The only thing that perhaps matched the vastness of the spread or the depth of the traction of the "death panel" lie was the predictability that such a lie would come to be told in the first place. After all, this was a Democratic president trying to sell a new health care reform plan with the intention of opening access and reducing cost to millions of Americans who had gone without for so long. What's the best way to counter it? Tell everyone that millions of Americans would have increased access ... to Death! The best account of how the "death panel" myth was born into this world and spread like garbage across the landscape has been penned by Brendan Nyhan, who in 2010 wrote "Why the "Death Panel" Myth Wouldn't Die: Misinformation in the Health Care Reform Debate." |
Showing posts with label Patient Protection and Affordable Care Act. Show all posts
Showing posts with label Patient Protection and Affordable Care Act. Show all posts
Friday, November 22, 2013
California Doctors Prescribe More Name-Brand Drugs Than Any Other State
Wednesday, November 20, 2013
Medicare’s Failure to Track Doctors Wastes Billions on Name-Brand Drugs
Versions of this story were co-published with Digital First Media websites and newspapers, with public radio station WNYC in New York and with American Public Media’s Marketplace.
Medicare is wasting hundreds of millions of dollars a year by failing to rein in doctors who routinely give patients pricey name-brand drugs when cheaper generic alternatives are available.ProPublica analyzed the prescribing habits of 1.6 million practitioners nationwide and found that a tiny fraction of them are having an outsized impact on spending in Medicare’s massive drug program. Just 913 internists, family medicine and general practice physicians cost taxpayers an extra $300 million in 2011 alone by disproportionately choosing name-brand drugs. These doctors each wrote at least 5,000 prescriptions that year, including refills, and ranked among the program’s most prolific prescribers. Many of these physicians also have accepted thousands of dollars in promotional or consulting fees from drug companies, records show. While lawmakers bitterly disagree about the Affordable Care Act, Medicare’s drug program has been held up as a success for government health care. It has come in below cost estimates while providing access to needed medicines for 36 million seniors and the disabled. But this seeming fiscal success has hidden billions of dollars lost to unnecessarily expensive prescribing over the program’s eight-year history. The waste is exacerbated by a ... |
ObamaCare's Union Favor
The Affordable Care Act's greatest hits keep coming, and one that hasn't received enough attention is a looming favor for President Obama's friends in Big Labor. Millions of Americans are losing their plans and paying more for health care, and doctors are being forced out of insurance networks, but a lucky few may soon get relief.
Earlier this month the Administration suggested that it may grant a waiver for some insurance plans from a tax that is supposed to capitalize a reinsurance fund for ObamaCare. The $25 billion cost of the fund, which is designed to pay out to the insurers on the exchanges if their costs are higher than expected, is socialized over every U.S. citizen with a private health plan. For 2014, the fee per head is $63. The unions hate this reinsurance transfer because it takes from their members in the form of higher premiums and gives to people on the exchanges. But then most consumers are hurt in the same way, and the unions have little ground for complaint given that ObamaCare would not have passed in 2010 without the fervent support of the AFL-CIO, the Teamsters and the rest. The unions ought to consider this tax a civic obligation in solidarity with the (uninsured) working folk they claim to support. Instead, they've spent most of the last year demanding that the White House give them subsidies and carve-outs unavailable to anyone else. But don't expect ObamaCare favors unless you helped to re-elect the President. In an aside in a Federal Register... |
Sunday, November 17, 2013
California sends misinformation to 246,000 new Medicaid enrollees
LOS ANGELES -- California has mistakenly sent letters to 246,000 low-income residents, warning they may need to find new doctors next year under the state's newly expanded Medicaid program.
The error frustrated counties and community health centers, which have repeatedly assured patients they can keep their providers when the Affordable Care Act takes effect in 2014. The patients are part of the state's "bridge to reform" program, which was designed to cover uninsured, poor Californians until they became eligible for Medicaid, known as Medi-Cal here. The program launched in 2011 and more than 600,000 people across the state enrolled in county-based health coverage. Many of them formed relationships with doctors and started seeking regular care. But county and clinic administrators said the incorrect mailing this month has put the counties' efforts in jeopardy. The mix-up occurred as people are scrambling to figure out how the health law impacts them, and as private policy holders have been receiving letters canceling their insurance plans. "The whole key to the success is that people seamlessly transition to Medi-Cal," said Sean South, an associate director at the California Primary Care Association. "It is vitally important that we don't confuse them." But that's what happened when the incorrect letters started going out on Nov. 1, said clinic and county officials. Patients immediately began calling and showing up with questions about the letter, said Eva Serrano, a... |
Saturday, November 16, 2013
Obama Selects Health Policy Advocate as Surgeon General
President Obama nominated Dr. Vivek H. Murthy, an early supporter and grass-roots advocate for the Affordable Care Act, as surgeon general on Thursday.
