Health Care: To Reform a la Socialists Part Deux: We've Lost the First Battle, But NOT the War
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The question is, will they take the case.
State decides what's not an emergency
Published: 09/26/11 12:05 am[Washington] State government is about to start refusing to pay for repeat visitors to emergency rooms whose conditions don’t truly rise to the level of emergencies.
The trouble is all in how you define an emergency.
Starting Saturday, Medicaid won’t pay for more than three ER visits in a year for a patient’s nonemergency conditions as defined by the state. A list of more than 700 diagnoses put into that category has drawn fire from hospitals and doctors’ groups over inclusions whose symptoms seem awfully similar to emergencies:
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The state Health Care Authority sent letters to patients on Medicaid, the federal-state health insurance for the poor, warning them the government wouldn’t pay for their nonemergency treatment after three visits.
The agency is trying to save an estimated $72 million in federal and state Medicaid spending, as directed by state lawmakers who tried this spring to crack down on emergency room misuse.
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Many patients who are poor make the emergency room their first stop.
More than 46,000 times in fiscal year 2010, Washington ERs treated the conditions listed as nonemergencies for Medicaid patients who already had come in for three, four or even more similar visits that year, state officials say. One person visited 125 times.
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A followup.
SEATTLE, Sept. 30, 2011 /PRNewswire-USNewswire/ -- Emergency physicians in Washington State today filed suit in the Superior Court of Washington for Thurston County against a state plan that would limit payment for Medicaid visits to three "non-emergency" visits to emergency departments each year and classify more than 700 diagnoses as "non-emergent," including chest pain, abdominal pain, miscarriage and breathing problems.
"This list of non-emergent diagnoses puts patients in danger and unfairly targets the poor and those in most need of care," said Dr. Stephen Anderson, president of the Washington Chapter of the American College of Emergency Physicians. "We understand that our state Medicaid office is working with 19 other states to develop this policy. If this plan goes into effect, other states will certainly follow suit."
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Exactly how does this alter EMTALA and its current implementation and potential for litigation? Did I miss the section where the State or ObamaCare places new limitations on plantiff's attorney actions?
More supreme illogic from the Left. Implement a rationing program which puts patients, physicians and hospitals at risk, as well as community jobs and tax bases when hospitals are no longer able to operate, while having zero plan or capability to treat these patients otherwise. Simultaneoulsy, it increases the risk of missing a critical diagnosis by exerting a downward pressure to ration care, including patients waiting longer to seek help resulting in more expensive care required (or death, which is a much cheaper final solution for the State, Obama and Sebelius) while diverting blame for increased morbidity and mortality onto physicians and hospitals, not the State and Obama Administration where it belongs. (ObamaCare is driving these changes because it requires more expenditure by States on health care)
This decision is akin to the Left's penchant for implementing or increasing entitlement programs without funds to pay for it. In this case, the Obama Administration wants to decrease nonessential utilization of ER's, a worthwhile goal, but fails to implemented a plan in which these patients can get medical care other than in an ER.
Once again, the Left's good intentions will produce more pavement for the road to Hell. If the Republicans had a firing brain cell, they would talk nonstop on how the State and Obama Administration are not only abandoning the poor and at risk, but also how they want medical staff and hospitals to be unpaid slave labor put at greater risk, which may result in even fewer services, jobs, and tax dollars available to the community when staff or hospitals close or move away.
Basically, this is a shit sandwich without the bread.
bookmarking :)
As I recall, one of the very FIRST topics we discussed here, well over two years ago, was the database of medical records. With dire predictions, I might add.
Looks like our worst fears may be coming true.
Oh my. We were so smart, and now we are so screwed.
And the Feds will also have direct access to your bank account in order to make sure you pay the fine for not having health insurance.
Dean: Employers will drop coverage under Obamacare
Former Democratic National Committee Chairman, and doctor, Howard Dean backed a McKinsey & Co. survey today that found that almost a third of private-sector employers will drop their employee health insurance coverage when Obamacare's government-managed insurance exchanges come online.
Dean told Morning Joe, "The fact is it is very good for small business. There was a McKinsey study, which the Democrats don't like, but I do, and I think its true. Most small businesses are not going to be in the health insurance business anymore after this thing goes into effect."
