Wednesday, June 27, 2012

News? What News?

It's all about the Supreme Court for me.  But let's see if there's anything else going on that warrants a closer look.

Okay, well, this is about the health reform case.  But this is the coolest thing I've seen.  It allows you to see how a ruling to uphold the law, strike down the law, or strike down the mandate only would affect you in particular.  You want to see what the law already means to people like you?  Click on the tab that says "the law is struck down."  I think what scares me most about this case is that it took a century -- literally -- to pass reform.  If it's struck down, it may take another century --  certainly another generation.  This is our moment.  Will nine people with insurance paid for by the federal government really understand what's at stake?  On the other hand, will the Justices' health issues influence their decision?  I've been wondering about Justice Sotomayor, who has diabetes.  Do you think she's sharing with her colleagues what it's like to live with chronic illness? 

Both presidential campaigns are all over the health reform ruling even before it's announced.   Romney -- who signed health reform with an individual mandate into law in Massachusetts before he (and the rest of the GOP) decided that the mandate, which is a Republican idea born at Republican think-tanks, is a horrible thing -- says he's the guy to lead us out of the mess caused by health reform.  President Obama says health reform was the right thing to do, and whatever the Court says, we need to keep moving forward, not backwards.  Expect to hear these themes over and over again through November.

For three years, we were told that the GOP wanted to "repeal and replace" the health reform law.  It turns out, though, that they're not in a hurry to replace it if the law goes down.  Your kids to age 26 on your policy?  That could go down.  Lifetime limits could be reinstated.  External appeals could go away -- meaning those of you in self-funded plans no longer would have a right to an independent review of your plan's coverage denials.  And on an on.  Not to mention premium hikes remain unchecked, the medical loss ratio, including rebates, would be gone.  Premiums skyrocket.  Millions more people become uninsured.  And the GOP sits on its hands? 

The health care industry is on edge.  Will this decision create chaos?  Will Congress and/or state legislatures pick up the slack

The Treasury Department has released proposed regulations that would require non-profit hospitals to give low income patients a four month breathing period to apply for financial aid before their bill is sent to collections.  This is AWESOME -- and yet another benefit of health reform.

What you eat may make more of a difference than how much you eat when you're trying to lose weight and keep it off.  A low carbohydrate diet helps you burn more calories than a low fat diet, for example.  This was a small study and not definitive, but it's good to know.

What's the role of pharmacists in health care?  Pharmacies would like to expand the role of pharmacists.  For those of us on complex medication regimens, I think this is a great idea.  I have a wonderful pharmacies, Elie.  He's gotten me through some very tough times, and he's always looking out for me.  When my tooth abscessed and I had to go through two rounds of flagyl, he checked in with me and made sure we had a really good reason for the second round -- he was concerned about c difficile, which often comes from antibiotics.  That's just one example of the concern he's showed towards me over the years.  He's definitely one of my health care providers.

One in three Americans can't afford dental care.  We often forget the importance of oral health, and it's not something most of us are prepared to go into debt for.  But if you're like me, putting off the dentist usually means things get a lot worse before they get better.  Still, it's expensive and since most of us don't have dental insurance, we're paying out of our pockets.  Tough one. 

And there you go.  Have a great day -- and stay tuned here tomorrow morning for news and analysis.  Jennifer



1 comment:

  1. The dental care problem calls for a national dental service. Access to dental care for the middle class is in these RAM events once a year, which is idiotic because you can't treat years of non-access with an hour visit in a barn or minor league sports stadium. (This isn't to criticize RAM or the doctors who volunteer, they're amazing but it really shouldn't have to exist in our country).

    The dental care problem also keeps people in poverty. Lots of companies won't hire people without teeth, especially for customer service positions. It's just stupid.

    The way to fix it: tell dentists if you join the Federal Dental Service the government will wave your loans after you pay 5% of your income for 5 years in repayments. Make the dental service free, like what they have in the UK, but tack on a $20 copayment for anyone making over 80% of the MHI. That really wouldn't cost anything if you take into account the increased tax revenues from newly employable (with teeth!) people and lowered ER visits.

    As for the Justices, it depends on what they see when interacting with the medical system. If you're really paying attention, you can see the anguish in people who cannot afford care or were booted off insurance when in waiting rooms. But you have to be paying attention to see it, and security needs may well keep Justice patients away from everyday people.

    The Thomas quote is pretty intetesting. Surprised no one had brought that up before. It indicates he did see how the medical system can fail and make people feel like their lives aren't valuable. I had not seen that before. We'll see...

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