Health care coverage for Children
Editor’s note: We are moving in the right direction on providing health care to our children — without a major health care overhaul.
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Life versus medical privacy
Editor’s note: Privacy is certainly important. However, electronic medical records and the appropriate conveyance of medical information can avoid medical errors, eliminate waste and above all save lives. Let’s not value privacy above life itself.
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EHR adoption limited in states with medical privacy laws
Adoption of electronic medical records by hospitals in states with restrictions on patient data disclosure declined by 24% in contrast with a 21% increase in states without such privacy laws, a new study found. Privacy protection may reassure patients but can restrict the implementation of information-sharing technologies, the study authors said. Healthcare IT
Everyone will pay for this health care design
Editor’s note: This comes from today’s Washington Post. What they are saying is that everyone is going to have to pay more for their health care and pay for the cost of health care for the uninsured. That unless they are willing to raise taxes yet, again, they will not be able to pay for existing and gathering debt of our current spending. So much for that campaign pledge of not increasing the taxes of 95% of the people.
As to the Post’s assertion that the tax break paid on the premium “pumps up demand for expensive treatments”, shows their total lack of understanding of the hydraulics of health care plan design that employers have been utilizing for many years.
Part of the reason that High Deductible Health Plans and other plans that use deductibles, coinsurance and out of pocket maximums have an effect on health care consumption is that it impacts the purchasing decision at the point of use. We long ago learned that increasing the premium or payroll deduction for health insurance had little effect on purchasing decisions. Standalone copayments we much of the same ilk. The consumer would pay their $10, $15, or $30 copayment and it would be like a buffet — all they could eat or convince their doctor that they needed.
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The Deep-Pockets Mirage
House Democrats would have us believe that the rich can pay for it all.
Wednesday, July 15, 2009
THERE IS a serious case to be made that the U.S. income tax system should become more progressive. The average rate paid by the top 1 percent of households shrank from 33 percent in 1986 to about 23 percent in 2006. At the same time, the share of adjusted gross income claimed by that highest-earning sliver of American society doubled, from 11 percent to 22 percent. So, in principle, higher taxes for the well-heeled could make sense — as part of a broader rationalization of the unduly complex tax code.
But there is no case to be made for the House Democratic majority’s proposal to fund health-care legislation through an ad hoc income tax surcharge for top-earning households. The new surtax would hit individual households earning $350,000 and above. It would start at 1 percent, bumping up to 1.5 percent at $500,000 in income and to 5.4 percent at $1 million. The new levy would begin in 2011 and is supposed to raise $540 billion over 10 years, about half the projected cost of health-care reform. The rest of the money would come from reduced spending on Medicare and Medicaid — though the surtax for the lower two categories would jump by a percentage point each in 2013 unless the Office of Management and Budget determines that the rest of the bill has saved more than $150 billion.
The traditional argument against sharp increases in the marginal tax rates of a very narrow band of Americans is that it could distort their economic behavior — most likely by encouraging them to put more of their money into tax shelters as opposed to productive investments. This effect could be greatest in certain states, such as New York, where a higher federal rate would add to already substantial state income taxes. The deeper issue, though, is whether it is wise to pay for a far-reaching new federal social program by tapping a revenue source that would surely need to be tapped if and when Congress and the Obama administration get serious about the long-term federal deficit.
That moment may be approaching faster than they would like. Even if Congress pulls off a budget-neutral expansion of health care, the gap between federal revenue and expenditures will reach 7 percent of gross domestic product in 2020, according to the Congressional Budget Office. And that’s assuming that the economy returns to full employment between now and then. The long-term deficit is driven by the aging of the population as well as by growing health-care costs, both contributing to Social Security and Medicare expenses. There is simply no way to close the gap by taxing a handful of high earners. The House actions echo President Obama’s unrealistic campaign promise that he can build a larger, more progressive government while raising taxes on only the wealthiest.
Mr. Obama praised the House bill yesterday without addressing the surtax. A far better way to pay for health care would be to end the tax break for employer-provided health benefits, a subsidy that not only artificially pumps up demand for expensive treatments but also disproportionately benefits upper-income earners. Eliminating or, at least, capping it would be good health-care policy as well as good tax and budget policy. Pretending that “the rich” alone can fund government, let alone the kind of activist government that the president and Congress envision, is bad policy any way you look at it.
