January 16th, 2011 by Linda Burke-Galloway, M.D. in Health Policy, Opinion
No Comments »
When the Nebraska lawmakers voted to end Medicaid prenatal care for approximately 1,500 women, their unborn babies paid the ultimate price.
Any labor room hospitalist who is responsible for the care of unassigned pregnant women will tell you that it is far easier to take care of pregnant women who have had prenatal care than it is to take care of women who haven’t. The recent vigil of the Equality Nebraska Coalition in front of their state capitol to honor five dead babies whose death can be related to the lack of access to prenatal care speaks volumes.
On or about February of 2010, Nebraska expectant mothers received a “Dear John” letter from Nebraska’s Health and Human Services stating that their pregnancies were no longer covered under Medicaid. It appeared that the rationale for making such a drastic decision involved a resistance of state politicians to pay for medical services of “illegal immigrants.”
However, when one reads the comments on a popular website called Baby Center.com, the pregnant women who were affected were U.S. citizens who were college students, wives of husbands who had lost their medical insurance, and unemployed women. Eventually all the women were able to receive government-sponsored healthcare coverage, but the panic preceding their reinstatement was palpable. Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
January 15th, 2011 by DrWes in Health Policy, Opinion
No Comments »
From CBS News:
President Obama is planning to hand the U.S. Commerce Department authority over a forthcoming cybersecurity effort to create an Internet ID for Americans, a White House official said here today.
It’s “the absolute perfect spot in the U.S. government” to centralize efforts toward creating an “identity ecosystem” for the Internet, White House Cybersecurity Coordinator Howard Schmidt said.
That news, first reported by CNET, effectively pushes the department to the forefront of the issue, beating out other potential candidates including the National Security Agency and the Department of Homeland Security. The move also is likely to please privacy and civil liberties groups that have raised concerns in the past over the dual roles of police and intelligence agencies.
No, they’re not talking about a national ID card, just an international internet ID. The announcement came at an event today at the Stanford Institute for Economic Policy Research, where U.S. Commerce Secretary Gary Locke and Schmidt spoke. The Obama administration is currently drafting what it’s calling the National Strategy for Trusted Identities in Cyberspace, which Locke said will be released by the president in the next few months. (An early version was publicly released last summer.)
“We are not talking about a national ID card,” Locke said at the Stanford event. “We are not talking about a government-controlled system. What we are talking about is enhancing online security and privacy and reducing and perhaps even eliminating the need to memorize a dozen passwords, through creation and use of more trusted digital identities.”
Imagine: Anyone registered with such a cyber-ID who conferences with their doctor via a “secure server” can also be tracked by the government with such a mechanism. And the issue of not needing more than one password? While convenient, the ramifications of multiple accounts being compromised if a data leak were to occur remains with such a mechanism. Read more »
*This blog post was originally published at Dr. Wes*
January 11th, 2011 by BobDoherty in Better Health Network, Health Policy
No Comments »
[Soon] the new GOP-controlled House of Representatives will be voting on and is expected to pass a bill to repeal the Affordable Care Act (ACA) — lock, stock, and barrel. There is virtually no chance the repeal bill will get through the Senate, though, which maintains a narrow Democratic majority, and President Obama would veto it if it did.
But let’s say that the seemingly impossible happened, and the ACA was repealed. What would the impact be on healthcare coverage, costs, and the federal deficit?
In a letter to Speaker John Boehner (R-OH), the Congressional Budget Office (CBO) released its preliminary estimates of the impact of repeal on the deficit, uninsured, and costs of care, and found that it would make the deficit worse, result in more uninsured persons, and higher premiums for many:
— Deficit: repeal of the ACA would increase the deficit by $145 billion from 2012-2019, by another $80 to $90 billion over the 2020-21 period, and by an amount “that is in the broad range of one-half percent of the GDP” in the decade after 2019* — or about a trillion dollars. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
January 10th, 2011 by DrRich in Better Health Network, Health Policy, Opinion
3 Comments »
From the ominously-titled book “New Rules” by Donald Berwick, M.D., and Troyen Brennan M.D.:
“Today, this isolated relationship [between doctor and patient] is no longer tenable or possible. . . Traditional medical ethics, based on the doctor-patient dyad, must be reformulated to fit the new mold of the delivery of health care. . . The primary function of regulation in health care…is to constrain decentralized individualized decision making.”
Unfortunately, Dr. Berwick’s straightforward formulation of the appropriate role of the individual physician in our reformed healthcare system is not isolated to thinkers of the Progressive persuasion. The notion that most clinical decisions can be usefully made by a centralized authority is attractive even to some conservatives.
For example, a few years ago the noted economist Arnold Kling strongly defended the idea. “My own view is that a remote third party probably can use statistical evidence to make good recommendations for a course of treatment.”
Now, Kling is no far-left radical, pushing for centralized control of healthcare (and everything else). Indeed, he is now with the Cato Institute, and before that he taught economics at George Mason University. So he has earned his conservative and/or libertarian chops.
And to be fair, he is not really calling here for “remote third parties” to have final authority on what’s best for individual patients. Rather, he thinks patients should make that decision for themselves, weighing the recommendations of data-driven guidelines promulgated by remote experts, against the ego-toss’d recommendations from their all-too-fallible doctors, or, as Kling sarcastically refers to them, their “heroic personal saviors.” (Such sarcasm, regular readers will know, is as abhorrent to DrRich as it probably is to you.) Kling is saying: Trust patients, armed with good evidence-based recommendations handed down from experts, to make the right decisions for themselves. Read more »
*This blog post was originally published at The Covert Rationing Blog*
January 10th, 2011 by RyanDuBosar in Better Health Network, Health Policy, News
No Comments »
Repealing healthcare reform has become a way of stockpiling ammunition for the campaign trail. The Republican-led House has scheduled a repeal of healthcare reform for Wednesday, Jan. 12, and they’d garner as allies some but not all 13 Democrats that voted against healthcare reform to begin with. The House’s quixotic vote would then promptly die in the Democrat-held Senate.
But recording votes on repeal would put pressure on already vulnerable lawmakers, as well as give a quick boost to incoming ones. A Gallup poll shows 46 percent of Americans want healthcare reform to be repealed, 40 percent don’t want repeal.
Unfortunately, not only can’t the law be passed, it would add $230 billion to the federal debt by 2021, according to the Congressional Budget Office. House Speaker John Boehner said, “I don’t think anyone in this town believes that repealing Obamacare is going to increase the deficit,” although Republicans have already exempted a repeal of the healthcare law from new rules prohibiting legislation from adding to the federal debt. (Politico, Kansas City Star, [Aurora, Ill.] Beacon-News, USA Today, CNN)
*This blog post was originally published at ACP Internist*
When the Nebraska lawmakers voted to end Medicaid prenatal care for approximately 1,500 women, their unborn babies paid the ultimate price.
