Anyone ElseTerrified about Repeal of ACA Bill
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Crowdfunding a 'Band-Aid' for Rising Healthcare Costs?
— Survey finds 1 in 5 Americans have donated to a medical crowdfunding campaign
Millions of Americans are contributing to crowdfunding platforms to help pay for rising healthcare expenses, researchers found.
"These results are very noteworthy in that they give us a sense of the size and scope of this phenomenon,"
...crowdfunding is..."putting a Band-Aid on major issues with our healthcare system." ... it has become normalized that Americans struggle to pay for their healthcare, but ... gaps in the system should be faced head-on: "We have to think about the areas where the Band-Aid doesn't hold."
https://www.medpagetoday.com/special-reports/exclu...
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"Notice of Benefit and Payment Parameters" Could Impact Health Care in Major Ways
Every year, the federal government issues new rules for most individual and small group health plans, including plans sold through healthcare.gov and state insurance marketplaces. Unfortunately, the Trump Administration's proposal this year would weaken health care coverage and access, and might make it harder for individuals and families to get the care they need. Included in the proposal are changes to how individuals are reenrolled in insurance plans and new rules that will make prescription drugs more costly.
You can let the Administration know how you feel about these proposals. Submit your comments to the Federal Register today.
Comments are due by March 2, 2020.
More details on how to comment here:
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For those who may be interested in advocating around breast cancer and healthcare related issues, I have set up a new thread. You can find it here:
https://community.breastcancer.org/forum/110/topic...
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Stalled Federal Efforts to End Surprise Billing — The Role of Private Equity
Though U.S. legislation targeting the problem of surprise medical bills advanced out of key congressional committees in 2019 with support from leaders in both parties, Congress ultimately failed to pass a law to end surprise medical bills.
An estimated 20% of U.S. emergency-department visits, 9% of inpatient admissions, and more than half of ambulance or air-ambulance transports involve an out-of-network provider. {FYI: you rarely have a choice about where the ambulance take you!}
More than half of U.S. states have enacted some protections against surprise medical bills. States have tried a variety of approaches to protect the public. State regulation do not protect people covered by a self-insured employer plans because of the federal Employee Retirement Income Security Act (ERISA).
The key sticking point to enacting federal legislation is determining how much health plans would pay an out-of-network provider in surprise-billing situations. In December 2019, the Senate HELP and House E&C committees reached a compromise regarding how to accomplish this. The Congressional Budget Office estimated that both the Senate HELP and House E&C bills would reduce the federal deficit by more than $20 billion over a decade! Less than a week after the compromise was announced, the House Ways & Means (W&M) committee modified its position and Congress ended the year without passing any legislation on this issue.
The strongest opposition came from a shadowy lobbying effort by private-equity–backed physician-staffing companies that profit from out-of-network billing strategies. One group spent $28 million in ads opposing the legislation. The House W&M leaders who thwarted the compromise appeared to be influenced by the large donations and lobbying pressure.
Congress has resumed efforts to curb surprise medical bills in 2020. Deep-pocketed private equity firms continue to oppose any legislation that cuts into their profits.
Article author: Erin C. Fuse Brown, J.D., M.P.H., Georgia State University College of Law, Atlanta. The article was published on February 19, 2020, at NEJM.org.
https://www.nejm.org/doi/full/10.1056/NEJMp1916443...
{NEJM offers free registration and access to 3 articles per month without a paid subscription. Libraries may offer access.}
{Call and write you legislators!}
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Lumpie - lymphedema is not covered by Medicare. I have contacted my national reps, and their response suggest they have no interest in seeing it added to Medicare, Check out https://www.stepup-speakout.org/ I opted to keep employer sponsored Health Ins. when I retired, expensive. Not elligible for Medicare for 3 more years. Right now I plan on keeping private when I get to 65. One person told me that if Medicare did not cover, my insurance would not either, and that I should "stock up" on sleeves and gloves, maybe a pump. I need to check out how private works/does not work with Medicare, but not sure who to ask.
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BlueGirl: Educated guess here: I am betting coverage depends on the Medigap plan you have... if you have one... or the Advantage plan you are in....if you are in one. If your "extra" coverage - besides Medicare - is from your employer, then it makes sense that they might cover lymphedema as a standard benefit. If you work for a large employer, as a rule, coverage is usually pretty sane (that is a generalization and there are definitely exceptions). It's frustrating for us all to not know what we have - and don't have - until we need it. Of course, that is part of how we got the ACA.
