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Harvard Upset Over Health Care Hikes – Obamacare – The Kelly File – Video

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Harvard Upset Over Health Care Hikes - Obamacare - The Kelly File
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Harvard Upset Over Health Care Hikes - Obamacare - The Kelly File - Video

Health-care jigsaw pieces fall into place

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SINGAPORE - The year 2015 should turn out to be a good year, as far as health care is concerned - barring unexpected developments. In fact, if all goes well, it should be the start of a few good years, as the hard work of the past comes to fruition.

Bed crunch eases

First, the severe bed crunch facing public hospitals should ease this year. The shortage still exists - some hospitals still report 100 per cent occupancy on some days and patients are still being put up in makeshift waiting areas, including corridors.

But this should ease as the year progresses.

The bed crunch was exacerbated last year by the six-month delay in the opening of the 700-bed Ng Teng Fong General Hospital in Jurong. It is now scheduled to open by the middle of this year.

Changi General Hospital made good its promise to open the new 280-bed integrated building it shares with St Andrew's Community Hospital by 2014 - but with just 20 beds at the end of last month. By end-January, another 10 beds will be ready. By July, 200 more beds will be up.

With the extra beds from the two hospitals, the load on both the National University Hospital and the Khoo Teck Puat Hospital will be lighter.

In all, there should be a 10 per cent increase in public general hospital beds this year - from more than 7,200 beds to about 8,000 beds - giving all hospitals some breathing space.

Lower costs

Next, the rising cost of health care, especially for older people, will be reined in.

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Health-care jigsaw pieces fall into place

Lavish Cadillac Health Plans Dying Out as Obamacare Tax Looms

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Large employers are increasingly putting an end to their most generous health-care coverage as a tax on Cadillac insurance plans looms closer under Obamacare.

Employees including bankers at JPMorgan Chase & Co. (JPM) and college professors at Harvard University are seeing a range of moves to shift more costs to workers. Companies are introducing higher deductibles and co-payments, rising premiums and the imposition of wellness programs that carry penalties for people who dont comply.

Requiring employees to shoulder more of the cost burden may undermine public support for Obamacare just as Congress, now firmly under Republican control, considers new ways to gut the law.

The tax takes effect in 2018, and employers are already laying the groundwork to make sure they dont have to pay the 40 percent surcharge on health-insurance spending that exceeds $27,500 for a family or $10,200 for an individual. Once envisioned as a tool to slow the nations growing health-care tab, the tax has in practice meant higher out-of-pocket health-care costs for workers.

I dont think theres any employer thats planning on paying that tax, Steve Wojcik, vice president of public policy for the National Business Group on Health, which represents large employers, said in a phone interview.

It doesnt help the company, it doesnt help the employees, it doesnt help the shareholders, he said. It doesnt really help anybody except the federal government.

The tax on Cadillac plans -- named after the luxury vehicle to denote their lavishness -- is one reason the growth in health-care premiums has slowed since the Patient Protection and Affordable Care Act took effect in 2010.

Last year, average family premiums rose 3 percent to $16,834, while single premiums held steady at $6,025, according to the Kaiser Family Foundation. Companies with a large percentage of high-wage workers paid more, with an average of $6,244 for single coverage.

Among employers with 200 or more workers, 51 percent had employees paying one-quarter or more of their premiums for family coverage last year, according to Kaisers report in September. That portion has been gradually increasing since 2011, when it was 42 percent.

Employers who have traditionally offered generous benefits to lure top professional talent, or who have conceded to demands from labor unions for better health benefits, are most susceptible to the tax, Wojcik said. Many are responding by imposing new requirements on workers and reducing their health benefits.

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Lavish Cadillac Health Plans Dying Out as Obamacare Tax Looms

Health Care Sector Update for 01/07/2015: GALT,ARNA,KBIO

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Top Health Care Stocks

JNJ +2.10%

PZE +1.26%

MRK +0.74%

ABT +1.90%

AMGN +3.10%

Health care stocks were sharply higher Wednesday with the NYSE Health Care Sector Index rising 1.4% and shares of health care companies in the S&P 500 ahead 2.1% as a group.

In company news, Galectin Therapeutics ( GALT ) after the drugmaker reported positive early-stage results demonstrating its GR-MD-02 drug candidate is safe with potential for therapeutic effect on fibrosis in patients with fatty liver disease.

The Phase I trial enrolled 30 patients divided into three groups, with patients receiving four doses of up to 8 milligrams per kilogram with no serious adverse events.

The drug also "had significant effects on a relevant biomarker of fibrotic liver disease and a potential signal indicating a reduction in liver stiffness," according to Dr. Stephen Harrison, the lead investigator and the Chief of Hepatology at Brooke Army Medical Center in Texas. The results justify further testing, Harrison said.