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The Congressional Budget Office (CBO) premised their Obamacare score on the assumption that only 7 percent of employers would drop their employee health plans. If the percentage is closer to the 30 percent, as the McKinsey survey results predict, Obamacare's price tag would rise by almost $1 trillion.
Dean did confirm the dirty little secret: ObamaCare will cause businesses to drop health care thereby driving more population into government run health care exchanges. The more people turning to government to provide health care then the better. This is one of the incremental steps the Left had to settle on in their relentless drive for single-payer, exclusively government-run Socialized Medicine.
So it takes more bites to eat the apple. The American Left begrudgingly acquiesce playing by the long-run end game of fellow world Communists while hoping for another crisis, real or imagined, in order to advance their ideology more rapidly.
I say this because even Dean gets it or at least some of it and that is hard to believe. There is still the fact that many small business don't offer health benefits and will be forced to pay fines to stay in business and that will cost many apprenticeship and entry level jobs.
$1 trillion in government projection = $3.5 trillion in actual tax payer expenditures
The US is on its way to redefining the term broke! - not just financially though that will be the core problem.
And for Liberals - tax increases do not equal an increase in tax revenue just like tax cuts do not equal a decrease in tax revenue. It is the result of the action on the overall economy that dictates tax revenue.
And just like a typical dimwit, Dean could care less where that money, or those services will come from.
Are we not through with these flat earth cretins yet?
Son of SGR: Congress’s Medicare advisory panel made progress Thursday on draft recommendations for replacing the unpopular formula that Medicare uses to pay doctors. The Medicare Payment Advisory Commission is looking at a 10-year replacement that would likely cost around $200 billion.
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MedPAC’s draft alternative would replace the [SGR] automatic payment cuts with … different automatic payment cuts.
The proposal would freeze payment rates for primary care. All other services would take a roughly 6 percent cut for three years, followed by a freeze. Replacing the SGR with this SGR-ish alternative would cost about $200 billion, which would come from further cuts to healthcare providers.
California could pose problem for Obama's healthcare reform
September 15, 2011California, a model for healthcare reform, is seeking to impose some of the toughest limits on government-subsidized coverage. If approved, the limits could herald deep Medicaid cuts nationwide.
Reporting from Washington -- For more than a year, as conservative states have battled President Obama's sweeping healthcare law, California was supposed to be a model that showed the law's promise.
But the state is emerging as one of the biggest headaches for the White House in its bid to help states bring millions of Americans into the healthcare system starting in 2014.
Though still outpacing much of the nation, cash-strapped California is cutting its healthcare safety net more aggressively than almost any other state, despite billions of dollars in special aid from Washington.
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From the article, some of the waivers California is asking the Federal government for:
California already spends less per beneficiary than any state. It is now seeking waivers from the federal government to impose copays of $5 for office visits and prescriptions, $50 for emergency room visits and $100 for hospital stays. Few other states come close to charging Medicaid recipients that much.
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The state plans to limit Medicaid beneficiaries to seven doctor visits a year, with exceptions for essential care. No state has imposed such stringent limits.
California, which already pays Medi-Cal providers less than all but two states, also is pushing to cut payments to doctors, hospitals and others who serve Medi-Cal patients by 10%. That would drop reimbursement for a standard physician visit to less than $12.
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I just saw this article, and decided to post it, despite it being over a month old.
Cataracts, hips, knees and tonsils: NHS begins rationing operations
Thursday, 28 July 2011[...]
Two-thirds of health trusts in England are rationing treatments for "non-urgent" conditions as part of the drive to reduce costs in the NHS by £20bn over the next four years. One in three primary-care trusts (PCTs) has expanded the list of procedures it will restrict funding to in the past 12 months.
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The alarming figures emerged from a survey of 111 PCTs by the health-service magazine GP, using the Freedom of Information Act.
According to responses from the 111 trusts to freedom-of-information requests, 64 per cent of them have now introduced rationing policies for non-urgent treatments and those of limited clinical value. Of those PCTs that have not introduced restrictions, a third are working with GPs to reduce referrals or have put in place peer-review systems to assess referrals.
