimate that up to 30 percent of all healthcare expenditures pay for care with little or no health benefit fails to shock. Experts now predict that 40 percent or more of all spending has little or no benefit. Meanwhile, the average cost of health insurance for a family of four has grown to more than $14,000 annually.” The Commonwealth Fund promotes a high-performing healthcare system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable — low-income people, the uninsured, minority Americans, young children and the elderly.
According to Probst, “High healthcare costs create significant suffering for American families, businesses and governments. Other leading nations spend half of what we do on healthcare, making it increasingly difficult for families to retain their standard of living and for American businesses to compete in a global economy.” Each and every American pays the nation’s healthcare tab indirectly through smaller paychecks, higher taxes and health benefit costs hidden in the price of non-healthcare goods. Compounding the situation is the fact that the jobs that the nation needs to make up for these costs are being outsourced to nations where healthcare is cheaper. “The outcome is soberly clear: In 2009, one of even seven Americans lived in poverty and 50 million Americans were uninsured, according to the U.S. Census,” Probst said.
Why is it that healthcare consumers know so little about spending and the waste associated with it? Probst says that “Despite consistent calls for price and quality transparency from the business community since the ‘buy-right’ movement of the early 1980s, the IOM’s call for action more than a decade ago, and the sustained effort of many labor and consumer groups, our nation has yet to achieve meaningful transparency. As long as price differences remain opaque to patients and their physicians, there is little hope for improving the affordability and efficiency of American healthcare.”
Tags: American healthcare system, American Medical Association, Commonwealth Fund, Healthcare, healthcare reform, Institute of Medicine
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Monday, November 1st, 2010
The Department of Health and Human Services celebrated National Mammography Day by establishing an advisory committee under the auspices of the Affordable Care Act at the Centers for Disease Control and Prevention (CDC). The 15-member panel will develop initiatives to increase awareness of breast cancer among women under the age of 40. “From prevention research, to education for health professionals, to designing and promoting awareness activities for the public, we look forward to working with the committee to educate providers, patients and young women about breast cancer prevention and treatments,” said Thomas Frieden, CDC director.
HHS Secretary Kathleen Sebelius announced the panel in a conference call with Jill Biden, who in 1993 established the Biden Breast Health Initiative, a non-profit organization that provides educational breast awareness programs in Delaware. In 17 years, approximately 10,000 high school girls have learned about breast cancer awareness through the program. Biden established her program in a year when four of her friends were diagnosed with breast cancer.
The Affordable Care Act includes a provision that if a woman or her family is enrolled in a health plan on or after September 23, 2010, mammograms will be required coverage for women aged 40 and above. Additionally, the act bans insurers from imposing lifetime dollar limits on essential benefits for women. Beginning January 1, 2011, Medicare patients will be able to have mammograms with no co-payment. Sebelius noted that 100 American women die each day from breast cancer, though survival rates run as high as 98 percent after five years if the disease is detected early.
Tags: Biden, breast cancer, Centers for Disease Control and Prevention, co-payment, Department of Health and Human Services, healthcare reform, Kathleen Seblius, mammogram, Medicare, Patient Protection and Affordable Care Act
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Wednesday, October 27th, 2010
When the Patient Protection and Affordable Care Act is fully implemented in 2014, approximately 81 percent of young adults aged from 19 to 29 will have healthcare coverage, according to a report from the Commonwealth Fund. In fact, young adults comprise approximately 30 percent of the 32 million Americans who will finally have healthcare coverage in 2014.
The 12.1 million young adults expected to get coverage include 7.2 million who will be covered by a Medicaid expansion, and 4.9 million who will buy subsidized private insurance. The law does not cover an estimated 1.8 million undocumented young adults, who are not eligible for Medicaid or subsidized insurance. According to the Commonwealth Fund report, the crucial time to get coverage is when young adults graduate from high school or college. Approximately 27 percent of young adults who don’t attend college lose their insurance; another 15 percent secure a new source of coverage. For college graduates who entered the workforce, approximately 32 percent lost their insurance while 43 percent had access to a new source.
Tags: Coomonwealth Fund, healthcare insurance, healthcare reform, Medicaid, Patient Protection and Affordable Care Act, uninsured
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Tuesday, October 19th, 2010
The American College of Healthcare Executives (ACHE) tested the waters of how its members feel about the Affordable Care and Patient Protection Act by conducting an in-depth survey. The primary finding is that hospital executives are reacting to healthcare reform by slashing expenses. Their goal is to bring their per-patient costs into line with Medicare payment levels.
Based in Chicago, the trade association for hospital and healthcare system executives, queried 539 CEOs and learned that more than 75 percent plan to cut per-patient costs. Additionally, they intend to study means to avoid penalties for preventable readmissions over the next year as a response to the healthcare reform law.
Thomas Dolan, ACHE President and CEO, said “Hospital CEOs are actively taking steps to ensure their communities are going to benefit from the advantages offered by healthcare reform legislation.”
Approximately 72 percent of executives who took the survey plan to build closer relationships with physicians so all can benefit from incentives for care coordination, enhanced quality, patient safety and reduced costs. Another 68 percent plan to apply for subsidies through the American Recovery and Reinvestment Act to purchase electronic health record systems. Fully two-thirds are investigating ways to prevent infections and avoid penalties. Almost 50 percent of respondents plan to look into ways to decrease the average patient stay or partner with community organizations to promote wellness.
Tags: American Recovery and Reinvestment Act, healthcare reform, Medicare, Patient Protection and Affordable Care Act, Thomas Dolan, wellness
Posted in Development, Economics, Healthcare, Hospital Systems, Wellness Centers | No Comments »
