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Judge Rules Healthcare Reform “Unconstitutional”

A federal judge in Virginia has ruled that healthcare reform is unconstitutional and expects the Obama administration to honor that ruling while it’s being appealed. But states and private companies are continuing to plan and budget for it nonetheless.

The court ruled that Congress exceeded its constitutional powers in compelling Americans to buy health insurance. Judges elsewhere have ruled the law is valid or dismissed the cases on procedural grounds, while a judge in Florida will hear another case later this week.

In the meantime, though, employers and healthcare companies have to continue adjusting to the reform law’s many provisions. States will continue to set up their health insurance exchanges, and they’ve already budgeted for the additional 16 million people who will qualify for Medicaid under the law. And the Obama administration is unlikely to stop what it’s doing, since many of the provisions won’t take effect until 2014.

A key of the lawsuit is “economic inactivity.” The ruling says that while Congress can regulate interstate commerce, it can’t regulate…well, non-commerce, in this case the decision not to buy health insurance. The judge’s decision is online. (Politico, Wall Street Journal, Associated Press, MSNBC)

*This blog post was originally published at ACP Internist*

New Food Allergy Guidelines

Walnuts and peanuts by viZZZual.com via FlickrThe National Institute of Allergy and Infectious Diseases (NIAID) issued comprehensive food allergy guidelines to help primary care physicians and subspecialists diagnose and manage patients.

The guidelines were published online at the NIAID food allergy guidelines portal, which also has a frequently asked questions section. The agency will release a patient synopsis early next year.

The guidelines establish consistent terminology and definitions, diagnostic criteria and patient management practices. Additional topics covered by the guidelines include the prevalence of food allergy and management of acute allergic reactions to food, including anaphylaxis. The report also identifies gaps about what is known about food allergy.

NIAID Director Anthony S. Fauci, MACP, said, “Because these guidelines provide standardized, concise recommendations on how to diagnose and manage food allergy and treat acute food allergy reactions across specialties, we expect both clinicians and food allergy patients to greatly benefit from these clear state-of-the-science clinical standards.” Read more »

*This blog post was originally published at ACP Internist*

Medicare’s Deficit Effect On The Economy

Medicare poses a deficit problem, note some very influential analysts. A former Congressional Budget Office head and a former Medicare chief chime in on the scope of the program’s impact on the economy, and the difficulties of trying to scale it back.

Yet, a presidential commission is considering just that among other measures. The 18-member, bipartisan commission released its report weeks ago and was scheduled to have voted today on a shocking scope of deficit-trimming measures that included changes to military spending, Social Security and Medicare, among other areas. But they deferred the vote until Friday to try to garner more votes from members who are also currently elected officials. The panel needs 14 votes and substantive approval from its roster of Congress members to gain serious attention.

In related news for Medicare recipients, the Employee Benefit Research Institute reports that seniors will need hundreds of thousands of dollars in savings to cover health insurance and other out-of-pocket health needs. (NPR, The New York Times, ACP Internist, The Washington Post, Reuters)

*This blog post was originally published at ACP Internist*

Bend The Healthcare Cost Curve By Preventing Diabetes

By 2020, an estimated 15 percent of adults will have diabetes and 37 percent will have prediabetes, a total of 39 million people, compared with rates of 12 percent and 28 percent today, respectively.

Today, more than 90 percent of people with prediabetes, and about a quarter of people with diabetes, are unaware of it, according to a report from UnitedHealth Group, the provider of insurance and other health care services.

The health savings alone of preventing diabetes would bend the cost curve of health care spending in the country. Health spending associated with diabetes and prediabetes is about $194 billion this year, or 7 percent of U.S. health spending, the report said. That cost is projected to rise to $500 billion by 2020, or a total of almost $3.4 trillion on diabetes-related care.

Engaging the at-risk population could save up to $250 billion, or 7.5 percent of estimated spending on diabetes and prediabetes, in the next decade. Of that money, $144 billion, or about 58 percent, would come from savings in Medicare, Medicaid and health care exchange subsidies. Read more »

*This blog post was originally published at ACP Internist*

Are Airport Security Pat-Downs Unhealthy?

Potential health effects of airport security are being questioned for their possible health consequences, from spreading germs to radiation exposure to the stress that being searched induces.

With cheaper flights available this year and the need for security in air travel, the Transportation Security Administration (TSA) is justifying its full body scans and its pat-downs that rise up travelers’ legs — all the way up.

The scanners use microwaves, leading some to question whether people may be receiving too much radiation. It’s also a concern to activists who may have already undergone a lot of radiation for existing condition, or who have other conditions for which TSA agents may not be trained. (Read one seasoned traveler’s personal experience here.) The TSA reports the scanners expose users less energy than a cell phone.

Some protesters refused the body scans in favor of a pat-down, in an effort to tie up air travel on the day before Thanksgiving and force a review on the issue. But a manual exam spreads germs, say others.

Amid all the speculation of potential health consequences, federal officials are reminding travelers that the security measures are there for passenger safety. However, retorts Jason Mustian‘s Twitter feed, “Body scans and genital fondlings would save more lives if our government was paying to have them done in hospitals rather than airports.”

*This blog post was originally published at ACP Internist*

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