Proposed Legislation to Make Homes Accessible

The City of Austin last year passed a law requiring all new homes be more visitable and accessible to people with mobility disabilities. Now U.S. Representative Jan Schakowsky has introduced a bill that would do the same nationally, at least for homes built with federal dollars. Maybe someone will amend it to catch up with where Austin has been for nearly two years now. Let’s hope so.

Eleanor Smith Inclusive Home Design Act Will Make Homes Accessible

Wheelchair Lady doing LaundryBy Jan Schakowsky, U.S. Representative for Illinois’s 9th congressional district (original on Huffington Post)

9/28/2015 — Today, I introduced the Eleanor Smith Inclusive Home Design Act, which would require new homes built with federal dollars to meet accessibility standards — including a zero-step entrance, wheelchair accessible doorways and bathrooms, and climate controls that are at a height reachable from a wheelchair. Above, I announced the introduction of this legislation to advocates at a Rally with the National Council on Independent Living. They support the legislation. Read More …

Republican Alternatives To The Affordable Care Act?

What Would Republicans Do Instead Of The Affordable Care Act?

By John McDonough and Max Fletcher

A new spate of proposals from Republican presidential candidates to repeal and/or replace the Affordable Care Act (ACA) raises the important question: Given an unobstructed opportunity, what would Republicans really do with the Affordable Care Act? Would they repeal the law wholly or just in part? With what might they replace it?

Some suggest that Republican Congressional leaders only advance full repeal to placate their Party’s conservative base, knowing well that repeal cannot survive a certain veto while Barack Obama is President. In January 2017, that obstacle will vanish if Republicans control the White House and both branches of the U.S. Congress. What then? Read More of this excellent article at

Hooray for Obamacare! How’s it doing?

No matter your politics, you must respect a Nobel Prize winning economist when he speaks in economic terms. The following is pulled from yesterday’s New York Times editorial by Paul Krugman.

Hooray for Obamacare!Paul Krugman

“Was I on the edge of my seat, waiting for the Supreme Court decision on Obamacare subsidies? No — I was pacing the room, too nervous to sit, worried that the court would use one sloppily worded sentence to deprive millions of health insurance, condemn tens of thousands to financial ruin, and send thousands to premature death.

It didn’t. And that means that the big distractions — the teething problems of the website, the objectively ludicrous but nonetheless menacing attempts at legal sabotage — are behind us, and we can focus on the reality of health reform. The Affordable Care Act is now in its second year of full operation; how’s it doing?

The answer is, better than even many supporters realize. Read More …

Supreme Court upholds Affordable Care Act… Again


Supreme Court says, "ACA OK"

The U.S. Supreme Court this morning ruled on the landmark King v. Burwell case about the legality of federal insurance subsidies. In their 6-to-3 ruling they saved coverage for more than 6M Americans.

According to FierceHealthPayer, Chief Justice John Roberts said, “Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter.”

Here at Modern Health Talk, we applaud the Court’s decision.

Wealth Inequality, Healthcare and the Economy

A Washington Post article last week concluded that People have no idea what inequality actually looks like, and that caused me to respond and to enhance this article, which was published here two years ago. It features some disturbing videos that help us understand the corrupting influence of big money in politics and the direct relationships between:

  • Special interest lobbying and policies resulting in a widening of income & wealth gaps,
  • Between the widening wealth gaps and poverty,
  • Between Poverty and obesity,
  • Between obesity and diabetes and other chronic illness,
  • Between chronic illness and rising healthcare costs, and
  • Between rising healthcare costs and our economic problems.

Read More …

Telehealth Legal Obstacles Delay Home Healthcare

Doctor Robot

DOCTOR ROBOT: Technology like this RP-VITA device at Mercy San Juan Hospital in Carmichael, Calif., lets doctors beam themselves to remote patient bedsides, but government rules need to catch up. (AP / Rich Pedroncelli)

Home telehealth” technology promises to be a critical component of providing quality care to the growing number of Americans who need long-term services and supports to “age in place” at home. Home telehealth and related technology can make it cheaper, easier and more comfortable for seniors to remain at home and avoid nursing facility placement.

