23-05-2012 15:55 In 2008, then-Candidate Barack Obama promised to usher in an era of transparency, "put an end to the game playing" in Washington, and broadcast health care negotiations on C-SPAN. The Energy and Commerce Committee launched an investigation more than a year ago to allow Congress and the American public to understand whether he upheld his promises when writing legislation that fundamentally transformed the nation's health care system. This video examines those promises and the confusion and conflicting information surrounding the closed-door negotiations that led to enactment of the law.

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Obamacare: Secret Deals and Broken Promises - Video

24-05-2012 14:51 Alexis Chesrow, MD, of Aurora Health Care discusses urinary stress incontinence on The Morning Blend on May 24, 2012. This common pelvic floor disorder affects one third of women and is treated at the Center for Continence and Pelvic Floor Disorders at the Women's Pavilion in West Allis, Wisconsin.

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Incontinence Treatment: Alexis Chesrow, MD: Aurora Health Care - Video

Without major changes in health care costs, the day of rationing of care draws near, even if elected officials dare not mention it, an economist writes.

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Economix Blog: Uwe E. Reinhardt: The Fork in the Road for Health Care

Posted at 2:00 PM on May 23, 2012 by Catharine Richert (3 Comments) Filed under: PoliGraph

Last weekend, Republicans endorsed Rep. Kurt Bills to run against U.S. Sen. Amy Klobuchar this fall. If elected, Bills says cutting government spending will be one of his top priorities.

To stress just how bad things have gotten in Washington, D.C., Bills pointed to the rising cost of the new health care law.

"You have to look at Obamacare that was projected to spend $800, $900 billion and is now at $1.7 trillion," Bills told MPR's Mark Zdechlik in an interview May 21.

It's true that the latest gross cost estimate of the new health care law is about $1.7 trillion, but that's only part of the story.

The Evidence

To make his case, Bills relied on a recent estimate from the non-partisan Congressional Budget Office that pegged the gross cost of the health care law at about $1.76 trillion between 2012 and 2022.

In 2010, the CBO projected the gross cost of the law to be $938 billion between 2010 and 2019. In part, the initial 10-year cost was lower because many of the law's key provisions don't go into effect until 2014, ramping up in subsequent years.

But Bills' claim leaves out an important point.

The health care law also collects new revenue to help pay for it, including fees paid by those who don't have insurance and some employers who don't offer coverage, taxes on top earners and provisions meant to slow the growth of Medicare, among other offsets.

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PoliGraph: Bills health care law claim leaves out key details

SPDR Health Care Select Sector (XLV - News) has been showing signs of an uptrend as companies within the index have dividend yields and decent valuations. The pending Supreme Court healthcare reform decision will eventually steer the healthcare sector.

Year to date through May 18, XLV was u 4.6%. This was near the 4.3% increase in the health care sector of the S&P 500 index, and ahead of the 3.0% gain for the S&P 500 Index. Interestingly, six of the 10 sub-industries in the sector were ahead of the broader benchmarks return, led by Healthcare supplies and Biotechnology, but this was partially offset by the larger Pharmaceuticals sub-industry, which was up only 0.9%, Todd Rosenbluth, S&P Capital IQ ETF Analyst wrote in a recent MarketScope Advisor note. [Checking up on Health Care ETFs]

The ETF XLV has stakes in some of the biggest names in health care: Johnson & Johnson, Pfizer, Abbot Laboratories and Merck. About half of the portfolio is dedicated to pharmaceuticals, followed by Healthcare equipment and Biotechnology. [Healthcare ETFs Look to Supreme Court Ruling]

Going forward, a decision to uphold the Healthcare reform law, or to vacate all or part of the law is due in mid-June of this year. Jeff Loo, head of Healthcare equity research for S&P Capital IQ, says there are three potential scenarios that would materialize from a decision: [Defensive ETFs for a Market Pullback]

Rosenbluth reports that the sector ETF is positioned to fare well if either scenario 1 or 2 plays out. The strength of the companies that the fund holds will keep performance steady, while the dividend yield is another plus. The fund yields 2.5%.

SPDR Health Care Select Sector

Picture 1

Tisha Guerrero contributed to this article.

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‘Obamacare’ Impact on Healthcare ETFs

The Department of Health and Human Services'recently signed $17.6 million dollar contract with public relations firm Porter-Novelli, to tout the Affordable Care Act, is coming under congressional scrutiny.

Sen. Rob Portman, R-Ohio, has written a letter to HHS Secretary Kathleen Sebelius asking for details on how that money will be used.