In the last year, 35 per cent of PCTs have added procedures to lists of treatments they no longer fund because they deem them to be non-urgent or of limited clinical value.
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It surprised me that a health service magazine (GP) had to use freedom-of-information requests to get the information.
I don't like piling on, but, in this case, why not:
NHS makes patients wait 'to lower expectations’
11:36PM BST 04 Sep 2011NHS managers are making patients wait longer than necessary for operations, with one claiming that treating them quickly “raises expectations”.
At least 10 primary care trusts (PCTs) have told hospitals to increase the length of time before they see patients in order to save money, an investigation by The Daily Telegraph has found.
In some areas, patients endured delays of 12 or 15 weeks after GPs decided they needed surgery, even though hospitals could have seen them sooner.
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It comes after an NHS watchdog suggested that if patients are forced to wait a long time, they will remove themselves from lists “either by dying or by paying for their own treatment”.
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Par - I thought this was old news, years old. What is new? That it is the more locally managed PCT's doing the rationing instead of the monolithic, Jaba the Hut of a beast NHS?
Doesn't NHS still make the overarching rules and and disperse the budgets for the PCT's, who then divvy up the money as they see fit (as allowed by the NHS rules) for their localities? The PCT's have flexibility in how they spend their budgets but they are still slaves to the master NHS.
The PCT's perform 2 main functions: 1) Hopefully they spend money more wisely because they are more likely to be aware of local needs than the NHS, and 2) The NHS gets to blameshift at least some complaints about service and rationing onto the PCT's. Note the downward pressure on physicians to ration remains and in a sense is intensified because it occurs more on a local level.
Physician recruiter firm Jackson & Coker has released the results of a survey of physicians' opinions concerning the AMA. In a nutshell, ~75% of physicians believe the AMA does not represent them on a variety of issues including ObamaCare, tort reform, political machinations and more. Interestingly, the results are split between current, former and nerver was members of the AMA. Even the members of the AMA display a high prevalence of disapproval with the AMA.
None of this is a surprise to any physician I know and have previously discussed any aspect of this survey prior to it being published. What I did find humorous, though unsurprising, is that some physicians left the AMA because they thought it was too Right in its political ideology or did not support full blown CommieCare. Of course, overwhelmingly survey participants brroke from the AMA because of a Leftward bent, its support of ObamaCare, and, number one, the AMA no longer speaks for them.
I hope one of the NB writers pick up on this survey and publish an article in the Blog section.
Sam: No, I am not a member of the AMA. I realized in residency that the AMA concentrated more on non-physician issues. I thought they should split into a patient advocate group and a physician advocate group. The issue of a lucrative coding monopoly has been extant for years. Good to see it received more sunlight.
I appreciate AAPS's recognition of Hippocrates Oath on their home page. None of that new fangled, watered down, abortion on demand and euthanasia supporting, politically correct Lasagna version held so dear by today's progressive medical students and the AMA.
I did not know some hospitals required AMA membership! What was their reasoning?
Even if the hospital "pays" for it as part of your compensation package, I believe a physician has the right to decide with whom he'll be associated with professionally. I wonder if the reversal by these hospitals is more of an economic decision than right of association issue. Not difficult to guess.
Heritage Foundation published an article predating the J&C survey which discussed the discontent of students and physicians with the AMA. Maybe it was the impetus of the J&C survey.
Student discontent seems a little unusual from traditional attitudes since AMA membership is provided at no charge during medical school, at least when I was a student. No one knew much about the AMA at that stage and were happy to be a member of the traditionally respected group.
Who couldn't see this coming.
Health care expansion to cost Illinois, study finds
Sep 03, 2011Expanding Illinois’ Medicaid program under the federal health-care reform law will cost the state $1.3 billion a year in 2020 and beyond, according to an analysis by the nonpartisan Rand Corp.
The annual cost is at least six times higher than what state officials have estimated since the federal Affordable Care Act became law in March 2010.
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HFS [IL Department of Healthcare and Family Services] officials had said the expansion would cost Illinois almost nothing initially, and only about $200 million per year in 2020 and beyond.