Yes! I have read https://www.stepup-speakout.org/ before. It's good. There is legislation pending in Congress about lymphedema coverage. Contact your representatives!
Quick link for others to the Lymphedema Treatment Act website:
https://lymphedematreatmentact.org/
{I posted info about this site and legislation over on the Advocacy smorgasbord thread.}
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California's Affordable Care Act coverage experiment
California reinstated the individual mandate and expanded the ACA's insurance subsidies in an experiment to see what happens when policymakers "beef up" the ACA. The result was a 41% increase in new enrollment.
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Nearly 50% of brand medicine spending goes to the supply chain and others
Nearly 50% of total spending on brand medicines – the sum of all payments made at the pharmacy or paid on a claim to a health care provider – went to the supply chain and other entities in 2018, according to a new analysis from the Berkeley Research Group (BRG). Here are four things from the analysis that you should know...
https://catalyst.phrma.org/nearly-50-of-brand-medi...
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ACA Litigation Round-Up: A Status Check
Friend of NCCS and ACA expert, Katie Keith from Georgetown University, says the Supreme Court will issue at least two ACA-related decisions before July 2020. The issues could have implications that extend beyond the ACA.
https://www.healthaffairs.org/do/10.1377/hblog2020...
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Health Care For All: What Does That Mean?
Health care is a top issue for many voters and, as Democrats fight over how best to cover more people, voters are worried about the COST of care — and for good reason. U.S. health spending is dramatically higher than other industrialized nations. Kaiser Health News explains health plans in the 2020 elections
{The basics summed up in < 3 minutes.}
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An assistant professor of medicine talks about the "cost" of dying at home
https://www.latimes.com/opinion/story/2020-02-16/d...
{Brief Op-ed. Very insightful.}
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How Should Patients Be Protected From "Surprise" Medical Bills?
The Latest: Democratic and Republican House staffers met with Speaker Pelosi's office to try to protect patients from getting large "surprise" medical bills. There was no breakthrough, according to The Hill.
The Issue: Patients can receive extremely high medical bills during emergency situations when they are taken to an out-of-network hospital, or from out-of-network providers, even at an in-network facility or hospital. There is consensus about the problem, but not about the solution. Journalist and physician Elisabeth Rosenthal outlines in the New York Times the biggest roadblock: the players in the health care industry are at war over "who gets to keep the fortunes generated each year from patient illness."Meanwhile: "All sides agree that patients should be protected," according to The Hill. Yet, the leaders of the House Energy and Commerce Committee and the House Ways and Means Committee have very different solutions and have put forward rival bipartisan bills.
For now, patients are still unprotected from surprise billing.https://thehill.com/policy/healthcare/483174-pelos...
https://www.nytimes.com/2020/02/14/opinion/sunday/...
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Supreme Court will once again consider fate of Affordable Care Act
The Supreme Court will hear a third challenge to the Affordable Care Act, this time at the request of Democratic-controlled states that are fighting a lower court decision that said the entire law must fall.
The court's review will come in the term that begins in October, which would not leave time for a decision before the November presidential election. The law remains in effect during the legal challenges.
https://www.washingtonpost.com/politics/courts_law...
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this country is a disgrace, as far as healthcare and pharma are concerned. The profiteering is obscene. Why would they bother coming up with a cure - so much profit in the treatment.