"If you're trying to educate the public as to how to comply with a specific law, there might be a purpose in it," Portman told Fox News. "If, on the other hand, you're doing a PR blitz to try to sell a program during an election year, that seems to me to be more in the realm of something a political organization should be paying for rather than us as taxpayers."

In the interest of belt-tightening, Portman and Sen. Claire McCaskill, D-Mo., earlier this year wrote to 12 federal agencies asking for an accounting of any taxpayer money spent on public relations, publicity and advertising. Ten of 12 agencies complied with their request. The Department of Health and Human Services did not, leading to Portmans new inquiry to Sebelius this week.

The HHS website describes the purpose of the Porter-Novelli contract as"a national integrated multi-media campaign education campaign that promotes the preventive healthcare benefits availableto all Americansas a result of the Affordable Care Act."

As written, the Health Care Law actually requires "A national science-based media campaign on health promotion and disease prevention..." But it does not stipulate how much should be spent on any such campaign.

Previous administrations have also been criticized for ad campaigns. Senate Democratsdemanded that the George W. Bush administration return $240,000of taxpayer money that was paid to conservative commentator Armstrong Williams to promote "The No Child Left Behind Act." The Bush Administration alsospent well over a hundred million dollars in 2003 to inform seniors about the Medicare Prescription Drug Plan.

Tom Schatz of Citizens Against Government Waste says the timing of the new $17.6 million dollar HHS contract to promote the Affordable Care Act is deeply suspicious.

"If part of the health care law is found to be unconstitutional, and it's something that they're advertising, then it's been a big waste of money," he said. "The real purpose of this seems to be to promote the president's achievement with the health care law in the hope that this might assist in his reelection."

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Senator Slams Possible Health Care PR 'Blitz'

Hundreds of thousands of people would see their health care cut back or even eliminated under legislation approved Thursday by Illinois lawmakers in a desperate attempt to shore up the states crumbling budget.

The Medicaid cuts include ending a prescription drug program for senior citizens, halting two programs that provide health insurance for about 35,000 people, and restricting access to services from heart bypass operations to wheelchair repairs.

Opponents said the cuts will mean suffering and death for some of the 2.7 million people who get care under Medicaid.

Im begging you, representative, for the life of the people who are going to die as a result of this legislation. Im begging you. Please, let us do something different, Rep. Mary Flowers, D-Chicago, said to the measures sponsor.

Rep. Sara Feigenholtz, D-Chicago, said the Medicaid program will fall apart without fast action. Helping the states poor in the long run requires cutting back now, she said.

I know it seems ironic, but this is the only way we can accomplish that, Feigenholtz said.

The measure passed 94-22 and went to the Senate, where it was approved on a 44-13 vote. The next stop is Gov. Pat Quinn, who supports the proposal.

Its part of a package meant to fill a Medicaid shortfall of $2.7 billion, or nearly $1 in every $5 the program spends.

Service cuts would save about $1.3 billion. Payments to hospitals, nursing homes and other Medicaid providers would be trimmed by an additional $240 million. In a separate bill, lawmakers will consider more than doubling the state cigarette tax to bring in more money.

Republican opposition has left the outcome of the tax vote in doubt.

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Health care for poor slashed by lawmakers

A community forum Thursday about Marion County's role in the state's health care overhaul attracted about 100 people interested in learning more about the new system and voicing their concerns.

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Forum discusses health care changes in Marion County

A recent coding competition in the Boston area brought together IT professionals, medical workers and others with an interest in health IT to show how data analytics can improve health care.

The Health 2.0 Boston Code-a-thon, held May 11 and 12, featured approximately 85 participants who formed groups to create, in approximately one day, an application that turns large amounts of health care data into useful information for patients and care providers.

The winning team created the No Sleep Kills website, where people can access information on how poor sleeping patterns can lead to drowsy drivers and auto accidents. The website aims to draw attention to the link between sleep apnea, a condition in which people temporarily stop breathing during sleep, and vehicular crashes.

Given the content's time constraints, Joel Sutherland and Guy Shechter, two members of the winning four-person team, noted that the site is still under development. They, along with team members David Dinatale and Amber Zimmermann, hope to incorporate additional information sources, allowing the site to offer deeper analysis.

Shechter wants to incorporate anonymized patient data from Athena Health, an event partner that offers health-care providers electronic medical record software.

"The whole goal of getting more health data digital is so you can start doing meaningful things with data," Shechter said. "If we can get access to Athena Health data on actual patients we can extract some of the risk factors we are looking at."

