New York Times | Congress Goes Home, and Constituents Fired Up Over Health Care Are Waiting New York Times In email alerts, MoveOn.org is mobilizing members to attend town-hall-style meetings across the country, and it has set up a website, ResistanceRecess.com, to help people find them. The site includes a guide to health care recess messaging. (The ... |
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Congress Goes Home, and Constituents Fired Up Over Health Care Are Waiting - New York Times
Photo: Colleen Ingerto / Times Union
Joan Regan Hayner, Chief Executive Officer at CapitalCare Medical Group, at her office in Albany, N.Y. on Tuesday, November 29, 2016. (Colleen Ingerto / Times Union)
Joan Regan Hayner, Chief Executive Officer at CapitalCare Medical Group, at her office in Albany, N.Y. on Tuesday, November 29, 2016. (Colleen Ingerto / Times Union)
Joan Regan Hayner, Chief Executive Officer at CapitalCare Medical Group, at her office in Albany, N.Y. on Tuesday, November 29, 2016. (Colleen Ingerto / Times Union)
Joan Regan Hayner, Chief Executive Officer at CapitalCare Medical Group, at her office in Albany, N.Y. on Tuesday, November 29, 2016. (Colleen Ingerto / Times Union)
January/February 2017 edition of Women@Work magazine.
January/February 2017 edition of Women@Work magazine.
Women in health care: Meet Joan Regan Hayner
After many years in public accounting, Joan Regan Hayner realized she hadn't found her passion. Then it found her. An accounting client who was a physician became involved with founding CapitalCare Medical Group. They were looking for a financial person, and he urged her to consider because he said, she had all the necessary skills. She was hired as controller at CapitalCare in 1997. She was quickly promoted to chief financial officer, then to chief administrative officer in 2000. On Jan. 1, 2004, Hayner was named chief executive officer.
Q: You've said that losing a brother to AIDS gave you a desire to bring quality health care to those who need it. After leaving the financial world, was there a point in which you said to yourself, 'This is where I'm supposed to be.'?
A: You have a tendency when you're young to drive toward something that you think you can be good at. I went into accounting because I was good at math. ... While I was working as a CPA, I did lose a brother to AIDS in the early 1990s, and I started second-guessing my own career and purpose ... but didn't really know what to do. It didn't happen immediately, but in 1997, I got a call because this CapitalCare Medical Group was forming, and they needed a financial person.
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This story also appears in the January/February issue of Women@Work magazine. For more inspiring stories about Capital Region working women and articles that offer career advice, sign up today for $25 at tuwomenatwork.com. You'll get a year's subscription to the magazine and become part of a network of 1,700 Capital Region women who want to grow their careers and help other women grow, too.
I wasn't really progressing in my career because I wasn't really thrilled with it, and I thought, 'You know what? I'm going to do something different.'
Harkening back when my brother went through what he went through, I saw some really positive aspects of health care and some really negative aspects. And I took a leap, and found I love it. I had a really rare opportunity professionally in that I was kind of given a blank slate and told create processes, create systems, put together at that time, the financial aspects of the organization.
It just all kind of clicked for me. I loved it all, and I loved learning.
Q: It sounds like you had to be open and aware that something big was presenting itself to you.
A: What happened to me was you just always have to have your eye open to possibilities. When I was in my last position in accounting, I just happened to get a client who was a doctor and he was my client for many years. And we just kind of hit it off, and I got kind of a kick out of all the entrepreneurial things he did on top of his position. He was one of the founding physicians in CapitalCare, and he saw something in me ... I was like, 'I do your taxes, and I do your tax planning, and I don't do that stuff.' And he saw that in me. I did business planning for him in these small entrepreneurial endeavors he had, and he said, 'You've helped me in your businesses, and I think you would do really well in this.'
What I tell people now, and young women in particular, is always be open to the possibility that you don't think is out there and put yourself in a position where you can be seen. Seek out a mentor. Reach out to people who you respect and admire and ask them for advice, take them out to coffee.
Try things you think you maybe wouldn't normally do to get exposure in other areas if you need help in trying to drive toward that passion.
There are certain skills that women excel in more than men that make it more easy to adapt to other situations. We excel in our emotional intelligence and in our ability to be creative. We're nurturers, and we want everybody to do well. Those natural tendencies that women have can really help them progress from one field to another field even more easily than men do.
Q: If more women move into top roles, do you think it would impact the health care industry?
A: We cannot achieve better outcomes and reducing costs without being creative. We cannot have an attitude of doing the same old thing. Women don't so much have a my-way-or-the-highway kind of approach to their thinking, and how they approach leadership. So I think our best chance of achieving what we want to achieve in this industry and really for the country, is to really see more women contributing and leading.
The women in nursing and who have been in the trenches in health care, they need to be informing the policymakers.
I got so frustrated with regulations and decisions that were being made without taking into account the operational aspect of the decision, so I just started calling legislators, and I started inviting them to come in. If you're considering legislation, come into my office and take a look at what the impact is going to be. And then I got invited to sit on this committee. And I think policymakers need to hear from people in the trenches about the impact their decisions are going to have.
Q: What advice do you have for women who work in health care and are looking to advance their careers?
A: Don't be afraid to speak up. That's a big one. If you have a good idea or you think you have a good idea, if you don't want to speak up in a big group, go to your mentor or go find somebody who you can bounce an idea off of. Look for mentor and be a mentor.
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Women in health care: Meet Joan Regan Hayner - Albany Times Union
Over the past decade, employees have seen their healthcare plans deductibles and co-pays increase six times faster than wages. Many experts agree that this cost-shifting was not a direct result of the enactment of the Affordable Care Act (ACA).
However, with the onset of the ACAs new reforms, these same experts suggest that the ACA did not stem this trend toward increased out-of-pocket spending. But, regardless of what happens to the ACA, one thing is clear: Individuals will be forced to take on more responsibility for their healthcare. Enter the dawn of the role of the individual.
Now, were looking to the new leadership in Washington, D.C. to create the equivalent for healthcare expanding and unbundling health savings accounts (HSAs) from high-deductible health plans (HDHPs).
HSAs are a powerful savings vehicle for healthcare. Like 401(k)s, consumers can put away money each month, tax free. But unlike 401(k)s, they can access that money at any point in their lives.
The theory is if consumers choose an HDHP bundled with an HSA, they are more responsible for upfront costs for their healthcare and will therefore be more judicious about how they spend these dollars ultimately slowing rising healthcare costs.
The problem with this theory is that the majority of healthcare plans now have high deductibles, regardless of whether theyre legally considered an HDHP. This puts consumers without access to an HSA at more financial risk.
My company, Benefitfocus, recently put out our annual State of Employee Benefits Report that looks at actual enrollment data from more than 500 large employers during the fall of 2016 data that shows its not just those with HDHPs that could benefit from an HSA. Almost everyone has seen their costs go up.
PPO subscribers saw substantial hikes in their deductibles and out-of-pocket maximums, 8 percent for individual and 9 percent for family coverage, putting PPOs only a couple hundred dollars below the IRS threshold for a plan to be considered an HDHP. This means were getting closer to a world where every plan can and should have an HSA.
Several proposals to replace the ACA call for expanding the scope of HSAs. For example, the House Republicans Better Way plan proposes to increase HSA contribution limits by allowing the tax-free contributions to equal the insurance plans annual deductible and out-of-pocket maximums meaning that families could put away more than $14,000 a year.
Other proposals would get rid of maximum contribution limits entirely and would allow HSAs to be coupled with any type of plan including those PPOs that are just below the current threshold.
This would support the long-held conservative view that consumers should be responsible for their healthcare a reality thats already here.
But HSAs are only the beginning of what I expect to be a robust system of financial wellness measures protecting individuals from the crippling effects of rising healthcare costs and less government protection.
