Thursday, February 28, 2013

These Health Law Bets Are No Figure Of Speech

More From Shots - Health News HealthNintendo Wii Helped Budding Surgeons Move To Head Of The ClassHealthNew York Medical School Widens Nontraditional Path For AdmissionsHealthWhat Happened To The Aid Meant To Rebuild Haiti?HealthHow Guinea Pigs Could Help Autistic Children

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Wednesday, February 27, 2013

UnitedHealthcare Pledges To Keep Popular Coverage, Regardless Of Supreme Court

More From Shots - Health News HealthHow Guinea Pigs Could Help Autistic ChildrenHealthScientists Sift For Clues On SARS-Like VirusHealthWhen Sizing Up Childhood Obesity Risks, It Helps To Ask About Random KidsHealthYounger Women Have Rising Rate Of Advanced Breast Cancer, Study Says

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Crisis = Opportunity for Single-Payer

Fiscal crises may force Obama to save costs via a single-payer plan.

By Roger Bybee for Dollars and Sense–

President Obama seems ready to proceed full-throttle toward a health care reform plan, but one that will keep private insurers at the center of the system. The plan, termed �guaranteed affordable choice,� would allow workers to �keep the insurance they like,� find a rival private insurer, or opt into a Medicare-style public plan.

To date, Obama has sensibly insisted that quick action on health care is imperative. �It�s not something that we can put off because of the [financial] emergency,� Obama declared in December. �This is part of the emergency.� Questioned about the wisdom of launching a $100 billion health care program at a time of mounting government deficits, �I ask a different question,� Obama countered. �How can we afford not to?�

He�s right: economic meltdown is making health care reform more urgent by the day. Hospitals are hurting; while �the number of paying patients and profitable elective procedures is down . . . ,� the LA Times reported recently, �the number of uninsured patients whom hospitals treat is rising.� At the same time, escalating health care costs are squeezing private employers and governments alike. �The new Congressional Budget Office report shows that rising health care costs are the largest driver of the nation�s long-term budget problems,� budget watchdog Robert Greenstein of the Center on Budget and Policy Priorities told Congress last fall.

But Obama�s hybrid, public-private plan is likely to hit a fiscal wall as federal spending balloons, and along with it the deficit. In the end, both popular sentiment and fiscal barriers may force him to follow a different course.

The administration�s plan subsidizes lower-income Americans to enable them to buy private health insurance. Contrary to Obama�s statements during the campaign, his plan will �need to require� all individuals to have health insurance, concludes the respected Commonwealth Fund. Such a mandate would be crucial to securing industry concessions necessary to move toward universal coverage, particularly a ban on excluding people with pre-existing conditions from coverage.

If so, the plan would eventually deliver tens of millions of new enrollees �the number of uninsured is about 47 million�to the insurance companies. Some 31% of their premiums, in many cases government-subsidized, will go into overhead and insurance company profits�an estimated $400 billion annual burden weighing down the health care system.

But this plan is on a collision course with the fiscal realities. On top of the budget wreckage left by the Bush years, the federal government�s fiscal demands are exploding. Health care reform faces daunting competition from a $787 billion stimulus package; the president�s $72 billion decision to delay repealing the Bush tax cuts for high earners; a Wall Street, bank, and insurance company bailout at $700 billion to date and likely to grow; and the ongoing Iraq and Afghanistan wars, together costing $170 billion in �extra� defense spending in FY2009.

Still, a leading advocate of the Obama plan, political scientist Jacob Hacker, argues that it can be billed as an important economic stimulus and thus escape the fierce budgetary competition. In December, Hacker cheerfully declared in The New Republic that the Obama plan offers nothing less than a �magic bullet� that will yield �short-term spending and long-term saving��a perfect combination as the economy moves deeper into recession.

However, it is likely that Hacker seriously overstates the long-term savings while underestimating the clash of government priorities that lies just ahead. First, Obama-style individual mandate plans have run aground in at least six states that have tried them. With no mechanism to control the premiums charged by private insurers, the ever-higher cost of subsidizing low-income residents� premiums soon exhausts available funds. Nor will sufficient savings be derived from Obama�s plan for electronic recordkeeping and more treatment of chronic illness, recent studies by the Congressional Budget Office and others suggest.

To many, a single-payer plan is the obvious way to ensure universal health coverage while containing costs. In addition to the dramatic reduction in administrative costs, single-payer plans offer other opportunities for controlling costs. For instance, they allow government�the �single payer� �to negotiate for lower costs with providers like doctors, hospitals, and pharmaceutical companies.

