Medicaid-300x225Republicans have long fumed about the federal government’s role in health care, ever since Medicare for the elderly and Medicaid for the poor were both passed in 1965. Now, though, we’re at a crossroads, where a frontal assault on Medicaid could cause big damage to both programs.

The temptation for too many Americans, as I’ve written before, may be to skip over the Medicaid-related parts of the GOP proposals to repeal and replace the Affordable Care Act, aka Obamacare. That would be wrong because those parts of the American Health Care Act, aka Trumpcare, may be the most radical and will be detrimental to the poor, working poor, children, sick, disabled, and seniors. They will hit many millions more middle-class Americans than might be thought.

Opponents also say that Trumpcare and its Medicaid and health insurance changes will harm Medicare, the linchpin of health care coverage for seniors.

ahca-300x169The president and his GOP allies on Capitol Hill already have rammed through two U.S. House committees a plan to repeal and replace the Affordable Care Act, aka Obamacare. But to paraphrase a best-seller’s title, those who will be affected by the American Health Care Act, the AHCA, are from Earth, while the Republicans who are pushing Trumpcare must be from Pluto.

That’s because their Trumpcare, as evidence already has shown, will divide Americans as never before, while at the same time unifying them in opposition to it and disbelief about its current form.

Here’s what the suddenly engaged, now arm-twisting president Tweeted about the House legislation:  “Our wonderful new Healthcare Bill is now out for review and negotiation. ObamaCare is a complete and total disaster— is imploding fast!”

consent-300x170Modern medicine has become so complex, bureaucratic, and forbidding that it’s little wonder that patients—already ailing—don’t grasp the risks and consequences of treatments they prescribe. Overwhelmed patients also don’t demand that doctors fully brief them.

And shame on physicians for failing to help patients more in this critical area of caregiving, two doctors have written in an excellent New York Times Op-Ed column. The doctors—Mikkael Sekeres, director of the leukemia program at the Cleveland Clinic, and Timothy Gilligan, director of coaching, Center for Excellence in Healthcare Communication, at the Cleveland Clinic—deserve credit for calling out colleagues while describing the vital health care concept of informed consent.

My firm has detailed information on this important patient right in health care (click here to see).

hospital-bed-300x144Although hospitals continue to try to shrug it off, the damning evidence is building that far more Americans die of preventable causes in their care than previously thought, and “approximately 200,000” such deaths each year in the United States is “not unreasonable” as an estimate.

Those are the top-line findings from a team of doctors and public health experts who have published new research in the Journal of Patient Safety. Theirs was the fourth study in recent times to try to quantify what one of the research groups has described as potentially the “third leading cause of death in the United States,” those from medical error, especially occurring in hospitals.

A year ago, the Heartland Health Research Institute looked at Iowa and six surrounding states to assess what experts call preventable adverse events, and examining the existing studies that might offer national insights on the issue. These researchers found that it was reasonable to conclude that “250,000 patients [die] annually in U.S. hospitals due to preventable mistakes.”

Republican leaders just can’t seem to help themselves. As they flounder in their assault on the Affordable Care Act, aka Obamacare, they have moved from the inaccurate and counter-factual, beyond partisan buzzwords and talking points, and into a territory where they keep uncorking one howler after another about American health care and the ACA.

goodlatte-300x256We all know how con artists work the streets. One might bump into you in a train or in a crosswalk, while the other grabs your wallet. Or one might smile and chat with a mom at a playground, while her partner nabs the purse.

Patients and consumers may want to watch carefully for the congressional version of the distraction scam, a series of stealth bills that aim to strip them of valuable legal rights and protections they’ll need if harmed by big hospitals, rich doctors, big insurance companies, or giant corporations. With so much commotion under way with the new administration, Republicans sneakily have launched a furious, multi-pronged so-called “tort reform” campaign. They’ve wanted it for a long time. They insist it is needed to curb excess and frivolous lawsuits, to save money for Uncle Sam (who often is a defendant), to make the economy work better, and to add jobs, and to make life in general more wonderful.

Their arguments are counter-factual and lacking in evidence.

Thanks to a tip from a finance wizard who helps me with pension savings, I’ve come across some entertaining and instructive videos about our American health care system. What’s up with the high costs? Do we get value for spending far more than any other civilized country? How could we do better?

Here’s one video explaining our health care costs, a bit over seven minutes, which is forever in YouTube land, BUT it covers a complex subject compactly and well. And another one here about five years worth of Obamacare. Both are by John and Hank Green, the Vlogbrothers.

Both point out how if we really wanted to save money and make American health care truly affordable, we’d empower a big buyer of health care services (like we already do with Medicare) to negotiate prices with providers.  That, of course, would mean something like “Medicare for All,” They do that all over the world and most advanced countries pay far less for the same care as a result.

hospital-300x209When a giant institution like MedStar Georgetown University Hospital announces it will spend more than a half-billion dollars to improve, rebuild, and expand its facilities, few of us blink.

That’s because we know that hospitals, in general, are “among the most expensive facilities to build, with complex infrastructures, technologies, regulations and safety codes,” observes Druv Khullar, an M.D. and M.P.P. at Massachusetts General and Harvard Medical School.

Khullar, however, goes on to write in a trenchant Op-Ed column in the New York Times that, “evidence suggests we’ve been building [hospitals] all wrong — and that the deficiencies aren’t simply unaesthetic or inconvenient. All those design flaws may be killing us.”

elder-abuse-awareness-300x210It’s one of the more disturbing, revolting, and painful health care investigations put out by a news organization in recent times. It’s disheartening but it also demands action: So, what steps will federal, state, and local authorities take now that CNN has reported that thousands of sick, disabled, and defenseless patients, most of them women, have been sexually abused and assaulted in nursing homes in the last decade?

The broadcast network said that data, collected by the U.S. Health and Human Services Department’s Administration for Community Living, show 16,000 sexual abuse complaints have been filed since 2000 over conditions at long-term care facilities (both nursing homes and assisted living facilities). Experts say there may have been more cases because sexual assault and abuse, due to stigmatization, often is un- or under-reported.

CNN, which turned up more than 380 sexual assault allegations in Illinois and more than 250 in Texas between 2013 and 2016, said it had analyzed U.S data in the same period, finding that “the federal government has cited more than 1,000 nursing homes for mishandling or failing to prevent alleged cases of rape, sexual assault and sexual abuse at their facilities … And nearly 100 of these facilities have been cited multiple times during the same period.”

PrecisionHealth-300x108It’s a $50-million business with a roster of blue-chip consultants who would be an envied faculty at most any major university. But look closely at the activities of Precision Health Economics because this firm’s esteemed academic economists, for big bucks, are boosting Big Pharma’s efforts to justify some of its sky-high prices for its products to policy-makers, regulators, and lawmakers.

Pro Publica, the Pulitzer Prize-winning online investigative site, deserves credit for raising questions about yet another area in which ordinary Americans may be outgunned by special-interest money. Big Pharma already has earned notoriety for seeking to advance its causes by paying physicians, underwriting patient advocacy groups—and now retaining high-powered economists.

Economists play a key role in providing expert views on drugs, their prices, and markets, all of which are increasingly controversial issues as Americans struggle to afford medications that can cost $1,000 a day or tens of thousands of dollars for treatment regimens lasting for a few months.

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