Friday, May 31, 2013

Proton Beam Therapy Sparks Hospital Arms Race

More From Shots - Health News Health D.C. Agency Approves 2 High-Tech Cancer CentersHealthSurvivor Of Boston Marathon Bombings Has Long Road AheadHealthYoung Women With Breast Cancer Opting For MastectomyHealth CareProton Beam Therapy Sparks Hospital Arms Race

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Tuesday, May 28, 2013

Obama's Next Big Campaign: Selling Health Care To The Public

Listen to the Story 4 min 20 sec Playlist Download Transcript   Enlarge image i

President Obama speaks about the Affordable Care Act at the White House on May 10.

Mandel Ngan/AFP/Getty Images

President Obama speaks about the Affordable Care Act at the White House on May 10.

Mandel Ngan/AFP/Getty Images

President Obama often tells audiences that he has waged his last campaign. But that's not exactly true.

The White House is gearing up for a massive campaign this summer that will cover all 50 states, plus Washington, D.C. And the president's legacy may hinge on whether it succeeds or fails.

The Affordable Care Act, or "Obamacare," has been through more life-and-death cliffhangers than a season finale of Homeland. After squeaker votes in Congress and a 5-4 ruling upholding the law at the Supreme Court, now there's another big hurdle: getting uninsured people to buy health care when it becomes available Oct. 1.

When Obama delivered the commencement address at Morehouse College this month, his advice to the graduates � along with working hard and helping others � was to sign up for health insurance this fall.

"We've got to make sure everybody has good health in this country," he said. "It's not just good for you, it's good for this country. So you're going to have to spread the word to your fellow young people."

Reaching Out

David Simas, deputy senior adviser to the president, works in a quintessential West Wing office � a windowless basement room � where he oversees one of the top projects on the Obama agenda: implementing universal health coverage.

In the first year, the administration hopes to sign up 7 million people across the country. Simas says that will require TV ads, door knocking and lots of word of mouth.

"It is an on-the-ground effort," he says. "It is a social media effort. It is a paid media effort. It is an earned media effort. But [it's] all leading to the same thing, which is that man or woman sitting in their living room online, comparing different prices for different products and deciding what works best for them."

The administration is developing an Expedia-style website, hoping to make the experience as customer-friendly as possible.

But just getting people to that website is a huge task. Last month, a Kaiser Family Foundation poll showed that 4 in 10 Americans don't even know the health care law is still on the books.

Nancy-Ann DeParle, who has worked on this issue for years � until recently as Obama's deputy chief of staff � says that's not a cause for concern.

"The truth is that people weren't paying attention until now," she says. "There's so much else going on that even if we had wanted to start a campaign two years ago, it wouldn't have been very effective because people weren't listening."

Financial Stumbles

But with the sign-up date approaching fast, the administration's efforts have already stumbled. Health and Human Services Secretary Kathleen Sebelius has repeatedly asked Congress for money to implement Obamacare.

Republicans have repeatedly said no, while they vote to repeal the law.

Without the money she wanted from Congress, Sebelius tried to fundraise for an independent group called Enroll America that is focused on implementing Obamacare. When Republicans heard that she was asking insurance companies and health care providers to donate millions of dollars, they cried foul.

Tennessee Sen. Lamar Alexander told Fox News: "Congress has said we refuse to give you more money to implement Obamacare, and she's saying, 'Well then, if you won't do it, I'll go outside and I will raise private money, use a private organization, and do it anyway.' "

Now two Republican-controlled House committees are investigating the solicitations. Dan Mendelson of the health care consulting group Avalere says that makes donors skittish.

"Much as a health care company might really want to improve enrollment, they also need to make sure that they do not run afoul of politicians on either side of the aisle," Mendelson says.

If health care companies hold back, he says, it's going to be much harder to reach all of those people in all of those communities.

"The fact of the matter is that if you starve a media campaign for funding, you're not going to have the reach that you otherwise would, and that's the situation that we find ourselves in," he says.

