>>> pretty shot of washington, d.c. very nice. capitol hill . with us now, the ceo of athena health. also with us, economic policy reporter for the "new york times," annie lowry. she wrote about the recent economic phenomenon and writes this. one of the economic mysteries has been the bigger than expected slowdown in health spending . a trend that promises to help close the wide federal deficit over the long-term. but only if it persists. while economists have cheered the flattening, families have assumed more and more of the health care burden, even if households benefit in the long-term, they might suffer in the long-term as their out of pocket health costs rise at a painful economic time to begin with. it is a painful economic time for most people even though the indicators show an upturn in so many ways. for the very rich.

>> yeah.

>> obama care obviously and the middle of the big debate, it still continues day in and day out. what's the future look like?

>> well, when you put that many sort of centrally administered little hooks and twists into anything of that scale, you're going to have a huge number of unintended consequences. some will be good and some bad.

>> which democrats very concerned right now, that kathleen sebelius may not be able to respond quickly. she has to respond quickly.

>> yeah. the basic problem right is you have an access problem that was driving the democrats. i got to get everybody something. this is 40 million people. too late. the market didn't work. we're stepping in and we're going to push everybody on to something. the other side of the argument is now you're going to forbid it from becoming affordable. you've boxed it in so you can't do a lot of things. so health plans aren't allowed offer to discount packaging. you can't have a no frills hmo. it's illegal not to have unlimited stage four cancer care in your package even though you cost it 25% more than not. that is the constriction that's going to make it harder for market forces to get in there and make it more affordable, but if the gravitational pull remains strong, if people remain feeling this is too much money and people somehow remotely are paying for it or can keep in mind they're paying for it, the entrepreneurial energy can still pull there. there are still things you can do to make it cheaper.

>> and annie, you obviously wrote an article talking about health care costs going down independent of the president's health care plan. i mean, people can obviously take credit for that, but for some reason a couple of years ago, it started to tick down about 2%. does that continue even after the recovery?

>> yeah, so there's a lot of evidence this happened independent of the health care law and of the really, really deep recession. so, the recession slowed the growth of health care cost, it's obviously a lot of people lost their insurance. they were very, very strapped economically, so they didn't want to spend a lot on procedures that were kind of on the line. but on top of that, you had slow growth because of changes in the medicare and medicaid programs and it looks like there are some things hospitals are administrating themselves to slow costs down.

>> i think she was right in that article, that we don't know, but there is this split. that the biggest phenomenon that happened during the slowdown is people who were insured, but at work when people are getting cut, didn't want to take time off to go get that hip or knee done because they wanted to be out on the floor. i'm killing it here, boss, when we're deciding how to meet our numbers.

>> how much do you think we could save if more doctors, hospitals, had online records? if you get sick in california, how much could we save? why haven't we done it.

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Can the economic recovery save our broken health care industry?

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Covered California:Bringing Affordable,High Quality Health Care to Millions of Californians - Video

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Visit: http://www.uctv.tv/) David Lansky, President and CEO, Pacific Business Group on Health, looks at health care and costs from the employer #39;s perspectiv...

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With hospitals, health insurers and pharma are looking to harness big data, there is a demand for new skills. In this report for NBR, Bertha Coombs takes a l...

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WASHINGTON When he talks to Republicans in Congress, Scott DeFife, a restaurant industry lobbyist, speaks their language: President Barack Obamas health care law is a train wreck well down the track. There will be collateral damage if changes are not made. Friends of the industry cannot sit back and let that happen.

Speaking to Democrats, he puts on his empathy hat: The Affordable Care Act is the law of the land. Its goal of universal insurance coverage is laudable, but its unintended consequences will hurt the cause.

Almost no law as sprawling and consequential as the Affordable Care Act has passed without changes significant structural changes or routine tweaks known as technical corrections in subsequent months and years. The Childrens Health Insurance Program, for example, was fixed in the first months after its passage in 1997.

But as they prowl Capitol Hill, business lobbyists like DeFife, health care providers and others seeking changes are finding, to their dismay, that in a polarized Congress, accomplishing them has become all but impossible.

Republicans simply want to see the entire law go away and will not take part in adjusting it. Democrats are petrified of reopening a politically charged law that threatens to derail careers as the Republicans once again seize on it before an election year.

As a result, a landmark law that almost everyone agrees has flaws is likely to take effect unchanged.