Unfortunately, Obama�s statements and key appointments suggest he has already disqualified single-payer as a serious option.

Tom Daschle, tapped for Health and Human Services secretary and �point man� on the health care reform effort until tax problems forced him to withdraw his name in February, appeared unwilling to let the private insurance industry go. His basic policy direction emerged in an interview last May. In a remark that seems staggering in hindsight, Daschle said, �And I would ask the question, if you think our banking system today is reasonably regulated, why not try the same model for our health-care system?�

Obama�s initial pick for surgeon general was TV health expert Dr. Sanjay Gupta. Gupta was trounced by Michael Moore in a televised debate over Moore�s documentary �Sicko,� and was then forced to retract some of the factually inaccurate criticisms of single-payer he had offered.

Another key player is Senate Finance Chair Max Baucus, author of a plan similar to Obama�s. Baucus recently dismissed the single-payer option on this basis: �We are Americans; we�re different from Canada, we�re different from the United Kingdom.� Baucus was probably not referring to the United States� poorer health outcomes at vastly higher costs when he spoke of the American �difference.�

Promoted by this kind of team, Obama�s health-care plan could prove to be the most vulnerable component of his domestic program. The Republicans feel confident about their ability to brand Obama�s plan as overly complex and a threat to consumer choice in medical care, as they did so successfully with the Clinton plan in the 1990s.

The Obama plan�s �pay or play� component, giving employers a choice between insuring their employees or paying a tax to help finance the government plan, will no doubt open it up to conservative criticism as a coercive, big-government program. This line may also strike a chord among moderate-income citizens who earn too much to qualify for a subsidy and consequently lose enthusiasm for reform once they start to pay mandatory health premiums.

The single-payer approach, on the other hand, would disarm many of the most explosive Republican arguments. It is far less costly to both employers and individuals�nearly 50% lower per person in Canada than the United States, for instance�and there is no billing of patients or other complexity. Every citizen enjoys the right to health care and a free choice of doctors and hospitals. Start-up costs would be minimal, especially if Medicare were simply expanded to cover the entire public.

Back in 2003, Barack Obama told the Illinois AFL-CIO: �I happen to be a proponent of a single-payer universal health care program. I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14% of its Gross National Product on health care, cannot provide basic health insurance to everybody . . . a single-payer health care plan, a universal health care plan. And that�s what I�d like to see. But as all of you know, we may not get there immediately. Because first we have to take back the White House, we have to take back the Senate, and we have to take back the House.�

Now that Obama himself occupies the White House and health care costs consume nearly 17% of GNP, the new president may rediscover that single-payer is the truly pragmatic course on health care reform. Hemmed in on all sides by the enormous costs facing the federal government, Obama may find�despite his misgivings�that pursuing a single-payer reform plan is the sole means of creating a low-cost and appealing alternative to the health-care status quo.

Roger Bybee is the former editor of the union weekly Racine Labor and is now a consultant and freelance writer whose work has appeared in Z Magazine, The Progressive, Extra!, The Progressive Populist, In These Times, commondreams.org, and other national publications and websites. Visit his webpage at www.zmag.org/zspace/rogerdbybee.

SOURCES: Jacob S. Hacker, �A Healthy Economy,� The New Republic, Dec. 31, 2008; S. Woolhandler, T. Campbell, and D. Himmelstein, �Costs of Health Care Administration in the United States and Canada,� New England Journal of Medicine, Aug. 21, 2003; Physicians for a National Health Program, �Barack Obama on single payer in 2003,� posted June 4, 2008; Maggie Mahar, �On Healthcare Reform Stimulating the Economy: the Massachusetts Example,� Health Beat blog (Century Foundation, Dec. 12, 2008); Sara Collins et al., �An Analysis of Leading Congressional Health Care Bills, 2007-2008: Part I, Insurance Coverage,� Commonwealth Fund, Jan. 9, 2009; Kevin Freking, �Health secretary pick seeks health care overhaul,� Associated Press, Jan. 10, 2009.

How the Insurer Knows You Just Stocked Up on Ice Cream and Beer

Your company already knows whether you have been taking your meds, getting your teeth cleaned and going for regular medical checkups. Now some employers or their insurance companies are tracking what staffers eat, where they shop and how much weight they are putting on�and taking action to keep them in line.

