The problem with cost? Health care fraud and health industry profit!
Below you will see a course offered by Johns Hopkins .....the drive behind making most people in America only accessible to primary care....public health checkups. It is indeed a policy taken from care implemented by Hopkins around the third world. It is third world health policy. It makes it hard to impossible for people to access hospital or procedures that have cost. Rather, the idea is to simply do preventative care to allow people to live as long as advanced care is not needed. So, prevent heart disease with nutrition and exercise, but don't come to the hospital for heart by-pass or transplants. At Unviersity of Maryland Medical Center, when these rules were put into action as part of health reform, a cancer patient went from having a doctor that was moving forward with cancer treatments, to being told University of Maryland does not give that treatment on Maryland's public health insurance. The man was told to go home and die.
The fastest growing health care businesses are those that treat in this fashion. They are convenient and affordable to low-income people.....but that's all there is my friend.
Preventative care and services are measures that are performed in an effort to prevent an illness or injury.
Common examples of preventative care are immunizations and yearly physicals. In fact, any screening test done in order to catch a disease early is considered a preventative service, such as routine Pap tests for women or prostate exams for men. Medications, like low-dose daily aspirin therapy, and counseling services, such as nutrition and exercise guidance, are also examples of preventative care and services.
In this article, we'll find out if these preventative steps actually make any difference in your health.
According to an August 2007 study by the Partnership for Preventative Care (think there is bias? For those middle-class that get all this preventative care....do you find this as comforting exclusive coverage?), preventative services are grossly underused, with racial and ethnic minorities receiving the least amount of preventative care in the United States. After studying the top 12 preventative care services, the authors concluded that if Americans began to utilize any five of them, up to 100,000 lives could be saved in just one year.
These lifesaving preventative measures are not expensive or particularly physically taxing. For example, the study estimates that less than half of adults in America use low-dose aspirin therapy. However, if 90 percent of all men over 40 and women over 50 took a daily low-dose aspirin, it could save up to 45,000 lives a year.
Similarly, more than 42,000 lives could be saved annually if doctors offered their smoking patients medications or counseling services in order to help them stop smoking. Today, doctors offer such medications or services to a mere 28 percent of patients after they have advised them to stop smoking. An additional 30,000 lives could be spared with the use of screening tests for breast and colorectal cancers, along with a simple flu shot. Currently, these screening tests and immunizations are underused, with less than 40 percent of all adults getting an annual flu shot.
Some may assume that preventative care is reserved for aging baby boomers. But the next section explains who can benefit from preventative care and exactly which services they should be utilizing.
Most Effective Preventative Services 1. Daily aspirin use for men over 40 and women over 50
2. Childhood immunizations
3. Smoking cessation advice and tools to help you quit
4. Hypertension screening and treatment for adults 18 and older
5. Cholesterol screening and treatment for men 35 and older and women 45 and older
Children are the most frequent recipients of preventative care and services. The majority of these services are in the form of immunizations, which work to prevent children from developing illness such as polio, measles and mumps. The rate of immunizations is rising each year and remains one of the few preventative services with little disparities in rates between racial and ethnic groups. Other preventative services for children include the charting of the child's height and weight, which works as an early screening tool for any developmental problems. Due to the increase incidence of Type II diabetes and obesity in young patients, increasingly common preventative services include nutritional services and exercise information.
Women have a number of preventative screening tests to take advantage of. Adult women (and men) should have their cholesterol levels checked yearly and their blood pressure checked every two years. Once sexually active, or once they've reached the age of 21, every woman should get a Pap test, which is a screening tool for cervical cancer. As long as these test results are normal, the test can be repeated once every one to three years. Women over the age of 40 have different preventative needs. At this age, women should begin to get mammograms every year or so, which screen for breast cancer. Women over 50 should also get a test to screen for colorectal cancer. Women over 65 should have regular bone density testing to screen for osteoporosis.
Along with screening tests, there are several medications that can help women prevent illnesses like osteoporosis. Calcium is a common preventative medicine that can prevent a number of bone problems. Pregnant patients often take a plethora of preventative medications, including prenatal vitamins, iron and folic acid -- all in an effort to prevent any complications.