Dr. Murthy, 36, is a founder and the president of Doctors for America, a group that campaigned for the health care law before Congress passed it in 2010 and that was an outgrowth of Doctors for Obama, which worked to help elect the president in 2008. He is a doctor at Brigham and Women’s Hospital in Boston and an instructor at Harvard Medical School.
At a Rose Garden event in October 2009, held as the Senate Finance Committee was set to vote on the legislation, Dr. Murthy said that Mr. Obama “understands that the current system isn’t working for patients, but it’s also not working for doctors.”
Jay Carney, the White House spokesman, said Thursday in a statement that Dr. Murthy “will be a powerful messenger” on health policy. His nomination is subject to Senate approval.
Last year, he was the co-author of an article for The New Republic responding to criticism of the health care law and citing its support among doctors, although it acknowledged qualms among them. “Doctors will support the new law to the extent that it becomes visible in their everyday lives, and make these lives better,” it said.
He also has been a leader in H.I.V. prevention and AIDS education in both the United States and India. In 1995, he helped found Visions, a nonprofit AIDS and...
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Wednesday, November 13, 2013
Professionalism and Caring for Medicaid Patients — The 5% Commitment?
 Physicians have good reasons for not accepting Medicaid patients, as I learned from direct experience as a member of a nine-physician primary care practice in California. We accepted Medicaid patients, but it was difficult. Medicaid's payment rate was very low — we lost money on each Medicaid visit. When referrals were necessary, we often had to personally ask specialists to accept our patient.... |
Tuesday, November 12, 2013
FAQ: How The Health Law Impacts Federal Employees’ Health Benefits
Open enrollment season begins Monday for the approximately eight million federal workers and their dependents who receive health care coverage through the Federal Employees Health Benefits Program or FEHB. The 2010 health law calls for some changes in that coverage. Below are some frequently asked questions and answers about how the measure will impact federal workers’ health insurance.
Q: I work at a federal agency and am enrolled in FEHB. Does the Affordable Care Act require me to purchase health insurance on the law’s new online marketplaces, known as exchanges? A: No, you do not have to buy coverage on the marketplace. You can stay with FEHB. But if you want to shop for a health plan on the exchange, you will not qualify for a subsidy because the federal government pays up to 75 percent of the cost of your FEHB coverage.  A: Yes. A provision of the health law, originally authored by Sen. Charles Grassley, R-Iowa, requires that, if you are a member of Congress or work on a lawmaker’s personal staff, you must obtain your health coverage through the online insurance marketplace. And, according to a recent ruling from the Office of Personnel Management, or OPM, whether or not you are employed in the D.C. Metro area, you must purchase coverage on the District of Columbia small business exchange. “Given the location of Congress in the District of Columbia,... |
Wednesday, November 6, 2013
Neuroscience may offer hope to millions robbed of silence by tinnitus
Occupational and traumatic hearing loss claims usually have a "tinnitus component" in measurable disability as a compensable portion of the award. Today's post is shared from pbs.org . On Easter Sunday in 2008, the phantom noises in Robert De Mong’s head dropped in volume -- for about 15 minutes. For the first time in months, he experienced relief, enough at least to remember what silence was like. And then they returned, fierce as ever. It was six months earlier that the 66-year-old electrical engineer first awoke to a dissonant clamor in his head. There was a howling sound, a fingernails-on-a-chalkboard sound, “brain zaps” that hurt like a headache and a high frequency "tinkle" noise, like musicians hitting triangles in an orchestra. Many have since disappeared, but two especially stubborn noises remain. One he describes as monkeys banging on symbols. Another resembles frying eggs and the hissing of high voltage power lines. He hears those sounds every moment of every day. De Mong was diagnosed in 2007 with tinnitus, a condition that causes a phantom ringing, buzzing or roaring in the ears, perceived as external noise. When the sounds first appeared, they did so as if from a void, he said. No loud noise trauma had preceded the tinnitus, as it does for some sufferers -- it was suddenly just there. And the noises haunted him, robbed him of sleep and fueled a deep depression. He lost interest in his favorite hobby: tinkering with his ‘78 Trans Am and his two Corvettes. He stopped going into work. |
Tuesday, October 22, 2013
Lousy Medicaid Arguments
For now, the big news about Obamacare is the debacle of HealthCare.gov, the Web portal through which Americans are supposed to buy insurance on the new health care exchanges. For now, at least, HealthCare.gov isn’t working for many users.
It’s important to realize, however, that this botch has nothing to do with the law’s substance, and will get fixed. After all, a number of states have successfully opened their own exchanges, doing for their residents exactly what the federal system is supposed to do everywhere else. Connecticut’s exchange is working fine, as is Kentucky’s. New York, after some early problems, seems to be getting there. So, a bit more slowly, does California.