Whether its through employer-sponsored care or some version of government protection for those most in need, consumers must have the resources to protect their health and financial well-being.
Voluntary income protection benefits, often referred to as gap products, should be offered alongside every type of insurance plan.
They often come in the form of accident, critical illness or hospital indemnity insurance, and can help cover the costs of unexpected healthcare needs needs that can bankrupt the average American, who has less than $1,000 saved for emergencies.
These benefits are gaining traction, as our State of Employee Benefits report also found nearly half of large employers are offering at least one. But we still have a long way to go. Consumers need more education and support to ensure they understand the value of HSAs and voluntary benefits, and that theyre equipped to take on the full burden of healthcare.
Healthcare decisions are unlike any other consumer choice deeply personal and with the potential for long-term financial and health implications. Employers, the government and individuals must share the responsibility of this burden, just like they do for retirement.
The government should expand the availability and reach of HSAs, and employers and any government protection for those most in need should ensure consumers have access to supplemental voluntary benefits to offset those rising deductibles. Thats the key to true success in the dawn of the role of the individual.
Shawn Jenkins is co-founder and CEO of Benefitfocus, is a platform that supportsbenefits enrollment/management for 825+ large enterprises, 55+ insurance carriers and numerous consumers. The company enables employers and carriers with a powerful SaaS technology platform that empowers people to make better health, wealth and wellness decisions.
The views expressed by contributors are their own and are not the views of The Hill.
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The role of the individual and taking control of their own healthcare - The Hill (blog)
New York Times | A Big Week for Health Care New York Times In the fight to save the ACA, next week is absolutely pivotal, Topher Spiro tweeted on Thursday, referring to the health care law. And YOU can help The fight for the law is really a fight to prevent millions of people from losing health insurance ... Republicans Outline Plan to Eliminate Health Care for Millions Sanford's plan for health care Trump says health care plan could come as early as March |
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Forbes | When Health Care Ignores Your Goals Forbes By Denise Logeland, Next Avenue Contributor. Five days after a surgery and being mostly bed-bound, my 83-year-old mom was discharged from the hospital and looked forward to one thing in particular. She hadn't been able to bathe since she left home. |
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As the former head of Harvard Pilgrim Health Care, Governor Baker (above) has been seen as friendly to businesses. But as a result of the soaring expense of MassHealth, last month he unveiled a proposal to penalize companies that dont offer workers adequate health insurance.
Governor Charlie Baker became one of the business communitys biggest allies on Beacon Hill the moment he moved into the State House two years ago. As the former head of Harvard Pilgrim Health Care, he knows what executives want out of government as little interference as possible, and definitely no new expensive mandates.
But for the first time, a major rift has opened up between business leaders and the Republican governor. Baker has been backed into a corner by the soaring expense of MassHealth, the states publicly subsidized health insurance program for lower-income residents. MassHealth now accounts for about 40 percent of the state budget, and he fears that even more people will choose it over their employers coverage.
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To help keep that from happening, the governor last month unveiled a measure that would penalize companies that dont offer adequate health insurance to their workers.
Bakers plan which could pump $300 million into the states budget for the next fiscal year also would snare many companies that offer generous health plans by penalizing those that fall short of a new 80 percent participation mandate. Business groups say most companies dont meet that goal, in part, because many workers get their insurance through a spouse or parents.
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From any administration thats got their ear to the business community, thats a surprising proposal, said Peter Ubertaccio, a political science professor at Stonehill College in Easton.
The blowback from business lobbyists has prompted a few of Bakers top aides, including budget chief Kristen Lepore and health and human services secretary Marylou Sudders, to start negotiating with them on an alternative.
Were hopeful that we can maybe all roll up our sleeves and find something thats a little fairer to the business community, said Christopher Geehern, an executive vice president at Associated Industries of Massachusetts, a trade group. You really are hitting employers who provide health insurance, who are doing what theyre supposed to be doing, as opposed to targeting those employers who arent providing health insurance.
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The goal is to have an alternative option ready by April, when House leaders take up the budget. Representative Jeffrey Sanchez, a House point person on health care issues, said Bakers plan requires more analysis to better understand its effects. Sanchez notes that its important to recognize the uncertainty surrounding federal health care reimbursements, now that President Trump and the Republican-led Congress are moving to undo the Affordable Care Act.
MassHealth enrollment rose about 3 percent in the past year, to more than 1.9 million people, or about one in four Massachusetts residents. Meanwhile, the states MassHealth costs rose from $13.7 billion to $14.1 billion, according to figures provided by the Baker administration. (This state spending is typically matched by federal funds.)
The big surge in enrollment started showing up by 2014, before Baker took office. Thats also around the time when the fair share assessment a provision of the 2006 Massachusetts health care overhaul was repealed. The assessment, which went away in mid-2013, was aimed at employers who didnt do their part to offer adequate insurance. There was an assumption that the Affordable Care Act would invoke a similar rule, but that never happened. MassHealth enrollment quickly ballooned as many workers sought cheaper coverage, state officials said. Participation grew from 1.4 million in 2013 to nearly 1.9 million in 2016.
One of the biggest drivers for the increase, according to the business-backed Massachusetts Taxpayers Foundation, is that the Affordable Care Act vastly expanded eligibility for MassHealth by allowing income-eligible adults without children to participate. That change took effect in January 2014.
Theres another possible culprit. The original state plan that passed while Mitt Romney was governor prevented income-eligible workers who had access to an employer-sponsored plan from choosing state-subsidized insurance instead. But that restriction went away with the advent of the Affordable Care Act.
Business leaders say Bakers version of the assessment is vastly different from the one put in place under the Romney administration. Instead of paying a $295 per employee penalty as the old regulation called for, companies would be hit with a $2,000-per-employee charge if they dont provide coverage that meets state standards. Companies whose health insurance participation rate is under 80 percent would have to pay the $2,000-per-worker fee for the amount of employees they would need to reach the threshold. Only businesses with fewer than 11 employees would be exempt.
Many companies expect to pay fees that total in the hundreds of thousands of dollars a year, according to business groups, and some could be on the hook for more than $1 million.
Briana Moore
Steve DiFillippo, chief executive of the Davios restaurant group, says the new regulations, as proposed, would cost him a lot of money.
Steve DiFillippo, chief executive of the Davios restaurant group, said he offers health insurance to full-timers after theyre on the payroll for at least 90 days. He said he pleads with some of his 400 Massachusetts workers to sign up for the companys health insurance plan but recognizes some younger employees stay on their parents plans until theyre 26 years old and then opt to go without any coverage.
He estimates that the participation rate in his plan is about 55 percent, far short of the 80 percent Baker would require. That means the new regulations, as proposed, would cost him a lot of money.
Why is it that I get in trouble? DiFillippo said. What theyre trying to do is to push me to spend more. I think thats wrong.
Greater Boston Chamber of Commerce chief executive James Rooney has a similar opinion. He says the proposed assessment, which he calls a tax, could punish employers trying to do the right thing. But Rooney also said theres some wisdom behind Bakers strategy it underscores the pressure that MassHealth is putting on state finances.
A blanket ... tax on companies that employ people, in and of itself, is not a solution, he said. [But] tactically putting it out there is smart, even if you disagree with it. Shining a brighter light on the problem is the right thing to do.
The Baker administration backs up its argument with a chart that shows a 16-percent increase in full-time workers between 2011 and 2015 who were not on employer-sponsored insurance. The Massachusetts Taxpayers Foundation has launched its own research to pinpoint the reasons for surging MassHealth costs.
What the administration was implying was that employers were cutting back on their coverage, said Eileen McAnneny, the groups president. The MTF is questioning the causal link that the administration is suggesting between the growth in MassHealth and the drop of employer-sponsored insurance.
