Author Topic: The Politics of Health Care  (Read 573974 times)

Crafty_Dog

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President Trump's EO-- well done
« Reply #1650 on: October 13, 2017, 06:39:04 PM »


President Donald Trump signed a new executive order on Thursday that moves health care a step in the right direction.

The executive order instructs the secretaries of treasury, labor, and health and human services to propose regulatory changes that would increase choice and competition in health insurance.

This is the right course of action. In the absence of congressional action to address Obamacare’s damage, Trump is right to seek ways within his power to help those hurt by Obamacare’s skyrocketing premiums and the reduced access to quality plans.

Trump’s executive order addresses three problems that hinder people’s access to the insurance and care they need.

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First, small business employees and the self-employed are most hurt by Obamacare. The percentage of workers at small firms receiving coverage through their employer has declined from nearly half in 2010 to about one-third in 2017. They face skyrocketing premiums and reduced choice in plans.

One challenge small businesses face is that, under current interpretations of a federal employee benefit law, they are limited in their ability to band together and secure coverage similar to plans offered by larger employers.

Obamacare exacerbated that problem by imposing costly new benefit mandates on small employer plans, but not on large employer plans. Thus, Trump is right to ask the Department of Labor to help by exploring ways to update this interpretation.

A change of this sort could allow small businesses and the self-employed to escape Obamacare’s costly benefit mandates and access new options run by associations that they have a stake in.

It could also help more small employers offer coverage to their workers. Newly enrolled individuals could save money—up to 20 to 50 percent on the cost of their insurance—by taking advantage of the tax break for employer-provided health insurance.

Second, President Barack Obama’s administration sharply reduced access to a low-cost option known as short-term, limited duration insurance.

These plans are often one-third of the cost of the cheapest Obamacare plans, yet typically feature broad provider networks and high coverage limits. That makes it harder than it should be for people between jobs to access a low-cost insurance plan.

As a result, people between jobs face suboptimal choices such as buying Obamacare’s heavily regulated and expensive plans, or going on Medicaid.

To address this, Trump rightly asks the departments of the Treasury, Labor, and Health and Human Services to consider reversing Obama’s decision.

Third, the Obama administration issued regulations limiting the ability of businesses to offer their employees coverage through “Health Reimbursement Arrangements,” in order to force such plans to comply with Obamacare’s standardized, one-size-fits-all benefit design.

Yet the whole point of those plans is to give businesses and workers a tool for customizing their health benefits according to their own needs and preferences.

Thus, Trump has rightly asked the departments of the Treasury, Labor, and Health and Human Services to explore ways to revise those regulations so that employers and workers have more flexibility and choices for health benefits.

While Trump’s executive order on health care is a step in the right direction, he needs Congress to get back to work in order to more fully improve our health system. The administration can only do so much, as it has to work within the confines of exiting law, including Obamacare.

For instance, the administration likely has sufficient authority to revise the regulations on health reimbursement arrangements so that employers have new options to give workers tax-free contributions to buy the individual market coverage of their choice.

But the potential benefits of that policy change will remain largely unrealized, so long as the law prevents insurers from offering anything other than Obamacare’s limited menu of standardized, overregulated, overpriced individual market plans.

Thus, Congress needs to do its job, fully undo Obamacare’s damage, and offer broader relief to all Americans struggling with rising premium costs and reduced choice of plans.


ccp

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The medical org I have been a member
« Reply #1652 on: October 14, 2017, 06:55:33 PM »
and I pay subscriptions has become a branch outlet of the Huffington Post:

http://www.acpinternist.org/archives/2017/10/why-acp-must-speak-out-against-discrimination.htm

What the hell does this have to do with health care or representing my interests ?

G M

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Re: The medical org I have been a member
« Reply #1653 on: October 14, 2017, 07:21:04 PM »
and I pay subscriptions has become a branch outlet of the Huffington Post:

http://www.acpinternist.org/archives/2017/10/why-acp-must-speak-out-against-discrimination.htm

What the hell does this have to do with health care or representing my interests ?

Nothing at all. The left does to organizations what a virus does to a healthy cell.

Crafty_Dog

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WSJ:The False ObamaCare Sabotage Meme
« Reply #1654 on: October 15, 2017, 12:31:51 PM »
The ObamaCare ‘Sabotage’ Meme
The solution for illegal health subsidies is a bipartisan trade.
Sens. Patty Murray and Lamar Alexander in Washington, Jan. 18.
Sens. Patty Murray and Lamar Alexander in Washington, Jan. 18. Photo: Andrew Harrer/Bloomberg News
By The Editorial Board
Oct. 13, 2017 7:10 p.m. ET
369 COMMENTS

By our deadline Friday the world had continued to spin without interruption—planes taking off and landing; men and women commuting home after another week at work—and if you’re reading this then you survived the ObamaCare subsidy apocalypse of 2017. We’re referring to the political meltdown over the Trump Administration’s decision to end extralegal payments to insurers.

The White House leaked Thursday night that the government will stop making “cost-sharing” payments, which are ObamaCare subsidies for insurers that defray the cost of deductibles or co-pays for some folks below 250% of the poverty line. President Trump unloaded on Friday in one of his predawn tweets that “The Democrats ObamaCare is imploding” and “subsidy payments to their pet insurance companies has stopped.” Why he chose to swamp his Thursday health-care executive order with this fresh controversy is a mystery.

In any event, first order of business: The payments are illegal. The Affordable Care Act leaves the subsidies contingent on an annual appropriation, but since 2014 Congress has declined to dedicate the funding. The Obama Administration wrote the checks anyway, and the House of Representatives sued. Federal Judge Rosemary Collyer last year ruled that the Obama Administration had violated the Constitution, and an appeal is pending.

Mr. Trump continued the payments on the hope that Republican health-care reform would repeal ObamaCare and moot the subsidy dispute. That did not happen. Now the Administration has decided to follow the Constitution, and fidelity to the law should trump the policy merits or political risks.

The left is accusing Mr. Trump of—this is a partial list—sabotaging the Affordable Care Act; conspiring to harm the poor; sending a wrecking ball into the American health-care system; killing people. One frequent citation is a Congressional Budget Office report from August that predicted premiums would increase if the subsidies ended, which is true.

Yet CBO also noted that the added expense would be covered by subsidies for individuals that increase with premiums. The market would continue to be stable by CBO’s report, and the change won’t invite the ObamaCare death spiral that Democrats would love to pin on Republicans. More generous individual subsidies mean the insurers now predicting Armageddon will still get paid.

But more uncertainty and turmoil could still drive some users from the exchanges, and the solution is straightforward: Congress can appropriate the money in a legal fashion. Republicans have an incentive to compromise, lest they have to take responsibility for rising premiums. Democrats could in exchange agree to liberalize the insurance markets—e.g., by repealing the individual or employer mandates, or allowing more flexibility on state waivers.

Republican Senator Lamar Alexander has tried to work a deal with Democratic Senator Patty Murray, but Democrats have refused to allow states any running room to experiment, aside from de minimis paperwork exemptions. Chuck Schumer has said for months that he’d negotiate once repeal was off the table, and now we’ll find out. If Democrats really care about the poor—and fixing a problem they helped create by violating the separation of powers—then they’ll compromise.

Meantime, the insurers will uphold the great American tradition of litigation and try to force the government to fork over the money. Mr. Trump deserves credit for upholding the Constitution, but this messy episode is one more consequence of the GOP’s failure in Congress to replace the Affordable Care Act.

Crafty_Dog

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ccp

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The planners in the US would do the same thing if they could
« Reply #1656 on: October 19, 2017, 06:29:50 PM »
and they had a national health care system to tell us all what to do.

But they have no problem taxing cigarettes in Britain like here
Why not make them illegal and put smokers in jail?

Why not tax those with BMIs over 30 and those over 40 double tax and those over 50 -> jail.

What about all the drunks in England and Ireland?  Refuse them care if they don't stop drinking.

