A New Edition of Health Wonk Review—Does Barack Obama Remind You of Richard Nixon? . . . Will Most States Expand Medicaid? Do All Non-Profit Hospitals Deserve a Tax Exemption? Why Didn’t Anyone From J&J Go to Jail?

Brad Wright has hosted the most recent edition of Health Wonk Review http://www.healthpolicyanalysis.com/2013/11/07/if-you-like-the-health-wonk-review-you-currently-have-you-can-keep-it/, a round-up of some of the best recent healthcare posts in the blogosphere. It’s an excellent read.

Wright begins with a post by John Goodman, published at the NCPOA Health Policy Blog, and titled “The Selling of Obamacare.” There, Goodman acknowledges, “As for the president himself, he is a complete enigma to me. I’ve never felt that I understood him.’  Goodman goes on to prove his point by comparing Barack Obama to Richard Nixon.

According to Goodman, when “the President suggested that most people will be completely unaffected by the new health law . . . he was lying.” After all millions who buy their own insurance in the individual market place are now getting cancellation notices. The President “looked directly into the TV camera and said something that was blatantly untrue . . . over and over and over and over again. You have to go all the way back to Richard Nixon to find something comparable.”

That’s one way of looking at things,” Wright observes, “but it’s certainly not the only way. Over at the Colorado Health Insurance Insider,/ Louise Norris counters with these words:

“Much has been said recently about how the ACA is causing a tidal wave of policy cancellations, and resulting in people losing coverage that they would prefer to keep.  The frustrating part about this – as has generally been the case with every big uproar about the ACA – is that we’re not really getting a complete picture of what’s going on, and it’s hard to see the reality through all the hype and hysteria.

I agree.

Here is the larger picture: in fact, most Americans will not be affected by Obamacare. The vast majority are insured by their employers. Medicare, Medicaid or the military. Of the 311 million people who now live in the U.S., just 15 million purchase their own insurance. They represent 5% of the population. And only some of the 5% who buy their own coverage are getting those cancellation letters,

We are talking about less than 3% of the population –far from “most people.” 

The folks I worry about most are those who should qualify for Medicaid under the Affordable Care Act, but live in states that have refused to expand the program. (Often they are not eligible for Medicaid simply because they don’t have children, no matter how poor they are.)

Wright offers hope by spotlighting Joe Paduda’s post on Managed Care Matters. There, he asks: “What’s happening with Medicaid Coverage?”

 
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Doctors Sue Hospitals to Protect Patients; A University Buys Insurance that Doesn’t Protect Students; What Gay Marriage Laws Mean for Gay Coverage . . . . and More

The newest Health Wonk Review has been posted. This time around, Colorado Health Insurance Insider’s Louise Norris is the host, and it’s an excellent read.

A few highlights:

                                 Doctors Sue Hospitals, Protect Patients

Over at Healthcare Renewal, Roy Poses digs into how doctors are pushing back against hopsitals who put profits above everything else. His article describes two recent lawsuits filed by physician groups alleging that the hospital systems they worked for were sacrificing patient welfare in the name of profit. 

As Louise observes, “the details are sickening to read:  One hospital group encouraged its docs to exaggerate the severity of patient conditions and needlessly admit patients from the ER to hospital beds in order to bill more for their treatment.  Another hospital group that owns three hospitals and also partially owns an ambulance company was making patient transfers (using their own ambulance company despite slower response times) a top priority – to the extent that a doctor’s transfer rate was a factor in bonuses and performance reviews.  An admin email stated that “the performance we are looking for are transfers.”  Wow.  Transfers just for the sake of racking up revenue – patient welfare had nothing to do with it, and was likely compromised when the slower ambulance company was used in cases where the transfer was actually warranted.”

I’m just skimming the surface of the corruption Roy exposes. You really should read his entire post.

Often doctors are afraid to stand up to greedy hospital administrators.  But by banding together, physician groups can stand up for patients.

I would add that, in the past  two doctors— working at separate non-profit hospitals—have told me about hospital administrators pressuring physicians to admit ER patients, even when they did not need to be hospitalized. This is how some hospitals “put heads on beds.” 

                 When Universities Buy Inadequate Insurance for Their Students

On his blog, Duncan Cross tells the story of the Arizona State graduate student who died because his Aetna plan (a student plan purchased through the university) capped how much the insurer would pay out over the course of a lifetime at $300,000. It also didn’t cover prescription drugs.  One might be tempted to blame the insurance company,
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Health Wonk Review –Waste, Warnings and the Future

 

Last week I hosted Health Wonk Review for HIO.  This round-up of some of the health care posts published over the past two weeks includes:

–  A piece by Managed Care Matter’s Joe Paduda that takes a hard look at “Flu season and Tamiflu,” and asks “Which one’s more hyped?”

 – A investigative post on Health Care Renewal that reviews “The Tragic Case of Aaron Swartz,”  the young computer activist who faced criminal charges for downloading thousands of scientific scholarly articles from the site JSTOR. After being pursued by a “tough as nails, relentless federal prosecutor,” Swartz committed suicide. Yet blogger Roy Poses notes, this same U.S. Attorney has been “soft as a marshmallow when dealing with top executives of health care corporations.”

– A post by The Hospitalist Leader’s Brad Flansbaum questioning the ACA’s assumption that a high rate of hospital readmissions signals waste. Just how many were preventable?

 –  In  a provocative post on Health Business Blog, David E. Williams asks why Cincinnati hospitals are furious because some employers have signed up for an insurance plan that would pay all hospitals just 40% more than Medicare pays for the same service.  The Hospitals claim  that isn’t enough. Moreover, each hospital would like to set its own prices—quietly. (This allows brand-name hospitals to charge far more than some of their competitors, for exactly the same services. )

 – On Wright on Health, Brad Wright describes a new rule, proposed by the Department of Health and Human Services that could prove “disastrous” for patients on Medicaid: “HHS is now attempting to woo states into participating in the Medicaid expansion by allowing them to increase cost-sharing in Medicaid” for all but the poorest of the poor. (More bloggers and reporters might want to write about this. The proposed rule will be open for comment until Feb. 13.)

 

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