Christopher Anderson, president of the Massachusetts High Technology Council, warns that an assessment could send the wrong message to businesses considering moving to Massachusetts or expanding their operations here.
We run the risk through a whole series of new developments to return closer and closer to the Taxachusetts moniker that weve worked so hard to minimize over the last 10 years, Anderson said.
The disagreement between Baker and business leaders, though serious, probably wont make them adversaries. The governor received a warm reception when he spoke before a Greater Boston Chamber of Commerce gathering Thursday, although he didnt focus on the new assessment in his speech.
I dont think this is an issue that will prompt the business community or business interests to walk away from this governor, said Ubertaccio, the politics professor at Stonehill. Youre not always going to see eye-to-eye with the main groups in your coalition, but theyre willing to give you some leeway.
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Baker, business leaders are at odds on health care - The Boston Globe
Rep. William "Bill" Huizenga, R-Mich., says House Republicans "know the direction we want to go and sort of the destination" with replacing Obamacare. Andrew Harrer/Bloomberg via Getty Images hide caption
Rep. William "Bill" Huizenga, R-Mich., says House Republicans "know the direction we want to go and sort of the destination" with replacing Obamacare.
House Republicans are debating a plan to replace the Affordable Care Act that would give consumers tax credits to buy insurance, cut back on Medicaid and allow people to save their own money to pay for health care costs.
The outline plan is likely to take away some of the financial help low-income families get through Obamacare subsidies, and also result in fewer people being covered under the Medicaid health care program for the poor.
"In general this is going to result in fewer people covered nationwide," says Caroline Pearson, a senior vice president at Avalere, a health care consulting group.
Republican leaders distributed the skeleton proposal at a meeting of the House Republican Conference in the Capitol on Thursday. Lawmakers now have an outline to bring with them to their districts for the Presidents Day holiday weekend, where they may face constituents with questions about what is going to happen to their health care. The plan is based on one outlined last summer by House Speaker Paul Ryan.
Rep. Bill Huizenga, R-Mich., called the 18-page outline "guideposts and a road map."
"We know the direction we want to go and sort of the destination," Huizenga said outside the meeting.
Lawmakers who attended the meeting said the plan is to repeal the Affordable Care Act with a bill similar to one that passed in 2015 but was vetoed by then-President Barack Obama. That proposal would have repealed all the taxes and subsidies associated with the health care law and would have killed the mandate for individuals to buy health insurance by getting rid of the tax penalty used to enforce it.
This Congress could either first pass a repeal bill and then a replacement bill, or include replacement elements in the repeal.
The meeting Thursday centered on "principles and goals on where we're going in patient-centered care," said House Ways and Means Committee Chairman Kevin Brady, R-La., after the meeting.
"We're talking about repealing, replacing and starting to return control of health care and restoring the free market," he said.
Most of the plan is silent on how much money lawmakers want to put behind their proposals, so it's impossible to know exactly how generous the plan is and how many people it would cover.
The elements of the plan include replacing the subsidies that help people buy insurance through Obamacare exchanges with fixed tax credits to buy coverage on the open market.
The major difference between the two is that the Obamacare subsidies increase as premiums rise so that consumers are responsible for the same premium amount, which is tied to their income. The tax credits proposed by Ryan are not tied to income but rise as a person ages and insurance rates increase.
"The important thing on the tax credits is that they're not income adjusted and we don't know how big they are," Pearson says.
She says it's unlikely they'll be as generous as the Obamacare subsidies.
"This likely means that low-income people will have difficulty affording individual insurance," she says.
The outline distributed by Republicans repeatedly mentions that people will be able to buy so-called catastrophic coverage, which has limited day-to-day benefits but protects people when they have a serious illness or accident that requires a lot of health care.
The plan also calls for expanding health savings accounts, which allow people to save their own money tax-free to pay for health care costs. It calls for the limits on HSA savings to rise from $6,750 per family to $13,100.
HSAs are a favorite among conservatives because they encourage people to save and plan for their health spending and to shop around for price.
Democrats have criticized the focus on HSAs because they only help people who have extra money to put away and give a bigger tax cut to people with higher incomes.
The Republicans' plan also calls for a major restructuring of the Medicaid health care program for the poor. It would repeal the Medicaid expansion that most states adopted under the Affordable Care Act, which allowed able-bodied people with incomes just above the poverty line to become eligible for Medicaid coverage.
And it would cap how much the federal government spends per person per year. Right now, Medicaid pays all health care costs for those who are eligible.
"This is a potentially significant incentive for states to get serious about efficiency," says Paul Howard, director of health policy at the Manhattan Institute, a conservative think tank.
Howard says states currently have an incentive to increase their spending on Medicaid, because it boosts the amount of federal money they get.
Ryan's plan would make Medicaid either a block grant program, where states receive a fixed amount of money, or it would be a per capita benefit, where the federal government would give the states a set amount for each beneficiary.
States could still offer Medicaid to those who became eligible under expansion, but the states' share of the costs would be higher than it is under the Affordable Care Act, likely making it too expensive for many states to do so.
Finally, the Republican plan would offer states pools of cash to come up with ways to expand insurance access to more people.
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Republican Health Care Proposal Would Cover Fewer Low-Income Families - NPR
Americans today can shop for a new TV by spending an hour online pulling up ads to compare prices and reading reviews to compare features and performance.
Dr. Daniel DeBehnke, the chief executive officer of Nebraska Medicine, said Thursday that those same Americans, driven by rising health care costs and market changes that have left them paying a greater share of their health care costs, are beginning to shop for elective health care services such as colonoscopies and knee replacements with the same eye toward value and quality.
To give them more of that data, Nebraska Medicine this summer plans to launch a star-based online rating system for its physicians that will incorporate patient ratings and reviews. Services such as Healthgrades and Yelp already provide some ratings, but many are based on a limited number of reviews.
DeBehnke, speaking at a forum on the future of health care at the Omaha Press Club, said health care providers need to focus on such changes or disruptions in the market, including new technologies and care delivery models, rather than becoming distracted by events in Washington, including debate about the repeal or replacement of the Affordable Care Act.
The disrupters are forming the market around us, he said. Until we change the system so it provides value to the consumer ... were going to miss the boat.
DeBehnke, who took over Nebraska Medicines top post in July, said other industries have missed disruptions in their own sectors. Blockbuster continued to compare itself with other brick-and-mortar movie retailers while online streaming services such as Netflix were on the rise.
The fact that the United States spends 16 percent of its GDP on health care and still doesnt have the best life expectancies helped drive the creation of the health care law. While it has flaws and needs tweaks, DeBehnke said, it has achieved its goal of increasing the number of people with insurance coverage.
At this point, he said, repealing the law without replacing it would be socially and politically untenable. I would go out on a limb and say it wont happen, he said.
Meantime, he said, some provisions of the law have resulted in shifting a greater share of costs to consumers. Some 39 percent of plans on the exchanges had deductibles of $6,000 or more. Thats spurred a need for greater data transparency. Shopping services such as Castlight and Healthcare Bluebook allow consumers to shop online for services and prices.
Virtual care services and retail clinics, from kiosks in stores to the Minute Clinics inside CVS drugstores, are providing consultations and minor medical care, he said. Walmart has even rolled out primary care clinics in some states.
One concern for health care providers about such outlets is fragmentation of patient information. A patients regular primary care doctor wouldnt necessarily know that a patient had received a new prescription. Common electronic medical records systems and data-sharing agreements may offer opportunities to partner with such services.