There's another key part of this campaign: Sicker and older people without insurance may be eager to sign up Oct. 1. But to make the system work financially, young and healthy people who don't need much medical care have to get into the pool, too.

So you can expect administration officials around the country to give lots more commencement speeches this season, telling captive audiences of 20-somethings: Congratulations on your diploma. Now make sure to sign up for health coverage in the fall.

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Saturday, May 25, 2013

Health Insurance At 'Good Prices' Coming To Calif. Exchange

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Friday, May 24, 2013

Healthcare For A Family Now Costs More Than Groceries To Feed Them For A Year

As medical costs continue to rise, the annual health expenses for a family of four now exceed the typical of cost of their groceries during the same time period, according to a new report from consulting firm Milliman, Inc.

The firm estimates that a typical family of four with an employer-sponsored health plan will end up incurring about $22,030 for all of their medical costs in 2013. That represents a 6.3 increase from last year, when the typical family racked up $20,728.

Some of that total sum ends up being covered by the family�s health insurance plan � the firm�s analysts found that employers paid about 58 percent of the total health care costs � but a big chunk of it falls onto the family itself. The average family pays more than $9,000 in payroll deductions and out-of-pocket bills for their health care, which is more than they typically spend on groceries and gas for an entire year:

�It is a huge expense,� Chris Girod, principal and consulting actuary at Milliman Inc. said in an interview. �Although the trends are slowing down, the total dollar amount has risen $1,300 per year each of the last four years.�

Meanwhile, the share a family and employees pay continues to rise as employers push more costs onto their workers. Therefore, the total share of the overall costs continues to mount, surpassing other household milestones like food and a year�s worth of gas.

�The total share of this cost borne directly by the family � $9,144 in payroll deductions and out-of-pocket costs � now exceeds the cost of groceries for the (Milliman Medical Index�s) typical family of four,� the study says. �The out-of-pocket cost alone � $3,600 for co-pays, coinsurance and other cost sharing, is more than the average U.S. household spends on gas in a year.�

That�s been a consistent trend over the past several years. As the cost of health care increases, Americans� contributions to their health plans have risen at a much faster rate than their employers� share. Since 2003, workers in every single state have had to increase their contributions to their family health plans by nearly 75 percent. At the same time, workers� wages have stagnated. As struggling Americans aren�t able to afford the treatment they need, they�re putting off doctor�s visits and skipping out on their medication.

And, if the regular health costs that a typical American family incurs over the course of the year already represent such a big expense, it�s easy to see how just one catastrophic medical event could plunge Americans into serious debt. The average trip to an emergency room costs 40 percent more than what most Americans spend on monthly rent. It�s even worse for those with ongoing conditions that need expensive treatment � for instance, the Americans who are battling cancer are twice as likely to go bankrupt, even if they have health insurance.

Thursday, May 23, 2013

Class of 2013: Graduate with Peace of Mind

To the Class of 2013:

Congratulations on a well-earned graduation. I know how much hard work it took to get here today.

This is a time when you�re making big decisions about the future. You might be embarking on a new career, transitioning to a different city, and thinking about the start of this next exciting stage in life.

I�m sure the last thing you�re thinking about is health insurance. But unfortunately, the unexpected can happen.

The good news is that now the Affordable Care Act provides protections and benefits that give you greater control of your health care.� The law helps you by:

Making it possible to stay on your parent�s health plan until you turn 26, giving you the flexibility to make choices about your future without worrying about where you�re going to get health insurance.Requiring most insurance plans to cover proven preventive services�like birth control and certain cancer screenings�without you paying a penny.Barring insurers, beginning in 2014, from denying you coverage because of a pre-existing condition, like cancer, asthma, or acne, or making you pay more just because you are a woman.�Creating an online Health Insurance Marketplace, where you can find coverage that meets your needs and budget. You can also find out if you qualify for financial assistance. Sign up now at HealthCare.gov for updates; enrollment begins October 1, 2013.

