Archive for November, 2012

Today’s Headlines – Nov. 30, 2012

Today’s early morning highlights from the major news organizations, including news about the continuing partisan back and forth regarding “fiscal cliff” negotiations as well as reports on the health law’s implementation.

The New York Times: GOP Balks At White House Plan On Fiscal Crisis
The proposal, loaded with Democratic priorities and short on detailed spending cuts, met strong Republican resistance. In exchange for locking in the $1.6 trillion in added revenues, President Obama embraced the goal of finding $400 billion in savings from Medicare and other social programs to be worked out next year, with no guarantees (Weisman, 11/29).

Los Angeles Times: Obama And Boehner Seem To Hit Wall As ‘Fiscal Cliff’ Looms
As Obama prepares to take his proposal on the road Friday, Democrats are increasingly buoyed, believing they hold a stronger hand. “Look, we don’t expect the Republicans to be enthusiastic and start cheerleading about a deal that includes higher rates on the wealthiest Americans,” said New York’s Sen. Charles E. Schumer, the No. 3 Democrat. “But they see the handwriting on the wall.” … Republicans are increasingly frustrated that Democrats have declined to outline specific cuts to Medicare, Medicaid and other government programs in exchange for Boehner’s willingness to consider new revenue sources (Mascaro and Parsons, 11/29).

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Friday, November 30th, 2012

Missouri Governor Backs Medicaid Expansion

Missouri Gov. Jay Nixon wants the state to expand its Medicaid program, marking the strongest stance the Democratic governor has taken to date on the state’s pending decision.

Nixon previously said he was evaluating the issue to see what’s best for Missouri.

Speaking to a packed crowd of hospital and clinic leaders in Kansas City on Thursday, Nixon said an expansion is the right thing to do and that it makes fiscal sense. The federal government would fully subsidize an expansion during the first three years, he emphasized, with the state kicking in about 10 percent of the cost in 2020.

It’s the smart thing to do, because if we take a pass on billions of health care dollars — dollars I should note which come out of Missourians’ paychecks when they pay their [federal] taxes — the money will go to other states,” Nixon said. “They’ll get the benefit. We’ll get the bill. That’s not smart.”

A report out yesterday by the Missouri Hospital Association projects Missouri would get about $8 billion dollars in federal funds during the first six years of an expansion. The state would spend an additional $300 million from its general revenue budget.

Moving forward with an expansion won’t be easy. State lawmakers have long opposed it, whether that be because of the unpopularity of the entire health law in the state, or because of worries over expanding an already large state health program.

This story is part of a reporting partnership that includes KCUR, NPR and Kaiser Health News.

Thursday, November 29th, 2012

Today’s Headlines – Nov. 29, 2012

Today’s early morning highlights from the major news organizations, including a report detailing why the idea of raising Medicare’s eligibility age always seem to crop up in policy discussions.

Politico: Inside The Talks: Fiscal Framework Emerges
Cut through the fog, and here’s what to expect: Taxes will go up just shy of $1.2 trillion — the middle ground of what President Barack Obama wants and what Republicans say they could stomach. Entitlement programs, mainly Medicare, will be cut by no less than $400 billion – and perhaps a lot more, to get Republicans to swallow those tax hikes. There will be at least $1.2 trillion in spending cuts and “war savings.” And any final deal will come not by a group effort but in a private deal between two men: Obama and House Speaker John Boehner (Vandehei and Allen, 11/29).

The New York Times: Obama Tilts Tax Debate Away From Spending Cuts
Mr. Obama has embraced specific cuts to the federal budget in the past and has committed to an agreement with Congress that will include deep reductions in spending. But it would be easy for those who listen to his public pronouncements lately to miss it. In public statements since his re-election, he has barely discussed how he would pare back federal spending, focusing instead on the aspect of his plan that plays to his liberal base and involves all gain and no pain for 98 percent of taxpayers. … Republican leaders were more scathing, saying the president was more interested in campaigning than sitting down to resolve difficult issues. They said they were willing to raise tax revenue by closing loopholes and limiting deductions, but Mr. Obama has not reciprocated with more restraint of entitlement programs (Baker, 11/28).

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Thursday, November 29th, 2012

More Workers Covered By Bosses’ Self-Insured Plans

The number of U.S. workers covered by self-insured health plans—in which their employer assumes the financial risk for health costs rather than paying insurance companies to do that—has grown steadily in recent years. But such plans are still primarily used by large companies, not small employers, a new study finds.

