Articles Posted in Health Care Reform

bullets-300x245When illness, accidents, and natural- or man-made calamities strike, victims discover in their long slog to recovery that our health insurance system only aggravates their pain and anxiety.  That’s a painful lesson that hundreds of Americans will keep struggling with in 2018, months after a madman rained gunfire from high-powered rifles down into a Las Vegas music festival crowd.

Modern Healthcare deserves credit for its follow-up of the October mayhem Nevada. It was part of what the industry publication calls an “epidemic of mass shootings,” tragedies stretching from San Bernardino, Calif., to Newton, Mass. They’re taxing hospitals’ capacities not only to provide large-scale emergency medicine but also to provide follow-up care — especially assisting survivors and their families and friends in dealing with their staggering medical expenses.

Victims in mass shootings, Modern Healthcare reported, confront a “proliferation of health plans with high deductibles and coinsurance requirements, leaving [them] exposed to many thousands of dollars in cost-sharing. Severely injured patients needing repeat surgeries may hit their out-of-pocket spending limits multiple years in a row, forcing them into bankruptcy. On top of that, even insured patients may face big balance bills if they are treated by out-of-network providers.”

obamacare1-300x154Millions of ordinary Americans closed out 2017 with a powerful message to the Trump Administration and GOP lawmakers about the nation’s health care. Despite efforts to make it harder to re-enlist for insurance plans, consumers signed up in strong fashion for health insurance under the Affordable Care Act. Their actions spoke loudly against the claim that Obamacare is dead. Nope, it’s popular and in high demand.

That 8.8. million Americans had sought Obamacare by the Dec. 15 general program sign-up deadline came as a pleasant surprise to ACA supporters. They were glum because the administration had halved the application time and slashed the money for advertising and other outreach — programs that proponents had considered necessary so those covered on ACA exchanges wouldn’t only be the sickest and oldest Americans but also the healthy and young. Administration officials also said little or nothing to support or promote Obamacare sign-ups, while the President and GOP lawmakers spent the first year of a new Congress and administration assailing the ACA, including a failed effort to repeal and replace it.

Partisans in Congress, as part of a more than $1.5 trillion bill to change the nation’s tax system, killed the ACA’s individual mandate — the requirement that all Americans show, as part of the annual tax returns, that they had health insurance or face penalties. That move, independent and nonpartisan analysts have said, will mean 13 million Americans will lack health coverage by 2027, and average health insurance premiums will go up by 10 percent each year for the next decade. With the prospect that the tax bill and the GOP budget plan will force billions of dollars in cuts, too, to Medicare and Medicaid, and with the unpopular individual mandate gone, President Trump has claimed that he and the Republican Congress have killed Obamacare.

spanking-187x300Kids can be a major part of what makes the holidays special. But if a house full of the little darlings hasn’t already driven the grown-ups around them to total distraction, parents, grandparents, and uncles, aunties may want to consider a few ways to ensure youngsters stay healthy and wise in the days ahead, including:

Spare the rod so children don’t get spoiled

If the kids get naughty during the winter break, their parents might find themselves agreeing with a controversial view: Two-thirds of Americans, when asked in surveys, say that misbehaving children younger than 7 need a “good, hard spanking” on occasion when they’re very bad.

fitzgeraldWhat’s going on at the Centers for Disease Control and Prevention?

It’s a federal agency with a $7 billion budget and more than 12,000 employees working across the nation and around the globe on everything from food and water safety, to heart disease and cancer, to infectious disease outbreak prevention. Its work and guidance on health matters long has been heeded and well respected.

But the Washington Post — in a story that sounds like it might have leaped from the satirical pages of The Onion or from a monologue by the late comedian George Carlin — has reported that CDC experts have been banned from using seven words in any upcoming communications with Congress about the 2019 budget.

Boston_University_Medical_Center-300x184Racial and economic disparities not only persist in American health care, they do so to the measurable detriment of millions. Have they become so common and accepted that too many ignore them and their harms?

