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Posts Tagged ‘Healthcare Reform’

I’m still amazed that a government agency is asking for our opinions – and better yet, they’re actually listening.

Check out this post for a little background. The verdict is in. The USDA is backing off on a proposal that might have inadvertently encouraged heavy drinking. They had originally proposed to ditch the daily recommendations and set weekly recommended quantities of alcohol, but the public spoke out. Since most people do their drinking only one to three nights a week, those who took the time to comment online were mostly concerned that drinkers would look at weekly guidelines and try to cram one week’s worth of drinking into one night. And that was a real possibility – most of us know how bright alcoholics are when it comes to justifying “let’s have another one!”

The USDA’s new guidelines retained a daily recommendation for alcohol consumption, and they now define heavy drinking and binge drinking as well. They admit there is evidence of health benefits of moderate drinking – apparently they’re trying extra hard not to give anyone the idea that it’s okay to drink like a fish – but they now give the stern “this is bad for your health” statement like you’ll find on a cigarette pack, listing all the health conditions that might get in your way if you drink too much.

According to Join Together, it was the online response from private citizens (both healthcare professionals and concerned consumers) that made a difference in the final policy decision. That is seriously encouraging. All government agencies should have a limited public commenting period like this every time new policies are being considered. 

Get ready to click again – someone else needs our input now. The Centers for Medicare and Medicaid Services (part of the Department for Health and Human Services) is asking what we think about Medicare covering alcohol screening and counseling in primary medical care.

This debate is about whether Medicare and Medicaid should cover alcohol abuse prevention, screening, and counseling. They already cover screening for other medical issues, but this time they’re considering doing that for something that might cross over into services that are normally performed by mental health providers.

Providing the service could mean a significant extension of prevention and early intervention services for individuals struggling with alcohol. It could also be pretty expensive, but then again so is the current drain on state and federal budgets when it comes to incarceration of drunk drivers and other alcohol-fueled criminals, child protective services, healthcare services for abused family members, emergency services for indigent people with alcohol poisoning, and anything else that relates to the public costs of excessive drinking.

A report on reducing underage drinking from the National Academy of Sciences found that government agencies, businesses, and individuals in the United States end up spending – and remember, this is just about underage drinkers – around $53 billion per year (including $29 billion due to violent crime and $19 billion from traffic crashes) because we can’t keep the alcohol away from the kids. Now that’s expensive. And that study was presented back in 2003. What are those numbers like today? And how much greater could the costs be for adults with alcohol problems?

If you want to get in on the debate, their National Coverage Analysis Tracking Sheet is open for comments until March 20, 2011. Let them know – especially if you work in healthcare – what you think about how this might work, who might coordinate the services, how often the services might be offered, or under what conditions Medicare or Medicaid might play a greater role in preventing a lot more unnecessary problems.

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I’ve been reading a lot of pontifications from people who think that they’re personally having to pay for the new health care law. They see that greed exists on both ends of the economic spectrum, and they’re offended at the possibility that they’re paying more than their share. I can understand that.

But when they start talking like everyone who doesn’t work or pay their own way is lazy or not worth a hill of beans, I’m sorry – I can’t let that one roll.

I was recently remarried, and if it weren’t for my husband, I would be one of those without health insurance, so I know what it’s like to have to go without. Most of my friends are still in that situation. They don’t ask for handouts, and if they’re eligible for food stamps, they don’t abuse the system any more than sharing their extra food with hungry out-of-work friends who have even less to eat. Their pride gets in the way of trying to actively work the system.

We’re not redefining greed to borrow from Robin Hood’s “steal from the rich and give to the poor.” Not all rich people are greedy, but not all poor people are greedy. We’re all naturally motivated to get money so we can have edible food and a decent roof over our heads, and some people in every economic situation take it to extremes and find greed to be a wonderful survival tactic.

What has been redefined is how the media works. It is now easier to spread the word about decent people who honestly can’t provide for themselves and earn their keep. Many times it’s not about whether or not they want to work. Employers won’t keep sick people on the payroll if they can help it – and that goes for both physical and mental illnesses. People without insurance tend to stay sick. Others get fired because they either call off work too much or they come to work sick because they’re afraid they’ll get fired – but they’re not operating at 100% so some get fired anyway and they lose their ability to pay the doctor.

It’s a big vicious circle – and it’s a realistic explanation of why people flood the emergency room when they get sick instead of seeing a regular doctor. They know that they can just get the bill later and hope they’re working by the time they get it. A lot of my friends don’t do either one. They can’t pay a regular doctor, and they don’t want the bill collectors blowing up their phone. They’d rather stay sick than incur a bill they don’t have much hope of paying, which in turn screws their chances of staying gainfully employed and screws their kids out of being able to pay attention in school, and it just goes round and round.

Health care reform is really an economic issue as much as a social issue. Full employment means getting the right leg brace and PT for someone with a bad leg instead of letting them limp around everywhere and depend on others. It means early detection of everything from the flu to cancer. It means making sure people with certain types of mental illness get the meds they need to be functional, productive members of society. Just a little bit of the right type of health care can put a lot of people back into the workforce (job availability permitting). More payroll tax income, more sales tax income, and more property tax income could make a real difference in the country’s cash flow.