DeBehnke said Nebraska Medicine also is beginning to explore online appointment booking for its patients. DeBehnke previously served as CEO of Medical College Physicians, a group of about 1,500 practitioners in the Milwaukee area. That system rolled out a similar online appointment system.
julie.anderson@owh.com; 402-444-1066
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Nebraska Medicine CEO talks about the future of health care - Omaha World-Herald
Molina Healthcare Inc. shares plunged Thursday, the day after the Long Beach insurer said losses related to its participation in the Affordable Care Act marketplace ledto clearly unacceptable earnings for 2016.
The stock dived $10.71, or 17.9%, to $49.18.
The insurer reported after the close of regular trading Wednesday that its adjusted earnings per diluted share fell to 50 cents last year, down from $2.57 the year before. The results were disappointing: Analysts surveyed by FactSet had expected earnings of $2.78 a share.Income before income taxes fell to $137 million last year from $322 million the year before.
Molina Healthcare said in a statement that the decreasewas primarily the result of the declining profitability of our Marketplace program.
Molina Healthcare covers about 600,000 ACA enrollees in nine states. Speaking during a Wednesday afternoon conference call with analysts, Chief Accounting Officer Joseph White singled out Texas as a state where the insurer was doing relatively well on the marketplace He said the insurer was hanging in there in Florida and California.
Molina Healthcare has been traditionally known as a Medicaid provider, and its HMO plans are often the low-cost option in ACA plan categories.
The company might soon end its participation in the marketplaces created by the Affordable Care Act, also known as Obamacare.It believes there are simply too many unknowns with the Marketplace programto commit to participation beyond 2017,J. Mario Molina, president and chief executive of Molina Healthcare, said in Wednesdays call with analysts.
We will wait and see how the new administration and Congress will adjust the program, and we plan to evaluate our participation on a state-by-state basis, Molina said.
Thecompanys 2016 results are clearly unacceptable, he said, butoutside of the Marketplace issues, 2016 was, in many respects, a successful year.
Revenue was $17.7 billion close to analysts expectations of $17.8 billion, and up from $14.1 billion the year before.
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UPDATES:
2:45 p.m.: This article was updated with the stocks closing price.
11 a.m.: This article was updated with a more recent stock priceand more information about Molina Healthcares performance in individual state marketplaces.
This article was originally published at 9:30 a.m.
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Molina Healthcare stock dives on 'clearly unacceptable' earnings - Los Angeles Times
The National Australia Bank (NAB) has announced it is working with health-tech startup Medipass Solutions to develop a new digital platform to connect patients with healthcare practitioners.
Although the "Uber-like" platform is currently in testing and development phase, NAB expects it will allow users to also receive upfront cost estimates, make appointments, and take care of payment or claiming for the consultation. It will also leverage the NAB-owned health claims and payments system (HICAPS).
NAB executive general manager NAB Labs Jonathan Davey said the bank has been working closely with Medibank and a small number of practitioners since late last year to test the platform, with a full market launch slated for mid-2017.
"We will shortly broaden testing to further practitioners and we will work with more health insurers to bring to fruition the full benefits this service can offer," Davey said.
For the initiative, NAB has also partnered with Melbourne-based tech startup Localz which won NAB Labs' inaugural Hackathon in December 2014, and received funding from NAB Ventures.
"NAB and Medipass Solutions are redefining the healthcare experience, delivering an 'Uber-like' approach to the way patients, practitioners, and health funds integrate," Davey added.
"The solution delivers a seamless and transparent experience for patients, practitioners, and health insurers, through a digitally integrated platform; the first of its kind globally with such breadth and capability."
The platform is being developed initially for Allied Health Practitioners who provide Healthcare services to patients with private health insurance cover, NAB said.
Last year, NAB chief executive Andrew Thorburn said the bank was looking to make faster, bigger, better changes, and to do that, it needed to embrace the hunger found within fintech companies.
"I actually think we are a fintech company ourselves. I think we have the mindset of a fintech company, and I actually think we have a lot of the assets of a fintech company," he said previously.
"Fintech companies -- the smaller, emerging ones -- they're hungry, they want to make an impact, they find an opportunity, and they go after it. And that's the sort of hunger we need inside our own company.
"They should be respected, but not feared."
NAB updated its internet banking app in November, with the bank touting the platform as not just an app, rather a "complete experience"; one that is sitting on top of a new digital backbone.
NAB then began the rollout of its application programming interface (API) developer portal in December, which will eventually see the public availability of selected NAB APIs to third-party developers.
Last year, NAB experienced three system outages in the space of seven days.
The first hit its internet banking, customer call centres, and payments processing as a result of a "number of system outages" experienced the night before.
The bank's customers Australia-wide were then prevented from using their bank cards in ATMs or at EFTPOS terminals, with the outage also affecting NAB merchant terminals and the HICAPS system.
The third outage meant customers were unable to access their internet banking.
The bank also reported a 94.4 percent statutory profit slump to AU$352 million for the 2016 financial year, citing technology investments as a main contributing factor.
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Long Beach-based health insurance giant Molina Healthcare watched its stock price tumble Thursday, dropping $10.71 to $49.18, setting off alarms in the wake of Wednesdays deeply disappointing revenue report.
The company reported an $8 million profit for the 2016 calendar year on Wednesday, down from $143 million in 2015. Officials blamed the fall on rules within the Affordable Care Act that seek to create an even-playing field in the insurance market.
Molina Healthcares total revenue last year topped $17.7 billion, but its risk transfer payments a complex system that seeks to provide parity to insurers who must take patients, regardless of their health needs added up to $325 million more than what the company projected when setting its 2016 pricing levels.
Molina said in a call on Wednesday with investors that the government needs to change the rules, which fueled its revenue losses. The company alleged the government collected millions of dollars more than it should have.
Molina officials say they filed a lawsuit in January seeking to recover roughly $52 million in risk corridors payments made in 2015. Molina also alleges that the government owes it $90 million in payments made last year.
Molina was not alone on a rugged Thursday on Wall Street. Avon Products, a direct seller of cosmetics, also plunged after reporting weaker-than-expected results. The company said the number of sales representatives, who are famous for selling its products door to door, slipped from a year earlier. The stock dropped $1.09, or 18.6 percent, to $4.77.
The days largest loss within the S&P 500 came from TripAdvisor, which fell $5.78, or 11 percent, to $46.92 after reporting weaker revenue and earnings for its latest quarter than analysts forecast.
The news came as stock markets around the world took a breather Thursday, breaking up a torrid run thanks to an improving economy, stronger corporate earnings and hopes for more business-friendly policies from Washington.
The Standard & Poors 500 index dipped Thursday to break a seven-day winning streak, its longest in three and a half years, though it remains a nudge away from its record high.
The dollars value also dipped against rival currencies, and Treasury yields fell as bond prices rose.
The S&P 500 fell 2.03 points, or 0.1 percent, to 2,347.22. The Dow Jones industrial average rose 7.91 points, less than 0.1 percent, to set another record at 20,619.77. The Nasdaq composite dipped 4.54 points, or 0.1 percent, to 5,814.90. Four stocks fell for every three that rose on the New York Stock Exchange.
Analysts said it wasnt surprising to see stocks take a break following their long run higher.
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The market has reacted quite strongly to the Trump reflation trade, deregulation and lower-tax comments over the last couple weeks, said Nate Thooft, senior portfolio manager at Manulife Asset Management. And on top of that weve had a pretty darn good earnings season. It just needs a little bit of a breather today.
He said he still sees stocks as better investments than bonds.
Originally posted here:
Microsoft Corp. is trying again in health care, betting its prowess in cloud services and artificial-intelligence can helpit expand in a market that's been notoriously hard for technology companies.
A new initiative called Healthcare NExT will combine work from existing industry players andMicrosoft's Research and AIunits to help doctors reduce data entry tasks, triage sick patients more efficiently and ease outpatient care.
"I want to bring our research capabilities and our hyper-scale cloud to bear so our partners can have huge success in the health-care world," said Peter Lee, a Microsoft Research vice president who heads Healthcare NExT.