The Cost of Heart Disease
Estimated Costs Associated with Cardiovascular Disease in the U.S. in 2009
- Hospital: $150.1 billion
- Medical Durables: $52.3 billion
- Nursing Home: $48.2 billion
- Physicians: $46.4 billion
- Home Health Care: $16.8 billion
Source: Journal of the American Heart Association, “Heart Association Statistics Committee and Stroke Statistics Subcommittee Heart Disease and Stroke Statistics 2009 Update: A Report From the American Heart Association.”
Getting the Care in Healthcare
Editor’s note: Creative disruption is a powerful force in the battle to reduce spending and improve quality and outcomes.
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Each year, about one in five older patients discharged from the hospital is rehospitalized — usually within two weeks — at enormous cost to the health care system and the patient’s well-being.
But when 79-year-old Andy Undem was discharged from Fairview Southdale Hospital after three weeks with pneumonia and a lung infection, he went directly into an experimental program that is pointing the way to billions of dollars in savings for Medicare.
A year-long study at a Minneapolis nursing home showed that focused care by a team of University of Minnesota medical specialists cut the number of older short-term patients who were rehospitalized by 20 percent — to a rate 33 percent below the national average.
The savings could be huge. High rates of rehospitalization cost the federal Medicare program more than $17 billion, a recent study estimated.
“I can’t tell you about savings,” said Undem, a retired president of the old First Produce State Bank in downtown Minneapolis, now site of the Target Center. “I just know their job was to get me better so I could go home, and that’s exactly what they did.”
The program in the Transitional Care Unit at Walker Methodist Care Center is the only one of its kind, officials say. Findings of the state-supported study indicate that if the program were in place at other short-stay centers that help patients transition from hospital to home, the annual savings could top $5 billion.
They are working now to pin down more precise savings and figure out how other short-term care units can adopt the model they have developed.
In the program, a physician, nurse practitioner, pharmacist and sometimes a dentist from the University of Minnesota join forces to care for patients, with special focus on the 75 percent most at risk of returning to the hospital. The idea is to avoid drug interactions, care lapses and other serious but preventable complications that are most likely to send the patient back to the hospital.
House Bill Would Make Health Care A Right
Editor’s note: We have a serious problem with health care in this country. Reflect for a moment on some of the themes and some of the rhetoric.
Health care is unaffordable. Health care cost increases are unsustainable. Health care in … the UK … Canada….
Health care is a right.
Okay, seriously what does this or any of the other proposals do to solve any of these problems? If the costs are unsustainable, taxing employers and the wealthy doesn’t make the costs sustainable.
Looking to other countries for answers — show me one state or one country in the world where health care costs are sustainable.
Health care is a right. Perhaps I am naive, but isn’t it the US Constitution that confers rights on US citizens? Is someone proposing a Constitutional amendment? There’s a whole other process for that.
Associated Press Online
Erica Werner
July 15, 2009
House Democratic leaders, pledging to meet the president’s goal of health care legislation before their August break, are offering a $1.5 trillion plan that for the first time would make health care a right and a responsibility for all Americans. Left to pick up most of the tab were medical providers, employers and the wealthy.
“We cannot allow this issue to be delayed. We cannot put it off again,” Rep. Henry Waxman, D-Calif., the chairman of the House Energy and Commerce committee, said Tuesday. “We, quite frankly, cannot go home for a recess unless the House and the Senate both pass bills to reform and restructure our health care system.”
In the Senate, Majority Leader Harry Reid said he wanted floor debate to begin a week from Monday. With the Senate Finance Committee still struggling to reach consensus, that timetable could slip. Even so, it underscored a renewed sense of urgency.
Obama himself was driving the action, going off-script to push the issue during a speech in Michigan and scheduling a Rose Garden news conference for Wednesday to make more comments on the topic.
“There’s going to be a major debate over the next three weeks,” Obama said in Warren, Mich., deviating from his prepared text on new spending for community colleges. “And don’t be fooled by folks trying to scare you saying we can’t change the health care system. We have no choice but to change the health care system because right now it’s broken for too many Americans.”
All involved were mindful of the dwindling days before Congress leaves town. Obama wants legislation through the House and Senate before then to slow rising costs and extend coverage to some 50 million uninsured Americans.
Under the House Democrats’ plan, the federal government would be responsible for ensuring that every person, regardless of income or the state of their health, has access to an affordable insurance plan. Individuals and employers would have new obligations to get coverage, or face hefty penalties.
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