For now, people who visit the site can enter personal information, including age, weight and number of poor sleep nights, to determine if they are sleep deprived. For medical professionals, the portal offers information on determining whether their patients have poor sleep patterns.

The team would like the site to eventually include Medicare cost data to show that sleep apnea testing may help lower health care costs.

Data analysis highlights how a common health issue has consequences that can greatly impact lives, explained Sutherland, who works for Mitre, which manages U.S. government research centers, but who entered the contest as an individual.

"We need action items that say this is a problem," he said. "Here we can show that paying attention to sleep apnea improves fatal crash rates. If you can show that, then policy makers can say this work actually saves lives more than just treating sleep apnea."

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Coding Contest Shows How Big Data Can Improve Health Care

Change leaves care of disabled patients on Medicaid to trio of managed care companies

For the second time in two years, the state Department of Health and Human Resources is under fire for plans to change how it handles the care of tens of thousands of vulnerable West Virginians.

Critics worry the agency is in a rush to turn over the care of a group of 57,000 elderly or disabled Medicaid patients to three health insurance companies.

The critics question whether DHHR has carefully thought out the plan. And they wonder if the companies are experienced enough to deal with the vulnerable population they are about to be handed.

Beginning in December, the state will gradually begin moving patients who receive Supplemental Security Income into managed care. Managed care, like a private sector HMO, attempts to coordinate health care while controlling costs.

The three companies - Carelink, The Health Plan and Unicare - already manage care for 170,000 Medicaid recipients. Medicaid is the state and federal health insurance program for low-income people.

But SSI recipients have a different and more expensive set of medical needs than the normal welfare population. To qualify for SSI, a person must be aged, blind or disabled, a category that includes people with serious mental disorders.

"This is our most fragile population and probably also our most costly population," said DHHR spokesman John Law.

That means managing their care could be more challenging than for other patients.

There are basically two reasons to put people into managed care.

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Health care move panned

FRIDAY, May 25 (HealthDay News) -- Doctors have long known that some kids suffering severe emotional turmoil find relief in physical pain -- cutting or burning or sticking themselves with pins to achieve a form of release.

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More Mental Health Care Urged for Kids Who Self-Harm

Last Thursday, I had the opportunity to sit in on a health care panel discussion organized by STEPMC. STEPMC is a nonprofit organization that provides support to families in poverty as they try to better their circumstances. STEP has a Big View committee, which I recently joined as a volunteer, that attempts to look at overreaching community issues that tend to keep families in poverty. During more than a year, the STEPMC families, called Circle leaders, designated lack of affordable health care as one of their greatest barriers to success. The individuals who sat on this panel included, Rob Monical, CEO at McPherson Hospital; Matt Schrader, therapist at Prairie View; Shelia Gorman MD in McPherson; Marla Ullom-Minnich MD in Moundridge; and Ken Cotton, dentist. One of the repeated themes of the discussion was a desire to have an urgent care clinic in McPherson. Area communities, such as Newton and Lindsborg, both have opened clinics with extended evening and weekend hours. Urgent care clinics generally offer similar services to doctors offices. The extended hours mean residents with minor ailments, such as ear infections, can avoid costly trips to the emergency room, which can cost in hundreds of dollars. The members of the panel said there has been no discussion to this point about creating an urgent care clinic in McPherson. Panel members said it likely would need to be a cooperative effort between the hospital and the local physicians. The urgent care model has been successful in metropolitan areas for some time. It is a waste of our community health care dollars to rely solely on the emergency room for minor illnesses and injuries that come up during nonbusiness hours. Such a clinic would not only be a benefit to McPhersons poor, but all community residents. The audience asked several questions about the possibility of bringing specialists into the community, specifically a pediatrician and an OB/GYN. Monical and Gorman explained bringing a specialist into a community is more difficult than residents might imagine. Recruiting a single specialist to a rural community is difficult enough, but most specialty practices need a least two physicians so that they can alternate nights on call. This means the community must have the patient load to support two physicians, not just one. The lack of specialists in the community means many community members must travel outside of the community to receive treatment. For some, this may be a minor inconvenience, but for families in poverty, this can be a serious problem. Many families in poverty have no or unreliable transportation or have few funds for gasoline, which makes travel outside the community to see a physician difficult. Monical said the hospital has worked with physicians to establish traveling clinics in McPherson and will continue to evaluate the possibility of bringing specialists to the community. If you dont have insurance, you may not be able to access a physician at all. Circle leaders said they had been refused service because of problems with billing and lack of insurance. Emergency rooms cant legally refuse service to individuals, and Gorman said she was disturbed to find physicians were refusing patients who did not have insurance. Patients who do not have insurance already are billed at the highest rate in the health care system. Insurance companies negotiate lower rates for those of us who have insurance, but if someone doesnt pay the full price, there cant be a negotiated lower price. Unfortunately, that ends up being the poor. McPherson is a prosperous community, and the fact there are members of the community who are denied access to health care based on their socio-economic status is unconscionable. Chad Clark, director of the McPherson Healthcare Foundation, discussed the establishment of a community health care fund that could help those who do not have insurance with health care costs. The hospital also provides thousands in charitable funds to those in need every year. However, for families who rely on minimum wage or low-wage jobs for income, health insurance remains out of reach. Health care will continue to be an issue for these families until some greater global solution to make health insurance more accessible is found.

