Articles Posted in Health Care Reform

conditionslowdowns-300x215Take heart, Americans. Taking care of ourselves makes a difference, making us healthier — and saving us money.  New research supports policies for spending on the wellness of the elderly, improving heart care, and how smart interventions can reduce rising overall health costs.

This evidence-based approach to figuring the government’s optimal role in individuals’ health also may provide a rebuke of sorts to the way that partisans are imposing draconian new rules to curtail medical assistance for the working poor, poor, aged, and chronically ill Americans.

The rare good news about the nation’s health care costs traces to investigators’ efforts to determine why, in contrast to expectations that spending would leap, Americans’ $3.5 trillion annual medical expenditures increased only slightly. They drilled down, focusing on an area where the “sharpest slowdown” occurred in their research period, 1999-2012: Medicare, a federal program that now enrolls roughly 15 percent of the U.S. population, with beneficiaries 65 and older.

hospitalprices-300x162Patients and reformers attacking skyrocketing health care costs may want to focus less on doctors and more on big, shiny hospitals, where in just five years prices soared by 42 percent for inpatient care versus the still sizable 18 percent price hikes that MDs scored.

Those findings are part of a new study that examined medical costs based on actual payments, focusing on common procedures like deliveries of babies (vaginal and cesarean), colonoscopies, and knee replacements.  “Hospital prices grew much faster than physician prices for inpatient and outpatient hospital-based care in the period 2007–14 … The same pattern was present for all four of our procedures,” wrote the researchers from Yale, MIT, and Carnegie Mellon. They found that hospital costs also spiked for outpatient care, increasing 25 percent, versus 6 percent for doctors.

This meant that for a knee replacement costing $30,000 or so, the doctors’ mean price was almost $4,900, while the hospital price was almost $25,000. For a $13,000 C-section, the doctor’s mean price was $4,600, while the figure for hospitals was $8,300. These numbers were derived from analyzing hundreds of thousands of procedures.

The Trump Administration has put out its latest prescription to try to slash out-of-control prescription drug prices: Officials want to call medication “rebates” what they say they’ve really become — “kickbacks” — and crack down on the crazy rise of profit-reaping middlemen in the drug business.

Alex Azar, secretary of the Health and Human Services Department, announced that Uncle Sam, via the giant Medicare and Medicaid plans, hopes to fix big flaws in the drug industry by barring prescription medication discounting to PBMs (prescription benefit managers). The discounts still would be available to patient-consumers. But eliminating them for PBMs could be a major step in cutting drug costs, not the least because this step could give parties in this medical “supply chain” more transparency on what products cost.

cracktv-300x169When reformers look for ways to slash the ever-higher costs of American medical care, one line item should leap from television screens, print pages, and radio broadcasts: How does the nation benefit from medical enterprises spending $30 billion annually in a growing avalanche of marketing and advertising — and why can’t this be stopped or subjected to tougher regulation?

Two physician-scientists at The Center for Medicine in the Media at the Dartmouth Institute for Health Policy and Clinical Practice have published on the JAMA Network their new research, showing that:

[M]edical marketing expanded substantially [between 1997 and 2016], and spending increased from $17.7 to $29.9 billion, with direct-to-consumer advertising for prescription drugs and health services accounting for the most rapid growth, and pharmaceutical marketing to health professionals accounting for most promotional spending.

acasite-300x160If you’re a resident of the District of Columbia and you qualify for help with your health insurance under the Affordable Care Act, don’t wait, you have until Jan. 31 to enroll in Obamacare. It’s still the law of the land and could benefit you and your loved ones, despite a sad and expected federal court ruling out of Texas that threatens the ACA and health coverage for tens of millions of Americans, yet again.

Eleven states and the District have extended Obamacare enrollment deadlines. Those deadlines have already passed in Virginia and Maryland. So, many in the area — along with the rest of the nation — will have to wait for what might be a while to see how the Texas case, brought by a group of Republican attorneys general and opposed by a group of their Democratic counterparts, gets resolved.

The legal elements of the case may be of interest to lawyers and policy wonks.

HCGopen19-300x200Political partisans are whipping ahead with their Grinch-like views about public support of any kind for health care for less affluent Americans — and now the nation’s children are bearing the brunt of mean-spirited policies.

Georgetown University reported that for the first time in almost a decade, the number of children lacking health coverage increased, with roughly a quarter of a million more youngsters uninsured this year versus last.

Joan Alker, executive director of Georgetown’s Center for Children and Families, which has issued authoritative data on kids’ and health insurance, told NPR the increase of uninsured children is unacceptable, adding, “The nation is going backwards on insuring kids and it is likely to get worse.”

Last week’s election leaves two questions lingering about health care: Will politicians really hear what voters said? And, what help might beleaguered patients now expect from their elected officials?

The Affordable Care Act, the central flash point of almost a decade of bitter political battles, appears stronger and more steadfast with Republicans losing the House, despite their last-minute counter-factual claims to support pillars of Obamacare like protections on pre-existing conditions, minimum- and lifetime-benefits.

Medicaid, a program expanded under the ACA to provide more and more affordable care to the poor and struggling, got a big boost, too, in the midterms. Voters, by the ballot, voted to expand its reach in the “red-red” states of Utah, Nebraska, and Idaho. The new governor in Maine will halt her predecessor’s resistance to the Medicaid expansion, according to her campaign promises. In Wisconsin and Kansas, Democratic gubernatorial candidates who also campaigned for Medicaid expansion, defeated Republicans who had opposed it.

Election18-300x146Take some time this week to do something big for yourself, your loved ones, friends, work colleagues, and our country, for that matter:

  • Exercise your privilege, right, and duty as a citizen: Please vote.
  • You may wish to look now at your health insurance coverage, please, being mindful of onrushing deadlines especially if you may be seeking or renewing a policy through the Affordable Care Act exchanges (their 2019 enrollment period opened on Nov. 1), or Medicare.

docnrecordsUncle Sam more than ever wants it to happen, and patient advocates are pushing hard, too. So, why, when technology can make it easier than ever to do so, must patients struggle still to get easy, convenient, low- or no-cost access to invaluable electronic records about their own health care?

Judith Graham, a columnist focusing on aging issues for the Kaiser Health News Service, has written a timely, troubling update on perplexing challenges consumers still confront when trying to secure their electronic health records (EHRs).

She cites a study recently published by Yale researchers who gathered information from 83 leading hospitals that purport to assist their patients with EHR access. The experts swept up policies and forms the institutions said patients would need, then contacted them, telling hospital staffers not that they were academic researchers but that they were checking on behalf of an elderly relative in need of their records and how soon and how difficult and costly might it be to get them? This is an everyday dilemma for consumers, and the institutions should have dealt with these requests with ease and alacrity.

drugpricetrump-300x163Days before politicians will face voters who tell pollsters they’re angry and upset about health care issues, President Trump made his first visit to the nation’s giant Health and Human Services Department to roll out a much-promoted proposal to attack soaring prescription drug prices.

The plan was plenty wonky, replete with data about how much less patients in other, similar developed nations pay for drugs than Americans do. And despite the president’s assault on “freeloading” foreigners, it was murky as to the outcomes and fate of the administration’s latest drug cost-reduction proposal.

That’s because, buried in its pages of prose, it amounted to little more than a sketch of what experts have termed a big, rigorous clinical trial of an approach that’s anathema to Trump’s own purportedly free-market-loving party: price controls.

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