I suppose gender re assignment surgery is covered.
What about all the people spreading STDs?  Talk about irresponsible behavior.  (can't blame it on Reagan he's dead)
I could think of other examples

Make it LAW ->  1) all people must exercise for 30 minutes a day for 6 days a week

2 )  Sweets banned

3)  limit red meat to 8 oz per week per person
4 )  you must prove you are eating your greens and fruit and nuts daily

Otherwise your labeled a deplorable and SJW have the right to decide your fate.


(PS my BMI is about 26)
« Last Edit: October 19, 2017, 07:48:03 PM by ccp »

G M

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Re: The planners would do the same thing if they could
« Reply #1657 on: October 19, 2017, 06:43:34 PM »
and they had a national health care system

But they have no problem taxing cigarettes in Britain like here
Why not make them illegal and put smokers in jail?

Why not tax those with BMIs over 30 and those over 40 double tax and those over 50 -> jail.

What about all the drunks in England and Ireland?  Refuse them care if they don't stop drinking.

I suppose gender re assignment surgery is covered.
What about all the people spreading STDs?  Talk about irresponsible behavior.
I could think of other examples

Make it LAW ->  1) all people must exercise for 30 minutes a day for 6 days a week

2 )  Sweets banned

3)  limit red meat to 8 oz per week per person
4 )  you must prove you are eating our greens and fruit and nuts daily

Otherwise your labeled a deplorable and SJW have the right to decide your fate.

Most socialist paradises have been very successful at ending obesity in the general population.



ccp

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Re: The Politics of Health Care
« Reply #1658 on: October 19, 2017, 07:42:15 PM »
GM,
Yes and
Venezuela is a more recent example

ccp

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Crats : Medicare for all
« Reply #1659 on: November 09, 2017, 07:32:39 AM »
Has nice ring to it to all those who will not have to pay for it much:

http://thefederalist.com/2017/11/06/democrats-finally-admit-real-goal-single-payer-health-welfare/

DougMacG

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Re: Crats : Medicare for all
« Reply #1660 on: November 09, 2017, 07:55:26 AM »
Has nice ring to it to all those who will not have to pay for it much:

http://thefederalist.com/2017/11/06/democrats-finally-admit-real-goal-single-payer-health-welfare/

Why don't they call it V.A. for all?  Venezuela for all...

Equal requires coercion; it is not the natural state of things.

And if the wait is too long, we go to Canada, Mexico, Haiti?

ccp

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Yes!!!
« Reply #1661 on: November 14, 2017, 06:56:54 AM »
*Finally* a concise well written discussion of the political self serving often data driven drivel I am seeing regularly in the medical literature.

This weeks journal of the american [political] medical association

has two more articles about "gun violence" !!!!


What the hell does that have to do with medicine?

http://www.nationalreview.com/article/453676/doctor-screening-not-key-preventing-gun-violence

Crafty_Dog

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ccp

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Re: The Politics of Health Care
« Reply #1663 on: December 24, 2017, 02:15:00 PM »
talking head on MSNBC with the coordinated left wing attack on the tax cuts criticizing them for being not "bipartisan"  and making the ridiculous claim that bills that are not bipartisan always fail

My first thought was how come in that case she was not blasting Obamster care!


ccp

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coming ban on autonomous driving
« Reply #1664 on: December 30, 2017, 08:27:35 AM »
***At some point in the future, be it years, decades, or a century hence, the federal government will seek to ban driving. This, I’m afraid, is an inevitability. It is inexorably heading our way. The dot sits now on the horizon. As is common, the measure will be sold in the name of public health. ***   

and from same article:

****Our debate will rest largely upon charts. The American Medical Association will find “no compelling reason to permit the citizenry to drive,” and Vox will quote it daily. Concurring in this assessment will be The New England Journal of Medicine, the Center for American Progress, and the newly rechristened Mothers against Dangerous Driving,.. ****

http://www.nationalreview.com/article/455018/autonomous-vehicles-will-spark-government-efforts-ban-driving

Mr Charles Cooke is EXACTLY right that medical organizations have in the past few yrs become propagandist  tools for the LEFT radicals.  Health care has never been more political . 

A recent JAMA (journal of the American [left wing] medical association ) had recent articles about firearms and now this month's Annals of Internal Medicine had half the journal dedicated to LEFT wing propaganda and again telling all doctors it is their duty to discuss guns with all patients and be a force for action (political activism ) for an assault on the Second Amendment .

Check out all these articles just from ONE journal this past month .  One could just imagine the authors are from Hollywood, the DNC or from faux - Pochahantus ' family:

http://annals.org/aim/fullarticle/2659346/state-interstate-associations-between-gun-shows-firearm-deaths-injuries-quasi

http://annals.org/aim/fullarticle/2659347/firearm-injury-after-gun-shows-evidence-gauge-potential-impact-regulatory

http://annals.org/aim/fullarticle/2658284/what-you-can-do-stop-firearm-violence

http://annals.org/aim/fullarticle/2658283/health-care-professional-s-pledge-protecting-our-patients-from-firearm

G M

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Re: coming ban on autonomous driving
« Reply #1665 on: December 30, 2017, 02:31:13 PM »
***At some point in the future, be it years, decades, or a century hence, the federal government will seek to ban driving. This, I’m afraid, is an inevitability. It is inexorably heading our way. The dot sits now on the horizon. As is common, the measure will be sold in the name of public health. ***   

and from same article:

****Our debate will rest largely upon charts. The American Medical Association will find “no compelling reason to permit the citizenry to drive,” and Vox will quote it daily. Concurring in this assessment will be The New England Journal of Medicine, the Center for American Progress, and the newly rechristened Mothers against Dangerous Driving,.. ****

http://www.nationalreview.com/article/455018/autonomous-vehicles-will-spark-government-efforts-ban-driving

Mr Charles Cooke is EXACTLY right that medical organizations have in the past few yrs become propagandist  tools for the LEFT radicals.  Health care has never been more political . 

A recent JAMA (journal of the American [left wing] medical association ) had recent articles about firearms and now this month's Annals of Internal Medicine had half the journal dedicated to LEFT wing propaganda and again telling all doctors it is their duty to discuss guns with all patients and be a force for action (political activism ) for an assault on the Second Amendment .

Check out all these articles just from ONE journal this past month .  One could just imagine the authors are from Hollywood, the DNC or from faux - Pochahantus ' family:

http://annals.org/aim/fullarticle/2659346/state-interstate-associations-between-gun-shows-firearm-deaths-injuries-quasi

http://annals.org/aim/fullarticle/2659347/firearm-injury-after-gun-shows-evidence-gauge-potential-impact-regulatory

http://annals.org/aim/fullarticle/2658284/what-you-can-do-stop-firearm-violence

http://annals.org/aim/fullarticle/2658283/health-care-professional-s-pledge-protecting-our-patients-from-firearm

There will be a direct and undeniable connection from those trying to take away guns from free people and those would be gun grabbers suffering GSW.

DougMacG

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Re: coming ban on autonomous driving
« Reply #1666 on: January 01, 2018, 04:46:12 PM »
[I forgot, what is GSW?]

I had the opportunity to drive a friend's top of the line Tesla this past year.  Besides accelerating 15-85 in 2 seconds with all wheel drive traction, you tap the cruise control twice and it shifts into 'self drive' mode.  Change lanes with the tap of a turn signal and keep a safe distance from the car in front of you - without your attention.  This is amazingly cool technology that will soon be reasonably affordable to many new cars and has great safety enhancement possibilities.  But I too fear / know that the central planners would love to use this power to stop us from driving, and control who can use our roads, when, at what speed, by what route, etc etc.

When they say switch to driverless vehicles, I say show me that you solved the hacking and cyber warfare issue for good.  But even then, this is an issue of liberty.  In spite of the dangers and costs, it was and is one of the most liberating moments of your life when you get your own car and can go where you want, when you want.  You were now in charge instead of your parents or school bus driver.  Therefore, it will be one of the greatest losses possible when they take that away - in the name of 'safety' and 'public health', and then the state is in charge, not you.

G M

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Re: The Politics of Health Care
« Reply #1667 on: January 01, 2018, 10:47:46 PM »
GSW=Gunshot wounds

G M

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Re: coming ban on autonomous driving
« Reply #1668 on: January 01, 2018, 10:49:56 PM »
This is a major issue on the horizon.


