We posted last week articles that stated the goals of Affordable Care Act was to create these global health monopolies with Obama and Clinton neo-liberals with team right wing Republicans to IGNORE ANTI-TRUST MONOPOLY LAWS in creating ACOs. Clinton era in 1990s wrote these same instructions when they broke Glass Steagall banking wall to create these same global monopolies in banking---we see where that ended and that same predatory, profit-driven, do anything to accumulate wealth will now take hold in our US health care. If we think having global Wall STreet fleece all our family wealth through Wall STreet fraud is bad----just wait until our bodies are considered HUMAN CAPITAL to profiteer-----that is to where Affordable Care Act and ACOs will go----TRUMP is simply MOVING FORWARD those goals with now Bernie Sanders as a global Wall Street player PRETENDING TO BE A GRASSROOTS leader sitting hand and hand with TRUMP to create that ONE WORLD ONE ONE GLOBAL HEALTH CARE FOR THE 99%----while the global rich 1% and their 2% access all that developed nation health care WE THE PEOPLE PRE-PAID THROUGH PAYROLL TAXES for several decades to receive.
THE GLOBAL WALL STREET PLAYERS ARE NOW TELLING US WE CANNOT REVERSE ACO POLICY WHEN WE ABSOLUTELY CAN.
Reversing ACO policy does not mean ending that health care platform---it means keeping a broad, local and regional free market health economy and strong public health as well.
'“I have never seen the evidence that consolidation improves quality in the health care space. I have never seen a study that comes out and says that consolidation makes things better,” says Cooper. Neither have I; consolidation does not improve quality. Cooper, like Mr. Roy, suggests rigorous antitrust legislation and increasing competition among hospitals as possible solutions'.
How can we break the Ivy League clique?
18 Jun 2014
Education is undoubtedly a critical driver of economic growth and social mobility. But efforts to expand access to education have typically focused on the primary level, while neglecting tertiary schooling. And initiatives that have emphasized post-secondary learning have placed relatively little emphasis on educational quality. This has to change.
The influence of higher education on social mobility is particularly pronounced in low-income countries, where the scarcity of skilled human capital gives tertiary-educated workers a significant wage premium. The problem is that many of these countries lack high-quality institutions of higher education, leaving even university graduates at a disadvantage within an increasingly interconnected global economy.
This is where study abroad programmes can help. Sending students to high-quality foreign institutions can help to advance a country’s international integration, including into global knowledge networks, as it has for many countries in Asia and the Middle East.
The advantages become even greater at the world’s elite universities. In the United States, roughly 54% of corporate leaders and 42% of government officials are graduates of only 12 institutions, including Yale, Harvard, Princeton and Stanford, meaning that the friendships and associations formed at such universities ultimately shape the global economy, the political system and public opinion.
For low-income countries, however, these elite networks remain largely inaccessible. While countries such as the US and the United Kingdom have been working to provide disadvantaged communities with greater access to their elite institutions, such efforts typically do not extend beyond national borders. With even their most highly educated professionals marginalized internationally, it is no wonder that low-income countries struggle to integrate into global systems.
High-quality institutions of higher education are largely concentrated in a few countries in Europe, North America, and Japan – the very countries that offer the most study-abroad opportunities. In 2009, 72% of foreign students in the European Union came from other EU countries.
While many developing-country citizens receive education and training abroad – 53% of all international students are Asian and 12% are African – only a small minority end up at elite universities. And the lower a country’s income, the fewer the opportunities. Nigeria and Pakistan each send twice as many students to study in OECD countries as Burundi, Congo, Ethiopia, Liberia and Malawi combined.
A recent World Economic Forum book (a chapter of which I co-authored) identifies more equal access to quality education as one of the principal challenges facing policy-makers, owing largely to the educational, financial and social advantages that make rich-country students better equipped for – and more appealing to – elite universities. Efforts to equalize access often entail shifting resources from one group to another, thereby spawning new imbalances.
Lower-income countries need new financing models for supporting education that account for social-capital gains, which amount to an added return on investment. For example, recent research from Chile has shown that graduates of elite universities tend to marry one another, and university graduates – especially women – are more likely to marry partners of similar or higher social status. Often, they also socialize with other graduates of elite universities within exclusive clubs and associations.