Cristina Janney is the managing editor of The McPherson Sentinel. She can be reached at cristina.janney@mcphersonsentinel.com.

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Column: Health care obstacle for McPherson’s poor

21-05-2012 13:58 President Obama speaks to leaders of the 50 nations that make up the International Security Assistance Force in Afghanistan before a meeting to discuss the next step in the transition of power there—setting a goal for Afghan forces to take the lead for combat operations across the country in 2013 -- next year -- so that ISAF can move to a supporting role. May 21, 2012.

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President Obama Speaks at ISAF Meeting on Afghanistan - Video

ehyman@newsobserver.com

Bill Roper, CEO of UNC Health Care, left, and Bill Atkinson, President and CEO of WakeMed, talk before a press conference announcing an agreement between WakeMed Hospital and UNC Health Care Tuesday, May 22, 2012 at the N.C. Legislative Building.

RALEIGH -- State lawmakers announced Tuesday a cease-fire between WakeMed Hospital and UNC Health Care, bringing to a civil end an unseemly public battle that had landed at the legislature with WakeMed trying to buy its cross-town rival Rex Hospital.

With the harmony comes an unexpected boon for Wake County: a $30 million, 28-bed psychiatric facility UNC will build and operate, easing some of the charity care burdens WakeMed has carried for decades. Left alone is Rex Hospital, a UNC subsidiary that WakeMed tried to buy to level the playing field with UNC.

The public and often invective spat between the states hospital system and Wake Countys largest hospital generated a $750 million hostile takeover bid, high-dollar lobbying efforts and legislative hearings in the last year. Earlier this month, the lawmakers called the leaders of the warring UNC Health Care and WakeMed to say enough is enough, setting in motion a series of private meetings to reach an accord. Both sides sent key experts to exhaustive meetings overseen by a legislative staff attorney to Sen. Tom Apodaca, R-Hendersonville. The leaders of UNC and WakeMed, however, were absent.

Sometimes leadership courage is about stepping back, WakeMed CEO Bill Atkinson said in an interview after the press conference. Everyone thinks you lead from the front, but sometimes, you need to get on the sidelines.

On Tuesday, Atkinson and UNC Health Care CEO Bill Roper stood near each other, smiling as state leaders offered their congratulations.

Lawmakers heralded the peace, saying both institutions brought quality and commitment to an ever fractured health care system.

(We) are celebrating the establishment of an expanded partnership that will positively affect patient care and the training of doctors in North Carolina for years to come, said Apodaca. We believe these two great institutions have more things in common than differences.

WakeMeds complaints

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WakeMed and Rex Hospital reach settlement, ending public feud

Despite uncertainty about the coming U.S. Supreme Court decision on its constitutionality, the 2010 health care law already has triggered a long-term transformation in the way U.S. health care is delivered and paid for, a panel of specialists said on Tuesday.

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Panelists: Health Care Law’s Innovations Taking Hold Despite Supreme Court Case

When Neenah resident Robin Holte left behind a 25-year career in interior design to return to college and become a registered nurse, job security was the furthest thought on her mind.

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Health care careers still best bet for job security

A health care tax credit meant to help small businesses has been called too weak and confusing. A recent report by the Government Accountability Office concurs.

NEW YORK (CNNMoney) -- A tax credit meant to help millions of small businesses afford health coverage for their employees was claimed by only 170,300 last year, a government watchdog has found.

The Government Accountability Office report, made public this week, is the latest to highlight the shortcomings of the tax credit, which has been criticized for being too weak and complex.

The report noted that only a fraction of those eligible have used the assistance. Between 1.4 million and 4 million small businesses were eligible for the tax credit, according to GAO.

