Why Republicans Want to Repeal Obamacare

Robert Reich on Why Republicans want to Repeal Obamacare

Here’s what Reich says about an Obamacare repeal:

  • 32 million people will lose coverage, [23M-24M if replaced with Senate or House versions, per CBO]
  • Tens of thousands of American’s will die as a result (over 50 times as many as killed by terrorists),
  • Medicare and Medicaid will be left in worse shape, and
  • The rich will get richer in a massive redistribution of wealth.

Missing from this list, and discussed after the video, is what appears to be racist resentment of having a black President in the White House, no matter how qualified. Repeal is also pragmatic, because it helps Republicans contain a demographic shift works against them and maintain control of Congress, the Presidency and the Supreme Court. Read More …

What to ask Clinton and Trump about Healthcare?

I responded to a Huffington Post article about proposed changes to Medicare and questions that should be asked of Hillary Clinton and Donald Trump, but I went deeper into the serious healthcare issues, citing an article I posted yesterday about The Ideal Healthcare System. It referenced differences between public and private sector organizations but primarily spoke of the need to better align incentives to the nation’s health goals. Therefore, my questions to Presidential candidates relate to that larger view of health and healthcare.

What to ask Clinton and Trump about Healthcare?

What would YOU ask Clinton and Trump about Healthcare? (please comment below and share with others)

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Texas has the Highest Uninsured Rate

Uninsured Residents - Red States versus Blue StatesThe data is in from a WalletHub analysis of 2015’s States with the highest & lowest uninsured rates, and as an Austin resident, I’m again embarrassed to say that Texas has the highest uninsured rate.

Having insurance is vital to the health of your family and your wallet. It can significantly reduce your out-of-pocket medical expenses, the leading cause of personal bankruptcy in the U.S. Today, however, 11.7 percent of all Americans — many of whom earn a low income — remain without coverage.

For the second year in a row, WalletHub’s analysts drew upon the most reliable data to estimate the rates of uninsured pre- and post-Obamacare for the 50 states and the District of Columbia. For a broad perspective of those rates, they broke the national figures down to the state level and other categories, including age, race and income level. A summary of their findings are included below. Read More …

HealthSpot visits reimbursed by Medicaid!

HealthSpot and CareSource Team to Improve Access to Healthcare
Managed Care company creates value for Medicaid members, increasing access to care through HealthSpot telehealth platform.

Telehealth KioskDUBLIN, Ohio–(BUSINESS WIRE, 8/20/2014)–HealthSpot®, a pioneer in patient and provider driven healthcare technology, and CareSource, an Ohio nonprofit managed care company dedicated to meeting the needs of healthcare consumers for more than 25 years, announced an agreement to increase access to quality healthcare for CareSource Medicaid, CareSource Just4Me and MyCare Ohio members.

HealthSpot has built a comprehensive healthcare delivery platform that combines cloud-based software with the award-winning HealthSpot station. The stations connect patients to medical providers from a variety of Ohio’s health systems including Cleveland Clinic, MetroHealth and University Hospitals. For the past 18 months, these providers and others have been using the stations for diagnosis of high frequency illnesses, such as the flu and upper respiratory issues.

“HealthSpot is the first open platform that enables community providers to see patients outside their facility and truly create value for everyone in the healthcare ecosystem.”

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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 the vision of Modern Health Talk, because it helped me see unfulfilled opportunity at the intersection of trends. (Click image to see book)

“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.

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Early-Stage Obamacare – How’s it Going?

Is your glass Half Empty, or Half Ful?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.

Early-Stage Obamacare:
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 More …

Fee-For-Service is Pervasive yet Perverse

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 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 …

The Forgotten Civil Right – Healthcare

MLK - I have a dreamIn 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 More …

Elders Get a CAPABLE Hand in Shoring Up Home Safety

Jack and Jill, a Mother Goose nursery rhyme

Jack and Jill went up the hill
To fetch a pail of water.
Jack fell down and broke his crown,
And Jill came tumbling after.

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 More …

Middle Generation: Rising Cost of Care for America’s Elderly

Middle Generation LadiesBy 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 More …

Understanding Confusing Medical Bills for Seniors

Senior couple studying Confusing Medical BillsThe rising cost of medical bills is a concerning issue, particularly if you are retired and are facing health challenges. As the cost of medical procedures increases, a large number of American adults are filing for bankruptcy. The high cost is expected to cause 1.7 million individuals and families to file for bankruptcy, reported Today.com. Although the numbers are troubling, it does not mean you do not have options to help improve your personal situation.

Check For Obvious Errors

Before you assume that the price given on your medical bill is accurate, read through the details and check it for accuracy. Roughly 80 percent of medical bills have an error, according to Mint.com. The errors can come from simple mistakes in inputting data, coding errors or bugs in the system. Read More …

Long-term Care – 11 Myths and Facts

Long-term Care Myths & FactsMost people over 65 will need some kind of help with the activities of daily living such as bathing, dressing, or moving around. The need for such help can stem from a chronic illness or the natural decline of eyesight, hearing, strength, balance, and mobility that comes with aging. It’s never too early, or too late, to start planning for long-term care.

Many people think the phrase “long-term care” refers to an insurance policy. While insurance may be part of your strategy, long-term care encompasses many other decisions. You will need to decide where you will live, how you will navigate the myriad of legal, family, and social dynamics along the way, and the many options for paying for everyday help. Though a number of government programs may help pay for some long-term care services, many people are faced with significant out-of-pocket costs.

In partnership with LongTermCare.gov, Huffington Post took a look at eleven myths that may be keeping some from planning for long-term care, and ways you and your loved ones can prepare for the future.