The exact impact that improved access to elite universities would have on low-income countries and communities remains unknown, owing largely to how few of their students study abroad. Of course, many middle- and high-income countries – including China, India, South Korea, and Lebanon – have benefited tremendously from sending their students to top universities in Europe and the US. But they owe much to their substantial diaspora populations in the West, as well as to their elites’ international connections.
What is needed is a funding mechanism – supported by the private sector, as part of its corporate social responsibility activities – to boost the number of students from low-income countries enrolling in the world’s elite universities. Such a mechanism could, for example, finance the establishment of special schools and training programmes to help students meet such universities’ admission requirements.
Moreover, to enable students to cover tuition fees, while encouraging them to return to their home countries once they have completed their studies, they could be offered loans with interest rates that fluctuate in line with how long they remain abroad after graduation. Students who return after a year or two would pay nominal rates, whereas those who remain outside their home country for prolonged periods could face very high – even prohibitive – rates.
The relationships that are formed at high-quality institutions of higher education are among the most influential in the world. As long as low-income countries are excluded from these world-shaping social circles, they will remain unable to attract the resources they need to improve their international position and enhance their contribution to the global economy.
This is the #1 priority issue for REAL LEFT SOCIAL PROGRESSIVES-----we see in the Affordable Care Act the policies allowing for-profit hospital systems to refuse treatment----this extends to marginalizing seniors, pre-existing condition patients, and low-income by accepting them only to TRANSFER THEM TO OTHER FACILITIES. This has been the case in Baltimore and it is growing.
WE THE PEOPLE cannot allow PRE-PAID MEDICAL SAVINGS be ignored or re-categorized. We did not pay what with inflation was plenty of money for our health needs ----that was why REAGAN TRIPLED PAYROLL TAXES ------just to be told by a global health system that their obligations can be meant by sending us to ECUADOR OR THAILAND.
As well, deliberately building a system in the US taking our strong public health down to third world levels at the very time seniors are expecting care----at the very time our young adults want to build that health savings----creating LOWER-TIERED preventative care for all KNOWING AMERICANS will die----will die sooner---thinking declining longevity in Americans is great as global Wall Street does----
THE MEDICAL ETHICS AND DO NO HARM VIOLATIONS ARE TIED VERY CLOSELY TO NEGLIGENT HOMICIDE.
Ethics Quiz: Therapist Biases And Ethics Confusion
(Boy, does this freak disgust me or what...)
The Tennessee Senate’s Senate Health and Welfare Committee members have overwhelmingly approved a proposed bill that seeks to protect therapists from 2014 changes in the American Counseling Association’s Code of Ethics. The Code decrees that “counselors refrain from referring prospective and current clients based solely on the counselor’s personally held values, attitudes, beliefs and behaviors.” The bill, however, will allow practitioners to refuse to accept a patient without legal or professional penalties as long as they refer the individual to another qualified professional.
The Tennessee Association for Marriage and Family Therapists opposes the legislation, saying “This bill is in direct opposition to the ethical code of the American Association of Marriage and Family Therapy and potentially harmful to clients,” the group said in a statement. “Our mandate to do no harm to the consumer, we believe, would be violated.” A therapist who testified before the committee opined that “they can keep their belief system and still offer good counseling but not based on their religious beliefs.” Others have objected to a legislative body dictating professional ethics.
For me this one’s easy, and I am shocked that the issue even came up.
The new American Counseling Association’s Code of Ethics rule is the unethical provision here, and a horrible example of a professional organization compromising good practice to kowtow to political correctness and irrelevant political agendas.
I have a close friend, a recovering alcoholic, who saw a therapist to address several emotional and psychological issues. After months of frustrating and ultimately useless sessions, the psychologist finally revealed that he had a long-standing problem with alcoholics and the issue of alcoholism, and couldn’t effective deal with them. Usually, he said, he refused to take alcoholics as patients. Of course, alcoholism is linked to many other conditions, like clinical depression. How dare this quack take on a patient he knew he was biased against and unable to treat compassionately— alcoholism was a major factor in his family—and then only reveal the bias after a few thousand dollars or so in fees?