But government regulations lag behind telehealth technology, according to this article in the National Law Journal. This is disappointing because “24-hour monitoring would allow Americans who need long-term care to ‘age in place’ at home.”  Read More …

101 MiniTrends in Health Care

Watch for Trends Ahead

This image is from MiniTrends, a book by John Vanston that I strongly endorse. I’ve known John for years and did consulting work for his company, Technology Futures. His book inspired my Modern Health Talk vision. (Click image to see book. Go to end to hear about the MiniTrends conference.)

“What the Hell is happening to health care?”

“And is it an Opportunity or a Threat?”

Insights by Wayne Caswell, Founder of Modern Health Talk.

An awful lot has changed in just the last few years and even more will change in the near future, with the aim of reducing (or at least containing) our health care costs. What’s behind these MiniTrends, and what is their implication for providers, payers and consumers? That’s the $1.5 trillion question. Here I talk about many, many MiniTrends–surely you can find 101 of them if you look! 

“It is not the strongest or the most intelligent who will survive but those who can best manage change.” – Charles Darwin

That quote is important, because 429 of the original Fortune 500 companies [1955] are no longer in business today. That’s a scary thought for those sitting at the top of the healthcare mountain, because they know they must adapt to the megatrend of health reform and Obamacare (the Patient Protection and Affordable Care Act) or die. And they are looking down with fear at the hungry competitors who are already exploiting the many related minitrends, because for them these are times of great opportunity.

Read More …

Telehealth is Shaping Healthcare for the Better

Game ChangerBy Karen R. Thomas, President of Advanced TeleHealth Solutions (original article here)

As incredibly innovative and efficient as telehealth is at providing greater access to care for consumers, lowering healthcare costs for both patients and healthcare systems, and improving outcomes, barriers have always existed that hinder the widespread adoption of telehealth. Yet recently, issues such as state requirement hurdles, reimbursement limitations, and a general resistance from physicians to learn and integrate new technologies into their care routines are quickly evaporating in the wake of the overwhelming proof of telemedicine’s many benefits. Read More …

Managing My Costs of Care [ESSAY]

MedicaidDollarsManaging My Costs of Care is a well-written essay by Jay Warner.

I recommend it, because this one example shows just how easy it “should” be to cut healthcare costs in half to get down to what the rest of the world pays — for better care and outcomes — and save $1.5 trillion/year. It all comes down to getting the incentives right, because with employer-provided health insurance, Jay had no incentive (or ability) to comparison shop. Now he does.

The healthcare landscape is changing as payers pressure providers for more price transparency and seek other ways to contain costs and maintain profitability now that they can no longer cherry-pick the healthiest customers or cut them off when care gets too expensive.

Other disruptive changes include remote sensor monitoring (telemedicine) that can follow trends and identify problems earlier, remote consultations (telehealth) that can replace in-person office visits, medical tourism when it’s less expensive and has better outcomes than local surgeries, and an overall shift away from the fee-for-service insurance model. That model once served as pre-paid medical care, but now payers are starting to view insurance as protection against catastrophic illness and injury with consumers paying for the small stuff out of pocket. With that trend comes two others: (1) increased competition and (2) an increased focus on overall health and wellness, including nutrition, exercise, and sleep as it’s pillars.

A side benefit of wellness, beyond dramatic reductions in health care costs, is improved safety and performance. Restorative sleep, for example, is associated with improved alertness, attention, creativity, decision-making, focus, learning ability, mood, reaction & recovery times, and working memory, all of which contribute to better grades at school, better productivity at work and in sports, and fewer motor vehicle accidents and deaths.

Hyper Growth of Private Insurance Exchanges

Shared with permission from MEDCITY News, by Dan Verel, 7/25/2015

Accenture Figure 1

While much attention has been heaped on the public health insurance exchanges over the year, private health insurance exchanges “are experiencing hyper-growth” and enrollment could exceed that of public exchanges by 2017, “if not sooner,” according to Accenture. Read More …

Poverty in America — living below The Line

The Line is an important documentary that covers the stories of people across the country living at or below the poverty line. They have goals. They have children. They work hard. They are people like you and me. Across America, millions are struggling every day to make it above The Line.

As shown in the Stats below and the accompanying infographic, poverty is a drag on the economy that also affects the cost of healthcare, as I’ve written before in this blog. Read More …

Austin Requires New Homes to be Accessible

Austin city council passes accessibility,
ramp ordinances for new homes

Wheelchair Lady doing Laundry
AUSTIN, TX (1/30/2014) — After two years of working on an ordinance amendment, the Austin City Council passed changes Thursday that will require all new homes be more accessible and visitable to people with mobility disabilities.