But the study by Rand, a respected not-for-profit research institute based in California, indicates that Illinois will incur about $700 million in new Medicaid costs not covered by the federal government in 2016. The cost to Illinois taxpayers would ramp up to $1.3 billion annually by 2020 and total $6.2 billion between now and 2020.
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Off by more than a billion dollars a year, nothing new to see here, it's just a rounding error, move along.
The RGPPC presents some ideas on reforming Medicaid:
A New Medicaid: A Flexible, Innovative and Accountable Future
Republican Governors Public Policy Committee
Health Care Task Force
August 30, 2011[...]
A New Medicaid: A Flexible, Innovative and Accountable Future is the culmination of the combined efforts of policymakers and health care administrators in the nation’s Republican-led states. This report will serve as the basis for dialogue during the upcoming RGPPC-sponsored Health Care Summit to be held in Washington D.C., on Oct. 24-25, 2011.2 The summit will feature governors, their senior health care staff, key House and Senate staff, and representatives from both the private sector and policy community. Together, stakeholders will engage in a serious – and much-needed – discussion focused on Medicaid reform and the policy options proposed by the nation’s Republican governors.
The RGPPC Health Care Summit is significant in that it will bring forward specific policy solutions for health care reform from the nation’s governors for the first time. Despite repeated efforts by governors from both parties to engage in the debate leading up to the passage of the Patient Protection and Affordable Care Act (PPACA), the White House largely ignored state input. This is in stark contrast to the welfare reform debate of the 1990s, in which governors played a major role in identifying the solutions that culminated in the 1996 passage of the bipartisan Personal Responsibility and Work Opportunity Reconciliation Act.
By carrying out a partisan and exclusively federal debate, the White House only made the health care crisis worse. Today, Americans are no closer to affordable health care with the passage of the PPACA than they were before the debate began. This makes the RGPPC’s efforts to identify improvements to provide health care to the most vulnerable individuals all the more important.
The PPACA expansion of the Medicaid program is the largest expansion of this program in history. As a result, we are deeply concerned the existing challenges Medicaid faces today will be exacerbated by the program’s unprecedented growth over the next few years. We must think about a new Medicaid program—one that more easily adjusts to the needs, ideas and culture of each state.
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I happened to see this GAO report, dated July 14, 2011, about the cost (contracts awarded by government agency) of implementing The Patient Protection and Affordable Care Act (PPACA), as amended by the Health Care and Education Reconciliation Act of 2010 (HCERA).
As of April 15, 2011, contracts awarded and amount paid by the various government agencies (I excluded some agencies that had only minor contract amounts) were:
Contracts Awarded by the Assistant Secretary for Administration for Implementation of the Patient Protection and Affordable Care Act (PPACA)
Awarded: $706,492,228.00; Paid: $105,919,565.00
Contracts Awarded by the Centers for Medicare & Medicaid Services for Implementation of the Patient Protection and Affordable Care Act (PPACA)
Awarded: $20,346,884.00; Paid: $3,898,227.00
Contracts Awarded by the Health Resources and Services Administration for Implementation of the Patient Protection and Affordable Care Act (PPACA)
Awarded: $877,448.00; Paid: $368,139.00
Contracts Awarded by the Employee Benefits Security Administration for Implementation of the Patient Protection and Affordable Care Act (PPACA)
Awarded: $3,713,844.00; Paid $1,576,322.00
Contracts Awarded by the Internal Revenue Service (IRS) for Implementation of the Patient Protection and Affordable Care Act (PPACA)
Awarded: $34,811,316.00; Paid $13,058,608.00
Footnote: An obligation is a definite commitment that creates a legal liability of the government that will give rise to a payment immediately or in the future. An agency incurs an obligation when it awards a contract, and the obligated amount is generally the amount of the agency’s liability at the time of award.
As of July 14, 2011, if I have added correctly, the government was obligated to pay $766,241,720.00 on implementation of PPACA.
It is unclear to me whether the Obama Administration is behind on obligations or the yet unpaid outlays are triggered by events or dates which have yet to occur.
