Articles Posted in Health Care Reform

sessions-300x200As voters make up their minds about this fall’s mid-term races, they may wish to burn into their memories how the Trump Administration has dealt, so far, and especially in recent days, with government social programs that have huge effects on Americans’ health and lives.

Take, for example, the late-week, late night announcement by the U.S. Department of Justice that it will decline to defend yet another part of the Affordable Care Act, as 19 states, most red and led by Texas, attack Obamacare in the courts. The legal aspects of this decision will keep lots of law degree holders and their kindred men and women in black robes arguing, heatedly, for a while. There also may be huge political smoke clouds.

But keep in mind this basic fact from the actions by the Justice Department led by Attorney General Jeff Sessions: The nation’s crack legal team is asserting that it is unconstitutional for the ACA to bar insurers from declining coverage due to preexisting conditions.

medicaidmap-300x196Hundreds of thousands of poor, middle-class, old, sick, and young Virginians will get increased access to health care as the Commonwealth, joining 33 states and the District of Columbia, saw the crumbling of five years of fierce GOP-led opposition to an expansion of Medicaid under the Affordable Care Act, aka Obamacare.

Partisans, who reviled an enlarged role of the state in health care, got to pin a partisan fig leaf on the state’s move, by amending the social support program to force more recipients to work or show that they cannot, to receive Medicaid benefits.

Although neither the Trump Administration nor congressional Republicans are likely to heed it, Virginia and other states are sending a clear message that voters see health care as a right, not a privilege, and that voters will go to the polls to deal with those who claim to represent them but who make a near religion out of seeming to want to punish the sick and poor and to make costlier the already skyrocketing price of medical services.

affordability-300x291As the nation churns toward the midterm elections, the Trump Administration has sent stark messages to voters about how they may wish to respond to Republicans’ unceasing attacks on health care and health insurance for the middle class and the poor.

The failed campaign to repeal and replace the Affordable Care Act, aka Obamacare, and the follow on steps, administratively and as part of the $1.5 trillion tax bill that benefited rich corporations and the wealthiest Americans, likely will hit Virginia and Maryland residents hard if they’re seeking health coverage under the ACA.

The two states are among the first to report insurers’ requested rate increases for 2019 — and the increases will be significant, reported Modern Health Care, a trade industry publication, which said:

Did you hear it? Was that a giant sigh of relief by Big Pharma executives around the globe? Or was it the air deflating from any Americans who still had high expectations that President Trump, as he had promised for more than a year, really would offer a quick, powerful, and effective public policy prescription to slash skyrocketing drug prices?

The stock market made a big bet that Big Pharma would do just fine, sending drug manufacturer stocks higher.

emergency-services_overviewResidents of the nation’s capital will participate in a public health test every time they pick up the phone to dial 911 for help. How their calls get answered says a lot about common sense, as well as the availability and affordability of medical services in Washington and the nation.

National Public Radio reported that a bunch of new faces now will join dispatchers in DC’s already hectic and often overloaded 911 center. They will be registered nurses specializing in urgent triage. And when 911 callers want what they claim is emergency medical help, dispatchers will hook in the nurses who will try to determine what kind of fast assistance might be appropriate.

This might raise hackles: Why can’t 911 dispatchers just get on with it and send ambulances with lights flashing whenever a caller reports an “emergency”? Here’s the problem, as NPR reported:

hjobs-300x169Although Americans’ spending for prescription drugs has taken a surprising dip, overall costs of medical care keep heading north. The rise this year is faster than it has been in a while. The culprit? Look to big, shiny hospitals. Or look around at people flocking to well-paying jobs in the health care sector.

Modern Healthcare, a trade industry publication, reported that “rising hospital price growth in March [of 2018] drove overall health care price increases to their highest rate since January 2012.”

It’s unclear exactly why hospitals increased prices, except maybe because they can, the magazine said, citing research by the nonprofit health research group Altarum. Its experts, and those quoted by Modern Healthcare, suggested that hospitals may have taken an earlier hit to their finances due to rising drug costs. Hospitals, after lagging, only now may be trying to recoup those costs by hitting patients with price increases at a time when the economy seems more solid.

NORC-chart-300x179Although the United States remains the world’s most affluent nation, it also is a country where money plays a driving, negative role in its people’s well-being. Sudden financial losses  may shorten some Americans’ lives, while dismal finances may keep many others from seeking medical care.

So why are politicians still pushing to slash the nation’s social safety net, even as millions of individuals and families are voting with their wallets to protect their health?

Lethal ‘wealth shocks’

superbugs-300x118Hospitals may be providing us all with too many causes for high anxiety, with reports on increasing findings of “nightmare” bacteria stalking more health care facilities than had been known, more disclosures about how taxpayers may foot an even bigger bill to deal with a beleaguered public hospital in Washington, D.C.,  and a respected reform advocate’s detailing of just how traumatizing many hospital stays may be.

Let’s start with the new research by the federal Centers for Disease Control and Prevention, a study that tried to determine just how many cases there might already be of patients infected in hospitals, nursing homes, and other medical care facilities with so-called Superbugs, bacteria that resist treatment not only with most standard antibiotics but also drugs that are deemed therapies of last resort. These include three types of bacterial infections deemed especially urgent but difficult to control: Clostridium difficile (C. difficile), aka C-diff; carbapenem-resistant Enterobacteriaceae (CREs, as shown above); and Neisseria gonorrhoeae.

CDC officials weren’t sure how many of the Superbug cases — which leave doctors and hospitals little option but to provide only supportive care — they might detect by scrutinizing records from pathology labs nationwide.

coveredcalif-300x169Although Republicans have ripped at the health insurance offered under the Affordable Care Act, a less known but also important aspect of Obamacare may soon benefit Californians. This West Coast ACA-related move also may be worth watching by patients and medical safety advocates, as well as employers and insurers.

The Golden State, the San Francisco public radio station KQED reported, soon will tell hospitals that “time’s up” for them to improve their care, and, if they fail to hit new quality and safety targets that will be part of an impending three-year contract with Covered California, the ACA marketplace operator, they will get the boot from Obamacare coverage.

Because bluer-than-blue Democratic California has gone all-in in supporting and putting ACA coverages in place, the state’s Obamacare exchange is big (more than 1 million customers and 11 approved companies) and lucrative — so much so hospitals and insurers can’t ignore the quality demands. They’re neither extreme nor should they be surprising, because state officials emphasize they have consulted with key parties for several years now in the “Smart Care California” collaborative about the plans they intend to put in place.

Dumpster-300x251Although enthusiasts still wax on about  how technology will improve lives, patients may want to be wary about purported advances that may end up complicating and even compromising crucial parts of their medical care — including how their medical records are kept and how payers decide if they’re covered.

Let’s start with some kudos for dumpster-diving doctors in Canada who discovered flaws in hospitals’ disposal of supposedly confidential and legally protected patient health records. They went around unidentified facilities collecting from various bins a half ton of paper that doctors, nurses, and hospitals were ready to toss.

After examining the piles of paper, they found most private records had been properly handled. But thousands of documents also were not: They were improperly disposed of, and contained identifying or confidential patient treatment information, the researchers found. Though Canada’s patient privacy laws differ from those in the United States, they agree that patient health records must be guarded, and the researchers found violations of practice, policy, and potentially privacy laws.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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