Friday, May 31, 2013

Proton Beam Therapy Sparks Hospital Arms Race

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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

Immigrants Subsidize, Rather Than Drain, Medicare

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Tuesday, May 28, 2013

NC Could Save $18.7B by Adopting Single-Payer

North Carolina could save as much as $18.7 billion next year on health-care costs if it changed the way it finances health care.

The catch? That change would require a switch to a single-payer system in which one entity collects all health-care fees and pay related costs, says Gerald Friedman, a professor of economics at the University of Massachusetts at Amherst.

“We have a system that was broken 10 years ago, and it�s getting worse,� he says. �You can�t fix it unless you change its fundamental basis.”

Friedman spoke Thursday night in Charlotte at the Health Care Justice meeting. That organization wants everyone in the community to have access to health care. It is a chapter of the Physicians for a National Health Program, which supports single-payer national health insurance.

Friedman has drafted financing plans for single-payer health systems for Maryland, Massachusetts and the United States. If adopted, he estimates such a payment model could result in $2 trillion in savings nationwide over the next decade mainly by cutting administrative costs and controlling prescription drug prices.

On Thursday night at the Midwood International and Cultural Center, he touted the need for universal-comprehensive coverage, in which everyone would have access to care. Individuals, businesses and the government stand to benefit, Friedman said.

Universal coverage would minimize billing expenses, avoid wasteful competition among insurers and eliminate adverse selection against people who are sickest, he said.

Friedman estimates that nationwide there is $1.5 trillion in waste annually when it comes to health-care spending. Such spending now accounts for roughly 18 percent of the gross domestic product. And it is expected to rise to 22 percent of the GDP within five years.

In North Carolina, health-care spending has risen more than 400 percent in North Carolina since 1990, Friedman said.

At the same time, per capita income has barely doubled, which puts increased pressure on a family�s income. In 1960, health-care spending accounted for just 7 percent of a family�s take home pay. That rose to 39 percent in 2010.

�More and more money is going to health care,� he said.

The current health-care payment system is unsustainable because it is focused on making profits, Friedman said. That results in waste, fragmented care delivery and significant administrative costs and monopolistic pricing, he added.

For example, he said drug prices are 60 percent higher in the U.S. than elsewhere.

Health insurers will spend nearly $200 billion on administrative costs in 2013, he noted.

Friedman expects the current payment system will collapse. He notes expanded access through federal health-care reform will fall short of providing universal coverage and does not do enough to stem rising health-care costs.

That means health insurance premiums will continue to rise, making it unaffordable for more individuals.

�Right now health-care is a lump-sum tax on individuals, especially sick individuals,� he said.

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Obama's Next Big Campaign: Selling Health Care To The Public

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President Obama speaks about the Affordable Care Act at the White House on May 10.

Mandel Ngan/AFP/Getty Images

President Obama speaks about the Affordable Care Act at the White House on May 10.

Mandel Ngan/AFP/Getty Images

President Obama often tells audiences that he has waged his last campaign. But that's not exactly true.

The White House is gearing up for a massive campaign this summer that will cover all 50 states, plus Washington, D.C. And the president's legacy may hinge on whether it succeeds or fails.

The Affordable Care Act, or "Obamacare," has been through more life-and-death cliffhangers than a season finale of Homeland. After squeaker votes in Congress and a 5-4 ruling upholding the law at the Supreme Court, now there's another big hurdle: getting uninsured people to buy health care when it becomes available Oct. 1.

When Obama delivered the commencement address at Morehouse College this month, his advice to the graduates � along with working hard and helping others � was to sign up for health insurance this fall.

"We've got to make sure everybody has good health in this country," he said. "It's not just good for you, it's good for this country. So you're going to have to spread the word to your fellow young people."

Reaching Out

David Simas, deputy senior adviser to the president, works in a quintessential West Wing office � a windowless basement room � where he oversees one of the top projects on the Obama agenda: implementing universal health coverage.

In the first year, the administration hopes to sign up 7 million people across the country. Simas says that will require TV ads, door knocking and lots of word of mouth.

"It is an on-the-ground effort," he says. "It is a social media effort. It is a paid media effort. It is an earned media effort. But [it's] all leading to the same thing, which is that man or woman sitting in their living room online, comparing different prices for different products and deciding what works best for them."

