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Daily Archives: August 22, 2013

Letters To The Editor: The Health Law And Alternative Medicine; Understanding Premium Rates; More On Hospital Readmissions

Letters to the Editor is a periodic KHN feature. We welcome all comments and will publish a selection. We will edit for space, and we require full names.

 

Last month’s story Health Law Boosts Status Of Alternative Medicine — At Least On Paper (Rao, 7/26) drew a number of reader responses. Here’s a sampling:

Melissa Miesen; Portland, Ore.

I am a licensed acupuncturist in the state of Oregon struggling to make ends meet in my practice with continuing insurance reimbursement decreases. Not only has the financial rate decreased, but the quantity of treatments has been restricted. It has been getting increasingly more challenging to provide quality care with insurers’ “quality control measures.” My cost of doing business has not decreased, and patients’ ability to pay cash has decreased. Perhaps the patient should be asked about their preference of treatment for chronic back pain; for example — a year’s worth of weekly acupuncture and physical medicine versus an MRI?

William J. Ryder; Quincy, Mass.

Isn’t the whole point of using science in health care, and in passing laws to make health care safe and efficient, to “discriminate” by choosing treatments that work and providers who are trained in such systems? Naturopaths can only be advanced by politics and anecdotes. The science on their approaches shows that most [treatments] either don’t work or are [based on] lifestyle advice already incorporated into the work of primary care providers. The truth is that naturopaths don’t drop treatments that are popular but ineffective. Do we need such dalliance and waste as we try to advance health care access and quality?

 

Five Things To Know About Obamacare Premiums: A Guide For The Perplexed (Appleby, 8/1), readers offered the following thoughts:

Thom Heckard; Virginia Beach, Va.

While rates may even out over time, this article is underplaying the initial “rate shock” that will be felt by the young and healthy on individual and group policies. It doesn’t help that on the eve of the exchanges/marketplace rollout, Congress has decided to back off its promise to participate in the exchanges for its members and staff. I am a broker in the small group market where most employers contribute 50 percent of the individual rate. From what I understand, we taxpayers appear to be footing the bill to cover 75 percent — at least — of congressional members’ and their staff’s individual coverage who knows what the federal employee contributions might be. Holding our public officials accountable to operate in the “real” world might help them to begin to understand the impact of the policies they enact on the engine of our economy that is the entrepreneur.

Vince Phillips; Mechanicsburg, Pa.

Regarding the observation that changes in health premiums won’t affect you at all, I question the author’s reasoning that most get insurance through larger groups and thus premium hikes won’t affect them. Au contraire, of course it will. The health insurance premium tax will be passed through and the change to eliminate medical underwriting, the limited age rate bands and other market changes beginning in 2014 will have an impact on the employer’s bottom line and, ultimately, the employees if the employer chooses to pay a fine (I can’t afford this anymore) and drops health coverage. The surcharge for smokers will also have an impact.

 

Also this month, the KHN story Armed With Bigger Fines, Medicare To Punish 2,225 Hospitals For Excess Readmissions (Rau, 8/2) drew this reaction:

Mary Dean; Keller, Texas

Since when does the government have the right to tell hospitals how often they can re-admit someone? This is the biggest power grab by our federal government I’ve ever seen. It should be up to the doctor and hospital to decide [when] re-admissions are necessary!!! In some parts of the country, people may wait too long before they go in to get treated. And consequently, they might have to be re-admitted because the first hospital stay did not get an illness in “check.” There are all kinds of reasons for re-admission. … What would our government know about such things?

 

A reader offered this take on the Insuring Your Health column Benefits On Health Marketplace Plans Will Be Similar But Costs Will Vary (Andrews, 7/30).

Michael R. Bertaut, health care economist and exchange coordinator, Blue Cross and Blue Shield of Louisiana; Baton Rouge, La.

I was surprised that … [Andrews] failed to mention or advise the readers to check the network of each plan. Our analysis of the plans on Covered California, for example, revealed low cost plans with small, or patchwork-type networks of care, which a reader could discern quickly by using the “find-a-doctor” link on the plan sites as they are shopping. Might want to bring that up next time.