Yet this situation is what the American Counseling Association is mandating, I suppose to curry favor with the LGBT furies, and avoid their wrath. It cannot possibly be in the best interest of any patient to be treated by a counselor or therapist who harbors a bias against him or his sexual preferences. A very least, the Ethics Code should require a counselor holding such biases, religion-based or not, to be transparent, let the potential patient know about them, and explain how these feelings could impede treatment. A counselor or therapist with a personal objection to a client’s sexual orientation has a personal conflict of interest. It is amazing to me that any professional organization would require that a counselor ignore the likely effects of conflict to the detriment of the patient, just so the association can grandstand its progressive support for the LGBT cause, when its result may be detrimental to LGBT patients.
For contrast, see the legal ethics rules, one of which (Rule 1.7) says…
…a lawyer shall not represent a client if …there is a significant risk that the representation…will be materially limited by ….a personal interest of the lawyer.
The only way this rule can be ethically overcome is if the client consents with full knowledge of the lawyer’s adverse interests, and if the lawyer sincerely and reasonably believes that his personal interest or biases will not adversely effect the quality of the lawyer’s representation client. This is how the situation should be handled in any relationship of dependence and trust.
That witness who said that “they can keep their belief system and still offer good counseling but not based on their religious beliefs” is full of malarkey. How does he know what “they” can or can’t do effectively? Only the therapist holding the beliefs and bias can know. That “do no harm” argument from the Association reinforces my biases against counselors and therapists. It isn’t harmful to patients to force therapists to treat people whose conduct and sexual preferences they find reprehensible, or who they think are engaged in willful sin? What is the matter with these people? The whole profession needs an ethics counselor.
The Code of Ethics in question is dead wrong, and embarrassingly unethical. Thus Tennessee’s proposed bill is necessary, and LGBT advocates should be supporting it.
When all the current discussion on medical ethics originates from global IVY LEAGUES and the American Medical Association----as it does-----we are having the very institutions driving GLOBAL WALL STREET PREDATORY, PROFIT-DRIVEN health care telling us what these ethics are------the United Nations and World Bank are installing in all Foreign Economic Zones the same PAYROLL TAX DEDUCTIONS from wages of third world workers not earning enough to live telling THEM these are HEALTH CARE SAVINGS ACCOUNTS. So, globally these structures pretending to protect citizens and their health are being attached to WORLD HEALTH ORGANIZATION structures of PREVENTATIVE CARE FOR ALL at the same time building that strong health care structure for the nations' rich.
THE US IS EXPORTING THESE UNETHICAL MEDICAL ETHICS TO THIRD WORLD NATIONS building structures that will assure those nations NEVER EXPERIENCE AMERICAN QUALITY OF HEALTH CARE.
Now, make no mistake---there was PLENTY OF REVENUE directed in taxation to meet the needs of 99% of citizens----it was allowed to be fleeced with fraud and corruption ---profiteering for extreme wealth-----
THIS IS DOING HARM------IT IS ANTI-HIPPOCRATIC OATH-----IT IS UNETHICAL AND IMMORAL----AND in the US it is illegal because WE THE PEOPLE PRE-PAID FOR DEVELOPED NATION QUALITY OF CARE.
We do not want to support ONE WORLD ONE WORLD HEALTH ORGANIZATION that takes these same payroll taxes around the global giving only preventative care to 99% of global citizens---we are exporting BAD PUBLIC HEALTH POLICY JUST FOR EXTREME WEALTH.
Do No Harm? Should Patients Still Trust Their Doctors?
Medical Journals Show Increasing Support for Euthanasia
August 22, 2012ZENIT StaffBioethics and the Defense of LifeBy Denise J. Hunnell, MD
WASHINGTON, D.C., AUG. 22, 2012 (Zenit.org).- Primum non nocere.
First do no harm. This edict has been part of medical ethics since the time of the ancient Greek physician, Hippocrates, in the fifth century B.C. It is found in the Hippocratic Corpus, a collection of medical writing attributed to Hippocrates.
The original Hippocratic oath includes:
I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.
For millennia the physician has been charged with being an advocate for the patient. Part of the impetus for the original Hippocratic oath was to ensure that doctors would not be paid by an enemy to give poison instead of medicine. Patients should be able to come to their doctor when they are sick and weakened, and have no fear that their vulnerability will be exploited.
