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Author Topic: The Politics of Health Care  (Read 157106 times)
ccp
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« Reply #1350 on: June 26, 2014, 11:27:20 AM »

As a primary I don't want another burden hoisted on me by another entity interested only on THEIR bottom line.  I spend half the day performing someone else's requirements to help them supposedly in the fraudulent claim it is for the "care of the patient".   I can confidently tell you it ain't and all information coming in is that statistical measurements are not showing more than very minimal if any gains in overall health.  It is all a bunch of people and business finding ways to cut costs are generate income.  And I am in the middle.  embarassed

***********Hospitals Spy on Your Purchases to Spot Bad Habits
 

By Shannon Pettypiece and Jordan Robertson  Jun 26, 2014 12:01 AM ET 
 
You may soon get a call from your doctor if you’ve let your gym membership lapse, made a habit of picking up candy bars at the check-out counter or begin shopping at plus-sized stores.

That’s because some hospitals are starting to use detailed consumer data to create profiles on current and potential patients to identify those most likely to get sick, so the hospitals can intervene before they do.

Information compiled by data brokers from public records and credit card transactions can reveal where a person shops, the food they buy, and whether they smoke. The largest hospital chain in the Carolinas is plugging data for 2 million people into algorithms designed to identify high-risk patients, while Pennsylvania’s biggest system uses household and demographic data. Patients and their advocates, meanwhile, say they’re concerned that big data’s expansion into medical care will hurt the doctor-patient relationship and threaten privacy.


“It is one thing to have a number I can call if I have a problem or question, it is another thing to get unsolicited phone calls. I don’t like that,” said Jorjanne Murry, an accountant in Charlotte, North Carolina, who has Type 1 diabetes. “I think it
Acxiom Corp. (ACXM) and LexisNexis are two of the largest data brokers who collect such information on individuals. They say their data are supposed to be used only for marketing, not for medical purposes or to be included in medical records.

While both sell to health insurers, they said it’s to help those companies offer better services to members.

Much of the information on consumer spending may seem irrelevant for a hospital or doctor, but it can provide a bigger picture beyond the brief glimpse that doctors get during an office visit or through lab results, said Michael Dulin, director of research and evidence-based medicine at Carolinas HealthCare System.


Carolinas HealthCare System operates the largest group of medical centers in North Carolina and South Carolina, with more than 900 care centers, including hospitals, nursing homes, doctors’ offices and surgical centers. The health system is placing its data, which include purchases a patient has made using a credit card or store loyalty card, into predictive models that give a risk score to patients.

Within the next two years, Dulin plans for that score to be regularly passed to doctors and nurses who can reach out to high-risk patients to suggest interventions before patients fall ill.

Buying Cigarettes

For a patient with asthma, the hospital would be able to score how likely they are to arrive at the emergency room by looking at whether they’ve refilled their asthma medication at the pharmacy, been buying cigarettes at the grocery store and live in an area with a high pollen count, Dulin said.

The system may also score the probability of someone having a heart attack by considering factors such as the type of foods they buy and if they have a gym membership, he said.

“What we are looking to find are people before they end up in trouble,” said Dulin, who is also a practicing physician. “The idea is to use big data and predictive models to think about population health and drill down to the individual levels to find someone running into trouble that we can reach out to and try to help out.”

While the hospital can share a patient’s risk assessment with their doctor, they aren’t allowed to disclose details of the data, such as specific transactions by an individual, under the hospital’s contract with its data provider. Dulin declined to name the data provider.

If the early steps are successful, though, Dulin said he would like to renegotiate to get the data provider to share more specific details on patient spending with doctors.

“The data is already used to market to people to get them to do things that might not always be in the best interest of the consumer, we are looking to apply this for something good,” Dulin said.

While all information would be bound by doctor-patient confidentiality, he said he’s aware some people may be uncomfortable with data going to doctors and hospitals. For these people, the system is considering an opt-out mechanism that will keep their data private, Dulin said.

‘Feels Creepy’

“You have to have a relationship, it just can’t be a phone call from someone saying ‘do this’ or it just feels creepy,” he said. “The data itself doesn’t tell you the story of the person, you have to use it to find a way to connect with that person.”

Murry, the diabetes patient from Charlotte, said she already gets calls from her health insurer to try to discuss her daily habits. She usually ignores them, she said. She doesn’t see what her doctors can learn from her spending practices that they can’t find out from her quarterly visits.

“Most of these things you can find out just by looking at the patient and seeing if they are overweight or asking them if they exercise and discussing that with them,” Murry said. “I think it is a waste of time.”

While the patients may gain from the strategy, hospitals also have a growing financial stake in knowing more about the people they care for.

Under the Patient Protection and Affordable Care Act, known as Obamacare, hospital pay is becoming increasingly linked to quality metrics rather than the traditional fee-for-service model where hospitals were paid based on their numbers of tests or procedures.

