PROTECT, IMPROVE, & EXPAND MEDICARE

On the 50th anniversary of the signing of Medicare, the President of Physicians for a National Health Program, Dr. Robert Zarr, makes a plea to expand Medicare. He particularly notes the low overhead of Medicare, compared to for-profit insurances. His piece "Happy 50th Birthday, Medicare! Next Steps in the Fight for Universal Health Care" was posted by Truthout on 7-30-15.  LEARN MORE

Posted on July 30, 2015 and filed under Health care reform.

HEALTH CARE ACCESS: GOOD NEWS & BAD NEWS

Undocumented migrant children are included in Medi-Cal's budget of 2016. The only west coast state not providing this coverage is Oregon. Sinsi Hernandez-Cancio, Yasmin Peled and Erika Ramirez piece "California's Historic Decision to Extend Health Coverage to Every Low-Income Kid" was posted at Families USA blog on 7-23-15.  LEARN MORE  

Human rights campaigners fear mergers of U.S. health insurance giants, such as Anthem and Cigna, may erode access due to price hikes. Sarah Lazare's article "Healthcare 'Oligopoly Wave Continues As Anthem Gobbles Cigna" was posted by Common Dreams on 7-24-15. LEARN MORE

HEALTH EQUITY DISCREPANCY & VIOLENCE

Victims of violence are more apt to survive if a level 1 trauma center is within 5 miles. Yet "trauma deserts" exist, particularly where people of color and poor people live. At the scene of shootings, decisions of the police may delay access by first responders. The People's Community Medics is training people of color in emergency trauma care. Maya Dukmasova's article "As Marginalized Communities Face Dearth of Trauma Care, Activists Step in to Fight for Survival" focuses on Portland (Oregon), Oakland, and Chicago. The piece was posted at Truthout on 7-21-2005.  LEARN MORE     

Posted on July 22, 2015 and filed under health equity.

OREGON HEALTH INSURANCE RATES GOING UP

Announcement of the final decision of 2016 rates for health insurance in Oregon drew both local and national press. For individuals rates averaged a 37.8% increase. For small groups the average was 15% rise. Rates are determined by the Oregon Insurance Division. Jake Sunderland covered the topic in "Final Health Insurance Rates Decision For 2016 Released" for The Lund Report on 7-1-15. It includes links to a summary table of final decisions.  LEARN MORE. Louise Radnofsky's article "Oregon Backs Hefty Rise in Health-Insurance Premiums" appeared in the Wall Street Journal on 7-3-15.   LEARN MORE

Posted on July 5, 2015 and filed under health insurance.

AFFORDABLE COVERAGE STILL CONCERN

The U.S. Supreme Court this week upheld financial assistance for insurance premiums of millions of Americans who have low or middle income. Yet, the cost of coverage remains a worry for many. Carla K. Johnson, of Associated Press, wrote "Coverage Worries Persist Amid Relief Over Health Care Ruling." One woman interviewed for the piece is from Oregon. The article was carried by many outlets, including ABC News on 6-26-15.   LEARN MORE

Posted on June 26, 2015 and filed under Affordable Care Act, health insurance.

MEDICARE FOR ALL: AN ECONOMIC SOLUTION

Professor Robert Reich makes the case that the way to address rising costs of health care and large numbers of senior citizens retiring is to make Medicare available to all. This moves towards a single payer system. He notes that Medicare is more efficient than private health insurance. His piece "Making the Economy Work for the Many and Not the Few #11 Medicare Isn't the Problem; It's the Solution" was carried by the Huffington Post on 6-22-15. LEARN MORE

$712 MILLION FRAUD FOUND IN MEDICARE

Bills for medical equipment and services not provided, and unneeded care are among charges announced by the Department of Health and Human Services and Department of Justice on 6-18-2015. These criminal activities drive up health costs. 243 individual providers were charged for false billing totaling $712 million uncovered in a nationwide review of Medicare. Accusations spanned kickbacks, money laundering, and identity theft,  involving hospice, physical therapy, and prescription drug fraud.  Doctor visits of 15 minutes billed for 90 minutes. The Medicare Fraud Strike Force now tracks in real time. The program includes prevention and enforcement. LEARN MORE

Posted on June 21, 2015 and filed under Affordable Care Act, Fraud.

HOSPITAL PRACTICES: NON-PROFIT & FOR-PROFIT

Recent studies published by Health Affairs highlight differences among hospitals according to tax status. 