Myth 1: I won’t need it

About 70 percent of Americans over 65 will need some kind of help with the activities of daily living for months or years as they age. It may be due to an illness, chronic disease, or disability. But often, the care is required because of the natural decline due to aging of one’s eyesight, hearing, strength, balance, or mobility. Read More …

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.

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Nine States Deny The Poor Health Care

GOP Governors Deny The Poor Health Care
In Opposing Obamacare’s Medicaid Expansion

 

Where states stand on the Affordable Care Act (Obamacare)

By Peter S. Goodman and Jeffrey Young

RUSTON, La. — With no health insurance and not enough money for a doctor, Laura Johnson is long accustomed to treating her ailments with a self-written prescription: home remedies, prayer and denial.

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Texas Rankings Disappoint

Texas on the Brink: How Texas ranks among the 50 states (2011 version)
Click on the image to view:
“Texas on the Brink,” a 2001 report from the Texas Legislative Study Group that includes many more rankings and supporting statistics.
Not much has changed.

Texas near the Top:

Blessed with an abundance of land, rivers, oil and other natural resources, Texas pioneers built a great state, and even today, it seems that everything is bigger in Texas. I’ve lived in this “Great State of Texas” for most of my live, moving here from Arlington, VA in 1976, and I now live in the state capitol of Austin. So I call myself a Texan, but in many ways I’m not proud of my state. Here’s why. We relish in being #1 in many things, but not these:

  • Texas is #1 in the percent of population uninsured
    (as if that would be something to brag about).
  • We have the largest number of uninsured children (#1).
  • We have the most toxic chemicals released into water (#1).
  • We generate the most hazardous waste (#1).
  • We have the most carbon dioxide emissions (#1).
  • We also have the most executions (#1).
  • We have the second highest birth rate
    and are 4th in the number of kids living in poverty.
  • We have the second highest percent of population under 18.
  • We’re #2 in percent of population with food insecurity.
  • We’re #4 in percent of population living below poverty.

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Understanding Obamacare

Healthcare became a hot potato during this political season, even though the U.S. Supreme Court ruled that the Affordable Care Act is constitutional. Governor Romney wants to repeal “Obamacare,” but what’s actually in the law and why was introduced in the first place? To address these common questions, I’m reposting one of my first articles on the topic.

This article describes a great presentation by Dr. James Rohack on Health System Reform. Rohack is a practicing cardiologist and Director of Scott & White Center for Healthcare Policy. He is also a professor at Texas A&M Health Science Center and was the president of the American Medical Association from 2009 to 2010 during debates over Obama’s Healthcare Law.

The presentation was held in Sun City, a planned community north of Austin for retirees with active lifestyles. It didn’t include handouts, but I was able to find some of Rohack’s slides online and offer them below with my notes.

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As Our Health Goes, So Does Our Economic Recovery

 

It’s the Health Care, Stupid:

As Our Health Goes, So Does Our Economic Recovery

As Our Health Goes, So Does Our Economic RecoveryBy Peter Abaci, M.D., Chronic pain specialist
(original on Huffington Post)

“We cannot solve our problems with the same thinking we used when we created them.”
— Albert Einstein

As we head into the final stages leading up to election day, expect the fight over whom and what is best for our economy to rage on. Debating how best to stimulate the economy has been anointed as the de facto topic of importance heading into our upcoming election, but let’s not forget that the health of Wall Street and Main Street is inextricably linked to the health of our citizens. As I have written here in the past, I am no economic expert, but I do work in the trenches every day in a profession that impacts our nation’s budget like no other.

The fact that doctors like me seem to drive the spending of tax dollars more than other occupations like teachers, governors, and generals tells you right there that health care is the elephant in the room of any debate on our economic future.

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A Disease-Creation Economy

Money, Politics and Health Care: A Disease-Creation Economy

By Mark Hyman, MD, practicing physician (original on Huffington Post)

“There is nothing more difficult to carry out, nor more doubtful of success, nor more dangerous to handle, than to initiate a new order of things. For the reformer has enemies in all those who profit by the old order, and only lukewarm defenders in all those who would profit by the new order.” —Niccolò Machiavelli, The Prince and The Discourses

Medical Economics - follow the MoneyMoney in politics is making our nation sicker, threatening our national security, and ultimately destroying the very economic prosperity the “money in politics” seeks to achieve. It is undermining our capacity to care for our citizens and threatening our global economic competitiveness in invisible, insidious ways. The links, connections and patterns that promote obesity and chronic disease are clear, though. The economic and social impacts are evident. As health care consumes an increasingly large percentage of our federal budget, the negative impacts of money in politics have become too alarming too ignore, and never more obvious than in this election cycle of 2012.

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Now the Real Work of Healthcare Reform Begins

Roberts Saves Obamacare: Now the Real Work of Reform BeginsArianna Huffington
By Arianna Huffington

The narrow survival of the Affordable Care Act last week was certainly cause for celebration. But as the jubilation subsides, it’s important to realize that having avoided what would have been a giant step backward doesn’t mean we’ve taken a giant step forward. Because the law as it now stands is only the first step toward health care reform.

On Sunday’s This Week, Vicki Kennedy (Ted Kennedy’s widow) spoke movingly of how “health care reform was the cause” of her husband’s life. “He believed that it was a moral issue,” she said, “that it defined the character of who we were as a society, who we were as a country, and that decent, quality, affordable health care should be a fundamental right and not a privilege.” She went on to say, “Families can go to sleep relaxed and happy knowing that their children who have asthma or diabetes or allergies are covered by insurance and aren’t barred because they have a pre-existing condition.” Read More …