Dog Brothers Public Forum
Return To Homepage
Welcome, Guest. Please login or register.
July 28, 2015, 12:45:06 PM

Login with username, password and session length
Search:     Advanced search
Welcome to the Dog Brothers Public Forum.
87198 Posts in 2280 Topics by 1069 Members
Latest Member: ctelerant
* Home Help Search Login Register
+  Dog Brothers Public Forum
|-+  Politics, Religion, Science, Culture and Humanities
| |-+  Politics & Religion
| | |-+  The Politics of Health Care
« previous next »
Pages: 1 ... 26 27 [28] 29 Print
Author Topic: The Politics of Health Care  (Read 242989 times)
ccp
Power User
***
Posts: 4520


« 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.
Logged
ccp
Power User
***
Posts: 4520


« 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
Logged
Crafty_Dog
Administrator
Power User
*****
Posts: 33805


« 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/
Logged
ccp
Power User
***
Posts: 4520


« 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
Logged
G M
Power User
***
Posts: 12599


« Reply #1354 on: July 05, 2014, 01:23:02 PM »

That's why today's dems are more accurately called the Free Shit Army.
Logged
DougMacG
Power User
***
Posts: 6576


« 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.
Logged
DougMacG
Power User
***
Posts: 6576


« 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...

Logged
Crafty_Dog
Administrator
Power User
*****
Posts: 33805


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



http://www.washingtontimes.com/news/2014/jul/8/carson-better-than-obamacare/
Logged
Crafty_Dog
Administrator
Power User
*****
Posts: 33805


« Reply #1358 on: July 17, 2014, 10:45:46 AM »



http://www.capoliticalreview.com/capoliticalnewsandviews/surgery-center-of-oklahoma-proving-free-market-medicine-works/
Logged
Crafty_Dog
Administrator
Power User
*****
Posts: 33805


« 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/
Logged
Crafty_Dog
Administrator
Power User
*****
Posts: 33805


« 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

Logged
Crafty_Dog
Administrator
Power User
*****
Posts: 33805


« Reply #1361 on: July 25, 2014, 06:02:45 PM »



http://www.forbes.com/sites/michaelcannon/2014/07/25/obamacare-architect-jonathan-gruber-if-youre-a-state-and-you-dont-set-up-an-exchange-that-means-your-citizens-dont-get-their-tax-credits/
Logged
G M
Power User
***
Posts: 12599


« Reply #1362 on: August 05, 2014, 07:55:04 AM »

http://www.weeklystandard.com/blogs/florida-obamacare-premiums-jump-132_802050.html
Logged
ccp
Power User
***
Posts: 4520


« Reply #1363 on: August 09, 2014, 08:41:48 PM »


I've heard this is the most expensive hospital in the country.  One of the guys who bought the hospital at basement rates, who used to be with Blackstone got his Wall Street buddies to finance fixing the place up and embarked on an out of network strategy and then resold it for something like a 40 million profit.  The health care mogul as he was called in a news article now has a mansion in the Hamptons.   So this poor guy gets stuck with a 9K bill.

I have a patient who told me he went to this hospital which is much farther from here than several others to have a procedure done via a limousine.   In this way the patient got in his mind "first class treatment".  The bill is usually multiples of what it would otherwise cost.  I explained this abuse to the patient.   His response:   "but it didn't cost me anything".  I asked him doesn't this dishonest game playing while using you as the pawn bother you?  His response, was again "it didn't cost me a thing".

So there you have it.   I replied, but it costs everyone else a bundle to finance this.  What do you think happens to everyone's insurance rates with this going on?   No response from him.  No concern.   

*********Hospital ER Charges $9,000 to Bandage Cut Finger

Money Talks News
By Krystal Steinmetz 8 hours ago
 
A New Jersey teacher was stunned when he received a $9,000 bill after his cut finger was bandaged in a hospital emergency room. Baer Hanusz-Rajkowski cut his finger with the claw end of a hammer. After waiting a few days to see if it would heal on its own, Hanusz-Rajkowski decided to go to the emergency room at Bayonne Medical Center in New Jersey, according to NBC New York. It was determined (without X-rays) that his finger didn’t need stitches. So Hanusz-Rajkowski left with a bandaged middle finger. NBC New York said he was surprised to get this in the mail:

Hanusz-Rajkowski got hit with an $8,200 bill for the emergency room visit. On top of that, Bayonne Medical Center charged $180 for a tetanus shot, $242 for sterile supplies, and $8 for some antibacterial ointment in addition to hundreds of dollars for the services of the nurse practitioner.

That $9,000 bill left Hanusz-Rajkowski speechless. From NBC:

“I got a Band-Aid and a tetanus shot. How could it be $9,000? This is crazy,” Hanusz-Rajkowski said. “If I severed a limb, I’d carry it to the next emergency room in the next city before I go back to this place.”

Why was the bill so high? The answer isn’t clear. It’s more of a he said, she said. Carepoint Health bought Bayonne Medical Center about six years ago, making it a for-profit business, NBC said. Dr. Mark Spektor, president and CEO of the medical center, said the big bill is the fault of Hanusz-Rajkowski’s insurance company, United Healthcare, which no longer has an in-network pricing contract with the hospital. Spektor said United doesn’t offer fair reimbursement rates. According to NBC, Mary McElrath-Jones, spokeswoman for United Healthcare, disagrees with Spektor. “United Healthcare is deeply concerned about hospitals establishing an out-of-network strategy to hike the rate they charge for emergency room services, often surprising patients,” she said. Regardless of whether there’s an in-network price deal, New Jersey law demands that insurers cover the costs of ER visits, NBC said. United Healthcare ended up paying $6,640 on the bill. After the story hit the news, the hospital wrote off Hanusz-Rajkowski’s portion of the bill. Some people are calling for a price cap on ER procedures, NBC reported. Spektor said that would put the hospital, which was once on the brink of bankruptcy and is now profitable again, at risk.