 

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Calcium-rich diet may reduce female mortality

A calcium-rich diet, whether from supplements or high-calcium foods, may increase lifespans for women, according to a study published in the Journal of Clinical Endocrinology and Metabolism. Researchers from McGill University in Canada analyzed data from a large-scale study called the Canadian Multicenter Osteoporosis Study (CaMos). The researchers monitored the health of 9,033 men and women between 1996 and 2007 and then analyzed whether calcium supplements had any beneficial effects on their health…

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MERS may have started in bats in Saudi Arabia

Researchers have discovered what they believe could be the animal origin of Middle East respiratory syndrome (MERS) – after examining a bat in Saudi Arabia near where the first person was infected with the mystery virus. Extensive tests revealed that the insect-eating bat was a 100% genetic match for MERS. However, if bats are indeed the source, then the team suggests it is likely another intermediary animal host is getting the virus from bats and then infecting humans…

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Lymphoma treatment aided by 25% cut in normal calories – animal study

A new experiment in mice suggests that a diet with below-normal calories could help the effectiveness of drug cancer treatment. The team, led by Jean-Ehrland Ricci of the French Institute for Health and Medical Research in France, put mice who had developed lymphoma into two separate groups: those who ate a diet with caloric intake 25% lower than normal, and those who ate a regular diet…

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UVA, UPS To Stop Health Benefits For Some Workers' Spouses

The university cited costs. Meanwhile, other news organizations followed Kaiser Health News’ UPS story.

The Hill: University of Virginia Cuts Some Health Benefits, Citing ObamaCare Costs
The University of Virginia said Wednesday that it will stop offering health insurance to some employees’ spouses because of rising costs under ObamaCare. The university said the Affordable Care Act will add $7.3 million to its healthcare costs next year. It indicated that it could face additional costs in the future because of the law’s tax on especially generous insurance policies (Baker, 8/21).

The New York Times: U.P.S. To End Health Benefits For Spouses Of Some Workers
United Parcel Service has told its white-collar employees that it will stop providing health care coverage to their spouses who can obtain coverage through their own employers, joining an increasing number of companies that are restricting or eliminating spousal health benefits. … U.P.S. told employees, “Since the Affordable Care Act requires employers to provide affordable coverage, we believe your spouse should be covered by their own employer — just as U.P.S. has a responsibility to offer coverage to you, our employee” (Greenhouse, 8/21).

The Wall Street Journal: UPS To End Health Benefits For Some Working Spouses Of Employees
The Atlanta-based package delivery giant said in an internal memo to employees last month that rising costs for coverage of chronic and other health conditions, “combined with the costs associated with the Affordable Care Act, have made it increasingly difficult to continue providing the same level of health care benefits to our employees at an affordable cost.” The change will affect about 15,000 spouses, UPS said—slightly fewer than half of the 33,000 spouses who are covered today under its health plan for nonunionized workers (Martin, Morris and Thurm, 8/21).

Bloomberg: UPS Ending Health Coverage For Spouses Signals Cost Cuts
The shift is a sign of corporate America’s increasing willingness to make deep changes to benefits once taken as a given by U.S. workers. The health-care overhaul, estimated to boost expenses for businesses by 2 percent to 4 percent next year, is adding to the momentum that already spurred higher deductibles and surcharges for covering dependents (Nussbaum and Credeur, 8/22).

Fox News: Employers Dropping Coverage For Thousands Of Spouses Over ObamaCare Costs
Republican lawmakers are raising new concerns about ObamaCare after several large employers announced they are dropping health coverage for some employee spouses due to rising costs under the new law. Both the University of Virginia and UPS told their employees recently they are no longer offering spousal coverage to those able to obtain insurance elsewhere; meaning thousands of Americans will no longer be able to choose the benefits they prefer (8/21).

Earlier KHN coverage: UPS Won’t Insure Spouses Of Some Employees (Hancock, 8/21).

 

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Political Hijinx Surround Gov't. Shutdown Threat, Push To Defund Health Law

News outlets report on the possible mid-term election impact of the GOP push to shut down the government if the health law receives funding. 

Politico: The Great Democrat Hope: Government Shutdown
As it stands now, the midterm is shaping up as a stale, status-quo election — with Democrats calling their counterparts right-wing extremists, Republicans attacking their rivals over Obamacare and neither side making much headway. That’s good for Republicans, since the party out of power in the White House almost inevitably picks up House seats in the sixth year of the presidency. Heavily-gerrymandered districts provide the GOP an extra layer of protection (Isenstadt, 8/22).