Hospital Fines

As a result, the U.S. has begun levying fines against hospitals that have too many patients readmitted within a month, and rewarding hospitals that do well on a benchmark of clinical outcomes and patient surveys.

University of Pittsburgh Medical Center, which operates more than 20 hospitals in Pennsylvania and a health insurance plan, is using demographic and household information to try to improve patients’ health. It says it doesn’t have spending details or information from credit card transactions on individuals.

The UPMC Insurance Services Division, the health system’s insurance provider, has acquired demographic and household data, such as whether someone owns a car and how many people live in their home, on more than 2 million of its members to make predictions about which individuals are most likely to use the emergency room or an urgent care center, said Pamela Peele, the system’s chief analytics officer.

Emergency Rooms

Studies show that people with no children in the home who make less than $50,000 a year are more likely to use the emergency room, rather than a private doctor, Peele said.

UPMC wants to make sure those patients have access to a primary care physician or nurse practitioner they can contact before heading to the ER, Peele said. UPMC may also be interested in patients who don’t own a car, which could indicate they’ll have trouble getting routine, preventable care, she said.

Being able to predict which patients are likely to get sick or end up at the emergency room has become particularly valuable for hospitals that also insure their patients, a new phenomenon that’s growing in popularity. UPMC, which offers this option, would be able to save money by keeping patients out of the emergency room.

Obamacare prevents insurers from denying coverage because of pre-existing conditions or charging patients more based on their health status, meaning the data can’t be used to raise rates or drop policies.

New Model

“The traditional rating and underwriting has gone away with health-care reform,” said Robert Booz, an analyst at the technology research and consulting firm Gartner Inc. (IT) “What they are trying to do is proactive care management where we know you are a patient at risk for diabetes so even before the symptoms show up we are going to try to intervene.”

Hospitals and insurers need to be mindful about crossing the “creepiness line” on how much to pry into their patients’ lives with big data, he said. It could also interfere with the doctor-patient relationship.

The strategy “is very paternalistic toward individuals, inclined to see human beings as simply the sum of data points about them,” Irina Raicu, director of the Internet ethics program at the Markkula Center for Applied Ethics at Santa Clara University, said in a telephone interview.
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ccp
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« Reply #1351 on: July 02, 2014, 08:31:03 PM »

So not making the employer pay for post conception birth control now jeopardizes women's health?
It seems most medical organizations have been hijacked by the left.   Donna Marbury and the ACP (I am a member to help me keep up with advances in medical care) do not represent me.    As always claiming to be objectively scientific and nonpartisan so common with the left Marbury claims this position paper is non partisan.   rolleyes:

****Will the Hobby Lobby decision allow employers to ignore medical evidence?
ACP says SCOTUS ruling could jeopardize women’s health

Publish date: JUL 01, 2014
By: Donna Marbury
As stakeholders across the country debate the religious, gender and political implications of the U.S. Supreme Court ruling in favor of Hobby Lobby, one physician advocacy group worries that the decision ignores the practice of evidence-based medicine.

The Supreme Court ruled on June 30 that "closely held" for-profit corporations can hold religious objections that allow them to opt out of the requirement to provide no-cost contraceptives for female employees under the Affordable Care Act (ACA). The justices' 5-4 decision is the first time the high court has ruled in favor of for-profit businesses holding religious views under federal law.

The American College of Physicians (ACP) released a statement concerning the ruling, saying that it could undermine physicians’ authority to treat patients and have adverse affects on women’s health. The ACP states that the decision could lead to challenges of other government mandated, and evidence-based healthcare.

“We have no position or expertise on the legal arguments and precedents involved in the Hobby Lobby case; our expertise is based on the potential impact of the decision on public health, and specifically, the adverse health impacts on the patients seen by the 137,000 internal medicine specialists and medical students who are members of ACP,” David A. Fleming, MD, FACP, president of the ACP said in a written statement. “We are concerned that allowing employers to carve-out exemptions to the ACA’s requirements that health insurance plans cover evidence-based preventive services without cost-sharing, including but not necessarily limited to contraception, will create substantial barriers to patients receiving appropriate medical care as recommended by their physicians.”

Under the ACA, companies with 50 or more employees who offer health coverage that does not include all U.S. Food and Drug Administration (FDA)-approved contraception methods for women without cost-sharing would face fines of up to $100 a day per worker. Large employers not offering coverage would face a fine of $2,000 for most employees. For example, Hobby Lobby would have faced fines of $475 million per year for excluding some forms of birth control from its health coverage.

As a result of the decision, the companies filing suit—Hobby Lobby Stores and Conestoga Wood Specialties, as well as Hobby Lobby subsidiary Mardel Christian book stores—will not have to offer women employees all FDA-approved contraceptives as part of a package of preventive services required to be offered without copays or deductibles.