In other words, the technical problems, while infuriating — heads should roll — will not, in the end, be the big story. The real threat remains the effort of conservative groups to sabotage reform, especially by blocking the expansion of Medicaid. This effort relies heavily on lobbying, lavishly bankrolled by the usual suspects, including the omnipresent Koch brothers. But it’s not just money: the right has also rolled out some really lousy arguments.
And I don’t just mean lousy as in “bad”; I also mean it in the original sense, “infested with lice.”
Before I get there, a word about something that, as far as we can tell, isn’t happening. Remember “rate shock”? A few months ago it was all the rage in...
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Friday, October 18, 2013
The Many Ways the Government Shutdown Hurt Public Health and the Environment
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Political extremists pushed our nation to the brink out of sheer obstinance. Speaker Boehner could have ended this days ago by simply letting the full House vote on reopening the government. Instead, he declared himself a willing hostage to the radical wing of his party. The reopening of the government and avoiding default are obviously good news. But the deal that allowed it to happen should be a signal to the environmental community to gird for the battles ahead. The deal puts off the big fights for just a couple of months. House Republicans had a long list of anti-environmental provisions they threatened to add to the debt limit before the Affordable Care Act became their single-minded focus, and they could be part of the brinksmanship next time around.... |
Thursday, October 3, 2013
Federal Workers Nationwide Protest Government Shutdown
The US government shut down at midnight as the Republican-controlled House continued to demand changes to Obamacare, and in response workers all across the country are protesting the GOP’s actions. Nearly 100 government employees rallied in downtown Chicago at Federal Plaza on Monday to protest the shutdown, the first in seventeen years, calling Congress’ actions, “political theater of the absurd.” Fox Chicago reports workers carried signs reading: “Jobs Not Furloughs.”  When asked about the impact of a shutdown, a spokesperson for Mayor Rahm Emanuel’s office responded vaguely: “I think we all know what that looks like.”The Chicago Tribune offered some more specifics: “The early prevailing wisdom is that the Chicago area should be able to weather a short-term shutdown largely unscathed but that the impact will become more apparent the longer federal funding is suspended.” And the Sun-Times reports that if employees considered “non-essential to national health safety and security” are furloughed, it will be “more difficult or impossible” to get a passport, a gun permit, or a new Social Security card. Chris Black, who workers for the EPA, told CBS that a shutdown would do more than just furlough workers. A shutdown will also affect the jobs they do. “I’m involved... |
Thursday, September 26, 2013
Work Comp Steps Up to ACA
The Affordable Care Act's impact on workers' compensation is going to take many forms. David DePaolo points out in his shared blog today some of the aspects as the ACA is close to launch. Whether the ACA is going to emasculates the workers' compensation system is yet unknown It is sure heading that way in the new less litigious and aging society.
One of the big questions I have had since the Affordable Care Act became law was how the workers' compensation underwriting market would react since it seemed that there would be a broadening in the class of health care workers coming into the scene. That question was given some evidence yesterday when ProAssurance, a writer of medical professional liability insurance based in Birmingham, Ala., announced a proposed acquisition of Pennsylvania-based workers' compensation writer Eastern Insurance Group for $205 million. Eastern offers workers’ compensation to employers with generally 1,000 employees or less that traditionally pay an average premium per policy of $21,956, according to filings with Securities & Exchange Commission. Also, Eastern concentrates on low- to middle-hazard classes of businesses, primarily in the Mid-Atlantic, Southeast, and Midwest regions. In 2012, it reported workers comp premiums written of $182.9 million. Among those employers Eastern counts as policy holders are small hospital systems, long-term care facilities, physician and dental practices and home health care providers.... |
Monday, September 23, 2013
State Politics and the Fate of the Safety Net
Only 2% of acute care hospitals nationwide are safety-net facilities, but they provide 20% of uncompensated care to the uninsured. Because most are in low-income communities, they typically generate scant revenue from privately insured patients. The Medicaid Disproportionate Share Hospital (DSH) program was established to help defray their costs for uncompensated care. Currently, Medicaid DSH disburses $11.5 billion annually to the states, which have considerable latitude in allocating these funds. Some states carefully target their DSH payments to hospitals providing large volumes of uncompensated care, but others, such as Ohio and Georgia, spread their payments broadly, transforming the program into a de facto subsidy of their hospital industry. Because the Affordable Care Act (ACA) was expected to dramatically expand insurance coverage, safety-net hospitals were expected to need less DSH money. Therefore, to reduce the cost of expanding Medicaid, the ACA reduced Medicaid DSH funding by $18.1 billion between fiscal years 2014 and 2020. To allow time for coverage expansion to take effect, the cuts are back-loaded — starting at $500 million (4% of current national DSH spending) in 2014 but reaching $5.6 billion (49% of current spending) in 2019. The DSH cuts are so deep in part because Congress assumed that all... |
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- It's Complicated: Obamacare's Choices for People with Disabilities (workers-compensation.blogspot.com)
- Law Will Shift Demographics For Medicaid Toward Healthier Group, Study Finds (workers-compensation.blogspot.com)
- Hacking the Affordable Care Act (workers-compensation.blogspot.com)
- Walmart CEO Mike Duke Pushes Back Against Company's Minimum Wage Reputation (workers-compensation.blogspot.com)
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CMS Publishes Rules to MSP Payments Under the SMART Act
Medicare has published proposed Rules to governor obtaining information concerning the conditional payments as required by the recently implemented SMART Act. The Regulations expand the bureaucratic framework for Medicare beneficiaries and their representatives in order to obtain and appeal information on condition payment demands from the government.