Microsoft has tried to expand in health care before, with mixed results. It had a Health Solutions Group for many years, but combined that into a joint venture with General Electric Co. Last year, it sold its stake to GE.
Microsoft unveiled the new effort ahead of the Healthcare Information and Management Systems Society conference next week.
The University of Pittsburgh Medical Center and Microsoft want to use things like speech and natural language recognition technology to replace manual data entry by doctors, Lee said.
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There's also a new Microsoft project called HealthVault Insights that works with fitness bands, Bluetooth scales and other connected devices to make sure patients stick to their care plan when they leave the hospital or doctor's office.
Many companies, like International Business Machines Corp. and AlphabetInc.'s Verily, are developing similar technology. However, the healthcare industry has been slow to adopt essential enabling technologylike electronic records. Entrenched, legacysystems and rigorous regulation are also obstacles, said Malay Gandhi, co-founder ofEnsemble Labs, which invests in health-care startups.
"The industry wasn't built as a tech-enabled industry," he said. Some large tech companies "aretrying to sprinkle AI or machine learning over the top of existing systems and I view that as misguided. We might need to rebuild these businesses with tech at the center."
Lee found the space daunting when Microsoft Chief Executive Officer Satya Nadella asked him to take it on.
"At first it felt like he threw me into the middle of the Pacific Ocean and asked me to find land and you see others swimming around aimlessly and beneath you people are drowning," Lee said. "Big technology firms have tried this and failed."
This time, Microsoft aims to support existing health-care organizationswith cloud services and AI software, rather than launch company-branded products that may compete with existing industry players, he said.
"We know health care will become more patient-focused, more cloud-based and that AI will make health care more data-driven. We just dont know when and and how it will come together," he said "But we can position Microsoft to be there when all these changes happen."
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Microsoft Takes Another Crack at Health Care, This Time With Cloud, AI and Chatbots - Bloomberg
SHRM | Top and Bottom Earners Responsible for Most Health Care Spending, Study Shows SHRM High-wage earners spend the most, per patient, on health care in the U.S., a new study finds. But the lowest-wage workers were the next biggest spenders on health care. In a Goldilocks scenario, those earning in the middle ranges were the least apt to ... Top and bottom earners account for most healthcare spending, Health Affairs study finds 2017 Health Care Heroes | Senior Services of Southeastern Virginia, innovations in health care |
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Top and Bottom Earners Responsible for Most Health Care Spending, Study Shows - SHRM
As GOP lawmakers work toward creating a just-right repeal and replace plan for Obamacare, some legislation being introduced has touched a nerve for AARP and older Americans.
In a letter to the Chairman and Ranking member of the U.S. House of Representatives Committee on Energy and Commerce Health Subcommittee, AARP Senior Vice President Joyce Rogers lashed out against the recently introduced State Age Rating Flexibility Act of 2017, legislation that would allow insurers to charge older Americans significantly more for health insurance.
This legislation has a simple explanation -- it would be an age tax -- charging older Americans not yet eligible for Medicare a penalty of five times what others must pay for health insurance. The term age rating is Washington-speak for overcharging older Americans by thousands of dollars for their health care, AARP Executive Vice President Nancy LeaMond told FOX Business.
Under the ACA, insurers can charge its oldest enrollees up to three times as much as the youngest adult enrollees. The new proposal would change the age rating ratio to 5:1 or even higher. According to a new study from AARPs Public Policy Institute conducted by the independent actuarial firm Milliman, under this proposal, on average, adults age 60 and older would see their insurance bills go up by $3,200 making their average annual premium a whopping $17,900.
LeaMond discussed with FOX Business what you need to know.
Boomer:What other financial burdens might Boomers face with health-care coverages, if this bill is passed?
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LeaMond:Charging older Americans five times more for the same coverage just isnt fair and AARP will fight to hold our elected officials accountable for taxing older American families with a burden they dont deserve. Seniors already spend one out of every six dollars on healthcarethey cant afford to spend more.
A typical senior without insurance in the individual market has a median income of only $20,000. Asking moderate and middle income older Americans to pay over $3,000 more out of pocket for insurance will put a major squeeze on other necessities. And, this group is already dealing with added expenses from the high prices of prescription drugs.
Add to that the fact that many parents pay for their childrens insurance until they turn twenty-six, a bill many are happy to foot, but that certainly adds to their financial burden.
Boomer: What is AARP doing to deter the passage of this bill?
LeaMond:This week, AARP launched a new campaign to stop the age tax that includes advertising and recess visits by AARP staff and volunteers to members of Congress in the states. AARPs latest efforts come in addition to our continued advocacy of members of Congress and the Trump administration about the age tax.
AARP visits with members of Congress will include vocal opposition to the age tax. Our latest efforts follow letters we have sent that lay out the negative impact of the age tax. The ads also come as an addition to AARPs Medicare campaign, which takes on premium support, a proposal that would harm Medicare beneficiaries by turning the successful program into a private voucher program.
We are encouraging our members to call their representatives in Congress at 844-617-2688 and urge them to oppose H.R. 708, the bill that would allow insurance companies to charge 50- to 64-year-olds thousands of dollars more for their health care. Remind Congress they should be standing up for their constituents, not insurance companies.You can also send a message to your Representative by going to the following website.
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AARP: 'Age Tax' Means Healthcare Price Hikes for Older Americans - Fox Business
WASHINGTON President Donald Trump said on Thursday he would be submitting planned reforms to the Affordable Care Act in early March or mid-March.
"We're doing Obamacare, we're in the final stages," Trump told a news conference, adding: "So we will be submitting sometime in early March, mid-March."
Trump ran for the White House last year on a promise to repeal and replace the signature healthcare program of his predecessor President Barack Obama known as Obamacare.
(Reporting by Susan Heavey; Writing by Eric Walsh)
WASHINGTON In a heated moment during his unconventional and combative news conference on Thursday, President Donald Trumps command of the facts was openly challenged by a reporter who asked, Why should Americans trust you?
WASHINGTON The U.S. Senate on Thursday voted to advance the nomination of President Donald Trump's pick to run the Environmental Protection Agency and a final vote could occur on Friday.
NEW YORK/CHICAGO Restaurants and other businesses around the United States shut their doors on Thursday and thousands of demonstrators took to the streets of cities across the country in a walkout aimed at protesting President Donald Trump's policies.
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Trump says he'll submit healthcare reforms in early or mid-March - Reuters
The term mindfulness is increasingly an integral part of the health care vocabulary as more medical practitioners discover how it helps create better treatment outcomes. Mindfulness clearly is a wave across the country, saysRonald Epstein, a physician and professor of family medicine, psychiatry and oncology at the University of Rochester Medical Center. He details his ideas in his recent book, Attending: Medicine, Mindfulness, and Humanity, which he discussedon the Knowledge@Wharton showon Wharton Business Radio on SiriusXM channel 111. (Listen to the podcast at the top of this page.)Below is an edited transcript of the interview.
Knowledge@Wharton: Why hasnt mindfulness been a part of medical science?
Ronald M. Epstein: It has and it hasnt. There are references to it [one can trace] even to the ancient Greeks. There were statements saying that a doctor needs to know a patient through and through in order to better take care of them. That has always been an undercurrent in medicine, because were so focused on other people on patients, and on people who are suffering.
Knowledge@Wharton: What was the tipping point to write this book now?
Epstein: Mindfulness and self-awareness were always a part of my life from a very young age. But it wasnt until Id been in practice for about 10 years that I realized that this was a fundamental and missing ingredient in medical education and medical practice, and that the public needed to hear about it.
Knowledge@Wharton: In terms of it being a missing ingredient from medical education, is it something that many institutions are realizing now, and are they starting to incorporate it?
