Articles Posted in Health Care Reform

northam-300x228Millions of Americans may qualify for federal help in paying for the health insurance, but they must sign up for coverages on exchanges set up under the Affordable Care Act, aka Obamacare, by Dec. 15. Doing so, starting with a visit to healthcare.gov, has become a surprisingly popular and perhaps a strongly political act.

That’s at least one way to look at it after voters, led by Virginians, sent a big electoral rebuke to President Trump and congressional Republicans over their failed congressional assault and continuing efforts to repeal and replace the ACA, especially its increasingly popular expansion of Medicaid. Its programs benefit the poor, young, old, chronically and mentally ill—and growing numbers of working poor and middle-class Americans, too.

The punditry has flowed since Tuesday’s elections in Virginia, New Jersey, Maine, and elsewhere. Virginia voters not only trashed Ed Gillespie, the Republican candidate who was supported by Trump, and elected Ralph Northam, a Democrat, a pediatrician, and a veteran who was the state’s lieutenant governor (see photo), they also churned the membership of the state legislature. Control of the House is up to recounts in a few tight races.

reuters-300x153Although countless doctors and nurses put in untold blood, sweat, and tears to provide quality care to their patients, health care profiteers can undo these good works in an instant with shameful plundering. Here is a roundup from multiple fronts.

The nonprofit, nonpartisan Kaiser Health News Service deserves credit for its painful reporting on the rising problems in the once much-admired area of hospice care.

Reporters JoNel Aleccia and Melissa Bailey have written, in a story carried by Time Magazine, that they “analyzed 20,000 government inspection records, revealing that missed [hospice worker] visits and neglect are common for patients dying at home. Families or caregivers have filed over 3,200 complaints with state officials in the past five years. Those complaints led government inspectors to find problems in 759 hospices, with more than half cited for missing visits or other services they had promised to provide at the end of life.”

choosing-wisely@2x-300x197Up to a third of medical spending goes for over-treatment and over-testing, with an estimated $200 billion in the U.S. expended on medical services with little benefit to patients. But getting doctors and hospitals to stop this waste isn’t easy, nor is it a snap to get patients to understand what this problem’s all about so they’ll push their health care providers to do something about it.

Which is why kudos  go to Julie Rovner, of the nonprofit, independent Kaiser Health News Service, and National Public Radio for the recent story on how older women with breast cancer suffer needlessly and run up wasteful medical costs due to over-testing and over-treatment.

Rovner and Kaiser Health News worked with a medical benefit management company to analyze records of almost 4,500, age 50-plus women who received care for early-stage breast cancer in 2017. She found that just under half of them got a medically appropriate, condensed, three-week regimen of radiation therapy. Research has shown this care is just as effective as a version that’s twice as long, costs much more, and subjects patients to greater inconvenience, especially with more side-effects.

trumpdrugs-300x177As the Republican-controlled Congress rams through a national budget and a package of changes to the tax system, President Trump and his partisans are staying true to course. They’re determined to slash taxes for the rich, even if they only half-heartedly tackle one of the biggest public health crises in decades, and if they inflict great harms on the health of the poor, sick, young, and old.

In answer to long and increasing criticism, Trump finally declared the opioid drug abuse epidemic a “public health emergency” (with zero new dollars in spending)  but not a “national emergency,” which would have opened the door for millions in new spending.  He scored points with some commentators with his discussion of how alcoholism destroyed his older brother Fred’s life, and, how his brother’s advice and example had kept him from any temptations of substance abuse. (He also reminded critics of ineffectual “Just say no” anti-drug campaigns.)

But for all his pronouncements, the president’s actions fell short of what many anti-drug experts and advocates had hoped would be White House leadership against opioids abuse and overdose deaths, a scourge that has claimed almost 60,000 lives since 2016.

eyedropWhether it happens in the drip, drip, drip of costly eye drops or it occurs in the flash of a pricey imaging scan, patients get gouged by modern medicine’s wasteful practices. The inefficiencies can be traced to many and different causes. But Americans need to keep asking whether they can allow or tolerate profit-seeking enterprises to keep getting bigger and ever more expensive.

