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Colby Hall says:
May 3, 2010 at 8:35 pm
Its disingenuous to quote what he said?

no Colby, it’s not, but like Norbit said before you replied, it is disingenuous to quote ANYONE when you fail to put the quote in proper perspective. bloomberg said it as just an example but you failed to tell the reader that and used his quote just for linkbate. i saw this video earlier and i just had a feeling you guys would take that bait and guess what…you did. you’re quickly turning into politico for dummies and that’s saying a lot. congrats?

example: colby said he likes diet coke.

my article: colby hall is for the death of bamboo because he likes diet coke.

see how hard that was colby? hell, i probably just gave you a writing tip.

North Bay (Santa Rosa, Calif.) Business Journal: “While community health centers are widely seen as winners with the passage of a sweeping health bill in late March, such centers in California face potentially crippling state budget cuts, which could offset potential gains that won't take effect until 2014, according to clinic directors throughout the North Bay. In an attempt to offset portions of California's budget deficit of $20 billion, Gov. Arnold Schwarzenegger has proposed deep cuts to services at community health centers, while the federal Patient Protection and Affordable Care Act promises to deliver scores of previously uninsured patients to clinics, thus increasing the need for services amid a dire state economy. Funding for clinics will increase significantly at the federal level, with $1.5 billion becoming available over the next five years for clinic expansions in California, according to the California Primary Care Association” (Verel, 5/3). 

The Boston Globe reports on sanitation and quality at Massachusetts General Hospital following the “hospital's newly imposed sanitation rules for dealing with Greater Boston's water crisis,” caused by a massive water main break. ”As the water emergency enters its third day, few places were as susceptible to potential trouble as hospitals, where sanitation is always an urgent priority. And few have as massive a challenge as Mass. General, the city's largest hospital. The mood at the hospital yesterday was one of calm adaptation, not chaotic alarm. The business of the hospital went on, but in some cases more slowly, as staff and patients struggled to avoid using tap water. … Tap water was now the enemy. The danger, from bacteria that could be in the water, was especially serious for the many patients whose immune systems had been weakened by disease” (Wen, 5/3).

The Associated Press/Boston Globe: The Connecticut “House of Representatives has passed legislation authorizing a massive overhaul of the University of Connecticut Health Center in Farmington, as well as the development of a regional health network. … It now awaits action in the Senate. The project's cost is estimated at $362 million” (5/1). 

The Portland Press-Herald: “Maine is starting an $8 million-a-year effort to provide health insurance to part-time workers who don't get coverage through employers and don't qualify for government plans. The state's Dirigo Health Agency is offering federally funded vouchers to help pay insurance premiums for qualified companies and workers. The first round of employees started receiving coverage May 1. … However, access to the vouchers will be limited, partly because of program restrictions and partly because $8 million will go only so far in today's expensive private insurance market. Officials said the money should allow them to provide insurance to about 3,000 Mainers, including workers and their family members” (Richardson, 5/3).

The Associated Press/NorthJersey.com: The top two Democrats in New Jersey's legislature say “they won't approve a budget that requires higher deductibles and copays for senior citizens enrolled in a subsidized prescription drug program. Senate President Stephen Sweeney and Assembly Speaker Sheila Oliver want Governor Christie to cut the proposal from the $29.3 billion spending plan he proposed in March. It assumes nearly $40 million in savings by requiring seniors in the PAAD program to pay a $310 deductible starting Jan. 1. The budget also calls for copays to more than double for brand-name drugs, from $7 to $15. … Administration officials have said seniors' access to discount medications has been preserved despite the tough economy and that New Jersey's program remains among the most generous in the nation” (5/2).

Green Bay Press Gazette: “Two Fox Valley lawmakers last week touted new state legislation aimed at improving mental health. The bill signed into law Thursday by Gov. Jim Doyle expands a 2009 federal parity law requiring most group health insurance plans to bolster coverage for the mentally ill and drug abusers. Assembly Majority Leader Tom Nelson, D-Kaukauna, and state Rep. Penny Bernard Schaber, D-Appleton, discussed the new law during a news conference at the Thompson Community Center. The new law requires qualifying group health plans for businesses with 10 or more employees to offer coverage for the mentally ill and drug abusers equal to coverage offered for traditional medical and surgical care, including mandating access to physicians” (Wideman, 5/3).

