RSS Articles and Information
  • American Women are Drinking More Heavily May 4, 2015
    Barbara Feder Ostrov, Kaiser Health News Whether quaffing artisanal cocktails at hipster bars or knocking back no-name beers on the couch, more Americans are drinking heavily – and engaging in episodes of binge-drinking, concludes a major study of alcohol use. …
  • Shortage of Available Surgery Causes Deaths Worldwide May 1, 2015
    Millions of people die worldwide with treatable conditions because of the lack of routine surgeries, more than from malaria, AIDS, and tuberculosis combined. Five billion of the seven billion people in the world cannot get needed surgery or pay for …
  • Cleaning Tips for a Healthy Home April 29, 2015
    Cleaning your home not only makes it look and smell better, it also can improve your family’s health.  Here are some activities you may not have thought of that will make you and your home healthy and safe: Dust Everything …
  • Using Mobile Devices at Night is Bad For Your Brain April 27, 2015
    Dr. Daniel Siegel, a psychiatrist from UCLA, states that staring into a glowing screen late at night is harmful to your brain and body. Staring at any screen at bedtime, be it computer, smartphone, or ipad, is worse than previously …
  • Few Patients Use Quality, Price Information To Make Health Decisions April 24, 2015
    by Jordan Rau, Kaiser Health News Despite the government’s push to make health information more available, few people use concrete information about doctors or hospitals to obtain better care at lower prices, according to a poll released Tuesday. Prices for …
  • Shopping Tools Save Patients Cash on Medical Care April 22, 2015
    Vicki Burns of New Mexico needed a total hip replacement in 2012, but could not afford the hospital’s non-negotiable cash estimate of $79,000. Within two days of placing a patient request on MediBid, she received two bids. She chose a …
  • Hysteria’s History Episode 3 April 21, 2015
  • 20th Century Experiment Attempts to Turn Back Time April 20, 2015
    Ellen Langer, a Harvard psychologist, conducted a radical experiment in 1979 – the results of which were never published. Last fall, this study was featured in the New York Times. The study examined how aging’s effects could be altered or …
  • https://youtube.com/devicesupport April 17, 2015
  • Make Spring Cleaning a Workout April 17, 2015
    Chores you do around the house and garden can burn calories and stretch and tone muscles if done correctly. Short episodes of mild exercise can improve your fitness level if done with intensity and speed. Adding 30 minutes of chores …
  • Provisioning for the Opt Out Journey April 17, 2015
    Ophthalmologist David Richardson, MD on how to prepare for opting out of Medicare. From AAPS 70th Annual Meeting, September 2013, Denver, Colorado.
  • What America’s Decline in Economic Freedom Means for Entrepreneurship and Prosperity April 16, 2015
    The United States was once considered the land of opportunity where entrepreneurs such as Henry Ford, Ray Kroc and Steve Jobs contributed to a flourishing economy by providing new products and services at prices people were happy to pay.Today America’s …
  • Obamacare Fines Debut This Tax Season April 15, 2015
    Taxes for 2014 are due this week, and your tax bill could be affected by your health insurance. If you had insurance during the entire calendar year of 2014 through an employer, a state exchange, or Medicare Part A, you …
  • Blood Transfusions: Less is More April 13, 2015
    The most common inpatient medical procedure in 2011 was the blood transfusion, with 12% of all hospitalized patients receiving one. The accrediting nonprofit Joint Commission reports transfusions as one of the five most overused hospital procedures. Now, there is a …
  • Health “Coverage” is Just a Distraction April 10, 2015
    by G. Keith Smith, MD I think it is good to be alert to any discussions that are “downstream of a flawed premise.” Let me explain. When I hear, for instance, that the “flat tax” is preferable to the current income …
  • Text Neck – Your Phone is Causing You Pain April 8, 2015
    In the last few years, more and more young people have come in for chiropractic care with symptoms of neck pain, headaches, shoulder pain, or numbness and tingling in their arms. This condition has been named “text neck”. A study …
  • Fat-Burning Foods Help with Weight Loss April 3, 2015
    Many people include losing weight as one of their personal goals. The benefits of losing weight go beyond the outward appearance. Fat-burning foods can help you lose weight, reverse diabetes and risk of obesity, and boost energy levels. Certain foods …
  • Monitoring Patient Compliance with Mobile Devices April 1, 2015
    Company iGetBetter hopes that remote patient monitoring with phone apps and wearables will reduce hospital admissions and increase patient compliance after procedures. The platform allows patients to access post-op directions on a mobile device, ask questions, and send data directly …
  • Americans Can’t Afford to Use Insurance They Own March 30, 2015
    One in three Americans have delayed medical treatment for themselves or a family member because of cost. Many patients, 25% of the non-elderly, don’t have enough cash to cover a mid-range deductible of $1,200-$2,400. These patients need to shop around …
  • Third Party Free Medical Practice Case Studies March 28, 2015
    Dr. Kathy Brown, Jack Brown, and Dr. Keith Smith speak at the 69th Annual Meeting of AAPS, September 2013. http://www.oregonderm.com/ & http://surgerycenterok.com

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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