Friday, May 31, 2013

Young Women With Breast Cancer Opting For Mastectomy

More From Shots - Health News HealthYoung Women With Breast Cancer Opting For MastectomyHealth CareProton Beam Therapy Sparks Hospital Arms RaceHealthAdministration Touts Competition In Insurance ExchangesHealthHeaded To Mars? Watch Out For Cosmic Rays

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Young Women With Breast Cancer Opting For Mastectomy

More From Shots - Health News HealthYoung Women With Breast Cancer Opting For MastectomyHealth CareProton Beam Therapy Sparks Hospital Arms RaceHealthAdministration Touts Competition In Insurance ExchangesHealthHeaded To Mars? Watch Out For Cosmic Rays

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Thursday, May 30, 2013

Health Law Spared Young Adults From High Hospital Bills

More From Shots - Health News HealthHeaded To Mars? Watch Out For Cosmic RaysHealthJoblessness Shortens Life Expectancy For White WomenHealthImmigrants Subsidize, Rather Than Drain, MedicareHealthMisplaced Blame On Childhood Ritalin For Later Substance Abuse

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Wednesday, May 29, 2013

Health Differences May Explain Medicare Spending Variation

More From Shots - Health News HealthDisinfect All ICU Patients To Reduce 'Superbug' InfectionsHealthMiddle East Coronavirus Called 'Threat To The Entire World'HealthHealth Law Spared Young Adults From High Hospital BillsHealthBird Flu Shrugs Off Tamiflu In 'Concerning' Development

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Health Differences May Explain Medicare Spending Variation

More From Shots - Health News HealthDisinfect All ICU Patients To Reduce 'Superbug' InfectionsHealthMiddle East Coronavirus Called 'Threat To The Entire World'HealthHealth Law Spared Young Adults From High Hospital BillsHealthBird Flu Shrugs Off Tamiflu In 'Concerning' Development

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Tuesday, May 28, 2013

Good News on Innovation and Health Care

A recent New York Times column, Obamacare�s Other Surprise, by Thomas L. Friedman echoes what we�ve been hearing from health care providers and innovators: Data that support medical decision-making and collaboration, dovetailing with new tools in the Affordable Care Act, are spurring the innovation necessary to deliver improved health care for more people at affordable prices.

Today, we are focused on driving a smarter health care system focused on the quality � not quantity � of care.� The health care law includes many tools to increase transparency, avoid costly mistakes and hospital readmissions, keep patients healthy, and encourage new payment and care delivery models, like Accountable Care Organizations.� Health information technology is a critical underpinning to this larger strategy.�� �

Policies like these are already driving improvements. Prior to the law, nearly one in five Medicare patients discharged from a hospital was readmitted within 30 days, at a cost of over $26 billion every year.� After implementing policies to incentivize better care coordination after a hospital discharge, the 30-day, all-cause readmission rate is estimated to have dropped during 2012 to a low of 18 percent in October, after averaging 19 percent for the previous five years.� This downward trend translates to about 70,000 fewer admissions in 2012.

Insurance companies are also now required to publicly justify their actions if they want to raise rates by 10% or more.� Since the passage of the Affordable Care Act, the proportion of requests for double-digit rate increases fell from 75 percent in 2010 to 14 percent so far in 2013.

Reforms like these have helped slow Medicare and Medicaid spending per beneficiary to historically low rates of growth.

Mobilizing Use of Health Information Technology

Last week, we reached an important milestone in the adoption of health information technology.� More than half of all doctors and other eligible providers and nearly 80 percent of hospitals are using electronic health records (EHRs) to improve care, an increase of at least 200 percent since 2008.

Friedman wrote of Dr. Jennifer Brull, a small-town Kansas family doctor, as an example of how health IT is making a difference in real patients. One of our �physician champions,� Dr. Brull installed alerts in her EHRs to improve the rate of colon cancer screenings for her patients. She found colon cancer early in three patients as a result � so early that they did not need chemotherapy or radiation.

Friedman also cited several companies, like Lumeris of St. Louis, that are using health IT and �mountains� of ��HHS data now in electronic form to improve health outcomes. Mike Long, the CEO of Lumeris, says his company is analyzing hospital, insurance and HHS data and getting the information to physicians in real time. � [W]e wind up delivering better care. �And it�s lower cost,� Long said.

Government Data as Fuel for Innovation

Since the early days of the Administration, we have provided the public with high quality health data.� Making our data more accurate, available and secure brings transparency to a traditionally opaque health care market and allows innovators and entrepreneurs to use it for discovering innovative applications, products, and services to benefit the public.

Earlier this month, the Administration released unprecedented data about what hospitals across the country charge for the 100 most common Medicare inpatient stays, which can vary widely. �For example, average inpatient charges for hospital services in connection with a joint replacement range from $5,300 at a hospital in Ada, Okla., to $223,000 at a hospital in Monterey Park, Calif.

In May, we announced a $1 billion challenge to help jump start innovative projects that test creative ways to deliver high quality medical care and lower costs to people enrolled in Medicare and Medicaid.