Providence (R.I.) Journal: “Nationwide, about 23 percent of employers offer health insurance waivers, according to a 2009 survey by Hewitt Associates, of Illinois, a global human resources consulting and outsourcing services company. But waivers — sometimes called 'opt-outs' or 'buybacks' — are commonplace among Rhode Island cities and towns. And they have come under fresh scrutiny as the state tries to find ways to plug its chronic annual budget deficits. The waivers are typically not one-time deals; workers who opt out of coverage generally receive the payments every year — often for as long as they remain on the payroll” (Downing, 5/3).

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Colby Hall says:
May 3, 2010 at 8:35 pm
Its disingenuous to quote what he said?

no Colby, it’s not, but like Norbit said before you replied, it is disingenuous to quote ANYONE when you fail to put the quote in proper perspective. bloomberg said it as just an example but you failed to tell the reader that and used his quote just for linkbate. i saw this video earlier and i just had a feeling you guys would take that bait and guess what…you did. you’re quickly turning into politico for dummies and that’s saying a lot. congrats?

example: colby said he likes diet coke.

my article: colby hall is for the death of bamboo because he likes diet coke.

see how hard that was colby? hell, i probably just gave you a writing tip.

Corporate disclosures about the federal health-reform legislation passed this spring continue to trickle in, with some striking differences in how companies see the measure.

Most of the disclosures are simply additional companies disclosing the tax-hit we (and others) have already written about, stemming from changes to a federal subsidy for retiree-health plans. Some of the more recent disclosures: Schlumberger Ltd. (SLB), with a $40 million charge; Beckman Coulter (BEC), at $8 million; Verizon Communications (VZ) at $962 million; Eaton Corp. (ETN) at $23 million; Exxon Mobil (XOM) at $200 million; Eli Lilly (LLY) at $85.1 million; and Norfolk Southern (NSC) at $27 million.

But what really interests us is how some of the biggest players in healthcare are talking about the new law in their filings. Take Bristol Myers Squibb (BMY), for example. In its April 29 earnings release, the company said that first-quarter sales fall by $49 million, and pre-tax income by $42 million, thanks to “higher rebates to Medicaid and Medicaid manged care organizations.”  Another $21 million was due to the retiree prescription subsidy tax change. In its 10-Q filed the same day, Bristol Myers said it expects other additional costs, including more discounts to certain rural hospitals and cancer hospitals, among others, and steep discounts on some prescription drugs for Medicare patients. Bristol Myers observes, without any apparent joy, that it will get 12 years of protected sales for “biologic” products before facing competition from cheaper generics, and says that it expects “the negative impact of healthcare reform in 2011 to be approximately twice the impact expected in 2010.”

Contrast that with health insurer Aetna (AET) and drug-store giant Rite Aid (RAD). Both took a more positive approach toward the new legislation.

While warning that it “is reasonably possible that Health Care Reform, in the aggregate, could have a material adverse effect on our business operations and financial results,” Aetna also says in the 10-Q it filed on April 29 that “Health Care Reform presents us with new business opportunities.” (The company’s litany of the measure’s provisions on pages 35-37 of the filing is a good summary of the bill from an insurer’s perspective.)

Just how it will balance out remains to be seen. “Many significant parts of the legislation require further guidance and clarification in the form of regulations,” Aetna said in the filing. “As a result, many of the impacts of Health Care Reform will not be known until those regulations are enacted, which we expect to occur over the next several years.”

Moreover, the insurer makes the case that the broader repercussions go beyond the specifics of the new federal laws:

“Health care reform will significantly alter the federal structure that shapes the state regulation of health insurance, and states will be required to significantly amend numerous existing statutes and regulations. … we expect many states to consider legislation to extend coverage to the uninsured through health insurance exchanges, increase the limiting age for dependent eligibility, restrict health plan rescission of individual coverage, mandate minimum medical benefit ratios, implement rating reforms and enact an autism benefit mandate.”

Rite Aid, meanwhile is practically upbeat in the 10-K it filed on April 28, thanks in part to the end of the so-called  ”donut hole” in Medicare prescription coverage, which left many seniors paying a significant portion of their drug costs. “We expect the estimated additional 32 million people who will be covered by health insurance in 2014, and the closing of the ‘donut hole’ in Medicare Part D to be good for our business,” the filing notes. That donut-hole issue is one that Bristol Myers cited as a negative, thanks to the discounts on brand-name drugs it will have to provide to Medicare recipients under the change.

