Finally Friday Edition

Team McCready events are happening all over the world tomorrow, to benefit Advocacy for Patients with Chronic Illness. For locations and m0re info, check out the Wishlist Foundation here. I'll be at the New York event, so stop by and say hello! Now, to the real news:

Today marks the second anniversary of health reform. Here's a timeline of the law's milestones to date. We have coverage of kids under age 19 despite pre-existing conditions. 2.5 million kids are on their parents' policies up to age 26. The elimination of lifetime caps and the phase out of annual caps. Free preventive care. The Pre-existing Condition Insurance Plan. Lower drug costs for seniors. And through external appeals, we are winning cases that, in the past, would have been unwinnable. Although the really big stuff comes in 2014, the changes that have already taken place have been entirely positive -- no rationing, no death panels -- none of the gloom and doom has occurred. So why aren't Americans jumping on the health reform bandwagon? Politico says it all comes down to the Dems' failure to explain the law to Americans, to message it and educate about it. And the White House is not doing much to combat that; the President is laying low on health reform in the run up to the Supreme Court arguments. But yesterday, HHS condemned insurance premium rate increases in 9 states as being excessive -- another benefit of health reform that has, in fact, slowed the rate of increase. And 49 of 50 states have implemented at least part of health reform.

What happens if the Supreme Court strikes down health reform? It depends on whether they strike down the whole law, but for sure, if they strike down the individual mandate, we will lose coverage of pre-existing conditions. And that, to me, is just unthinkable. What do the big players in the health care industry -- insurers, pharmaceutical companies, hospitals, doctors -- think of health reform? It seems all pretty driven by self-interest. If the individual mandate falls, insurers are worried they'll still have to cover people with pre-existing conditions -- although the government asks the Court to strike down that provision, too, if it finds the individual mandate to be unconstitutional.

Yesterday, the House voted to repeal the Independent Payment Advisory Board (IPAB), which is supposed to help control Medicare costs by studying treatments and making recommendations about what to cover and what not to. The GOP calls it rationing (although they are willing to turn Medicare into a voucher system, so I don't really buy their hand-wringing about reducing access to care). The intent is to study different treatments to determine cost-effectiveness -- if a more expensive treatment really doesn't work any better than the less expensive alternative, for example. And Congress has the right to overturn their recommendations. Indeed, the IPAB isn't even appointed yet. Striking it down before we can even see how it works without any suggestions on how better to control costs (other than by gutting Medicare entirely) seems short-sighted to me.

Insurers are selling a new kind of insurance -- self-funded insurance for small businesses. The plans offer stop-loss coverage, so after the employer has spent $10,000 (or whatever amount the policy dictates) on an employee, the insurer then kicks in. The allegation is that insurers are using this to cherry pick employers with low health care costs -- and it takes these plans out of regulation by state insurance departments because self-funded plans are not governed by state law. And that is worrisome, as consumers will lose important consumer protections.

The Justice Department has accused AT&T of improperly collecting $16 million from the government to support communications for the deaf, knowing it was being used to perpetrate a scam. If this is true, it's horrendous.

Anthem Blue Cross of California has reduced the premium rate hike that they previously requested. They still want an 8.2% rate increase, though.

The war on women's health in Texas has been brewing for quite some time, according to this account. There are those of us who are old enough to have lived through this war the first time around. I don't know about you, but I'm pretty offended at having to fight this war all over again.

The ever-wonderful Dr. Pauline Chen writes about patients learning from other patients -- peer mentoring, she calls it. That's sort of what I do, at least some of the time. I definitely think I'm more effective at my work because I'm also a patient. Interesting.

And that's it for this morning. Have a great day. Jennifer