EDITOR: Opinions of Obamacare, and whether it’s a glass half empty or half full, depend largely on one’s political viewpoint and sources of your information. Opponents of the law, including many in the medical industrial complex with lots to lose if health reform cuts costs, often cite articles hinting that it’s a failure, while proponents cite articles highlighting successes and progress. The mainstream media, in efforts to generate buzz and attention, seem to stoke the fires of controversy by avoiding the hard task of investigative journalism and simply publishing inflammatory stories fed to them by either political party without checking the facts. Then again, the official government numbers, which you can believe or not based on your politics, present a moving target. So, I’m more interested in the trends and the long-term implications and publish today’s byline article with some editorial comments added.
A Checkup on the Health of the Affordable Care Act Thus Far
By Paisley Hansen
What will be the ultimate impact–for good or bad–of the Affordable Care Act on Americans? Although it’s still too early to tell, a January 13 article by the Associated Press posted on AOL sheds some light on the health status of Obamacare thus far [2.2M through December, 2013]. Read the rest of this entry »
The FFS payment model was created long ago, during a time when physicians treated less-complex problems and offered only a few inexpensive therapeutic interventions. It worked back then but a significant percentage of patients today have multiple chronic conditions. Meanwhile, the number of complex and very expensive tests, medications and interventions available are practically unlimited.
Economics 101 teaches that as supply goes up, costs should come down. But this tenant doesn’t hold true in medical care – not when the supplier also controls demand.
In health care, doctors can stimulate demand because (a) health insurance blinds most patients to the costs of services and (b) patients often don’t know whether a complex procedure is as necessary as a non-invasive one.
As a result, we have seen a major increase in utilization of complex services over the past 20 years.
That’s a short extract from an important FORBES article, The High Cost Of American Health Care: You Asked For It. Everything in the article is consistent with my understanding of economics and long-held view that the problem with our healthcare system is perverse incentives in the payment model. I highly recommend it. Read the rest of this entry »
By Wayne Caswell
The rapid and accelerating pace of tech innovation has profound implications for healthcare delivery & payment, aging, and disability employment, but regulations that support that are spotty or nonexistent.
The good news
“Durable medical equipment” is a class of assistive technology that can be paid for by Medicare, Medicaid and many private insurance plans. Motorized wheel chairs most often fall into this category. Read the rest of this entry »
By Lucy Stewart, a financial counselor
for families looking to get out of debt
Forty-eight percent of middle-age adults provided support to their adult children in 2012, which is up from 42 percent in 2005, according to PewSocialTrends.org. Also up is the financial support they provide their aging parents: 21 percent said they provided some financial support to a parent age 65 or older in 2012, up from 19 percent seven years earlier.
Offering financial support to your adult children and 65+ parents does not mean that you give up your own financial plans and dreams. Family is family, but sacrificing your personal well-being won’t benefit anyone. Look for ways to cut expenses and create streams of income, and don’t assume you have to do this alone. Read the rest of this entry »
FierceHealthPayer.com recently published an article that looked at successful strategies to improve health care and lower costs. It mentioned
- bundled payments,
- global payments, and
- accountable care organizations.
But that’s as far as it went, so I added the following response to show other ways that the ACA and changes to the healthcare Payment system can disrupt the Deliver system. Read the rest of this entry »
As a member of the American Telehealth Association (Austin chapter), I too support the Telehealth Enhancement Act, however I see it as just a baby step and think much more is needed. Still, it’s a step in the right direction.
The proposed bill would modernize the Medicare program by allowing Medicare patients to be cared for remotely by a licensed healthcare provider from any state. That way, if you need medical help while on vacation, you could connect online or by phone with your own doctor back home without requiring that they be licensed in the state you traveled to. I urge Congress to adopt this bill and expand it beyond Medicare, to other federal agencies and health benefit programs.
In honor of the 50th anniversary of the March on Washington and Dr. Martin Luther King Jr.’s ”I Have a Dream” speech, Dan Munro wrote a wonderful column on Forbes reminding us that King saw healthcare as a civil right. Sadly, we have made little progress on healthcare inequality, with roughly 50 million Americans without health insurance and another 40 million under-insured.
The Affordable Care Act (Obamacare) is poised to relieve some of that, with the individual mandate to buy healthcare insurance and subsidies for low-income Americans. But individual states are still allowed to choose whether or not to support and fund a key component of the ACA – Medicaid expansion. Many will, but some won’t.
Many doctors have walked away from taking Medicaid patients, and some have abandoned Medicare patients too. Read the rest of this entry »
CAPABLE, which stands for Community Aging in Place, Advancing Better Living for Elders, is a Baltimore-based project that helps low-income older adults “age in place” with assistance from occupational therapists, nurses and handymen.
The project is being closely watched by Medicaid officials in other states as a way to coordinate care, improve personal function, and avoid pricey and sometimes preventable nursing home admissions. Today, it’s difficult for Medicaid patients to get these services.
With more than $8 million in research money from the National Institutes of Health and the Centers for Medicare and Medicaid Services, the project goes beyond home repair for health. It starts with a full-scale assessment of each participant’s needs. Read the rest of this entry »
Guest article by Albert Lester (editor enhanced)
Americans keep living longer. According to the CIA World Factbook, 26% of Americans are older than 55. Just more than 40% fall in the 25-54 age range, double the rate for those under age 14, and dwarfing the number of 15-24 year olds. Moreover, our population growth is less than one percent. For baby boomers, some of whom have already entered retirement, this brings an interesting question: will there be enough entitlement funds to help support them in old age, and will there be enough caregivers in the smaller generation groups that follow them to meet the demand? Read the rest of this entry »
By Caroline Montague
With an aging population and a generation of young adults struggling to achieve financial independence, the burdens and responsibilities of middle-aged Americans are increasing. Nearly half (47 percent) of these adults have a parent age 65 or older and are either raising a young child or financially supporting a grown child (age 18 or older). In addition, about one in seven middle-aged adults (15 percent) are providing financial support to both an aging parent and a child.
Adult children, worried about costs and the loss of their parents’ independence, must make difficult decisions about the best options for care for their loved ones. Assisted living communities, such as Emeritus assisted living, allow individuals to remain independent as long as possible in an environment that maximizes the person’s autonomy, dignity, privacy and safety. These types of communities also encourage family and resident involvement. (Editor: Emeritus is one of the largest and most well known, but you can also compare facilities in your area by zip code.) Read the rest of this entry »