Anyone ElseTerrified about Repeal of ACA Bill
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And we're supposed to believe a pathological liar because.....?
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There are plenty of those around in Washington these days.
Diane
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Lots of politicians are people with real values, no less honest than any of us, trying to make a difference. When we paint them all with a broad brush, we provide cover for those who are exploitative grifters, make it seem 'normal', deter people from voting and participating, and deter good people from running for office. I think it does real harm.
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Well, I was specifically referring to ONE politician, making wild promises he's made over and over about having the most awesome medical plan ever. Yet, somehow that plan never materializes.
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I knew that.
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Yes, I for one would like him out preferably behind bars.
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Same here Meow
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Yes. I was more responding to the post of edwards750. I agree.
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At the risk of sounding jaded.... I know I don't have to tell you all that it's just so terrifying that one person... or a few people... could be so callous as to publicly advocate taking people's healthcare away when they are in ill health.... and that there might not be any consequences. It makes me question what kind of world we are living in. Maybe I am in la la land expecting better of people. One of the major proposals out there from a think tank is to control healthcare costs by rigorously capping lifetime spending on healthcare and putting those who are too expensive on hospice. It's creepy. Isn't there a famous futuristic dystopian novel about something like that? Except there it was old people rather than sick people....?
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Logan’s Run ....?
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I was sickened to hear Mitch McConnell not understanding the importance of healthcare for our 911 first responders.
Some suggesting New York state should be responsible for them!
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That's because McConnell's financial backers don't care about them. If there was a financial benefit to keeping the poor healthy then McConnell (and others would be all over it).
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Hopeful Mitch gets voted out. Scumbag. I think he's up for reelection soon.
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The Declining Middle Class and the Use of Healthcare in the United States
"If you... believe you fit into the middle class in the United States, it is important to read this. According to the Wall Street Journal, the mix of who is getting crushed by healthcare expenses is changing rapidly.
"...a Kaiser study found healthcare deductibles for individual workers had risen 67% between 2010 and 2015. An analysis of millions of insurance claims found patient cost-sharing during the years between 2004 and 2014 was driven by a 256% jump in deductible payments."
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Trump's attorneys are before courts as we speak to declare the affordable care act unconstitutional to strike it down with no intention to replace it. If this thread is going to become a propaganda conduit for the Republican healthcare plan(if you get sick, die), I'll be leaving the thread.
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Nancy Pelosi's latest Medicare proposal would pass drug discounts to all consumers
JUL 1 2019
- House Speaker Nancy Pelosi is working on a proposal that would give the U.S. Department of Health and Human Services the power to negotiate lower drug costs for Medicare.
- The legislation would also extend the drug discounts to private insurance plans, according to a senior Democratic aide.
- Currently, pharmacy benefit managers negotiate drug benefits for private insurance plans and employers.
It's unknown if Pelosi's plan would apply to all drugs. But according to Kaiser, it would authorize HHS to negotiate the prices of the 250 most expensive drugs.
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Why It's Still 1989 for Primary Care
Time and financial pressures keep PCPs from keeping up
- by Milton Packer, MD
- July 03, 2019
{This article provides remarkable insight on the "nuts-and-bolts" challenges associated with providing good quality primary care in today's healthcare - and payment - environment.}
Without doubt, U.S. patients with many chronic illnesses are not receiving good quality medical care to reduce suffering and prolong life.
What happens if a physician tries to make a difference and spends a bit of extra time? Their schedule runs late. When a survey subsequently asks if their appointment started on time, patients say no. And thus, the physician's patient satisfaction scores suffer.
To get real medical attention these days, you need to have an illness that requires or is amenable to a procedure for which the physician is paid. The result: when compared with other countries, we have the most expensive healthcare in the world, but we have worse outcomes.
..finding someone to blame does not fix the problem.
Our healthcare delivery system for chronic illness is horribly ill, even for those with full access to healthcare. Financialization has hollowed out its core mission and has made it meaningless. Increasing access to a failing medical infrastructure may sound good, but it does not address our core issues.
Healthcare for patients with chronic illnesses in the U.S. is on life support. The medical community seems helpless to fix this problem -- presumably because the solution is political, not medical.
The most important crisis facing U.S. medicine is not access to healthcare. It is access to 21st century healthcare.
{Author provides disclosures.}
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I didn’t read this yet ....
https://www.huffpost.com/entry/aca-obamacare-lawsu...