The goal, say employers, is to lower health-care and insurance costs while also helping workers. Last month, 1,600 employees at four U.S. workplaces, including the City of Houston, strapped on armbands that track exercise habits, calories burned and vital signs, part of a diabetes-prevention program run by insurer Cigna. Some diabetic AT&T employees also use mobile monitors; in September, AT&T also started selling to employers its blood-pressure cuffs and other devices to track wearers 24/7.

But companies also have started scrutinizing employees’ other behavior more discreetly. Blue Cross and Blue Shield of North Carolina recently began buying spending data on more than 3 million people in its employer group plans. If someone, say, purchases plus-size clothing, the health plan could flag him for potential obesity�and then call or send mailings offering weight-loss solutions.

Marketing firms have sold this data to retailers and credit-card companies for years, and health plans have recently discovered they can use it to augment claims data. “Everybody is using these databases to sell you stuff,” says Daryl Wansink, director of health economics for the Blue Cross unit. “We happen to be trying to sell you something that can get you healthier.”

Some critics worry that the methods cross the line between protective and invasive�and could lead to job discrimination. “It’s a slippery-slope deal,” says Dr. Deborah Peel, founder of Patient Privacy Rights, which advocates for medical-data confidentiality. She worries employers could conceivably make other conclusions about people who load up the cart with butter and sugar.

Analytics firms and health insurers say they obey medical-privacy regulations, and employers never see the staff’s personal health profiles but only an aggregate picture of their health needs and expected costs. And if the targeted approach feels too intrusive, employees can ask to be placed on the wellness program’s do-not-call list.

For their part, companies say tracking employees’ medical data saves money because they use it to make people healthier�and sometimes reward them in other ways, too.

Johnson & Johnson, for example, pays employees $500 to submit their biometrics and other health information; J&J then offers eligible employees an additional $250 if they get pregnancy counseling, enroll in a disease-management program or get their colonoscopy on time. The “tailored and targeted messages” paired with the monetary incentives are a “great way to bring people to participate in the program,” says Dr. Fikry Isaac, the company’s vice president of global health services.

With companies under more pressure than ever to reduce health-care spending, the so-called advanced analytics industry provides an opportunity to zero in on errant employees and alter their behavior. “As an employer, I want you on that medication that you need to be on,” says Julie Stone, a Towers Watson TW +0.09% benefits consultant.

Tuesday, February 26, 2013

Governors' D.C. Summit Dominated By Medicaid And The Sequester

More From Shots - Health News HealthMost People Can Skip Calcium Supplements, Prevention Panel SaysHealthGovernors' D.C. Summit Dominated By Medicaid And The SequesterHealthTo Spot Kids Who Will Overcome Poverty, Look At BabiesHealthSpanish Test: Mediterranean Diet Shines In Clinical Study

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Monday, February 25, 2013

Hospitals Clamp Down On Early Elective Births

More From Shots - Health News HealthSpanish Test: Mediterranean Diet Shines In Clinical StudyHealthPediatricians Urged To Treat Ear Infections More CautiouslyHealthHow 'Crunch Time' Between School And Sleep Shapes Kids' HealthHealthAncient Chompers Were Healthier Than Ours

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

More Answers To Your Questions About The Health Care Law

More From Shots - Health News HealthSpanish Test: Mediterranean Diet Shines In Clinical StudyHealthPediatricians Urged To Treat Ear Infections More CautiouslyHealthHow 'Crunch Time' Between School And Sleep Shapes Kids' HealthHealthAncient Chompers Were Healthier Than Ours

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Saturday, February 23, 2013

Hospital Observation Units Fill Gaps, But Patients May Foot The Bill

More From Shots - Health News HealthContagion On The Couch: CDC App Poses Fun Disease PuzzlesHealthParents, Just Say No To Sharing Tales Of Drug Use With KidsHealthTreating HIV Patients Protects Whole CommunityHealthFeds Set New Rules For Controversial Bird Flu Research

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Jill-Care: Pre-Existing Condition Insurance Plan Keeps Her Running

Jill from North Carolina is a writer and a tutor, but she�s also a runner. A few years ago, she was even training for the Olympic trials in the marathon. But one day, she suddenly passed out in a parking lot. She was diagnosed with a heart condition, atrioventricular nodal reentrant tachycardia (AVNRT).

The good news was that the condition could be remedied with a surgical procedure.

The bad news was that Jill could not afford the surgery.

For years following her diagnosis, she lived within reach of a cell phone just in case she had to call 911. Her condition worsened. �I did stop running; I stopped exercising completely because any kind of exertion would trigger an episode. So I went from running marathons competitively to doing nothing,� Jill says.