“Insurance companies in the state of New Jersey particularly have had record profits last year. Billions of dollars in profits while hospitals are struggling and closing. That is the real story,” Spektor said.

What do you think of Hanusz-Rajkowski’s hospital bill? Do you think you’ve been massively overcharged at a hospital? Share your comments below or on our Facebook page.

This article was originally published on MoneyTalksNews.com as 'Hospital ER Charges $9,000 to Bandage Cut Finger'.

 

 
 
 
Logged
DougMacG
Power User
***
Posts: 6576


« Reply #1364 on: August 11, 2014, 11:58:54 AM »

This should also go in the President Rubio thread.

http://www.foxnews.com/opinion/2014/08/08/more-obamacare-woes-congress-must-act-to-block-health-insurance-bailout/

More ObamaCare woes: Congress must act to block health insurance bailout
By Sen. Marco RubioPublished August 08, 2014FoxNews.comFacebook431 Twitter217 livefyre325

As evidence mounts of a looming taxpayer-funded bailout of health insurance companies under ObamaCare, the urgency grows for Congress to take this possibility off the table for good.

As expected, ObamaCare's costs are rising, and health insurers are passing them along to patients in the form of higher premiums and deductibles.

Just this week, a majority of insurers offering health plans in Florida announced rate increases ranging from 11 to 23 percent. This means that if patients balk at paying this sharp increase and drop their coverage, these health insurers will have to make up the difference somehow.

Enter section 1342 of the ObamaCare law, which established so-called "risk corridors".

According to this provision, taxpayers will make up the difference for health insurance companies whose plans lose money under ObamaCare. Last November, as it became clearer what this section of the law actually meant, I introduced legislation repealing it and protecting taxpayers from being forced to cover insurers' ObamaCare losses.

Afterwards, as pressure from taxpayers mounted on the Obama administration, it announced that it had no intention of operating this bailout program at a net cost to the American people. As expected, health insurers and their lobbyists revolted. I called the administration's bluff, and introduced new legislation that would codify into law what they have promised and prohibit this "revenue neutrality" from being achieved through use of taxpayer funds. Not surprisingly, it's gone nowhere in the Democratically-controlled Senate, and the White House won't go anywhere near it.

In recent weeks, the public has learned that senior White House officials have been working closely with insurers behind the scenes to make sure that their earlier bailout deal, which helped assure ObamaCare's passage in 2010, would stand and that a taxpayer-funded bailout was still, in fact, on the table.

According to a recent investigation conducted by the House Oversight and Government Reform Committee chaired by Darrell Issa, insurers widely expect to receive funds from the bailout program. One large health insurer recently filed financial statements claiming they expect part of their revenue to come from American taxpayers via the ObamaCare bailout "fund".

This "fund" brings us to another dimension of the Obama administration's maneuvering to make sure that health insurers get paid. Knowing that the current U.S. House of Representatives will never appropriate money for this bailout, the Department of Health and Human Services (HHS) figured out a way to use general funds available through the Centers for Medicare and Medicaid Services to pay off health insurers. The effect is to circumvent Congress' power of the purse for the purpose of bailing out health insurers with taxpayer funds.

On this ObamaCare bailout, as with so many issues, Washington politicians are misleading average Americans and planning to stick them with the bill. This is government favoritism and corporate cronyism at its worst.

With ObamaCare's costs rising and projected to cost more than $2 trillion over the next decade, its damage on people's jobs and work hours continuing, and the prospect of a taxpayer-funded bailout of health insurers still alive and well, it's clear this law has failed. It's time to repeal and replace it, but at the very least, we should make it the law of the land that health insurers won't be bailed out by taxpayers because ObamaCare has not proven to be as profitable as its proponents hoped it would be.


Republican Marco Rubio represents Florida in the U.S. Senate. He is a member of the Senate Committee on Commerce, Science and Transportation.

Logged
ccp
Power User
***
Posts: 4520


« Reply #1365 on: August 11, 2014, 08:22:51 PM »

"According to this provision, taxpayers will make up the difference for health insurance companies whose plans lose money under ObamaCare. Last November, as it became clearer what this section of the law actually meant, I introduced legislation repealing it and protecting taxpayers from being forced to cover insurers' ObamaCare losses."

Again the top health care companies stocks and their top officials are making millions and are at all time highs and the rest of us get bulldozed.  Their employees can't even afford their own health care.

My rates going up another 50% despite sky high deductibles.   The whole thing will crash.

 
Logged
DougMacG
Power User
***
Posts: 6576


« Reply #1366 on: August 21, 2014, 08:45:44 AM »

Republicans should circle back to the Obamacare failure, especially in the NINE Senate toss up races.  Great article:
 http://www.thefiscaltimes.com/Columns/2014/08/20/6-Reasons-Obamacare-Can-Win-Senate-GOP
« Last Edit: August 21, 2014, 06:26:57 PM by Crafty_Dog » Logged
Crafty_Dog
Administrator
Power User
*****
Posts: 33805


« Reply #1367 on: September 04, 2014, 11:29:46 AM »

DC Circuit Agrees to En Banc Hearing of ObamaCare Ruling

In July, the U.S. Court of Appeals for the DC Circuit ruled in Halbig v. Burwell that ObamaCare subsidies given through the federal exchanges were illegal because the law provides for them only through state exchanges. It was a huge blow for the law's supporters, who ironically argued the law doesn't mean what it says. However, the full court has granted a rehearing en banc in December. Clearly, Barack Obama hopes for a favorable ruling this time before the case heads to the Supreme Court. This is exactly why Senate Majority Leader Harry Reid went nuclear to change confirmation rules so Obama could pack the court with his jurists favorable to his lawlessness.
Logged
DougMacG
Power User
***
Posts: 6576


« Reply #1368 on: September 05, 2014, 11:36:28 AM »

This is just one reason why we don't centralize all our personal and governmental functions, any more than necessary.

