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  • 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 …
  • Wellness Health Check – July Special July 7, 2014
    Men and Women’s Health Check Blood Tests for $99! (Retail is $800) This is a good way to be proactive and keep up with your health and that of your loved ones. Women’s Test includes: The Comprehensive Wellness Panel(CWP) is …
  • 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 …
  • Ralph Weber: Healthcare with Transparency in Quality & Pricing July 2, 2014
    MediBid helps patients find the best treatment solution for them at the best quality and price. Physicians set their own prices and this transparency allows for competition. MediBid started as a means for Canadians on waiting lists to get timely …
  • Steps to Increase Price Transparency June 30, 2014
    Summary by The Market Institute The Center for American Progress recently published a brief detailing their opinion on how hidden health care costs are hindering market competition and ultimately making healthcare expensive for consumers. Unlike almost every other scenario in …
  • How Obamacare Affects the Affordability of Your Medical Care June 27, 2014
    Those who do not get health insurance from their employers or Medicaid/Medicare find their premiums increasing, some states more than others. While some people will be eligible for Obamacare tax credits, many will still have to pay these premium increases …
  • Canada needs a prosperous Ontario June 27, 2014
    Ontario’s poor economic performance is dragging down Canada’s economy.A Fraser Institute study, Can Canada Prosper without a Prosperous Ontario?, examines Ontario’s shift from the economic engine of Canada to a “have not” province that received $3.2 billion in equalization payments …
  • Why Coconut Milk Might Not Be Your Friend June 25, 2014
    Those following a Paleo diet get most of their fat from coconut milk. Coconut milk is great for making smoothies. Canned coconut milk may contain BPA, a chemical which can leach out of the metal and into acidic foods, such …
  • Increasing Cost of Medical Care Can Make You Sick June 23, 2014
    At the onset of an illness or serious injury, Americans are finding the costs too much to bear – even when they have insurance. Medical expenses are the biggest financial burden in American households today. Nearly 50% of Americans cannot …
  • Natural Alternatives for Sun Protection and Sunburn Treatment June 20, 2014
    With summer activities in full swing, many of them outdoors, it is important to remember to protect your skin from the damaging effects of the sun. Some exposure is beneficial, and can cause your skin to produce Vitamin D. Vitamin …
  • Your HSA Can Double as an IRA June 18, 2014
    Some Americans are supplementing thier retirement funds with a Health Savings Account. People with a high-deductible insurance plan can have an HSA to cover future medical expenses. There is a penalty to withdraw this money for nonmedical reasons, yet after …
  • OMTEC 2014 – The Past, Present and Future of the Implant Market: A Surgeon Inventor Perspective June 17, 2014
    What does the future hold for the orthopaedic implant market? Dr. Robert S. Bray, Jr., a globally recognized spine surgeon, entrepreneur and inventor, provides a look at the industry past and present and answers the question: How will the development …
  • Real Illness or Not? June 16, 2014
    by Sue Redmond Should Doctors prescribe for a “non-disease”? Infants spit up.  Many on a daily basis (some studies show as high as 40-70%).  Just one of the reasons may be that they drink a large volume of liquids and …
  • How Obamacare Impacts Small Businesses June 13, 2014
    Cost increases due to Obamacare will be sharp and immediate for small businesses. As they renew their group health plans, they are discovering an onslaught of new regulations which will also affect their future hiring and business growth. Over 60% …
  • B12 deficiency: a silent epidemic with serious consequences June 11, 2014
    Symptoms of B12 deficiency include: Alzheimer’s, dementia, other memory loss MS and neurological disorders mental illness (depression, anxiety, bipolar) heart disease learning disorders in children autism spectrum autoimmune disease cancer infertility   B12 deficiency is quite common, more so than …
  • Poorer Health of Surgery Patients on Medicaid May Alter Law’s Bottom Line June 9, 2014
    When Medicaid patients arrive at the hospital, they are in worse shape than privately insured patients because of complications stemming from years of poor health habits, smoking, avoiding or delaying medical treatment, and diseases left undetected. These patients are sicker, …

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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