The first and most common preventative tests for adult men are regular checks of their weight, cholesterol levels and blood pressure. For men over 50, a test to screen for colorectal cancer is recommended. Men older than 50 should also consider prostate exams to screen for prostate cancer, with current studies suggesting that they should be done every four years. Of course, along with these tests, preventative care includes counseling on different prevention practices including proper diet and exercise, safe sex practices and even smoke detectors in the home.
As this article states preventative medicine does not save in health carer cost....it actually is shown to increase costs. This is true because as with all health care fraud....it is these lab tests and Xrays.....the primary care office visits that cost the most in health fraud so if you are doubling down on the very procedures known to be filled with fraud.....you will lose money....Medicaid and Medicare is full of this.
I know here in Baltimore doctors are having people back to their offices every three months just to take blood levels and have the primary care doctor counsel the patient to stop eating this and walk more.
So why is this the backbone of the health reform? All this may cost more for taxpayers and patients, but it is the cheapest medicine to apply. It makes profits soar when people do this and are not being able to access hospital stays.
FOR RESIDENTS OF MARYLAND.....THE ENTIRE HEALTH REFORM CENTERS ON THESE POLICIES. I HAVE ALREADY SHARED THAT DENTAL SERVICES COMING TO BALTIMORE SCHOOLS ARE ABUSING THE CHILDREN WITH UNNECESSARY PREVENTATIVE TREATMENT JUST TO MAKE PROFIT.
The Truth-O-Meter Says: "Preventive care … saves money, for families, for businesses, for government, for everybody."
Barack Obama on Friday, February 10th, 2012 in a briefing at the White House
Barack Obama says preventive care 'saves money' Share this story: President Barack Obama, accompanied by Health and Human Services Secretary Kathleen Sebelius, announces the revamp of his contraception policy that required religious institutions to fully pay for birth control, on Feb. 10, 2012, at the White House.
It’s been a staple of health care politics for years -- the claim that preventive care saves money. A little money up front, lots of money saved on the back end. Patients living longer and healthier lives. That makes sense, right?
But while there’s little doubt that preventive care saves lives, the money is a different story. In general, academic studies do not support the idea that paying for preventive care ultimately saves money.
We first published that conclusion in 2009, when we rated True a claim by New York Times columnist David Brooks that preventive care does not save the government money. When President Barack Obama claimed it did save money in a September 2009 speech to Congress, we rated it False.
On Feb. 10, 2012, Obama revived this line of argument. His comments came during a media briefing to announce a partial reversal of a policy that would require church-affiliated organizations such as hospitals to provide a package of free preventive coverage, including contraception. Catholic groups criticized the policy -- which was set in motion by Obama’s health care law in 2010 -- on the grounds that it conflicted with churches’ religious beliefs.
In announcing a partial shift of policy, Obama said, "As part of the health care reform law that I signed last year, all insurance plans are required to cover preventive care at no cost. That means free check-ups, free mammograms, immunizations and other basic services. We fought for this because it saves lives and it saves money –- for families, for businesses, for government, for everybody. That’s because it’s a lot cheaper to prevent an illness than to treat one."
However, as we wrote in 2009, it’s not true that preventive care generally "saves money."
Brooks' critique relied on estimates by the Congressional Budget Office. "The evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall," CBO director Douglas Elmendorf wrote in an Aug. 7, 2009, letter to Rep. Nathan Deal, the top Republican on a congressional subcommittee involved in the debate.
Elmendorf explained that while the cost of a simple test might be cheap for each individual, the cumulative cost of many tests adds up:
"But when analyzing the effects of preventive care on total spending for health care, it is important to recognize that doctors do not know beforehand which patients are going to develop costly illnesses. To avert one case of acute illness, it is usually necessary to provide preventive care to many patients, most of whom would not have suffered that illness anyway. ... Preventive care can have the largest benefits relative to costs when it is targeted at people who are most likely to suffer from a particular medical problem; however, such targeting can be difficult because preventive services are generally provided to patients who have the potential to contract a given disease but have not yet shown symptoms of having it."
In fact, a government policy to encourage prevention could end up paying for services that people are already receiving, including breast and colon cancer screenings and vaccines, Elmendorf said.
Other studies backed up the CBO's analysis, including a Feb. 14, 2008, article in the New England Journal of Medicine that was written in response to campaign promises for more preventive care.