http://www.dailymail.co.uk/news/article-2744241/Foreigners-hacked-Obamacare-website-July-HHS-just-discovered-10-days-ago-claims-no-consumer-data-stolen.html

Foreigners hacked Obamacare website on July 8 – but HHS only discovered it 10 days ago
Malicious code was inserted into an Obamacare server and lay dormant, waiting for a command to attack other computers
Logged
DougMacG
Power User
***
Posts: 6576


« Reply #1369 on: September 16, 2014, 09:57:35 AM »

CBO: Cost of Obamacare Subsidy Will Increase 8-Fold in 10 Years

(The increases in the out-years are most certainly UNDER stated.  - Doug)

http://www.cbo.gov/sites/default/files/cbofiles/attachments/45653-OutlookUpdate_2014_Aug.pdf





Under the Patient Protection and Affordable Care Act, the federal government requires Americans to purchase a health-insurance plan that meets government specifications. If they buy that insurance through a government-run exchange, and earn less than 400 percent of the federal poverty level, the U.S. Treasury will pay a part of their premium. The amount the Treasury pays decreases as a person’s income increases toward the 400-percent-of-poverty level.

At the same time, the Affordable Care Act expands the Medicaid rolls by providing subsidies to states that make people earning up to 133 percent of poverty eligible for the program. People signing up for insurance on the exchange whose income is below that level must be enrolled in Medicaid.

“ACA’s Medicaid expansion provisions have the potential for affecting eligibility for premium credits if certain low to middle income individuals and families seek health insurance through the exchanges,” says the Congressional Research Service. “Under ACA, states have the option to expand Medicaid eligibility to include all nonelderly, non-pregnant individuals (i.e., childless adults and certain parents, except for those ineligible based on certain noncitizenship status) with income up to 133% FPL.”

“States that choose to implement the ACA Medicaid expansion will receive substantial federal subsidies,” says the Congressional Research Service. “If a person who applied for premium credits in an exchange is determined to be eligible for Medicaid, the exchange must have them enrolled in Medicaid.”
http://cnsnews.com/news/article/terence-p-jeffrey/cbo-cost-obamacare-subsidy-will-increase-8-fold-10-years
« Last Edit: September 16, 2014, 09:59:47 AM by DougMacG » Logged
Crafty_Dog
Administrator
Power User
*****
Posts: 33805


« Reply #1370 on: September 21, 2014, 11:24:21 PM »

 shocked shocked shocked
http://www.nytimes.com/2014/09/21/us/drive-by-doctoring-surprise-medical-bills.html?emc=edit_th_20140921&nl=todaysheadlines&nlid=49641193&_r=0 
Logged
Crafty_Dog
Administrator
Power User
*****
Posts: 33805


« Reply #1371 on: September 30, 2014, 12:00:34 PM »

http://online.wsj.com/articles/how-to-game-obamacare-1412032995
Logged
Crafty_Dog
Administrator
Power User
*****
Posts: 33805


« Reply #1372 on: October 02, 2014, 07:39:17 PM »

http://www.tpnn.com/2014/10/02/obamacare-one-year-later-five-lessons-learned/
Logged
Crafty_Dog
Administrator
Power User
*****
Posts: 33805


« Reply #1373 on: October 03, 2014, 05:03:14 PM »

http://www.capoliticalreview.com/capoliticalnewsandviews/calif-governor-vetoes-bill-to-protect-assets-from-medi-cal/ 
Logged
Crafty_Dog
Administrator
Power User
*****
Posts: 33805


« Reply #1374 on: November 10, 2014, 11:28:22 PM »

Enter: The GOP Alternative To ObamaCare
By DICK MORRIS
Published on DickMorris.com on November 10, 2014
The Supreme Court decision to hear challenges to the legality of giving subsidies to families and individuals who signed up for ObamaCare through federal exchanges could lead to the de facto repeal of the program.  And, with the Republican victory in the midterm elections, the next step could be the passage of the Republican version of ObamaCare -- an excellent piece of legislation that the country will happily accept.

The Republican alternative to ObamaCare, passed by the House but, obviously, never brought up for a vote in the Democratic Senate, provides for tax credit subsidies for all who need them to buy health insurance and incorporates the basic consumer protections embedded in the Affordable Care Act.  Insurers cannot discriminate based on pre-existing conditions under the GOP bill nor can they either terminate coverage or raise rates when their customers become ill.


But the Republican alternative eliminates the coercive aspects of ObamaCare.  Nobody has to buy insurance nor does any employer have to offer it.  And those who do purchase insurance can get as much or as little coverage as they want.  One size will no longer attempt to fit all.

A particularly important provision of the bill extends Medicare coverage to those who are sickest with the highest medical bills, so the government pays for all their costs.

Would Obama veto the Republican bill? 

Much as his veto pen will be itching to do so, he really won't be able to use it.  Once ObamaCare subsidies are struck down by the Supreme Court, seven million or more Americans will be out of health insurance entirely.  Most will have once had adequate policies for which they paid themselves, only to find that Washington forced cancellation of their policies and made them buy insurance on the federal exchanges.  Having gotten more coverage, at a higher cost, than they could either afford or need, they became dependent on the federal subsidies the court will have just thrown out. 

Obama and the Republican Congress will have a moral and political imperative to restore their coverage.  They and most of America will approve of the Republican alternative and Obama will be unable to veto it with the presidential elections looming.

So the ObamaCare saga will have had a happy ending with a good bill filling a gap in our healthcare coverage.  And all the wrangling will seem to have been so unnecessary.
Logged
G M
Power User
***
Posts: 12599


« Reply #1375 on: November 10, 2014, 11:40:04 PM »

I'd insist on full repeal, let Obama veto each one.
Logged
Crafty_Dog
Administrator
Power User
*****
Posts: 33805


« Reply #1376 on: November 17, 2014, 02:21:09 PM »



http://www.theblaze.com/stories/2014/11/17/guess-how-john-kerry-described-jonathan-gruber-in-2009/

Even has him saying that Gruber did the numbers when the CBO would not!