She applied for insurance that might cover her surgery, but was turned down due to her pre-existing condition. Her appeal was denied.

There didn�t seem to be a place in the health care system for her situation.

In 2011, Jill heard about the Pre-Existing Condition Insurance Plan (PCIP). PCIP is a program created by the health care law. It is designed to provide affordable health coverage for people who were otherwise locked out of the private system. It also serves as a bridge to 2014, when insurance companies are prohibited from refusing to sell coverage based on someone�s pre-existing condition.�

Jill applied for PCIP. �It took about about 10 minutes to fill out the online application. I received a [approval] letter two weeks later,� Jill says. �In another two weeks, she had her surgery. It�s been over a year since her surgery and Jill hasn�t had another episode. She�s running every single day again.

�The Affordable Care Act---and PCIP program in particular--allows me to pursue what I love to do and have medical coverage and have the comfort of having that medical coverage,� Jill says. �So I don�t have to worry if I have an injury, or an illness, or an accident, that I�m going to go bankrupt; I�m going to lose everything.�

Jill-Care in Action: Coverage for Pre-Existing ConditionsVisit PCIP.gov to learn more about this programSee Myrna's story about trying to find insurance with a pre-existing conditionSee all MyCare stories ?

Friday, February 22, 2013

Medical Waste: 90 More Don'ts For Your Doctor

More From Shots - Health News HealthThe Whole Community Gets A Health Boost From HIV TreatmentHealthFeds Set New Rules For Controversial Bird Flu ResearchHealthFlu Vaccine Has Been Feeble For Elderly This SeasonHealthMorning-After Pills Don't Cause Abortion, Studies Say

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Wednesday, February 20, 2013

Hispanic Heritage Month and Community Health Centers

One great way to celebrate Hispanic Heritage Month is to visit a community health center like First Choice Community Health Care in Albuquerque. Community health centers are the backbone of our health care system, especially for Latinos, who make up 62 percent of health center patients in New Mexico.

Because of the health care law and other Administration initiatives, community health centers are stronger than ever.

Under the health care law, we�re investing $11 billion over five years to bolster and expand more than 1,200 community health centers across the nation, helping centers renovate, increase services, build new facilities and add new technology. Health centers are already serving three million more patients today than they were in 2009, including nearly one million more Latino patients, and that number will continue to grow. We�ve also added thousands of primary care providers to the ranks of the National Health Service Corps.

These investments won�t just improve health in a community; they�re also a boost to the local economy, creating good jobs in construction and health care. New Mexico health centers employed more than 2,100 staff last year, and, nationally, centers have added 25,000 jobs since 2009.

At First Choice Community Health Care, investments from both the Affordable Care Act and the Recovery Act have added 35 new full-time equivalent permanent medical and support staff. The health care law also supported the creation of a new healthcare delivery site in Los Lunas;�including fifteen medical exam rooms and ten dental operatories. The combined investments from�the health care law and the recovery act at First Choice Community Healthcare alone have meant capacity has expanded to give nearly 10,000 new patients the ability to receive quality health care services in their local community.

Investments in health centers like First Choice Community Health Care are just the beginning. Because of the health care law, all Americans will have the opportunity to lead healthier lives and be able to get the quality health care they need and deserve.

Tuesday, February 19, 2013

Why The Hospital Wants The Pharmacist To Be Your Coach

More From Shots - Health News HealthHow The Sequester Could Affect Health CareHealthBritish Man Dies From SARS-Like Virus In U.K. HospitalHealthFew Public Family Planning Centers Accept Insurance, YetHealthCancer Rehab Begins To Bridge A Gap To Reach Patients

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Don't Count On Extra Weight To Help You In Old Age

More From Shots - Health News HealthFew Public Family Planning Centers Accept Insurance, YetHealthCancer Rehab Begins To Bridge A Gap To Reach PatientsHealthTargeted Cancer Drugs Keep Myeloma Patients Up And RunningHealthWhat Nuclear Bombs Tell Us About Our Tendons

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Saturday, February 16, 2013

Thousands Of Hospitals Face Penalties For High Readmission Rates

More From Shots - Health News HealthWhat Nuclear Bombs Tell Us About Our TendonsHealthPopular Workout Booster Draws Safety ScrutinyHealthDon't Count On Extra Weight To Help You In Old AgeHealthDarkness Provides A Fix For Kittens With Bad Vision

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Friday, February 15, 2013

HealthMap Vaccine Finder: Helping Adults Find the Vaccines They Need

When we talk about vaccines, most people think of �flu� or �childhood immunizations.� But there are actually a number of vaccines available to protect adults from serious infectious diseases and their long-term consequences. Adult vaccines can prevent diseases such as shingles, pneumonia and whooping cough. The HPV vaccine can prevent cervical cancer. And the hepatitis B vaccine also prevents the liver cancer that can develop as a result of chronic hepatitis B infection.

