Friday, March 16, 2012

Finally Friday Edition!

Well, we made it through another week -- and all things being equal, a relatively quiet week, which is nice since the last 5 weeks have been killer. Just have to get through today, starting with the news:

Those who challenge health reform in the Supreme Court argue that, if the government can make you buy health insurance, it can make you buy anything -- a car, broccoli, whatever. However, the government provides $43 billion to cover uncompensated care -- those unpaid health care bills -- for people who choose not to buy insurance. The government does not pay $43 million for cars people didn't buy, or broccoli, for that matter. Sort of a big difference, no? And nobody claims that the government does not have the power to require coverage of pre-existing conditions. If the individual mandate is necessary to accomplish this -- which it is -- then that, too, makes this different from buying a car or broccoli. And look at the good the law already has done -- covering kids to age 19 despite pre-existing conditions, allowing kids to age 26 to stay on their parents' policy, the Pre-existing Condition Insurance Plan, lower prescription drug costs for seniors, eliminating lifetime limits on coverage, coverage of preventive care -- with coverage of everybody, despite pre-existing conditions, and the creation of exchanges where people can shop for and buy insurance all to come in 2014. Here's more on what the health reform law has done. But will health reform mean a shift away from employer-sponsored insurance? To some extent -- but at least some of this will be due to the end of mini-med plans, which provide extraordinarily limited coverage, so when insurance is available on the Exchanges with subsidies making it more affordable, people will find better options to employer-sponsored coverage. I'm not at all sure this is a bad thing. All of this is being discussed in anticipation of the Supreme Court arguments, which start on March 26.

A new GOP bill would enroll seniors in the federal employee health benefits plan -- increasing premiums for federal employees as well as for seniors, and ending Medicare as we know it. The bill would also raise the eligibility age from 65 to 70.

It may be that the House GOP has begun to realize the harm to their party from fighting over insurance coverage of contraceptives -- or maybe not. The Catholic bishops say this isn't about contraceptives, which are plentiful and inexpensive, they say -- this is about religious liberty. And here's the slippery slope -- a non-religious employer sues over contraceptive coverage, saying forcing his employer-based health insurance to provide free contraceptives violates his religious freedom. Don't let anybody tell you this is just about the Church -- this is about allowing employers to control women's health.

Meanwhile, the White House has defunded the Texas Women's Health Program for excluding Planned Parenthood, including clinics where abortions are not performed. Federal law doesn't allow states to exclude a particular provider.

The wonderful Dr. Pauline Chen talks about how important it is for doctors to think about costs when they prescribe tests and treatments. What can the patient afford? What will their insurance cover? Do you want your doctor thinking about this, or should they just do whatever's best, cost be damned?

Home health care companies' profits are up dramatically. MedPAC -- the Medicare advisory board -- has urged Congress to lower reimbursement rates for home health care since they are seeing about 19.8% profit in Medicare, while the industry fights legislation that would require them to pay minimum wage to their workers.

And that's it for this morning. Have a great day and a great week-end! Jennifer

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