I’m on Obamacare and definitely would be effected if it is taken away
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I doubt it'll pass especially since it's election year when they say supreme court would rule, spring/summer 2020.... 10 years is huge to pull the rug under 20 million people.
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What Can Be Done About 'Pay for Play'?
Kevin Campbell, MD, calls for an overhaul of the U.S. pharmaceutical and device industries
Kevin Campbell, MD, takes a look at pharmaceutical industry influence on physician prescribing and lobbying on Congress, and says both are in need of a fix.
{Both video and article formats are available.}
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No Faith in 'Christian' Health Plan
No Faith in Healthcare Cost-Sharing Ministry
Customers paying thousands of dollars to a religiously affiliated healthcare cost-sharing ministry under Aliera Healthcare shouldn't have much faith that their medical bills will be paid.
The Houston Chronicle writes that this "obscure but growing type of coverage based on the biblical principle that the like-minded should help each other in times of need" comes with a catch -- it's not technically insurance. As such, it's not bound by laws under the Affordable Care Act that require coverage of pre-existing conditions or that insurers spend 80% of premiums on medical care. Authorities say the company spends just 20% of "member fees" on medical bills.
Aliera is under fire from regulators in multiple states for allegedly deceiving customers into thinking its product was legitimate insurance when it wasn't. One customer from Texas was stuck with a $130,000 bill for his wife's surgery -- though the company reversed its multiple prior denials and said it would pay the entire claim when the Chronicle's story published. Aliera also said in a statement that it would "vigorously defend against the false claims directed at our company."
While some legitimate healthcare cost-sharing ministries do exist, "there are others that are taking advantage of this wild west of insurance we are living in now," said one expert on insurance reform.
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White House Cedes Battle, but Not War, Against Drug Rebates
HHS Secretary said he hopes Congress will consider taking action
The Trump administration isn't giving up on getting rid of drug rebates to pharmacy benefit managers or insurers to instead give negotiated discounts directly to consumers, Health and Human Services (HHS) Secretary Alex Azar said Thursday.
the administration confirmed that it was withdrawing a proposed rule that would have required drug company discounts -- with some exceptions -- to go directly to consumers. The rule, first proposed in February to apply to Medicare and Medicaid, would have required that any discounts received by pharmacy benefit managers as rebates be passed directly on to Medicare and Medicaid beneficiaries when they received their prescriptions.
The risk of a premium increase under the plan "was a known risk in our proposal and ..... while we support the concept of getting rid of rebates ... we're not going to put seniors at risk of their premiums going up." Congress might take this up; they have more tools....
Public Citizen's Health Research Group...{advocates}....advancing direct government drug pricing negotiation, stopping price spikes, and taking on the monopoly power of prescription drug corporations..."
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The Centers for Medicare and Medicaid Services proposed a new payment model for radiation oncology. Here's what the American Society for Radiation Oncology has to say about it.
The aim of this model would be to test whether prospective episode-based payments to physician group practices (PGPs), hospital outpatient departments (HOPD), and freestanding radiation therapy centers for radiotherapy (RT) episodes of care would reduce Medicare expenditures while preserving or enhancing the quality of care for Medicare beneficiaries.
ASTRO has worked for many years to craft a viable payment model that would stabilize payments, drive adherence to nationally-recognized clinical guidelines and improve patient care. We appreciate the Administration's focus and commitment to ensuring radiation oncologists' ability to participate in an advanced APM."
https://innovation.cms.gov/initiatives/radiation-oncology-model/
https://www.astro.org/News-and-Publications/News-and-Media-Center/News-Releases/2019/APM-statement
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HOUSE PANEL ADVANCES SURPRISE BILL PACKAGE
A package of 10 healthcare-related bills, including funding for expiring public health programs and addressing surprise medical billing, was advanced out the House Energy and Commerce (HEC) Health subcommittee Thursday afternoon
https://www.healthleadersmedia.com/finance/house-panel-advances-surprise-bill-package
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Trump officials tell one court Obamacare is failing and another it's thriving
Los Angeles Times
The Trump administration argues two different narratives about the ACA in different court cases. This article highlights how eliminating the individual mandate didn't severely affect insurance enrollment rates. "In an insurance market that guarantees access to people with pre-existing conditions, there need to be both carrots and sticks to encourage healthy people to sign up for coverage and keep the market stable. It turns out, if the carrot is large enough, the stick is less important."0 -
New Judicial Advocacy Project to Help Ensure that Medicaid is Meeting the Goals and Needs of the People It Serves
With support from the Robert Wood Johnson Foundation, the National Health Law Program will execute a judicial advocacy strategy to protect rights conferred by Medicaid.
