For most people in the health policy community, the word “coverage” carries a certain emotional power. People without health insurance coverage, we believe, are one bad break away from disability and destitution. Hence, many politicians, researchers, and activists believe that expanding coverage is more important than any other policy goal. But not all health insurance is created equal. Indeed ...
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The United States, four years after the devastating collapses of the real estate and financial sectors, shoulders a national debt of $16 trillion, maneuvers through vast changes in the health-care system and braces for possible changes to safety-net entitlement programs.
Against this backdrop, Virginia Foxx, a four-term Republican incumbent in northwestern North Carolinas 5th Congressional District, and her Democratic opponent, Elisabeth Motsinger, a member of the Winston-Salem/Forsyth County Board of Education, seek to deal with those national issues, among others.
Last week, in separate interviews, they answered questions about five key national issues, including military spending, the Affordable Care Act and illegal immigration.
Entitlements
Programs such as Medicare and Social Security should be strengthened and preserved so that they may continue to benefit future generations, Foxx said in an email.
Motsinger gave a similar response.
But they have different views on how these programs should be preserved.
Motsinger opposes proposed reforms that have in the past been favored by Foxx and recommended by Rep. Paul Ryan, R-Wis., the GOP vice presidential candidate and chairman of the U.S. House Budget Committee.
Ryan, in 2005, recommended a plan that would offer a privatization option for Social Security for younger people, and the 2010 budget he proposed had a privatization option, though his latest plan does not, according to an analysis by The Washington Post.
Motsinger said she is opposed to privatizing Social Security or creating individual accounts.
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Nonprofit health plans are leading the pack in the annual health plan rankings from the National Committee for Quality Assurance, which Consumer Reports recently published.
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John Crudele
DEAR JOHN...THE ANSWER MAN
Dear John: I am a registered nurse who has been working in a major trauma center in New York City for the past 20 years.
I have a son who is 22 years old and does not have a job that provides health insurance. Before he was covered on my plan (under ObamaCare) we had to pay out of pocket for doctor visits.
The doctor visits are $150, and the procedures are more. We found it hard to pay the $150. I prayed every day that he was not a victim of trauma because where would we come up with the money to pay the hospital?
I would have to sell my house.
When is the right time for ObamaCare? Ever since I could remember, both Republican and Democratic presidents have promised some type of universal health care, and nothing has materialized.
I understand that the new health- care bill is not perfect, but we need to start somewhere.
Too many people are uninsured and are not getting medical care. And when they get medical care, the bill is never paid.
When the president, congressmen and senators get sick, they have access to the best health care in America.
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A 59-cent sterilizing sponge and an additional minute to draw each patients blood have helped Memorial Medical Center save at least $2 million in health-care costs over the past two years.
More important, the modification Memorial adopted for testing patients blood for dangerous infections such as sepsis has meant quicker and more appropriate medical responses to those infections. Patients have suffered less as a result, and its likely that some lives have been saved, Memorial officials say.
Its provided physicians with the right information sooner, said David Neff, a Memorial project leader for operations improvement.
The effort to hone in on certain types of blood tests to make them more accurate the first time around is one of dozens of projects the Springfield hospital has undertaken to improve care at a time when the federal government and private insurers are starting to reward hospitals for quality rather than quantity.
Memorial recently learned it performed well in the first year of one of the first large pay-for-performance programs set in motion by the federal Affordable Care Act. The hospital also expects to receive a financial bonus in December through another such incentive in the health-reform law.
Readmissions low
Memorial was one of 17 hospitals in Illinois, out of about 130 ranked, that will receive no financial penalty over the next 12 months based on readmission rates for patients treated for heart attack, congestive heart failure or pneumonia.
Weve been working hard on this, and we track this, and weve done a number of initiatives, so we were certainly gratified to have this result, said Charles Callahan, vice president for quality and operations at Memorials parent organization, Memorial Health System.
Readmissions are one focus of the governments health-care reform efforts because they often result from uncoordinated care, both inside the hospital and after a patient is discharged. Almost one in five Medicare patients return to the hospital within a month, and until now, hospitals have been financially rewarded for that with additional Medicare payments.
Memorial could have faced a penalty of up to 1 percent of its base Medicare rates, or about $1 million annually, based on the percentage of patients readmitted within 30 days of discharge, with adjustments made for patients age, gender and medical history. The not-for-profit institution annually posts about $480 million in patient-service revenues; about $192 million of those revenues come from Medicare.