Logged
Crafty_Dog
Administrator
Power User
*****
Posts: 33805


« Reply #1377 on: November 19, 2014, 11:14:45 AM »

During the 2008 presidential campaign, Barack Obama attacked Hillary Clinton's health care plan because "it forces everyone to buy insurance, even if you can't afford it, and you pay a penalty if you don't." Gee, that sounds familiar. Oh, that's right -- it's a critical part of ObamaCare now. What changed Obama's mind? Jonathan "Stupid American Voters" Gruber, of course. After adding Gruber to his transition team and meeting with him about health policy, Obama came out in favor of the mandate in July 2009. And, according to a 2012 New York Times report, "It is [Gruber's] research that convinced the Obama administration that health care reform could not work without requiring everyone to buy insurance." It's no wonder Obama has tried to distance himself from Gruber, saying, "I just heard about this" kerfuffle, and, "The fact that an adviser who was never on our staff expressed an opinion that I completely disagree with in terms of the voters is not a reflection on the actual process that was run." Sure thing.
Logged
DougMacG
Power User
***
Posts: 6576


« Reply #1378 on: November 24, 2014, 10:30:19 AM »

In a case likely to be heard in March and decided in June, the justices will dissect the meaning of four words on page 95 of the 906-page Patient Protection and Affordable Care Act — four words that could render health insurance premiums unaffordable for millions of Americans.

Tax credits will be available through so-called exchanges, or online marketplaces, "established by the State."

http://www.usatoday.com/story/news/politics/2014/11/22/supreme-court-obama-health-care/19271273/

Whether you look at meaning of the words or context, tax credits are only available through so-called exchanges, or online marketplaces, established by the State.

Now we will see if 5 Justices can read written law.
Logged
DougMacG
Power User
***
Posts: 6576


« Reply #1379 on: December 01, 2014, 10:17:51 AM »

The starting point for a full replacement plan should be a rational synthesis of the two best reform plans now on the table: one developed by the 2017 Project (a group dedicated to developing a conservative reform agenda for the next administration) and the other by Republican Senators Richard Burr, Tom Coburn, and Orrin Hatch. The two plans share much in common. They are practical, market-based solutions. They both retain the employer-based health-insurance system for the vast majority of Americans, even as they would encourage more cost discipline in the most expensive job-based plans with a limitation on the federal tax break for employer-paid premiums. To broaden insurance enrollment and to correct an inequity in current law, they also would provide a new federal tax credit to households without access to employer coverage. The credit would be adjusted by age (and, in the case of Burr-Coburn-Hatch, by income) and could be used to purchase any state-approved health-insurance product. Finally, the plans would create a new “continuous-coverage protection” construct: People who stay continuously enrolled in health insurance would be protected from premium hikes based on their health status and from exclusions from coverage based on a preexisting condition.
— James C. Capretta, AEI
http://www.nationalreview.com/article/393678/how-replace-obamacare-james-c-capretta

2017 Project:  http://2017project.org/site/wp-content/uploads/2014/02/An-Obamacare-Alternative-Full-Proposal.pdf

Burr, Coburn, Hatch:  http://www.coburn.senate.gov/public/index.cfm?a=Files.Serve&File_id=871b0ef8-7705-4f72-aef2-e81d01b9c009
Logged
DougMacG
Power User
***
Posts: 6576


« Reply #1380 on: December 04, 2014, 10:38:18 AM »

Too bad candidate Romney never understood or articulated this point.

"Overall, the ACA erodes nationwide average work incentives about eleven times more than Romneycare did in the state of Massachusetts"

http://acasideeffects.com/
http://caseymulligan.blogspot.com/2014/11/professor-krugman-continues-to.html
http://caseymulligan.blogspot.com/
Logged
DougMacG
Power User
***
Posts: 6576


« Reply #1381 on: December 11, 2014, 09:20:54 AM »

The gaffe was that he told the truth, right up until he was sworn in to tell the whole truth and nothing but the truth.  Then this 40-something, apparently healthy economist started to lose all important recollections.

Read Byron York:  http://www.washingtonexaminer.com/jonathan-gruber-and-the-ocare-memory-hole/article/2557215

"Complicating the picture, Gruber's was a specialized type of memory loss: the more difficult and challenging the question about his notorious descriptions of Obamacare's birth, the more tenuous Gruber's memory became."
...
The questioner, again, was Turner. "You said this bill was written in a tortured way to make sure CBO did not score the individual mandate as taxes," Turner said to Gruber. "Did you ever speak to anyone in the administration who acknowledged that to you?"

"That was an inexcusable term used by — " Gruber began.

"I'm not asking you about how you believe that whether or not you should have said that or not," Turner replied. "It's a factual statement you're making. Did anybody in the administration ever have that conversation with you?"

"I do not recall anyone using the word 'tortured,' " Gruber said.

"Did they have the conversation with you that it had to be drafted in a way that the CBO did not score the individual mandate as taxes?" Turner persisted.

"I don't — " Gruber began.

"You're under oath."

"I honestly do not recall."

When the talking point (what I said was inexcusable) didn't work, and then when the parsing (no one used the word 'tortured') didn't work, Gruber went to Plan C, the last resort: I don't recall. And just for emphasis, he added that he honestly did not recall.
...
In all, Gruber said "I don't recall" or some variant of the phrase about 20 times during his testimony, frustrating the Republicans who had hoped to elicit actual information during the hearing. What the GOP got instead was one of the nation's foremost experts on healthcare who, for a few hours at least, could barely remember his name.