I dont think it can be fixed, Sen. Mitch McConnell of Kentucky, the Republican leader, said in an interview. Everything is interconnected, 2,700 pages of statute, 20,000 pages of regulations so far. The only solution is to repeal it, root and branch.

Sen. Max Baucus, D-Mont., one of the laws primary authors, said: Im not sure were going to get to the point where its time to open the bill and make some changes. Once you start, its Pandoras box.

As the clock ticks toward 2014, when the law will be fully in effect, some businesses say that without changes, it may be their undoing.

Are we really going to put the private sector in a situation where theres a real potential mess for posturing points? DeFife asked.

The rest is here:

Changes to health care law thwarted

By Charles P. Wallace

Ma Weihua, CEO of China Merchants Bank, and Cigna CEO David Cordani in China last year.

FORTUNE -- (SHANGHAI) By 8 a.m., Renji Hospital, founded in 1848 by Western missionaries and still one of China's best medical centers, is already in a state of chaos. A veritable sea of patients is crammed into the reception area, waiting impatiently to see a doctor. They first line up under giant neon boards that list physicians' specialties to collect a number on a waiting list, then join another snaking line at a cashier's window, and finally shuffle into even longer queues to wait for a doctor to see them in examination rooms with chipping paint. This scene is played out daily across China, which has a limited primary health care system. Medical services are cheap but rudimentary: If you have any malady, from a bad cold to cancer, you must go to the emergency room to seek medical treatment.

But in a modern building less than 100 yards from the main Renji emergency ward is a glimpse at China's future. It is the guibin texu, known more commonly by its English translation: VIP hospital. In the VIP building, patients don't line up but wait for appointments on leather sofas, entertained by widescreen TVs. Instead of the shouting heard at Renji's main hospital, the noise level in the VIP section remains an understated murmur. Patients are escorted into private examination rooms by nurses in crisp white uniforms. The specialists who are so very hard to see at Renji are now suddenly available by appointment -- for a price. The physicians at the VIP hospital charge $60 or more for a consultation, 50 times what patients pay across the road.

MORE:China - a nation on the move

To help pay for such VIP treatment (and treatments), a growing number of Chinese consumers are turning to supplemental health insurance -- a thoroughly American concept. The irony is that despite soaring demand for various financial services, foreign firms have just 2% of the banking and insurance market, according to McKinsey & Co. State-owned insurance companies dominate the market to such extent that last year New York Life abandoned its China joint venture, selling out to Japanese firm Mitsui Sumitomo Insurance because of slumping earnings.

But one U.S. firm, Bloomfield, Conn.-based Cigna (CI), is quietly winning over Chinese consumers, largely by defying conventional wisdom about how an American insurer should operate in China. Cigna entered the China market in 2003, partnering not with a local insurer but with a leading retail lender, China Merchants Bank, which is known for its deft handling of consumers. Rather than deploying an army of relatively expensive salesmen, which has burdened many other firms with a huge overhead, the Cigna joint venture has instead deployed innovative marketing, call centers equipped with the latest data-mining techniques, television commercials featuring a movie star pitchman, and online and social media sales to gain a growing foothold in the Chinese market. Last year Cigna's joint venture in China had revenues of $331 million, up 32% from the year before (though still a small fraction of the company's overall $29 billion in sales). After a decade of operation, the firm just sold its 1 millionth policy in China. The business broke even after just three years and is now solidly in the black.

Lines still snake through Shanghai's Huashan Hospital, a guibin texu (translation: VIP hospital).

Cigna's early success in China sets the company up to capitalize on a confluence of forces reshaping the nation, starting with the rise of private hospitals and clinics as a key pillar in Beijing's evolving efforts to provide health care to 1.3 billion people. These VIP institutions target China's rising middle class and wealthy, a group whose affluence will -- and this may seem counterintuitive -- actually create more demand for health care and insurance. They will live longer, requiring special care and treatments for diseases common among the elderly; their diets will change (not necessarily for the better); and they'll insist on drugs and medicines that previously had not been prescribed because of costs.