The Christian-based companies object mainly to the emergency contraceptives known as Plan B and Ella, and two types of intrauterine devices, on the grounds that the therapies are abortion equivalents that violate their religious convictions. Medical research from the National Institutes of Health, the Mayo Clinic and several other authorities has proven that emergency contraceptives do not cause abortions. Nearly 50 businesses have sued over
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Crafty_Dog
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« Reply #1352 on: July 05, 2014, 10:56:54 AM »

http://www.tpnn.com/2014/07/03/the-new-welfare-berkeley-to-start-giving-free-marijuana-to-homeless-and-the-poor/
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ccp
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« Reply #1353 on: July 05, 2014, 11:33:21 AM »

"It’s unbelievable that we have reached a place in society where free marijuana is treated as a right for those who cannot afford to buy their own weed."

This says it all.   cry
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G M
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« Reply #1354 on: July 05, 2014, 01:23:02 PM »

That's why today's dems are more accurately called the Free Shit Army.
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DougMacG
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« Reply #1355 on: July 05, 2014, 05:02:57 PM »

All incentives have been turned upside down.  It used to be that you had to use your hard earned money to buy the stuff and hide it from the government.  One of the pundits had it right.  As soon as something is legal, it has to be mandatory, and free and provided to you by others.
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DougMacG
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« Reply #1356 on: July 09, 2014, 07:04:03 AM »

More Than Expected Will Drop Out Of Colorado’s Obamacare Program

Nearly twice as many people are expected to drop out of Colorado’s state-run health care exchange in the coming years than originally projected, leading to nearly $2 million lost in associated fees for the financially embattled program over the next two years.
http://dailycaller.com/2014/07/09/report-more-than-expected-will-drop-out-of-colorados-obamacare-program/#ixzz36yJp05ga
---------------------------------------------------------------------------------------------------------------------------------

ObamaCare Enrollment Numbers Unreliable, Audit Finds
By JOHN MERLINE, INVESTOR'S BUSINESS DAILY
 Posted 07/08/2014 06:59 PM ET

Buried in a largely overlooked government audit of the Obama-Care exchanges is a finding that casts still more doubt on the reliability of the 8 million enrollment number commonly cited by the administration and the press.

In a section titled "Other Issues," an inspector general report released last week found that the HealthCare.gov marketplace couldn't show it had been reconciling its monthly enrollment numbers with insurance companies.

That's despite the fact that the law specifically calls for this reconciliation, and the fact that, as the IG report notes, "the federal marketplace obtained the services of a contractor to reconcile enrollment information."

Obama administration officials "stated that the system to support reconciliations had yet to be developed."

But as the IG makes clear, without this monthly reconciliation, the government "cannot effectively monitor the current enrollment status of applicants, such as ... termination of plans."

Perhaps Far Fewer Enrollees
In other words, there could be far fewer enrollees than advertised if these numbers were reconciled as required by law.

Investor's Business Daily: http://news.investors.com/politics-obamacare/070814-707833-obamacare-enrollment-numbers-unreliable-government-audit-finds.htm#ixzz36yKHET6C
-----------------------------------------

Most transparent administration in history, and they all seem so honest...

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Crafty_Dog
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« Reply #1357 on: July 10, 2014, 12:44:10 PM »



http://www.washingtontimes.com/news/2014/jul/8/carson-better-than-obamacare/
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Crafty_Dog
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« Reply #1358 on: July 17, 2014, 10:45:46 AM »



http://www.capoliticalreview.com/capoliticalnewsandviews/surgery-center-of-oklahoma-proving-free-market-medicine-works/
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Crafty_Dog
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« Reply #1359 on: July 17, 2014, 10:58:08 AM »

second post

http://www.capoliticalreview.com/capoliticalnewsandviews/million-more-patients-in-california-25-less-doctors-for-medi-cal/
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Crafty_Dog
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« Reply #1360 on: July 22, 2014, 02:02:17 PM »

Health Law Subsidies Upheld, Conflicting With Ruling Hours Earlier
Two federal appeals court panels issued conflicting rulings Tuesday on whether the government could subsidize health insurance premiums for people in three dozen states that use the federal insurance exchange. The decisions are the latest in a series of legal challenges to central components of President Obama’s health care law.

The United States Court of Appeals for the Fourth Circuit, in Richmond, upheld the subsidies, saying that a rule issued by the Internal Revenue Service was “a permissible exercise of the agency’s discretion.”

The ruling came within hours of a 2-to-1 ruling by a panel of the United States Court of Appeals for the District of Columbia Circuit, which said that the government could not subsidize insurance for people in states that use the federal exchange.

That decision could cut potentially off financial assistance for more than 4.5 million people who were found eligible for subsidized insurance in the federal exchange, or marketplace.

Under the Affordable Care Act, the appeals court here said, subsidies are available only to people who obtained insurance through exchanges established by states.
READ MORE »
http://www.nytimes.com/2014/07/23/us/court-rules-against-obamacare-exchange-subsidies.html?emc=edit_na_20140722

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