Epstein: [That is occurring] more and more. Most medical schools now have at least an elective opportunity for medical students to participate in some kind of mindfulness workshop or a mindfulness course. At a few medical schools, including ours, [that is part of] required content for all students. As people go on through training, there are more and more opportunities for practicing physicians to learn to be more mindful, to be more attentive, and to be more present. It clearly is a wave across the country.
Its not that you just do mindfulness, or sit on a cushion, or do meditation, or take a mindful attitude, but it becomes a habit.
Knowledge@Wharton: This has been in your mind for quite some time. In fact, you lay out instances such as when you were going through your learning stages as a doctor, of other doctors that you saw making mistakes.
Epstein: They were big and obvious mistakes. When I was a third-year student, I noticed a physician who ignored something that was completely obvious within the operating field, partly because it was surprising. It was something that he wasnt expecting. It reminded me many years later of that video thats gone viral, where people are playing basketball, and then a gorilla comes across the screen, and half the people dont even see the gorilla.
This invisible gorilla in medicine is not only in the operating room, but also in the clinic. I noticed that doctors pay attention to certain symptoms more than others. They tend to ignore things that later seem obvious and are often keys to understanding whats going on with patients.
Knowledge@Wharton: This is obviously something that varies from doctor to doctor, and some are more aware of it than others.
Epstein: I think so. Its really an ability to be aware of yourself while being aware of whats going on outside.
Knowledge@Wharton: My kids are 10 and eight years old and have a mindfulness class in school this year, which caught me off guard. Is this push to bring mindfulness forward something that were seeing in many different places?
Epstein: Yes, my kids, too, [had such a class] when they were in elementary school. They were in somewhat of an alternative school setting, but they clearly had mindfulness content. Increasingly, in education, this is viewed as something important, because learning is about knowing your own mind and how it works, how you take in information, how you process information, and what biases you have. I would extend that to everything that you do in life. In your work setting, in terms of relationships, knowing yourself is important.
Knowledge@Wharton: Many people would say that being able to deal with not-so-normal situations, especially when youre younger, will help you as you get through college and head out into the business world.
Epstein: I think of these as habits of mindfulness. Its not that you just do mindfulness, or sit on a cushion, or do meditation, or take a mindful attitude, but it becomes a habit. It becomes the way that you deal with the world in general.
Knowledge@Wharton: In your research, you mention experiences with Zen Buddhism in understanding mindfulness better.
Epstein: My interest in the mind goes back to when I was a teenager and I studied Zen Buddhism. I eventually ended up at a Zen center in California for a few months, which was a formative time for me. I brought not only the practice the practicality of doing lots of sitting meditation may or may not appeal to people but the underlying attitude towards ones own mind, the possibility of knowing ones self better and using that self-knowledge to be more effective and more compassionate.
Knowledge@Wharton: Theres an interesting line in the book Doctors are trained to cling to categories. Obviously, a part of that is that doctors have specialties and they follow that path. But it sounds like doctors can be their own worst enemy in terms of maybe [diagnosing] a potential disease.
Epstein: Absolutely, and this is one of the biggest problems in diagnostic errors. In psychology they call it premature closure. That is, you find a set of symptoms, grab at the first thing that seems to fit with those symptoms, and then your mind closes even if theres disconfirming data, and even if things dont continue to add up.
I tell a couple of stories in the book that exemplify that. A friend of mine had bladder cancer and had a catheter put in. The catheter was removed, and later he was found not to be urinating normally. He went to an emergency room. It was a hot day, and the emergency room doctors thought that he must be dehydrated. Heres a relatively young, fit-looking guy whos not peeing very much. So they started an IV and gave him more and more and more fluid, not recognizing the fact that he had just had bladder surgery, and there might be an obstruction. In fact, that was the case, but it took three changes of shift and about 18 hours of IV fluids before anyone realized it.
Knowledge@Wharton: Are you able to determine, through your research for this book and maybe other studies, the impact we may have from not having this approach of mindfulness among doctors and nurses, and the health care sector in general? I would think if youre making these mistakes, there is obviously an economic impact that will happen patient by patient.
Epstein: I cant even begin to calculate what the economic impact would be. But I do know what the human impact would be for each patient, if they feel that theyve not been understood and the treatment theyre receiving is not necessarily the ideal treatment for what [medical condition] they have. It really just takes once to have an experience like that.
Im a practicing family physician, and in family medicine, probably you encounter more ambiguity than in other areas of medicine, just because people can come in with anything. Im humbled every day, realizing that its a very inexact science that Im practicing. Its a human endeavor and with some scientific trappings, if you will.
But adopting that sense of not knowing, and that sense of humility, in some ways is very protective, because then Im always not too sure of myself. Im sure of myself; Im confident. Ive been in practice for a number of years, but Im not so sure of myself that the door to other possibilities is closed.
Health care has become much more productivity-oriented and less of a human enterprise.
Knowledge@Wharton: It has to be a challenge, when most of the people you treat have the expectation that this is a perfect science.
Epstein: What youre saying is absolutely true. When Im a patient, I want things to be exact and perfect, and everything to go smoothly. But the reality is that thats a desirable goal but not achievable 100% of the time.
Knowledge@Wharton: I guess this filters down to other people within the hospital structure, as well.
Epstein: Absolutely, and it filters down to anyone whos in a high-risk profession. It would filter down to air traffic controllers. It would filter down to police officers and the military anyone who has to make judgments under uncertainty.
Knowledge@Wharton: You mention that were seeing a higher rate of doctors either leave this field because of burnout, or they change what they are doing within the medical field. That is a concern that the medical industry has to continue to deal with on a day-to-day basis.
Epstein: The degree to which health care professionals are burned out affects the quality of care that they provide. This has been proven over the past 20 years, and it clearly is a connection. The burnout problem is not just about the well-being of clinicians, but its also really about the safety of the public. When you think about that, having a resilient and self-aware and engaged health care workforce is in everybodys best interest.
Two things have happened over the past 10 or 15 years. One is that health care has become much more productivity-oriented and less of a human enterprise. No one goes into medicine to be working on an assembly line. People go into medicine because they like people, and they enjoy the interactions they have with people. [But] were spending less and less of our time face-to-face with people and more and more of our time doing administrative tasks. Some of those administrative tasks are related directly to the computerization of medical records.
Knowledge@Wharton: Can this at times be a learned experience, as well to be able, to a degree, to change your mindset as a doctor so that you are more aware of this?
Epstein: I see this as an individual enterprise, as well as a collective one. On an individual level, for example, I know that what I enjoy about seeing patients is face-to-face contact, so I dont even turn the computer on until the patient and I have had a couple of minutes to talk face-to-face, without a computer screen.
Thats a personal decision Ive made, because thats what gives me satisfaction at work, and it makes a big difference for me. However, health care institutions have a huge responsibility because in the design of health care, they have not taken human factors into account. They have not taken into account the degree to which we can assimilate information. Theyve not taken into account the fact that multitasking is impossible that we alternate between tasks. We dont do two things at the same time. And they dont take into account what gives patients and physicians the most satisfaction about their visits. Its about having real conversations.
Knowledge@Wharton: What are some of the things that you would like to see incorporated in medical education to better prepare doctors and nurses for this?
Epstein: Some of these things are really simple. There are courses in communicating with patients, but theres no education in how to prepare yourself psychologically for a potentially difficult encounter that you might have with a patient or even a routine one. I teach medical students, resident [doctors] and practicing physicians simple things, like when your hand is on the door handle and about to go into the patients room, what do you do? You can use that as a mindful moment. You can take a breath. You can mentally set aside whats happened before with a previous patient. You can practice presence. You can practice being present. The more you do this, the more it becomes second nature, so that each time you enter a patients room, your mind is just that much more fresh, more open, more receptive and the patient sees that youre present that youre really there.