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March 2, 2020
Bloomberg's Dystopian Health Care Vision
Democratic presidential primary candidate Michael Bloomberg took flak again at Wednesday night's debate in Charleston over his past statements regarding women and minorities. But the other candidates once again ignored one of his most recent controversial positions. Earlier this month, a video emerged of Bloomberg arguing that some healthcare for the elderly should be restricted in order to prevent healthcare costs from bankrupting the country. He ends with the caveat, "Society's not willing to do that yet." Yet powerful groups are working to overturn this societal consensus that patients should be treated as individuals. Exhibit A is a nonprofit partially funded by the health insurance industry that's working to limit access to breakthrough medications that would extend and improve their lives. Those with rare, life-threatening, or chronic diseases -- in addition to the elderly -- have the most to lose. Last month,...(Read Full Article)
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March 4, 2020
The Canadian Health Care Myth
I recently had the opportunity to listen to two Canadian citizens discuss the Canadian health care system, and their personal experiences within it. They were a very successful, middle-aged couple who had been involved in a motor vehicle accident in the United States while driving to Florida. The accident in which they were involved was quite serious. The wife suffered fractured ribs and a fractured sternum. She also experienced pain in her shoulder, which wasn't initially detected or diagnosed due to the extent of whole-body pain she was in. She was taken to a nearby hospital. Her husband, however, was more seriously injured. He was trapped in the vehicle and had to be cut out by emergency personnel. He was taken by helicopter to one of the premier shock trauma centers in the state, where he remained hospitalized for four days. A broken leg, and a shattered wrist and forearm, necessitated surgeries, with hardware permanently...(Read Full Article)
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March 4, 2020
The problem with attacking for-profit health care...especially for Bernie
By Jess Jones
Bernie Sanders has been running advertisements about "patients before profits," blaming deaths in America on the greed of the pharmaceutical industry. I could understand that belief if he grew up in a small town outside Havana where the government controlled every aspect of his information and all innovation had been frozen on the day of the revolution, but he can't make that claim. Sadly, the spectacular ignorance underlying the belief is a common problem. Let's start to dispel the notion that profit-seeking is a problem by pointing out some current events. The coronavirus that is causing global panic and bringing superpowers to their knees seems to be the most pressing concern of the day. According to an article in statnews.com, there are nine treatments and vaccines of note to tackle the global pandemic. All of them are being developed by for-profit companies. None of the governments,...(Read Full Post)
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I note that American Thinker is a conservative opinion blog. Media Bias Fact Check cite it for "extreme bias, promotion of propaganda and poor or no sourcing." Entitled to their opinion but probably not very objective.
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and the washington post and new york times are objective? Hmmmmmm....
And most of those media bias organizations....not too objective either....
Anyone interested in media bias might start by reading Sharyl Attkisson’s book, The Smear. Actually, it is so informative, I would recommend reading it twice0 -
https://www.amazon.com/Smear-Shady-Political-Operatives-Control-ebook/dp/B01JYX44LE
The Smear: How Shady Political Operatives and Fake News Control What You See, What You Think, and How You Vote Kindle Edition
by Sharyl Attkisson (Author)
https://www.goodreads.com/en/book/show/31371268-the-smear0 -
Media Bias Fact Check is a subjective rating system.
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They all have their outlook. (Some more so than others.) It is possible to peruse a number of assessors to get an idea the perspective of the outlet in question.
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if you read The Smear, I can assure you it is not that simple
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marijen, the article you posted about the Canadian healthcare system, "The Canadian Health Care Myth" says nothing about the Canadian health care system. Is it talking about the experiences of two Canadians - a married couple - who had an accident while traveling in the U.S. and then had crappy care upon their return to Canada. Two individuals working through one PCP. Well that's representative, isn't it? We have no idea what information or reports these individuals provided to their PCP about the accident when they first arrived back home. We have no idea where they live, although this statement about needing to travel to get an MRI suggests that they live in a small town: "she was informed that she could be put on a waiting list, and perhaps within six to nine months, she might be instructed to travel several hours to another city, where an MRI facility might have an appointment in the early morning hours, perhaps 3:00 a.m. or so." (As an FYI, because we don't have for-profit MRI clinics on every corner, unlike some cities in the U.S., many hospitals in Canada run their MRIs 24-7 to provide as much opportunity as possible for people to get MRIs quickly. Is there is a problem with that? A family member of mine recently was scheduled for a non-urgent MRI within less than a week.)
Yes, in Canada there are crappy PCPs who don't prescribe adequate care. Are there none of those in the States?
Yes, in Canada you can find people who are very dissatisfied with their health care experience. Is there no one like that in the States?
I can guarantee you that if an American had an accident in Canada and was initially treated (fully adequately and to their satisfaction) in Canada, and then returned home to the U.S., there would be a good probability that some balls might be dropped in their care once back home because of the lack of continuity of care within one jurisdiction.
Is the Canadian system perfect? Far from it. I can provide a long list of issues. But I see many of the same complaints from many American women on this site. Health care depends so much on the individual doctor, the specific hospital, the location of the patient and availability of care in that area... The one big difference between Canada and the U.S. is that for the most part, cost is not an issue in Canada. That's not entirely true, however, since unlike what you hear from Bernie, not everything is covered in Canada, so some people do incur expenses (for drugs, for example) that could be onerous. But this is much less of an issue in Canada than in the U.S..