[I forgot, what is GSW?]

I had the opportunity to drive a friend's top of the line Tesla this past year.  Besides accelerating 15-85 in 2 seconds with all wheel drive traction, you tap the cruise control twice and it shifts into 'self drive' mode.  Change lanes with the tap of a turn signal and keep a safe distance from the car in front of you - without your attention.  This is amazingly cool technology that will soon be reasonably affordable to many new cars and has great safety enhancement possibilities.  But I too fear / know that the central planners would love to use this power to stop us from driving, and control who can use our roads, when, at what speed, by what route, etc etc.

When they say switch to driverless vehicles, I say show me that you solved the hacking and cyber warfare issue for good.  But even then, this is an issue of liberty.  In spite of the dangers and costs, it was and is one of the most liberating moments of your life when you get your own car and can go where you want, when you want.  You were now in charge instead of your parents or school bus driver.  Therefore, it will be one of the greatest losses possible when they take that away - in the name of 'safety' and 'public health', and then the state is in charge, not you.

Crafty_Dog

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MORRIS: TRUMP nails it
« Reply #1669 on: January 08, 2018, 05:07:20 PM »
Trump To End ObamaCare As We Know It
By DICK MORRIS
Published on DickMorris.com on January 8, 2018

The other shoe in Donald Trump's war on ObamaCare is about to drop.  It will end ObamaCare as we know it.

The first step in ending this obnoxious, intrusive program was to end the requirement that everybody must have health insurance coverage.  Thanks to deft manuring by a unanimous Senate majority, this diktat was lifted in the Christmas tax cut.

Now, the second step is about to happen: Trump will eliminate the requirement that all ObamaCare policies cover everything -- from psychological counseling to drug addiction therapy to maternity benefits to smoker cessation to sex change operations whether the customer wants it or can afford it or not.
 
It is this requirement -- enacted at the behest of the various lobbyists representing the provider organizations -- that has forced up the cost of ObamaCare, triggering the need for massive taxpayer subsidy, and putting its premiums and deductibles, even after the federal subsidy, out of reach for many Americans.

But, soon you will be able to buy what coverage you want from ObamaCare without restriction or buy nothing at all.

Eureka!

All of the prodigious efforts of Texas Senator Ted Cruz (R-TX) and others to make these changes by amendment are now being swept up in a massive rule change by the Administration.

With this change, ObamaCare could become just one of the many options consumers have and not a particularly bad one at that.

To make this change work within the current statutory language, Trump will loosen the rules governing small businesses that band together to buy health insurance, through what are known as association health plans.  This change, recommended in this column for months, will allow them to circumvent ObamaCare's regulations.  Under the new rules, associations will be able to buy cheaper health insurance that won't cover the ten "essential health benefits" mandated in ObamaCare.

Trump is also expected to allow the expansion emergency, short-term health insurance plans, allowing them to last for an entire year and to be renewed.  These plans would be exempt from the regulations governing ObamaCare policies, meaning that insurers will be able to charge more for people with pre-existing conditions.  (But, don't worry, those with major pre-existing conditions -- that make policies unaffordable -- will still be able to get low cost coverage through the Pre-Existing Conditions Insurance Program (PCIP) created by ObamaCare and unaffected by the current regulations.  Currently, over 100,000 people are covered by PCIP.

If, as Democrats contend, President Trump is losing it mentally, he must still have something upstairs to come up with so deft a way of reforming ObamaCare by regulation.

Crafty_Dog

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Trump officials move to allow Medicaid work requirements
« Reply #1670 on: January 11, 2018, 05:29:51 AM »
Trump officials move to allow Medicaid work requirements

The Trump administration on Thursday unveiled guidance allowing states for the first time to impose work requirements in Medicaid, a major shift in the health insurance program for the poor.

The move opens the door for states to apply for waivers to allow them to require Medicaid enrollees to work in order to receive coverage.

Crafty_Dog

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WSJ: A Canadian calls for more free market
« Reply #1671 on: January 22, 2018, 10:12:55 AM »
Single-Payer Health Care Isn’t Worth Waiting For
An orthopedic surgeon challenges Canada’s ban on most privately funded procedures.
by Sally C. Pipes
Jan. 21, 2018 3:27 p.m. ET

When Brian Day opened the Cambie Surgery Centre in 1996, he had a simple goal. Dr. Day, an orthopedic surgeon from Vancouver, British Columbia, wanted to provide timely, state-of-the-art medical care to Canadians who were unwilling to wait months—even years—for surgery they needed. Canada’s single-payer health-care system, known as Medicare, is notoriously sluggish. But private clinics like Cambie are prohibited from charging most patients for operations that public hospitals provide free. Dr. Day is challenging that prohibition before the provincial Supreme Court. If it rules in his favor, it could alter the future of Canadian health care.


Most Canadian hospitals are privately owned and operated but have just one paying “client”—the provincial government. The federal government in Ottawa helps fund the system, but the provinces pay directly for care. Some Canadians have other options, however. Private clinics like Cambie initially sprang up to treat members of the armed forces, Royal Canadian Mounted Police officers, those covered by workers’ compensation and other protected classes exempt from the single-payer system.

People stuck on Medicare waiting lists can only dream of timely care. Last year, the median wait between referral from a general practitioner and treatment from a specialist was 21.2 weeks, or about five months—more than double the wait a quarter-century ago. Worse, the provincial governments lie about the extent of the problem. The official clock starts only when a surgeon books the patient, not when a general practitioner makes the referral. That adds months and sometimes much longer. In Novemberan Ontario woman learned she’d have to wait 4½ years to see a neurologist.


Some patients would gladly go to a clinic like Cambie for expedited care, paying either directly with their own money or indirectly via private insurance. But Canadian law bans private coverage for “medically necessary care” the public system provides and effectively forbids clinics from charging patients directly for such services. The government views this behavior as paying doctors to cut in line. Doctors who accept such payments can be booted from the single-payer system.


Dr. Day’s lawsuit aims to overturn these provisions. It alleges that the government’s legal restrictions on private care are to blame for the needless “suffering and deaths of people on wait lists.” Dr. Day argues that the current system violates citizens’ rights to “life, liberty, and security of the person,” as guaranteed by the Canadian Charter of Rights and Freedoms, the equivalent of the U.S. Bill of Rights.

Moreover, Dr. Day claims the government has long tacitly approved of patients paying private clinics out of their own pockets. For decades, he argues, conservative and liberal politicians have offered him quiet praise and encouragement even as they publicly defend the single-payer system. It’s easy to understand why Canada’s leaders would talk out of both sides of their mouths. Private clinics perform more than 60,000 operations a year, saving the public treasury about $240 million.

British Columbia’s lawyers know that Dr. Day could embarrass Canada’s double-talking politicians by naming them at trial. This could explain the endless stream of seemingly deliberate delays that have kept the court proceedings moving at a snail’s pace. Dr. Day and his colleagues were supposed to testify in November but may not take the witness stand until February or March at the earliest.

Canadians have suffered long enough under single-payer waiting lists. There shouldn’t be a waiting list for justice, too.

Ms. Pipes is president and CEO of the Pacific Research Institute and author of “The False Promise of Single-Payer Health Care,” forthcoming from Encounter.

Crafty_Dog

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POTH: The Chilean Option
« Reply #1672 on: February 07, 2018, 09:16:57 PM »


SANTIAGO, Chile — They killed Tony the Tiger. They did away with Cheetos’ Chester Cheetah. They banned Kinder Surprise, the chocolate eggs with a hidden toy.

The Chilean government, facing skyrocketing rates of obesity, is waging war on unhealthy foods with a phalanx of marketing restrictions, mandatory packaging redesigns and labeling rules aimed at transforming the eating habits of 18 million people.

Nutrition experts say the measures are the world’s most ambitious attempt to remake a country’s food culture, and could be a model for how to turn the tide on a global obesity epidemic that researchers say contributes to four million premature deaths a year.