There is much work yet to be done to change the habits of the health care system. But by encouraging transparency and market-based innovation around health data, we are playing to America's greatest strength to solve our most pressing problems.

Eyelid-Lift Payments From Medicare Rise, And Raise Eyebrows

More From The Two-Way EuropeLondon Attack Suspect Leaves Hospital; More Charges FiledAfricaSomali Militants Claim To Have Shot Down U.S. DroneNewsThree Years In A Row, Australia Named Happiest Place By OECDNewsNike Is Cutting Ties To The Livestrong Charity

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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.

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

Some unions protest Obamacare’s impact on Multiemployer Health Plans

The Affordable Care Act (ACA) of 2010, also known as Obamacare, presents challenges to the multi-employer plans through which some unions bargain collectively to provide health care insurance for their members. These plans, often called Taft Hartley Plans, currently cover about 26 million workers, families, and retirees. Unless there is a major regulatory change made by Health and Human Services, these union negotiated plans will be struck a harsh blow once the exchanges go into effect in 2014.

A quiet effort by many unions to persuade the Obama administration to make this change is now becoming very public.

In an Op Ed published in The Hill, Joseph T. Hansen, President of the United Food and Commercial Workers (UFCW), said,

�But as currently interpreted, the ACA would block these plans from the law�s benefits (such as the subsidy for lower-income individuals and families) while subjecting them to the law�s penalties (like the $63 per insured person to subsidize Big Insurance). This creates unstoppable incentives for employers to reduce weekly hours for workers currently on our plans and push them onto the exchanges where many will pay higher costs for poorer insurance with a more limited network of providers. In other words, they will be forced to change their coverage and quite possibly their doctor. Others will be channeled into Medicaid, where taxpayers must pick up the tab.

�In addition, the ACA includes a fine for failing to cover full-time workers but includes no such penalty for part-timers (defined as working less than 30 hours a week). As a result, many employers are either reducing hours below 30 or discontinuing part-time health coverage altogether. This is a cut in pay and benefits workers simply cannot afford. For example, a worker making $10 an hour that has his or her schedule cut by six hours a week would lose $3,100 a year in income. With millions of workers impacted, this would have a devastating effect on our economy.�

The effort of unions to persuade the Obama administration to change the regulations in order to resolve the problems was reported in the January 30, 2013, Wall St. Journal.

�Top officers at the International Brotherhood of Teamsters, the AFL-CIO and other large labor groups plan to keep pressing the Obama administration to expand the federal subsidies to these jointly run plans, warning that unionized employers may otherwise drop coverage.�

�We are going back to the administration to say that this is not acceptable,� said Ken Hall, general secretary-treasurer for the Teamsters, according to the WSJ article.

Many unions have been working through the National Coordinating Committee for Multi-employer Plans (NCCMP) to find a solution. In a memorandum to the Department of Health and Human Services, the NCCMP stated:

�If subsidies are available only for plans purchased through Exchanges, employers contributing to multi-employer plans will face tremendous economic pressure to stop contributing to multi-employer plans�. Many employers will feel the need to drop coverage and access the subsidies to remain competitive.�

On April 16, 2013, the United Union of roofers, Waterproofers and Allied Workers International President Kinsey M. Robinson issued a statement calling for a repeal or complete reform of President Obama�s Affordable Care Act (ACA). He stated that the union has supported President Obama for both terms in office but that the union�s concerns �over certain provisions in the ACA have not been addressed, or in some instances, totally ignored.�

�In the rush to achieve its passage, many of the Act�s provisions were not fully conceived, resulting in unintended consequences that are inconsistent with the promise that those who were satisfied with their employer sponsored coverage could keep it. These provisions jeopardize our multi-employer health plans, have the potential to cause a loss of work for our members, create an unfair bidding advantage for those contractors who do not provide health coverage to their workers, and in the worst case, may cause our members and their families to lose the benefits they currently enjoy as participants in multi-employer health plans,� Robinson stated.

The Cornell University Industrial and Labor Relations School recently held a special workshop on The Affordable Care Act: Impact on Multi-employer Plans. The materials from that educational event are available here.

So far there is no adequate answer from the Obama administration to the efforts of unions to resolve the issues. The state exchanges must be in place by October of 2013 so that they are ready to go by January 1, 2014.

Many of the unions involved contend that regulations for the ACA could be written to allow the employers that pay into these union negotiated plans to receive the same subsidies that employers will receive in the exchanges. So far, that has not happened.

This is one of many conundrums that face unions as the costs of health care in our corporate-controlled, profit-oriented system make the maintenance of health benefits increasingly difficult to achieve.

This growing crisis underlines the need for unions to press for passage of HR 676, Expanded and Improved Medicare for All, national single payer health insurance. HR 676 has been reintroduced by Congressman John Conyers (D. MI) into the 113th Congress and has 41 cosponsors. This real solution awaits a dynamic, massive, in-the-streets movement that makes sound health policy also politically feasible.

Such a solution would improve the lives of all workers by assuring that everyone has all medically necessary care with no co-pays and no deductibles. Even dental care and long term care are covered.