As of 2011, more than half of U.S. employees were covered under these self-insured plans, compared to about 41 percent in 1998, according to a report by the Employee Benefit Research Institute. These plans can lower costs for employers by reducing administration, exempting them from state-mandated services, and allowing them to provide uniform coverage across state lines.

Sometimes workers do not even know that their employer is self-insuring because the company will hire a traditional insurance plan to administer the program.

Businesses with less than 50 employees have not followed the same trend, with only 10.8 percent of private sector enrollees in self-insured plans in 2011. The number has remained generally around 12 percent since 1998, according to EBRI.


Wednesday, November 28th, 2012

Study Questions Benefits Of Many Double Mastectomies

This story comes from our partner ‘s Shots blog.

It’s a startling trend: Many women with cancer in one breast are choosing to have their healthy breast removed, too.

But a study being presented later this week says more than three-quarters of women who opt for double mastectomies are not getting any benefit because their risk of cancer developing in the healthy breast is no greater than in women without cancer.

“People want absolute certainty,” breast surgeon Monica Morrow of Memorial Sloan-Kettering Cancer Center tells Shots. “Unfortunately, even having a double mastectomy doesn’t provide certainty that breast cancer will not recur. So it’s a false sense of security.”

Morrow is a co-author of a paper that will be presented at the American Society of Clinical Oncology’s Quality Care Symposium in San Diego.

Another co-author, Sarah Hawley, of the University of Michigan, says double mastectomy “does not make sense” for about three-quarters of the women who are choosing the operation “because having a non-affected breast removed will not reduce the risk of recurrence in the affected breast.”

The researchers looked at nearly 1,500 women who had been treated for early-stage breast cancer. Of those who chose mastectomy instead of lumpectomy, nearly 20 percent opted to have both breasts removed.

But of those who chose double mastectomy, three-quarters had no medical justification, Hawley tells NPR’s Shots blog.


Wednesday, November 28th, 2012

Today’s Headlines – Nov. 28, 2012

Today’s early morning highlights from the major news organizations, including reports about how party positions on entitlement programs are playing into the ‘fiscal cliff’ negotiations.

The New York Times: House Republican Urges Party To Yield On Tax Cuts For Most Earners
Democrats said they would not accept cuts to Medicare or Medicaid as part of the upfront “down payment” on deficit reduction that would be passed next month along with a broader framework on tax and entitlement changes to be worked over in 2013. In a speech at the liberal Center for American Progress, Mr. Durbin still expressed confidence that beneath all the public posturing, the White House and Speaker John A. Boehner, Republican of Ohio, were making progress toward averting the so-called fiscal cliff. … He made clear that the parties agreed on what a final deal would look like: an initial deficit-reduction down payment to calm financial markets and avoid most of the fiscal jolt that would otherwise hit in January; instructions to Congressional committees to draft tax, spending and entitlement legislation to save around $4 trillion over the next decade; and some form of fallback deficit plan in case Congress fails to pass those changes. Mr. Durbin said that Medicare should not be tapped for that upfront down payment but that federal health care programs should be part of next year’s deliberations. And he opened the door for money-saving adjustments to Mr. Obama’s signature health care law (Weisman, 11/27).

Los Angeles Times: Senate’s No.2 Democrat Calls For Cuts To Social Safety Net
A top Democrat pressured fellow progressives Tuesday to consider long-term changes to the social safety net, even as the party digs in for a fight to save Medicare and other government programs from deep budget cuts. As closed-door talks continue with the hope of a year-end deal, President Obama will travel to a Pennsylvania toy store this week to pressure Congress to extend the expiring tax cuts for the middle class, while letting those for the wealthiest 2% of Americans expire (Mascaro and Parsons, 11/27).

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Wednesday, November 28th, 2012

Hospitals Get New Grades On Safety

Updated at 9:35 a.m.

The Leapfrog Group is out with its second round of hospital safety ratings, and what a difference a few months has made.

Photo by Phil Jern via Flickr

In the results released Wednesday, 103 hospitals that Leapfrog had given a “C” or lower in its first round of ratings in June got an “A” in the updated Hospital Safety Score, based on more recent data and a slightly tweaked methodology. These included New York-Presbyterian Hospital, the Hospital of the University of Pennsylvania and Geisinger Medical Center.

Two hospitals awarded an “A” in the first round, Leonard J. Chabert Medical Center in Houma, La., and Lawrence General Hospital in Lawrence, Mass., both slipped to a “D.”

Altogether, 8 percent of the 2,619 hospitals that Leapfrog rated changed by two or more grades, like an “A” to a “C,” according to Leapfrog, a patient safety nonprofit based in Washington, D.C. Thirty-four percent changed one grade, like a “C” to a “B,” and 58 percent kept the same grade, Leapfrog said.

