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  • Tisha Casida interviews Ralph Weber: Free Market Solutions to Healthcare March 25, 2015
    Tisha Casida with Rebellion.life interviews CEO of MediBid, Ralph Weber, about his work educating the public and the government about common sense health care solutions. MediBid is an online marketplace with true transparency, listing not only prices, but qualities and …
  • Small Business Coverage Uncertain Future with Association Health Plans March 23, 2015
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  • Outpatient Surgery Saves Patients Time and Money March 20, 2015
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  • Study Finds Hormones Can Help Younger Women Through Menopause March 18, 2015
    Hormone replacement therapy used to only be given to women who had completed menopause, relieving hot flashes, sleeplessness, and other symptoms. In 2009, about 8 million women used HRT, most over the age of 60. A recent Cochrane review finds …
  • Retail Health Care Clinics Multiply with Increasing Demand March 16, 2015
    Integrated care facilities offer primary care, specialty services, labs, and diagnostics all under one roof. These clinics follow a model common in Latin America. This consumer-focused type of providing medical care is gaining in popularity and increasing in number since …
  • Avoiding Caregiver Burnout March 13, 2015
    Over 43.5 million Americans care for older parents, grandparents, spouses, or other loved ones. Most family caregivers are spouses or children. The demands of caregiving can be overwhelming and can take a toll on your health, relationships, and sanity – …
  • It is Safe to Assume They Lie March 11, 2015
    by G. Keith Smith, MD I laugh every time I see headlines bragging about the number of people enrolled in “Obamacare.”  What choice to people have, after all?  ”Buy this crappy insurance plan (that you wouldn’t buy unless you were …
  • FinalHayes1 March 11, 2015
  • Physician Burnout – What To Do March 9, 2015
    Signs of physician burnout can range from decreased enthusiasm for work, increased cynicism and a low sense of accomplishment.  Where at one time the physician may have felt a burning passion for medicine, he may feel that “light” burning out, perhaps …
  • Increasing Wait Times for Hip Surgery Ruin Patients’ Lives March 6, 2015
    Frustrated patients in British Columbia are in constant pain as their wait times for hip replacement surgeries increase. Wait times for joint replacements have increased in most Canadian provinces despite promises from the government to address the problem. B.C. is …
  • Staying Physically Active: How Much Exercise is Right for You? March 4, 2015
    by Adrienne Snavely Everyone knows that the key to keeping a healthy body is a combination of a healthy diet and regular physical activity. What is considered “regular” differs from person to person. The Dietary Guidelines for America (DGA) first …
  • Supreme Court to Hear New Obamacare Case This Week March 2, 2015
    Later this week, the Supreme Court will hear arguments in King v. Burwell, the results of which could affect the future of Obamacare. This case addresses if consumers who buy health insurance at HealthCare.gov are eligible to receive tax credits …
  • How to Fight and Prevent Sugar Cravings February 27, 2015
    The average American consumes about 16 teaspoons more sugar per day than what is recommended. Sugar causes the brain to release serotonin, creating a natural high, and the endorphins leave us wanting more. Kicking a sugar addiction can be tough, …
  • Hospital Closures Bring “New Day” in Healthcare February 25, 2015
    Hospitals are operating with fewer beds or closing, as patients seek more affordable medical care at clinics and outpatient surgery centers. A low occupancy rate makes for a high-priced facility, which is not competitive. These closures are due to the …
  • Do Your Part to Protect Your Heart – February Special February 23, 2015
    February is Heart month. Protect the health of your heart, preventing heart disease and stroke, with a simple blood test. Below are the February specials from DirectLabs. Lipid Profile – $19 (Regular Price $29, $98 Retail) Test includes: Cholesterol, Total …
  • The Various Dimensions of Mammogram Screening February 20, 2015
    by Adrienne Snavely Every year, over 200,000 women in the U.S. are diagnosed with breast cancer and about 40,000 will die from it. When breast cancer is detected early, it is easier to treat. Forty million mammograms are performed each …
  • Crashing the Free Market Party February 16, 2015
    by G. Keith Smith MD Riding in to rescue the victims of Obamacare and other government healthcare schemes are guess who? The legislators? The regulators? Don’t make me laugh. It is the growing group of healthcare free marketeers. The celebration …
  • Dark Chocolate is Good For You and Your Valentine February 13, 2015
    Dark chocolate is loaded with nutrients, one of the best sources of antioxidants, and can improve health and lower risk of heart disease. Dark chocolate is very nutritious. It contains a fair amount of soluble fiber and is full of …
  • The Fraser Institute: Education Spending in Canada February 12, 2015
    Despite a steady decline in student enrolment, spending on public schools in Canada has skyrocketed.Teachers’ unions and activists repeatedly claim that education spending is being cut and school budgets are in peril. That’s simply not true and ignores the reality …
  • Eye-Tracking Test Detects Early Alzheimer’s Disease February 11, 2015
    One in nine Americans over 65 has Alzheimer’s disease. There is no way to revive dead cells, but if detected early enough, the disease progression can be slowed with treatment. Spinal fluid analysis and PET scans can detect the approaching …

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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