Other disclosures are shedding additional light on some of the longer-term effects of the legislation. Medical device maker Teleflex Inc. (TFX), for example, noted in its April 28 10-Q that “the expansion of medical insurance coverage should lead to greater utilization of the products we manufacture,” counterbalancing to some degree the 2013 onset of a 2.3% excise tax on medical-device sales. Teleflex is one of the first companies we’ve seen quantifying the impact of the law beyond the retiree-health provision, saying the excise tax could cost it $16 million a year. Still, the company notes, “As this new law is implemented over the next 2-3 years, we will be in a better position to ascertain its impact on our business.”

So there you have it. Consider it the yin and the yang of the new legislation.

Image source: MAMJODH via Flickr

————

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So with all the discussion surrounding Nevada Senate candidate Sue Lowden's idea to use bartering as a way to pay for health care, we thought we'd take a look at whether the idea would actually work. Since Lowden, a Republican, touted the fact that her grandparents' generation would bring a chicken to the doctor for payment, we decided to look at whether the math would work for a chicken-based health care economy. The answer? Absolutely Not. There aren't enough chickens in the world — let alone the United States — to cover the costs of health care in this country alone.

The numbers on chicken economics, right after the jump.

Total U.S. health care costs in 2008: $2.3 trillion
US population: About 300 million
Average cost of health care per person: $7,681
Average weight of a chicken: 5.9 lbs
Market price per pound: 85 cents
Average spot price per chicken: $5.02
Average number of chickens per resident needed to cover health care costs: 1,530 chickens
Total number of chickens needed to cover United States health care costs: 459 billion chickens
Estimated worldwide chicken population: 16 billion chickens
Current worldwide chicken shortage to cover U.S. health care: 443 billion cluckers

Of course, it should be noted that chickens are only one of many commodities, and are thus only one component of a barter economy — for example, Tennessee state Rep. Mike Bell (R) has referred to Mennonites paying for health care with vegetables. There are also the options of beef, pork, turkeys, sugar, metal ore, or even finished products like iPods or gasoline. What would really help here is if there were some kind of single, universally accepted commodity, which could be used as a medium of exchange for all the others…

(Hat tip to TPM reader EH, for inspiring us to look up the numbers and do all this math.)

by Blair Latoff

We were told that once health care reform passed we would get to find out what's in it. From the AP:

President Barack Obama's health care overhaul law is getting a mixed verdict in the first comprehensive look by neutral experts: More Americans will be covered, but costs are also going up. Economic experts at the Health and Human Services Department concluded in a report issued Thursday that the health care remake will achieve Obama's aim of expanding health insurance — adding 34 million to the coverage rolls. But the analysis also found that the law falls short of the president's twin goal of controlling runaway costs, raising projected spending by about 1 percent over 10 years. That increase could get bigger, since Medicare cuts in the law may be unrealistic and unsustainable, the report warned.

In particular, concerns about Medicare could become a major political liability in the midterm elections. The report projected that Medicare cuts could drive about 15 percent of hospitals and other institutional providers into the red, "possibly jeopardizing access" to care for seniors.

…At the outset of the health care debate last year, Obama held out the hope that by bending the cost curve down, the U.S. could cover all its citizens for about what the nation would spend absent any changes. The report found that the president's law missed the mark, although not by much. The overhaul will increase national health care spending by $311 billion from 2010-2019, or nine-tenths of 1 percent. To put that in perspective, total health care spending during the decade is estimated to surpass $35 trillion. Administration officials argue the increase is a bargain price for guaranteeing coverage to 95 percent of Americans.

It should be remembered that the cost curve before health care reform was acknowledged by all to be unsustainable. No reduction and a slight increase, not much of a bargain. And then there is this:

In another flashing yellow light, the report warned that a new voluntary long-term care insurance program created under the law faces "a very serious risk" of insolvency.

Insolvent at the point of creation. We are indeed finding out what's in it.

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If we can put a man on the moon, we can re-write the basic laws
of supply and demand and get more quality health care, dispensed by
fewer providers per patient, at lower prices for all Americans.
Sure we can. Just like we ended poverty with the Great Society, and
like we’ll impose liberal democracy on the corrupt oligarchy ruling
a collection of tribes known as Afghanistan.