Ana Gupte, an analyst at Bernstein Research, says spending on health care in China is expected to more than triple, to $648 billion in 2015 from $182 billion in 2008. She reckons that the market for health insurance in China will reach $15 billion in 2015, and that Cigna's revenues there could approach $1 billion a year, nearly a third of what the company now earns from its international business. "China is the fastest growing asset in our international portfolio," says David Cordani, Cigna's CEO, during a visit to Shanghai. "Over a five- to 10-year horizon, China will become the critical part of our business portfolio because we will bring multiple products and services to the market, both for the individual and the emerging employer landscape here. It's an exciting part of our future."

Continue reading here:

Cigna's unlikely partnership to change Chinese health care

By Charles P. Wallace

Ma Weihua, CEO of China Merchants Bank, and Cigna CEO David Cordani in China last year.

FORTUNE -- (SHANGHAI) By 8 a.m., Renji Hospital, founded in 1848 by Western missionaries and still one of China's best medical centers, is already in a state of chaos. A veritable sea of patients is crammed into the reception area, waiting impatiently to see a doctor. They first line up under giant neon boards that list physicians' specialties to collect a number on a waiting list, then join another snaking line at a cashier's window, and finally shuffle into even longer queues to wait for a doctor to see them in examination rooms with chipping paint. This scene is played out daily across China, which has a limited primary health care system. Medical services are cheap but rudimentary: If you have any malady, from a bad cold to cancer, you must go to the emergency room to seek medical treatment.

But in a modern building less than 100 yards from the main Renji emergency ward is a glimpse at China's future. It is the guibin texu, known more commonly by its English translation: VIP hospital. In the VIP building, patients don't line up but wait for appointments on leather sofas, entertained by widescreen TVs. Instead of the shouting heard at Renji's main hospital, the noise level in the VIP section remains an understated murmur. Patients are escorted into private examination rooms by nurses in crisp white uniforms. The specialists who are so very hard to see at Renji are now suddenly available by appointment -- for a price. The physicians at the VIP hospital charge $60 or more for a consultation, 50 times what patients pay across the road.

MORE:China - a nation on the move

To help pay for such VIP treatment (and treatments), a growing number of Chinese consumers are turning to supplemental health insurance -- a thoroughly American concept. The irony is that despite soaring demand for various financial services, foreign firms have just 2% of the banking and insurance market, according to McKinsey & Co. State-owned insurance companies dominate the market to such extent that last year New York Life abandoned its China joint venture, selling out to Japanese firm Mitsui Sumitomo Insurance because of slumping earnings.

But one U.S. firm, Bloomfield, Conn.-based Cigna (CI), is quietly winning over Chinese consumers, largely by defying conventional wisdom about how an American insurer should operate in China. Cigna entered the China market in 2003, partnering not with a local insurer but with a leading retail lender, China Merchants Bank, which is known for its deft handling of consumers. Rather than deploying an army of relatively expensive salesmen, which has burdened many other firms with a huge overhead, the Cigna joint venture has instead deployed innovative marketing, call centers equipped with the latest data-mining techniques, television commercials featuring a movie star pitchman, and online and social media sales to gain a growing foothold in the Chinese market. Last year Cigna's joint venture in China had revenues of $331 million, up 32% from the year before (though still a small fraction of the company's overall $29 billion in sales). After a decade of operation, the firm just sold its 1 millionth policy in China. The business broke even after just three years and is now solidly in the black.

Lines still snake through Shanghai's Huashan Hospital, a guibin texu (translation: VIP hospital).

Cigna's early success in China sets the company up to capitalize on a confluence of forces reshaping the nation, starting with the rise of private hospitals and clinics as a key pillar in Beijing's evolving efforts to provide health care to 1.3 billion people. These VIP institutions target China's rising middle class and wealthy, a group whose affluence will -- and this may seem counterintuitive -- actually create more demand for health care and insurance. They will live longer, requiring special care and treatments for diseases common among the elderly; their diets will change (not necessarily for the better); and they'll insist on drugs and medicines that previously had not been prescribed because of costs.

Ana Gupte, an analyst at Bernstein Research, says spending on health care in China is expected to more than triple, to $648 billion in 2015 from $182 billion in 2008. She reckons that the market for health insurance in China will reach $15 billion in 2015, and that Cigna's revenues there could approach $1 billion a year, nearly a third of what the company now earns from its international business. "China is the fastest growing asset in our international portfolio," says David Cordani, Cigna's CEO, during a visit to Shanghai. "Over a five- to 10-year horizon, China will become the critical part of our business portfolio because we will bring multiple products and services to the market, both for the individual and the emerging employer landscape here. It's an exciting part of our future."

