Tag: health care reform
By John Stark
Did the Wednesday night faceoff between President Barack Obama and his Republican challenger, Mitt Romney, change your view of either man?
If you are a devout follower of either one, that’s fine. But spare us the partisan cheerleading, if you can. Tell us if the debate shifted your thinking, your leanings, your attitude in any way.
I’ll confess to tuning in a bit late, but from what I saw, Obama’s vaunted debate and speaking abilities were not much in evidence. To me he seemed tired–the Presidency seems to do that to people– and his delivery was often halting.
It was clear that Romney was working hard to convince us he’s a sensible moderate alternative–not a wild-eyed right-wing radical. He spoke earnestly about the need for government regulations.
In the discussion of Medicare, it seemed as though the world was turned upside down. Romney–standard-bearer for the party of fiscal conservatism–repeatedly bashed Obama for cutting billions from Medicare by reducing the reimbursement rates the government pays to health care providers.
But both Romney and Obama agreed on the obvious need to bring down the cost of health care. The fact is that private insurers are also trying to control costs by holding down reimbursement rates. Here is a local example.
Cutting back on reimbursements is a simple way to force health care providers to cut their own costs. Maybe too simple. But if health care costs are really going to be cut, then we need to spend less on health care. Am I missing something?
By John Stark
Atul Gawande, a Boston surgeon, suggests that hospital executives could learn a lot from restaurant chains if they want to improve the quality of their product while cutting costs.
Writing in The New Yorker, Gawande compares hospital and emergency room management practices with those at The Cheesecake Factory, a corporate chain restaurant that he and his family enjoy. He contrasts the restaurant’s intense focus on efficiency, customer service and quality with the haphazard practices that still prevail in many segments of the health care industry.
In one telling passage, Gawande reports that when he told a young Cheesecake Factory restaurant manager how the medical system operates, the restaurant guy replied, “You’re scaring me.”
Gawande also reports that corporate chain ownership is becoming more common in the hospital industry, and corporate owners are already trying to shift to the kind of management practices that Cheesecake Factory uses to mass-produce decent plates of fettucini Alfredo.
Corporate ownership and corporate cost-cutting is going to trigger knee-jerk reactions in some people. Try to keep your legs still until you read the article.
I’m sure we would all welcome informed comment from Bellingham and Whatcom County health-care providers.
From Stark
As he continues to bash Obamacare, Mitt Romney is beginning to outline his own ideas on how to decrease health care costs while improving health care availability.
He still wants to protect people with pre-existing conditions, but his approach relies on measures that he says would increase the amount of free market competition for medical coverage.
From Stark
This just in:
THE WHITE HOUSE
Office of the Press Secretary
__________________________________________________________________________________________________________________________________________________________________________________________
FOR IMMEDIATE RELEASE
February 10, 2012
FACT SHEET: Women’s Preventive Services and Religious Institutions
Thanks to the Affordable Care Act, most health insurance plans will cover women’s preventive services, including contraception, without charging a co-pay or deductible beginning in August, 2012. This new law will save money for millions of Americans and ensure Americans nationwide get the high-quality care they need to stay healthy.
Today, President Obama will announce that his Administration will implement a policy that accommodates religious liberty while protecting the health of women. Today, nearly 99 percent of all women have used contraception at some point in their lives, but more than half of all women between the ages of 18-34 struggle to afford it.
Under the new policy to be announced today, women will have free preventive care that includes contraceptive services no matter where she works. The policy also ensures that if a woman works for religious employers with objections to providing contraceptive services as part of its health plan, the religious employer will not be required to provide contraception coverage, but her insurance company will be required to offer contraceptive care free of charge.
The new policy ensures women can get contraception without paying a co-pay and addresses important concerns raised by religious groups by ensuring that objecting religious employers will not have to provide contraceptive coverage or refer women to organizations that provide contraception. Background on this policy is included below:
· Section 2713 of the Affordable Care Act, the Administration adopted new guidelines that will require most private health plans to cover preventive services for women without charging a co-pay starting on August 1, 2012. These preventive services include well women visits, domestic violence screening, and contraception, and all were recommended to the Secretary of Health and Human Services by the independent Institute of Medicine of the National Academy of Science.