“It’s hard to overstate how significant Chile’s actions are — or how hard it has been to get there in the face of the usual pressures,” said Stephen Simpson, director of the Charles Perkins Centre, an organization of scholars focused on nutrition and obesity science and policy. The multibillion dollar food and soda industries have exerted those pressures to successfully stave off regulation in many other countries.

Since the food law was enacted two years ago, it has forced multinational behemoths like Kellogg to remove iconic cartoon characters from sugary cereal boxes and banned the sale of candy like Kinder Surprise that use trinkets to lure young consumers. The law prohibits the sale of junk food like ice cream, chocolate and potato chips in Chilean schools and proscribes such products from being advertised during television programs or on websites aimed at young audiences.

Beginning next year, such ads will be scrubbed entirely from TV, radio and movie theaters between 6 a.m. and 10 p.m. In an effort to encourage breast-feeding, a ban on marketing infant formula kicks in this spring.

Still craving Coca-Cola? In Chile, beverages high in sugar include an 18 percent tax, which is among the steepest soda taxes in the world.

The linchpin of the initiative is a new labeling system that requires packaged food companies to prominently display black warning logos in the shape of a stop sign on items high in sugar, salt, calories or saturated fat.

The food industry calls the rules government overreach. Felipe Lira, the director of Chilealimentos, an industry association, said the new nutrition labels were confusing and “invasive,” and that the marketing restrictions were based on a scientifically flawed correlation between the promotion of unhealthy foods and weight gain. “We believe that the best way to approach the problem of obesity is through consumer education that changes people’s habits,” he said in an emailed statement.

PepsiCo, the maker of Cheetos, and Kellogg’s, producer of Frosted Flakes, have gone to court, arguing that the regulations infringe on their intellectual property. The case is pending.

G M

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Re: The Politics of Health Care
« Reply #1673 on: February 08, 2018, 07:18:08 AM »
Venezuela has been very effective in reducing obesity through policy.



Crafty_Dog

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The Trillion Dollar Surprise in the Budget Deal
« Reply #1676 on: February 27, 2018, 05:52:57 AM »
https://www.forbes.com/sites/johngoodman/2018/02/22/the-trillion-dollar-surprise-in-the-budget-deal/2/#c7779ad4bc93

Came across this article on Alan Reynolds twitter-- hat tip to Doug on his post on the SC&H "Economics" thread.
« Last Edit: February 27, 2018, 05:54:44 AM by Crafty_Dog »


ccp

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Lib doctor just cannot control himself
« Reply #1678 on: March 12, 2018, 05:25:34 AM »
Just has to speak out.
Oh, the whole teaching hospital was so depressed when their gal lost :

http://annals.org/aim/article-abstract/2672915/politics-professionalism

I agree about the personal nature of Trump actually is offensive, but the rest is just Democrat Party lamenting drivel.

DougMacG

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The Politics of Health Care: Why Little Alfie Evans had to Die (??)
« Reply #1679 on: May 02, 2018, 06:15:00 AM »
It's not often I ask people to read Sparta Report but they published a very worthwhile twitter feed here.  The author wrote a long string of tweets that describes the whole ordeal.  I have no personal idea of the accuracy of this but it seems to be well informed, linked and documented.  The author worked in the past for the NHS.
https://www.spartareport.com/2018/05/alfie-evans-had-to-die/

At the start I didn't know which way the author was going with this.  None of us know when the exact right time is to pull the plug on a person who is not recovering.  The most important part to me is who should decide.  When there is a loving family involved, it is not government that should decide.  The only power a health insurer or government agency should have in these cases is to decide when they should not have to expend more of their resources toward what they believe is not a viable cause.  At some point they are entitled to have a bed back to treat another patient.  That does not mean they should have any power over anyone to not pursue treatment somewhere else at their own expense.

Read through this and decide for yourself.  The UK NHS has some say in the matter of care, end of life care(?), because it is a nation of national health care, socialized medicine, and they have scarce resources to treat an abundance of needs.  But that was not the issue with little Alfie.  The question was whether they would release him to the wishes of his family to pursue treatment somewhere else and on that question they got it horribly wrong.

Alleged by the writer, this facility provides horrible care and they got this horribly wrong because of an arrogance of life ending consequence.  Because we can't cure him, no one can.  That is unscientific and very likely to be wrong. 

What is the harm of trying something different with a terminal patient?

ccp

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Re: The Politics of Health Care
« Reply #1680 on: May 02, 2018, 07:37:30 AM »
Doug

this is a really difficult situation
and every one IMHO is unique

I recall reading  the case of this little girl it was offered to bring her to US for some other form of treatment.
seems on the face of it to be worth a try.

OTOH if her brain is permanently damaged it is permanently damaged .

I have been doctor to situations where patients are completely brain dead or very brain damaged but on "life" support .  
Sometimes the family is not realistic and it is true to say they have lost all objectivity because it is a loved one they cannot in mind and heart let go.

Yet the other TRUTH is it might cost $100s of thousands to keep the patient's heart and lungs and kidneys going with no further hope then just that .

This might sound harsh but I guarantee that in most of these situations the insurance often pays for it all.. IF the family had to shoulder any of the cost their sentiments might change - and fast.   That IS a factor  like it or not.

I admit I have not studied the case in England that the political "RIGHT" is holding it up as some sort of great example about the slippery slope of someone else deciding about the decision to pull the plug
but I see the opposite side about cost .  When a family is in dream world why should everyone else have to pay to keep the essentially brain dead pt with no hope going on life support?

  I do remember two specific cases .
One a man in his 40 s who had major irreversible brain damage from a large stroke.

He was on life support for a year and his family refused removing him from breathing machine and tube feeding even though there was zero chance of recovery. In the middle of the night I was the intern "on call"  when his nurse called (after  she inadvertently pulled out the breathing tube)  ; he passed away . I recall calling his designated family member to inform him of the sad news .  After I told him what happened I could here
the man on the other end of the phone say  to his wife "daddy passed away".  And then he added "thank God"  .  

Another time a loving son and husband would come in daily to hold hands with the women also in her 50 s  who also was so brain damaged also from stroke that she couldn't respond to them or even know they existed.  For months doctors suggested gently to them to let her go.  husband though it reasonable son would not agree.

AFfer long discussions with both and they could over time see she was not getting better and she would get the  inevitable  infections etc they agreed to stop life support.
After we stopped life support and they had time to grieve they actually thanked me for doing the "right thing" .  It was time and they were relieved of their stress.

I believe the Right's holding this little girl's case up as a bona fide good example of the danger of someone else deciding for the family is  wrong - just my take -> this is NOT a good example .  Again just my opinion and everyone has one about these things.
« Last Edit: May 02, 2018, 07:41:36 AM by ccp »

G M

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Why do once-great nations crumble and fall?
« Reply #1681 on: May 02, 2018, 08:20:30 AM »
http://coldfury.com/2018/04/28/why-do-once-great-nations-crumble-and-fall/

Why do once-great nations crumble and fall?

 Posted on 4/28/2018      by Mike     
Because they deserve to.

Like the parents of Charlie Gard – another child similarly condemned to death by a preening NHS – Alfie’s parents disagreed with the hospital’s plans to abandon further treatment and remove life support from their son.  They began to investigate alternatives for care outside the NHS system, never suspecting that the state-run system would see their love for their child as a threat to the NHS and would respond with ferocity.

Alder Hey’s physicians have been unrelenting in their abandonment of this child, having decided more than a year ago, in February of 2017, that Alfie should quit embarrassing them by surviving in spite of receiving no treatment and get on with the business of the afterlife.

Since making that decision, the hospital has refused to perform even the most common of procedures for a patient with Alfie’s needs, such as a tracheostomy to facilitate easier breathing or a gastrostomy feeding tube for nutrition and medication.

For all this time, Alfie has been fed through a nasal tube, never intended as a permanent solution, but rather as a stopgap (weeks, not months) designed to be used until a g-tube can be placed.

The medical treatment Alfie has received is abominable, as a direct result of the hospital’s decision, and subsequent criminal obstinacy toward anyone suggesting that their prognosis might be in error.