Excerpt from:

Cigna moves to shake up Chinese health care

By Charles P. Wallace

Ma Weihua, CEO of China Merchants Bank, and Cigna CEO David Cordani in China last year.

FORTUNE -- (SHANGHAI) By 8 a.m., Renji Hospital, founded in 1848 by Western missionaries and still one of China's best medical centers, is already in a state of chaos. A veritable sea of patients is crammed into the reception area, waiting impatiently to see a doctor. They first line up under giant neon boards that list physicians' specialties to collect a number on a waiting list, then join another snaking line at a cashier's window, and finally shuffle into even longer queues to wait for a doctor to see them in examination rooms with chipping paint. This scene is played out daily across China, which has a limited primary health care system. Medical services are cheap but rudimentary: If you have any malady, from a bad cold to cancer, you must go to the emergency room to seek medical treatment.

But in a modern building less than 100 yards from the main Renji emergency ward is a glimpse at China's future. It is the guibin texu, known more commonly by its English translation: VIP hospital. In the VIP building, patients don't line up but wait for appointments on leather sofas, entertained by widescreen TVs. Instead of the shouting heard at Renji's main hospital, the noise level in the VIP section remains an understated murmur. Patients are escorted into private examination rooms by nurses in crisp white uniforms. The specialists who are so very hard to see at Renji are now suddenly available by appointment -- for a price. The physicians at the VIP hospital charge $60 or more for a consultation, 50 times what patients pay across the road.

MORE:China - a nation on the move

To help pay for such VIP treatment (and treatments), a growing number of Chinese consumers are turning to supplemental health insurance -- a thoroughly American concept. The irony is that despite soaring demand for various financial services, foreign firms have just 2% of the banking and insurance market, according to McKinsey & Co. State-owned insurance companies dominate the market to such extent that last year New York Life abandoned its China joint venture, selling out to Japanese firm Mitsui Sumitomo Insurance because of slumping earnings.

But one U.S. firm, Bloomfield, Conn.-based Cigna (CI), is quietly winning over Chinese consumers, largely by defying conventional wisdom about how an American insurer should operate in China. Cigna entered the China market in 2003, partnering not with a local insurer but with a leading retail lender, China Merchants Bank, which is known for its deft handling of consumers. Rather than deploying an army of relatively expensive salesmen, which has burdened many other firms with a huge overhead, the Cigna joint venture has instead deployed innovative marketing, call centers equipped with the latest data-mining techniques, television commercials featuring a movie star pitchman, and online and social media sales to gain a growing foothold in the Chinese market. Last year Cigna's joint venture in China had revenues of $331 million, up 32% from the year before (though still a small fraction of the company's overall $29 billion in sales). After a decade of operation, the firm just sold its 1 millionth policy in China. The business broke even after just three years and is now solidly in the black.

Lines still snake through Shanghai's Huashan Hospital, a guibin texu (translation: VIP hospital).

Cigna's early success in China sets the company up to capitalize on a confluence of forces reshaping the nation, starting with the rise of private hospitals and clinics as a key pillar in Beijing's evolving efforts to provide health care to 1.3 billion people. These VIP institutions target China's rising middle class and wealthy, a group whose affluence will -- and this may seem counterintuitive -- actually create more demand for health care and insurance. They will live longer, requiring special care and treatments for diseases common among the elderly; their diets will change (not necessarily for the better); and they'll insist on drugs and medicines that previously had not been prescribed because of costs.

Ana Gupte, an analyst at Bernstein Research, says spending on health care in China is expected to more than triple, to $648 billion in 2015 from $182 billion in 2008. She reckons that the market for health insurance in China will reach $15 billion in 2015, and that Cigna's revenues there could approach $1 billion a year, nearly a third of what the company now earns from its international business. "China is the fastest growing asset in our international portfolio," says David Cordani, Cigna's CEO, during a visit to Shanghai. "Over a five- to 10-year horizon, China will become the critical part of our business portfolio because we will bring multiple products and services to the market, both for the individual and the emerging employer landscape here. It's an exciting part of our future."

Read more:

Cigna's unlikely to change Chinese health care

The real health care battle in this country isn't the one being fought over the bill everyone now calls "Obamacare." In fact, it's not a battle between Republicans and Democrats at all. Therealbattle is the one millions of Americans face every day as they struggle to pay medical bills that now average nearly $10,000 per year -- if they're "lucky."