Logged
DougMacG
Power User
***
Posts: 6576


« Reply #1382 on: December 11, 2014, 09:48:33 AM »

Very important piece, IMHO.  He discusses the balancing act Republicans will face as they attempt to undo this mess.  The public disapproves of Obamacare, but doesn't want empty repeal with a return to all that was wrong before.  And conservatives will revolt if they see Republicans acting like Democrats, tinkering around the edges or replacing with their own government monstrosity.  Not having a plan isn't going to work any longer.  Take the best of the market driven, conservative plans and start making the positive case for change. 
----------------------------------------------------
Getting beyond Obamacare 
It’s time to make the case for replacing it, not fixing it. 
By Ramesh Ponnuru, National Review, December 8, 2014

http://www.nationalreview.com/article/394161/getting-beyond-obamacare-ramesh-ponnuru
Logged
ccp
Power User
***
Posts: 4520


« Reply #1383 on: December 17, 2014, 09:13:17 PM »

Now at age 37 the nation's surgeon general.  I used to get emails from this big socialist liberal to join his Obama Care fan club.  This is a joke.  All politics.  Has nothing to do with medical care.  All about promoting obama care.  The damage continues for the next two years:

****Washington (CNN) -- The Senate confirmed Vivek Murthy as surgeon general on Monday night as Democrats -- in the final days of their majority control of the chamber -- overcame stiff opposition from the National Rifle Association.

The 51 to 43 vote ends more than a year of uncertainty over Murthy's nomination. Obama had tapped the founder of the pro-Obamacare group Doctors for America for the post in November 2013.

But a confirmation vote had been held up after the gun lobby pointed to a letter Murthy had signed calling for new gun control measures in the wake of the Newtown, Connecticut, school shootings, and promised to score a vote in Murthy's favor against senators in its ratings of how strongly lawmakers support gun rights.

Murthy, 37, is America's youngest-ever top doctor, and he is also the first surgeon general of Indian-American descent.

Obama lauded Murthy's confirmation, saying he will help the United States combat the threat of Ebola.

"As 'America's Doctor,' Vivek will hit the ground running to make sure every American has the information they need to keep themselves and their families safe. He'll bring his lifetime of experience promoting public health to bear on priorities ranging from stopping new diseases to helping our kids grow up healthy and strong," Obama said in a statement.

Opinion: Surgeon general's win is a political miracle

"Vivek will also help us build on the progress we've made combating Ebola, both in our country and at its source," he said. "Combined with the crucial support for fighting Ebola included in the bill to fund our government next year, Vivek's confirmation makes us better positioned to save lives around the world and protect the American people here at home."

But soon-to-be Senate Majority Leader Mitch McConnell, the Kentucky Republican whose party will take control of the chamber once new members are in place next month, called Murthy a political appointment.

"The surgeon general is known as America's doctor and the men and women chosen to fill that role in the past have usually been highly qualified individuals with substantial experience in patient care," McConnell said in a statement.

"Unfortunately, Dr. Murthy's nomination had more to do with politics -- he was a founder in 2008 of a group called Doctors for Obama, and has been an outspoken political advocate of Obamacare and gun control -- than his medical experience," he said. "With America facing the challenge of Ebola and other serious health challenges, it's unfortunate that the President chose a nominee based on the candidate's political support instead of a long career delivering patient care and managing difficult health crises."

Democrats taunt Cruz over surgeon general vote

This story has been updated****

Logged
ccp
Power User
***
Posts: 4520


« Reply #1384 on: January 20, 2015, 07:58:01 AM »


"I've know him for years!"

http://michellemalkin.com/?p=162894

At this rate we will have a
federal holiday (government employees get the day off) for him.
Logged
Crafty_Dog
Administrator
Power User
*****
Posts: 33805


« Reply #1385 on: January 24, 2015, 12:14:41 PM »

The Revolution at the Corner Drugstore
The CVS chief executive on upending the debate about costly specialty drugs and how he’s going to make sure you take your medicine.
By Joseph Rago
Jan. 23, 2015 6:42 p.m. ET
WSJ

For the better part of a year, the worlds of health-care finance and health-care politics have been scandalized by the specialty drug called Sovaldi. The $84,000 cost for a course of treatment of this hepatitis-C cure was said to reveal that pharmaceutical prices were irrational or abusive; that markets were helpless to respond; and that, absent government intercession, this new wave of complex biological therapies would bankrupt the nation.

Then, this winter, all of a sudden, discipline and competition arrived. The response has largely come in the form of new hep-C medicines and pharmacy-benefit managers, or PBMs, a kind of quasi-insurance company that purchases medications in bulk from drug makers, negotiates prices and oversees patient drug plans. The controversy continues to boil, though the CEO of the second-largest PBM in the U.S., Larry Merlo, exhibits little of the Sovaldi-fueled acrimony of his industry colleagues, much less the self-defeating policy responses.

“We saw the expected growth in specialty pharmacy coming. The latest trends around specialty say that unabated—unabated—we’re going to see midteens growth for the foreseeable future,” Mr. Merlo says of the rise of specialty-drug spending, tapping the table in his office with an index finger for emphasis. In other words, there are real problems, but there are solutions too, and the costs are manageable.

Mr. Merlo heads CVS Health, which in the age of the Affordable Care Act is expanding beyond the drugstore around the corner, sometimes radically. About 100 million Americans are CVS customers each year, whether in a brick-and-mortar outlet, paying a visit to one of its 960 “minute clinics,” or through its PBM unit, Caremark. CVS fills more than one of every five prescriptions in the U.S., either in-store or via mail. The company supplies fully 1% of all federal corporate-tax revenue.

In the case of specialty drugs, CVS is now the largest supplier and dispenses about 25% of prescriptions in the $86 billion business. Mr. Merlo expects these therapies to grow to 50% of total pharmaceutical spending, from 38% today, as innovations for unmet medical needs—or even common conditions like high cholesterol, which will be targeted by the forthcoming PCSK9 inhibitors—come to market.

So what to do? Think of an “illustrative trend” of a 20% growth rate in specialty drug costs, Mr. Merlo says. He estimates that CVS Caremark, which covers 65 million people, can erase as much as 16 percentage points. PBMs create tiers of preferred drugs, for example, which give patients an incentive to choose cheaper generics over name brands. Other management tools, like drug formularies, narrow pharmacy networks, care coordination, step therapy and the like, can add to the savings.