Bottom line: Because of the Affordable Care Act, you�ll be able to begin this next chapter of your life with the peace of mind and security health insurance provides.

Congratulations on your achievement!

Wednesday, May 22, 2013

Unions break ranks on ObamaCare

Labor unions are breaking with President Obama on ObamaCare.

Months after the president�s reelection, a variety of unions are publicly balking at how the administration plans to implement the landmark law. They warn that unless there are changes, the results could be catastrophic.
The United Food and Commercial Workers International Union (UFCW) � a 1.3 million-member labor group that twice endorsed Obama for president � is very worried about how the reform law will affect its members� healthcare plans.

Last month, the president of the United Union of Roofers, Waterproofers and Allied Workers released a statement calling �for repeal or complete reform of the Affordable Care Act.�

UNITE HERE, a prominent hotel workers� union, and the International Brotherhood of Teamsters are also pushing for changes.

In a new op-ed published in The Hill, UFCW President Joe Hansen homed in on the president�s speech at the 2009 AFL-CIO convention. Obama at the time said union members could keep their insurance under the law, but Hansen writes �that the president�s statement to labor in 2009 is simply not true for millions of workers.�

Republicans have long attacked Obama�s promise that �nothing in this plan will require you to change your coverage or your doctor.� But the fact that unions are now noting it as well is a clear sign that supporters of the law are growing anxious about the law�s implementation.

Many UFCW members have what are known as multi-employer or Taft-Hartley plans. According to the administration�s analysis of the Affordable Care Act, the law does not provide tax subsidies for the roughly 20 million people covered by the plans. Union officials argue that interpretation could force their members to change their insurance and accept more expensive and perhaps worse coverage in the state-run exchanges.

Hansen, who is also the head of the Change to Win labor federation, told The Hill that his members often negotiate with their employers to receive better healthcare services instead of higher wages. Those bargaining gains could be wiped away because some employers won�t have the incentive to keep their workers� multi-employer plans without tax subsidies.

�You can�t have the same quality healthcare that you had before, despite what the president said,� Hansen said. �Now what�s going to happen is everybody is going to have to go to private for-profit insurance companies. We just don�t think that�s right. … We just want to keep what we already have and what we bought at tremendous cost.�

If the administration were to expand the subsidies to cover the Taft-Hartley plans, it�s likely that the price tag for ObamaCare would rise, though it�s unclear by how much.

Union angst over the healthcare law is being matched by some Democrats on Capitol Hill. Senate Finance Committee Chairman Max Baucus (D-Mont.) has said the law�s implementation could be a �train wreck,� while other senior Democrats, including House Minority Whip Steny Hoyer (D-Md.), have expressed reservations.

Both parties agree that ObamaCare is going to be a major issue in the 2014 midterm elections, especially because the bulk of the law is scheduled to go into effect on Jan. 1 next year.

Labor recently shared its concerns with senior Democrats.

Earlier this month, the subject of how multi-employer health plans would be treated under ObamaCare was brought up at a private May 8 meeting between union leaders and the Senate Democratic Steering and Outreach Committee.

�A number of people were making this point at that meeting. People said that their members are upset about this and the more they learn about it, the more upset they are,� said one union official.

�I was pretty blunt about it,� said Hansen. �I told them it was a very serious issue. That it was wrong. Taft-Hartley plans should be deemed as qualified healthcare providers and I also said it�s going to have political repercussions if we don�t get this fixed.�

Hansen wants the Obama administration to use its regulatory powers to address the matter; a legislative remedy is all but impossible in the divided 113th Congress.

�When [the Obama administration] started writing the rules and regulations, we just assumed that Taft-Hartley plans � that workers covered by those plans, especially low-wage workers � would be eligible for the subsidies and stay in their plans and they�re not,� Hansen said.

