DO YOU KNOW THAT WE HAVE ONLY 25 DAYS TO FILE AS A CANDIDATE FOR STATE-WIDE ELECTION IN MARYLAND AND NO ONE IS CHALLENGING NEO-LIBERALS WHO INTEND TO MOVE ALL THESE POLICIES FORWARD!!!!!!!
As I rant about having all health care decisions now placed in the hands of corporations I want to be clear.....corporate wellness/ACOs are not across-the-board bad.....just as charter schools, individual programs can be innovative. But, as with charter chain businesses.....when the whole process becomes market-driven none of what is done is done for the good of people. Remember as well, as these health systems go global they will behave just as Wall Street banks do.....they will be predatory and unaccountable.
Looking towards health care policy I am glad to have been able to share with friends across the country that Maryland is ground zero for ending Medicare and Medicaid as Federal programs by sending them to these state health systems and having people simply treated as they are with the tiered system being built. So, working/middle class......you paid all the payroll taxes and income taxes that allowed this first class health care system to exist.....but, at best, only upper middle-class will have a Medicare we have always been used to. Who are those upper/middle class-----give or take $250,000. You see, disposible income is hard to find in a society that has the middle-class preyed upon from the top and bottom income groups!
Raise your hands if you understand that the ACA reforms make hospitals profitable and therefor they are not private non-profits. Look, they are being rated for profitability for goodness sake.....
TAX THEM AND USE THAT TAX TO BUILD AND RUN PUBLIC HOSPITALS!
We are now to believe that once these hospitals take steps to become more cost-effective and profitable.....that they will still be private non-profits. After all, even though they use that extra money earned to expand globally....they are not handing out dividends-----OH REALLY????? Below you see Wall Street modelling these corporations and you see how these corporations are planning and investing all those PROFITS. As I show below that.....the UMMS health care union shouts loudly and strongly how what is in Maryland a quasi-governmental state university hospital.....see how far they go not to say corporation.....uses Wall Street investments of what should be public money to the detriment of staff and patients all to boost profit and expansion.
THESE ARE NOT NON-PROFITS AND NEED TO EITHER GO BACK TO BEING PUBLIC HOSPITALS OR PAY TAXES AS CORPORATIONS.
33 Statistics on Nonprofit Hospital Operating Margin by Credit Rating
Written by Bob Herman (Twitter | Google+) | January 17, 2014 BEcker's Hospital Review
Healthcare CFOs and other top finance leaders view operating margin as one of the most important metrics to gauge the sustainability of their organizations.
In 2012, the median operating margin at most nonprofit hospitals and health systems varied, depending on credit rating and other factors, but generally it fell between 1 and 4 percent.
Here are 33 statistics on nonprofit hospital and health system operating margins, separated by credit rating categories from the three major rating agencies. Note: All data are medians and reflect audited 2012 financial statements.
Hospital credit rating
Median operating margin (2012)
10 Priorities for Nonprofit Hospital Investment Committees
Written by Bob Herman (Twitter | Google+) | January 16, 2014
Given the large-scale changes in the healthcare sector today, investment strategy has become more important.
As the calendar flips to a new year, prudent hospital and health system executives are looking at their investment strategies from 2013 and evaluating what worked — and what didn't. A report from consulting firm Mercer identified 10 priorities that investment committees at nonprofit hospitals and health systems should consider as 2014 gets underway.
1. Assess whether risk tolerance in the investment portfolio has changed, given a challenging operating environment.
2. Review the fixed income allocation in both a low and a rising interest rate environment.
3. Consider whether a delegated investment approach could offer time and cost savings for your organization.
4. Evaluate whether investment strategy should take into account a pending or potential strategic action, such as a merger, acquisition or joint venture.
5. In a post-merger situation, conduct an investment policy survey to facilitate successful integration of investment assets.
6. Develop a strategy for getting a defined benefit pension plan fully funded.
7. Recognize the growing importance of the defined contribution pension plan.
8. Consider how best to meet the fiduciary obligations of defined contribution plan governance.
9. If you are considering moving a captive insurance company offshore, understand the governance, reporting and regulatory requirements.
10. Assess the balance sheet implications of taking on capitation or insurance risk.
Here you have real patient advocates in the UMMS Code Red union shouting that 'IF AN INSTITUTION WALKS LIKE A DUCK AND TALKS LIKE A DUCK, IT IS A CORPORATION FOR GOODNESS SAKE AND NOT A NON-PROFIT.
Let's be clear......we all know a health system based on privatized corporate policies will be purely profit-driven and bad for patients and their employees!
UMMS is seeking $155 million for the Upper Chesapeake Health System even as the system’s debts mount from the purchase of St. Joseph Hospital and even though UMMS has failed to build a promised hospital on the Eastern Shore. All the while, UMMS is laying off frontline caregivers.