CNN: Playing Chicken Over Obamacare
Some GOP lawmakers appear willing to shut down the government in their fight to defund the president’s health care law, but not everyone is on board (Acosta, 8/22).

Bloomberg: Republicans In Echo Before Big Burn Defy Affordable Care
Joseph Califano remembers the moment well. The nation’s doctors were threatening to boycott the new Medicare program, and President Lyndon Johnson had to get them on board or the 1965 extension of health care to elderly Americans would collapse. So the president set a trap (Tackett, 8/22).

The issue, and surrounding debate, is being replayed at town hall meetings held this month in congressional districts –

The Associated Press: Cassidy Won’t Support Shutdown Over Health Law
U.S. Rep. Bill Cassidy (R-La.) split with some hard-line members of the GOP on Wednesday, saying he wouldn’t support a federal government shutdown as a way to defund President Barack Obama’s health care law if the move would stop defense spending (Deslatte, 8/21).

The Lund Report: Wyden-Smith Town Hall Spreads Word About Cover Oregon, Health Reform
The drumbeat to inform Oregonians about impending health reform continued on Monday with a town hall hosted by Oregon Senator Ron Wyden (D) and Multnomah County Commissioner Loretta Smith that 120 people attended. Wyden trumpeted the Affordable Care Act and the changes it will bring to the healthcare system and people’s lives. “Healthcare is no longer going to be just for the healthy and the wealthy,” he said, particularly mentioning the Affordable Care Act’s provision illegalizing denying someone health coverage because of pre-existing conditions (Waldroupe, 8/21).

Health News Florida: Rally Cry: ‘Defund Obamacare’
Opponents of the Affordable Care Act rallied hundreds of conservatives at a Tampa hotel Wednesday night with a call for the Republican House to strip funds for the law out of next year’s budget. The budget vote is scheduled for right after Labor Day, in time for the 2014 fiscal year, which begins Oct. 1 (Gentry, 8/22).

Arizona Republic: Salmon To Help Target ‘Obamacare’
U.S. Rep. Matt Salmon drew cheers from a Mesa town-hall crowd Monday, saying he plans to enter the fray this fall to support a government shutdown aimed at defunding the president’s health-care law. The Republican congressman was piggybacking on an ultimatum issued by fellow conservative Texas Sen. Ted Cruz, who wants the GOP to refuse to fund the federal government past Oct. 1 unless money is cut from the health care law that will be rolling out in earnest at that time (Sanders, 8/21).

Also in the news –

Politico: Bobby Jindal Withdraws Request For Obamacare Funds
Gov. Bobby Jindal, a fierce Obamacare critic, pursued funds from an under-the-radar program in the health law until this week, when his administration reversed course, citing cumbersome federal rules. Health aides to the Louisiana governor began eyeing the program – a long-term care reform effort called Community First Choice – last year and went as far as submitting a formal application to CMS (Cheney, 8/21).

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Political Cartoon: 'Gonna Need A Bigger Boat?'

Kaiser Health News provides a fresh take on health policy developments with “Gonna Need A Bigger Boat?” by John Darkow.

Here’s today’s health policy haiku:

HEALTH INSURANCE — NOT ALWAYS A MARITAL ASSET

Marry for love, not
health care, says UPS. Some
spouses not covered.
-Anonymous

If you have a health policy haiku to share, please send it to us at http://www.kaiserhealthnews.org/ContactUs.aspx and let us know if you want to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

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Political Hijinx Surround Government Shutdown Threat, Push To Defund Health Law

News outlets report on the possible mid-term election impact of the GOP push to shut down the government if the health law receives funding. 

Politico: The Great Democrat Hope: Government Shutdown
As it stands now, the midterm is shaping up as a stale, status-quo election — with Democrats calling their counterparts right-wing extremists, Republicans attacking their rivals over Obamacare and neither side making much headway. That’s good for Republicans, since the party out of power in the White House almost inevitably picks up House seats in the sixth year of the presidency. Heavily-gerrymandered districts provide the GOP an extra layer of protection (Isenstadt, 8/22).

CNN: Playing Chicken Over Obamacare
Some GOP lawmakers appear willing to shut down the government in their fight to defund the president’s health care law, but not everyone is on board (Acosta, 8/22).

