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  • The Ebola Virus: Global Threat or False Alarm? August 18, 2014
    by Adrienne Snavely The Ebola virus was discovered in 1976 near the Ebola River, in what is now Congo. All 25 outbreaks of human illness or death have occurred thus far in Africa. In rural areas, people live close to …
  • Save Yourself From Your Desk Job! August 15, 2014
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  • Thyroid Health & Testing August 13, 2014
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  • Canadian Consumer Tax Index 2014 August 12, 2014
    Canadian families spend more money on taxes than on food, clothing, and shelter combined.The Fraser Institute’s Canadian Consumer Tax Index tracks the total tax bill of the average Canadian family from 1961 to 2013 by adding up the various taxes …
  • Keys to Exercise Success August 11, 2014
    by Lee Kurisko, MD I have had exercise as a regular habit for 41 years. Through all of that time, I have been analyzing what I do and trying to refine my approach always in search of a better way. …
  • MediBid in Kaiser Health News & Washington Post August 8, 2014
    Patients Seeking Cheaper Care Are Soliciting Bids From Doctors Online By SANDRA G. BOODMAN  AUG 05, 2014  This KHN story also ran in . It can be republished for free. (details) Francisco Velazco couldn’t wait any longer. For several years, the …
  • Are We Heading Towards a Two Tiered Health Care System? August 6, 2014
    In 2013, 117 insurance plans were offered on average in each state. Only 41 plans are offered in the exchanges, and in 16 states, consumers have access to 3 or fewer insurers.  In addition, these plans have increasingly restricted networks… …
  • OMTEC 2014 – Keynote Interview with Industry Leaders (Installment 2 of 5) August 5, 2014
    Original, essential content from OMTEC. Industry leaders Michael Butler, Dirk Kuyper and Mike Matson discuss the intricacies of supplier relationships within the orthopaedic industry.
  • OMTEC 2014 – Keynote Interview with Industry Leaders (Installment 1 of 5) August 5, 2014
    Original, essential content from OMTEC. Industry leaders Michael Butler, Dirk Kuyper and Mike Matson discuss the intricacies of supplier relationships within the orthopaedic industry.
  • Life Without Antibiotics Would Likely Be Grim August 4, 2014
    The first antibiotics came on the market after World War II. Bacteria continue to mutate so antibiotics cannot destroy them. Some have become so resistant that nothing is effective on them. A treatment that may have worked five years ago …
  • An Introduction to Fibroids August 1, 2014
    By Dayton Interventional Radiology What are Fibroids? Fibroids are non-cancerous growths that develop in the walls of the uterus. They can occur in bunches or alone, and can be very tiny or grow to the size of a cantaloupe. An …
  • Hopeful New Cancer Treatment System July 30, 2014
    Tumor-combatting drugs could allow melanoma patients to live much longer. Immunotherapy could revolutionize cancer treatment. New drugs can work in different types of cancer and last years. The two-year survival rate for advanced melanoma has improved from 10 to 25% …
  • Hobby Lobby wins Supreme Court case, can opt out of mandate July 23, 2014
    The Supreme Court ruled in favor of Hobby Lobby and against Obamacare mandates.  They decided that the government cannot force employers to violate their religious beliefs.  Christian corporation Hobby Lobby did not want to have to cover certain types of …
  • Hundreds of Newborns to have Genomes Sequenced July 21, 2014
    Genome sequencing would not replace the newborn screening tests most states require. They are researching if sequencing is better than regular screening at detecting genetic disorders, immune function, as well as metabolic disorders. Researchers believe that cataloguing a newborn’s genome …
  • VA Seeks Help from Corporate Healthcare Giant HCA July 18, 2014
    The Department of Veteran’s Affairs has recruited the Chief Medical Officer of hospital giant HCA, Dr. Jonathan Perlin, to help them find solutions for all the problems of their mismanaged system. Dr. Perlin is known for being a leader in …
  • The Trap Known as Health Insurance July 16, 2014
    The cost of health care is on the rise and is continuing to grow exponentially. One of the biggest factors to this cost is health insurance. Third parties don’t care about quality or affordability. They are spending your money for …
  • Current Health System Provides No Privacy for Patients July 14, 2014
    Dr. Deborah Peel has advocated for patient privacy for over 20 years.  She explains to the tech community how breaches in computer systems using electronic health records destroy privacy.  When patients are in control of their own money and move …
  • Is There a Link Between Saturated Fat & Heart Disease? July 11, 2014
    For the last several decades, we have been taught that saturated fats in butter, cheese, and meat are dangerous for your health. The truth is that this has never been proven. Countries that have high fat diets do not have …
  • Men’s and Women’s Comprehensive Wellness Panel (CWP) for $99! (Retail $800) July 7, 2014
    This is a great way to be proactive and keep up with your health as well as that of your loved ones. The Comprehensive Wellness Panel (CWP) includes over 50 individual laboratory tests that provide a thorough Biochemical assessment of your …
  • Physicians’ Declaration of Independence July 4, 2014
    by Richard Amerling, MD A physician’s responsibility is to the patient. To protect the patient-physician relationship, payment should be decided between these two parties, assuring all information is kept confidential. Involving third parties is destructive to the patient-physician relationship. Physicians …