In the end, of 17 peer countries, Canadian life expectancy is 6th, at 81.2 years. The U.S. is 17th, at 78.2 years. Oh, and we have a lower infant mortality rate, so more of our citizens successfully make it into the world in order then then survive longer.
Having said all that, the simple fact is that Canada has had universal healthcare for 52 years. Our system has been built-up over this time, and the coffers have been filled by baby boomers taxes through all these years. Even if Canadian healthcare was the best thing on earth (and I'm certainly not suggesting that it is), it would be impossible for the U.S. to replicate the Canadian system starting fresh today in a completely different socioeconomic and political environment. Americans need to stop looking at other countries thinking that they can plop these other systems straight into the U.S.. It can't happen. The comparisons to other countries, whether positioned positively for the other countries (Bernie) or negatively for the other countries (the article linked above) are completely irrelevant to the U.S. and what can realistically be done there. Of course, learn from the experiences of other countries, but Americans need to focus on how to develop a universal healthcare system from the real starting place where you are at today.
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March 5, 2020
We must stop importing medication from China
By Carol Brown
If there's a silver lining to the novel coronavirus, it's that our dependence on China for medication and medical devices has been brought to the fore (at least to those paying attention). Our dependence on China for these vital supplies is insane for all the obvious reasons, not the least of which is how quickly we could be brought to our knees. We must act now to break this dependence and start manufacturing medication here at home. India, which manufactures most of the world's generic drugs, is already taking steps to reduce its reliance on ingredients from China (here). This point is worthy of a brief explanation. Although a medication may be made in a certain country, the active and inactive ingredients for that medication almost always come from China. So while China may not manufacture the final product, it holds the keys to production. Not good. But there's movement afoot in Congress to change...(Read Full Post)
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Over 100 Lawmakers Call on Administration to Open Special Enrollment Period Now to Combat COVID-19
https://doggett.house.gov/media-center/press-relea...
This link goes to a Congressional Representative's website. It outlines his position in favor of a special enrollment period. The text of a letter to The Secretary of HHS, which oversees the federal marketplace, is on the page. If you wish to advocate for a special enrollment period, you could use this language as a template/model to petition Secretary Azar and to ask your own congressional representatives to encourage the Secretary to open a special enrollment period.
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Most of our drugs and their ingredients come from China and India. See Katherine Eban's "Bottle of Lies". This puts us at huge risks from political, environmental, social, health....... upheavals. It is seldom in discussions about health care.
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BlueGirl: I think you are correct. Our "just in time" supply chains which sometimes have little or no redundancy are a serious threat to health and safety. Not only China and India. Some will recall that just a few years ago, a hurricane wiped out most of the facilities that produced the normal saline used in hospitals across the U.S. Those are located in Puerto Rico. Greater disaster preparedness would at least identify these risks. Actually making the changes that would address these risks will take a greater focus of attention, a greater intentionality. It is easy to ignore these needs when things are going smoothly. I hope that the requisite commitment can be mustered and sustained.
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This administration continues forward with repealing ACA despite our critical need for healthcare presently. Too many people with employer provided health insurance don't seem to understand the gravity of this current crisis. It will be interesting to see how that view changes if employers begin to cut these benefits. In the early stage of testing people were appalled at the cost b/c it was early in the year and they had not met deductible and were outraged at the cost but are fine with the government picking up the cost of testing (a socialized medicine act). Those that oppose a national health plan b/c it's a socialist ideology should return their stimulus checks b/c, that too, is a socialist action. Bet not one check gets returned. Kind of like those in states with school vouchers are happy for tax payers to support their kids private education but don't think we should provide health care. This one really cramps my ass. It's no wonder my extended family in Sweden call us backwards.
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Yogatyme: I saw a post on FB, supposedly from a Norwegian university, warning students to return home if they were "in a country with poorly developed health services... for example, the USA." Sad. I am constantly amazed that the American people just don't seem to care whether they, their family members, or their neighbors can access health care - at least not without going bankrupt. I can't believe that they don't know.... I think there's a lot of complicated history there.... but it's so odd.
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