I did notice that Pennsylvania was awarded roughly twice that of Ohio despite only a one million state citizen difference in population. Why such a wide variance? Could it be politics, or something like Pennsylvanians hammer healthcare resources more than Ohioans, or Pennsylvania finds more dollars to be matched by the Feds, or Ohio "needs" fewer Fed dollars because Ohioans are contributing more to their own healthcare needs?
Thought I'd give props to Lachlan for this article he wrote for Heritage:
In Verizon Strike, Unions Protest Obamacare Law They Supported
Lachlan Markay
August 19, 2011 at 12:00 pmTwo unions are on strike against Verizon Communications in protest of proposed company policies that the unions themselves helped bring about. The new Obamacare law, which both unions supported, dramatically hikes the cost of Verizon’s employee health care plan. Efforts to pass some of that cost on to employees have sparked outrage.
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Is Obama "not resting" until he finds a way to exempt these union folks?
Small Business and Health Insurance: One Year After Enactment of PPACA
July, 2011[...]
Executive Summary
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Twenty (20) percent of small employers currently offering expect to significantly change their benefit package and/ or their employees’ premium cost-share the next time they renew their health insurance plans. Almost all significant changes expected involve a decrease in benefits, an increase in employee cost-share, or both.
Since enactment, one in eight (12%) small employers have either had their health insurance plans terminated or been told that their plan would not be available in the future. Plan elimination is the first major consequence of PPACA that small-business owners likely feel.
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The prime goal of ObamaCare is to drive citizens into government exchanges and ultimately into a singular healthcare plan run by the government.
Your article details successes for the Left in their Europification of the USA.
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Panel: Medicare should give prior approval for imaging tests
By Julian Pecquet - 06/15/11 03:29 PM ETPhysicians who order lots of diagnostic imaging tests should be required to get prior approval if they want to get paid under Medicare, the panel of experts who recommend payment policies urged Congress.
The near unanimous recommendation from the 17-member Medicare Payment Advisory Commission immediately provoked rationing accusations from industry. The recommendation is part of a semi-annual report to Congress, released Wednesday.
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Mark Miller, MedPAC's executive director, told reporters on Wednesday that imaging has been growing steadily over the past decade. The commission recommends cutting back on payments and subjecting providers who order the most imaging tests to a dual process: they would have to submit data on the tests they order, which would then be compared to clinical guidelines (prior notification); if the tests were ordered inappropriately, federal regulators or contractors would have to approve future tests (prior authorization).
Asked about other services where MedPAC has concerns about overuse, Miller mentioned pathology, radiation therapy and physical therapy. Still, he made it clear that the commission isn't considering prior authorization for those services — or at least not yet.
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Modern medicine uses imaging precisely for the reason that CTs, MRIs and PET scans are non-invasive and thus do not put the patient at risk from exploratory surgery or other procedures. You can group EKGs, EEGs and EMGs to the "imaging" list and even more potentially non-invasive or less invasive procedures will be affected.
This "panel of experts" more than likely consists of "politically reliable" academics who do not treat many patients.
How about having to get a plain film xray before CT or MRI and the more advanced study is ok'ed anyways regardless of the xray results.
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Soviet Economist Warns of Age Discrimination, Quality Loss in “Healthcare Reform”
Jun 10, 2011The incentives that are an essential part of recently passed healthcare reform have been tried many times before, always with the same result, warns economist Yuri Maltsev, Ph.D., in the summer 2011 issue of the Journal of American Physicians and Surgeons (www.jpands.org/vol16no2/maltsev.pdf) and in a presentation to AAPS members in Omaha last month.
Before defecting to the West, Maltsev was a member of a senior Soviet economics team that worked on President Gorbachev's reform package under perestroika.
The Soviet system looked good on paper, employing plan indicators to indicate hospital performance, Maltsev observes. Statistics such as infant mortality were misleading, however, and actual quality was appalling. In Russia, patients over the age of 60 were considered worthless parasites, and those over 70 were often denied even routine care unless they were members of the elite class.
"Age discrimination is very apparent in all government-run or heavily regulated medical systems," Maltsev writes. It has not yet taken hold in the U.S. because the elderly vote in large numbers. But Americans are insidiously being prepared for it by the architects of Obama's plan, he notes.