Landing humans on the lunar surface looks like an easily do-able
dream when set beside many of the ideologically and anecdotally
driven social, economic, and foreign policy nightmares cooked up by
public officials in the last half-century of big government. That
truth is explored in the appropriately titled book,
If We Can Put a Man on the Moon…: Getting Big Things Done in
Government (though, it should be noted, the book doesn’t
advocate getting big things done by big government).

Published last year, it was co-authored by former Reason
Foundation privatization analysts John O’Leary and William D.
Eggers. Together, the authors bring experienced insight about how
good, bad, and really awful public policy ideas are generated, and
then how those ideas should be tested in terms of design, adoption,
implementation, achievement of intended results, and periodic
review.

And after deconstructing health care “reform” via the
O’Leary-Eggers model, you’d have to be moonstruck to believe that
ObamaPelosiCare is headed for anything but a crash landing.

When the Supreme Court was trying to define pornography in order
to judge certain anti-obscenity statutes, Justice Potter Stewart
famously said, “I know it when I see it.”  Therein lies the
fatal flaw in trying to reform a sixth or seventh of the economy
related to personal health. So-called health care reform fails at
the very first stage posited by Eggers and O’Leary,
ideation, because—like beauty and porn—reform is in the
eyes of the beholder.

In the left-liberal imagination, health care reform means
getting the greedy bad guys in private enterprise out of health
care delivery and securing the “right” to health care with a
“single payer” system. That euphemism, like most verbal
obfuscations, is a tacit admission that there’s nothing remotely
close to public consensus about changing health care delivery. In
the free-market conservative imagination, reform would mean buying
health care in the same way we purchase milk, whiskey, or a new
Lexus, linking consideration of price to unlimited desire for
stuff.

Of course, we already have both free-market and government-run
health care, which is the other great obstacle to reform. We have
the worst of both worlds, with government Medicare and Medicaid
providing a big pile of increasingly deficit-financed dollars
sitting aside another mountain of cash generated by mostly tax
exempt, employer-provided insurance coverage. Both of these mounds
of free moolah discourage any consideration of price while they
encourage demand. Doctors, hospitals, and Big Pharma do their best
to Hoover suck billions from both piles. And politicians facilitate
the process by pandering to a 40-million-strong lobby of greedy
geezers (“the folks who built this great nation”) and a free
lunch-seeking middle class.

For the sake of argument, let us hallucinate that reform was a
big idea whose time had come. Then let’s subject it to the second
phase of the O’Leary-Eggers construct: design.

ObamaPelosiCare was most certainly not designed by
Barack Obama or Nancy Pelosi or any other leader. In fact, it
wasn’t designed by anybody. It was a Rube Goldberg contraption of
bells, whistles, and trap doors tossed together by K Street
representatives of insurers and providers, colluding with their
congressional clients. In a lobbying orgy, they mostly succeeded in
getting bigger pieces of what promised to be a hugely expanding
pie, bringing millions into the private (though massively
subsidized by the government) insurance pool, with largely unfunded
mandates against insurance exclusion for pre-existing conditions,
and deficit-funded new “services” like even more free drugs for old
people.

By the summer of 2009, with the president of the United States
engaging in sloganeering and finger-pointing at the enemy du
jour (insurers and Big Pharma, mostly), an angry citizenry
emerged to flail away at the Big Idea. Yet there wasn’t even a
clear definition of what reform actually meant, which left the
specifics up to the imagination. This in turn produced much angry
howling and congressional town hall meetings and helped stimulate
the amorphous, citizen-directed tea party movement.

By year’s end, reform seemed doomed, until Commanders Barack
Obama and Nancy Pelosi rammed it through the wormhole of Stargate,
as O'Leary and Eggers metaphorically label the adoption
stage of their construct. The Stargate is the sci-fi gateway from
our apparently real world to parallel universes with alternate
forms of reality, popularized in the military science fiction movie
and TV series of the same name. Without a trace of bipartisan
consensus, and with the opposition from the center of the
electorate bordering on fury, Pelosi and her allies used brute
political force to hurl “reform” cosmic distances ahead into the
regulation-writing hands of future bureaucrats, who will have to
square liberal hallucinations with real-economy conditions sometime
far, far away.