And if you don’t like Obamacare, I suggest you get execs from the insurance, provider, pharmaceutical, and technology industries together and figure something else out, because what we have in the existing free market doesn’t really work for anyone but the top brass raking in the dough. Lock everyone in a room and don’t let them out – not even to go to the doctor – until they craft a system that everyone can live with.

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The Patient Protection and Affordable Care Act (PPACA) began its journey into the wild blue yonder today.

You know the laundry list of benefits that went into effect today. There’s no way some part of the media has not reached you by now. Across the board, we’re getting ready to see:

  • elimination of lifetime coverage limits
  • restrictions on or phaseouts of annual coverage limits
  • extension of dependent coverage up to age 26
  • no more policy cancellations for sick people

And these changes are also being made, but only for employer plans or new individual policies – they may not apply if your insurer chooses not to amend your existing policy:

  • no more plans that deny or cancel coverage for children with pre-existing conditions
  • free evidence-based preventive care services
  • no more out-of-network increases for medical emergencies

Now, I think that making predictions about what these changes will or won’t do is a little like predicting whether getting a new job will make you a happier, more productive person. The grass may look greener, but you don’t know until you get there. There are too many variables involved.

But I have another list for you.

According to the Bazelon Center for Mental Health Law, we have the following facts staring us in the face:

  • 26% of Americans have a diagnosable mental disorder.
  • Only 29% of those people actually receive treatment.
  • 50% of Americans with a mental disorder have problems by age 14.
  • Mental disorders are the leading cause of disability for Americans age 15-44.
  • Major mental disorders cost America at least $193 billion per year in lost wages alone. This study only focused on comparative wage levels – it didn’t include the costs of presenteeism (showing up but being unproductive) or absenteeism (calling off work) on the job.

Insurance parity is an economic issue. Mental health parity is great, but it isn’t enough. Now we need to get people into treatment and back to productivity, and cost – lack of insurance coverage – is the biggest roadblock to getting that help.

Think of the cost savings if we could get people off of public disability assistance and/or Medicaid. Think of the extra cash flow that America could experience with additional payroll tax income, sales tax income, and property tax income because so many more people would be able to work and buy things like appliances and furniture and homes. Think of what could happen if all those kids got help and became productive citizens instead of being homeless or in jail.

No matter who reacts how to the new law, we’re taking another step in the right direction for the good of our country as a whole. You can talk about bleeding hearts all you want, but the return on investment here is too great to pass up.

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The great thing about the Internet is that we – the public – can weigh in on proposals that our government is trying on for size, and they’re actually asking our opinion straight up, without asking us to contact our representatives! Now that’s democracy in action – I love this country.

The latest open commentary has to do with the USDA’s recommendations on how much alcohol is too much – in this case, the cap on “low-risk drinking” and “moderation” would now be defined as 14 drinks weekly (no more than 4 drinks per day) for men and 7 drinks weekly (no more than 3 drinks per day) for women. CLICK HERE to read what other people are saying about the Rethinking Drinking report and submit your own comments. But don’t wait – the deadline for weighing in on this issue is this Thursday, July 15.

Personally, I think it’s interesting that someone thinks we’re going to consult the USDA recommendations before we go to a party or a bar and have a few. But people really take this sort of thing as an authoritative statement for how much is too much. We don’t know – we’re not doing the research. We rely on them for information. And they are citing research about how alcohol is actually good for your health sometimes. On the other hand, nobody’s changing the legal limit for how drunk is too drunk, and we’re having a hard enough time keeping the kids and the drunks from thinking that getting smashed is cool.

What do you think? Are they giving people license to drink more, or are they just telling us to lighten up?

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Check this out. The US Patent Office has officially declared that we don’t own our own genetic material, and apparently they’ve been doing it for years.

Now, normally I don’t jump every time the ACLU has a problem with something, but this one I like. On behalf of 20 plaintiffs, including other researchers and individual cancer patients who can’t get the testing they need, the ACLU has filed a lawsuit in a New York federal court to release the patent which says that Myriad Genetics is the only company that can study, test, and report on the BRCA genes related to breast and ovarian cancer.

This isn’t exactly a new story, but twelve years and eight patents ago, someone at the US Patent Office began setting a seriously questionable precedent.

If they’re really preventing anyone else from even looking at these genes, Myriad’s patents have succeeded in holding up cancer research – for now. Fortunately, someone has already recognized the futility of patenting nature. Myriad’s motion to dismiss was denied by the judge. Stay tuned.

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I was reading an article on MSNBC this evening entitled, “Insurers escalate criticism of health overhaul.” Apparently, the health insurance industry commissioned a cost analysis from PriceWaterhouseCoopers that projected higher premium costs for privately insured individuals over the next several years.

Let’s see. We’re going to require that health insurance companies accept all applicants, we’re going to take away their right to deny coverage based on pre-existing conditions, and we’re going to increase their customer base because of that. Meanwhile, we’re going to legislate a series of give-and-take taxes, credits, and conditions to level the paying field (no, that’s not a typo). Finally, either they will raise their rates and watch their customer base decline in favor of public programs, or they will find a way to control costs and keep their customers.

No – wait. They just said that the legislation will raise their rates again, and that would be bad. The health care reform bill will raise their rates for them. It will be all someone else’s fault that we’ll be paying higher premiums, not theirs.

Do you think there will ever come a time when the insurance industry will see raising rates as a choice instead of a mandate?

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