Medicare Maneuvers, Part 3: The Insurer Showdown
July 16, 2008
It seems that Harry Reid gambled and won. In our previous two posts we described the battle being waged in Congress over the proposed 11% paycuts to Medicare physicians. After the Independence Day recess, the Senate Majority Leader and advocacy groups working on behalf of doctors and seniors - as well as informed and angry constituents - were able to put enough pressure on Senate Republicans to finally cross the aisle.
But party lines weren’t the real issue. The two sides squaring off in this debate were private insurers versus the average American. Why? Two words: Medicare Advantage.
As discussed in our July 2 post, Medicare Advantage came about when insurers convinced government that they were getting good at cutting spending on health care, and that maybe the government should learn from some of their tactics. Heck, they said, let’s just let insurers do the job themselves!
Medicare Maneuvers, Part 2: The Solution?
July 3, 2008
As we wrote about yesterday, payment cuts for doctors who treat Medicare patients finally went into effect July 1. Unfortunately, the first legislative attempt to block the looming doctor payment cuts didn’t come until the end of 2007, and was part of the doomed legislation to improve public funding for children’s health care (see WhatIf’s piece on SCHIP). With the competing SCHIP bills finally all defeated this spring by Presidential vetoes and Republican opposition, there was little time left to deal with doctor payment cuts before the July deadline.
Medicare Maneuvers, Part 1: The Problem
July 2, 2008
Payment cuts for doctors who treat Medicare patients - which have been looming for about a year - finally went into effect yesterday. The payment cuts of 10.6% will affect the 600,000 doctors who treat Medicare patients, and thus millions of elderly and disabled Medicare enrollees who rely on them.
Maybe if you’re under 65 and/or not relying on government health care benefits you think this isn’t your problem. You’re wrong.
A little history (based on the writings of Jonathan Cohn):
DNA, Disease, and Discrimination
June 10, 2008
Can you imagine being faced with the difficult decision of having your breasts removed - not because you have breast cancer, but because you’ve determined that you carry the genes for it? Women at risk for the disease can now find out whether they have the same DNA that killed their mothers and grandmothers.
In recent years, advances in genetic research have helped push medicine into realms once reserved for science fiction.
In the 1850s there were only 140 categories of disease, differentiated by their symptoms. By 1993, genetic mapping had allowed scientists to distinguish 12,000 categories of disease, to determine that some diseases were linked genetically despite having widely different symptoms, and to find better drugs and measures to treat or prevent these diseases.
Get Active to Save Medicaid!
April 22, 2008
April 23 UPDATE:
Thanks to your support the bill passed! The final count was 349 in support and 62 against (20 didn’t vote). See how your Representative voted.
Also, read this Congressional report to see what was at stake: THE ADMINISTRATION’S MEDICAID REGULATIONS: State-By-State Impacts
Today, Tuesday, the House will vote on a bipartisan bill that would suspend harmful Medicaid regulations from being implemented – regulations that cut billions from Medicaid. Passing this bill would be a significant victory in our struggle to protect health care for our most vulnerable citizens.
The President has already threatened to veto.
Thank You for Smoking
April 14, 2008
People have been smoking tobacco for over a thousand years. Even a generation ago smoking was considered the norm. Now we know of its link to a variety of cancers and diseases, and many laws have been introduced at all levels of government to try to protect nonsmokers and smokers alike. The numbers of U.S. smokers are declining, but cigarette smoking is the still the single most preventable cause of untimely death in this country – claiming 400,000 Americans each year – 1 in every 5 deaths. Treating cancer cost $219 billion in 2007.
Dialysis Treatment – A Punch in the Kidneys
April 2, 2008
Here’s a fact that may surprise you: kidney failure is the one disease that you can get coverage for – from the Federal Government - no matter what.
For this reason, after 30 months of treatment by a private insurer, dialysis facilities bill Medicare regardless of whether the patient is over 65 or financially stable. For those with kidney failure (End Stage Renal Disease) due to diabetes or other causes, having a machine take over the complicated (and therefore expensive) task of cleaning their blood several times a week allows them to live.
Costs of Cancer Care?
March 31, 2008
Part of the heartache of cancer is that surviving it is ultimately a game of statistics. There are no assurances - except in the worst case scenarios where they are grim.
Even determining the best treatment is a matter of weighing likelihoods rather than having clear-cut solutions. On top of all that, patients must deal with the cost of various treatments.
Fortunately, cancer death rates have been falling in recent years - for several reasons:
- There is more and more information available on how to prevent cancer.
- Regular screening can catch the disease in early stages when it’s more treatable.
Congress Ready to Promote Mental Health
March 5, 2008
Originally posted November 17, 2007: Metal Health Discrimination? The AP reports that the Senate has passed a bill that would require group health insurance to cover mental health services and substance abuse treatment at the same levels as typical medical coverage. From this little article one gets a glimpse at the way the US has treated mental health. There is a more expansive House version of the mental health parity bill that would also require insurance changes to begin in January 2008 - almost a year earlier than the Senate bill, which has the support of insurance companies. The House bill has made it through three committees.
Beware Drug Reps Bearing Gifts
February 21, 2008
Only 1 in 3 medical schools have policies to prevent conflicts of interest between their academic departments and the drug or medical device companies that may fund individual researchers. Only 6 U.S. medical schools are completely free from the “influence” of pharmaceutical kickbacks. While universities as private institutions set their own rules on ethics and proprieties, government can regulate medical professionals and health care.
Now Minnesota is leading the way in banning drug company gifts to doctors. In 2005, a state official decided that current law allowed the state to forbid drug makers from giving doctors more than $50 worth of food or other gifts per year. Since then, this kind of direct-to-doctor marketing has decreased, with the number of visits from drug reps declining twice as fast as the rate nationwide.
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