The administration is developing an Expedia-style website, hoping to make the experience as customer-friendly as possible.

But just getting people to that website is a huge task. Last month, a Kaiser Family Foundation poll showed that 4 in 10 Americans don't even know the health care law is still on the books.

Nancy-Ann DeParle, who has worked on this issue for years � until recently as Obama's deputy chief of staff � says that's not a cause for concern.

"The truth is that people weren't paying attention until now," she says. "There's so much else going on that even if we had wanted to start a campaign two years ago, it wouldn't have been very effective because people weren't listening."

Financial Stumbles

But with the sign-up date approaching fast, the administration's efforts have already stumbled. Health and Human Services Secretary Kathleen Sebelius has repeatedly asked Congress for money to implement Obamacare.

Republicans have repeatedly said no, while they vote to repeal the law.

Without the money she wanted from Congress, Sebelius tried to fundraise for an independent group called Enroll America that is focused on implementing Obamacare. When Republicans heard that she was asking insurance companies and health care providers to donate millions of dollars, they cried foul.

Tennessee Sen. Lamar Alexander told Fox News: "Congress has said we refuse to give you more money to implement Obamacare, and she's saying, 'Well then, if you won't do it, I'll go outside and I will raise private money, use a private organization, and do it anyway.' "

Now two Republican-controlled House committees are investigating the solicitations. Dan Mendelson of the health care consulting group Avalere says that makes donors skittish.

"Much as a health care company might really want to improve enrollment, they also need to make sure that they do not run afoul of politicians on either side of the aisle," Mendelson says.

If health care companies hold back, he says, it's going to be much harder to reach all of those people in all of those communities.

"The fact of the matter is that if you starve a media campaign for funding, you're not going to have the reach that you otherwise would, and that's the situation that we find ourselves in," he says.

There's another key part of this campaign: Sicker and older people without insurance may be eager to sign up Oct. 1. But to make the system work financially, young and healthy people who don't need much medical care have to get into the pool, too.

So you can expect administration officials around the country to give lots more commencement speeches this season, telling captive audiences of 20-somethings: Congratulations on your diploma. Now make sure to sign up for health coverage in the fall.

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Thursday, May 23, 2013

10,000 Signatures for Universal Healthcare

New Yorkers from across the state � including hundreds of doctors, nurses, patients, labor unions, community organizations, faith groups, and seniors � delivered 10,000 signatures supporting a single-payer health care bill sponsored by Assemblyman Richard Gottfried, D-Manhattan, and Sen. Bill Perkins, D-Harlem.

The press conference was coordinated with Healthcare-NOW NYC, Hunger Action Network of New York State, Physicians for a National Health Program (New York Metro chapter), Single Payer New York, and Statewide Senior Action.

“These signatures are a testament to the dedication of New Yorker all across this great state to reach out to members of their communities and help build the grassroots movement it will take to make healthcare a human right in New York,” said Katie Robbins, an organizer with Healthcare-Now.

The New York Health bill (A.5389-a/S.2078-a) �”an act to amend the public health law and the state finance law”� would expand health coverage to all New Yorkers regardless of age, income, or employment status, and would control costs by implementing a single-payer, universal healthcare system, its supporters say.

The bill has 74 co-sponsors in Assembly and 17 in the Senate.

“The affordable care act has made some important improvements in how we organize and pay for health care in this country but it still leaves us and our health care, and our wallets, in the hands of insurance companies�with their premiums, and their administrative costs, and deductibles, and co-pays, and limited network, and denials of payment for the care we need. We can do better and New York can do better,” said Gottfried, chair of the Assembly Health Committee.

“President Obama during [his] campaign said that no American should have to spend their golden years at the mercy of insurance companies, and I agree with that, but I want to know why that is only for golden years. We can get better health care, more affordable health care, more fairly paid for, for every single New Yorker if we enact the New York Health bill to provide universal, publicly sponsored, publicly funded, single-payer health coverage. We want to get this bill to the floor of the Assembly this year for a vote,” he said.

Under the legislation, there would be no premiums, co-payments, or deductibles, and coverage would be publicly funded. Advocates said they would like to see the bill passed in the Assembly, in the Senate, and signed by the governor.