The United States is now the only developed nation on Earth where the average family with insurance pays more for health care than it does for groceries. That includes both the family share of premiums and out-of-pocket costs for medical treatment. In fact, those out-of-pockets costs alone exceed a family's average yearly cost for gasoline, according to a new study.

That study found that the average household medical bill for a family of four with "good" PPO coverage is nearly now $9,144 per year. That's a crippling and unsustainable expense for most family budgets, a burden which is crippling the economy and ruining lives.

This struggle seems to have been forgotten in all the back-and-forth over Obamacare. Who's fighting for these American households as they wage their losing battle against health care costs?

The wrong argument.

Certainly not the Republicans. They've offered no alternative vision except that of unrestrained greed, a 'free-market' health care jungle red in tooth and claw.

For their part, too many Democrats and liberals have concentrated on defending the Affordable Care Act. Sure, that bill has some good features: It's a good thing that young people can now access their parents' health care coverage until they're twenty-six, and that people with pre-existing conditions are no longer excluded from coverage, and we should say so. And the ACA may help to slow the rate of health care cost increases.

But those costs are already unacceptably - and unsustainably - high. Medical costs are a heavy burden for many people. More attention must be paid to outlining the vision of a better health system which improves life for all Americans.

Premature exhilaration.

Many of the ACA bill's defenders took a victory lap over last week's rate announcement from California's health exchanges. "Obamacare Will Be A Debacle -- For Republicans," wrote Paul Krugman. California's rates were "very good news" for the law, wroteEzra Klein and Evan Soltas.Matt Yglesiassaid California's results were "evidence" that "fundamentally (the bill's) implementation is going to work out great, and people are going to love it."

Read more:

Richard (RJ) Eskow: Health Care's Forgotten Crisis, Part 1: Families Can't Afford Medical Care.

>>> with months to go before open enrollment begins for obamacare, there's good news for the white house coming out of california. the state has revealed the prices for the health care plan under the affordable care act and the rates are lower than previously expected. however, the president's signature piece of legislation still faces an uphill battle when it comes to winning over voters. a new cnn poll finds 54% of americans are opposed to the law. that number is relatively unchanged since the bill was signed into law three years ago. 35% oppose the law because it is too liberal while 16% say it's not liberal enough. meanwhile, if you already have insurance through your employer, you may still feel the effects of obamacare. the "new york times" reports many companies are looking to avoid the so-called cadillac tax which penalizes companies that offer high-end health care plans to the employees. some employers looking to cut back on costs, meaning some of the more generous health care perks you enjoyed may be a thing of the past. the burden of making sure the affordable care act has a smooth rollout falls on the shoulders of secretary health and human services kathleen sebelius . the hill says several democrats are already concerned over sebelius' handling of the bill since it became a law three years ago. acknowledging any missteps could tip the scales of the 2013 midterm elections in favor of the gop.

>> john heilemann, i'm sure you're hearing it all the time. i heard it, max baucus came in, talked to us before he retired. said there was the number one concern next year, implementation of obama care. they don't think they're up to it. they think the law of unintended consequences is going to blow up in the democrats' face. what do you think?

>> well, i think it's absolutely obviously a political concern for democrats. because this law has not -- almost, most of the provisions have not gone into effect. so most people don't understand what it is and we still don't know what the economic consequences are going to be. there's the level of uncertainty still hangs over it and the politics of it were miserable for the administration throughout its passage. until people start to feel in a significant way the benefits of the law, whatever benefits those are, the political support for it is going to remain tenuous. and so in this period of transition into the law, it remains politically vulnerable.

>> it is interesting that 16%, willie , actually wanted to be more liberal. you look at those numbers. there are a lot of times during the vietnam war where a majority of people in america disapproved of the handling of vietnam and it was america 's most unpopular war. well, a big chunk of those people wanted us to be more aggressive, more engaged in vietnam. you've got the opposite case here.

>> it's interesting if you look at that number 54% oppose the affordable care act according to the cnn poll. i wonder how much people understand to begin with about obama care. if you ask anybody in this room what are the particulars of obama care, i'd be shocked if anyone could tell you exactly what it means next year.

