April 1st, 2011 by Debra Gordon in Health Policy, Opinion
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Who would have thought when we first looked upon you a year ago, barely formed, still somewhat embryonic, that you would have grown so much in just a year, and created so much, well, trouble? Yes, I’m talking about you, health reform. After all, aren’t you the reason for the sea change in Washington? Aren’t you behind several pending appeals that will get to the Supreme Court? Aren’t you the reason that the country is going to hell in a handbasket?
But wait. Let’s look at some other major milestones of the past year.
– You sent $250 checks to Medicare beneficiaries to help cover the “donut hole” in their drug coverage.
– You created special insurance pools designed to provide health care NOW to people with preexisting conditions who can’t get coverage.
– You allowed parents to keep their kids on their health insurance until the children turn 26, providing a major safety net.
– You did away with lifetime caps, enabling those with some serious medical conditions to continue receiving health insurance.
And that’s just in a year. Imagine what the next year and the year after that will bring. So I’ll say it again, Happy Birthday, Healthcare Reform. May you live to a ripe old age and only get better.
*This blog post was originally published at A Medical Writer's Musings on Medicine, Health Care, and the Writing Life*
March 20th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
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Last year’s “Doctor Fix” was passed the last week congress was in session in 2010. This was after the medical profession was held in suspense for 9 months.
The “Doctor Fix” was supposedly the result of President Obama making a deal with the AMA for the AMA’s support. He was going to pass a real “Doctor Fix” in 2011 by repairing the defective sustainable growth rate formula (SGR). Nothing has been done about this by President Obama in 2011. The cumulative physician reimbursement reduction of 25% was suspended until January 2012.
Physicians face a 29.5% Medicare Pay Cut in January 2012. Four and one half percent was added to last year’s cumulative physicians reimbursement reduction. The reduction was calculated into the CBO’s cost score for President Obama’s Healthcare Reform Act.
Last week an official with the Centers for Medicare and Medicaid Services unveiled the 29.5% rate reduction for 2012 in a recent letter to the Medicare Payment Advisory Commission. This will become another distraction for physicians and the media as President Obama stalls for time. Read more »
*This blog post was originally published at Repairing the Healthcare System*
March 11th, 2011 by John Mandrola, M.D. in News, Opinion
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It’s heart wrenching when young athletes die of sudden cardiac death (SCD). Last week the death of Wes Leonard, a Michigan high school star athlete, was especially poignant since he collapsed right after making the game-winning shot. This sort of tragedy occurs about one hundred times each year in America. That’s a lot of sadness. The obvious question is: Could these deaths be prevented? Let’s start with what actually happens.
Most cases of sudden death in young people occur as a result of either hypertrophic cardiomyopathy (HCM), an abnormal thickening of heart muscle, or long QT syndrome (LQTS), a mostly inherited disease of the heart’s electrical system. Both HCM and LQTS predispose the heart to ventricular fibrillation — electrical chaos of the pumping chamber of the heart. The adrenaline surges of athletic competition increase the odds of this chaos. Unfortunately, like heart disease often does, both these ailments can strike without warning.
Sudden death is sad enough by itself, but what makes it even worse is that both these ailments are mostly detectable with two simple painless tests: The ECG and echocardiogram (heart ultrasound). Let’s get these kids ECGs and echos then. “Git ‘er dun,” you might say.
On the surface the solution seems simple: Implement universal cardiac screening of all young athletes. And you wouldn’t be alone in thinking this way. You could even boast the support of Dr. Manny Alvarez of Fox News and the entire country of Italy, where all athletes get ECGs and echos before competing. But America isn’t Italy, and things aren’t as simple as Fox News likes to suggest. Read more »
*This blog post was originally published at Dr John M*
March 7th, 2011 by Elaine Schattner, M.D. in Health Policy, Opinion
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[Recently] a short article in the New York Times, New Kidney Transplant Policy Would Favor Younger Patients, [drew] my attention to a very basic problem in medical ethics: Rationing.
According to the Washington Post coverage, the proposal comes from the United Network for Organ Sharing, a Richmond-based private non-profit group the federal government contracts for allocation of donated organs. From the Times piece:
Under the proposal, patients and kidneys would each be graded, and the healthiest and youngest 20 percent of patients and kidneys would be segregated into a separate pool so that the best kidneys would be given to patients with the longest life expectancies.
This all follows [the recent] front-page business story on the monetary value of life.
I have to admit, I’m glad to see these stories in the media. Any reasoned discussion of policy and reform requires frank talk on healthcare resources which, even in the best of economic times, are limited.
*This blog post was originally published at Medical Lessons*
March 7th, 2011 by RyanDuBosar in Health Policy, News
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A federal judge who’d ruled healthcare reform was unconstitutional and that his decision as a federal judge was the equivalent of an injunction has relented. Healthcare reform can continue in the states, pending appellate and Supreme Court review.
“The sooner this issue is finally decided by the Supreme Court, the better off the entire nation will be,” wrote federal judge Roger E. Vinson, who’d decided that the healthcare reform act’s mandate that people buy insurance or face penalties overextended Congress’ powers under the commerce clause of the constitution.
One reason for granting a stay, despite his previous clear intent that healthcare reform cease, includes his statement (on page 18) that:
“Can (or should) I enjoin and halt implementation of the Act in a state where one of its federal courts has held it to be Constitutional? In addition, many of the plaintiff states have publicly represented that they will immediately halt implementation of the Act in light of my declaratory judgment, while at least eight plaintiff states (as identified by the defendants in their motion and reply) have suggested that, in an abundance of caution, they will not stop implementing the Act pending appeal. In addition to these apparent disagreements among the plaintiff states, there is even disagreement within the plaintiff states as to whether the implementation should continue pending appeal. For example, while the plaintiffs (a group that includes the Attorney General of Washington) have requested that I enjoin the defendants from implementing the Act, the Governor of Washington has just filed an amicus brief specifically opposing that request.”
The decision gives the Obama administration seven days to file an appeal against his decision, which a U.S. Department of Justice spokesperson said the administration intends to do. Read more »
*This blog post was originally published at ACP Internist*