Preparing for the obamacare Exchanges

Some states are very anxious to install an obamacare exchange. I think it has to do with addiction to government money. Legislators don’t always understand that the government doesn’t actually make any money (other than running printing presses). It is the citizens and residents who make money. The government simply takes it from us, and borrows it from China. So when you hear the term “federal monies”, these are your dollars and mine.

http://thehealthcareblog.com/blog/2011/09/22/preparing-for-exchanges/

By JOHN GRAHAM

What is the biggest waste of effort in American health care today?

I’d suggest it is the hustle and bustle to establish PPACA’s Health Benefits Exchanges.  The health insurers’ trade association, AHIP, has an entire educational series on “preparing for exchanges.”  The likelihood of exchanges being up and running by January 2014 is vanishingly close to zero.  Indeed, they may not exist at all except in very few states – whether or not President Obama wins re-election.

Last January, I wrote in The Health Care Blog that states should not collaborate with the federal government in establishing exchanges.  Almost all states have taken this course.  Recent days have brought forward new evidence that exchanges are facing even bigger problems than previously understood.  The New York Times reports that Republican state senators are blocking a bill that would allow the state to establish an exchange and claim federal handouts to get it up and running. (A few weeks previously, Kansas governor Brownback actually sent a $31.5 million federal PPACA grant back to D.C.).

If they can’t get a PPACA exchange up and running in New York, of all places, where the heck will they? Only 13 states have passed pro-exchange legislation (and some of these bills don’t do much more than establish study groups).

Republican state politicians are clearly hardening their stance against exchanges. It appears that they are no longer fooled by the argument that if they do no collaborate to establish state-based exchanges, the federal government will enter their state and do it for them. Recent close reading of the law has debunked this notion. As written, the Patient Protection and Affordable Care Act (PPACA) has (at least) two clauses that will prevent this from happening – even if the Obama Administration had the operational capacity to establish federal exchanges (which it does not.  That’s why it desperately pitched “Partnership Options” to states the other day.)

First, courtesy of Investors’ Business Daily’s David Hogberg and the Cato Institute’s Michael Cannon, we learn that federal exchanges will not be able to funnel the gusher of refundable tax credits to individuals who enroll in them.  The gist of the argument is that the law only allows state-established exchanges to funnel the tax credits. If a state fails to establish an exchange, and the federal government steps in, that exchange is not eligible for the tax credits.  Neither Hogberg nor Cannon cite it, but it appears that they are referring to section 1401 of PPACA (on page 110 of this version), which clearly refers to section 1311 (state-based exchanges) as eligible for the tax credits, and does not mention section 1321 (federal exchanges).

Please read the section yourself. I hate to play barrack-room lawyer, but I’m 80% to 90% sure that Hogberg and Cannon are right.  Writing in The Health Care Blog, Professor Timothy Stoltzfus Jost makes an argument that no court would accept this interpretation – even though it’s what the law states!  (The reconciliation act, which Professor Jost cites, does not amend this constraint.  It merely demands that federal exchanges report any tax credits, not provide them.)  As for “standing,” Hogberg notes that any business (in a state with a federal exchange) which is fined for not providing health benefits, should have strong claim to standing.

Maybe it is ridiculous to think that a court would actually adjudicate what the law states, rather than what its proponents wish it to state.  But courts do interesting things.  When I first heard that some attorneys general were planning to challenge PPACA’s constitutionality, I thought they were in fantasyland.  Today, the law hangs by a judicial threat, and will eventually be adjudicated by the U.S. Supreme Court.

Second, as I noted in a recent article, states can also stop federal exchanges by threatening to pull the licenses of health insurers which intend to participate in them (p. 58 of this version). The law defines a “qualified health plan” as one that is “licensed and in good standing in each State…”, and only qualified health plans can participate in exchanges.

So, federal exchanges have a double whammy against them. States have learned not to fear that the federal government will step in and operate exchanges for them. Health IT vendors and other businesses that are investing in winning business from exchanges would be well advised to cut their losses, and reinvest in more fruitful business development.

John R. Graham is Director of Health Care Studies at the Pacific Research Institute, & Senior Fellow at the National Center for Policy Analysis.



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