Tuesday, November 9, 2010

Tuesday Morning News Clips

Well, we here in Connecticut finally have a governor, Dan Malloy and his super-fantastic running mate, Nancy Wyman. This bodes well for our State, but what about the rest of the nation?

More on how the GOP governors will affect the health law implementation. And here, as well. This makes me nervous, at least in part because it's going to be hard to keep track of what each state is doing if they all do something different. We will have to see how this plays out.

Meanwhile, the Supreme Court rejected a challenge to reform, although only because it had not come up through the lower courts first, as cases must. So this has very little significance.

More about premium increases in 2011. Just so we're clear, these are NOT because of health reform. I have been reviewing Anthem's rate filing here in Connecticut in advance of a public hearing. They admit that only 2% of the 19.9% increase they are requesting is due to reform. The rest is due to rising health care costs and utilization. I have a response to this that I will share with you when my testimony is final, but I just want to be clear that even the insurers, when it counts, are saying that health reform is NOT the driver of these rate increases. Indeed, this article explains that what's happening this year is pretty much the same as what happened last year -- before there was reform.

But because of high premiums, more people are opting for high deductible plans. But here's an article about how high deductible plans benefit insurance companies. I don't really get the urge to high deductible plans. If I'm paying a premium, I don't want to have to spend another $3000 or more before my insurer will start paying my bills. I wonder if this is one of the reasons for the calls I'm getting from people WITH insurance who are overwhelmed by medical debt. As the second article points out, it's certainly at least partly the reason people are skipping doctor visits. I know medical debt by people who are insured is at least partly due to copays and things insurance won't cover, but before you choose a high deductible plan, make sure you have a plan for how to pay that deductible if you end up needing health care.

And here we are again. Last June, Congress passed a 6 month delay in greatly reduced reimbursement rates for doctors who treat Medicare patients. Well, the 6 months is almost up. Doctors are (rightly) pushing for a longer-term solution. Can it get done in a lame duck Congress? Watch health reform get blamed for this when this arose WAY before health reform was passed, when Congress first passed these rate cuts. We cannot afford doctors to leave the Medicare system, so Congress needs to step up and fix this once and for all. But what are the chances? Too good an opportunity to blame reform, is my guess.

Should we privatize VA health care? Here are reasons why not, at least right now.

And here's a really interesting take, what the author learned about treating cancer at this years' TEDMED conference. The reason this is particularly interesting to me is that it's about seeing cancer as part of a system, not just a disease, suggesting that we need to treat the cause, not just the symptoms. I think this is very interesting. Some day, they are going to figure out that Crohn's disease is all about the immune system -- I'm convinced, as are a whole lot of patients who have more than one immune-related disease, and so we live the connections in a very real way. I'm excited at the prospect of medicine catching up to our experience.

A lot of big ideas today. Read, think, and comment if you like. This is all open for discussion. Jennifer

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