Private for-profit health insurance companies and the massive waste they cause would be removed. Unions would free their health care from corporate control as labor has done in other industrialized countries where some form of publicly funded single payer care is guaranteed. Care would be expanded and costs brought under control. By leading this fight for universal care, unions would once again prove that social justice can be achieved through the leadership of the nation�s organized workers.

With all of labor harmed by the attacks in Wisconsin, the �right to work for less� in Michigan and Indiana, a host of Koch-sponsored legislation in states across the country, and the brutal assault on pensions, what better way to fight back than to use labor�s vast grass roots mobilizing clout to promote HR 676?

The union movement will grow as it leads this vital struggle. Labor has always led progress for workers, and that progress also lifts up the nation.

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.

How A Florida Medical School Cares For Communities In Need

More From Shots - Health News HealthFeds Push For Lower Alcohol Limits For DriversHealthHow A Florida Medical School Cares For Communities In NeedHealthA Sharper Abortion Debate After Gosnell VerdictHealthAngelina Jolie And The Rise Of Preventive Mastectomies

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Even After Overhaul, Gaps In Coverage For Young, Pregnant Women

More From Shots - Health News HealthFeds Push For Lower Alcohol Limits For DriversHealthHow A Florida Medical School Cares For Communities In NeedHealthA Sharper Abortion Debate After Gosnell VerdictHealthAngelina Jolie And The Rise Of Preventive Mastectomies

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Friday, May 10, 2013

California Weighs Expanded Role For Nurse Practitioners

More From Shots - Health News HealthHow Can Identical Twins Turn Out So Different?HealthUsing Bacteria To Swat Malaria Inside MosquitoesHealthPrice Break For Cervical Cancer Shots In Developing WorldHealth CareCalifornia Weighs Expanded Role For Nurse Practitioners

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California Weighs Expanded Role For Nurse Practitioners

More From Shots - Health News HealthHow Can Identical Twins Turn Out So Different?HealthUsing Bacteria To Swat Malaria Inside MosquitoesHealthPrice Break For Cervical Cancer Shots In Developing WorldHealth CareCalifornia Weighs Expanded Role For Nurse Practitioners

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Thursday, May 9, 2013

Medicare Pulls Back Curtain On Hospital Bills

More From Shots - Health News Health CareCalifornia Weighs Expanded Role For Nurse PractitionersHealthNot All Antioxidants Halt Macular DegenerationHealthWhy Bill Gates Thinks Ending Polio Is Worth ItHealthMedicare Pulls Back Curtain On Hospital Bills

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Medicare Pulls Back Curtain On Hospital Bills

More From Shots - Health News Health CareCalifornia Weighs Expanded Role For Nurse PractitionersHealthNot All Antioxidants Halt Macular DegenerationHealthWhy Bill Gates Thinks Ending Polio Is Worth ItHealthMedicare Pulls Back Curtain On Hospital Bills

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Privately Insured Americans to Learn about the Health Insurance Marketplaces

Starting in 2014 there will be a new way for you to buy health insurance through the Health Insurance Marketplace.� Whether you�re uninsured, or just want to explore new options, the Marketplace will give you more choice and control over your health insurance options.

Today, the Departments of Health and Human Services and Labor are taking another step to let you know about new insurance options available in 2014.� Over the course of the remainder of the year, businesses and health insurers in the individual market will send Americans information about coverage through the Marketplace.

Among those who will get notices are the approximately 7 million individuals and their dependants who become eligible for coverage through COBRA every year, including people who may be in between jobs and have the option to buy into their former employer�s coverage.� COBRA coverage is generally expensive, and a number of people turn it down and become uninsured.� From now on, people leaving their jobs will learn that they may be eligible for affordable insurance through the Marketplace.� People who purchase coverage through the Marketplace instead of COBRA could cut their premiums by as much as half. �They may also qualify for a new kind of tax credit that lowers monthly premiums right away.

These notices are the just another step in the Administration�s efforts to raise awareness of the new, quality, affordable health insurance options available in 2014.� Open enrollment in the Health Insurance Marketplace begins October 1, 2013. �

To learn more visit www.healthcare.gov/marketplace.

Friday, May 3, 2013

Colorado Weighs Reopening Psychiatric Hospital For Homeless

More From Shots - Health News HealthFrom Battlefield To Boston: Marine Comforts Bombing SurvivorsHealthUrologists Recommend Less PSA Testing For Prostate CancerHealthPaleo Diet Echoes Physical Culture Movement Of YesteryearNewsOutbreak Of New SARS-Like Virus Kills 5 In Saudi Arabia

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Thursday, May 2, 2013

Ratting Out TB: Scientists Train Rodents To Diagnose Disease

More From Shots - Health News HealthRecovery Begins For Mother, Daughter Injured In BostonHealthImagine A Flying Pig: How Words Take Shape In The BrainHealthMate Doesn't Have Your Back? That Boosts Depression RiskHealthSecond Thoughts On Medicaid From Oregon's Unique Experiment

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