The hepatitis-C shakeout is more contested. The first-to-market maker of Sovaldi, Gilead Sciences, followed with a next-generation treatment called Harvoni, while AbbVie brought out Viekira Pak. More are in the pipeline. Express Scripts , the largest PBM and a vocal Gilead critic, signed an exclusive deal with AbbVie. In January, CVS turned around and made Harvoni and Sovaldi the preferred hep-C treatments on its own PBM formularies. Both PBMs almost certainly received concessions on list prices in return for offering one therapy in lieu of competitors, though details haven’t been disclosed.

One way of reading all this is that the drug makers are being forced to compete, even while they retain intellectual-property protection. But it has stirred a new debate about patient access to needed medicines, and whether the limits of closed formularies will interfere with medical decision-making and in the long run cost patients or society more.

Obviously PBMs make individual exceptions and conduct clinical reviews, with a goal of generating the best value at the lowest cost. But the strategies do illustrate the trade-offs that are increasingly coming to define U.S. health care—and who will decide.
***

Mr. Merlo observes that CVS Caremark’s clients—whether health plans, self-insured employers or government programs like Medicare and Medicaid—“can pick and choose, they can mix and match, how aggressive they want to be to satisfy the goal of the appropriate level of cost, not at the expense of quality.” But as he sees it, individuals are increasingly dominant.

What Mr. Merlo calls “the retailization of health care” is accelerating, with consumers taking more responsibility for their own care choices, sharing more of the costs and becoming “part of the thought process and part of the solution. . . . I think consumers will have more decision-making, and with that comes more accountability.”

In part, this trend is a response to what Mr. Merlo sees as the defining challenge of American health care: “the quality-cost conundrum,” or how “to improve health outcomes at lower costs” amid a changing mix of how the U.S. finances health care. The Affordable Care Act is expanding insurance coverage, especially through Medicaid. What he calls the “silver tsunami,” or the 10,000 people turning 65 each day, is swelling the Medicare rolls. Employers and health plans are as “intensely focused” as ever “on reducing the cost of care.”

Mr. Merlo thinks the “ultimate answer” for high drug prices are payment methods that reward value and outcomes and allow everyone “to share the benefits.” He adds: “We’ve operated on a fee-for-service model, you know, forever.” That is changing, but “we’re in the top of the second inning. We’re very, very early.”

Still, “consumers have been left out of the process for years,” Mr. Merlo says, and now require new “education, tools and transparency.” The third-party-payer system for decades cast medicine as business-to-business transactions and thus left many health-care companies with no comprehension of normal people and their needs, preferences and sometimes irrationalities. Long retail experience is providing different answers.

“Obviously you think of our retail pharmacies,” says Mr. Merlo, a pharmacist by training and CVS chief since 2011. He is repositioning the company and thinks the better description of CVS is “an integrated pharmacy-care organization. Our purpose, our goal is to help people on their path to better health.”

Take CVS’s 960 walk-in clinics in 31 states and growing, which together constitute the biggest retail clinic in the country, with 23 million visits to date. Nurse practitioners treat minor acute ailments like strep throat, ear infections or sprains, and offer immunizations. Convenient (open on nights and weekends, with no appointments) and affordable (40% to 80% lower than traditional providers, with posted prices), these clinics can help solve one problem: “the confluence between more people entering the insured market and at the same time a growing shortage of primary-care physicians,” Mr. Merlo says.

They can also reduce spending by migrating treatment “at a fraction of the cost” from more-expensive settings like emergency rooms. “We have a lot of employees here at CVS Health”—about 200,000—“and sometimes that becomes our best learning,” Mr. Merlo explains. A recent internal study of CVS workers who used its walk-in clinics suggested their overall health costs are 8% lower than those with the same age and health status who don’t. A shelf of academic research shows the quality of care at such clinics is the same or sometimes better than the ER.

The pharmacist, Mr. Merlo says, isn’t often imagined on the front lines of medicine—but should be. Advanced pharmaceutical therapies, for diseases like multiple sclerosis and HIV, are often more complex than simply taking a pill. But sometimes the opposite is true, and Mr. Merlo notes that adherence—ensuring that patients take the medications they are prescribed—is one area where CVS can contribute.

About half of all Americans suffer from one or more chronic conditions such as high cholesterol, diabetes or asthma. “More times than not,” Mr. Merlo says, “the treatment for those diseases is prescription therapy, and that’s where the statistics start to get alarming—it’s a huge opportunity to take unnecessary costs out of the system. One out of four people drop off therapy. They don’t even get the first refill. By the time one year goes by after someone is newly diagnosed, as many as three of four will stop taking their medication or not take the medication as prescribed.”

One consensus economic estimate is that this adds about $300 billion a year to national health expenditures—as when a patient fails to take statins and has a heart attack or stroke. The tragedy is that the sickest people tend to be the least adherent.

“There’s no one reason, there’s no one answer,” Mr. Merlo says. Forgetfulness is common. The medication’s benefits may be imperceptible and patients may not feel any different as a result, or they experience side effects like the muscle cramps of statins, or they find a treatment regimen involving multiple drugs and doses too complex to understand.

CVS has launched a campaign “to make sure that the right patient is on the right therapy at the right time at the right dosage,” Mr. Merlo says. The company aims to improve adherence by as much as 15% by 2017. The goal is to “manage the pharmacy patient, not just the administration of the drug.”

To take one example, only a few years ago prescriptions were printed out and handed to the patient or submitted to the pharmacy by fax. Physicians and pharmacists often had no idea what happened next or any reliable method to know. Now 70% of prescriptions are submitted electronically, creating a digital trail and actionable information.

CVS technologists mine prescription and claims data and “identify gaps in care and keep people on their medications,” Mr. Merlo says. The system might then send a text message when someone has forgotten to refill a prescription. A pharmacist is prompted to discuss the importance of taking medication during the patient’s next visits, and CVS alerts the prescribing doctor.