In the past many Americans faced financial barriers to immunization, but thanks to the Affordable Care Act, millions of Americans now have free access to the vaccines recommended by the Advisory Committee on Immunization Practices without co-payments or other cost-sharing requirements when those services are delivered by an in-network provider.

Despite the numerous benefits of vaccination, too many adults are not getting the protection that they need.� So, starting this month, it will be even easier for adults to find where to get vaccinated. Now, you can just go online and enter an address or zip code and HealthMap Vaccine Finder will locate nearby immunization providers (including health clinics and pharmacies) that offer the vaccinations routinely recommended for adults. In addition to telling people where to get the flu vaccine, the HealthMap Vaccine Finder will now tell consumers where to find providers of 10 other vaccines, including:

Hepatitis AHepatitis BHerpes Zoster (Shingles)HPV (Human Papillomavirus)MMR (Measles, Mumps, Rubella)Varicella (Chickenpox)Td (Tetanus and Diphtheria)Tdap (Tetanus, Diphtheria, and Pertusis)MeningococcalPneumococcalhttp://wcdapps.hhs.gov/Badges/Handlers/Badge.ashx?js=0&widgetname=vaccinefinderw199

The new HealthMap Vaccine Finder is an expansion of the Flu Vaccine Finder, and lists more than 50,000 providers across the country that offer flu vaccinations, searchable by vaccine delivery type (nasal spray, shot, etc.) and location. To find out where to get vaccinated in your area, go to vaccines.gov!

Thursday, February 14, 2013

Lab Findings Support Provocative Theory On Cancer 'Enemy' Within

More From Shots - Health News HealthReport: Action Needed To Wipe Out Fake And Substandard DrugsHealthSARS-Like Virus Spreads From One Person To AnotherHealthBorn First And Headed For Health Trouble?HealthWorld's Most Popular Painkiller Raises Heart Attack Risk

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Tuesday, February 12, 2013

Cancer Patient Gets Help From 'Bake Sale' And Aetna CEO

More From Shots - Health News HealthWorld's Most Popular Painkiller Raises Heart Attack RiskHealthFolic Acid For Pregnant Mothers Cuts Kids' Autism RiskHealthHospital Observation Units Fill Gaps, But Patients May Foot The BillHealthAttacks On Health Workers Put Fight To End Polio Under Fire

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Need A Price For A Hip Operation? Good Luck With That

More From Shots - Health News HealthNeed A Price For A Hip Operation? Good Luck With ThatHealthU.S. Fertility Rates Fall To All-Time LowHealthHow Parents Can Learn To Tame A Testy TeenagerHealthWhy Even Radiologists Can Miss A Gorilla Hiding In Plain Sight

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Sunday, February 10, 2013

Hanging A Price Tag On Radiology Tests Didn't Change Doctors' Habits

More From Shots - Health News HealthObscure Chagas' Disease Takes Costly TollHealthWidely Used Stroke Treatment Doesn't Help PatientsHealthFeds Reject Mississippi's Plan For Insurance ExchangeHealthStressed Out Americans Want Help, But Many Don't Get It

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Isbah-Care: Getting Health Coverage as a Young Adult

Isbah Raja, a 23-year-old student at the University of Texas, suffered from lupus, an autoimmune disease that attacks her organs, causing pains in her joints and clumps of hair to fall out. Like too many other young adults prior to passage of the health care law, she had to worry about getting and staying well while also trying to get health insurance.

She�s now covered by her father�s health plan and will be until she�s 26, because of the health care reform law. More than 3 million young adults now have health coverage because the Affordable Care Act requires insurers to allow young adults up to 26 to be covered by their parents� health plans.

YouTube embedded video: http://www.youtube-nocookie.com/embed/k9XFBOLxs2E���

The Affordable Care Act �directly had an impact on my life,� Isbah says. �I don�t have to worry about not being able to see a specialist, not being able to get the medications I need.�

And, Isbah notes, that when she ages off the plan and has to secure health insurance on her own, the health care law will bar insurers from denying her coverage because of her pre-existing condition.