Perkins began his speech with a call and response of “you’re heath is your wealth.”

“We not only want to get [the New York Health bill] passed in the Assembly, we also want to get it passed in the Senate, and most importantly, we want the governor to sign the bill. In fact if we could, we would ask the governor to advocate [and] make sure it gets passed in the Assembly; to advocate [and] make sure it gets passed in the Senate; to be standing there with us so that our wealth, our health, is not compromised,” Perkins said.

New York Hunger Action Network Executive Director Mark Dunlea said health care costs are “one of the three big bills” that send people to emergency food programs.

“When Massachusetts enacted their insurance mandate, many low-income residents found they had less access to health care services. It is immoral that the rich country in the world still refuses to treat health care as a basic human right, even while we spend far more money on health care per capita than countries with universal access,” Dunlea said.

The 10,000 signatures were delivered to the offices of Gov. Andrew Cuomo, Senate Republican Leader Dean Skelos, R-Rockville Centre, Independent Democratic Conference head Sen. Jeff Klein, D- Bronx, and Assembly Speaker Sheldon Silver, D-Manhattan.

Wednesday, May 22, 2013

Unions break ranks on ObamaCare

Labor unions are breaking with President Obama on ObamaCare.

Months after the president�s reelection, a variety of unions are publicly balking at how the administration plans to implement the landmark law. They warn that unless there are changes, the results could be catastrophic.
The United Food and Commercial Workers International Union (UFCW) � a 1.3 million-member labor group that twice endorsed Obama for president � is very worried about how the reform law will affect its members� healthcare plans.

Last month, the president of the United Union of Roofers, Waterproofers and Allied Workers released a statement calling �for repeal or complete reform of the Affordable Care Act.�

UNITE HERE, a prominent hotel workers� union, and the International Brotherhood of Teamsters are also pushing for changes.

In a new op-ed published in The Hill, UFCW President Joe Hansen homed in on the president�s speech at the 2009 AFL-CIO convention. Obama at the time said union members could keep their insurance under the law, but Hansen writes �that the president�s statement to labor in 2009 is simply not true for millions of workers.�

Republicans have long attacked Obama�s promise that �nothing in this plan will require you to change your coverage or your doctor.� But the fact that unions are now noting it as well is a clear sign that supporters of the law are growing anxious about the law�s implementation.

Many UFCW members have what are known as multi-employer or Taft-Hartley plans. According to the administration�s analysis of the Affordable Care Act, the law does not provide tax subsidies for the roughly 20 million people covered by the plans. Union officials argue that interpretation could force their members to change their insurance and accept more expensive and perhaps worse coverage in the state-run exchanges.

Hansen, who is also the head of the Change to Win labor federation, told The Hill that his members often negotiate with their employers to receive better healthcare services instead of higher wages. Those bargaining gains could be wiped away because some employers won�t have the incentive to keep their workers� multi-employer plans without tax subsidies.

�You can�t have the same quality healthcare that you had before, despite what the president said,� Hansen said. �Now what�s going to happen is everybody is going to have to go to private for-profit insurance companies. We just don�t think that�s right. … We just want to keep what we already have and what we bought at tremendous cost.�

If the administration were to expand the subsidies to cover the Taft-Hartley plans, it�s likely that the price tag for ObamaCare would rise, though it�s unclear by how much.

Union angst over the healthcare law is being matched by some Democrats on Capitol Hill. Senate Finance Committee Chairman Max Baucus (D-Mont.) has said the law�s implementation could be a �train wreck,� while other senior Democrats, including House Minority Whip Steny Hoyer (D-Md.), have expressed reservations.

Both parties agree that ObamaCare is going to be a major issue in the 2014 midterm elections, especially because the bulk of the law is scheduled to go into effect on Jan. 1 next year.

Labor recently shared its concerns with senior Democrats.

Earlier this month, the subject of how multi-employer health plans would be treated under ObamaCare was brought up at a private May 8 meeting between union leaders and the Senate Democratic Steering and Outreach Committee.

�A number of people were making this point at that meeting. People said that their members are upset about this and the more they learn about it, the more upset they are,� said one union official.