Bloomberg: Republicans In Echo Before Big Burn Defy Affordable Care
Joseph Califano remembers the moment well. The nation’s doctors were threatening to boycott the new Medicare program, and President Lyndon Johnson had to get them on board or the 1965 extension of health care to elderly Americans would collapse. So the president set a trap (Tackett, 8/22).

The issue, and surrounding debate, is being replayed at town hall meetings held this month in congressional districts –

The Associated Press: Cassidy Won’t Support Shutdown Over Health Law
U.S. Rep. Bill Cassidy (R-La.) split with some hard-line members of the GOP on Wednesday, saying he wouldn’t support a federal government shutdown as a way to defund President Barack Obama’s health care law if the move would stop defense spending (Deslatte, 8/21).

The Lund Report: Wyden-Smith Town Hall Spreads Word About Cover Oregon, Health Reform
The drumbeat to inform Oregonians about impending health reform continued on Monday with a town hall hosted by Oregon Senator Ron Wyden (D) and Multnomah County Commissioner Loretta Smith that 120 people attended. Wyden trumpeted the Affordable Care Act and the changes it will bring to the healthcare system and people’s lives. “Healthcare is no longer going to be just for the healthy and the wealthy,” he said, particularly mentioning the Affordable Care Act’s provision illegalizing denying someone health coverage because of pre-existing conditions (Waldroupe, 8/21).

Health News Florida: Rally Cry: ‘Defund Obamacare’
Opponents of the Affordable Care Act rallied hundreds of conservatives at a Tampa hotel Wednesday night with a call for the Republican House to strip funds for the law out of next year’s budget. The budget vote is scheduled for right after Labor Day, in time for the 2014 fiscal year, which begins Oct. 1 (Gentry, 8/22).

Arizona Republic: Salmon To Help Target ‘Obamacare’
U.S. Rep. Matt Salmon drew cheers from a Mesa town-hall crowd Monday, saying he plans to enter the fray this fall to support a government shutdown aimed at defunding the president’s health-care law. The Republican congressman was piggybacking on an ultimatum issued by fellow conservative Texas Sen. Ted Cruz, who wants the GOP to refuse to fund the federal government past Oct. 1 unless money is cut from the health care law that will be rolling out in earnest at that time (Sanders, 8/21).

Also in the news –

Politico: Bobby Jindal Withdraws Request For Obamacare Funds
Gov. Bobby Jindal, a fierce Obamacare critic, pursued funds from an under-the-radar program in the health law until this week, when his administration reversed course, citing cumbersome federal rules. Health aides to the Louisiana governor began eyeing the program – a long-term care reform effort called Community First Choice – last year and went as far as submitting a formal application to CMS (Cheney, 8/21).

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Birth Control Mandate Could Cause Health Law's Speedy Supreme Court Return

The Hill: ObamaCare Birth-Control Mandate On Fast Track To Supreme Court
ObamaCare’s birth control mandate is putting the president’s signature legislative issue on a fast track back to the Supreme Court. Lawyers on both sides of the issue say the high court will almost certainly have to rule on the controversial policy, possibly as early as its next term (Baker, 8/22).


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Rate Of Circumcisions Falls 6 Percentage Points, Study Finds

The analysis by the National Center for Health Statistics shows the rate dropping from 64 percent to 58 percent over 32 years.

USA Today: Hospital Circumcisions Down 10% Over Three Decades
During the 32-year span, the percentage fell from 64.5% to 58.3%, finds the analysis by the National Center for Health Statistics. It was highest in 1981 at 64.9%, and lowest in 2007 at 55.4%. Numbers do not include circumcisions outside hospitals for religious or other reasons, says study co-author Maria Owings (Healy, 8/22).

Reuters: Baby Circumcisions In U.S. Hospitals Decline Over Three Decades
[T]he practice has been the subject of heated debate, including efforts to ban circumcision in San Francisco and Germany. The American Academy of Pediatrics said last August that the health benefits of infant circumcision outweigh the risks of the surgery. The National Center for Health Statistics offered little explanation in the report for the falling rates, but said fluctuations over the years followed changes to the American Academy of Pediatrics’ assessment of the procedure’s medical value (Johnson, 8/22).

Earlier, related KHN coverage: An Alaska-Sized Price Difference: A Circumcision In Anchorage Hospitals Can Cost $2,110 or $235 (Feidt, 8/21).  

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