�That�s a comforting feeling,� Isbah says. �There�s no more anxiety anymore.�

Friday, February 8, 2013

Health Care Law Saves Seniors Billions on Prescription Drugs

For the third straight year, the Affordable Care Act provided millions of American seniors and people with disabilities on Medicare lower costs on prescription drugs and improved benefits.� Since the health care law�s enactment, 6.1 million Medicare beneficiaries have saved over $5.7 billion on prescription drugs.

In 2010, the Affordable Care Act provided a one-time $250 check for people with Medicare who reached the Part D prescription drug coverage gap also known as the �donut hole.� Since then, individuals in the �donut hole� have continued to receive discounts on prescription drugs. Discounts on both brand name and generic drugs will continue to increase each year until the coverage gap is completely closed in 2020.

In 2012, 3.5 million people with Medicare in the �donut hole� saved $2.5 billion on prescription drugs, more than the $2.3 billion they saved in 2011.

Increased Access to Preventive Services

In addition to making prescription drugs more affordable, the Affordable Care Act is helping Americans take charge of their own health by removing barriers to preventive services.� Prior to the healthcare law, people with Medicare had to pay deductibles or co-pays for many preventive care services.� But in 2012, many recommended preventive services, including annual wellness visits, were offered to people with Medicare, with no deductibles or co-pays. �Cost is no longer an issue for seniors and people with disabilities who want to stay healthy by detecting and treating health problems early.�

As a result of better access, use of preventive services has expanded among Medicare beneficiaries.� An estimated 34.1 million people with Medicare benefited from coverage of preventive services with no cost-sharing last year.

Under the Affordable Care Act, the Medicare program has also been strengthened in other areas.� Compared to 2011, people with Medicare saw only moderate premium increases in 2012 for Medicare Part B benefits, which cover outpatient care, doctors' services, lab tests, durable medical supplies, and other services.� For those who enrolled in Medicare Advantage and prescription drug plans, average premiums remained steady.� And they now have access to a wider range of high-quality plan choices, with more four and five star plans than were previously available.� Moreover, the Affordable Care Act continues to make Medicare a more secure program, with new tools and enhanced authority to crack down on criminals who are looking to defraud the program.

With free preventive services and more affordable prescription drugs, Medicare is improving access to care and promoting the best care for people with Medicare.

Thursday, February 7, 2013

Magnets May Pull Kids With Sunken Chests Out Of Operating Room

More From Shots - Health News HealthCatholic Bishops Reject Compromise On ContraceptivesHealthBotulism From 'Pruno' Hits Arizona PrisonHealthDespite Rocky Economy, Money For Global Health Remains SolidHealthSilica Rule Changes Delayed While Workers Face Health Risks

More From Shots - Health News

Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Please enable Javascript to view the comments powered by Disqus.

Wednesday, February 6, 2013

Opening Day Crowd Shows Growing Support for Single-Payer in Oregon

An Oregon house bill sponsored by Rep. Michael Dembrow, D-Portland, is not expected to pass, but advocates claim momentum

Nearly a thousand people swarmed the front of the Oregon Capitol Building for the opening session Monday, demanding that Oregon become the second state to enact single-payer healthcare legislation, which would set up a government financing system to pay for and provide health care coverage and access for all Oregon residents.

Protestors at the Health Care for All Oregon rally hoisted signs, listened to speeches, heard woeful tales of the current health care system, and sang along to bluesman Norman Sylvester: �I don�t care what party you�re in, Democrat or Republican, we don�t need to fight, healthcare is a human right.�

�The brother said we don�t need a fight, but they�re going to fight us,� said Rep. Michael Dembrow, D-Portland, leading the crowd. Dembrow is the chief sponsor of the single-payer legislation, House Bill 1914. �We don�t necessarily need to fight back, we need to organize. Let�s go forward and organize this state, everybody in, nobody out.�

Dembrow said HB 1914 and companion legislation in the Senate already had 19 co-sponsors, all Democrats � eight more sponsors than its predecessor from the last session, HB 3510.

One of those new sponsors, Rep. Jennifer Williamson, D-Portland, said she supported the legislation because her sister was one of the thousands of Oregonians who each year file for bankruptcy under the weight of medical bills.

�I�ve been a legislator for three weeks now,� Williamson said. �The first bill I signed onto as chief legislator was a bill for universal healthcare.�

Dr. Paul Gorman, a member of Physicians for a National Health Program, said he ran a free clinic where a man came in complaining of pain in his abdomen. The man had no insurance and he put off seeing a doctor for a long time, allowing his pain to get worse and worse. �By the time he came to see us, his liver cancer was advanced, and he died.� Gorman said 500 Oregonians die each year because they don�t have insurance.