Fifty U.S. hospitals with the highest charge-to-cost ratios billed the uninsured ten times their Medicare-allowable costs during 2012. 49 out of the 50 such hospitals were for-profit. The article by Ge Bai and Gerard F. Anderson "Extreme Markup:  The Fifty US Hospitals With The Highest Charge-To-Cost Ratios" appears in Health Affairs June 2015, vol. 34 No. 6, p. 922-928. LEARN MORE 

Commentary on the article by Wendell Potter "For-profit hospitals mark up prices by more than 1,000 percent because there's nothing to stop them" adds insights of a former insurance insider. His piece was posted at Public Integrity on 6-15-15. LEARN MORE

The Internal Revenue Service (IRS) requires non-profit hospitals to provide community benefits, such as care for the indigent, participation in means-tested public insurance, training of health professionals, research, and community health improvement. Sara Rosenbaum, David A. Kindig, Jie Bao, Maureen K Byrnes, and Colin O'Laughlin  calculate the worth of these benefits and anticipate changes due to fewer uninsured.  Their study "The Value Of The Nonprofit Hospital Tax Exemption Was $24.6 Billion In 2011" was published online ahead of the print issue of Health Affairs, June 2015. LEARN MORE

 

Posted on June 19, 2015 and filed under Affordable Care Act, Health care reform, Public good.

DARES FROM DRUG TRADE

Big Pharma made plenty of news this week. Amarin sued the Food & Drug Administration for violating the firm's First Amendment free speech rights in prohibiting promoting a drug for unapproved uses. Michael Carome, M.D. explores the public health implications in "Outrage of the month:  Industry Lawsuit Threatens FDA's Regulation of Drugs" posted at Public Citizen's Health Letter of June, 2015. LEARN MORE

Then text of the Trans-Pacific Partnership (TPP) was leaked that shows pharmaceutical and medical device companies would gain more power over public access to their products and stymie public health programs, including limiting Congressional reform of Medicare and lower drug costs.  Big Pharma could challenge decisions a government makes on which drugs are offered and rates of reimbursement. Deirdre Fulton reported on the situation in "Leaked Text Shows Big Pharmacy Bullies Using TPP To Undermine Global Health" posted at Common Dreams on 6-10-15. LEARN MORE   

Posted on June 11, 2015 and filed under health policy, Public good.

5% in MEDICAID ACCOUNT FOR HALF EXPENSE

The GAO released a report to Congress "A Small Share of Enrollees Consistently Accounted for a Large Share of Expenditures" on 5-8-15. The study analyzed those enrolled only in Medicaid from 2009-2011. Results of the study are available as one-page of highlights, or the 45-page full report  at gao.gov. In the full report five chronic conditions (asthma, diabetes, HIV/AIDS, mental health, and substance abuse) account for large expenditures. These varied among the states. Oregon had the highest percent of adults of high expenditure Medicaid-only enrollees.   LEARN MORE

Posted on June 7, 2015 and filed under health insurance.

SINGLE PAYER REVIVES

A single-payer bill, "The New York Health Act" passed the New York state Assembly on May 27th by 89-47. It had been introduced annually since 1992. However, it is not expected to pass the New York senate. James 321 reported the event in "New York's State Assembly just passed a single-payer bill" posted on the Daily Kos on 5-27-15. LEARN MORE

Posted on June 7, 2015 and filed under Health care reform.

MODA SEEKS 25% RATE INCREASES

Higher premiums for health insurance are anticipated for 2016. In Oregon, Moda Health Plan seeks an average of 25% increase in rates. The biggest rise is drug costs that increased 11% during 2014. A recent study shows those with employer-sponsored plans spend 30% more on drugs than exchange customers did. Paul Demko covered the topic in "Experts see big price hikes for Obamacare" posted by Politico on 5-30-15. LEARN MORE

Posted on June 1, 2015 and filed under Affordable Care Act, affordability.