In Russia, the trend is toward privatization, while "Obama suggested a system that we can rightly define as communist or socialist," states Maltsev, quoting Oleg Kulikov, a member of the Russian Duma (parliament). Kulikov also remarked that "they [Americans] are assuming positions that we've abandoned."
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An article about vouchers for low income participants in Obamacare and the hypocrisy of the left regarding Ryan's plan for reforming Medicare.
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On Political Expediency and Health Care Reform
Jun 12, 2011
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Recall the basics of the Obama reform. "Premium credits" (vouchers!) are given to participants in the new state-based health care exchanges. These credits are set based on a reference plan offered in the exchanges, and they don't vary based on the plans selected by participants (but do vary based on the household incomes of the participants). Does all this sound familiar?
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Finally, the credits that are given to exchange participants won't keep up in future years with the expected increases in premium costs. That's right. The Obama "vouchers" are indexed in a way that will gradually push more premium costs onto the low-income exchange enrollees. For some reason, in all of the heat and fury over the Ryan Medicare blueprint, this feature of the Obama plan has been almost entirely overlooked by the media, with the notable exception of Jed Graham at Investor's Business Daily.
It doesn't help that the Obama indexing provision was written extremely carelessly, which has led the Congressional Budget Office and Health and Human Services actuaries to different interpretations. But no matter the interpretation, it's clear that, if health care costs don't moderate, the new law will end up pushing higher premium costs onto low-income exchange participants. CBO recently issued a report on this subject that shows that the premium increases for low-income households could easily reach 10 to 12 percent every year.
Meanwhile, now that their plan is law, the tune has changed. The enthusiasm for premium credits, consumer choice of private health plans and decoupling of credits from health costs seems to have waned. Indeed, it's waned to such an extent that these are now not just bad ideas but ideas that would destroy America as we know it!
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Mayo Clinic opposes key health reform provision
June 11, 2011The Mayo Clinic says it will not be part of a critical piece of national health care reform under the government's proposed rules.
The prestigious Rochester clinic is raising questions about accountable care organizations, or ACOs, which are supposed to be updated -- and better -- versions of health maintenance organizations.
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But Mayo says the proposed regulations from the federal Centers for Medicare and Medicaid Services (CMS) conflict with the way it runs its Medicare operations, which treat about 400,000 patients a year.
Dr. Douglas Wood, Mayo's chairman of health care policy and research, said Mayo does not want to significantly change what it believes is an efficient, patient-friendly program. Wood said Mayo "is not going to participate in a Medicare accountable care organization under the circumstances proposed."
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Again, why am I not surprised.
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Vt gov taps lawyer for new health care post
MONTPELIER, Vt.—Vermont Gov. Peter Shumlin is tapping a veteran state government lawyer to fill the new job of director of health care reform.
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With all due respect to Jer, hiring a government lawyer to oversee the State's new single payer health care reform implementation begs the question, what can go wrong. :))
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Medicare experiment has little effect
Friday June 3, 2011WASHINGTON — A key government experiment that set out to lower costs and coordinate care for Medicare patients — now the blueprint for an innovation the Obama administration is trying to move to a national scale — has failed to save a substantial amount of money.
The five-year test enlisted 10 leading health systems around the country and offered financial bonuses if they could save enough by treating older patients more efficiently while providing high-quality care.
In 2010, the final year, just four of the 10 sites, all long-established groups run by doctors, slowed their Medicare spending enough to qualify for a bonus, according to an official evaluation not yet made public. Two sites saved enough to get bonuses in all five years, the evaluation shows, but three did not succeed even once.
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What can - and cannot - be accomplished by changing the way Medicare pays for and delivers care is particularly relevant now because the Obama administration proposed rules this spring for groups that want to become ACOs under Medicare. Many health-care providers, including the leaders of all 10 sites in the experiment, are complaining that the rules would to too burdensome.
The experiment began in 2005 under the George W. Bush administration. It offered "performance payments" to participants that met most of 32 measures of quality - half as many as in the proposed rule - and spent at least 2 percent less for Medicare patients, compared with a group of similar Medicare patients outside the experiment who lived nearby.