If you can recognize when youre beginning to burn out and what those signs are, then you can begin to take action before things get out of hand.
Knowledge@Wharton: You also talk about how these approaches can help health care systems.
Epstein: Yes, and some health systems have done this mindfully, and others have not. Some systems are actively looking at patients experience and clinicians experience of care. Other systems are taking a production-oriented approach, in which physicians and other health care professionals are viewed as merely widgets in a very large machine.
Knowledge@Wharton: What is it that doctors and nurses need to be aware of? You have a chapter in the book called Healing the Healer.
Epstein: The first step for anyone in a high-stress profession is to recognize the earliest warning signs they have that theyre beginning to burn out. So for someone it might be a headache. For someone else, it might be a sense of an upset stomach. For some people, it may be feeling tired. Some people might not sleep as well. Some people might make more typos when theyre typing on the computer. If you can recognize when youre beginning to burn out and what those signs are, then you can begin to take action before things get out of hand. Its a collection of these simple actions that you can take during the workday that can make a difference.
Sometimes the solutions are simple, like just reminding yourself to slow down or finding a quieter place to work, where youre less likely to be distracted or taking a break, or doing something to help you connect better to your work.
Knowledge@Wharton: It could be just as simple as realizing youre at a point where you need to take a vacation or a couple of days.
Epstein: Absolutely, or even a mini-vacation. If I finish seeing patients at 7:00 at night, and Im exhausted and beginning to see double, Ill say, Well, wait a second. Finishing these charts I could try to do this now and possibly risk making some errors, or I could just leave it until early the next morning and finish them then. Without that awareness, you keep plowing ahead, and you feel worse about yourself, and the work that you do is of lower quality. So its just about becoming aware. I call it turning towards, because it means that these are not pleasant feelings, when youre beginning to feel burned out. But if you push them away and dont acknowledge them, its just going to get worse.
Knowledge@Wharton: You talk about doctors being able to practice compassion.
Epstein: I think compassion takes work. I believe that humans fundamentally have a compassionate side, but when youre dealing with suffering and tragedy, sometimes it feels too much to take that in, and you create a wall. We often forget that by creating a wall, we actually need energy to create that wall, and that energy becomes exhausting. So it may seem that its self-protective and trying to preserve yourself, but creating walls like that just sometimes makes matters worse. Now this doesnt mean that you dont need time for yourself, that you dont need space. Thats important, as well. But recognition is the first thing. The second is that there are exercises you can do to learn to be more compassionate.
In a research study that is ongoing at Duke University, they ask people to write down every day three things for which they feel grateful. Just the act of writing those things down helps you its more energizing. It makes you realize what you have and others dont, and creates what are called more pro-social attitudes attitudes that are concerned with the welfare and well-being of other people.
Knowledge@Wharton: It sounds like you have had to take the course Physician, heal thyself from time to time, as well.
Epstein: We all do. Yes, thats the little secret. We all do.
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How Mindfulness Can Lead to Better Health Care Outcomes - Knowledge@Wharton
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By Sarah Ravani, San Francisco Chronicle
Photo: Justin Sullivan, Getty Images
A worker passes out American flags during a naturalization ceremony Wednesday held by U.S. Citizenship and Immigration Services at the Los Angeles Convention Center.
A worker passes out American flags during a naturalization ceremony Wednesday held by U.S. Citizenship and Immigration Services at the Los Angeles Convention Center.
Bay Area political events: Health-care town hall, anti-Trump rallies
Political events
in the Bay Area
Friday
Anti-Trump rally and march: Justin Herman Plaza in San Francisco at 5 p.m., organized by Answer Coalition.
Saturday
Anti-Trump demonstration: A gathering under the awning of the Grand Lake Theatre, 3200 Grand Ave., Oakland, from 12 to 1 p.m. to bring attention to racial-injustice issues.
Town hall on health care: Hosted by Democratic Reps. Mark DeSaulnier of Concord, Mike Thompson of St. Helena and Jerry McNerney of Stockton, from 10:30 a.m. to noon. On the agenda are the Affordable Care Act, Medicare and Medicaid. Contra Costa County Board of Supervisors chambers, Room 107, 651 Pine St., Martinez.
Sunday
Day of remembrance: Groups in San Francisco and San Jose are holding a day of remembrance marking the 75th anniversary of Executive Order 9066, which resulted in the incarceration of Japanese Americans in internment camps in World War II. AMC Kabuki 8 Cinemas, 1881 Post St., San Francisco, 2 p.m. San Jose Buddhist Church Betsuin, 640 N. Fifth St., 5:30 p.m.
Monday
Anti-Trump rallies: Not My President rallies in San Francisco, at noon in Justin Herman Plaza; outside San Jose City Hall at 200 E. Santa Clara St. at 10 a.m.; and on the sidewalk of the 300 block of El Camino Real in San Mateo at 4:30 p.m.
Thursday
Town hall: Hosted by Rep. Mark DeSaulnier, D-Concord, from 6:30 to 8 p.m. at Diablo Valley College cafeteria, 321 Golf Club Road, Pleasant Hill.
Feb. 26
New women activist brunch: Meet and greet for women and members of womens organizations working to elect progressive, pro-abortion rights women to office. Hosted by Democratic Activists for Women Now, 11 a.m. to 3 p.m., 2302 Zanker Road, San Jose.
Anti-Trump planning meeting: Activists organizing to resist the Trump administration will hold a general meeting from 7:30 to 9:30 p.m. at the Finnish Hall, 1970 Chestnut St., Berkeley.
To list an event, email Sarah Ravani at sravani@sfchronicle.com
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Bay Area political events: Health-care town hall, anti-Trump rallies - SFGate
JOHANNESBURG
Nigerian President Muhammadu Buharis nearly monthlong medical leave in London is a sharp reminder to taxpayers that while they finance their leaders health care abroad, they often are stuck with decrepit, ill-staffed government health facilities at home.
For decades, Nigerians have paid for their leaders and former rulers to get medical treatment overseas. That courtesy also extends to senior government employees.
This is despite taxpayers funding of the State House Medical Center, said to be Nigerias best-equipped facility, which serves the president and vice president, their families and staff. The centers budget this year of 3.8 billion naira to care for fewer than 1,000 people represents 1 percent of the entire public health budget for the countrys 170 million people.
For years, billions have been budgeted for the State House Medical Center while it has always been evident that every president mostly accessed medical facilities outside the country, going back to the 1980s, said Oluseun Onigbinde, co-founder of BudgIT, an organization that tries to bring clarity to the West African nations opaque budget.
Anti-government protesters hold flags as they march in Abuja, Nigeria, Feb. 9, 2017.
Recession at home
The mysterious nature of Buharis absence is adding to the unhappiness at home, as one of Africas largest economies and oil producers lurches through a recession.
His government has not said what exactly his health issues might be or when he will return. The presidents trip, originally scheduled from January 20 to February 6, was described as a vacation during which he would undergo routine medical tests. It has been extended for further tests.
Officials insist that Buhari is hale and hearty, and he was well enough this week to speak by telephone with U.S. President Donald Trump.
Human rights lawyer Femi Falana said Nigerians should seize on the presidents medical leave to demand adequate funding for public hospitals he described as mortuaries for the masses.
The practice of allowing poor citizens to die of preventable diseases while top public officers and rich private citizens are allowed to travel abroad for medical treatment can no longer be justified, he said in a lecture this week, noting that Nigerians have a life expectancy of 52 years.
Medical bills add up
It is not clear how much the countrys taxpayers pay for leaders treatments abroad.
Former first lady Patience Jonathan has claimed that half of $31.5 million frozen in a corruption investigation was a government payout for medical bills she incurred in London in 2013. Ever-witty Nigerians took to social media to ask if she was buying eternal life.