The Boston Globe, as part of its series on race relations, has reported that “segregation patterns are deeply imbedded in Boston health care. Simply put: If you are black in Boston, you are less likely to get care at several of the city’s elite hospitals than if you are white.” The newspaper explained:

The reasons are complex. More whites live near [renowned academic medical centers like Massachusetts General Hospital — aka MGH]. Certain lower-cost health insurance plans generally don’t pay for care at Harvard Medical School’s high-priced academic medical centers, including Dana-Farber and MGH. And some blacks are uncomfortable at mostly white institutions — or those institutions may not make them feel welcome — a divide compounded by a dearth of black physicians. All of this creates likely disadvantages for blacks, who suffer far worse health overall than whites because of poverty and environmental reasons — a gap city planners recently said is persistent and growing. Some black leaders worry that blacks are handicapped because they don’t have, or don’t believe they have, the same array of health care choices.

asthma-300x123Even as they rake in big bucks and ride  a tsunami of mergers and consolidations sweeping the U.S. health care system, big hospitals and academic medical centers must step up on patients’ behalf, doing much more, for example, to battle America’s growing asthma woes and the opioid drug abuse epidemic.

Kaiser Health News, the Capital News Service, and the Washington Post deserve credit for their report on “Forgetabout Neighborhood,” the “worst asthma hot spot” in Baltimore. This part of the city is filled with “decrepit houses, rodents and bugs” that “trigger [asthma] and where few community doctors work to prevent asthma emergencies,” the news organizations have found. They say that residents of this neighborhood “visit hospitals for asthma flare-ups at more than four times the rate of people from the city’s wealthier neighborhoods.”

This area, zip code 21223, also sits in the shadow of not just one but two renowned medical centers, noted, among other things, for their respiratory expertise: Johns Hopkins, and the University of Maryland Medical Center. As the news organizations have reported:

gifts-300x184Looking for a gift with more meaning for a holiday season of higher purpose and lasting impact? Here are some ideas:

srdrugs-300x178When families and friends visit Kansas nursing homes, they may be startled to see how listless and lethargic their elderly loved ones may be, especially if the facility residents suffer from dementia. There’s a sad, simple, and likely reason—the seniors may be drugged up with potent anti-psychotics.

The Kansas City Star deserves credit for providing a powerful reminder that nursing homes, not just in the Heartland but nationwide, persist in over-relying on off-label dosing of their sometimes difficult to handle patients with drugs such as olanzapine (more commonly known by the branded product Zyprexa), aripiprazole (Abilify), risperidone (Risperdal), or quetiapine (Seroquel).

As the newspaper reported:

mitch-300x226It may take days, weeks, years, or even a decade to fully determine what the Republicans in Washington have done to the nation’s health care with the U.S. Senate’s middle-of-the-night approval of more than $1 trillion in changes to the U.S. tax code. But it will at least be big, and maybe huge.

The House and Senate still must reconcile their versions, and President Trump must agree to what lawmakers settle among themselves. So the extent of the health harms the ostensible tax bill—which many have said is really a health bill with tax cuts attached—may inflict on Americans remains up in the air, to a degree.

Millions will lose their health insurance coverage,  because the tax bill repeals Obamacare’s requirement that taxpaying citizens show they have health coverage, the so-called individual mandate. Without the mandate, consumers can wait to buy insurance until they get sick, the equivalent of buying fire insurance on your house when it’s burning down. But this means insurers have to jack up rates to offset all the gaming of the system.  It also opens the way to “skinny” or skimpy health plans that really offer little or no coverage for the sick or those in need of medical services.

azar-235x300Members of Congress have scattered back to their districts for Thanksgiving, giving the nation a bit of a break from the health policy turkey shoot that has besieged the nation’s capital. The health- and medical-related actions have piled up so fast and furious that it can be daunting.

But let’s not overlook:

  • The hot mess that’s supposed to be a GOP wish list of tax changes has, instead, turned into yet another attempt to gut the Affordable Care Act, aka Obamacare, this time by eliminating the “individual mandate” that requires Americans to show through their tax returns that they have health insurance coverage. Tax policies invariably are complicated. Let’s simplify this one: Partisans want to slash the ACA, so they can take money from it — $300 billion or so — to help “pay for” $1 trillion or more in tax cuts for giant corporations and the wealthy. This legislative legerdemain will mean 13 milllion Americans will lose health coverage and insurance premiums for millions will rise 10 percent, according to the independent Congressional Budget Office.

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