Protesting Rep. Paul Ryan's plan for Medicare

Kaiser Health news reports that The Alliance for Retired Americans is staging union-backed protests throughout aiming to get seniors not to vote certain republican candidates into office on November 2nd. They are especially targeting Representative Paul Ryan of Wisconsin who has plans to privatize Social Security and turn Medicare into an income-adjusted voucher program.

In their book titled “Young Guns”, by Ryan and his co-authors republicans Eric Cantor of Virginia and Kevin McCarthy of California, Ryan explain his plans for Medicare and Social Security as part of his “Road Map for America”. Ryan’s plan preserves Medicare as it is for those currently eligible and those within 10years of the eligibility age and proposed that those under 55 upon reaching the eligibility age will receive an initial voucher averaging of $11,000 which will be adjusted for inflation, and income; low income earner he proposed will receive more support and high income earners less.

Source:

http://www.kaiserhealthnews.org/Stories/2010/October/26/Ryan-Medicare-plan.aspx

http://www.roadmap.republicans.budget.house.gov/Issues/Issue/?IssueID=8520

CO pays for some preventive care to go away

The Chicago Tribune reported today that starting January 1st 2011, employees would not be required to pay a co-payment for preventive services as required by the Affordable care act. The act hopes that by eliminating the co-pays for preventive care more people will be encouraged to go seek preventive care.

From Kaiser weekly update-10/15/2010

I was excited to here the terms Pace (program for all inclusive care of the elderly) programs and accountable care organization(ACO) from head of the Center for Medicare and Medicaid Services (CMS), Dr. Don Berwick as he highlights his organization plans for improving Long-Term facility, during the Kaiser Family Foundation Weekly update.

According to CMS, ACO are entities establish by providers who agree to be responsible for the improving care, cost, for medicare beneficiaries enrolled in the traditional fee-for-service plans.

The Pace program according to medicare.gov an optional benefit under both Medicare and Medicaid that focuses entirely on older people, who are frail enough to meet State's standards for nursing home care and it features comprehensive medical and social services that can be provided at an adult day health center, home, and/or inpatient facilities.

Healthcare reform and the upcoming elections

Health care reform


In a recent article titled “Health care and the mid-term elections”, The Economist discusses the role the Health care reform will play on the upcoming mid-term election in the U.S. Many people are in favor of parts of the reform such as the one that stops insurers from excluding those with pre-existing condition from coverage but some are wary of parts such as the “individual mandate” option that requires everyone to carry health insurance.
This uncertainty regarding the individual mandate and the other unpopular pieces of the reform is a “useful weapon” for the Republicans in the campaign. The article goes on to say that, most of the democrats running are “staying mum and are not apologizing for their votes for the reform, whilst the Republicans are vocal.

Not only are the Republicans vocal about their disdain for the reform they can do whatever they can except repeal (can be vetoed by the president) to stop the law. They could not fund the program, which will prevent agency from administering it, they could attach a vital bill (a common practice by both parties) to the law, which will forbid its implementation, and they can just not implement the programs. Already, as I reported last week, 20 states have been given approval to precede their lawsuit charging that the reform is unconstitutional.
http://www.economist.com/node/17259055

news.

Health care reform news: 10/14/2010
According to the Wall Street Journal’s news hub, a Florida judge ruled that the lawsuit from by 20 states challenging the constitutionality of the health care bill that requires that effective 2014 everyone must carry health insurance would move on.

Medicare crackdown news: 10/14/2010
According to NPR’s Morning Edition program, a dozen people in New York were charged for committing Medicare Fraud. The FBI is cracking down on Medicare fraud around the country prosecute doctors and patient bleeding the Medicare fund.

Recently in Brooklyn, New York, the FBI arrested three doctors for submitting false claims to Medicare; how dumb are these doctors really, why did not think performing 85 hemorrhoidectomies on one patient in 20 months will raise a red flag?

These scammers would pay patients for allowing them to submit false claim to Medicare, and because of such frauds, which is prevalent though out the country, the Medicare program has lost billons.

According to the Wall Street Journal’s news hub, a Florida judge ruled that the lawsuit from by 20 states challenging the constitutionality of the health care bill that requires that effective 2014 everyone must carry health insurance would move on.

According to NPR’s Morning Edition program, a dozen people in New York were charged for committing Medicare Fraud. The FBI is cracking down on Medicare fraud around the country prosecute doctors and patient bleeding the Medicare fund.

Recently in Brooklyn, New York, the FBI arrested three doctors for submitting false claims to Medicare; how dumb are these doctors really, why did not think performing 85 hemorrhoidectomies on one patient in 20 months will raise a red flag?

These scammers would pay patients for allowing them to submit false claim to Medicare, and because of such frauds, which is prevalent though out the country, the Medicare program has lost billons.

More physicians opting for hospital instead of private practice.

10/14/2010

According to NPR’s morning edition, physicians are giving up private practices and are going to work for hospitals and hospitals are very pleased with it because it means more revenue.
The high cost starting a business, which includes high malpractice insurance rates, makes going to work for a hospital very attractive to physicians who can now focus on caring for their patients instead on the balancing act of patient-care and practice management.
The hospitals will benefit because the physicians can bring their patients with them because patients are what hospitals need.

Health Risk Assessment-for whose benefit/

If I want to choose the type of health insurance coverage I want, I will have to answer some health risk assessment questions, if I do not answer I will be defaulted into a high deductible hra medical plan.

I have been told this information will provide me with necessary information to identify risk factor early on, well thank you for your concern, but what are your other reason for requesting this information?

Comparative Effectiveness Research- What do people think about it.

I am scared of the one-size-fit-all approach to medicine and I hope that the comparative effectiveness research does not go there, it will not work, it does not work for me just ask my physicians.
It will be helpful to doctors as a starting point of how to treat an ailment or disease but they must not loose sight of the fact that what works for one person will not work for another.
According to a study by Health affairs, I am not the only one weary about this.



Source: WSJ Health blog, Health Affairs

Insurance returning unused premium to insured? a good idea.

This article by the Cato institute got me thinking. I have to agree with this article, refunding money not will be bad for the sick since the money not spend on the healthy is used on the care for the sick. I know the law is trying to prevent insurance company from using too much money for administrative cost but hope they set guidelines because insurance companies with more sick people than healthy people might have to limit care to stay afloat.

getting health insurance

Last week, Governor Schwarzenegger made California the first state to board the health insurance purchasing pool train by signing two bills into law. His goal is to provide health care to Californians without relying on the state’s general fund. The new bill is set to be effective in 2014.

It is that time of the year for many companies around the nation as insurance open enrollment period is upon them, what should employees expect? When the law that mandates everyone to have health insurance goes into effect, most people will be comparing government plans, to their companies plans and choosing the one that offers them the most for their money.

The Fed's response to Mcdonald's Mini-health worry

According to WSJ, the Department of Health and Human Services (HHS) says that the secretary will exercise her discretion in enforcing the new minimum medical loss ration requirement. The requirement puts the minimum cap of annual benefit payout at $750,000 and the law requires plan to spend between 80% and 85% of premium on medical benefits. For plans that charge enrollee $14 a week, this is not feasible.
However, the nearly good news is that HHS might extend waivers to employers facing similar issues as to prevent the disrupting of health care coverage for employees that exempt them from meeting the $750,000 cap.


Source: The World Street Journal.