· Today, the Obama Administration will publish final rules in the Federal Register that:
o Exempts churches, other houses of worship, and similar organizations from covering contraception on the basis of their religious objections.
o Establishes a one year transition period for religious organizations while this policy is being implemented.
· The President will also announce that his Administration will propose and finalize a new regulation during this transition year to address the religious objections of the non-exempted religious organizations. The new regulation will require insurance companies to cover contraception if the non-exempted religious organization chooses not to. Under the policy:
o Religious organizations will not have to provide contraceptive coverage or refer their employees to organizations that provide contraception.
o Religious organizations will not be required to subsidize the cost of contraception.
o Contraception coverage will be offered to women by their employers’ insurance companies directly, with no role for religious employers who oppose contraception.
o Insurance companies will be required to provide contraception coverage to these women free of charge.
Covering contraception saves money for insurance companies by keeping women healthy and preventing spending on other health services. For example, there was no increase in premiums when contraception was added to the Federal Employees Health Benefit System and required of non-religious employers in Hawaii. One study found that covering contraception lowered premiums by 10 percent or more.
From Stark
The Susan G. Komen Foundation official linked to the group’s (quickly reversed) decision to slash funding for Planned Parenthood has resigned.
The Christian Science Monitor reports.
This episode is one more example of social media as a powerful new political channel. This thing exploded on Facebook a few days ago.
Are left-liberal-progressives using Facebook, Twitter etc. more effectively at this point? If that is the case, will the other side of the political spectrum catch up at some point?
From Stark
Newt Gingrich, Mitt Romney and Jon Huntsman may be making a political miscalculation in blasting the individual health care mandate in President Barack Obama’s health care reform measures, Fox News analyst Juan Williams says.
Williams notes that in previous political incarnations, all three men were in favor of individual mandates–an idea that originated from the conservative Heritage Foundation.
He also notes that even as Gingrich, Romney and Huntsman scurry away from that mandate to court Republican primary voters, the idea is slowly gaining more support in the country at large — along with a number of other features in Obama’s reform package.
From Stark
Atlantic Monthly has an interesting article on a large California medical practice that has developed systems to keep elderly patients healthier. In the process, they also save health care costs, and the doctors involved make more money.
In the past, we’ve argued a bit in this space about the role of government vs. market forces in fixing our health care system. It’s encouraging to see that private-sector operators, responding to financial incentives, can provide good outcomes. It’s also worth noting that this medical firm, CareMore, works with the government’s Medicare Advantage program. And “Obamacare” apparently contains provisi0ns that will encourage widespread adoption of this kind of payment structure to drive down medical costs.
Remember: The real issue isn’t providing medical coverage for everyone. The issue is figuring out how we, as a society, can spend less on health care without shortening peoples’ lives. The CareMore experience shows how it is possible to spend less and live better and longer.
From Stark
At a gathering of conservative activists, GOP presidential hopeful Mitt Romney has proposed some major changes to Medicare, the government-funded health care system for older people.
Romney wants to give senior citizens vouchers that they could use to purchase private insurance, or to enroll in something like the existing system.
Perhaps those of you with some experience with the current Medicare system could comment on whether you think this is a good idea.
From Stark
In Las Cruces, N.M., a local hospital recently billed a woman $1,122 to cover the cost of conducting a police-ordered cavity search on her.
According to this report in the Las Cruces Sun-News, the police had enough evidence to get a search warrant from a local judge to have the invasive procedure done. They believed the woman was concealing heroin, and took her to the hospital for the search.
But no heroin was found, and now the woman’s attorney has written a letter to the county putting forth the proposition that the county, not the woman, should pay the hospital bill.
This might be a good time to check the fine print in your own health insurance policy.
From Stark
From the Associated Press, via Seattlepi.com: The Washington State Supreme Court has rejected the city of Seattle’s attempt to get Washington Attorney General Rob McKenna out of litigation aimed at blocking President Obama’s health care reform law.
I don’t have the legal opinion in front of me, but it appears that the justices held that Seattle has no legal standing to block McKenna’s involvement. At the same time, they indicated that the governor may outrank McKenna even though McKenna is independently elected, and the governor may have the authority to order the AG off the case.
But they didn’t actually rule on that possibility, because it was not in front of them in the lawsuit filed by the city of Seattle.