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Memorial works on efficiency to improve care, avoid health-reform penalties
Voters at a recent rally for Republican presidential candidate Mitt Romney cited not just disagreement, but outright fear of the new health-care law.
I dont think theres going to be enough money, said Karen Albright, a nurse from Parker, on a warm autumn evening waiting in line to hear the candidate. I expect rationing. They will say you are too old.
Armeda Freel, who traveled from Scottsbluff, Neb., to a rally in Lakewood, is on Medicare, the government health-insurance program for people 65 and older. She said she hurried to have surgery on the carpal tunnel problem in her hands this year because she fears it would be denied after the health-care law takes full effect in 2014.
I thought there was a chance they would say, Live with the numbness. Youre not going to die. Freel said.
Charles Patricoff, also in line, looked tanned, strong and younger than his 60 years, yet said he had suffered a major heart attack just three months earlier. He believes he might have been denied treatment under the new law.
They might have looked at me and my age, and said, Youve lived a full life. he said.
Romney and most Republican congressional candidates have promised to overturn the health-care law if they are elected. The law, passed in 2010, was upheld by the U.S. Supreme Court in June. If left intact, it will go into effect in 2014.
Colorado Public News asked two leading physicians in Colorado on opposite sides of the political fence whether these fears of the federal government interfering with treatment of their patients were justified. The answers were enlightening, and very different.
Dr. William G. Plested, president of the American Medical Association from 2006 to 2007, retired as a thoracic and cardiovascular surgeon in Santa Monica, Calif., to Bayfield. He is a severe critic of the health-care law.
In stark contrast is Dr. John Bender, president-elect of the Colorado Medical Society and a family medicine doctor with Miramont Family Medicine in Fort Collins. He does not see anything in the health law that would cause interference in the daily practice of medicine.
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Health care reform is a key issue in the November presidential election. We asked readers what they think it should look like.
Cady Gebhardt, 22, Dayton
I would like to see people who need health care be able to get it. But the people who dont need it shouldnt have to buy it. I dont feel like I need it, so I dont want to have to buy it, and I dont want to be taxed for it.
Jared Stephens, 23, Dayton
For the most part, I definitely agree with Obamas health care plan, but there should be more of an option in it, with different levels so that if Im making this much, this is the health care you get, so people at the younger end of the spectrum, who dont need all that health care, theyre not paying as much if theyre not earning as much. They should tailor it per the generations.
Colleen Wells, 63, Springboro
What I know about Obamacare scares me to death. I think theres a happy medium between Obamacare and what we need. I cant believe no one can figure it out. I dont think its fair theyre burdening small businesses with health care. Its keeping my son, who owns a small business, from wanting to hire more people because he doesnt know what hes going to be taxed with.
Asia White, 26, Dayton
As a single parent who works part-time, I qualify for Medicaid. It does play a major role for me. As long as the Democratic Party continues to see fit that low-income families can afford health care, then Im definitely for that. If the other party would make known that it has a better option, Id be forced to weigh my options. If I was middle class, then I could afford to have a different option, but right now, I cant.
Beverly Rowell, 49, Dayton
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DECATUR Iris Lewis-Beasley knows all too well about the importance of health care.
Beasley, a trust administrative officer at Hickory Point Bank and Trust in Decatur, has had multiple surgeries on her knee, ankle and thumb after being involved in several car accidents.
Her daughter, Ilaina, recently had to have a benign tumor surgically removed after several visits to specialists.
But it was her experience with her 3-month-old-son in the mid-1990s that shaped Lewis-Beasleys views on health care.
What people care about this election season is the focus of a month-long series by Lee Enterprises reporters, who spent recent weeks talking to Central Illinois residents about what they want to see addressed by the presidential candidates. Lingering worries about health care, for instance, center on people concerned about both the availability and cost of appropriate care.
Lewis-Beasley was a teen in 1995 when she gave birth to her son, Caylin. Without access to quality health care, she received a medical card and relied on lesser care.
Caylin developed beta strep soon after being born, but the disease was not diagnosed or treated. It developed into meningitis and three months after he was born, Caylin was dead.
At that point in my life, I vowed never to be put back in that situation where I didnt have medical insurance again and that Id have to be dependent on the coverage you may or may not get because you dont have good insurance, Lewis-Beasley said.