>> no, absolutely. the difference between this and, say, the prescription drug benefit under medicare that was passed under bush is everybody basically understood, all seniors did that you can sign up with an insurance company and get drug coverage. and when you look back on that, there was a lot more money appropriated by congress to implement a much more simple proposal than obama care. and i think the way they organized obama care, the president and this plan are at the mercy of the states. and where you have governors who really want to implement it, california's a good case, colorado, oregon, washington , my hunch is the implementation is going to go well. but in states where republican governors are very hostile to it, it may not go very well. and yet the president's going to be on the hook for that. so it's going to be complicated.

>> it is going to be complicated. it's also going to get really complicated. stories coming out in the "new york times" that i don't really -- i'm having a hard time getting my arms around as far as intel, political intel. we're going to talk about that in one minute.

>> political intelligence firms. that was in the washington post yesterday.

>> where the white house preps hedge funds on certain items. we're going to talk about that in one minute. first, some news over the weekend that --

>> yes.

Continued here:

‘Cadillac tax’ takes toll on employer health care plans

Dr. Benjamin Carson Responds To IRS Scandal Agency #39;s Role In Health Care Law - Obamacare - 5/23/13
(May 23, 2013) - Dr. Benjamin Carson Responds To IRS Scandal Agency #39;s Role In Health Care Law - Obamacare - Neil Cavuto.

By: MichaelSavage4Prez - Politics and More...

Excerpt from:

Dr. Benjamin Carson Responds To IRS Scandal

Dr Jennifer Daniels M.D. on the U.S. Health Care System
This piece was done by http://timeoutmultimedia.com for the Paul Revere, film contest entry DNA SUPER SCIENCE at Infowars.com sponsored by http://vitalitycap...

By: Ania Rodriguez

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Dr Jennifer Daniels M.D. on the U.S. Health Care System - Video

AUGUSTA, Maine The Dirigo Health insurance program, established with great fanfare a decade ago as a nationally pioneering program to cover the uninsured, is phasing out of business.

Once seen as a leap toward universal health care in Maine, Dirigo was a centerpiece of former governor John Baldaccis agenda and was created with bipartisan support.

But the program bumped and lurched on unstable financial underpinnings and never lived up to its full expectations. In 2010, as Republicans gained control of state government, detractors vowed that Dirigo will be diri-gone. They kept their promise and voted to end the program at 2013s end. Full story for BostonGlobe.com subscribers.

Copyright 2013 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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Maine health care agency to phase out of business

If you are anything like me, you have spent the last 10 days listening to President Barack Obama and his Republican challengers accuse each other of being the meanest miser when it comes to denying health care to seniors. Unless you are an actuary or have a fondness for, and facility with, budget math, you were probably left wondering what and whom to believe.

Thats the good news. The bad news is, nothing that has been enacted (the Patient Protection and Affordable Care Act of 2010) or proposed (Republican Representative Paul Ryans Path to Prosperity) addresses the fundamental problem plaguing the U.S. health-care system: It is designed to manage disease rather than promote wellness.

Where do Middle East potentates go when they get sick? The U.S., of course. This country has the highest success rates when it comes to treating disease.

Americas life-expectancy rates, on the other hand, pale in comparison with other developed and developing nations, even though the U.S. outspends them by a huge margin (see below). Imagine what the U.S. could do if it harnessed its resources and talent and focused on disease prevention.

Some communities have already taken the initiative, creating accountable care organizations (ACOs) that use an integrated model for patient care. Cheshire Medical Center/Dartmouth-Hitchcock Keene, for example, introduced Vision 2020 in 2006 with the goal of making Cheshire County, New Hampshire, the U.S.s healthiest community. Cheshire is one of 32 pioneer ACOs selected to test new models of health-care delivery and payment -- paying for results, not volume -- as provided in the Affordable Care Act. Medicare will eventually pay ACOs a lump sum per patient, allowing providers to share in any cost savings compared with traditional fee-for-service plans.

The challenge of saving Medicare from insolvency in 2024 would be easier if seniors had lived healthier lives. It would be a lot easier if the system corrected the perverse economic incentives that reward doctors for unnecessary procedures.

Nothing changes until the people giving the care change the care, says Don Berwick, administrator of the Centers for Medicare and Medicaid Services from 2010 to 2011. That requires redesigning the way care is given into an integrated system, with primary care as the base.