But most often, a trusted clinician who listens and seems to care is best. For all the technological progress, CVS figures a one-on-one conversation with a pharmacist is two to three times more effective than any other method to change patient behavior—in a way, the human element that often goes missing in the U.S. health-care debate.

“I can pick up the phone and in a matter of minutes I can talk to the pharmacist, I can have a conversation,” Mr. Merlo says. “Can I really do that anywhere else across health-care delivery?”

Mark it down as another way that private innovation is finding ways to serve patients despite, or because of, the policy mess in Washington.

Mr. Rago is a member of the Journal editorial board.
Logged
ccp
Power User
***
Posts: 4520


« Reply #1386 on: January 24, 2015, 07:07:33 PM »

Some of what Merlo says has validity from my point of view.   Some of it is clearly propaganda.   People can come up with data to say almost anything.

Like this notion about empowering the patient to be part of the solution and have a day in their drugs.   There is nothing new here. This was  done years ago with managed care.

One can turn it around just the opposite and say the insurance companies won't pay for the better more expensive drugs so they push the cost onto the insured.

Pharmacy benefits managers are middle men effectively so they have to justify themselves in every way imaginable.

I also question physician shortages.   By constantly claiming there are he justifies the use of nurses which he can pay less.

Even Emanuel didn't believe there is a shortage.

Of course I am biased so  no one has to take my word for anything.

But listen to the central planners with a open skeptical mind. 
Logged
Crafty_Dog
Administrator
Power User
*****
Posts: 33805


« Reply #1387 on: January 24, 2015, 10:00:51 PM »

Worthy comments.
Logged
ccp
Power User
***
Posts: 4520


« Reply #1388 on: January 25, 2015, 10:36:49 AM »

"the patient to be part of the solution and have a day in their drugs"

Correction:   I meant "have a day in selecting their drugs" with the ones not contracted to between the PBM and the drug companies having a higher co-pay cost to the patient.

What I want to ask is exactly how much of these elevated copays (making patients have skin in the game - which by itself is probably a good thing) actually translates to lower costs to all of us at the bottom line.   How do we know these savings are not mostly kept by these middle men or CVS itself?

And worst of all - whose answers to  these questions - are we to believe?   Good luck.

Please recall that I mentioned that probably 95 % of medicine research is not definitive and of questionable value.   So one can only speculate on the validity of data business people will make pronouncements about.   My ex brother in law who is a dentist once told me the dental literature was even worse than the MDs.   Of less validity.

I am not saying most of it is purposely manipulated.  I don't think that, but just that much is no of significance enough to be valid.   Listen to all the radio shows and online sales "gurus" who tell us about dozens, sometimes hundreds of research studies that purport to show a benefit of some "natural" substance in slowing disease, reversing disease, helping us live longer, feel more energy, sleep like babies, copulate like porno kings, remember everything, and have less pain.  Even the shark tank guys agreed on one show these are ALL cons.   But most if not all of these wild claims come from academic research.   I am coming to the opinion that many of these professors have to be in on these money making schemes in some way.  Either through grants, investments in some of these "businesses", or possibly even kick backs.

It is of supreme importance to think about who is doing the research.

Everyone who post on this board already knows these things  but for the rest,

Don't assume just because it comes from an academic center it doesn't have personal or political interests.    Sad to say.   Look at how environmentalists twist and cherry pick data.
« Last Edit: January 25, 2015, 10:53:59 AM by ccp » Logged
Crafty_Dog
Administrator
Power User
*****
Posts: 33805


« Reply #1389 on: January 26, 2015, 12:01:10 PM »

http://patriotpost.us/posts/32644
Logged
Crafty_Dog
Administrator
Power User
*****
Posts: 33805


« Reply #1390 on: January 27, 2015, 10:27:06 AM »

This is from a progressive site, but the point is dead on:   The Reps are years past where they should have a list of bullet points to answer the question presented here:

http://www.ifyouonlynews.com/politics/boehner-mcconnell-humiliated-when-asked-about-gop-obamacare-alternatives-they-still-got-nothin-video/
Logged
G M
Power User
***
Posts: 12599


« Reply #1391 on: January 27, 2015, 11:07:18 AM »

This is from a progressive site, but the point is dead on:   The Reps are years past where they should have a list of bullet points to answer the question presented here:

http://www.ifyouonlynews.com/politics/boehner-mcconnell-humiliated-when-asked-about-gop-obamacare-alternatives-they-still-got-nothin-video/

"Our bloated government healthcare duster cluck is better than Obama's!"
Logged
ccp
Power User
***
Posts: 4520


« Reply #1392 on: January 27, 2015, 11:09:48 AM »

Still nothing!   Wow! 

 cry
Logged
DougMacG
Power User
***
Posts: 6576


« Reply #1393 on: January 27, 2015, 11:20:28 AM »

This is from a progressive site, but the point is dead on:   The Reps are years past where they should have a list of bullet points to answer the question presented here:

http://www.ifyouonlynews.com/politics/boehner-mcconnell-humiliated-when-asked-about-gop-obamacare-alternatives-they-still-got-nothin-video/

Republicans have alternative plans, but they don't have a consensus on one - or leadership.  They can't do anything until 2017, but they can't do anything then, either, if they don't get clear and persuasive and win the argument about where we need to be heading.  

http://www.burr.senate.gov/public/index.cfm?FuseAction=PressOffice.PressReleases&ContentRecord_id=5103477b-cca0-2f3a-dd0e-a7ac35366eb4
http://2017project.org/

http://dogbrothers.com/phpBB2/index.php?topic=1411.msg84940#msg84940
http://www.nationalreview.com/article/394161/getting-beyond-obamacare-ramesh-ponnuru

Republicans need to reassure conservatives that they really will repeal Obamacare if given the chance and reassure the public at large that they will replace it in a way that does not leave millions of beneficiaries bereft. They could accomplish both of these tasks at once if they devised a conservative health-care plan that replaces Obamacare without threatening people’s coverage. Then they could commit themselves to that plan without making swing voters anxious, and thereby begin showing conservatives that they have a real plan to get rid of the law.