Because of his death, Lewis-Beasley believes health care needs to change and focus on helping those in the community less fortunate than others.
I really worry about those people who are already in a high-risk situation, she said.
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Access to affordable, quality health care has Central Illinoisians concerned
In the first presidential debate of this election, held recently in Denver, the court of popular opinion tagged Republican candidate Mitt Romney as the decisive winner.
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The signature achievement of President Barack Obamas term could be out the door if Mitt Romney wins in November, but the debate over the future of health care in America will continue and possibly dominate the next term no matter who gets elected.
The candidates competing visions could scarcely be more dissimilar, even though Obamas Affordable Care Act was closely modeled after the health care plan Romney signed into law while governor of Massachusetts.
If President Barack Obama wins re-election, he can be expected to fully phase in the 2010 law which is designed to extend health coverage to millions of Americans without insurance. And he likely will retain the basic structures of Medicare and Medicaid, the Great Society programs that provide health coverage to the elderly and the poor respectively.
Should Romney win the presidency, count him on him to try to repeal the 2010 law which has earned the nickname Obamacare, while launching a sweeping transformation of Medicare and Medicaid.
The competing roads on dealing with the millions of Americans without health insurance while simultaneously trying to restrain the growth of federal health programs has been a dominant dispute in a testy presidential race that is sure to get testier in the coming weeks.
During the first presidential debate this month in Denver, Obama complained that Romney wants to replace the 2010 health law but he hasnt described what exactly wed replace it with other than saying were going to leave it to the states.
By contrast, Romney argues that the health law has discouraged small companies from hiring people. During the same debate, he assailed Obama for spending his energy and passion during his first two years in office fighting for Obamacare instead of fighting for jobs for the American people. It has killed jobs.
No matter who wins the election, the grim reality of Americas health care system is not going to vanish. Even under Obamas health law, as many as 20 million Americans will still lack health coverage. If Romney either persuades Congress to repeal the law or allows states to ignore it, some predict that the number of uninsured people could climb to nearly 50 million.
In addition, the crushing costs borne by the federal government to finance Medicare and Medicaid only will grow more burdensome. The non-partisan Congressional Budget Office projects that combined federal spending on Medicare and Medicaid will increase from $822 billion this year to more than $1.6 trillion by 2022.
By contrast, the CBO calculates that by 2022, the government will spend just $647 billion on domestic discretionary programs such as housing, education, and transportation. In essence, the government will be devoting more financial resources to the elderly as opposed to the young.
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12-10-2012 17:34 New stadium, new health care rates for Purdue
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A former executive with a Topeka-based non-profit corporation has pleaded guilty to scheming to steal more than $2 million in Medicaid funds
From about 2007 to 2011, Sellers was involved with several Topeka area sports teams. In addition to billing Kansas Health Solutions for sports equipment and uniforms for sports teams, Sellers used some of the stolen money to build and furnish a $375,000, 3,755-sq. ft. home on 11 acres in Lyndon, Kansas.
Medicaid funds are state and federal money that were administered in Kansas by the Kansas Health Policy Authority and the Kansas Department of Health And Environment, Division of Healthcare Finance. In order to manage community-based mental health services for Medicaid recipients, Kansas Medicaid contracted with Kansas Health Solutions in Topeka. Kansas Health Solutions was responsible for overseeing a provider network that provided all community-based health services covered under the contract with Kansas Medicaid.
Sentencing is set for January 17. The parties are recommending a sentence of three years in federal prison and restitution of more than $2 million.
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Barack Obama wins three to one against Mitt Romney among those voters who say that health care is their primary concern, researchers at the Harvard School of Public Health learned. Overall, with voters ranking health care as the second most important factor in determining their presidential choice for the first time since 1992, Obamas lead among that category of voters may prove significant.
With the passage of the Affordable Care Act, weve started a debate about one of the biggest pieces of health care legislation in U.S. history, said Robert J. Blendon, a School of Public Health professor who authored the study. Because its so large and so controversial, it really has become a voting issue.
Controversy over Obamas 2010 health care legislation, combined with campaign trail talk about Medicare policy, shifted voters attention to the issue of health care, Blendon said.