Unfortunately, the sacred trust of the doctor-patient relationship is being strained by a new ethical model. Physicians are being urged to place the “greater good” above the needs of their individual patients. A disregard for the sanctity of human life as well as a utilitarian philosophy that judges the value of a patient to society is becoming more mainstream in the medical profession. This is evidenced by the increasing number of articles in respected medical journals that call for approval of assisted suicide and euthanasia, euphemistically called “assisted dying.”
The British Medical Journal (BMJ), a publication distributed to the members of the British Medical Association, devoted much of its June 14, 2012, issue to endorsing voluntary euthanasia and physician assisted suicide. Raymond Tallis, emeritus professor of geriatric medicine at the University of Manchester, argues in this issue that respect for patient desires and autonomy renders irrelevant any opinion on the matter by the Royal College of Physicians or the British Medical Association. Therefore, all opposition to euthanasia is merely inappropriate paternalism and should be dropped.
In this same issue, Tess McPherson relates the difficult last days of her mother, Ann McPherson, and uses this painful experience as a call for legalized physician assisted suicide and euthanasia. Rather than seeking better pain control, she argues that death is the best option for those suffering at the end of their lives.
Finally, Fiona Goodlee, editor in chief of the BMJ, rounds out the arguments by declaring that legalization of assisted dying is not a medical decision, but rather a societal question. She argues that the role of the physician is compatible with providing euthanasia or assisted suicide and if society wants it, they should get it.
Amid these scholarly endorsements of euthanasia come the claims of British physician Patrick Pullicino that the National Health Service (NHS) is effectively killing 130,000 patients every year when doctors place these patients on the Liverpool Care Protocol (LCP) and deny them nutrition and hydration.
According to the Daily Mail:
Professor Pullicino claimed that far too often elderly patients who could live longer are placed on the LCP and it had now become an ‘assisted death pathway rather than a care pathway’.
He cited ‘pressure on beds and difficulty with nursing confused or difficult-to-manage elderly patients’ as factors.
Professor Pullicino revealed he had personally intervened to take a patient off the LCP who went on to be successfully treated.
The medical literature from the United States also shows an increasing acceptance of physician assisted suicide and euthanasia. The July 12, 2012, issue of the New England Journal of Medicine (NEJM) included an article by Dr. Lisa Soleymani Lehmann and Julian Prokopetz that suggested physician opposition to assisted dying was an unreasonable barrier to patients seeking lethal medications. They recommended that all patients who met the legal criteria for assisted suicide as outlined in the state laws of Oregon, Washington, and Montana should be able to obtain the drugs necessary for suicide without a physician’s prescription or approval.
Perhaps the most chilling example is the enthusiastic endorsement in the Journal of the American Medical Association (JAMA) for the book Death, Dying, and Organ Transplantation: Reconstructing Medical Ethics at the End of Life, by Drs. Franklin Miller and Robert Truog. This book seeks to do away with two core principles of medical care. The first is that a physician cannot intentionally cause the death of his patient. The second is that donors of vital organs for transplantation must be dead before the organs are harvested.
Catholic health care ethics, in accordance with natural law, holds that when the burden of life-sustaining extraordinary care such as a ventilator is greater than the benefit it provides, such care can be withdrawn. This is not seen as causing the death of the patient, but rather allowing the patient to die from his underlying illness. Miller and Truog disagree and assert that such an act directly causes the death of the patient. They then begin their descent down the slippery slope by claiming that if causing death by withdrawing life-sustaining care is acceptable, then active voluntary euthanasia by lethal injection should also be acceptable. Further, if voluntary euthanasia by injection is acceptable, then voluntary euthanasia by removal of vital organs to be used for transplantation should be equally acceptable. This radical argument could be disregarded as fringe thinking had it not been so prominently and positively recommended in JAMA.
It is reasonable to say that the notion that physicians should not kill their patients is still widespread among medical professionals. Indeed, several of the aforementioned authors take their colleagues to task for opposing euthanasia and physician assisted suicide. The growing numbers of prestigious medical journals that are routinely publishing support for all forms of “assisted dying” are, however, a clear indication that this approach to end of life “care” is making significant inroads in mainstream medical ethics. The foundational principles of health care that date back to Hippocrates are in jeopardy.