Obamacare relies on ACOs and IPAB to control costs. After reading the above, ACOs don't sound too promising, so it appears IPAB, using payment reductions to providers, will have to be the main instrument used to reduce costs.
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Carroll students read entire health care bill
May. 23, 2011When the national health care reform act was being debated, there was so much misinformation floating around about the bill that it was difficult to know what the legislation actually included without reading its approximately 2,500 pages.
So that's exactly what a group of about 40 Carroll College students and two professors did.
Professors Brian Matz and Zac Callen created a class at Carroll College that used the Patient Protection and Affordable Care Act as the main text.
"The students were required to read the whole bill over the course of the semester," said Matz, assistant professor in Carroll's theology department.
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"It was very much about understanding the health care bill," he said. "We literally would go page by page through the bill and talk about the issues that were being raised by the bill."
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What a missed opportunity for Nancy Pelosi. She should have signed up for the course. Maybe she would have learned something. Oh wait, Nancy said she read the whole thing.
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Addressing an audience at Harvard University on Friday, House Speaker Nancy Pelosi offered assurances that she had read the entire 1,900-page health care bill.
"I've read 3,200 pages," Pelosi said. "We gave 1,000 pages to each of the three committees and then they reported their findings to us."
Maybe the students that took the class can ask Nancy some questions, to see if she actually read the bill, let alone understood it.
Valuable info you continue to put up...thanks for all your efforts.
HHS announced its new rate review rule yesterday.
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Affordable Care Act helps fight unreasonable health insurance premium increases
Today, The Department of Health and Human Services (HHS) issued a final regulation to ensure that large health insurance premium increases will be thoroughly reviewed, and consumers will have access to clear information about those increases. Combined with other important protections from the Affordable Care Act, these new rules will help lower insurance costs by moderating premium hikes and provide consumers with greater value for their premium dollar. In 2011, this will mean rate increases of 10-percent or more must be reviewed by state or federal officials.
“Effective rate review works – it does so by protecting consumers from unreasonable rate increases and bringing needed transparency to the marketplace,” said HHS Secretary Kathleen Sebelius. “During the past year we have worked closely with states to strengthen their ability to review, revise or reject unreasonable rate hikes. This final rule helps build on that partnership to protect consumers.”
Starting September 1, 2011, the rule requires independent experts to scrutinize any proposed increase of 10-percent for most individual and small group health insurance plans. States will have the primary responsibility for reviewing rate increases. While most states will take on this responsibility, HHS will serve in a backup role in states that don’t have the resources or authority to review rates. HHS has awarded $44 million in Affordable Care Act grants to states to help strengthen their oversight capabilities. An additional $200 million will continue to be available to states under the Act.
Starting September 2012, the 10-percent threshold will be replaced by state-specific thresholds that reflect the insurance and health care cost trends in each state. The final rule clarifies that HHS will work with states in developing these thresholds.
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Then I saw this:
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AARP latest to receive Obamacare break
Published: 10:43 PM 05/19/2011The Daily Caller has learned that the Department of Health and Human Services (HHS) rate review rules, which it finalized on Thursday, exempt “Medigap” policy providers, like the American Association of Retired Persons (AARP), from oversight when such providers increase payment rates for their supplemental insurance plans.
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The AARP is the nation’s biggest seller of Medigap policies, or supplemental healthcare plans that add onto what Medicare won’t cover for seniors. The senior citizens interest group advocated for Obamacare to include an attack on Medigap policies’ biggest competitor, Medicare Advantage.
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Senate Majority Leader Harry Reid and Sens. John Kerry, Massachusetts Democrat, and Max Baucus, Montana Democrat, wrote to HHS Secretary Kathleen Sebelius last October asking her not to do what HHS just finalized today – that is exempt Medigap policies from rate increase oversight.
“While Medicare Advantage premiums are declining, we are hearing disturbing stories from beneficiaries across the country about excessive premium increases for Medigap supplemental insurance policies,” Reid, Baucus and Kerry wrote to Sebelius on Oct. 6.
“For example, some beneficiaries enrolled in the United of Omaha Life Insurance Company will see their Medigap premiums increase by approximately 40 percent between 2010 and 2011,” the letter read. “An increase of this magnitude raises serious concerns about premium-setting practices and rate review procedures in place for Medigap policies.”