"Sweeping statements about the cost-saving potential of prevention ... are overreaching," according to the paper. "Studies have concluded that preventing illness can in some cases save money but in other cases can add to health care costs." They write that "the vast majority" of preventive health measures that were "reviewed in the health economics literature do not" save money.
"Some preventive measures save money, while others do not, although they may still be worthwhile because they confer substantial health benefits relative to their cost," the authors write. "In contrast, some preventive measures are expensive given the health benefits they confer. In general, whether a particular preventive measure represents good value or poor value depends on factors such as the population targeted, with measures targeting higher-risk populations typically being the most efficient."
Meanwhile, a separate study conducted by researchers from the American Diabetes Association, American Heart Association and the American Cancer Society concluded that, while interventions to prevent cardiovascular disease would prevent many strokes and deaths, "as they are currently delivered, most of the prevention activities will substantially increase costs."
To make sure that the data hadn’t changed dramatically since we last looked at this issue, we contacted Peter J. Neumann, director of the Center for the Evaluation of Value and Risk in Health at the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center. He was one of the three co-authors of the New England Journal of Medicine article.
He said the patterns his group found in 2008 have not shifted dramatically since then.
"Sometimes preventive measures save money, sometimes not," Neumann said. "The general message is that it depends."
Milton C. Weinstein, one of Neumann's co-authors, agreed. "In general, the comparative effectiveness literature supports the general proposition that preventive care does not save money," said Weinstein, a professor of health policy and management at the Harvard School of Public Health.
As a general notion, the idea that "preventive care … saves money, for families, for businesses, for government, for everybody" is no more true today than it was in 2009. Yes, preventive measures often save lives and keep patients healthier. Certain preventive measures may save money as well. But the findings of CBO and physicians who have studied the medical literature indicate that Obama’s sweeping generalization that preventive services save money is not accurate. We rate the statement False.
Here we have our corporate master.......Johns Hopkins who is pushing this policy of ending health care access for most in exchange for preventative public health care. They are doing that because Hopkins is now going corporate with patents and luxury boutique health care bringing all kinds of profit to this corporation. Keeping the working class and poor out of hospitals and limiting care to only preventative care has already made health institutions in Maryland more profitable Hopkins reports!
Below you see a course by Hopkins that is teaching medical students to push preventative care as the 'Health Care for All' answer. Everyone knows that getting a lab test for cholesterol with a lecture from a doctor does not have strong efficacy. The attitude will be 'we told you what to do and you ignored it'....like the law Bloomberg tried to pass banning extra-large sodas. Meanwhile, the wealthy are living in excess of food and drink and able to pay to treat their gout for example.
PREVENTATIVE CARE DOES NOT EQUATE TO HEALTH CARE FOR ALL!
Health for All Through Primary Health Care
Dr. Henry Perry
This course explores why primary health care is central for achieving Health for All. It provides examples of how primary health care has been instrumental in approaching this goal in selected populations and how the principles of primary health care can guide future policies and actions.
Workload: 3-4 hours/week Watch intro videoSessions:May 29th 2013 (5 weeks long)Sign UpFuture sessions
About the Course
Two of the most inspiring, least understood, and most often derided terms in global health discourse are “Health for All” and “Primary Health Care.” In this course, we will explore these terms in the context of global health, their origins and meanings, the principles upon which they rest, and examples of how these principles have been implemented both at small scale as well as at large scale. We will also explore some ultra-low-cost approaches to Health for All through primary health care and the promise that primary health care holds for eventually achieving Health for All.
This is another O'Malley lie. Maryland has long had in place a tiered system of access to health care that has the poor and working class showing life spans as much as 20 years shorter than affluent because of lack of quality care. We have people in Maryland hating to go to the hospital because of fear of outcomes either from bad service or infection. Johns Hopkins had the highest death from infection rates in the country for decades.
What we see in Maryland are the low premiums that will have large deductibles and co-pays that keep people from accessing most care other than preventative care. Just like catastrophic auto insurance.....you may pay less in premiums....but you will not be able to pay the piper to use it! Maryland has a growing contingent of Universal Care groups because they know there will be no access for most in Maryland!