UMMS Code Red December 17, 2013 In Maryland, private hospitals fall under the National Labor Relations Act and public hospitals fall under the Maryland Labor Relations Act. The University of Maryland Medical Center, based in Baltimore, is governed by neither. UMMC is the only hospital in the state where workers do not have basic labor protections.
The issues at stake at UMMS are the same issues at stake nationally. An ethos has developed in this country in which executives, even those of taxpayer supported nonprofits, are lavished with high pay, perks and bonuses while their employees struggle to make ends meet, and risky financial schemes by CEOs are given a pass. Will we continue to live in a society where executives can squander taxpayer dollars at will? http://ummscodered.org/
Between 2008 and 2012, pay jumped 75 percent for the top four UMMS executives, who received more than $21 million during that time, and that’s not including perks like exclusive health club memberships, each for worth thousands of dollars. www.ummscodered.org
Why should a "non-profit" hospital, which gets more than 58 percent of its funding from tax dollars, sic "nasty" lawyers on anyone or push patients into bankruptcy? If you are also looking at patient issues, fiscal problems or other types of mismanagement at UMMS, write us at info@UMMSCodeRed.org or call our hotline: 877-434-1011.
Raise your hand if you understand that something with the title of corporation and headed by a CEO is not public!!!!!!!!! EVERYONE.
This is what public private looks like and it does not work for you and me.....it works to maximize profits for the health industry. So, the first thing a real progressive would do is dismantle the private from the public!
Dr. Ramanathan Raju Named President of New York Health and Hospitals Corporation
Written by Akanksha Jayanthi
January 21, 2014 Becker Hospital Review
New York City Mayor Bill de Blasio has selected Ramanathan Raju, MD, as president of New York Health and Hospitals Corporation, the largest public hospital system in the country.
Dr. Raju currently serves as CEO of Cook County Health and Hospitals Systems in Chicago, the third largest public hospital system in the country.
He previously served as CMO, corporate COO and executive vice president of New York City HHC.
Dr. Raju has also served as director of surgery, director of medical education and senior vice president of Lutheran Medical Center and COO and CMO of Coney Island Hospital, both in Brooklyn, N.Y.
'In other words, if you are high maintenance because you don’t do what your doctor says (and remember, “non-compliant” includes people who don’t follow orders because they think the cookie-cutter approach isn’t right for them) or want higher service or per the example of the pediatrician Patricia’s 40 minute case, have a complicated set of ailments, you’ll be shunted. The brave new world of corporate medicine will eject you'.
WOW......JUST AS I SAID FOUR YEARS AGO.....It's almost like I knew the goal of ACA was to consolidate the health industry into Wall Street sized global health systems that would maximize profits by excluding most people from coverage. All labor and justice leaders knew this too------leaders shouting loudly for ACA knew you would lose access to health care and Medicare and Medicaid would be ended as a Federal program.
We are watching as corporations are now being given rights to force their employees to behave a certain way regarding health care and health conditions are else be without health coverage and perhaps a job. These preventative plans are simply a way of having people tied to blood tests that show high levels of sugar, cholesterol, fats, for example and expect that employee to use a wellness program to bring levels into range.......it will be a boot camp and this is all supposed to bring wellness. It will be more about having all that data on you in a database and sold for profit and it will be used to discriminate in employment and how much you pay for health insurance premiums.
Remember, many health risks are hereditary and cannot simply be wellnessed away. Many health problems like obesity are now linked to chemicals placed in common foods that are impossible to avoid. There is no way that preventative care will stop much of what most people experience in illness......cancers, diabetes, heart disease..... but these neo-liberals are going to deny access to these ordinary treatments using these arbitrary prevention schemes. I had my doctor tell me I am obese. This places me in an insurance premium and preventative care regime that I do not need BECAUSE I AM NOT OBESE FOR GOODNESS SAKE.....I AM SIMPLY A MID-AGED WOMAN!
This is not a good thing. It follows the idea of a totalitarian society where everything you do is guided by corporations and this health policy is truly regressive. Here in Maryland it comes from Johns Hopkins.
THE PROBLEM WITH COST IN HEALTH CARE IS HEALTH FRAUD AND PROFITEERING NOT PATIENT ABUSE OF THE SYSTEM!!!!!
Obamacare penalties spawn 'skinny' plans
The law is nearly silent on what employers need to include in their health plans. | Reuters
By BRETT NORMAN | 7/16/13 4:59 AM EDT
Employers heaved a sigh of relief when the Obama administration announced it would not enforce Obamacare’s mandate that large companies provide insurance to their workers next year.
But some companies plan to offer “skinny plans” designed to duck the biggest penalties anyway, according to industry consultants. And the Obama administration has extended its blessing to this limited coverage, even though it would not protect individuals from medical bills that could cause financial ruin in the case of severe injury or illness.