This has serious implications for patients. No longer can a patient assume that his physician has his best medical interests at heart. Now physicians are being urged to consider the cost to society of a patient’s care and judge whether a patient is worthy of such expense. Instead of seeking to provide comfort and authentic compassion at the end of life, there is increased support for hastening death as an expedient solution to suffering.
It is now incumbent upon every patient to explore the ethical principles of his doctor. Does he uphold the sanctity of life from conception to natural death? Does he understand that treatments can be deemed burdensome, but human life is never burdensome? Does he view nutrition and hydration as ordinary care as long as a patient can derive a benefit from it? Does he reject all justifications for intentionally causing the death of his patients?
If your physician does not answer unequivocally “yes” to each of these questions, can you really trust him with your life?
THE MAYO CLINIC is of course one of those global IVY LEAGUES telling us high-deductible health plans are good for us because it controls health costs----if you cannot use it then that money can go to the global rich and their health care says MAYO CLINIC. Here we see as well that term HSA----HEALTH SAVINGS ACCOUNTS -----rebranding what was MEDICARE/MEDICAID PAYROLL TAX DEDUCTIONS AS HEALTH SAVINGS-----to now being payroll taxes placed in the GLOBAL WALL STREET STOCK MARKET. MAYO CLINIC thinks this is good----knowing global Wall Street is criminal and fraudulent fleecing 99% of Americans of their wealth-----KNOWING that will happen to these HSA-----
WHAT IS THE MEDICAL ETHICS OF A GLOBAL IVY LEAGUE HEALTH SYSTEM TELLING WE THE PEOPLE THESE POLICY STANCES---AND YES, HARVARD, PRINCETON, JOHNS HOPKINS, STANFORD ARE ALL TELLING US THE SAME THING.
Changing our Federal public Medicare and Medicaid into private Wall Street health savings accounts saying THIS WILL BE BETTER? REALLY??????????????
'Why were health savings accounts created?
HSAs and high-deductible health plans were created as a way to help control health care costs.
The idea is that people will spend their health care dollars more wisely if they're using their own money'.
THESE FEW GLOBAL IVY LEAGUE HEALTH SYSTEMS WILL VERY QUICKLY BE THAT GLOBAL HEALTH SYSTEM MONOPOLY..
'Minnesota Mayo Clinic Constructing $72M Hospital Expansion
Posted by Laura Braden on Wed, Mar 04, 2015
The Mayo Clinic in Rochester, MN
The Mayo Clinic is one of the most well-known research and treatment centers in the world. With facilities in Arizona, Minnesota, and Florida, the Mayo Clinic receives millions of dollars in funding each year, performs cutting edge research and clinical trials, and sees more than one million patients each year.
The Mayo Clinic in Rochester, MN is currently working on expanding the Saint Mary's Hospital, a $72.1 million project that is expected to be completed in 2016. This new construction project expands on the already underway project that is adding 4 new stories to Saint Mary's Hospital and expanding the emergency room. Once completed, an additional five floors will be added to the Mary Bright East Building and the third floor of the Domitilla Building of Saint Mary's Hospital will be renovated, adding 132,000 square-feet of finished space and 25,000 square feet of shell space to the buildings.
Within these 5 new floors, three will have 23 new private rooms for patients, and two floors will be used for shell space and mechanical infrastructure.
The Mayo Clinic in Minnesota has proposed a 20-year, $5 billion investment plan to upgrade and expand the campus. Along with expanding the Hospital, the plan also includes constructing a Proton Therapy Center that is expected to be able to treat patients in 2015. The Mayo Clinic Healthy Living Center will also be expanded by adding an additional 4 floors'.
GENE - SPLICING VIRTUAL REALITY MIND -CONTROL HOSPICE are all MEDICINE AS GLOBAL TECHNOLOGY CORPORATIONS. MAYO CLINIC in Arizona and Florida two of the states identified with the most MEDICARE AND MEDICAID Trust frauds------Hmmmmmm isn't that UNETHICAL AND IMMORAL?
Lying, cheating, and stealing from our US Federal medical savings accounts to expand nationally and globally and now BIOTECH FACILITIES racing to create patented products only the global rich will be able to afford access.