Instead of listening to three top Senate Democrats, the Obama administration decided to go ahead anyway with the Medigap exceptions from rate increase reviews.
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You can't make this stuff up.
[Edited to add] AARPs response is at the end of the article.
Can't seem to find a list of States who do not regulate health care insurance. HHS and the Media keep mentioning this but continue failing to identify either the number or specifically the States by name. Maybe it's because this is a garbage excuse for the Federal government to further erode liberties and take over health care.
The linked article makes prominent mention of States who have denied instances of high percentage rate hikes, including one occurrence in California. Yet this talking points memo failed to mention the Anthem rate increase of 16% on average permitted by California insurance regulators despite intrusion by the Obama Administration to the contrary. Why? Because it was a sound amount determined after examining the books and current costs. Also missing was the mention that Blue Shield of California was granted a 19% increase. Where was all the angst over this?
In other words, California, like every other State, can determine what insurers may charge in their State. No Federal involvement is needed. Every State can do this, and, apparently most are by the Feds own words. Federal money may be useful, but Big Brother from the Fed is overstepping.
While scouting for the elusive names of States not regulating insurance, I came across this Cato Institute Cato Handbook For Policymakers 7th Edition handbook chapter entitled Health Insurance Regulation. The last paragraph sums up their opinion:
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"The Constitution, however, does not grant Congress the power to regulate health insurance. Thus, in the same legislation, Congress should relinquish any role as an insurance regulator. Were Congress to do otherwise, the federal government itself would soon emerge as a monopoly provider of regulatory protections, and consumers would be even worse off than
they are today. Over time, rent-seeking special interests would storm
Capitol Hill with demands for additional regulation. Once those federal regulations were enacted, they would be even further removed from the people than state regulations, and much more difficult to dislodge. It is crucial, therefore, that any federal law aimed at regulatory federalism do nothing more than allow consumers to purchase health insurance regulated by another state and ensure that those are the only regulations that govern. If Congress uses the opportunity to regulate health insurance itself, reform will not have been worth the effort."
Wonder if they've walked back on this now?
Concerning AARP's political payoff - shocking, just shocking. The Obama administration hits record lows for corruption of thought and action. Nearly single-handedly, and with direct support by the Leftist Media, Obama is rehabilitating the tarnished images of Nixon and Carter by virtue of Barry and Co.'s stupendously corrupt machinations.
Not sure where she got it but it is interesting:
A recent "Investor's Business Daily" article provided very interesting statistics from a survey by the United Nations International Health Organization.
Percentage of men and women who survived a cancer five years after diagnosis:
U.S. 65%
England 46%
Canada 42%
Percentage of patients diagnosed with diabetes who received treatment within six months:
U.S. 93%
England 15%
Canada 43%
Percentage of seniors needing hip replacement who received it within six months:
U.S. 90%
England 15%
Canada 43%
Percentage referred to a medical specialist who see one within one month:
U.S. 77%
England 40%
Canada 43%
Number of MRI scanners (a prime diagnostic tool) per million people:
U.S. 71
England 14
Canada 18
Percentage of seniors (65+), with low income, who say they are in "excellent health":
U.S. 12%
England 2%
Canada 6%
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Gov. Deal inks out-of-state insurance option
May 13, 2011Georgia’s sole proprietors and self-employed will be able to buy out-of-state health insurance polices under legislation signed Friday by Gov. Nathan Deal.
[...]
The bill drew opposition in the General Assembly from lawmakers who warned that allowing out-of-state policies to be sold in Georgia could deprive the state of the ability to require insurers to cover preventive health care.
Critics argued that the availability of out-of-state policies would render impossible the enforcement of state mandates to cover preventive screenings, including mammograms, that lead to lower treatment costs.
[...]
To the critics, shouldn't it be up to the individual to decide if they want to pay for policies that include preventive health care coverage?
are the ones mandating what insurance must cover, and then wonder why it's so damn expensive.
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Off topic, but the format has changed, the latest comment is first, rather than last. And it appears we're not going to be able to have 300 comments per page.
This might take some time to get use to.