It isn’t often a landmark law makes it though the Stargate given
the fortunate Madisonian obstacle course that thwarts change. But
when paradigm shifting legislation has cleared those hurdles, there
almost always has been significant consensus—or at least some
modicum of bipartisan cooperation. Not so with ObamaPelosiCare.

It doesn’t take much imagination to see the pitfalls that will
occur when bureaucrats attempt to enter the implementation stage of
an undesigned, unpopular public policy creation. The results are
likely to be even worse than the 1000 percent error made
in projecting eventual Medicare costs when that program was adopted
in the 1960s. Today, Medicare is eating tax dollars like some
hungry Godzilla. In a few years, ObamaPelosiCare will make that
monster look like a little lizard.

A former reporter and political press secretary, Terry
Michael teaches college journalists  about politics, and
writes at his “libertarian Democrat” web site, www.terrymichael.net.

Bonus Reason.tv video: If We Can Put a Man
on the Moon… authors William D. Eggers and John O’Leary
discuss why large-scale government projects typically go so
wrong—and how to change a culture that almost demands such
failure.

An electronic medical record (EMRs) that just sits in your doctor’s office isn’t doing much good. (Picture from CNET.)

But when should it be allowed to move? Who should your doctor trust? What should be required before they trust an online connection and send your health records somewhere else?

This is a key question that must be solved for the so-called Health Internet — the National Health Information Network — to work.

The NHIN Connect system shown at HIMSS and profiled here in early March uses a top-down approach. “Getting into the network takes technology, clearances, contracts and training. All these elements are also required for private health records and scans to be transferred securely under HIPAA.”

The NHIN Direct system would be different. Connections could be ad-hoc, so long as both sides of the data transfer meet technical specifications and agree to a transfer. Any doctor, hospital or network could use NHIN Direct.

The group is currently defining standards within a government-run Wiki. The goal is to come up with both technology standards and policies that vendors can implement quickly, allowing EMR data to be exchanged between any clinics or hospitals in a matter of months rather than years.

But how can you guarantee trust? Sending medical records flying to who-knows-where guarantees security problems.

Fred Trotter, an expert on open source in health technology, developed a trust model at a health information exchange called Healthquilt in Houston. He’s pushing for that work to be a model for NHIN Direct:

• Health data should use a standard encryption system called X.509.
• There should be multiple Certificate Authorities, recommended by authorities running the network, handing out credentials to use the system.
• The encrypted Health Internet would be a VPN tunnel, with both sides of every transfer having certificates and encryption keys.
• Certificate Authorities could pull credentials, and members of the Health Internet would know that if someone has credentials they have been vetted.

Trotter calls this “automatic inclusion” comparing it to the way you buy a book on Amazon using https. (Check it out next time you’re buying something — https has security on it which normal http connections lack.)

There are problems with this model, Trotter admits. Not all actors in the medical industry trust one another. Some don’t want the network deciding who is trustworthy. Trotter responds that his model is precisely how current Internet trust systems work.

Trotter, who is usually distrustful of Microsoft, writes that the company is on the side of the angels in this one, having already argued against a top-down trust model.

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Are you ready to begin your journey toward any one of the many, rewarding careers in natural health? If you are, and you have the right frame of mind to pursue your professional goals, then you can join the thousands of natural healing and alternative medicine practitioners who are making a difference in the lives of people everywhere.

As you may be aware, more patients are turning to complementary and alternative medicine, so the natural healthcare industry is expected to grow in these coming years. Natural healing professions like massage therapy are some of the fastest growing careers in natural health today.

Massage therapists, who have acquired a minimum of 500 practical training hours, may be eligible for National Certification in massage therapy. This designation is helpful in establishing educational credentials and for expanding potential client services.

The spa and aromatherapy industry offers various careers in natural health and beauty as well. Whether individuals aspire to be a day spa manager, or would like to explore diverse working environments like health retreats and resorts, or in wellness clinics, professional spa workers are often cross-trained in many aspects of the field and can achieve high levels of professional success.

These particular careers in natural health and beauty may necessitate education and training in cosmetology, hair design, chair massage, facial massage, massage therapy, esthetics, holistic wellness, herbal body wrapping, and manicuring and pedicuring, among others.