To hear the barristers for Alder Hey wax poetic about the “first class care” given Alfie by the NHS (parroted by judge after judge in court proceedings) is indeed revolting – the British equivalent of Baghdad Bob. In truth, they have made no attempt to diagnose Alfie’s condition, preferring instead to place him on heavily sedating anti-seizure medications, then claiming that his lethargy is further evidence of his irreversible decline.

The world is witness to slow-motion murder. The perpetrators are the NHS, and the motive is not pecuniary, but rather a perverse form of institutional vanity.

Italy has conferred citizenship to Alfie, and there is a medical air ambulance standing by at the request of the pope to fly Alfie to the Vatican’s children’s hospital, Bambino Gesù, where Alfie can be treated.

But while socialism requires citizen confidence to operate, it will settle for coercion to gain compliance. This is why Alder Hey refuses to release Alfie. Should the boy survive outside NHS care, their “infallibility” would be shattered, and (gasp!) the sheep may begin to question their shepherd.

Collectivist schemes of medicine are no more sustainable (or just!) than collectivist schemes of societal order. Both require submission, even unto death.

The only “life unworthy of life” is that of the arrogant, self-congratulatory medical murderers of the NHS and their judicial enablers. May God’s judgment be realized in the fullest.

Amen to that. The decree refusing to allow the child to be flown to Italy for treatment at precisely no cost to anybody is what shifts this from typical bureaucratic heartlessness and obstinacy into the realm of purest evil. No caring person—no healer worthy of the designation—would ever countenance being party to such an atrocity.

But these are neither caring people nor healers. We’re talking here about monsters, abominations. To grant them an indulgence they in no way deserve by calling them “human” besmirches the word itself.

Yet instead of being righteously cast out of decent society as they should be—shunned to grub about its margins in wretched disgrace and deprivation—they’re running the damned place. Astoundingly, incomprehensibly, it gets even worse (see the attached threatening Tweet from the Merseyside Police for that). Perhaps worse still, the Facebook post linked in the Tweet is chock-full of nitwit statements of support for the NHS posted by Old Blighty’s bleating sheeple.

Maybe it would be better after all if little Alfie winds up succumbing to England’s inhuman savagery and indifference in the end and passes on to a better place. It might be better than living out his life in such a place, forced to acknowledge such contemptible curs as his countrymen.

May the perpetrators of this repulsive display of wanton cruelty burn in the hottest fires of Hell for all eternity.

And yeah, when the day comes that America’s government-(mis)run health-care system has attained this summit of degeneracy, I think everyone here will agree that it is DEFINITELY time to start shooting the bastards.

Update! The cold, hard truth:

If you don’t understand why the NHS and British courts refused, you don’t get socialized medicine. It is not, nor has it ever been, about health care. It’s about power. Once a government — any government — takes control of your health care, they own you and your children. Alfie’s parents and the British public had for months demanded Alfie’s release just to seek treatment by doctors competent enough to figure out what was wrong with him. But, for a socialized system, that’s dangerous. It implies that an individual Brit has rights not bestowed by the state.

In a social “democracy” like Great Britain, the state isn’t there for the purpose of serving the people — sick or otherwise. The people are there for the purposes of the state. If the state can hold your child hostage in a hospital whose doctors are too incompetent to arrive at a diagnosis — yet may terminate his life without your permission — neither you nor your child are “free” in any meaningful sense of the word. And this doesn’t stop at health care, of course. Remember Brexit? What happened when the voters of Great Britain made their wishes known regarding the European Union? The will of the British electorate was ignored.

Likewise, the wishes of Alfie’s parents never meant anything. Nor did the overwhelming public support they received. It is the “interests” of the state that matter in Perfidious Albion, and they have little or nothing to do with those of the “free people” who populate that benighted isle. There is only one way that Alfie is ever going to escape the clutches of the state apparatus they call, with no intentional irony, the National Health Service. The NHS and Alder Hey Children’s Hospital was always going to have the final word on Alfie’s fate.

The most chilling thing about all this has little to do with Britain or its inhabitants; the people of Europe have for centuries been perfectly willing to subject themselves to despotism, oppression, and abuse by tyrants—nor have they ever suffered a shortage of would-be dictators willing to step up and take the job. It’s that here in America, a substantial percentage of our own population demands that we walk down this exact same ruinous road ourselves.

Which in turn is why, in my more pessimistic moments, I’m convinced that either a conflagration or a breakup is inevitable. How can people who cherish liberty and self-determination peacefully coexist for long with grasping, megalomaniacal fools and still call themselves free?

DougMacG

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Re: The Politics of Health Care
« Reply #1682 on: May 02, 2018, 09:10:22 AM »
Thanks ccp.  Great points.
"I see the opposite side about cost .  When a family is in dream world why should everyone else have to pay to keep the essentially brain dead pt with no hope going on life support?"

I agree with you on that.  I understand that a financial decision has to be made at some point no matter who is paying.  But in this case, the 'state' took custody to prevent family from trying something else, somewhere else.  It was about power, not resources.  The agency's only interest should have been to end their efforts, not to prevent other options.

"if her brain is permanently damaged it is permanently damaged "

Yes, and keyword, if.  That is exactly right all the time - except when they're wrong.  A more difficult ethical question is what is the value of a life with a partially damaged brain if they do recover. My cousin came out of 6 month coma; he is a burden but has a reasonable life. A great guy in a wheelchair, he requires permanent care.  Were they wrong to keep him alive?  Probably an unanswerable question.

We treat or cure things every day, every year, that used to be untreatable, incurable.  My guess is that they would have failed with this British kid at the next place too, but somebody might have learned something that helps the next person.  And the parents would believe they tried everything they could.
-----------
My own chip on my shoulder isn't perfectly analogous, they weren't going to put me down.  I was hit by a 50 mph car as a pedestrian at age 17, hit and run, left to die below the highway in freezing cold rain, discovered by luck or fate, rescued, then told not likely to walk again, quite dis-spiriting for a teenager.  All those different doctors and all their different opinions during college years is the short story.  At 21 I canceled my appointment at Mayo Clinic to have my leg re-broken and tried my luck on my own ever since not to see a doc again until colonoscopy age.  Slow recovery but fun proving them wrong.  I missed the college tennis of my peers but by my 50s and now 60s have accumulated city, state and USTA section titles and wins over guys who won NCAA championships while I was in handicapped parking.  I play hockey with former olympians and extreme skiing at 61 with 20 year olds.  I still have pain, a lift and a limp but it beats the alternatives.

I respect doctors and all they face. You see them get things wrong too, I imagine.  God, fate, luck and imperfect information have a role in it.

ccp

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Re: The Politics of Health Care
« Reply #1683 on: May 02, 2018, 03:06:31 PM »
all good points

that is why I suggested each case is unique and needs its own separate evaluation with input from all sides

I am not sure why England did not let the patient go to the States whether political or other.  Could they have absolutely prevented the family from taking him in some sort of air ambulance?
expensive to be sure but maybe crowdfunding would have helped

" I was hit by a 50 mph car as a pedestrian at age 17, hit and run, left to die below the highway in freezing cold rain, discovered by luck or fate, rescued, then told not likely to walk again, quite dis-spiriting for a teenager. "

unbelievable story.  I take it the driver who hit you was never found?

no doubt we doctors are not always right!!!

DougMacG

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Re: The Politics of Health Care
« Reply #1684 on: May 04, 2018, 10:42:59 AM »
ccp, No they never caught the hit-and-run driver. Never really investigated, it wasn't a felony then.

ccp

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Re: The Politics of Health Care
« Reply #1685 on: May 04, 2018, 01:14:18 PM »
"Never really investigated, it wasn't a felony then"

I didn't remember it wasn't .  Unless it was different in NJ.

Extreme skiing!

Well I do lots of extreme surfing.  Channel surfing  :lol:

G M

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Re: The Politics of Health Care
« Reply #1686 on: May 04, 2018, 01:58:00 PM »
"Never really investigated, it wasn't a felony then"

I didn't remember it wasn't .  Unless it was different in NJ.

Extreme skiing!

