Tuesday Tidbits

Tuesday is the busiest health news day, so let's plunge right in!

As you know, the challenge to the health reform law begins with the argument that Congress overstepped its authority under the Commerce Clause of the Constitution. If you want to understand what the Commerce Clause cases say, here's a well-told story of the landmark case upon which the government relies. And here's some maneuvering on the political side of the case. Is it true that, if people understood health reform better, they would support it? I tend to think so, which is why I try so hard to educate people about what the law does and does NOT do. For example, most people think the individual mandate is unconstitutional and should be struck down. But when I tell people that, in order to get coverage of pre-existing conditions without premiums going bonkers, we have to have an individual mandate so healthy people join the pool -- and that there will be subsidies to help people pay for health insurance -- they think again. And we know seniors have saved a lot of money as a result of health reform. Here's a chart that shows the politics of the law. Here's more. Insurers say the worst case scenario is that the mandate is struck down but they still have to cover people with pre-existing conditions. Insurers are adamant that the end of the mandate means the end of covering people with pre-existing conditions. Indeed, the Obama Justice Department has already asked the Court to strike down coverage of pre-existing conditions if the mandate is ruled unconstitutional. And that, to me, is the worst case scenario. People with chronic illnesses -- pre-existing conditions -- must be able to buy insurance in America. If we lose that piece of the law, we will go back to having second-class status, the uninsurables. I truly can't bear the thought. But health reform implementation continues. There certainly are pieces of the law that will survive overturning the individual mandate. Here's a list of things to watch in the coming year.

Texas has the highest rate of uninsurance and Massachusetts has the lowest. What's it like in those two states? Read about it here. You need to read this.

The Pre-existing Condition Insurance Plan (PCIP) -- part of the health reform law -- has premiums that are low when compared with private sector individual insurance, but still too much for some. So nonprofits and states are helping some with those premiums. But not every state. From the perspective of the people who call us, the biggest problem isn't the premium; it's the requirement that you go without insurance for 6 months in order to qualify.

And now extended unemployment benefits will start to dry up in several states. This was part of the deal the GOP extracted in exchange for extending the payroll tax cut. Just awful.

The GOP's budget czar, Paul Ryan, will release his 2013 budget proposal today. Let's see what it does to Medicare? The best guess is that there will be an option -- stick with traditional Medicare or take the money to buy insurance. Of course, if the health reform law is struck down and we don't have coverage of people with pre-existing conditions, most seniors won't be able to buy individual coverage for any amount of money. But hey -- what's a little scamming of the American people all for the cause of shrinking the size of the federal government no matter who loses?

Women spend more on health care than men. Insurance premiums are higher. That will change if health reform is allowed to take full effect.

Most women see their gynecologist for a breast exam and pap smear every year, but with new national recommendations saying that's not necessary, is this a good message to be sending to women?

Gut infections are becoming more lethal. Clostridium difficile (c-diff) is the leading cause of GI deaths. The second leading cause is norovirus. Both are contagious and can be prevented largely if people (including doctors and nurses, especially in hospitals) wash their hands.

A better approach to advanced illness, treat at home, stay comfortable, and save a ton of money in the process.

You know those new cigarette labels with the graphic pictures? A trial court said cigarette makers couldn't be forced to use them, but a court of appeals says they're legal. Another case headed to the Supremes?

Here's a good one. A man freezes his sperm and then dies, perhaps at war. His child is conceived and born after he dies. Is his child entitled to Social Security survivor's benefits? The Supreme Court will have to decide.

How much of your health info do you get from the internet? Be careful -- there's bad info out there.

A headache that was hard to treat and harder to diagnose -- "new daily persistent headache." Not a migraine. Just a headache. Every single day. I think I would cut my head off.

Hearing loss may raise the risk of falls in seniors.

Exercise can help recovery from a stroke.

If you're going to the London Olympics, it's best to get your measles vaccine. Indeed, it's important to get this and other vaccines in any event -- and in some parts of the country, vaccination rates are way lower than they should be.

And that is today's health news. Have a great day! Jennifer