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Health Care Sector Update for 01/07/2015: GALT,ARNA,KBIO

When a nurse is your health-care provider, youre at risk

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Next time youre a patient, ask whether your health-care provider is a doctor.

On Jan. 1, New York changed the standard for who can practice medicine, putting patients at risk. It became the 19th state to capitulate to aggressive lobbying by nursing groups to let some nurses play doctor without going to medical school.

In these states, nurse practitioners can do everything primary-care doctors do diagnose, treat, prescribe and even open their own independent practices once theyve worked 20 months under a physicians direction.

That is, can legally. That doesnt mean they have the know-how. And therein lies the danger.

Dont get me wrong: Nurses are the backbone of the health-care system, and generally theyre better than doctors at educating patients and providing many types of routine care.

But their training is different, and it doesnt prepare them to do everything doctors do especially diagnosing less common conditions.

Nurse practitioners are registered nurses whove earned an advanced degree. But theyve never been to medical school; they have half the years of training a doctor gets (generally six years beyond high school, instead of 12), and they dont take the same state licensing exam as doctors.

So youll be fine if you have a urinary-tract infection or a sprain. But dont assume they have the in-depth knowledge to diagnose an uncommon illness or handle a complex problem.

Indeed, Health Maintenance Organizations cooked up the term health-care provider to blur the differences between physicians and less expensive caregivers.

Dr. Sandeep Jauhar, a cardiologist at Long Island Jewish Medical Center, criticized New Yorks law when it was enacted last April.

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When a nurse is your health-care provider, youre at risk

Wonkblog: Steven Brill: Obamacare wont lower Americas health-care bill, but it was still worth it

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About two years ago, journalist Steven Brill offered a blockbuster story in Time Magazine on why Americans' medical bills are so high. He's now followed that up with a new book released Monday explaining why he doesn't believe Obamacare will change that.

Brill's book, "America's Bitter Pill,"details the backroom deals that allowed the Affordable Care Act to become law, why HealthCare.gov was such a mess when it launched in October, and why he believes the law won't do anything to keep health care costs from running wild. His assessment: the deals Democrats struck with industry to get the law passed ensured that the flawed system would remain intact.

Brill also details in his own frustrations with the health-care system when he underwent open-heart surgery during the reporting of his book, and people who's lives have been changed because of the ACA. And he closes with a vision for what he thinks health-care should look like. Below is a transcript of our conversation Monday morning, edited for brevity and clarity.

JM: This book dives into the process that led to the passage of the Affordable Care Act about five years after it became law. What lessons do you hope can be taken away from this account?

SB: The whole process by which Washington attempted to tackle and fix the largest industry and the most important industry in the country is really emblematic of how Washington works and doesn't work. What I realized as I was doing the first piece for Time Magazine and what I realized in spades as I was reporting this book was that the only way legislation this big, this important can possibly come out of Washington is if the most important group of special interest lobbyists say that it can.

The basic deal that the Obama administration and the Democrats in the Senate had to make was we'll get more coverage for people. But we'll get more coverage for people at the same high prices that allow the drug companies to be so profitable, that allow the non-profit hospitals to be so profitable, that allow the device-makers to be so profitable and that is the result that is Obamacare.

So the good news is this couple I interviewed in Kentucky who hadn't had access to doctors in years suddenly had access to health care. The bad news is that you and I and all the other taxpayers are paying the same high prices for that health care that dominated and completely screwed up the system in the first place.

Is it too cynical to say that deal-making with industry is just what happens when you want to pass major legislation?

When the lobbying behind the industries that are affected by that legislation spends four times as much as the next largest industry when it comes to lobbying, which is the military industrial complex, this is what you get. The second sort of theme through the book is Washington not only is dominated by money, but it's dominated by a kind of partisanship which I think is also the result of too much money going into primaries and gerrymandering and everything else. The third overriding theme of the book is not only is Washington beset by money and by partisan politics, but it's also beset by a lack of attention being paid to the sheer competence of the government. We all missed the story, me included, in the run-up to the [Healthcare.Gov] launch. The Web site was a train wreck two or three years in the making.

Why do you think the administration missed this?

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Wonkblog: Steven Brill: Obamacare wont lower Americas health-care bill, but it was still worth it

Afghan health care at risk as international aid is scaled back

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KABUL, Afghanistan At one of Afghanistans busiest hospitals, signs abound of one of the signature rebuilding successes of Americas longest war.

Afghans hobble into a spotless emergency room and are quickly seen by trauma specialists, including orthopedic surgeons. Modern equipment tracks heart rates, and health care professionals are careful to sterilize their equipment.