That point is hammered home in an independent film, Escape Fire: The Fight to Rescue American Healthcare, directed by Matthew Heineman and Susan Froemke, an official selection at the 2012 Sundance Film Festival. The documentary combines facts and figures with personal stories from doctors and patients, and innovative ideas from leaders trying to transform the industry.

The film title is a story in itself. It comes from a 1999 speech that Berwick gave at the Institute for Healthcare Improvement, a nonprofit organization in Cambridge, Massachusetts, where he was president. In it, he compares saving the U.S. health-care system to what has become standard practice for fighting forest fires: intentionally setting fire to an area to divert an oncoming blaze. This is known as an escape fire.

The analogy to health care? An out-of-control menace for which there are simple, not easy, solutions.

Read more here:

Diving Into Health Care Is Dangerous to My Health

Nurse practitioner Julie Dance closed her midwife practice and joined Women's Health Specialists in April. With the move, Dance will continue to offer midwifery care as well as obstetrics and gynecology.

After owning and operating his own practice since March 2010, Dr. Robert Barnett is also joining Women's Health Specialists, located at 2911 S. 8th Ave., in June. He, too, is returning to full scope obstetrical and gynecological care.

Dance and Barnett are part of a trend that has doctors closing their small, independent practices and consolidating offices with other health-care practitioners.

They aren't alone. In 2000, 57 percent of America's physicians were independent. By 2013, just 33 percent are, according to the American Enterprise Institute.

In addition, the number of independent physicians will decline by 5 percent a year starting in 2013, reports Accenture Health, a consulting firm.

Why is this happening?

Many say the Patient Protection and Affordable Care Act (PPACA), commonly called Obamacare, is driving the trend.

It's all about the PPACA, or Obamacare. It has so many complexities, said Wendy Steward, Women's Health Specialists administrator.

The law includes changes in privacy, coding and billing requirements. New regulations even require new terminology.

It's one of the most complex things I've ever heard of. It's changing the payment mechanism, it's changing everything we know about health care, Stewart explained.

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Health care consolidation

Ed note: First in an occasional series of reports leading up to the special election June 18.

By SARA KENNEDY

skennedy@bradenton.com

MANATEE -- The year was 1983 and the chief of the medical staff at Manatee Memorial Hospital was applying for staff privileges at a competing hospital.

His doctors were fleeing Manatee Memorial, which was running low on patients. They preferred what is now called Blake Medical Center, a newer hospital.

Bradenton's publicly owned hospital needed renovation, and the county didn't have the money, so officials began looking for a buyer.

They found a suitor in nonprofit Baptist Hospitals and Health Systems, of Phoenix, which in 1984 paid $44,264,075 for the venerable hospital located at U.S. Highway 301 and Manatee Avenue.

The money from the sale went into a health care trust fund.

Up to 75 percent of the interest earned on proceeds from the sale, or $3,576,789 in the first year, went toward health care for indigent patients.

The remaining interest was to be put back into the fund used for other health-related programs. By 2002, the fund balance had risen to a high of $61 million, according to a county spreadsheet charting the health care trust fund's entire 29-year history.

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Manatee indigent health care trust fund: wisely spent or squandered?

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May 24, 2013 - 01:39 PM

If all goes according to plan, Federal Way's health care sector could significantly grow again this year.

Two unnamed health care providers are scheduled to move into some of Federal Way's vacant office space, according to Patrick Doherty, director of Community and Economic Development for the City of Federal Way.

"Once we get those, we will have quite a list of newcomers," he said, adding that the city has decreased its vacant space, though it's still around 600,000 square feet. Doherty said that "it's great to see the buildings fill up" whether or not the tenants are health care-related, but he also added that City has also actively been encouraging the formation and growth of a health care cluster.

"We didn't create it or anything," he said. "If a certain number of health care providers, or any other industry, start to cluster in your community, you go out and find out why and try to support and grow that cluster."

Doherty was tight-lipped about the potential new health care tenants, but did reveal that a major regional medical center in the area is looking to open a clinic in Federal Way, and that a physician group is in final lease negotiations on a building.

While nothing's been finalized, Doherty said after the two openings are announced the city will likely start advertising directly to health care employers in an effort to grow this emerging cluster.

"Health care (businesses) specifically provide good jobs," Doherty said. "From very skilled all the way down to service jobs, it's a good range of jobs for people in the community."

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Health care providers set to move into FW