Health Care for All Oregon argued that while the Affordable Care Act signed into law by President Obama in 2010 does improve access for some people � expanding Medicaid and offering private health insurance subsidies to others � the single-payer advocates said the reforms were inadequate and would do little to rein in skyrocketing costs.

Single-payer healthcare would work similar to Medicare, with a single government fund paid for through taxes rather than paying premiums to several private companies.

HB 1914 isn�t expected to pass the Legislature or even come to the floor for a vote this session. But Dembrow expected to double the number of legislative sponsors and asked everyone in the crowd to lobby their representatives to support single-payer, hoping to find three more legislators by the end of the day.

The number of sponsors didn�t immediately grow to the goal of 22 legislators, but Marissa Johnson, an aide for Dembrow said they hoped to exceed that goal by the end of the week.

�We have interest from more than a handful of representatives and [Dembrow] will be following up with them today,� Johnson said.

Dembrow said at the rally he expected a million votes would be needed to pass a statewide measure while withstanding millions of dollars of negative advertising from groups like the for-profit private health insurance industry, which would be cut out of healthcare under the proposed system.

�The real work is not going to be done inside this building,� he said. �It�s going to be solved by a million people in Oregon, organized.�

�I think it�s going to take a lot of people stepping outside their comfort zones,� said Rio Davidson of Newport, who volunteered at the end of the rally handing out lists of legislators and asking people to contact their representatives. �Unfortunately, a lot of people who want single-payer are working low-wage jobs.�

Longtime advocate Betty Johnson said afterward that 60 organizations had been involved in the Health Care for All Oregon rally, and the group had recently hired a full-time field organizer. �Absolutely we are growing. We are organizing a number of chapters throughout the state,� she said.

Gov. John Kitzhaber has not shown support for single-payer, putting his energies instead into implementing a private health insurance exchange and transforming the healthcare delivery system through coordinated care organizations. Despite his position, Johnson said she hoped he would meet with single-payer advocates to discuss how it could work in tandem with the CCO model.

�He�s strengthening the delivery system,� Johnson said. �We really want to change the financing system. When we pass single-payer, the CCO system will work alongside it.�

Dembrow said there are restrictions in the federal Affordable Care Act that prevent states from passing single-payer laws without special permission before 2017. He lamented the added restriction, but said it also gave single-payer supporters three years to build support, get better organized, and develop a plan that would work for Oregon.

The state of Vermont enacted single-payer legislation in 2011 to cover all of its residents, but funding mechanisms are still being worked out and the state will also have to wait until 2017 to receive federal waivers.

Dembrow is introducing a second bill this session that would call on the Legislature to support a formal study of how single-payer would work in Oregon. Activists on Monday called on supporters to ask their legislators for public money, but Johnson said Dembrow believes the study could be paid for with private money.

Tuesday, February 5, 2013

Court’s Ruling May Blunt Reach of the Health Law

From the New York Times –

The Congressional Budget Office said Tuesday that the Supreme Court decision on President Obama�s health care overhaul would probably lead to an increase in the number of uninsured and a modest reduction in the cost to the federal government when compared with estimates before the court ruling.

Of the 33 million people who had been expected to gain coverage under the law, 3 million fewer are now predicted to get insurance, the budget office said in assessing the likely effects of the court decision.

The court said, in effect, that a large expansion of Medicaid envisioned under the 2010 law was a state option, not a requirement.

While it is not yet clear how many states will ultimately opt out of the expansion, the budget office said it now predicted that six million fewer people would be insured by Medicaid, the federal-state program for low-income people. Half of them, it said, will probably gain private insurance coverage through health insurance exchanges to be established in all states.

On balance, the budget office said, in 2022, �about three million more people will be uninsured� than under its previous estimates. It now says that 30 million people will be uninsured in 2022, against its estimate of 27 million before the Supreme Court decision.

The report estimates that 53 million people are now uninsured and that 60 million would be uninsured in 2022 if the law was repealed, as Republicans in Congress have proposed.

With the expected changes as a result of the court decision, the budget office said the law would cost $84 billion less than it had previously predicted.

�The insurance coverage provisions of the Affordable Care Act will have a net cost of $1.168 billion over the 2012-2022 period � compared with $1.252 billion projected in March 2012 for that 11-year period � for a net reduction of $84 billion,� or about 7 percent, the budget office said.