The health law spells out in detail the comprehensive coverage that insurers have to provide on the new insurance marketplaces or exchanges. But it’s nearly silent about what the employers who provide insurance to a majority of Americans need to include in their health plans.
“There are no rules on how good that coverage has to be,” said Gretchen Young, senior vice president of health policy at the ERISA Industry Committee.
About 95 percent of large employers already offer health insurance. Most of them offer fairly comprehensive coverage, as good or better than the typical plans that will be offered on the exchanges.
That’s not the case for many retailers, restaurant chains and the hospitality industry, which often rely on low-wage, part-time workers and offer few or no health benefits.
And those are the businesses that were most seriously affected by the employer mandate.
“There are particular employers in particular industries for whom the Affordable Care Act is a disaster,” said Andy Anderson, who leads the health division at the law firm Morgan, Lewis & Bockius in Chicago. The Congressional Budget Office estimates the penalties would bring in $3.7 billion per year.
The health care law required employers with the equivalent of 50 or more full-time workers to provide health insurance or else pay a $2,000 per employee fine, starting in 2014. After intense lobbying from the business community, the Treasury Department announced earlier this month that the mandate won’t take effect until 2015.
The penalty is a fraction of the roughly $8,000 it costs to provide an employee with comprehensive health insurance. But it would be a major new expense for large employers that don’t pay for coverage now.
A firm with 2,500 employees would pay about $5 million in penalties each year.
But there’s a second penalty that gets less attention. Large employers that don’t provide robust, affordable insurance to their workers will pay a $3,000 penalty for each employee who gets taxpayer-funded subsidies on an exchange.
And there is a new type of insurance plan that is designed to protect employers from the first penalty and lower their exposure to the second. They are the skinny plans, a descendant of limited benefit — or “mini-med” — plans that are set to be phased out at the end of this year.
“Skinny alternatives are an attempt to manage liability for ACA penalties,” said Neil Trautwein, employee benefits policy counsel at the National Retail Federation.
The mantra with the Affordable Care Act people is that these reforms give access to health care to more people and boosts the number insured for health care. Before all of this the poor had clinics that gave them all the care they needed and they were able to go to the emergency rooms for more serious conditions. So, the poor were far better off then now. Now, they are excluded from most hospitals for many kinds of care.....they are eligible for less preventative care, rather than more. It will be a debacle for the poor as regards access to ordinary medical procedures.
The expanded Medicare takes in what used to be people with strong workplace health policies that were lost or will be shed in this reform as businesses stop health plan coverage for low-income workers. It is simply an step down to basic Medicaid and will encompass 80% of Americans. So, the ACA is indeed a type of single-payer.......Medicaid for All.
This is a good article showing what basic procedures that save lives will not fall under the venue of ACA......and how lots of people will not be in the window of Medicaid.
THAT'S A NEO-LIBERAL FOR YOU.....MAXIMIZING PROFITS BY ENDING PUBLIC SERVICES AND PROGRAMS.
We already see the number of poor and low-income who try to access dental care for instance is extremely low because these people are getting such poor care and/or abused by these caretakers to which they are referred....they are not using it.....WHICH I FEEL IS DELIBERATE.
Sen. Grassley Investigating Abuse at Corporate Dental Chains
July 2, 2012, 1:23 pm ET by David Heath Center for Public Integrity
a joint investigation by FRONTLINE and the Center for Public Integrity. Sen. Charles Grassley (R-Iowa) says that his investigators have found evidence of abuses by corporate dental chains treating children on Medicaid.
For months now, Grassley’s staff has been asking questions of three dental chains serving poor children on Medicaid. Each is owned by a private-equity firm. The chains are Kool Smiles, Small Smiles and ReachOut HealthCare America.
Medicaid Programs Vary in Coverage of Preventive Care, Report Says
Released: 7/3/2013 9:00 AM EDT
Embargo expired: 7/8/2013 4:00 PM EDT
Source Newsroom: George Washington University more news from this source Contact Information Available for logged-in reporters only
Newswise — WASHINGTON, DC—Existing Medicaid beneficiaries have largely been left out of the health reform movement when it comes to preventive services that can ward off cancer, heart disease and other potentially deadly diseases, according to a new study by researchers at the George Washington University School of Public Health and Health Services (SPHHS).
The study, which appears in the July issue of Health Affairs, notes that under the Affordable Care Act most private insurance plans, Medicare and Medicaid expansion programs are required by law to cover a full range of crucial preventive services such as screening tests for colorectal cancer, high blood cholesterol, HIV infection, and diet counseling that can prevent obesity. But state Medicaid plans are not required to cover such care for adults already enrolled in Medicaid—and this report suggests that those adults will not have access to the full range of preventive services.