It’s good to see that two online news organizations, Vox and Pro Publica, are digging into soaring costs for medical goods and services.

Vox is aiming to crowd-source some of its investigation, and it has tantalized its audience with a motivating source of outrage—a story detailing a sky-high bill for a 30-minute imaging scan for Elodie Fowler, an ailing 3-year-old girl. The site says her parents got socked with a $25,000 tab for her test. That sum was far higher than they expected, even after they researched and shopped around to find their most affordable option, given their insurance and various providers operating the service.

trumphealtheo-300x205President Trump has made good on his promise to try to blow up the Affordable Care Act, aka Obamacare. His latest, twin executive actions seek to gut the national health insurance program that Republicans have reviled but could not unwind with seven years of congressional action.

If the American health care system was rocky before, and if it breaks, Trump and the GOP now own it, analysts insist. That’s because the president, effectively, has officially given the nation Trumpcare, though it, too, has an uncertain path ahead.

Although partisans had vowed that their ACA repeal and replacement would result in better, more affordable, and more accessible health coverage for Americans, Trumpcare goes nowhere close to any of those goals, experts say.

lindsey-300x200
As the 40th President of the United States used to mutter, well, there they go again.

The Republicans in the 115th Congress apparently will make another go at repealing and replacing the Affordable Care Act, what may be their 70-something such try. It may come in the form of legislation advanced by GOP Senators Lindsay Graham of South Carolina, Bill Cassidy of Louisiana, Dean Heller of Nevada, and Ron Johnson of Wisconsin.

The so-called Graham-Cassidy bill, which analysts say would slash tens of millions of Americans from health coverage, cut tens of billions of dollars in federal aid for health care, and convert the ACA into state-controlled block grant funding, must overcome major obstacles to advance.

hookworms-300x201It can be too easy to forget the unfortunate, inequitable legacy of the Old South, especially how racist Dixie created stark racial health disparities. But sometimes a foreigner’s jab in the ribs can remind us how making America great again could mean tending much better to our collective p’s and q’s in public health, especially so poor, rural people of color don’t get tropical parasite infections and they do get reasonable access to critical maternal care.

The Guardian, a British news outlet, has pointed out that new, published research shows a disgusting resurgence in Americans, notably in Alabama, testing positive for hookworms, a debilitating “gastrointestinal parasite that was thought to have been eradicated from the U.S. decades ago.”

As the Guardian reports:

aarpAmerican workers have gotten back a little breathing room from corporations’ intrusive push to try to get them to surrender more of their personal, private health information as part of workplace wellness programs linked to company-provided health insurance plans.

This is due to a federal judge’s rejecting a rule by the federal Equal Employment Opportunity Commission that allows companies to describe the wellness programs as “voluntary,” even though workers may pay thousands of dollars if they decline to participate in them.

Such “coercive” company conduct is discriminatory, runs roughshod over workers’ health privacy rights, and is unfair, the AARP had asserted when it sued the EEOC to overturn its workplace wellness rule.

heart-300x190Hospitals and heart doctors may need to rethink their common test to determine if their patients have suffered a heart attack, and whether a newer alternative open-heart procedure carries with it more risks than benefits.

Health News Review, a health information watchdog site, has raised interesting questions as to why mainstream media outlets haven’t paid much attention to the recommendation by the High Value Practice Academic Alliance (HVPAA), a blue-chip group of medical scientists and institutions (including Johns Hopkins), for the phase out of the creatine kinase-myocardial band. CK-MB is the “go-to blood test doctors used to determine if a patient’s heart muscle had been damaged by a heart attack (or myocardial infarction).”

To the tune of $400 million or so annually, doctors turn to CK-MB tests millions of times each year to distinguish, along with patient symptoms and EKGs, if the person before them has suffered a heart attack, HVPAA members write in the medical journal JAMA Internal Medicine.

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