Finally Friday!

As unemployment runs out, tragedy abounds for over 1 million people who've been out of work for the long term.  This article tells the story of an office manager who was laid off two years ago and hasn't been able to find work.  She's spent her savings and even used candlelight to save on electricity bills. If she doesn't find a job in the next month, she will be evicted and homeless.  Now, add to that a serious chronic illness and no way to pay for health care.  Those are the calls I get.  That is why health reform's Medicaid expansion is so important. 

A month or so ago, it seemed like health reform would be a hot button issue throughout the presidential campaign.  However, both campaigns have gone silent on health reform. Is it because Romney can't really attack the law since he signed the same plan into law in Massachusetts?  That and the fact that the President doesn't want to highlight it too much due to opposition.  It's still a big issue in Congressional races, but the presidential campaigns aren't talking about it -- at least for now.  I'm sure it will come back during the debates.

The House GOP challenges the IRS on interpreting the health reform law to allow subsidies to be paid through federal exchanges where states refuse to create their own exchange.  The IRS says this was its best interpretation of the law.  I suspect this one's going to court.

And a liberal think tank has come out with a second generation health reform law -- this one focusing on controlling cost.  As I said earlier in the week, the Massachusetts plan was always intended to involve two steps -- first, get everyone covered; then, focus on costs.  To a large extent, that was the model of the federal law, too.  But we need to deal with costs -- and we need all the ideas we can muster.  This one is interesting in that it avoids cutting entitlement programs in way that would affect health care quality, moving away from fee for service to an umbrella payment per patient to take care of that patient's care.  I worry that this would incentivize providers to provide fewer services, but if you figure that each provider would have some healthy people and some sick people, maybe it balances out.  We surely have to try something new.

Speaking of controlling costs, Vermont has created a Green Mountain Board, which is controlling health care pricing in the state as they transition to a single-payer system.  Now, if hospitals want to raise rates more than 3.7%, they need approval.  Another interesting experiment.

The horror of being shot is compounded by the cost of care, the inability to work -- a bullet, a chronic illness -- random things that change lives forever. 

There's a nursing shortage, so you'd expect nursing schools to be booming -- but apparently, they're having a hard time finding professors.  Hmm.  I think of teaching as such a desirable profession, especially at the graduate level.  This surprises me.

A new report says Medicaid providers who owe thousands in back taxes still were paid for providing services to Medicaid beneficiaries.  Apparently, the IRS has no authority to garnish Medicaid payments to providers who owe federal taxes.  That's one loophole I'd get rid of really quickly. 

HHS is awarding $2.3 million in grants to help veterans become physician's assistants. This is so smart -- we need more primary care providers and they don't all have to be doctors.  Veterans need jobs (as do all of the unemployed).  Why not kill two birds with one stone, designing a program to address both needs?  We should be doing more of this. 

Important discovery -- the reason cancer comes back after chemotherapy is that chemo doesn't kill the stem cells that fuel the cancer.  Now, researchers can focus on finding ways to kill the errant stem cells -- a whole new territory to explore.

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