Democratic Gov. Chris Gregoire’s office has filed legal briefs supporting Obama’s reforms. Gregoire is not seeking reelection. McKenna is expected to be the GOP candidate to replace her.
From Stark
The individual health care mandate approved in Massachusetts under then-Gov. Mitt Romney–requiring everyone to buy health care insurance–was enacted with the help of the late Sen. Ted. Kennedy and President George W. Bush, plus backing from conservative groups like the Heritage Foundation.
So says Ryan Lizza’s lengthy report in the June 6 issue of the New Yorker. Regrettably, you have to pay to see the full article online, but there is a concise summary.
Why were Bush and Kennedy involved? Because Massachusetts had a special funding arrangement with federal medical payment systems that needed to stay in place for the Massachusetts plan to work.
The article also notes that during the 2008 campaign, Obama bashed Hillary Clinton for favoring an individual mandate. But once he got in office, Obama’s economic analysts told him the same thing that Mitt Romney had learned: universal care only makes sense when everyone has to pay a fair share.
At the time, Romney and the Republican theorists at the Heritage Foundation touted that idea as basic conservatism: no free ride.
While the 11th Circuit has joined some other federal judges in ruling against the mandate in Obama’s federal plan, this isn’t going to be over until the Supreme Court weighs in, or until Congress changes the law.
From Stark
As reported in the Washington Post, a long-term, county-by-county study of life expectancy shows that this key health metric is declining in many areas of the US, and rising elsewhere. It also shows that on a nationwide basis, the gap between life expectancy here and in Europe is increasing, even though Americans spend 50 percent more on health care.
The story includes a cool rollover map with county-by-county data. How does Whatcom stack up? I thought you’d never ask. Out of 3,143 US counties, male life expenctancy here ranks 126th, female life expectancy 142nd. From 1987 to 2007, male life expectancy here rose 4.1 percent to 77.7 years, while female life expectancy rose to 82.2 years, an increase of 2.4 percent.
From Stark
In the United States, any political talk about government-run health care is pretty much beyond the pale. All but a few of our political leaders — from both parties –assure us they would never dream of subjecting Americans to the kind of health care tyranny that oppresses the Canadians and the English.
But in Great Britain, the tables are turned. In that country, with its long-established national health care system for all, politicians of all stripes must take the pledge of allegiance to the national system, and disavow any intention of moving toward a U.S.-style private health care system.
This Los Angeles Times story, via Seattle Times, reports on the issue from the British perspective.
Prime Minister David Cameron, who generally gets high marks from U.S. conservatives for his government’s austerity budget, has recently felt compelled to insist that his reforms of the British system are not meant to move his country to a U.S.- style system.
“If you’re worried that we’re going to sell off the NHS or create some American-style private system, we will not do that,” Cameron recently told his constituents. “In this country we have the most wonderful, precious institution and also precious idea that whenever you’re ill … you can walk into a hospital or a surgery and get treated for free, no questions asked, no cash asked. It is the idea at the heart of the NHS, and it will stay. I will never put that at risk.”
From Stark
Rick Santorum, a former GOP Senator from Pennsylvania, announced his presidential candidacy Monday, June 6.
Santorum’s staunch right-to-life, anti-abortion positions have made him popular with social conservatives, and his announcement speech indicated he wants to reach out to voters concerned with economic issues and issues of federal power.
He denounced President Barack Obama’s health care reforms, and repeated the common theme that these reforms will reduce patient “choices.”
(Every time I read that statement, I wonder what choices they are talking about. Maybe that will become clear at some point.)
From Stark
In this report from the Associated Press, Democrats are touting Medicare as the issue that enabled a Democrat to score an upset win for a New York congressional seat in a Tuesday, May 24 special election.
I’m not saying that’s not true, but it’s also worth noting that this was a three-way race: The winning Democrat got 47 percent of the votes cast. The Republican got 43 percent, and a third candidate, described as a “wealthy tea party candidate,” got nine percent. Forty-three plus 9 equals 52, which indicates to me that the Democrats don’t enjoy majority support in this district.
Three-or-four-candidate general elections are bad for democracy, IMHO. Members of Congress, as well as Presidents, should be able to take office only after getting a majority of the votes. But the system doesn’t always work that way.
And as our politics become increasingly fragmented at the national level, I dread the day when a President takes the oath of office with 38 percent of the voters behind her or him.
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