Leapfrog’s effort to provide a single letter grade based on 26 different measures of safety is part of a burgeoning effort to help consumers evaluate medical providers. Consumer Reports this year also started boiling down hospital metrics into its signature circular symbols, known as “Harvey Balls.”


Wednesday, November 28th, 2012

Momentum Builds For Hepatitis C Testing Of Baby Boomers

This story comes from our partner ‘s Shots blog.

The U.S. Preventive Services Task Force, an influential and often controversial panel of doctors, is moving toward a recommendation for testing that could apply to all baby boomers.

The group issued draft advice to doctors saying they should consider giving a hepatitis C test to people born between 1945 and 1965, regardless of their risk factors for having the disease.

Until now, the group has recommended the test only for people at high risk for the infection, such as those with a history of intravenous drug users or those who received a blood transfusion prior to 1992.

The panel says it may no longer be be a good idea for doctors to rely on patients to disclose their risk factors. Someone who received a blood transfusion before 1992 (when routine screening of blood donations for hepatitis C started) may not remember it more than 20 years later. Also, patients who used intravenous drugs — even once — in their youth may be reluctant to tell their doctors about it as an adult.

Three-fourths of all people in the U.S. with hepatitis C, a viral infection, are baby boomers, according to the Centers for Disease Control and Prevention. Most have no idea they’re infected with the virus that causes the disease because. People can be free of symptoms for decades before serious liver damage becomes apparent.


Tuesday, November 27th, 2012

Today’s Headlines – Nov. 27, 2012

Today’s early morning highlights from the major news organizations, including reports about how increasing the Medicare eligibility age and making other entitlement program changes are a part of the ongoing “fiscal cliff” discourse.

The Wall Street Journal: ‘Cliff’ Wranglers Weigh Medicare Age
The fiscal cliff has revived an old idea that long seemed unfeasible: gradually raising the Medicare eligibility age to 67 from 65. Proponents of the idea point out that the health-overhaul law makes it easier, beginning in 2014, for seniors to buy private insurance, by banning insurance denials based on pre-existing conditions. Opponents caution that the change could raise premiums for younger people who buy private plans alongside these seniors in the law’s new marketplaces, and on large employers who would be required to cover seniors in company plans.(Radnofsky, 11/26).

The New York Times: Efforts To Curb Social Spending Face Resistance
President Obama’s re-election and Democratic gains in Congress were supposed to make it easier for the party to strike a deal with Republicans to resolve the year-end fiscal crisis by providing new leverage. But they could also make it harder as empowered Democrats, including some elected on liberal platforms, resist significant changes in entitlement programs like Social Security and Medicare (Pear, 11/26).

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Tuesday, November 27th, 2012

Study: States Face Increased Medicaid Costs Even If They Don’t Expand Program

If state officials think they can escape a fiscal quagmire by refusing to expand Medicaid under the federal health law, they might want to reconsider.

State Medicaid costs will jump $76 billion, or nearly 3 percent, over the next decade if all 50 states decide to expand Medicaid eligibility in 2014 under the federal health law. But state spending on the program would still increase to the tune of $68 billion even if not a single one opts for the expansion, according to a study released Monday by the Kaiser Family Foundation. (KHN is an editorially independent program of the foundation.)

That’s because even states that do not expand eligibility would see a surge of people sign up for the health insurance program for the poor, who were previously eligible but not enrolled. Beginning next October, people will find it easier to sign up for Medicaid because of new online health insurance marketplaces set up under the law, as well as simplified enrollment methods, said Diane Rowland, executive vice president of the foundation and executive director of the Kaiser Commission on Medicaid and the Uninsured. The insurance exchanges and new enrollment rules start in 2014 regardless of whether states expand Medicaid, with coverage slated to take effect on Jan. 1, 2014.

Republican governors of several states, including Florida and Texas, have said they can’t afford the expansion.

State eligibility for Medicaid today varies nationwide. Under the federal law, starting in 2014, nearly everyone under 133 percent of federal poverty level (about $31,000 for a family of four) will be eligible. The Supreme Court in June gave states the option to decide whether to expand the program. The federal government will pay for the full cost of the newly eligible from 2014 through 2016, after which  states will have to pick up some of the costs, but no more than 10 percent after 2019.

The report, conducted by researchers from the Urban Institute, estimated 21 million additional people would sign up for Medicaid if all states participated.


Monday, November 26th, 2012

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