The National Health Law Program will work with Medicaid stakeholders, including advocates, providers, Medicaid beneficiaries, policymakers, and other legal experts, to (1) monitor legal developments in courts that will impact rights and benefits set forth in the Medicaid Act and regulations; (2) forecast opportunities to advance and protect health rights and benefits set forth in those laws; (3) submit amicus briefs in cases with a potential impact on Medicaid rights; and (4) connect with additional allies to support the work of the project.
This project rests on the theory that a comprehensive monitoring and response system directed at judicial threats to Medicaid, with a central focus on amicus curiae briefs in pivotal cases, will demonstrably increase the number of judges who are educated about the important Medicaid issues at stake. In addition, it will increase stakeholder knowledge about and involvement in the judicial process and Medicaid issues. The training component of the project will result in stakeholders who have the capacity to engage in the judicial process, either by drafting amicus briefs themselves (in the case of legal organizations) or by engaging legal representation to do so on their behalf. The ultimate goal is to increase the likelihood of judicial rulings that better reflect the complexities of Medicaid coverage -- how Medicaid works legally and what coverage means to the more than 70 million Americans who depend on Medicaid for their health care needs.
We are grateful to the Robert Wood Johnson Foundation for making this project possible and look forward to working with our existing partners and joining with new allies as we advance health rights and make progress toward our goal of health equity.
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Stopping 'Pay-for-Delay' a Top Priority for Klobuchar
Minnesota senator and Democratic presidential candidate outlines her health priorities
One of Sen. Amy Klobuchar's (D-Minn.) top priorities as president would be to stop "pay-for-delay" deals in which brand-name drugmakers pay generic firms to delay their entry into the market... a president can do that herself," Klobuchar, who is running for the Democratic presidential nomination, said at an event held at the National Press Club. "And I will apply for waiver from the ban on re-importing safe drugs from other countries ... and put forth a bill to require Medicare to negotiate prices for our seniors.
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New CMS resources help states waive ACA requirements
Most states have gotten or are seeking the waivers to establish a reinsurance program to reimburse insurers that are covering high claim costs.
The Centers for Medicare and Medicaid Services has released new resources to help states submit waivers to Affordable Care Act requirements.
The resources are to identify areas of flexibility and variations states can consider, such as combining multiple waiver concepts or coming up with their own.
Most states have gotten or are seeking the Section 1332 waivers to establish a reinsurance program to fully or partially reimburse insurers that are covering claims for high-risk beneficiaires. This reduces the price of premiums in those states.
States that have approved 1332 waivers are Maine, Wisconsin, Minnesota, New Jersey, Maryland, Oregon, Alaska and Hawaii, according to a Kaiser Family Foundation report.
States may waive seven ACA requirements, including: the individual and employer mandates to have health insurance; essential health benefits; limits on cost sharing for covered benefits; metal tiers of coverage; requirements for marketplaces to have a website, call center and a navigator program; and premium tax credits and cost-sharing reductions.
An ACA requirement that remains in place is preserving access to coverage for people with pre-existing conditions. Other guardrails mandate that the new plan provide coverage that is at least as comprehensive in covered benefits, at least as affordable and cover a comparable number of residents.
https://www.healthcarefinancenews.com/news/new-cms-resources-help-states-waive-aca-requirements
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But if no one can find the insurance ("requirements for marketplaces to have a website, call center and a navigator program") then all the rest of the coverage guarantees don't matter much.
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Bernie Sanders Returns to Geo Washington University
The 2020 Democratic presidential candidate gave a speech on campus about his "Medicare for All" proposal.
Sen. Bernie Sanders (I-Vt.) defended his proposed "Medicare for All" plan Wednesday amid recent attacks on the proposal from his opponents for the 2020 Democratic presidential nomination, including former Vice President Joe Biden.
During a speech at the George Washington University, Mr. Sanders also urged his fellow Democratic contenders to reject campaign donations from private insurance and pharmaceutical companies.
https://gwtoday.gwu.edu/bernie-sanders-returns-gw-0
{I had hoped that there would be a link to a recording of the talk but I did not locate one. This write up does describe the event and provide links to discussion of the Senator's prior visit to GWU and other related material.}
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