Well I do lots of extreme surfing.  Channel surfing  :lol:

You watch MSLSD, that's something too extremely nausea inducing for me to handle.  :-D

DougMacG

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Re: The Politics of Health Care
« Reply #1687 on: May 07, 2018, 10:04:23 AM »
"Extreme skiing!"

Yes, it's a crucial part of my health care plan.  )  One place we went this year was Valhalla, British Columbia in January where they take you by helicopter, or snowcat in our case, to continuous runs all day, untracked in 14 feet of fresh powder, steep, deep, cliffs, chutes and through the trees.  20 people share a mountain 6 times the area of Whistler Blackcomb, Canada's largest ski resort.  Guides work non-stop to manage the avalanche risk.  Medical evacuation insurance is included.   https://www.valhallapow.com/ 
https://www.youtube.com/watch?time_continue=53&v=0NjNeZzgoI8

The A - Z Chutes at Big Sky Montana, what could possibly go wrong?
https://www.youtube.com/watch?v=Z1LlvwF-y9Q

My Vail season pass shows "1,217,974" vertical feet tracked.  A typical day equals about three parachute descents.

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Crafty_Dog

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On the horizon: AR and VR
« Reply #1689 on: May 31, 2018, 08:49:40 AM »
John Spooner, Rosanna Jimenez

Augmented reality (AR) and virtual reality (VR) are technologies whose terms are often used interchangeably and thought of strictly as enhancements for entertainment or equipment maintenance. However, they are getting new attention in healthcare across a range of use cases, most often as tools for treating patients and training doctors.
AR is showing early promise in treating PTSD (post-traumatic stress disorder) and substance abuse disorders. VR is also showing similar spark for a range of training and assistance use cases, just as it has in manufacturing, where it is a key assistant in training and performing machine maintenance.

451 Research defines VR as a 'completely immersive replication of the user's world.' The ability to create a controlled immersive environment makes it possible to design new kinds of therapies for patients, ranging from those battling substance abuse and serious injury as well as chronic pain to those suffering from PTSD and aging.
Albert Rizzo, director for medical virtual reality at the University of Southern California's Institute for Creative Technologies, called the use of VR in treating PTSD among soldiers "hard medicine for a hard problem." As part of its effort to treat PTSD, the university's Bravemind project is applying VR technology to re-immerse soldiers in battlefield situations then provide them with immediate therapy.

The 451 Take

The use of AR and VR technologies in healthcare is still nascent. But there is potential for the technologies, used individually or in combinations, to transform the traditional ways patients are treated, particularly for pain, paralysis and psychological trauma.

When applied in clinical trials, AR technology has shown positive results in enhancing some treatments, such as for PTSD; replacing some others, such as opioids for chronic pain; and in creating certain new therapies, such as achieving some level of mobility for victims of paralysis. The collective results show that AR holds promise for new ways of treating patients, while VR shows promise in training and assisting doctors.

Despite initial progress, a wide range of additional clinical trials and government approvals are needed to secure the technology's place in approved methods of treatment within patient care plans. As with most applications of technology in directly treating patients in healthcare, testing will take time and vendors must show both clinical success and provide a return on investment without forcing clinicians to become IT experts.

That testing, along with approvals by regulatory bodies such as the US Food and Drug Administration (FDA), will take years and cost millions. Vendors are already getting started through a broad range of partnerships with healthcare providers and payers.

Clinicians' Challenges

Clinicians generally see promise in using AR and VR, sometimes together, in reinventing how patients are treated, particularly for pain and psychological trauma. The use cases for AR and/or VR in healthcare generally fall into three buckets.

First is the creation of new treatments for chronic conditions and mental health problems, such as post-traumatic stress, which favor AR. Second are training and assistance, especially for complicated procedures, which favor VR. Third is the augmentation of existing medical treatment procedures for alleviating physical injuries that result in chronic pain or paralysis and assist aging patients in managing cognitive decline.

These are mainly focused on AR but can use elements of both technologies. The challenge for clinicians is in proving the clinical impact of these technologies so they can be considered viable replacements for traditional treatments, such as prescribing opioids for pain. Whether AR-focused, VR-focused or using some combination, putting these technologies to work for patients requires close partnerships between technology vendors and clinicians.

Many such partnerships are underway; for example, Dell Technologies working with the USC Institute for Creative Technologies and supporting its Bravemind program and Samsung working with appliedVR and Cedars-Sinai for pain management. The vendors are supporting these efforts with a range of assets from providing hardware and software as well as platforms to providing technical assistance and funding. Dell pledged a $100,000 grant to Bravemind in May.

Vendors' Opportunities

Although costly to prove as a means of treatment, there is much potential opportunity for AR and VR vendors. The technology is applicable across treatments provided by the spectrum of healthcare institutions including outpatient clinics, long-term care facilities and hospitals, while addressing the range of patient populations from young and relatively healthy to the chronically ill and aging.

Vendors are pursuing AR and VR adoption through continued product development and providing support for applicable medical content, plus investment in supporting a broad range of clinical trials that test AR and VR across the range of treatments previously described in this report. Samsung, for one, has supported several medical studies using its Gear VR device for pain management, treating paralysis, diagnosing macular degeneration and even diagnosing and treating concussions.
The following are examples of several AR and VR vendors applying the technologies to a range of healthcare use cases.

VR for Treatment

Samsung Electronics has partnered broadly and is one of the most active VR providers in healthcare. In one partnership, with appliedVR and Cedars-Sinai, the company is supporting the study of VR for pain management and opioid replacement.

In another treatment example, Limbix VR enables therapists to provide a guided VR experience for mental health, addressing problems such as phobias. By placing a patient in a realistic but controlled VR environment built of images and videos, clinicians can gradually expose patients to situations that cause distress while maintaining safety.
Oculus VR, known for going from Kickstarter to a $2bn acquisition by Facebook, is using its Oculus Rift VR headset in a range of applications, including investigating treatments for conversion disorder, in which mental stresses are converted into physical symptoms.

AR for Medical Training

Surgical Theater, of Mayfield, Ohio, says it applies fighter jet simulation technology to neurosurgery. The company's Precision VR merges 2-D brain scans to create patient-specific VR reconstructions that help surgeons better study and treat neurological problems.
Evena Medical offers an AR approach to phlebotomy training, by using its headset to depict a patient's vascular system to offer digitally mediated support for those less skilled in the practice or save time for those who are.

Oculus VR is also pursuing medical training use cases, including partnering with Children's Hospital Los Angeles in 2017 to build a VR simulation for medical training.

Benefits to Providers and Patients

The increasing use of AR and VR technologies in treatment, especially, and training follows a general trend toward applying information technology and IoT technology-enhanced treatments, specifically, to address healthcare market trends.

Providers and payers are looking to lower costs and also treat larger numbers of patients by making treatments more readily available via telemedicine and remote monitoring. This trend has healthcare providers and payers collaborating to move along the path to proactive outpatient-based treatment and monitoring, performed remotely, for a larger population.

In theory, the shift toward proactive outpatient care, away from a reactive inpatient treatment model, can reduce costs for payers and patients by focusing on leveraging technology to monitor and treat patients at home.

This keeps patients at home for longer, reducing hospital admissions or readmissions, driving down costs. At the same time, increasing the number of patients that can be monitored or evaluated by a given clinician in a given day has potential to bolster revenue for providers by allowing them to follow, treat and thus bill for more patients. AR and VR technologies would become part of these processes.

DougMacG

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New court case against Obamacare could hurt Republicans
« Reply #1690 on: June 15, 2018, 08:18:54 AM »
At the time Obamacare was passed without a single Republican vote, Republicans had already conceded they would support pre-existing conditions in a plan, really the only popular part of Obamacare.  With Obamacare going down in flames now, we are back to square one.

There HAS to be a catch with pre-existing conditions coverage or else everyone would wait for their 'pre-existing' condition to materialize in order to buy coverage, ending the entire concept of insurance.

In 2017, R's tried hard to repeal and replace Obamacare.  The effort failed when not all Republicans got on board.  As an serious, private sector based proposal needs to, there were curtailments on pre-existing coverage and they were hammered on that in the liberal press.

This needs to be solved actuarially and this needs to be solved politically by republicans or else the public will turn to the other side for their 'solution'.

