Big news day yesterday -- the House GOP released their 2013 budget, which pretty much destroys Medicare, Medicaid, cuts food stamps and low income housing -- and cuts taxes for wealthy individuals and corporations; and the Supreme Court handed down an awful ruling saying state employees who take FMLA for their own illnesses cannot sue if their employer violates the law. Made me want to stay in bed and hide under the covers -- but, then, who would bring you the news?
So first, the FMLA. There are 2 parts to the FMLA -- one part that says you can take leave to take care of another person -- spouse or child -- and one part that says you can take leave to take care of yourself. In general, you can't sue a state for money damages unless Congress has properly invaded sovereign immunity due to race or sex discrimination. Several years ago, the Court held that allowing state employees to sue their employers over FMLA violations of the family leave part of the law was okay because there was a history of discrimination in the workplace against women who took care of children and spouses. However, yesterday, the Court held that allowing state employees to sue for violations of the self-care portion of the FMLA is NOT a valid exercise of Congress's power because the self-care portion of the FMLA was not, they said, motivated by a desire to correct a history of discrimination based on gender. States can waive sovereign immunity, as I suspect some will after this ruling. But as a general rule, state employees who are sick cannot sue their employers for violating the FMLA. Justice Ginsberg wrote a scathing dissent.
Next, the GOP budget. It would cut spending by $5.3 trillion, shaving $205 billion from Medicare and $770 billion from Medicaid and other health programs, and $2 trillion from other programs for the poor, unemployed, farmers. It also would repeal health reform (which, by all accounts, would save money, but why nitpick?). Medicare would become a voucher program -- assuming, of course, that you can find an insurance policy that will cover someone over age 65 with pre-existing conditions, as most seniors have. More details are here. The 35 percent corporate tax would be decreased to 25 percent, and individual tax rates would be collapsed into two rates, the highest being 25 percent -- a break for the wealthy. Now, I'm sorry folks, but REALLY???? This budget is so transparently one-sided, favoring the rich and deeply harming the poor. It's one thing to take the deficit seriously. It's another thing to place the entire burden for fixing it on those who are most vulnerable while delivering high rollers a huge break. Setting aside my outrage for the moment, the GOP proposal also abandons the deal made over the debt ceiling for agency budgets. Since the new fiscal year starts in the fall, you could see a threat of a government shut-down leading up to the Presidential election.
The uninsured consumed $116 billion in health care costs in 2008, while failing to pay for 63 percent of that. Do you need more of an argument in favor of an individual mandate? Even if you are not in favor of health reform, do you support allowing people a free ride on taxpayer dollars? Because key pieces of the law don't take effect until 2014, you can't see yet all the good it will do. If you were the parent of a kid with hemophilia who lost his insurance over and over because there used to be lifetime caps on benefits, though, you'd get that this law already is saving lives. Here are some of the things we would lose if the law were repealed. And we know from the experience of New Jersey that forcing insurers to cover people with pre-existing conditions without an individual mandate driving healthy people into the pool drives prices up and healthy people leave the system -- a train wreck. If health reform is going to work, we are going to have to do something to drive healthy people into the pool. Here's an analysis of how people in Illinois will fare under health reform.
IBD patients take note: The Supreme Court has ruled that blood tests that rely on a correlation between medication and disease state are NOT patentable -- SO the Mayo Clinic's tests that duplicate the Prometheus labs for 6MP levels are entirely legal. Watch for the other big labs to follow suit. We may finally be getting to insurance coverage of these tests.
More and more, anesthesia is being used for colonoscopies rather than the old conscious sedation -- at a cost of $1 billion per year in unnecessary spending.
Black women are less likely than white women to get breast cancer, but they are more likely to die from it due to fear of confronting it. But income is also an issue, access to health care is critical, and public education efforts need to be properly targeted.
Two new studies find that an aspirin a day may reduce cancer risks. So if you do NOT have a digestive disease, it may be a good idea to take one. If you DO have a digestive disease, check with your doctor first to make sure your stomach can tolerate aspirin.
Obesity can cause joint pain, diabetes, heart disease.
A relatively inexpensive drug may help bleeding victims. It's used on the battlefield, and slowly is becoming accepted in emergency rooms.
Take a generic drug and you can't sue the manufacturer if it harms you. Hmm.
And that's it for today. Have a great day! Jennifer
Wednesday, March 21, 2012
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