THIS IS THE 99% TOP DISCUSSION ON MEDICAL POLICIES---DO YOU HEAR THESE ISSUES BEING DISCUSSED IN YOUR NECK OF THE WOODS? IF NOT, YOU HAVE NO HEALTH CARE JUSTICE ACTIVISM.
Mayo Clinic joins private equity giants, biotech firm in new gene-sequencing venture
Aug 19, 2015, 6:46am CDT
Mayo Clinic is partnering with private equity firms Warburg Pincus and Sutter Hill Ventures as well as San Francisco-based gene-sequencing firm Illumina to create Helix, a new venture that's envisioned as a digital hub for genomics companies.
The New York Times reports on the launch of Helix, which has been in the works for a year. All four companies are investing in the project — the Times puts Warburg Pincus, Sutter Hill and Illunima's stake at $100 million; the size of Mayo's investment isn't detailed.
Helix isn't aimed at a particular provider of gene-sequencing but is instead meant to help boost the growing ecosystem of companies; Illumina will sequence customer genetic information and put that data in Helix, where it will be available to other partners. The Silicon Valley Business Journal has more details on Illumina's role.
Rochester, Minn.-based Mayo Clinic, meanwhile, will act as a sort of a consumer face for the venture, helping educate consumers about what gene-sequencing technology can and can't do. The Post-Bulletin reports on what's at stake for Mayo— in theory, partnering with the venture could give the clinic access to patients who it might otherwise never reach.
Here is the policy that is forcing more and more US citizens to move away from Federal Medicare as these private HSA accounts as payroll deductions run opposite of Medicare---they do not re-enforce our strong Medicare Trust. Before CLINTON/BUSH/OBAMA and health industry profiteering with rates soaring our Medicare and Medicaid could easily pay for most of our health expenses. That 20% deducible in Medicare was not prohibitive in cost. Here we have that vehicle to privatizing our Medicare----AARP-----they are the Medicare Advantage private insurance corporate non-profit which backs all MOVING FORWARD policies including ACA----its only concern with ACA was ending their MEDICARE ADVANTAGE PRIVATE BUSINESS.
It would be organizations like this which would lead in REAL LEFT social progressive health policy discussion ----outing those global IVY LEAGUES --all that health industry fraud of our Medicare and Medicaid Trusts----but they are silent on all these issues of MEDICAL ETHICS AND IMMORALITY OF CURRENT HEALTH POLICY.
HSA is the WORLD HEALTH ORGANIZATION ONE WORLD policy for health care and it is designed only for that 99% preventative care for all.
Can I Have a Health Savings Account as Well as Medicare?No, but understanding the details of this IRS rule may help you get around it
by Patricia Barry, AARP Bulletin, Updated October 2016
Q. I have health insurance from my employer in the form of a Health Savings Account. But I’m told I can’t use it if I’m eligible for Medicare. Is this correct? If so, what can I do to keep this insurance if I continue working after age 65?
A. A Health Savings Account (HSA) is a type of health insurance offered by an increasing number of employers. It combines a high-deductible health plan with a tax-free health savings account to which the employee and the employer can contribute. (It is not the same as a Medicare Medical Savings Account, a health plan available only to Medicare beneficiaries, which is not discussed in this article.)
IRS rules say that you can’t contribute to an HSA if you’re enrolled in Medicare. You can draw on funds already in the account but you can't add to them. So it’s important to know how you can get around this rule if you have an HSA at work and want to continue working beyond age 65.
Here’s what you can do, according to different situations:
- If you’re eligible for Medicare but have not filed an application for either Social Security retirement benefits or Medicare, you need do nothing. As long as your employer has 20 or more employees, you have the right to postpone applying for Social Security and Medicare — and therefore can continue to contribute to your HSA — until you stop working. There is no penalty for this delay, , and when your employment ends you’re entitled to a special enrollment period to sign up for Medicare. (For more details, see the related article “Medicare When Working Beyond 65.”)
- If you’re entitled to Medicare because you signed up for Part A at age 65 or later (perhaps not realizing that it can affect the use of your HSA) but have not yet applied for Social Security retirement benefits, you can withdraw your application for Part A. (To do so, contact the Social Security Administration at 1-800-772-1213.) There are no penalties or repercussions and you are free to reapply for Part A at any future date.