Republicans need to go on the offensive SOON with new laws that open up all kinds of new plans at lower prices and steal this issue back from the party that brought us the last Obamination abomination, Unaffordable healthcare Act.

https://www.cbsnews.com/news/pre-existing-conditions-coverage-at-risk-more-than-thought-obamacare/
https://www.politico.com/story/2018/06/07/obamacare-trump-administration-court-case-texas-606930

[2017]
https://www.theatlantic.com/business/archive/2017/06/ahca-senate-bill-preexisting-conditions/531375/
https://www.huffingtonpost.com/entry/gop-senate-health-care-bill-preexisting-conditions_us_5967b4c6e4b03389bb15e1fe
https://www.usatoday.com/story/news/politics/2017/07/13/new-health-bill-offers-plan-flexibility-pre-existing-conditions/475308001/
https://www.cnn.com/2017/04/30/politics/trump-health-care-pre-existing-conditions/index.html
https://www.cbsnews.com/news/is-trump-right-that-pre-existing-conditions-are-covered-in-the-gop-health-care-bill/

GOP Health Bill Leaves Many 'Pre-Existing Condition' Protections Up To States
https://www.npr.org/sections/health-shots/2017/05/08/527415655/gop-health-bill-leaves-many-pre-existing-condition-protections-up-to-states

Maybe that is the right answer.

Crafty_Dog

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Re: The Politics of Health Care
« Reply #1691 on: June 15, 2018, 11:14:29 AM »
Excellent and timely post Doug.

For the record, my thoughts:

*PRICES MUST BE KNOWN IN ADVANCE OF SERVICE/CONSUMPTION
*Insurance is for extreme events, not everyday matters:  Fire, Flood, Car Accidents, Cancer, Heart Surgery, etc.  
*Dr. Ben Carson's Health Savings Accounts Plan!!!
*Interstate competition

DougMacG

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Unreported Obama Healthcare crisis, Disabilities, Cured by Trump
« Reply #1692 on: June 20, 2018, 10:21:30 AM »
I will add this to our government programs thread and Trump accomplishments too but if you believe the news on the face of it, people were becoming disabled in America under Obama at an EPIDEMIC rate. 

Disability claims skyrocket: Here's why
CNN  April 11, 2013:
http://money.cnn.com/2013/04/11/news/economy/disability-payments/index.html

Cured by Trump somehow.
Disability Applications Plunge as the Economy Strengthens
https://www.wral.com/disability-applications-plunge-as-the-economy-strengthens/17639836/

What did Eddie Murphy say in Trading Places?  "I can see!!"

It's as if they didn't have disabilities at all.

ccp and I and a few others knew.  The epidemic was in people not working by choice, doctor shopping, and taking a check from the government to do nothing.  If anyone believed this was a health crisis, the Obama Surgeon General would have been all over it.  He or she wasn't.

"the number of Americans who are on disability has skyrocketed"
https://apps.npr.org/unfit-for-work/

NPR continued: 
The federal government spends more money each year on cash payments for disabled former workers than it spends on food stamps and welfare combined. Yet people relying on disability payments are often overlooked in discussions of the social safety net. The vast majority of people on federal disability do not work.[1] Yet because they are not technically part of the labor force, they are not counted among the unemployed.

In other words, people on disability don't show up in any of the places we usually look to see how the economy is doing.


In Hale County, Alabama, nearly 1 in 4 working-age adults is on disability.[2] On the day government checks come in every month, banks stay open late...
...
"Just out of curiosity, what is your disability?" the judge asked from the bench.
"I have high blood pressure," the man said.
"So do I," the judge said. "What else?"
"I have diabetes."
"So do I."

There's no diagnosis called disability. You don't go to the doctor and the doctor says, "We've run the tests and it looks like you have disability."[/i]

Crafty_Dog

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WSJ: HSAs Health Savings Accounts
« Reply #1693 on: June 22, 2018, 09:11:05 AM »
Health Savings Accounts for Everyone
Congress should make HSAs universal and raise the cap to $7,350, which would drive competition.
By Scott W. Atlas
June 19, 2018 7:05 p.m. ET
270 COMMENTS

Despite failing to repeal and replace ObamaCare fully, health-care reform is progressing under President Trump. The individual mandate is nullified. The administration has permitted more low-cost “limited duration” insurance plans, and more small businesses now have access to association health plans. The next step should be to expand and improve health savings accounts.

Health savings accounts allow people to set aside money tax-free to pay for health expenses, but their fundamental purpose is not simply to cushion the blow of costly care. HSAs put consumers directly in charge of their health-care purchases. This drives competition, which leads to lower prices for everyone.

ObamaCare, and most of the proposals that followed, stressed making insurance more affordable, mainly through subsidies. Subsidizing premiums artificially props up coverage that typically minimizes out-of-pocket payment. This is counterproductive. Patients with such coverage don’t think of themselves as paying for services. This shields medical providers from competing on price.

Instead of subsidizing premiums, policy should focus on reducing the cost of medical care itself by generating competition for patients. That is the most effective pathway to affordable, high-quality care. The market should be reformed to encourage patients to consider the price of the medical care they consume and to equip them with the tools to do so.

Outpatient nonemergency care, which forms the bulk of health expenditures, is amenable to price-conscious purchasing. Almost 60% of all health expenditures for privately insured adults under 65 and almost 40% of the elderly’s expenses are for outpatient care, according to a 2012 report from the IMS Institute for Healthcare Informatics. Prices rapidly decrease when patients pay out-of-pocket for procedures like Lasik corrective vision surgery and MRI or CT screening. Data from MRI and outpatient surgery confirm that prices fall almost 20% when patients are motivated to shop around.
Health Savings Accounts for Everyone
Illustration: Barbara Kelley

Because HSAs reward saving, they are particularly effective at putting downward pressure on prices. Spending reductions averaged 15% annually, according to a 2015 National Bureau of Economic Research working paper, when workers were given high-deductible plans and personal medical accounts. When HSAs were added to high-deductible plans, savings increased to up to double the savings that high-deductible plans alone produced. More than one-third of the savings reflected price-conscious decision-making. Corroborating prior studies, these reductions occurred without harming patients’ health.

By increasingly choosing HSAs when given the opportunity, American consumers are approving their value. By the end of 2017, there were at least 22 million health savings accounts in the U.S., up 11% year-over-year. This isn’t a tax benefit for the rich: Median household income for HSA holders is $57,060, and two-thirds earn less than $75,000 a year. The challenge now is to expand HSA use and fully leverage its power to reduce health-care prices.

Congress should pass legislation making HSAs universally available. These accounts should not be connected to specific insurance deductibles, a counterproductive requirement that limits the possibility of HSAs with tailored- or direct-payment plans. To maximize consumer power on prices, Congress should remove restrictions on full HSA participation by seniors on Medicare. Motivating seniors, the biggest users of health care, to seek value is crucial to driving prices down.

Congress should raise the maximum allowable HSA contribution to match total possible out-of-pocket spending under ObamaCare—$7,350 for individuals in 2018. Account holders should be allowed to use their HSA funds to pay for the care of elderly parents. And the accounts should be fully owned by individuals. This means abolishing more restrictive variants tied to employers and eliminating expiration or forfeiture due to arbitrary “use it or lose it” deadlines. When account holders die, they should be allowed a tax-sheltered rollover of their HSA funds to all surviving family members, not only spouses.

HSAs have also been a valuable vehicle through which employers offer effective wellness programs and medical screening. Yet ObamaCare limits financial incentives from employers, like deposits into employee HSAs. Congress should abolish this rule.

Legislators can also change the tax code to encourage more people to sign up for HSAs. Today’s unlimited income exclusion for employer-sponsored health benefits is harmful, because consumers are rewarded for spending more on health care. This reduces concern for price and value. Beyond capping any total health expense deduction or exclusion, the tax code should also limit eligibility to HSA contributions and catastrophic coverage premiums.