In addition, the budget office said that repealing the health care law would add $109 billion to federal budget deficits over the next 10 years. Specifically, it said, repeal of the law would reduce spending by $890 billion and reduce revenues by $1 trillion in the years 2013 to 2022.

The latest estimate from the nonpartisan budget office establishes a new political and fiscal reality against which future health care proposals will be measured. It also provides grist for election-year debates in campaigns for the White House and Congress.

The federal government will subsidize coverage for most people buying insurance through the exchanges, and the per-person cost to the government will be higher than if they were in Medicaid, in part because private insurers typically pay higher rates to doctors and hospitals, the report said.

�For the average person who does not enroll in Medicaid as a result of the court�s decision and becomes uninsured, federal spending will decline by roughly an estimated $6,000 in 2022,� said Douglas W. Elmendorf, director of the Congressional Budget Office.

Moreover, Mr. Elmendorf said, �for the average person who does not enroll in Medicaid as a result of the court�s decision and enrolls in an exchange instead, estimated federal spending will rise by roughly $3,000 in 2022 � the difference between estimated additional exchange subsidies of about $9,000 and estimated Medicaid savings of roughly $6,000.�

In March, before the Supreme Court decision, the budget office predicted that 17 million more people would enroll in Medicaid because of the 2010 law. In its new report, the agency does not try to determine which states will expand their Medicaid programs.

Rather, it makes a general forecast of state behavior. It estimates that one-third of �the potential newly eligible population� is in states that will fully expand Medicaid, while half is in states that will partly expand eligibility, and the remainder is in states that will not expand Medicaid at all in the next decade.

The budget office said �many states will try to work out arrangements� for partial or gradual expansion of Medicaid. Whether the Obama administration will allow such arrangements is unknown, it said.

In its report, the budget office said the court decision �will probably lead to a gap in access to coverage� as some people can obtain neither Medicaid nor insurance subsidies. This, in turn, will reduce �the strength of the social norm� for people to have insurance, it said.

In addition, it said, premiums charged for private insurance will be 2 percent higher than previously estimated because the additional subscribers will have lower average incomes, will be in �somewhat poorer health� and will need more care than previously expected.

The report says the insurance coverage provisions of the new law will cost the government $1.7 trillion from 2012 to 2022. That includes $642 billion for Medicaid, $1 trillion for subsidies and $23 billion of tax credits to help small employers buy insurance.

But, it said, the expense will be more than offset by revenues from new taxes, penalties and fees and by savings squeezed from Medicare and other government programs.

From 2014 to 2022, the report says, the federal government will collect $55 billion in tax penalties from individuals and families who go without insurance and $117 billion from employers who provide no coverage or inadequate coverage to employees.

The budget office reaffirmed its conclusion that the spending and revenue provisions of the health care law, taken together, would reduce future budget deficits. Savings in Medicare alone are expected to total roughly $700 billion in the coming decade.

Democrats have repeatedly cited the law�s deficit-reducing potential when Republicans attack it as a costly new entitlement.

Republicans say the projected savings in Medicare may be impossible to achieve because, under the law, Medicare payments to health care providers will fall further and further behind the providers� costs.

Representative Tom Price of Georgia, chairman of the House Republican Policy Committee, said the law was unaffordable, and he pointed to the $1.7 trillion price tag mentioned by the budget office.

But Representative Allyson Y. Schwartz, Democrat of Pennsylvania, said the law was a good deal that would �save $109 billion over the next decade, while increasing access to health care for millions of Americans.�

Sunday, February 3, 2013

Teaming Up with WebMD to Take Your Questions

Starting August 1st, and for the first time ever, women will have access to potentially life-saving preventive care free of charge.� Thanks to the health care law, services including well-woman visits, gestational diabetes screening, breastfeeding support and supplies, contraception, domestic violence screening, and more will be covered without cost sharing in new health plans starting August 2012 � giving women more control over their own health.

To talk about these new benefits becoming available for women, we are teaming up with WebMD to take your questions on what this means for women and their families. Please join HHS Secretary Kathleen Sebelius and Annic Jobin, WebMD�s Director of News and Partnerships, for a live online discussion on Wednesday, August 1st at 1:30pm EST.

You can watch the conversation live at www.healthcare.gov/live, and submit questions on Facebook at www.facebook.com/healthcaregov or on Twitter using the hashtag #womenshealth. You can also join the conversation here on WebMD.

To learn more about the preventive benefits that many insurers are required to cover, visit www.healthcare.gov/prevention. We hope you can join us for this important discussion.