But everything is not as it appears at Wazir Akbar Khan Hospital.

A closer look at some of the heart-rate monitors reveals they arent working. Whats more, the X-ray technology here is outdated, there is a shortage of oxygen tanks and medicine, and doctors must work punishing hours to keep up with the steady stream of patients.

We dont have time to sleep, said Ahmad Tariq, an orthopedic surgeon.

In key areas, health care in Afghanistan has undeniably improved since the Taliban regime was toppled 13 years ago. But some highly touted gains may have been overstated, and others are at risk as international militaries pull out of the country and aid organizations scale back their efforts.

Improvements in health care are one of the main success stories the international military coalition and aid groups like the U.S. Agency for International Development point to in Afghanistan. Maternal mortality has been reduced by 80 percent and child mortality by 60 percent, according to USAID; life expectancy has risen, and more rural Afghans have access to health care, though the extent of that improvement is debated.

The Afghan Public Health Ministry estimates that there are now 2,286 health facilities across Afghanistan, compared with about 500 in 2002, and 60 percent of Afghans are within one hour of a health clinic. But some watchdogs have criticized such numbers as misleading, as facilities vary widely in quality and some cited by both U.S. and Afghan officials may not even be in operation.

It doesnt mean we dont have problems in health were a long way to go to provide quality health care for the people of Afghanistan, Qadir Qadir, director of policy and planning for the Public Health Ministry, said. In terms of quality, we have a lot to do.

Larry Sampler, the chief of Afghanistan and Pakistan operations for USAID, says he understands the concerns of health care professionals. But rather than diminishing support, his organizations biggest challenge may be the uncertainty during this transition period and the fact that the unity government headed by President Ashraf Ghani is still finding its footing. Still, he says he is cautiously optimistic USAID, the biggest aid donor in Afghanistan, can build on the health care gains it has made.

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Afghan health care at risk as international aid is scaled back

Which Path for Health-Care Politics in 2015?

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Yogi Berra said that when you come to a fork in the road, take it. It will be that kind of year for health-care politics. The status quo is not an option.

The key to which path the Affordable Care Acttakes is how the Supreme Court rules in King v. Burwell,the case that concerns whether subsidies in the health law can be provided to millions of low- and middle-income enrollees in states with federally run insurance marketplaces.

The effect on people as well as politics could be substantial. A decision for the plaintiffs would deny insurance subsidies for millions, threaten the viability of the marketplaces, and potentially throw the ACA back into the congressional arena (and onto front pages nationwide). Partisan debate about the health-care law could reignite nationwide.

But if the court sides with the government, the ACA could gradually be transformed from the lightning rod of partisan division it has been since enactment in 2010 to a more ordinary political issue. The upside scenario for the ACA has received much less attention than the downside. Consider:

*After a rough start with the infamous Web site problems in 2013, the ACA is largely working as intended. There is no obvious risk of serious meltdown on the horizon to keep the law at the center of political or media debate. The law faces many implementation challenges, but none of the doomsday predictions have proved accurate: There has been no rate shock. Premium increases in the new marketplaces have been modest. Employers have not dumped coverage, and the ranks of the uninsured are shrinking.

*Efforts by the Republican-controlled Congress to chip away at the ACA could fuel the fire if they gain traction and force presidential vetoes. But congressional debates may turn out to be largely symbolic gestures to satisfy campaign promises to the base. They may also be relatively short-lived as the political world pivots to the 2016 presidential campaign. The majorpresidential candidates who set the tone for the election will want to look forwardnot backand to appeal to the political middle. So will many of the 24 Republicansscheduled to defend Senate seats in 2016 (Democrats will be defending nine).

*The president is likely to veto any legislation he views as striking at the core of the ACA. Vetoes would sustain the political war surrounding the law that has benefited critics by rallying anti-Obamacare partisans to their side. But vetoes would also play into the hands of a president whose poll numbers are going up as he aggressively wields executive authority to advance his policy agenda in his final two years in office.

*The anti-ACA fervor on the right has always been a proxy for anti-Obama sentiment. That sentiment is being redirected to other issues as the president exercises executive authority on immigration and the environment (including toward the presidents use of executive authority itself). When President Barack Obama leaves office, the ACAs role as a proxy for anti-Obama fervor will fade, as will, in all likelihood, the term Obamacare.

Ahead of oral arguments at the Supreme Court this spring, it is far from clear which path ACA politics will take. But as the Supreme Court weighs the ACA once again, its clear that the heat will go either way up or way down in 2015.

Drew Altman is president and chief executive officer of theKaiser Family Foundation. He is on Twitter:@drewaltman.

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Which Path for Health-Care Politics in 2015?


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