UNIVERSAL CARE: EVERYONE IN SAME SYSTEM

Dr. Philip Caper, notes the popularity of universal health care in other countries relates to everyone being in the same system.  This contrasts to the complex, confusing, and costly American system that focuses on choice of health insurance plans, yet limits choice of doctors and hospitals.  Caper makes the case for reforming the way health care is financed in the U.S. in his blog "Obamacare's health plan choice benefits are vastly overrated" published by the Bangor Daily News on 5-14-15. LEARN MORE

RECORD PROFITS FROM HEALTHCARE REFORM

The Center for Public Integrity recently posted two articles about rising profits after changes in health insurance. Wendell Potter explores insurers, such as UnitedHealth Group, which just showed the highest profit in years, despite initial concerns that the Affordable Care Act would cut into their profits. His commentary "Insurers backed Obamacare, then undermined it. Now they're profiting from it" was posted by the Center for Public Integrity on 4-20-15. LEARN MORE  

On the same site Fred Schulte documents how investors made billions when the Centers for Medicare and Medicaid Services announced before the markets closed, that they'd go easy on overcharging Medicare Advantage. This created $2 billion in new equity for UnitedHealth Group alone. His article "How Medicare Advantage investors made billions off loose government lips" was posted 5-20-15. LEARN MORE 

HIGH DEDUCTIBLES YIELD UNDERINSURANCE FOR 31 MILLION

The Commonwealth Fund's biennial Health Insurance Survey found 31 million Americans underinsured due to high deductibles. Underinsured was defined as out-of-pocket costs of 10% or more of household income, or out-of-pocket costs are 5% of more of household income if income is under 200% of federal poverty level, or deductible is 5% or more of household income. S.R. Collins, P.W. Rasmussen, S. Beutel, and M.M. Doty reported their findings in "The Problem of Underinsurance and How Rising Deductibles Will Make It Worse. Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2014." The survey was posted on 5-20-15 by The Commonwealth Fund. LEARN MORE

Posted on May 21, 2015 and filed under Affordable Care Act.

FLUCTUATING INCOME THREATENS HEALTH COVERAGE

People on Medicaid whose income varies from month to month have to report the changes. These shifts in enrollment affect continuity of care. Timing of changes may interrupt coverage. Strategies by some states mitigate the harm. Michelle Andrews covers the topic in "Shifts in Earnings for Consumers Near Medicaid Line Can Threaten Coverage" posted by Kaiser Health News on 4-7-15. LEARN MORE

The issue was addressed from a policy perspective by Charles Milligan in "From Coverage to Care: Addressing the Issue of Churn" and by Sara Rosenbaum in "Addressing Medicaid/Marketplace Churn through Multimarket Plans:  Assessing the Current State of Play." Both articles were published by the Journal of Health Politics, Policy and Law in February (Vol. 40 (1): 227-232). LEARN MORE

Posted on May 21, 2015 and filed under Affordable Care Act.

OREGON LEADER IN HEALTH CARE

Oregon House Bill 2828 relates to study on financing health care in Oregon. A letter-to-the-editor urging passage of this bill from Shirley Kingsbury of Eugene, was published by Eugene Weekly on 5-7-15 under the headline "Oregon Leads The Way." Scroll down to the 17th letter. LEARN MORE

Posted on May 14, 2015 .

PATIENT ENGAGEMENT

Participating in your own health produces better outcomes and lowers costs. Yet, patient engagement may amount to only satisfaction ratings, or paying your bills and scheduling appointments on-line. Writer Michelle Ronan Noteboom cautioned that true participation requires human interaction and intervention of doctors. She addressed this in her piece "What does 'patient engagement' really mean?" posted at Health Care IT News on 5-1-15.  LEARN MORE.

Posted on May 4, 2015 and filed under healthcare IT.

HEALTHCARE ACCESS FOR EVERYONE

Susan Gharib interviewed Bernard J. Tyson, CEO of Kaiser Permanente, about the Affordable Care Act (ACA). He finds improved access to healthcare under the ACA. He notes the next step is controlling costs by value-based pay and delivery systems, along with an active role for patients. The 2.5 minute video "Kaiser Permanente CEO: Everyone should have access to U.S. healthcare" was posted by Fortune on 4-30-15. LEARN MORE

Posted on May 4, 2015 and filed under Affordable Care Act.

DRUG BILL: $103 BILLION

Medicare alone spent $103 billion on drugs under Medicare D during 2013. The figure does not include drugs billed under Medicare Part B. The top ten drugs by volume are generics. The top 10 drugs by cost are all brand names. Regional variations exist in the number of drugs patients are prescribed. These are among the facts reported by Jordan Rau in "Medicare Itemizes Its $103 Billion Drug Bill" posted by Kaiser Health News on 4-30-15. LEARN MORE 

Posted on May 4, 2015 and filed under affordability.