- But if you have applied for, or are receiving, Social Security benefits—which automatically entitles you to Part A—you cannot continue to contribute to your HSA. And in these circumstances, the only way you could opt out of Part A is to pay back to the government all the money you’ve received in Social Security payments, plus everything Medicare has spent on your medical claims. You must repay these amounts before your application to drop out of Part A can be processed. If you take this action, you’re no longer entitled to Social Security or Medicare—but you can reapply for both at any time in the future (for example, if you end or lose your HSA coverage).
What if you received Medicare Part A under age 65 through disability? In this situation, you’re entitled to Medicare as soon as you’ve received your 25th disability check from Social Security. In other words, you automatically go into the Medicare system. If you’re able to return to work, eventually your disability payments will stop—but your Medicare entitlement continues for up to 93 months from the time you first applied for disability. For most people, this is an advantage. But if your employer offers health insurance in the form of a health savings account, you’re ineligible to take it because you have Medicare. Again, the only way you can opt out of Part A is to repay Social Security for all the disability payments you’ve received, even if you’ve never used Medicare for medical services, and to repay Medicare for any services that you have used. Most people with disabilities simply could not afford to make those repayments.
This situation was the focus of a lawsuit that alleged that denying Social Security benefits to people who wish to opt out of Part A is unlawful and unconstitutional. On February 7, 2012, a federal court of appeals rejected plaintiffs’ arguments and ruled that “there is no statutory avenue for those who are 65 or older and receiving Social Security benefits to disclaim their legal entitlement to Medicare Part A benefits.”
Some members of Congress have introduced bills that would allow people to opt out or suspend their Part A entitlement without affecting their Social Security payments, but none of these has yet passed into law.
Warning for when you retire: You cannot contribute to an HSA in any month that you are enrolled in Medicare. And there’s a pitfall inherent in that rule that you need to be aware of. When you finally sign up for Social Security retirement benefits—probably when you’re on the point of retirement—and if you’re already at least six months beyond your full retirement age (currently 66)—Social Security will give you six months of “back pay” in retirement benefits. It’s a generous gesture, but it means that your enrollment in Part A will also be backdated by six months. Under IRS rules, that leaves you liable to pay six months’ of tax penalties on your HSA. To avoid the penalties, you need to stop contributing to your account six months before you apply for Social Security retirement benefits.
Every nation tied to Foreign Economic Zones are told to install payroll deductions for HEALTH SAVINGS ACCOUNTS as is now happening in the US with the goal of ending MEDICARE AND MEDICAID. When everyone knows the rising costs in health care is PROFITEERING AND EXTREME WEALTH OF A FEW-----but all we hear from global health organizations is----IS THIS WORKING?
Filled with JUKED DATA and networks filled with fraud and corruption----sounds like far-right wing global Wall Street!
Let's stay with the REAL problems for our solutions to health care for all-----
Why an MRI costs $1,080 in America and $280 in France
By Ezra Klein March 15, 2013
OF COURSE IT IS NOT WORKING IT WAS NEVER MEANT TO WORK FOR GOODNESS SAKE.
Let's have these public discussions now in our communities as we demand DO NO HARM HEALTH CARE ----this cannot be done if we allow global health care monopolies called ACOs-----ACCOUNTABLE CARE ORGANIZATIONS MERGING INTO GLOBAL HEALTH SYSTEMS.
IN THE US WE HAVE US CONSTITUTION AND CENTURIES OF FEDERAL LAW AND COURT RULINGS SAYING NO TO MONOPOLIES====LOTS OF ANTI-TRUST---WE THE PEOPLE MUST DEMAND THEY ARE ENFORCED.
The concept of Medical Savings Accounts (MSAs)
– that individuals save and pay for their own
medical needs – emerged in response to concerns
of escalating healthcare costs. The appeal of
enlisting consumers in reducing costs as well as m
obilising additional funds for healthcare led to
implementation of this mechanism in countries as di
verse as Singapore, China, the United States, and
South Africa over the last 20 years. MSAs purport to address some of the main inefficiencies of
private health insurance – moral hazard, escalating costs, adverse selection, and gaps in coverage.
This essay explains key theories supporting MSAs in addressing these challenges. The validity of
theoretical arguments is then examined using em
pirical findings from country studies. This is
followed by a discussion analysing if MSAs sufficien
tly address inefficiencies of private insurance
and thus represent an attractive alternative to financing healthcare. Does the design of MSAs deliver
benefits promised by theory? If not, what is at risk?