The Rules are effective on November 10, 2013 and the comment period closes at 5pm on that date.
The government will be establishing a multifactorial implementation process to keep information secure: DX Codes, provider names. dates of service and conditional payment amounts. Ultimately, it appears that the process will be yet another hurdle to obtain information for workers' compensation claims and release the beneficiary from government liability for medical expenses.
The proposed CMS Rules can be reviewed at: https://www.federalregister.gov/articles/2013/09/20/2013-22934/medicare-program-obtaining-final-medicare-secondary-payer-conditional-payment-amounts-via-web-portal
The Rules are effective on November 10, 2013 and the comment period closes at 5pm on that date.
The government will be establishing a multifactorial implementation process to keep information secure: DX Codes, provider names. dates of service and conditional payment amounts. Ultimately, it appears that the process will be yet another hurdle to obtain information for workers' compensation claims and release the beneficiary from government liability for medical expenses.
The proposed CMS Rules can be reviewed at: https://www.federalregister.gov/articles/2013/09/20/2013-22934/medicare-program-obtaining-final-medicare-secondary-payer-conditional-payment-amounts-via-web-portal
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Jon L. Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). For over 4 decades the Law Offices of Jon L Gelman 1.973.696.7900 jon@gelmans.com have been representing injured workers and their families who have suffered occupational accidents and illnesses.
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Wednesday, September 18, 2013
For Workers Leaving Their Jobs, Health Exchanges Offer Insurance Choices Beyond COBRA
Workers who lose their jobs and their employer-based health insurance will have new coverage options when the Affordable Care Act's state marketplaces open in October. But consumer advocates are concerned many may not realize this and lock themselves into pricier coverage than they need.
 Many of these people will likely be better off buying a plan on the state health insurance marketplaces, also called exchanges. Plans sold there must cover a comprehensive set of 10 "essential health benefits," and consumers can choose among four plan types with different levels of cost-sharing. Premium tax credits will be available to people with incomes between 100 and 400 percent of the federal poverty level ($11,490 to $45,960 for an individual in 2013), often making exchange coverage significantly more affordable than COBRA. "COBRA was a transitional type of coverage while you're between jobs, but now we have a subsidized form of coverage available, exchange plans with subsidies," says Edwin Park, vice president for health policy at the Center on Budget and Policy Priorities. It's... |
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Friday, September 13, 2013
Hacking the Affordable Care Act
| By ROGER COLLIER The most detailed so far is from the conservative American Enterprise Institute, which has published an unexpectedly non-doctrinaire study authored by Harvard professor Michael Chernew and seven other respected academics. It’s far from perfect, but it’s worth reading. Structural details of the AEI proposal, modestly titled “Best of Both Worlds,” aren’t always clear (page 1 lists four “principles,” page 5 lists five “priorities”, and page 16 lists three “major planks”), but it does attempt a bipartisan approach, combining ideas from left and right. Some of these ideas have been contained in other proposals, such as those of Wyden and Bennett and Fuchs and Emanuel (which may damn the AEI proposal in right-wing eyes), and most recently in a THCB piece by Martin Gaynor. They include the elimination of the employer coverage tax preference, the provision of “premium support” subsidies for most individuals, and the establishment of a national insurance exchange. Together, they are designed to encourage individual choice and responsibility and to maximize competition between insurers, while removing some of the inequities of the present system (and of the ACA). The AEI... |
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Tuesday, September 10, 2013
Law Will Shift Demographics For Medicaid Toward Healthier Group, Study Finds
The health law is expected to change the face of Medicaid – literally. Using statistics from the National Health and Nutrition Examination Survey, the authors found that the group of newly eligible individuals is:
“It’s really a game changer,” said Dr. Tammy Chang, a lead author of the report. “A lot of providers think of Medicaid... |
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