The tax credit, enacted as part of the 2010 Affordable Care Act, is aimed at defraying the high cost of health coverage. It is available to companies that have 25 or fewer workers, pay average salaries of $50,000 or less and cover at least half of employee health insurance premiums.

Many small employers have told CNNMoney that they found the tax credit program to be too confusing -- and often too costly -- to be worth the accounting endeavor.

So many small firms are forgoing the extra cash that $20 billion dollars meant to go to small businesses over the next decade won't be distributed, according to the Congressional Budget Office.

The GAO report noted the credit "was not large enough to incentivize employers to begin offering insurance." According to the report, the average credit was $2,700.

Worse still, company owners were deterred from making claims because of the confusing way the credit is calculated. The formula includes odd features, such as counting some workers as 1/15th of an employee and reducing federal help if a firm insures more workers.

The GAO suggested that the Internal Revenue Service revise its procedures and take a softer approach with companies that make mistakes on credit applications.

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Small business shuns health care tax credit

Health Care Reform by Elizabeth Stawicki, Minnesota Public Radio

May 23, 2012

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ST. PAUL, Minn. The primary goal of the federal health care overhaul is to help provide affordable health insurance to the millions of Americans who lack it. But health planners are wrestling with a little known, yet significant gap in the plan.

A low-income group under age 65 falls into a kind of no-man's land for affordable coverage. They earn too much to qualify for assistance through Medicaid, but not enough to afford even subsidized commercial insurance.

Minnesota officials are considering an optional program to help fill this gap but there is a huge unknown: how much it will cost.

The affordability gap affects about 100,000 low-income Minnesotans, people whose household incomes are slightly above the threshold to qualify for Medicaid's free or low cost coverage.

Yet their incomes are low enough that the deductibles and co-pays of their private health insurance could cause hardship even with the federal health care law's subsidies.

Many individuals in this predicament earn less than $2,000 a month.

According to the non-profit Kaiser Foundation, their out-of-pocket costs for the health care overhaul's benchmark plan could run as high as $220 per month.

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State could help cover federal health care 'no-man's land'

When Neenah resident Robin Holte left behind a 25-year career in interior design to return to college and become a registered nurse, job security was the furthest thought on her mind.

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Demand for health care jobs growing

If you want to see what womens health care in America will be like if Mitt Romney becomes president, just look at Texas and Arizona.

Both states are in the news for trying to prevent women from getting health care at Planned Parenthood. Its wrong and it will have devastating consequences for women for years to come, and Mitt Romney wants to do it in all 50 states.

Romney said in November he wants to eliminate the nations family-planning program, which was signed into law by President Richard Nixon in 1970 and provides essential preventive health services to over 5 million people a year, the vast majority of whom are poor and uninsured. Beyond the millions of people who are helped by this health-care program, investing in family planning saves the government money. For every dollar spent on family planning, experts say taxpayers save around $4.

Romney said in March that, if elected president, he would get rid of Planned Parenthood. He clarified his remarks to say he would end federal funding for Planned Parenthood.

This isnt about abortion. These health-care programs provide blood pressure and cholesterol monitoring, flu shots, breast-cancer screenings, Pap tests and birth control.

Michele Azzaro knows what Mitt Romneys America would look like because shes already experiencing it in Texas. Michelle has been a Planned Parenthood patient in Dallas for more than 20 years. Planned Parenthood was there when she had a breast-cancer scare, and her local health center has been there when she needs her yearly cholesterol test.

Last year, Texas drastically cut its family planning funding, the same way Mitt Romney says he would cut federal funding. Michele lost access to annual breast screenings and the birth-control pills she needs to manage her painful uterine fibroids.

She isnt alone. An estimated 160,000 women lost their health care when Texas slashed its family planning program last year. Now, the state is trying to throw another 100,000 women off health care by taking Planned Parenthood out of the Medicaid-supported Womens Health Program. Planned Parenthood health centers provide care to fully 40 percent of women in the program.

Texas program provides low-income, working women with lifesaving cancer screenings, well-woman exams, contraception, screening for diabetes and high blood pressure, and testing for sexually transmitted infections. The program was sponsored and implemented by Republicans less than a decade ago, an indication of how far to the right some in the party have gone in just a few years.

Planned Parenthood sued the state in federal court in order to continue providing these critical health services to women, and on Friday a federal appeals court blocked the states effort to deny women the health care they rely on at Planned Parenthood while the lawsuit proceeds. Meanwhile, Gov. Jan Brewer signed legislation that cuts state funding for Planned Parenthoods preventive care.

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States show outlook for women's health under Romney