Articles Posted in Health Care Reform

files-150x150A laptop and a cardboard box. These two items could be major tools in improving regular folks’ health throughout this year — and beyond — if they get launched on important tasks, pronto.

What needs to happen is for patients to be hyperconscious, persistent, and skeptical enough to start gathering vital records about themselves and their medical care. The documents they should have handy include all their medical records, as well as a file of any bills, insurance statements, and correspondence with providers about their treatment.

It might seem like a lot of bumpf. But consider, with patience: Doctors value the material so much that they make it their prime order of business in taking on a patient’s care to look fast and first at the individual’s health record.

cardmedicare-300x194Editor’s note: The blog will shift in ’23 to more episodic publication.

Just a reminder: 2023 will begin what could be consequential changes in aspects of older Americans, notably those age 65-plus and covered by Medicare.

As part of law of the Inflation Reduction Act passed by Democrats in the Congress and pushed by the Biden Administration, diabetics on original Medicare will see their cost for lifesaving insulin capped at $35-a-month under Part-D prescription drug plans. As the official Medicare site reports:

cash-150x150Editor’s note: The blog will shift in the days ahead to more episodic publishing.

Members of Congress raced at the year’s end to avoid the consequences of a brutal snowstorm battering huge swaths of the country. Before hitting the holiday exits, lawmakers approved a whopping $1.7 trillion bill to fund the federal government through the fiscal year and until next fall, spending giants sums on guns over butter.

Those who drill down on military budgets will be better positioned to determine the wisdom of the $858 billion appropriation by Congress for the Pentagon. The 4,000-plus pages that detail the measure’s allocations included $772 billion for domestic spending, including, of note for those focused on health care, items such as:

ascnesionlogo-300x102Big hospitals and hospital chains have wailed, with considerable justification, since the outbreak of the coronavirus pandemic about financial damages they have suffered due to costly shortages of desperately needed health staff. But the institutions fostered this staffing crisis, with profit-ravenous suits in executive suites boosting hospital bottom lines in flusher times by slashing one of the biggest expenses in the business — frontline health care workers.

To see this up close, let’s zoom in on the experiences of Ascension, one of the nation’s largest chains, to see how hospitals plunged themselves into an economic and medical care mire, the New York Times reported:

“Ascension …spent years reducing its staffing levels in an effort to improve profitability, even though the chain is a nonprofit organization with nearly $18 billion of cash reserves. Since the start of the pandemic, nurses have been leaving hospitals in droves. The exodus stems from many factors, with the hospital industry blaming Covidstaff burnout, and tight labor markets for acute shortages of staff. But a New York Times investigation has found that hospitals helped lay the groundwork for the labor crisis long before the arrival of the coronavirus. Looking to bolster their bottom lines, hospitals sought to wring more work out of fewer employees. When the pandemic swamped hospitals with critically ill patients, their lean staffing went from a financial strength to a glaring weakness.

voting-150x150Voters from coast to coast made decisions last week not just about which candidates to favor but also about an array of health-related concerns from abortion to health insurance expansion to legalized ways to get high.

Women’s reproductive rights: a big deal

A major motivator in the 2022 midterm elections was the U.S. Supreme Court’s decision to abolish the constitutional right to abortion and leave it to the states to decide women’s reproductive health rights.

cvsad-150x150Well, hear, hear! A much delayed, but important health care reform has gotten off to a rocking start. Consumers with moderate hearing loss now can buy hearing aids with greater convenience and less cost  — over the counter and without prescriptions.

New devices, new makers, and new retailers have raced in to tap a big need and potentially lucrative market, due to regulatory changes finally put in effect by the federal Food and Drug Administration, as the Wall Street Journal reported:

“Retail chains such as Walgreens, CVS, Walmart and Best Buy carry [hearing aids now], and they are also available on Amazon.”

betterworkplacemurthy-300x263Although the still-chugging U.S. economy is providing workers with more employment opportunities than many economists expected, it is always tough to leave a job, even with the highly publicized trend of “quiet quitting” supposedly in full force.

Still, no less an authority than Dr. Vivek Murthy, the U.S. Surgeon General, has warned Americans that too many of their workplaces put their health and mental health at risk. He has called on employers large and small to practice the Golden Rule, better share companies’ good fortunes, and to improve regular folks’ work-life balance. Stat, a science and medical news site, quoted Murthy’s statement on toxic workplaces and needed changes, thusly:

“As we recover from the worst of the pandemic, we have an opportunity and the power to make workplaces engines for mental health and well-being. It will require organizations to rethink how they protect workers from harm, foster a sense of connection among workers, show workers that they matter, make space for their lives outside work, and support their growth. It will be worth it because the benefits will accrue for workers and organizations alike.”

coinstack-150x150The Biden Administration has tackled the “family glitch” in Obamacare, issuing new eligibility rules that will open up more affordable health insurance for many more poor, working poor, and middle-class Americans who otherwise might struggle to pay for coverage, even as provided by their employers.

This change in health care regulation is taking effect, even as tens of millions of people roll into an important period to protect their well-being — the annual “open enrollment” months for health coverage under the Affordable Care Act, by many employers, as well as for those eligible for Medicare.

The Treasury Department’s new regulations on the “family glitch” affects as many as 5 million people, more than half of them children, according to the nonpartisan, independent Commonwealth Fund. Here is how the Associated Press described what federal regulators are doing to make health coverage more affordable to many more people under the Affordable Care Act or Obamacare:

healthrecords-150x150Patients have hit a red-letter day in the long, too-difficult struggle to win control of a crucial part of their care — their electronic medical care records. Hospitals and other caregiving institutions no longer can block access to these documents, with federal law now holding them accountable for any runarounds they may try.

As Stat, a medical and science news site,  reported:

“Under federal rules taking effect [Oct. 6,2022], health care organizations must give patients unfettered access to their full health records in digital format. No more long delays. No more fax machines. No more exorbitant charges for printed pages. Just the data, please — now. ‘My great hope is that this will turn the tide on the culture of information blocking,’ said Lisa Bari, CEO of Civitas Networks for Health, a nonprofit that supports medical data sharing. ‘It’s a ground level thing to me: We need to make sure information flows the way patients want it to.’”

medadvantagesuitsnyt-300x239The nation’s biggest health insurers are gaming a giant program to provide health coverage to seniors, exploiting the privatization of Medicare Advantage plans to rake in profits with schemes that have drawn fire from federal prosecutors.

The sustained, costly campaign by insurers to maximize their profits not only leaves older, vulnerable patients at risk of reduced care, it also imperils the overall health of the entire Medicare system, the New York Times  found in its investigation, reporting this [see chart above, courtesy the newspaper]:

“Medicare Advantage, a private-sector alternative to traditional Medicare, was designed by Congress two decades ago to encourage health insurers to find innovative ways to provide better care at lower cost. If trends hold, by next year, more than half of Medicare recipients will be in a private plan. But a New York Times review of dozens of fraud lawsuits, inspector general audits and investigations by watchdogs shows how major health insurers exploited the program to inflate their profits by billions of dollars. The government pays Medicare Advantage insurers a set amount for each person who enrolls, with higher rates for sicker patients. And the insurers, among the largest and most prosperous American companies, have developed elaborate systems to make their patients appear as sick as possible, often without providing additional treatment, according to the lawsuits. As a result, a program devised to help lower health care spending has instead become substantially more costly than the traditional government program it was meant to improve.

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