The Gold Premium is obviously that plan closest to what Americans have always gotten so just because they call it an insurance premium.....it is not access to care!
Maryland Touts Low Obamacare Health Insurance Premiums
Posted: 07/26/2013 6:45 pm EDT | Updated: 07/26/2013 10:11 pm EDT Huffington Post
Health coverage sold on Obamacare's health insurance exchange in Maryland will be among the cheapest in the country, state officials said Friday.
A 21-year-old nonsmoker will be able to buy health insurance that costs as little as $93 a month on the Maryland Health Connection, the state's health insurance exchange, starting Oct. 1 for coverage that takes effect Jan 1, the Maryland Insurance Division revealed in a press release. Rates for insurance with richer benefits and lower deductibles will be higher and premiums will vary by age, residence location, tobacco use and whether family members enroll.
Maryland is the latest state to disclose how much health insurance actually will cost under President Barack Obama's health care reform law. The state joins California, New York and elsewhere in achieving monthly premiums below estimates by the Congressional Budget Office and others. Officials in states including Indiana have released preliminary findings suggesting health insurance costs will skyrocket as a result of the law.
Younger, healthier people who buy inexpensive, bare-bones insurance on today's market may see higher prices for more comprehensive coverage on the exchanges, while older people are expected to see lower rates. People with pre-existing conditions can't be turned down or be charged higher premiums because of their medical histories. The law also prohibits women being charged more than men.
Maryland Gov. Martin O'Malley (D) and his administration have wholeheartedly embraced Obamacare implementation, in stark contrast to the the 34 states, mostly with Republican governors, that left the federal government to erect the health insurance exchanges that will be used by residents who don't get health benefits at work or are employed by small businesses. Maryland also exercised its regulatory authority to force health plans to curb rate increases for next year, such as the 25 percent hike initially requested by CareFirst BlueCross BlueShield in April.
In the Baltimore metropolitan area, a 25-year-old nonsmoker will have access to "bronze" level coverage -- the second-least generous of four tiers of benefits -- for $124 to $237 a month. A 50-year-old nonsmoker will see monthly prices for a "silver" plan ranging from $267 to $470, according to a Maryland Insurance Administration analysis.
By contrast, the median cost of an individual health insurance plan for a 30-year-old, nonsmoking man in Maryland this year is $190 a a month and the cheapest is $62, according to a report issued by the Government Accountability Office this week. An exact comparison can't be made because current plans aren't subject to Obamacare's minimum benefit standards and the least expensive policy has a $10,000 deductible -- far higher than will be allowed on the health insurance exchanges.
The new exchange prices don't account for tax credits available on a sliding scale to people who earn from the federal poverty level -- $11,490 for a single person this year -- and four times that amount. The Maryland Insurance Administration estimates that three-quarters of the people who will use the health insurance exchange will qualify for tax credits that will cut the cost of their coverage. Maryland also is expanding Medicaid to anyone earning up to 133 percent of poverty under Obamacare next year, joining 22 states and the District of Columbia in doing so.
The Maryland Insurance Administration said the state's health insurance premiums are among the lowest available in 12 states that have released pricing information to date.
"Among Bronze plans compared for young adults, Maryland rates were lower than those proposed or approved in all other eight states for which a comparison was possible. For example, the lowest price for a Bronze plan for a 25-year-old in Maryland was $114, compared to $134 in Virginia, $146 in Colorado, $163 in Ohio, $167 in Washington State, and $174 in California," a report by the Maryland Health Connection concludes.
The U.S. Department of Health and Human Services announced last week that premiums in 10 states and the District of Columbia will be lower than Congressional Budget Office projections. The federal government won't issue information about the rates on federally run exchanges until nearer to the beginning of the six-month Obamacare enrollment period that begins in October.
Regarding this 25% rate hike that O'Malley and commissioners famously held at beigh; remember when O'Malley stopped a doubling of electricity rates from BGE/Constellation before his election and then after his election Exelon comes and asks for that doubling. Too embarrassed to give it all at once these Public Service commissioners will simply do it in two steps. That is what this negotiated rate will do....it will be implemented when O'Malley finishes his 2016 campaign.