Chiropractic is yet another one of the many growing careers in natural health and wellness today. Placing an emphasis on the whole person, Chiropractic Doctors (D.C.) can earn a lucrative income; however, individuals who are seriously thinking about achieving this occupation must realize that in addition to traditional education from an accredited college or university, standard academic training at one of the chiropractic colleges and universities is a must.

These careers in natural health require over 4,000 training hours in chiropractic philosophies, applications and principles. Other in-depth studies entail biochemistry, spinal biomechanics, neuroanatomy, osteology, pathology, and more.

Individuals who desire careers in natural health, but prefer shorter academic programs, have educational options to enroll in programs in reflexology, Reiki, acupressure, or colon hydrotherapy. In most cases, healing arts schools offer a variety of diploma and/or certificate courses in these disciplines, in addition to more advanced training options in massage therapy, holistic health, or herbal medicine.

If you (or someone you know) are interested in learning more about these or other wellness occupations, let professional training within fast-growing industries like massage therapy, naturopathy, acupuncture, Chinese medicine, Reiki, and others get you started! Explore careers in natural health near you.

Careers in Natural Health

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This partnership will extend CureMD's distribution network in the middle eastern region for advanced, award winning, web based CureMD (an all-in-one suit of enterprise level electronic health records, practice management and patient portal applications and related services) allowing Health Matrix to exclusively distribute, implement and support CureMD products and services providing organizations superior choice when it comes to advanced primary care technology.

According to Abdul Rahman Qasim, chief executive officer of Health Matrix Corporation, the market trends and recent efforts to promote Primary Healthcare Automation solution as part of our innovative 'First Point of Care Platform for everyone' in the Middle East region made it essential that Health Matrix partner with the most innovative e-health vendor in the industry. He said Health Matrix spent over a year evaluating various solutions and business offering before selecting CureMD.

“Health Matrix is committed to helping Healthcare providers and consumers improve efficiency and care quality. Our exclusive partnership with CureMD is another feather in our cap evidencing how we are all set to lead the healthcare IT revolution currently brewing in the middle east by empowering caregivers with ground-breaking CureMD technologies. We are proud of the fact that our clients trust us to bring them the best solutions and that we have selected the best mix of people, processes and technologies on the market today in the form of CureMD,”

Abdul Rahman Qasim said.

According to CureMD's CEO Kamal Hashmat, CureMD have realized the immediate needs in the Middle East Region to introduce Primary Care Solution in order to improve the quality of care at the first point of care and reducing the pressure from the hospitals.

“CureMD is committed to the Middle East region, and we are practicing this commitment through transforming the best international practice with local approach which fits the region's culture and specific needs,” Kamal Hashmat said.

CureMD's CIO Bilal Hashmat terms this relationship as a long term initiative to provide the Middle East with proven internet technology backed by local R&D Support and American healthcare standards compliance, ultimately pushing Middle East into the league of nations that have deployed pervasive best-of-breed web technologies to drive clinical, administrative and operational outcomes. CureMD will empower healthcare providers looking for an advanced yet easy solution to effectively drive care quality and efficiency while reducing costs and life threatening errors.

“With CureMD's inimitable Web-based enterprise class technology, Middle East will take a giant leap forward and, in a matter of months, bring itself at par with the excellence that the American healthcare achieved in over 4 decades of technological evolution. CureMD Users will appreciate our advanced collaborative care model with anytime any where integrated data availability, common user interface based configurable workflows providing advanced capabilities with localized extensions truly delivering on the promise of IT beyond any other health IT vendor in the global industry which we have led as innovators for over one and a half decade helping thousands of providers in North America transform their operations to deliver better care with ease,” Bilal Hashmat said.

“Now is the time when we want to share this success in the Middle East in order to bring physicians and care delivery organizations of the region into the era where lives and costs can be tremendously impacted,” he added.

Bilal further said, “I deeply admire health Matrix's vision of the primary care market in the Middle East and am sure technical expertise combined with our R&D capabilities will deliver most innovative solution of the times to this market before anywhere else in the World. Middle East, a mature market with advanced infrastructure, committed man power, reasonable budgets and deeper commitments is a ripe market for an initiative of this kind.”

CureMD and Health Matrix intend to create a network of channel partners in the Middle East region with established trusted local presence and understanding.

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