�I was pretty blunt about it,� said Hansen. �I told them it was a very serious issue. That it was wrong. Taft-Hartley plans should be deemed as qualified healthcare providers and I also said it�s going to have political repercussions if we don�t get this fixed.�

Hansen wants the Obama administration to use its regulatory powers to address the matter; a legislative remedy is all but impossible in the divided 113th Congress.

�When [the Obama administration] started writing the rules and regulations, we just assumed that Taft-Hartley plans � that workers covered by those plans, especially low-wage workers � would be eligible for the subsidies and stay in their plans and they�re not,� Hansen said.

Union anger on multi-employer plans has been percolating for months. In January, The Wall Street Journal reported that UNITE HERE and the Teamsters were pressing the administration. UFCW was also mentioned in that report.

Asked why he decided to raise the volume on his worries about ObamaCare, Hansen said he needed to speak out in support of his members.

�I owe it to my members to do everything I can to see if we can make this law better,� Hansen said.

He added, �[Administration officials] have given us a lot of time and attention. We just don�t agree and I still think that I have taken the correct position. They have been responsive as far as trying to get the meetings. It�s just we can�t get it across the finish line and we need to do that.�

Hansen, however, said he has no regrets about endorsing Obama or supporting the healthcare reform law. UFCW is a major Democratic donor, contributing to several of the party�s candidates and giving to last year�s convention in Charlotte, N.C., and this year�s inauguration.

The union president said changes to his members� health insurance might lead to problems at the ballot box for candidates.

�What happens in 2014 could be at issue here. … There is going to be a lot of disenchantment with how did this happen and who was in power when it happened. No matter what I say, that�s going to be there,� Hansen said. �They are upset already and it hasn�t even taken effect already.�

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Friday, May 17, 2013

Oregon Single-Payer Activists Keep Dream of Universal Healthcare Alive

In Oregon, a separate measure, giving state sponsorship of a comprehensive study on universal healthcare financing, makes its way through the Committee on Ways & Means.

May 15, 2013 � Wes Brain was uninsured last winter when a tonsillectomy showed signs of throat cancer. He qualified for the high-risk Oregon Medical Insurance Pool, which the state has administered through Regence BlueCross BlueShield.

But gaining access to that insurance soon proved a big obstacle for the Ashland resident, when Regence erroneously told him he hadn�t submitted his driver�s license.

�Denial and delay, denial and delay are the way these insurance companies work. They make money this way,� Brain vented to the House Health Committee on Tuesday. He had previously lost his daughter after a nine-year struggle with leukemia while contending with insurance companies over access to necessary healthcare services.

Eventually, his policy was approved. He paid $2400 � three month�s premium. His doctor ordered a PET scan for March 1. But then Regence came back and told him no, he�d have to wait until March 1 to even begin authorization.

His clock was ticking. His throat cancer could be spreading.

He enlisted his local Rep. Peter Buckley, D-Ashland, to help him. He got the state Insurance Division on his case.

They came through. He received his PET scan, and spent four days at Oregon Health & Science University, receiving additional tonsil surgery. �They cut the hell out of me,� said Brain, who’s now cancer-free.

�There is no way that Regence should have delayed my care at all,� Brain added. �That�s how they do business. They kill people doing it. Let�s get them the hell out of it, and let�s pass this bill.�

Buckley and 23 other Democrats have signed on to support House Bill 2922, which would throw out the private health insurance industry and set up a single-payer health insurance system administered by the Oregon Health Authority.

The bill has no chance of passage this session, but House Health Committee Chairman Rep. Mitch Greenlick allowed fellow Portland Democrat and chief sponsor Rep. Michael Dembrow to lead single-payer health care advocates in an informational public hearing.

Brain and other activists aired their support for a privately delivered, government-sponsored health system that would revolutionize Oregon healthcare and make it similar to health systems in Japan, Europe, Canada and the rest of the developed world.

HB 2922 closely parallels House Bill 3510 from the 2011 session, but at 76 pages, it�s 30 percent longer than the previous measure, repealing newly acted reforms such as Cover Oregon, which offers subsidized private insurance for people with moderate incomes.

No Republicans have yet come on board as supporters, but the single-payer bill has twice as many sponsors this session from Democrats across the state, including rural districts as well as Portland and Eugene. Two of the state’s largest unions � the Oregon Nurses Association and the Oregon Education Association � have also thrown their support behind the measure.