Increasing the supply of medical care by eliminating anticompetitive barriers would make HSAs even more effective, as patients need enough choices to compare. Despite widely recognized doctor shortages, scope-of-practice limits on nurse practitioners and physician assistants prevent competition with doctors for simple primary care. Archaic nonreciprocal state licensing restricts telemedicine. State certificate-of-need requirements limit competitive technology. Scandalous contractual gag clauses prohibit pharmacists from telling patients that medication may be cheaper if purchased outside insurance.

Health savings accounts are not appropriate for every patient. But they represent a powerful tool to lower prices and improve access to quality care for everyone. And those are goals that everyone can share.

Dr. Atlas, a physician, is a senior fellow at Stanford University’s Hoover Institution and author of “Restoring Quality Health Care: A Six Point Plan for Comprehensive Reform at Lower Cost” (Hoover, 2016).

ccp

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From the American College of Physicans
« Reply #1694 on: July 10, 2018, 04:54:34 PM »
IN between articles about firearms diatribes and women deserve "better health care"
was this summary of an article on the safety of abortions:

"The rate of abortions performed for U.S. women aged 15 to 44 years has decreased by half since 1980, from 29.3 per 1000 women to 14.6 per 1000 women in 2014 (1–3). With 926 190 abortions reported in 2014, abortion remains a common medical intervention and, as is standard for most medical interventions, should be assessed periodically for safety and quality. The Institute of Medicine last evaluated abortion services in 1975 (4). Many advances and improvements in available technologies have occurred since then. As such, the National Academies of Sciences, Engineering, and Medicine (NASEM) was asked by a group of sponsors to answer a series of questions on the appropriate use of different abortion services, associated physical and mental health risks, safety and quality of care, necessary facility requirements, health care provider skills, safeguards for different interventions, safe provision of pain management, and research gaps in providing care. This paper provides a synopsis of the resultant report: “The Safety and Quality of Abortion Care in the United States” " 

abortions down - good (more birth control - obviously not chastity !)

the timing of this is NO accident .  We will soon see follow up articles about back room abortions and the lack of safety of such .  We know the rest................

Crafty_Dog

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WSJ: How much does a hip replacement cost?
« Reply #1695 on: July 13, 2018, 07:33:06 PM »
The subject here is one I have been pounding on the table for a long time-- the need for price transparency:

You Can’t Put a Price on a Hip Replacement, and That’s a Problem
Andrew Cuomo’s FAIR Health was supposed to make costs transparent. It hasn’t worked out.
You Can’t Put a Price on a Hip Replacement, and That’s a Problem
Photo: Getty Images/iStockphoto
By Steve Cohen
July 13, 2018 6:45 p.m. ET
13 COMMENTS

How much does a new hip cost in New York? The answer isn’t at all clear, despite Gov. Andrew Cuomo’s efforts to improve price transparency. Confusing insurance deductibles and balance billing mean that the actual amount patients pay can vary widely and unexpectedly, often with a painful shock.

That’s what happened to Michael Frank, a 52-year-old Westchester County executive who had his left hip replaced in 2015. The Manhattan hospital charged roughly $140,000. The insurance company paid a discounted rate of about $76,000, and his share—a 10% copay, plus a couple of uncovered expenses—was a bit more than $8,000. Mr. Frank, an actuary, was outraged. The hospital, he was sure, had inflated his bill, and then his insurer had negotiated a lower rate. That smacked of collusion.

Mr. Frank called me because my name had appeared in the media regarding a lawsuit against a different insurer. After hearing his story, I told Mr. Frank what I thought was an odd twist: I’d recently had two hips replaced, six months apart, at the same hospital that had treated him.

“What did they cost you?” Mr. Frank asked.

“Just my deductible,” I answered.

But then he asked what the total price had been, and I had to admit, sheepishly, that I didn’t know.

My policy didn’t have a 10% copay, like Mr. Frank’s, so I didn’t pay much attention to the overall cost. But I told him I’d check. Eventually I learned that the hospital had charged $175,000 for my right hip and $180,000 for the left. The insurance company had paid discounted rates of $75,000 and $77,000.

That should have been the end of the story, save for my momentary guilt knowing that healthy young people’s premiums were paying to replace my decaying baby-boomer parts. But I wondered: If I were facing a 10% copay, would I have been so quick to get into the operating room? Would I have shopped for a lower-cost alternative? What is the real market price for a hip replacement?

This last question should have been relatively easy to answer. In 2009, New York’s then-attorney general, Andrew Cuomo, announced the creation of a nonprofit organization called FAIR Health. Its mandate is to provide consumers accurate pricing information for all kinds of medical services.

I found the FAIR Health website and queried its database. It reported that the out-of-network price for a hip replacement in Manhattan was $72,656, close to what Mr. Frank’s and my insurance companies had paid. The problem: We were both in-network, and FAIR Health estimated that cost as only $29,162.

Something didn’t make sense, so I called FAIR Health. “Maybe you had complications,” the spokesperson suggested. Happily, I hadn’t. I was discharged from the hospital each time in under 24 hours, with no issues and no need for a home health aide. How many data points did FAIR Health use to calculate its price estimate? I was told “4,500 in Manhattan over the last six months.” Who submitted these prices? “The insurance companies.”

I never did figure out the reason for the difference in pricing—but somebody ought to. Giving consumers predictability in health-care costs is a smart idea, and although FAIR Health is trying, clearly there’s a disconnect. Rather than relying on insurers, it might be more effective if FAIR Health collected pricing information directly from hospitals and doctors. That way the data would be less susceptible to selective reporting or massaging. That’s what happened in the early 2000s, when class-action lawsuits revealed the main pricing database was being manipulated to the advantage of insurance companies.

Along with prices, FAIR Health should report the number of procedures performed by each hospital and physician’s practice. Together, these data would give consumers real comparative shopping power. Knowing whether a hospital is performing a particular procedure regularly or only occasionally would help patients make informed decisions about where to seek treatment.

Many policy experts believe transparent pricing is central to any attempt at controlling health-care costs. Nationwide, more than 300,000 people a year undergo hip replacements. If a fraction of them have an experience similar to Mr. Frank’s and mine, that’s a lot of confusion and inefficiency clogging up the system. Real change won’t come until patients have better information—data that are both accurate and granular.

How much does getting a new hip cost in New York? I’ve spent months trying to figure that out. Best I can tell, nobody really knows.

Mr. Cohen is an attorney at Pollock Cohen LLP in New York

ccp

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Drug pricing
« Reply #1696 on: July 23, 2018, 08:35:03 AM »
https://www.nationalreview.com/2018/07/trump-administration-targets-prescription-drug-costs/

With regards to rebates negotiated by Pharmacy Benefits Managers (PBMs) it is my understand from a review of this in one of the medical journals (I don't remember which one - probably JAMA)
that these negotiations are all done in secrete between the pharm companies the the pharm benefits managers and the all the so called rebates is taken by the PBMs and no given to consumers.

The article did not necessarily state the negotiations are bad but there is zero transparency .   It is all done behind scenes and the public and consumers are all kept in the dark.

So if these negotiations must not really be on the up and up.


ccp

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the billionaires fix for health care
« Reply #1697 on: July 30, 2018, 09:19:43 AM »
https://www.bostonglobe.com/business/2018/06/22/buffett-bezos-dimon-health-care-firm-likely-start-with-modest-digs/ejjJVt0Pb4WlYKvoLLqw2J/story.html

where else but Harvard : of course. 

so we can already surmise what socialized legislation will come down the pike.

if they can really lower the cost curve down without making themselves big profit out of it then great and do it where it benefits all I am all for it.

I just don't want THEM to become, themselves the middleman.  I am suspecting this is what will be proposed though

recent article in medical journal questions all this too.

Crafty_Dog

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Re: The Politics of Health Care
« Reply #1698 on: July 30, 2018, 12:39:59 PM »
I am not allowed to  read this without giving up my privacy.

DougMacG

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Re: The Politics of Health Care
« Reply #1699 on: July 30, 2018, 01:05:36 PM »
I read but couldn't copy it. It says they (Bezos, Buffet, etc) are starting small, not leasing very much office space for the headquarters in Boston. They don't give away much of what they are up to. The impact and expectation is big just because of the players involved.