With Romney pledging to repeal Obamas Affordable Care Act and to follow his vice presidential candidate Paul D. Ryans plan to offer seniors a fixed voucher for either private insurance or Medicare, the divide between the candidates positions on health care seems stark.
Suddenly, you have two candidates representing vastly different policies on different elements of health care, and voters are taking notice and beginning to choose sides. Three times to one, that side was with Obama, Blendon said.
John M. Benson, a research scientist at the School of Public Health, said, We are always interested in what role health care has in the election. We wanted to, in this case, look at the issues that have been in the campaign, which would be the ACA, Ryans Medicare proposal, block grants for Medicaid, and more restrictions on abortionthe big four health care issues...and to look at the people who said health care and Medicare specifically was going to alter their vote.
To measure the significance of issues to the voters, Benson, Blendon, and their colleagues gathered polling data from citizens nationwide. After determining that a subject was registered and planning to vote in the 2012 election, poll administrators presented subjects with a list of issues: the economy and jobs, health care and Medicare, federal budget deficit and taxes, abortion, the war in Afghanistan, and immigration. They asked, What is your single top issue when it comes to your choice of a presidential candidate?
For 51 percent of the respondents, the economy and jobs was the most important issue. Health care and Medicare beat out the other options with 20 percent of votes.
Those who selected health care as their top issue were then presented with sets of issues that presidential candidates are talking about regarding nationwide health care and the candidates respective stances. Participants chose the specific decisions important to them.
The last time health care ranked as so many voters main concern was 20 years ago, when former President Bill Clinton ran in 1992 on implementing nationwide health insurance.
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HSPH Study Suggests Health Care is a Deciding Factor for Voters
Poor Mitt Romney. In trying to be all things to all people on health care, he's found himself stuck in a time warp.
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By Rich Scinto, Register Staff rscinto@newhavenregister.com / Twitter: @rscinto_nhr
Healthbridge and CareOne jointly filed a RICO lawsuit against two Service Employees International Union affiliates just days before the union strike at five Connecticut nursing homes, including one in Milford, reaches its 100th day.
The companies claim United Healthcare Workers East, SEIU 1199 and New England Health Care Employees Union, District 1119 have engaged in a long-term pattern of sabotage, intimidation and other acts of extortion, according to a release from CareOne Management.
The nursing homes are in Danbury, Newington Stamford, Milford and Westport. About 700 strikers took to the picket lines in July to protest what they say are imposed labor concessions.
District 1199 representatives said the lawsuit is another desperate attack on union members.
The announcement of HealthBridges lawsuit against its own employees is just the latest in a series of aggressive actions by the company that has no basis in either fact or law, said David Pickus, president of SEIU District 1199 in a statement. HealthBridge has repeatedly filed charges at the labor board against the union that were then quietly withdrawn or dismissed.
The Racketeer Influenced and Corrupt Organizations (RICO) Statute is a federal law enacted in 1970 as part of the Organized Crime Control Act.
It doesnt necessarily apply only to organized crime, but thats certainly the paradigm, said W. John Thomas, a professor in the School of Law at Quinnipiac University who specializes in health policy law.
Thomas said that RICO lawsuits arent unheard of in similar situations.
Its certainly an extreme tactic, Thomas said. Ive never seen it used successfully in this type of situation.
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As we approach the presidential election in November, Weekend Edition is seeking your questions about issues and candidates in a new segment called Reporter Hotline. This week, we answer inquiries about health care.
Question from Bob Dunne of Cedar Park, Texas: "Why do you have to work to maintain health insurance? In other words, I know many people who won't quit their jobs because they're not working for the salary; they're working for the health insurance."
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Answer from NPR's Julie Rovner: "Well, you have to go back to World War II the U.S. had wage and price controls, but also a labor shortage because so many men were part of the war effort. So one of the ways employers started to differentiate themselves was by boosting benefits, and health insurance was one of those benefits they started offering. After the war, there was a huge boom in hospital building, so it made sense for more people to have hospital insurance, and our system kind of grew up as an employer-based one.
"By the time health care got so expensive that insurance was a real necessity rather than something that was just a nice fringe benefit, which was around the 1970s really we as a country were sort of settled into the idea of having that employer-based system. In fact, it was President Richard Nixon who first proposed the idea of getting everyone covered by requiring all employers to provide health insurance to their workers. That came in response to the Democrats' proposal of that same era to have a tax-funded insurance plan for everyone.