Union anger on multi-employer plans has been percolating for months. In January, The Wall Street Journal reported that UNITE HERE and the Teamsters were pressing the administration. UFCW was also mentioned in that report.

Asked why he decided to raise the volume on his worries about ObamaCare, Hansen said he needed to speak out in support of his members.

�I owe it to my members to do everything I can to see if we can make this law better,� Hansen said.

He added, �[Administration officials] have given us a lot of time and attention. We just don�t agree and I still think that I have taken the correct position. They have been responsive as far as trying to get the meetings. It�s just we can�t get it across the finish line and we need to do that.�

Hansen, however, said he has no regrets about endorsing Obama or supporting the healthcare reform law. UFCW is a major Democratic donor, contributing to several of the party�s candidates and giving to last year�s convention in Charlotte, N.C., and this year�s inauguration.

The union president said changes to his members� health insurance might lead to problems at the ballot box for candidates.

�What happens in 2014 could be at issue here. … There is going to be a lot of disenchantment with how did this happen and who was in power when it happened. No matter what I say, that�s going to be there,� Hansen said. �They are upset already and it hasn�t even taken effect already.�

Wednesday, May 15, 2013

Obamacare Issues Beg the Questions that Single-Payer Answers

In recent days, many of us have read and tried to follow the reports that Congressional offices are engaged in discussions about how to make sure their health insurance coverage available under the Affordable Care Act (Obamacare) remains affordable for Congresspersons and their staff members. If you�d like to read more about the hullabaloo, this piece from the Washington Post probably explains it as clearly as any.

Basically, a mischievous amendment drafted and inserted by Republicans and later agreed to by Democrats anxious to pass the ACA leaves some challenging issues to be resolved regarding the employer�s (in this case the Federal government, a.k.a., you and me) contributions to paying their share of premiums for Congressional members and their staff members. Negotiations and discussions continue, but some fear that some Congressional staff may leave their positions rather than take on the bigger financial burdens of paying more of their health insurance premiums. Stay tuned, if you are worried about how this plays out.

For the human beings involved who have health needs and families to support just as the rest of us do, I hope a fair resolution is reached in the short term. In the longer term, this should serve as yet another reinforcement of the need to move well beyond the incredibly unaffordable Affordable Care Act to the common sense, common decency, and simplicity of a single-payer, Medicare for all for life model for our dysfunctional health care system.

If Congressional members and their staffs are having difficulties comprehending and navigating the details of the ACA, imagine the millions and millions of �average� Americans who will face incredible confusion, expense, and delays of access to needed health care as we slog through the details of the ACA. Most of us will not have anyone to negotiate or advocate for us when we try to make decisions about health coverage. We will have �navigators� who will explain various plans available on the exchanges but that�s vastly different from having true advocates to make sure we aren�t overburdened with costs or enrolling in coverage that really isn�t coverage at all but simply compliance with the mandate to carry the financial product that is insurance. I am already worried, just as millions of others are.

Why would single-payer, Medicare for all for life be so much better? Simplicity � everybody is in, nobody is out. Vastly reduced administrative costs � strip out the profit made on misery and deception and advertising and claims denials and delays. Incredibly improved access to providers of our choice. No need to navigate me to one plan or another. No need to bankrupt me with co-pays, deductibles and out-of-pocket expenses. No need for anyone in charge of profit-making to lemon drop (get rid of those with costly medical conditions or who are aging) or cherry pick (keep the healthy, less costly folks enrolled). We all have one single standard of high quality care under a social insurance model, not a model aimed at maximizing profits.

Some of us will face harsh realities more quickly than Congressional members of staffers on the Hill. In just four days, I must decide once and for all whether or not to spend more than $800 a month on my coverage for the next several months or just go bare until the exchange (more stealthily named the �marketplace�) is up and running here in Colorado in January 2014. No matter what I, as a two time cancer survivor and 58 year old, think is possible financially for me or even wisest from a health standpoint over the next eight months, once I get to October of this year, I will be able to begin exploring what I may be able to find under the ACA for my coverage. I am so grateful that my husband is covered under Medicare and a supplemental (as are many member of Congress, I suspect).