“Preventive services save lives by detecting diseases before they can progress,” says lead author Sara Wilensky, PhD, JD, special services faculty for undergraduate education in the Department of Health Policy at SPHHS. “Why should some Medicaid beneficiaries be left out when it comes to coverage for this kind of care?” Screening mammograms, colonoscopies, cholesterol screenings and other preventive services are aimed at staving off health problems early on rather than trying to provide costly health care for established and hard-to-treat disorders, she said.
Wilensky and her co-author Elizabeth Gray, JD, a research associate at SPHHS, reviewed Medicaid policies in all 50 states and the District of Columbia from June 2012 through November 2012. The initial review looked at all publically available information on coverage of preventive services. After that first review, the researchers then contacted state Medicaid officials to fill in any missing information about coverage for this population.
The researchers found that most states do not cover all of the preventive services recommended by the U.S. Preventive Services Task Force, an independent panel that looks at preventive care and offers guidelines for health plans and providers. In addition, it was often difficult to discern exactly which services were covered by Medicaid programs based on the vague language used by many programs. The report highlighted some serious gaps in coverage. For example, while most states provided coverage for screening mammograms, not all Medicaid programs offered such care to existing beneficiaries. In fact, three states don’t cover preventive mammograms for this population at all—a shortfall that could mean low-income women will go without the test, the authors said.
The analysis also says that states appear to rarely cover other types of preventive care for breast cancer for those at high risk. Only 11 state Medicaid programs, for example, make it clear that they will pay for breast cancer susceptibility testing for the BRCA1 gene that increases the risk of breast and ovarian cancer. And just three states explicitly cover chemoprevention for such beneficiaries. This medication can be used to lower the risk of breast cancer, a disease that kills about 40,000 American women every year.
"The Affordable Care Act guarantees millions of low-income Americans access to mammograms, colonoscopies and other lifesaving preventive services, but that assurance does not extend to people who currently have Medicaid coverage," said Chris Hansen, president of the American Cancer Society Cancer Action Network (ACS CAN), the advocacy affiliate of the American Cancer Society and one funder of the study. "States have a responsibility to ensure that all people in Medicaid have access to preventive care for a life-threatening disease such as cancer."
The authors of the study also say there is wide variation in coverage of tests for sexually transmitted diseases (STD) and the test for the HIV virus that causes AIDS. And in some states STD screening is limited to family planning visits, a restriction that means people visiting the doctor for some other reason or those who are not eligible for family planning services may not have coverage. Going without this screen, increases the risk that an infected person will not receive treatment and could unknowingly spread a disease to others, Wilensky said.
Many of the preventive services evaluated by the study, such as screenings for early signs of heart disease, depression or diabetes, were either not covered or it was unclear if they would be paid for by Medicaid. In some cases, state Medicaid officers said that the preventive services would be paid for only if deemed “medically necessary.” But Wilensky says that these terms should not be used together because medically necessary tests are for instances when a provider has a reason to suspect an established health problem, while preventive tests are crucial in detecting an emerging problem in an otherwise healthy, asymptomatic person.
Such confusion could leave providers wondering if preventive services will be covered by Medicaid, says the report. In the end, providers may simply fail to provide care if they are uncertain about Medicaid coverage and/or payment for their services, the authors said.
“By lowering risk factors such as high blood pressure and cholesterol, Americans can reduce their risk of heart disease or stroke by as much as 80 percent,” said Nancy Brown, CEO of the American Heart Association, which also helped fund the study. “Evidence-based screenings play an essential role in identifying and reducing these factors. Without Medicaid coverage of preventative screenings and services, we could fall behind in the battle against the nation’s No. 1 and No. 4 killers.”
The authors conclude that there are many opportunities to increase the coverage of preventive services for this population. For example, managed care plans could choose to cover services that end up saving lives even if not required by state Medicaid programs. In states that do not clearly spell out covered preventive services or require providers to follow a specific standard of care, providers could choose to follow the guidelines of the U.S. Preventive Services Task Force. Alternatively, Congress could step in and give existing Medicaid beneficiaries the same coverage of preventive services as most other Americans enjoy under health reform, the authors point out.
The Health Affairs study, “Existing Medicaid Beneficiaries Left Off the Affordable Care Act’s Prevention Bandwagon,” was funded by the American Cancer Society, the American Cancer Society Cancer Action Network, the American Heart Association and the National Colorectal Cancer Roundtable.
The full report, “Coverage of Medicaid Preventive Services for Adults—A National Review,” includes state-specific data and additional information about this topic. To access the report click here.
About the George Washington University School of Public Health and Health Services:
Established in July 1997, the School of Public Health and Health Services brought together three longstanding university programs in the schools of medicine, business, and education and is now the only school of public health in the nation’s capital. Today, more than 1,100 students from nearly every U.S. state and more than 40 nations pursue undergraduate, graduate, and doctoral-level degrees in public health. http://sphhs.gwu.edu/