Study Bill Moves Forward

Dembrow has also sponsored House Bill 3260, which had a budget hearing on Tuesday. That bill, which passed unanimously earlier this session from the House Health Committee, would solicit $250,000 to $600,000 in private funds to comprehensively study how best to implement universal healthcare in Oregon.

The study will look at several different options, including single-payer, a public option and the basic health plan envisioned for low-income people who wouldn’t qualify for Medicaid by the Affordable Care Act.

Chunhuei Chi, a professor at Oregon State University�s College of Public Health and Human Sciences, told The Lund Report the study would aim for transparency, be replicable and available for peer review. The Oregon Health Authority could either choose Oregon State or another entity to conduct the study.

Previously, Health Care for All Oregon, which supports the single-payer bill, had considered asking the Northwest Health Foundation to conduct such a study. But according to Dembrow, a state-sanctioned study would lend more credibility.

Earlier, he told The Lund Report that while he expects single payer the best route to universal healthcare, he believes the underlying bill is written well enough to turn into the best solution for Oregon, and he will support its recommendations.

�This is exactly the way it�s done,� said Sen. Elizabeth Steiner Hayward, D-Portland, who favors doing such a study but has not come out in support of the single-payer option. �I like that you�ve laid out a menu of options, and that it doesn�t make a predetermined decision,� she added, calling the study outcome-based rather than motivated by political ideology.

Contrasting Systems

Alan Journet, a retired professor and dual British-U.S. citizen, pointed out that in Great Britain, socialized medicine is so popular even Conservative icon, former Prime Minister Margaret Thatcher, was a big supporter.

While living in the U.S., he came down with cancer and was given two months to live, absent treatment. �Thanks to insurance, I didn�t have to worry much about the cost of treatment, but I did constantly have to worry about the insurance company approving doctor-recommended treatment,� Journet said.

Journet said he felt lucky � his insurance company approved his treatment, unlike his sister-in-law who fell ill earlier.

�Her insurance company denied treatment, and she died,� Journet said. �We often hear the complaint that we should fear government functionaries making decisions on treatment, as though we are better served having insurance company functionaries make such decisions, employees whose income encourages denying treatment and generating a sizable profit.�

Dembrow said his passion for single-payer healthcare started following the birth of his two children. His daughter, who was born in France, received exemplary care, including house calls from physicians for just a small co-payment and a tax taken out of the family paychecks.

His son, on the other hand, was born in Indiana. At the time, insurance companies weren’t required to cover infants for the first 30 days of their life. His son had a digestive abnormality called pyloric stenosis that required surgery. A graduate student at the time, Dembrow and his wife had to deplete their savings to pay for the care.

�The contrast of those experiences have committed me to try to do things differently in this country,� Dembrow said.

Dembrow praised the reform efforts of Gov. Kitzhaber to deliver healthcare for the poor through coordinated care organizations and also lauded many of the aspects of the Affordable Care Act, including the expanded Oregon Health Plan and the insurance exchange. Yet, he said these reforms fall far short of an equitable universal healthcare system.

�We�ll continue to have jobs kept temporary or part-time for no good reason other than to keep workers from being eligible for coverage,� he said. �Our system will still rely on private insurance companies who charge high administrative fees, create administrative burdens for doctors and other healthcare professionals, and whose primary interest is their own profits. � At best what we�re going to continue to have an expensive, complicated patchwork system.�

Wednesday, May 15, 2013

Feds Push For Lower Alcohol Limits For Drivers

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

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Friday, May 10, 2013

California Weighs Expanded Role For Nurse Practitioners

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Tuesday, May 7, 2013

Pfizer Goes Direct With Online Viagra Sales To Men

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Friday, May 3, 2013

Suicide Rate Climbs For Middle-Aged Americans

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Suicide Rate Climbs For Middle-Aged Americans

More From Shots - Health News NewsOutbreak Of New SARS-Like Virus Kills 5 In Saudi ArabiaHealthWomen's Health Groups Angered By Morning-After Pill MovesHealthColorado Weighs Reopening Psychiatric Hospital For HomelessHealthSuicide Rate Climbs For Middle-Aged Americans

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