The Ministry of Health estimated that Nigeria paid about $1 billion for government officials traveling abroad for medical care in 2014, with ordinary Nigerians spending about $6.3 billion in 2015 for what is called medical tourism.
Senior Nigerian officials get high yearly allowances for health care abroad, which provides them opportunity to demand amounts to take care of their non-health care needs like shopping abroad, economist Vitalis Chi. Nwaneri wrote in his 2013 book Governing the Ungovernable.
Former military dictator Gen. Ibrahim Babangida returned home this month from a six-week medical vacation in Switzerland. Last year, he was treated for weeks in Germany.
Taxpayers also footed the bill when former President Umaru YarAdua received months of medical treatment in Saudi Arabia in 2008-2009, before he returned home to die in office.
Best Nigerian clinic not enough
In April, Buhari announced that his government would no longer pay for officials to travel abroad for medical services available at home. But two months later, the president was in London for treatment of an ear infection.
The best-funded clinic in Nigeria does not suffice to treat the presidents ear infection. Nor does the president have enough confidence in the same clinic to do his routine checkups there, novelist Okey Ndibe wrote at saharareporters.com .
Imagine, then, the fate of Nigerians who have no choice but must seek treatment at the ill-equipped, wretchedly funded hospitals in our country? he asked.
Nigeria has just five hospital beds and not even one doctor for every 100,000 people, as opposed to an average of 35 beds and 24 doctors per 100,000 in South Africa, which has the continents most advanced medical care, according to a PricewaterhouseCoopers study in 2015.
Nigerians who can afford it shun even private health care at home.
Because the country has one of the worlds worst infant and maternal mortality rates, women fly to the United States and Britain to have babies safely delivered. The risk of a woman dying because of pregnancy or childbirth in Nigeria is one in 15, compared to one in 5,000 in developed nations, according to Dr. Chris Akani, professor of obstetrics and gynecology at Nigerias College of Health Sciences at the University of Port Harcourt.
Buharis medical bills do not come with a bed at a heftily priced five-star hotel, as did those of predecessors. The 74-year-old anti-corruption crusader known for his simple lifestyle is staying at the residence of the Nigerian High Commission in London, a spokesman said.
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Nigerians Pay for Leaders' Treatment Abroad, Get Little Health Care at Home - Voice of America
In this undated photo provided by CCRM New York, sunlight streams in to a serene, calming waiting space overlooking midtown New York's bustling cityscape, at the Colorado Center for Reproductive Medicine's New York offices. (CCRM New York via AP) less In this undated photo provided by CCRM New York, sunlight streams in to a serene, calming waiting space overlooking midtown New York's bustling cityscape, at the Colorado Center for Reproductive Medicine's New ... more Photo: AP In this undated photo provided by Perkins+Will, a fantastic flower blooms overhead in the dining area at Nemours children's hospital in Orlando, with a design theme centered on creating a hospital in a garden. (Jonathan Hillyer Photography/Perkins+Will via AP) less In this undated photo provided by Perkins+Will, a fantastic flower blooms overhead in the dining area at Nemours children's hospital in Orlando, with a design theme centered on creating a hospital in a garden. ... more Photo: Jonathan Hillyer Photography, AP
This undated photo provided by Perkns+Will shows the Lytle Center at Swedish First Hill Medical Center in Seattle, where a cozy fireplace welcomes visitors. (Eckert and Eckert Photography/Perkins+Will via AP)
This undated photo provided by Perkns+Will shows the Lytle Center at Swedish First Hill Medical Center in Seattle, where a cozy fireplace welcomes visitors. (Eckert and Eckert Photography/Perkins+Will via AP)
Designers take a holistic approach to health-care spaces
Health-care facilities can be stressful places for patients and visitors, with depressing waiting rooms, rows of uncomfortable seating, a blaring television. But designers of some medical spaces are remedying the situation.
A more holistic approach includes mood-elevating colors and artwork. Chairs are angled to look out the window. Screens offer calming nature scenes instead of newsfeeds. There's softer overhead lighting and skylights. Sometimes, diffusers even waft a gentle breeze of lavender or citrus to mask the harsh scents of disinfectants and medicines.
Sheila Semrou, a Milwaukee-based design consultant who has worked on numerous health-care facilities, says she takes inspiration from local scenery and geography. Think big windows, natural light and a palette that reflects outside vistas.
"The results can be supportive spaces that nurture occupants and provide comfort," she says.
New research is showing that a lot of clinical design norms are hard on patients, she says. Bright, polished floors can be slippery, and create glare. Bland color schemes aren't so much soothing as uninspiring.
"Studies suggest that some of the best environments for health and healing incorporate a variety of hues, use both warm and cool tones, and vary color saturation," Semrou says.
At the Diane L. Max Health Center in New York City, a project by Stephen Yablon Architecture, upbeat primary and neon colors were used on midcentury-style seating, facades and to define different areas of the building.
On the other hand, in the reception area of Memorial Sloan Kettering in West Harrison, New York, blonde terrazzo floors, rift white oak and chic, light blue chairs clad in walnut veneer create a serene space, designed by EwingCole.
In colder climes, a fireplace can add a welcoming feel at little cost, says Carolyn BaRoss, who leads a health-care interior design division at the New York firm Perkins and Will.
"A number of our projects in Canada and the northwestern U.S. have included fireplaces as part of the waiting areas and other lounges," she says. "We try to specify ones that look the most realistic and surround them with interesting materials. We've used both electric and gas fireplaces. They provide a source of warmth, but are fitted with a protective enclosure for safety."
BaRoss says an Orlando, Florida, project, Nemours Children's Hospital, has a "hospital in a garden" theme, with nature elements, daylight and views woven into the design. There are small "picnic blanket" designs in the flooring pattern, and child-size play areas, as well as "ceiling elements like the large flower in the dining area."
Treatment areas are also benefiting from this kind of patient-focused design. The Florida Hospital for Children in Orlando and the Women and Children's Hospital in Adelaide, Australia, are among facilities offering the "Philips' Ambient Experience" in MRI suites. Patients select a lighting color, as well as audiovisual projections like nature scenes, to help ease anxiety during the procedures.
At Mercy St. John's Hospital in St. Louis, an enormous vibrant butterfly greets visitors in the lobby, while patient floors are decorated with laser-cut images of animals.
BaRoss says new LED technology allows for more dimmable, flattering lighting, which can also be used to help patients find their way in a new facility.
At the Colorado Center for Reproductive Medicine in New York City, designed by Perkins and Will, chairs face out onto the cityscape. Look out the window, and you'll also see Robert Indiana's large "Hope" sculpture on the street below.
"The waiting room is typically where a patient will spend the most time. With that in mind, we took care to design an environment that's low-stress and soothing," says Dr. Brian Levine, the practice's director.
"We took advantage of the views by placing our waiting room in the brightest and most visually stimulating aspect of our floor plan. We chose light-colored wall coverings, flooring, and furniture to help reflect and carry the light throughout the room, so no patient would ever feel like they're in a 'dark corner,'" he says.
Melissa Thompson, a health-care industry strategist from Westport, Connecticut, developed breast cancer shortly after giving birth to her daughter in 2015, and began a long treatment journey. The experience got her thinking about how important physical environment was to her comfort and, she believes, even her recovery.
She didn't stay long at the first hospital she went to: "It smelled bad like an old cafeteria full of chemicals."
But Greenwich Hospital in Connecticut and Memorial Sloan Kettering in New York City were a different story. Rooms were oases of natural woods and light. Both hospitals had lounge areas where patients could relax outside of their rooms in a warm, comfortable atmosphere.
"I was noticeably happier, and discharged sooner," she says.
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Designers take a holistic approach to health-care spaces - SFGate