The idea to require changes to make housing more accessible first came up inside City Hall back in 1998. That’s when Austin adopted the changes for homes built with city funds. The intention was that it would lead to an across the board policy, but that never came to be.

City staff and council members have spent the last two years working with stakeholders to draft an ordinance amendment.

After much debate, and several postponements, the council passed the ordinance amendment 6-1 with Mayor Lee Leffingwell voting against the measure. Read More …

We Endorse Telehealth Across State Lines

Medicine Unplugged: Your phone, your DNA, your data

By Wayne Caswell

Modern Health Talk strongly endorses telehealth and efforts to break down barriers to wider adoption nationwide. The TELE-MED Act of 2013 (HR 3077) is still not out of committee but is intended to start breaking down barriers related to licensure and payment when medical care is given online across state lines, starting with Medicare providers. Hopefully Congress will pass this bill and then start extending telehealth to all insurance carriers. Read More …

Regulations Not Keeping Up with Technology

Health ReformBy 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 More …

Telehealth Enhancement Act takes Important Step

Telehealth KioskAs 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.

Read More …

Opposition to Universal Health Care

Obamacare Protest SignWhat’s the REAL reason people oppose universal healthcare? The fear of helping “LOSERS”

That was the title of an article by MedCity News, and I couldn’t help but comment.

The article said FEAR was a dominant reason some Americans find it so hard to support universal healthcare. The dark side of this belief is that “Anyone who doesn’t work hard enough, or doesn’t have enough determination, is a Loser, and nobody wants to pay for free healthcare for those losers.”

It doesn’t seem to matter whether these ‘losers’ are old people or little kids or bankrupt people or people who’ve lost their job or people who have serious health problems through no fault of their own. People who are afraid of helping ‘losers’ talk about impeachment or defunding the government or killing Obamacare.  Read More …

Why Health Care Costs are Obscenely Expensive (Infographic)

Health Care Spending


Americans spend more on health care
but live sicker and die younger. Why?


We’ve published dozens of articles addressing that issue and have accumulated thousands of statistics in hundreds of Infographics. But today we include an important infographic that combines 12 charts created by Jan Diehm for The Huffington Post. Afterwards is a video description, a counter-point argument, and my own view of how Obamacare will address some of the issues.


Read More …

Understanding Obamacare in Three and a Half Minutes

Main CAHCBy Wendell Potter, Author, consultant, columnist at Center for Public Integrity and

Since 2010, the year President Obama signed the Affordable Care Act, more than $400 million has been spent by the law’s opponents to turn Americans against it, according to an analysis earlier this summer by the Campaign Media Analysis Group at Kantar Media. That compares to just $75 million spent by supporters to defend and explain the legislation.

The vast majority of that anti-Obamacare advertising has been misleading and in many cases downright false, but, hey, this is a free country and truth-in-advertising rules don’t apply. People who have an agenda, motivated by political or financial gain, just make stuff up. And then they use TV ads and the Internet to make sure the made-up stuff is repeated often enough so that gullible Americans eventually accept it as truth. Or at the very least grow confused and skeptical. Read More …

OBAMACARE – a moving infographic

Obamacare does so many things to give people better access to affordable, quality health care. The folks at Colorado Consumer Health Initiative just like to say THANKS OBAMACARE with this moving infographic about President Obama’s healthcare plan and how it actually helps people. Nothing is perfect, but we think there are a lot of positives that came out of this whole thing, and politicians focus only on negative talking points. ugh.

Obamacare: What’s at Stake if it’s Repealed

Obamacare Pre-existing ConditionsBy Kathleen Sebelius, Secretary of Health and Human Services

More than three years ago, Congress passed the Affordable Care Act and President Obama signed it into law. Last year, the Supreme Court upheld it. Millions of Americans have already benefited from its provisions, and millions more are looking forward to benefits that will soon go into effect. And in November, the American people re-elected the president as an affirmation of the law’s promise that no person should go broke if they get sick.

Yet today, for nearly the 40th time since it’s been the law of the land, House Republicans staged yet another repeal vote in their latest attempt to turn back the clock on progress and deny Americans health insurance coverage they can count on.

For the 37th time, Congress is voting to repeal the health care law, the Affordable Care Act.
Learn what’s at stake for Americans if the law were repealed.

Read More …