"Later on, the Democrats would pick up Nixon's idea and propose that so-called employer mandate. In response, Republicans came up with the idea of requiring individuals to have their own coverage, which is of course what ended up passing first in Massachusetts under then-Gov. Mitt Romney, and then in the Affordable Care Act, which we have today."
Question from Majal Perry of Monterey, Ky.: "I really want to know what each candidate's health care solution would specifically mean for me and other women like me, who are in their mid-20s, working, but low- to lower-mid-income and without insurance. How would their plans cover me should I ever choose to have children?"
Answer from Rovner: "Well, you're one of those people who would likely face a very stark difference between the two candidates' plans. Under the Affordable Care Act, starting in 2014, you'll likely be able to afford your own insurance through one of the health care exchanges, and you'll probably qualify for a subsidy. Insurance companies also won't be able to charge you more because you're a woman of child-bearing age, and they will have to cover maternity benefits. None of those things are true now.
"Gov. Romney hasn't told us enough about what he would do to replace the Affordable Care Act, which he wants to repeal, to know if he'd offer any of those same protections. He does have some proposals he said would improve competition and potentially lower prices for insurance for people like you, though."
Question from Patrisha Thomson of Los Angeles: "A social worker I know who works in the medical field was telling me that many doctors are not accepting Medicare patients because they're not receiving the amount of money that really makes it a reasonable income. I would be interested to know how prevalent that is. And if that's true, what has changed?"
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11-10-2012 21:41 During the vice presidential debate Thursday night in Danville, Ky., Rep. Paul Ryan rebuked Vice President Joe Biden for interrupting his argument that Democrats "got caught with their hands in the cookie jar, turning Medicare into a piggy bank for 'Obamacare.'"
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Ryan chides Biden for interrupting him on health care argument - Video
11-10-2012 22:50 Dr. Marc Siegel, Dr. Martha Boone weigh in
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12-10-2012 12:40 "The problem is that we've so completely surpressed the marketplace in healthcare that none of us ever sees a real price for anything," says economist John Goodman. Reason magazine's Matt Welch sat down with Goodman at FreedomFest 2012 to discuss solutions to healthcare discussed in Goodman's book, "Priceless: Curing the Healthcare Crisis." Held each July in Las Vegas, FreedomFest is attended by around 2000 limited-government enthusiasts and libertarians a year. ReasonTV spoke with over two dozen speakers and attendees and will be releasing interviews over the coming weeks. For an ever-growing playlist, go here now: About 4:11 minutes. Camera by Tracy Oppenheimer and Alex Manning; edited by Paul Detrick.
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Orange, California (PRWEB) October 12, 2012
Yale University Press releases a new book on health care exploring The Cost Disease.
William J. Baumol, a professor of economics and academic director of the Berkley Center for Entrepreneurship and Innovation, New York University, and professor emeritus, Princeton University, has written a book delving into the question Why Computers Get Cheaper and Health Care Doesnt.
Its a topic that plagues consumers, as each year brings a new level in increase in the costs of health care, while things like the prices of computers are not rising, yet, nor are salaries or Medicare coverage.
Baumol, author of more than forty books and recipient of numerous awards, explains it like this: Its the Cost Disease.
And that once the public understands the parameters of this disease and how it effects the rising costs of the service sectors of the economy, then appropriate and effective responses can be made to the problem thats causing widespread alarm across the country.
HealthCompare, a nationally recognized health insurance comparison site, is aware of the ever-compounding increases that health care is placing on the population and wants consumers to be as educated as possible when making decisions that could affect their health care.
Knowing what a patients limits are when it comes to what doctors he is willing to see and which ones he is and knowing his medical history intently and the history of his family, and how much he is honestly able to afford, the patient can better make health care decisions that could help him find policies that are more suitable for his budget, without losing its effectiveness.
Its this kind of research and adjustment that will help health insurance consumers become more adaptable to the Cost Disease and Dr. Baumols ideals that service related industries require more and more people to manage and run the industry, in opposition to the idea that technology requires fewer people and less moving parts, so the costs can stay down.
Health Insurance shoppers are encouraged to visit HealthCompare.com to make comparisons that could help them in buying individual health insurance and lower their costs in an industry affected by the Cost Disease.
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HealthCompare Attempts to Help Health Insurance Consumers Counter the "Cost Disease"