This course of action does not amount to searching for a unicorn. Several plans that meet these criteria have been put forward, such as the CARE Act, proposed by Senators Orrin Hatch, Richard Burr, and Tom Coburn, and a plan put forth by the 2017 Project, a conservative nonprofit (links above). The key step would be to change the tax treatment of health insurance. We now have a tax break for employer-provided health insurance, including fairly expensive employer-provided insurance. That break should be flattened — so that it no longer rewards people for choosing the most expensive insurance options, and so that people who do not have access to employer-provided plans can use an equivalent tax break to buy insurance on the individual market.

A replacement plan should also make existing entitlement programs more market-friendly. Most of Medicaid should be converted into subsidies that help beneficiaries buy into this enlarged individual market. Ideally, Medicare, too, would be converted into a system in which private plans compete for the business of empowered consumers, as almost all Republicans have already endorsed.

Plans along these lines have been estimated to be competitive with Obamacare on the number of people insured, and superior to it in cost and choice of doctors. A higher proportion of the insured would have protection from large medical expenses, and coverage would generally be of higher quality than Medicaid (which is responsible for most of Obamacare’s expansion of coverage). The resulting system would feature lower premiums and taxes than Obamacare. It would lack the law’s centralizing Medicare board and essential-benefits package, its employer mandate, and its individual mandate. It could be structured to avoid discouraging work, as Obamacare’s subsidies do.
Logged
G M
Power User
***
Posts: 12599


« Reply #1394 on: January 27, 2015, 11:28:10 AM »

We could let the free market actually determine prices and let free individual determine what kind of health care they wanted to obtain, and insurance companies could compete for business.   shocked
Logged
DougMacG
Power User
***
Posts: 6576


« Reply #1395 on: January 27, 2015, 02:45:32 PM »

We could let the free market actually determine prices and let free individual determine what kind of health care they wanted to obtain, and insurance companies could compete for business.   shocked

Exactly.  And free choices and competition are the only way that costs come down.  Now welcome to a world where the right answer is not the right answer.  Also, that is the reason why R's haven't easily settled on a solution.  The question at the moment is, what canl realistically move us in that direction.  What will turn the liberal wedge upside down?  What reverses Cloward-Piven and the current, rules for radicals sequence?

We've created generations of people for whom working for a living is an abstraction. http://en.wikipedia.org/wiki/Cloward%E2%80%93Piven_strategy

Now we need to create generations of people where the vast majority have a stake in the success of our society and feel it.  Healthcare is a big part of it.  Too many people today are ready to give up on working and earning more in order to qualify for free healthcare for life.  How do we show them the opportunity to grow their incomes to the point where market price for healthcare is affordable and acceptable?

On our current course, the government is on track to make up 66% of healthcare spending.
http://www.forbes.com/sites/chrisconover/2012/08/07/takeover-government-on-track-to-make-up-66-of-healthcare-spending-obamacare/
An element of dependency comes with that. (!)

Immediate elimination of the federal government's (mostly unconstitutional) role in healthcare opens the door for the endless and successful, taking-away-Granny's-meds, commercials and guarantees losses in elections.  Every cut in O-care will elicit the Republicans-want-to-kill-you response, but the accusation sticks better with some proposals than with others.

The Republican plans listed above do not remove the federal government but hopefully remove the dynamic where people give up and take whatever the government will give them.  The plans listed have some level of government support based on need, yet leave people with choices and, more importantly, a stake in their costs and coverage, resulting in what GM wrote above - free markets determining prices, individuals determining what kind of health care they want, and insurance companies competing for business.

The so-called ACA does none of what it promised to do.  We will not end it by standing out on a precipice and giving our opponents a clear shot to take us down.  (MHO)
Logged
Crafty_Dog
Administrator
Power User
*****
Posts: 33805


« Reply #1396 on: February 02, 2015, 12:05:03 PM »

I don't care for the tone of the article, but the question posed is one we must address.

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/15/why-an-mri-costs-1080-in-america-and-280-in-france
Logged
G M
Power User
***
Posts: 12599


« Reply #1397 on: February 02, 2015, 01:04:24 PM »

I don't care for the tone of the article, but the question posed is one we must address.

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/15/why-an-mri-costs-1080-in-america-and-280-in-france

http://www.theglobeandmail.com/life/health-and-fitness/access-to-mris-ct-scans-improving/article1389394/

An older article I saw stated that Pittsburg, PA. Had more MRI machines than all ofCanada.
Logged
DougMacG
Power User
***
Posts: 6576


« Reply #1398 on: February 02, 2015, 08:38:48 PM »


On the same line, the southwest suburbs of Mpls (also) has more MRI machines than all of Canada.  Canada has a population of 35 million so this is screwed up by a factor between 10 and 20-fold.  (I don't know about the French)

The question I think is asking us to compare apples with oranges.  One is the price charged for immediate usage of available equipment.  The other is the hypothetically cost of a service  not available without unacceptable delay - in Canada, up to 270 days for a routine orthopedic procedure.

The US cost is inflated with government dollars and other third party money payers can push the buyers out of pocket cost toward zero.  The French cost is artificially low and doesn't likely provide enough incentive to increase the large fixed cost supply of these machines to meet the demand for their service at that price.  Countries like that limit the number served some other way such as queuing and service denial.

Imagine if we legalized the MRI service and let the forces of supply and demand set the price at market equilibrium.  Wouldn't that be better than these other misallocations?


Logged
Crafty_Dog
Administrator
Power User
*****
Posts: 33805


« Reply #1399 on: February 02, 2015, 09:15:54 PM »

Good post Doug.
Logged
Pages: 1 ... 26 27 [28] 29 Print 
« previous next »
Jump to:  

Powered by MySQL Powered by PHP Powered by SMF 1.1.19 | SMF © 2013, Simple Machines Valid XHTML 1.0! Valid CSS!