When my time comes to decide about my health and my life, there will be no committee convened that worries about my costs or my coverage as is the case with the current effort on behalf of the Congressional members and staffs my tax dollars cover. I will decide alone, likely in front of my computer screen, making calculations about paying my bills and other living expenses. And I guarantee that my coverage will be bare bones as no one will want to cover me and though under the ACA they will not be able to deny me coverage, insurance companies will be able to age-rate my premiums and make sure they factor in my health history. My premiums will likely be so high that I will either have to opt to pay a penalty for not having coverage or I will be grossly under-insured.

None of this is necessary. None of it. Under a Medicare for all for life, single-payer model, we are all in one risk pool, we all pay a fair and progressive tax or premium for our coverage, and our medical and health decisions will no longer be business calculations. We will be free of this mess. We must thunder forward through the confusion of this difficult transition to the unnecessary complexity of the ACA to the day when we all are covered simply as a matter of human right and public good.

Donna Smith is the Executive Director of Health Care for All Colorado and the Health Care for All Colorado Foundation.

Obamacare Issues Beg the Questions that Single-Payer Answers

In recent days, many of us have read and tried to follow the reports that Congressional offices are engaged in discussions about how to make sure their health insurance coverage available under the Affordable Care Act (Obamacare) remains affordable for Congresspersons and their staff members. If you�d like to read more about the hullabaloo, this piece from the Washington Post probably explains it as clearly as any.

Basically, a mischievous amendment drafted and inserted by Republicans and later agreed to by Democrats anxious to pass the ACA leaves some challenging issues to be resolved regarding the employer�s (in this case the Federal government, a.k.a., you and me) contributions to paying their share of premiums for Congressional members and their staff members. Negotiations and discussions continue, but some fear that some Congressional staff may leave their positions rather than take on the bigger financial burdens of paying more of their health insurance premiums. Stay tuned, if you are worried about how this plays out.

For the human beings involved who have health needs and families to support just as the rest of us do, I hope a fair resolution is reached in the short term. In the longer term, this should serve as yet another reinforcement of the need to move well beyond the incredibly unaffordable Affordable Care Act to the common sense, common decency, and simplicity of a single-payer, Medicare for all for life model for our dysfunctional health care system.

If Congressional members and their staffs are having difficulties comprehending and navigating the details of the ACA, imagine the millions and millions of �average� Americans who will face incredible confusion, expense, and delays of access to needed health care as we slog through the details of the ACA. Most of us will not have anyone to negotiate or advocate for us when we try to make decisions about health coverage. We will have �navigators� who will explain various plans available on the exchanges but that�s vastly different from having true advocates to make sure we aren�t overburdened with costs or enrolling in coverage that really isn�t coverage at all but simply compliance with the mandate to carry the financial product that is insurance. I am already worried, just as millions of others are.

Why would single-payer, Medicare for all for life be so much better? Simplicity � everybody is in, nobody is out. Vastly reduced administrative costs � strip out the profit made on misery and deception and advertising and claims denials and delays. Incredibly improved access to providers of our choice. No need to navigate me to one plan or another. No need to bankrupt me with co-pays, deductibles and out-of-pocket expenses. No need for anyone in charge of profit-making to lemon drop (get rid of those with costly medical conditions or who are aging) or cherry pick (keep the healthy, less costly folks enrolled). We all have one single standard of high quality care under a social insurance model, not a model aimed at maximizing profits.

Some of us will face harsh realities more quickly than Congressional members of staffers on the Hill. In just four days, I must decide once and for all whether or not to spend more than $800 a month on my coverage for the next several months or just go bare until the exchange (more stealthily named the �marketplace�) is up and running here in Colorado in January 2014. No matter what I, as a two time cancer survivor and 58 year old, think is possible financially for me or even wisest from a health standpoint over the next eight months, once I get to October of this year, I will be able to begin exploring what I may be able to find under the ACA for my coverage. I am so grateful that my husband is covered under Medicare and a supplemental (as are many member of Congress, I suspect).

