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):
Country Living
June 13, 2008
Most Americans live in cities and their surrounding metropolitan areas and suburbs. Around 1 in 5 Americans live in the “country” – farms as well as small towns.
When country folks get really sick or injured, they typically have to make the long trip to a city medical center to get expert help. Though 20% of America’s population is rural, only 9% of its doctors are.
A recent study suggests that special programs in medical school to train students for country caregiving could boost the numbers of doctors available.
The DNA Dilemma: Desperate for a Diagnosis?
June 11, 2008
Yesterday, we posted on last month’s passage of the Federal Government’s Genetic Information Nondiscrimination Act.
We hope that the law will help protect Americans’ coverage and employment despite their genetic likelihood for disease. This should allow them to feel more comfortable with seeking information about their own DNA in order to better manage their health.
Prior to this legislation passing, however, patients were seeking more private ways of testing their DNA - primarily through take-home kits.
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.
Can You Profit from Health Care? Part 2
May 21, 2008
A couple weeks ago WhatIf explored whether the U.S.’ largest industry – health care – is recession-proof. It seems health insurance companies’ profits are starting to slip. Rising health care costs means that insurers must pay out more to cover health services, which means they raise the price of their policies to recoup these costs. As a result, the number of employers purchasing insurance is decreasing.
Even so, the nation’s largest publicly-traded health plans say they will continue to raise premium prices and reduce provider payments in order to please Wall Street. “We will not sacrifice profitability for membership,” WellPoint President and CEO Angela Braly said recently.
When Insurers Take Their Toys and Go Home
May 10, 2008
For the past few years there has been work in cities and states across the country to improve our citizens’ access to health care. From San Francisco to Vermont, 39 states and a number of cities are in the process of creating legislation that would help address their numbers of uninsured.
Washington, D.C. is one of these. A look at the trouble our nation’s capital is facing on this issue may shed a light on why the words “health care reform” are often greeted with less than a smile.
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.
Have a Heart
April 9, 2008
Have you heard the flak that began early this year over the now infamous ad for the cholesterol drug Lipitor? In the world of marketing nothing beats celebrity.
In the view of Pfizer, apparently, nothing beats a celebrity doctor to convince folks that the science behind a medicine is sound. Thus began the 2-year ad campaign in 2006 in which the famous inventor Dr. Robert Jarvik touts what became the world’s best selling medication, Lipitor, with billions in sales. Except that, even though Robert Jarvik got his M.D. and created the artificial heart, he is not licensed to practice medicine. (He tells his side of the story here.)
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