What O'Malley's claim to fame will be that he joined neo-liberals in turning health care into a market.....a private one at that rather than going with the public option that will lead to Universal Care....which all of Maryland citizens want. So, rather than spin the data, let's look for real information outside of Maryland and Baltimore mainstream media. Try PNHP Physicians for a National Health Program
Premiums to go up as much as 25 percent under health reform Insurance administrator improves rates for plans to be sold on state exchange
By Andrea K. Walker, The Baltimore Sun 8:42 p.m. EDT, July 26, 2013
Marylanders who buy health insurance on a state exchange under health reform could see their premiums jump as much as 25 percent under rates approved by state regulators, but those increases are less than insurers sought.
Maryland Insurance Commissioner Therese M. Goldsmith approved premium increases Friday for nine insurance companies who applied to sell plans to individuals through a state exchange, called Maryland Health Connection, established under health reform.
The rates were significantly lower than what insurance companies had requested, but still higher than the 6 percent to 7 percent annual premium increase that is typical across the country. Insurers said they were seeking the increases to cover the uncertainty of new costs associated with health care reform.
The full impact of Goldsmith's decision is not known because it is not certain how many people will buy insurance from the exchange. The rate increases would not affect most people who purchase insurance through their jobs, but there are many others who buy insurance individually or who are uninsured who will be able to buy from the exchange.
Maryland Health Connection estimates 180,000 people will buy from the exchange for 2014. They largely will come from the 146,078 Marylanders who currently buy in the individual market and from the estimated 740,000 uninsured people in the state.
The rate review process was scrutinized by critics who thought insurers were seeking exorbitant hikes. Goldsmith approved increases as much as 33 percent below what insurers asked. The commissioner said she sought to balance the needs of both consumers and insurers.
"The rate review process is designed to test data and assumptions underlying proposed rates and to ensure those rates are neither excessive nor inadequate," Goldsmith said in an email through a spokeswoman.
Supporters of the Affordable Care Act acknowledged rates would go up, but also said consumers will get plans with better coverage.
"A lot of the lower rates have been a result of people having really poor coverage with high deductibles with really minimum coverage," said Vincent DeMarco, president of the Maryland Citizens Health Initiative. "Everybody is going to get full coverage now. When you have coverage with a $5,000 deductible, you basically have no coverage."
Maryland Attorney General Douglas F. Gansler said the rate increases still were too high given the uncertainty of what will happen when health reform is fully implemented Jan. 1. Nobody knows how many people will sign up for insurance or how much more it will cost the system, if anything, he said. Gansler had proposed capping rate increases to no more than 5 percent.
"It certainly seems that insurance companies are taking advantage of the Affordable Care Act coming down the road and using that to be greedy at a time when we don't know if it will cause costs to go up or lower costs," he said.
Rep. Andy Harris, who opposes the health reform law, said the premiums demonstrate that "Obamacare will in fact lead Marylanders to pay more for their health care. It is hardly welcome news for young Marylanders who are already struggling in this economy to say their health insurance will still go up under Obamacare, but not as much. Despite promises by President Obama and others that this law would lead to lower premiums, the exact opposite is turning out to be true — Marylanders will be paying more."
The highest rate increase of 25.4 percent was granted to Aetna Life Insurance Co.. The rate was 29 percent lower than the insurer sought. Aetna also recently bought Coventry Health.
Walt Cherniak, a spokesman for both companies, said the insurer still was reviewing the recommendations before commenting.
There is an appeal process if insurers don't like the commisioner's decision.
Kaiser Permanente of the Mid-Atlantic States had the lowest premium increase at 4.3 percent, about 1 percent less than it requested
"[We] worked with Maryland officials to ensure our 2014 rates are as consumer friendly as possible," the company said in a statement. "We believe all residents should have access to high quality, affordable care, and we're confident our rates reflect that."
CareFirst BlueCross BlueShield, the state's largest insurer, wanted to raise rates an average of 25 percent on those who buy coverage individually. Goldstein approved increases of 11.3 percent, 15.4 percent and 12.1 percent for various CareFirst insurance brands.
CareFirst, which has 2.2 million customers in Maryland, about 48 percent of the market, said in a statement that the commissioner's rate adjustments were "modest" and that its plans under the exchange "are competitively priced."
"We look forward to the launch of the exchange this fall," the statement said.