When my time comes to decide about my health and my life, there will be no committee convened that worries about my costs or my coverage as is the case with the current effort on behalf of the Congressional members and staffs my tax dollars cover. I will decide alone, likely in front of my computer screen, making calculations about paying my bills and other living expenses. And I guarantee that my coverage will be bare bones as no one will want to cover me and though under the ACA they will not be able to deny me coverage, insurance companies will be able to age-rate my premiums and make sure they factor in my health history. My premiums will likely be so high that I will either have to opt to pay a penalty for not having coverage or I will be grossly under-insured.

None of this is necessary. None of it. Under a Medicare for all for life, single-payer model, we are all in one risk pool, we all pay a fair and progressive tax or premium for our coverage, and our medical and health decisions will no longer be business calculations. We will be free of this mess. We must thunder forward through the confusion of this difficult transition to the unnecessary complexity of the ACA to the day when we all are covered simply as a matter of human right and public good.

Donna Smith is the Executive Director of Health Care for All Colorado and the Health Care for All Colorado Foundation.

Tuesday, May 14, 2013

A Sharper Abortion Debate After Gosnell Verdict

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Sunday, May 12, 2013

Dramatically Different Medicare Bills Set Hospitals Thinking

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Wednesday, May 8, 2013

Veterans Have Unusual Choice Thanks To Health Exchanges

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Tuesday, May 7, 2013

About Half of Adults Lacked Adequate Health Coverage in 2012

About half of United States adults ages 19 to 64 didn�t have health insurance for at least part of last year or were underinsured, a new report from the Commonwealth Fund says.

The fund, a private nonprofit organization that finances research into health care and health policy issues, conducts the health insurance survey every two years.

One bright spot, the report found, is that the proportion of young adults without health insurance fell significantly over the last two years, probably because of a provision of the Affordable Care Act that allows young adults to stay on their parents� health plans until age 26. The rule took effect in September 2010.

Nearly eight out of 10 (79 percent) young adults reported that they were insured, up from 69 percent in 2010. That marks �an abrupt reversal in a decadelong climb� in the number of uninsured young adults, the report said.

Uninsured rates for other age groups, however, either rose or stayed the same. About half of adults ages 19 to 64 didn�t have health insurance for all of 2012 or were underinsured, meaning that they had insurance but struggled to pay for medical costs anyway.

At the time of the survey, about 30 percent said they were uninsured or were insured but hadn�t been at some point during the year. Another 16 percent had insurance, but had such high out-of-pocket medical costs relative to their income that they were effectively uninsured.

The survey also found that people are increasingly skipping needed health care because they can�t afford it (about 43 percent answered yes to that question). That�s up from 37 percent in 2003, the report noted.

The report found that about two out of every five adults had trouble paying medical bills last year or were paying off medical debt over time, and that many of those struggling with medical debt (42 percent) said they had received a lower credit rating as a result.

The results are based on a telephone survey of 4,432 adults by Princeton Survey Research Associates International from April 25 to August 19, 2012. The margin of sampling error is plus or minus 2 percentage points.

The report is the last one the fund will conduct before the major provisions of the Affordable Care Act are scheduled to go into effect, in January 2014.

Did you have a gap in insurance coverage last year? Do you expect the health care law to help provide you with coverage?

Pfizer Goes Direct With Online Viagra Sales To Men

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Saturday, May 4, 2013

Urologists Recommend Less PSA Testing For Prostate Cancer

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Friday, May 3, 2013

Colorado Weighs Reopening Psychiatric Hospital For Homeless

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Wednesday, May 1, 2013

Ratting Out TB: Scientists Train Rodents To Diagnose Disease

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