Articles Posted in Insurance

kingMembers of Congress and lobbyists are taking public and premature bows for debasing the nation’s democracy and potentially harming Americans’ health and well-being.

The Washington Post has given readers a disturbing glimpse into what’s going on in the halls of the U.S. House these days, detailing how Republican representatives jammed through a bill that would strip Americans of rights in seeking redress when they suffer harms while seeking medical services.

The GOP’s so-called “reforms” of the nation’s medical malpractice laws, which independent and expert analysts have said are unnecessary and won’t produce the magical cost-savings or medical care efficiencies that advocates suggest, were concocted by a coterie of special interests—a handful of doctors and insurance industry lobbyists, the Post reports.

obama-240x300As the late, sultry diva Peggy Lee used to croon: Is that all there is?

The Republicans in Washington, after seven years of trying and dozens of faux earlier votes, have failed to repeal and replace the Affordable Care Act. Obamacare, the signature legislation of the previous Democratic administration, persists as the law of the land.

Not hearing champagne corks flying after the end for now of the desperate legislative floundering of Republicans in the House, Senate, and White House?

PE-Color-240x300The Republicans haven’t waved a white flag—yet. They may never formally surrender. But the GOP’s seven-year, take-no-prisoners campaign to repeal and replace the Affordable Care Act, aka Obamacare, has foundered. For good?

Political prediction is a knucklehead’s sport. It’s never safe to predict what’s going to happen, especially when unpredictable tragedies rear up like  Sen. John McCain’s brain cancer diagnosis.

No matter. We now know painful truths about the politicians who have sway over our health care—and will continue to do so in vast ways, Trumpcare or no.

viagra-300x169This fall’s National Football League games will be markedly different in an unexpected way that also offers insight into the nation’s skyrocketing costs of medical care.

The makers of the erectile dysfunction drugs Viagra and Cialis are yanking $50 million in advertising from TV broadcasts of NFL games, their top contact point with male consumers.  Indeed,  the makers of both drugs are going dark with their costly ads across a variety of sports programs, including summer pro golf and tennis.

After billions of dollars in revenues reaped every year for their manufacturers, Viagra and Cialis both are Big Pharma hot shots no longer. They may have erased any remaining decorum on TV over the years with their advertising and marketing hype. But they cannot outrun a typical drug’s economic life cycle. Their patents are expiring, and their makers are trying to figure how best to exploit their profitable, branded drugs when generics—already regulator approved and ready to go—saturate markets and drive prices down, perhaps as early as next year.

kessler-203x300Even as congressional Republicans advance their counter-factual campaign to strip patients who have been harmed while seeking medical services of their rights to seek legal redress, another state appeals court has rejected key GOP arguments about medical malpractice lawsuits.

An appellate court in Wisconsin has declared unconstitutional that state’s $750,000 cap on non-economic damages, reinstating a jury’s decision that a Milwaukee woman and her husband should be paid $16.5 million for their pain and suffering after emergency doctors failed to inform her fully about the severity of a strep infection she had and that led to the amputation of her arms and legs.

The jury assessed total damages against the doctors and their insurers of $25.3 million, including $8 million for the medical and other care the 57-year-old mother of four will require for the rest of her life. But the defendants appealed the total, arguing the couple, under Wisconsin law, should get no more than $750,000 for non-economic harms like pain and suffering.

Donald_Trump-1-225x300Republicans in the U.S. Senate will spend a long Fourth of July break trying to figure if they can repeal and replace the Affordable Care Act, aka Obamacare, with their Better Care Reconciliation Act, aka Trumpcare. Their bill, drafted in large part by just 13 GOP senators, some of the most conservative in the Senate, failed to win sufficient support so Majority Leader Mitch McConnell even could get it up for a vote before the holiday recess.

Lots of negotiations are under way.

In case you missed it, the Congressional Budget Office provided its independent analyses, scoring the cost and effects of the bill. The CBO estimated it would save the nation $321 billion in health-related expenditures in the next decade but would strip 22 million Americans of coverage, slightly fewer than would lose health insurance under the House-approved Trumpcare.

pbj-300x172What do PBJs, PBM “black boxes,” industry friendly advisory panels, and CME (aka doctor training programs) all share in common? They’re blamed for contributing to Big Pharma’s skyrocketing prices—and it’s worth diving into recent reports on these disparate causes to understand how Americans got into such dire shape with the costs of their medical care.

Let’s start with peanut butter and jelly sandwiches and a little math. A jar of generic peanut butter might cost a bit more than a buck and change, with a jar of strawberry jam running about the same. Now if you buy them in a combined product—Smucker’s version is called Goober—it sets you back $3.49.

This pricing comes from Marshall Allen, a reporter for Pro Publica, a Pulitzer Prize winning investigative news site. He goes on to compare PBJs with a medication his orthopedist recently prescribed for him: Horizon Pharma’s Vimovo. It’s a non-steroidal anti-inflammatory drug (NSAID). Allen points out it also is little more than a combination of the pain-reliever naproxen (best known in the branded version Aleve) and the upset-stomach remedy esomeprazole magnesium (best known as Nexium).  He could walk into a drug store and buy a month’s supply of both for $40.

newmitch-300x176After weeks of huddling in partisan secrecy, majority Republicans in the U.S. Senate have coughed up what they’ve dubbed the Better Care Reconciliation Act , aka their version of Trumpcare.

In brief, the GOP Senate bill would:

  • Slash Medicaid, faster and more than the House version, aka the American Health Care Act

mitch-300x226bernieBernie Sanders recently offered on Twitter what he described as a display of all the Senate Republicans’ public considerations of the American Health Care Act, aka Trumpcare: a photo of a blank piece of paper.

Not a bad jibe, and a window into the deepening bipartisan dismay that Majority Leader Mitch McConnell and his  Republicans soon will try to jam through the next step in their long-sought effort to repeal and replace the Affordable Care Act, aka Obamacare.

Does McConnell have the 50 votes he needs so Vice President Pence can break a Senate tie and move Trumpcare closer to reality? Will this occur in just days, before Congress heads to its July Fourth recess? Or will it happen in the small period before the long August recess, when Trump Administration officials also want Congress to take up an increase in the debt ceiling and to tackle a budget and maybe some tax law changes?

Florida_Supreme_Court_Building_2011-300x266As congressional Republicans pursue their counter factual campaign this week to strip patients of their rights to pursue legal redress for harms they suffer while seeking medical services, the Florida Supreme Court has sent a powerful message to federal lawmakers about the wrongheadedness of some of their key notions.

The justices in Tallahassee have repudiated state lawmakers’ assertions of the existence of a “malpractice crisis,” in which dire action is needed to ensure doctors can get affordable liability insurance and be sufficiently protected to practice good medicine.

They also have rejected caps on patients’ claims for pain and suffering, finding that these limits on “non-economic” damages violate constitutional rights to equal protection under the law, and “arbitrarily reduce damage awards for plaintiffs who suffer the most drastic injuries.”

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