"The Medicare problem is a basic flaw in the way HSAs are designed," said Jody Dietel, chief compliance officer of WageWorks Inc (WAGE.N), a provider of HSA and other consumer-directed benefit plans to employers'.
Medical savings accounts: Singapore’s non-solution to healthcare costs
BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f4797 (Published 31 July 2013) Cite this as: BMJ 2013;347:f4797
- Martin McKee, professor of European public health1,
- Reinhard Busse, professor of healthcare management2
Not a model worth emulating
Because of the obvious failings of the American health system, health policy analysts in the United States have traditionally looked abroad for inspiration.1 William Haseltine, president of ACCESS Health International, is among the latest to do so. Inspired by a 2010 lecture on the health system in Singapore, he searched for a book that would provide him with a detailed explanation of how it worked. Finding that none existed, he set out to fill the gap. The result is a short, highly readable book whose title, Affordable Excellence, summarises accurately, if somewhat uncritically, his judgment on Singapore’s achievements.2 In it, he documents how Singapore has managed to contain costs while ensuring access to healthcare and achieving health outcomes that are as good, and in many cases better, than those in other developed countries.
One reason why Singapore has attracted international interest is its unique system of healthcare financing, with the concept of the medical savings account (Medisave) at its core. Under this system, all people are responsible for their own healthcare and that of their family. Money is saved into an account from which they can draw when necessary. Workers and their employers (and since 1992 the wealthier self employed) are mandated to contribute a tax-free proportion of their income, which reduces with increasing age, into a designated account that they can use to pay for care when needed. Funds can be shared among members of the immediate family, and any money left over at death is inherited by surviving family members.
However, there are restrictions on what the money can be spent on. Initially only inpatient stays in the most basic level of Singapore’s hierarchy of hospital wards were covered, but the system then expanded to include outpatient treatment. More recently, mental illness and some specified preventive interventions, such as mammography and certain immunisations, have been included. However, payments are subject to deductibles and co-payments.
Not surprisingly, this concept is attractive to those who most vocally advocate for individual responsibility for health, who reject the social solidarity that underpins European health systems and call for a radical shrinking of the state (and by extension their tax bills).4 5 Yet, as Haseltine notes, the medical savings account is only one small element of Singapore’s health system, even if it is the one that has attracted most attention. It has never accounted for more that 10% of total health expenditure. As he shows, it only works by being wrapped up in a complex network of mechanisms that compensate for its failure to deal with the fundamental challenge in delivering universal healthcare6—those in most need of healthcare, typically older and poorer people, are least able to pay for it.
Firstly, Medisave accounts are supplemented by a variety of government contributions, such as the “grow and share package,” which makes direct payments into accounts of younger people on low and middle incomes, and a scheme to support older lower paid workers.
Secondly, the cost of care is limited by major subsidies to hospitals—up to 80% of the cost of inpatient treatment—on top of other payments for capital expenditure. There are also strict controls on what hospitals can do and what they can charge, including limits on purchase of advanced technology. This reflects the lessons learnt from a move to give hospitals more autonomy in the 1980s, in the misguided belief that competition would reduce costs.
Thirdly, two other funds fill the gaps left by Medisave. Medishield covers what is termed “catastrophic health expenditure” but which, in reality, includes all long term treatment that would soon drain Medisave accounts. Since 2002, this has been supplemented by the Eldershield scheme, which provides cover for older people with long term disability. Finally, for those who have no remaining funds, there is a safety net, called Medifund, which gives priority to older people whose Medisave funds have become depleted. This is paid for from the income of a large endowment fund created by the government. Even with these measures, there are concerns about the system’s ability to fund care for an ageing population.
All of these interventions create a system in which, despite a high level of out of pocket spending—almost two thirds of total health expenditure--9poor people are relatively well protected. This is not quite the model of individual responsibility that it is so often portrayed to be.
Given the many specificities of Singapore, it is not surprising that the medical savings account has not found success elsewhere. In the US, such schemes lack the many safeguards in place in Singapore and thus have limited use. The Commonwealth Fund argued that “encouraging people to join such health plans will exacerbate some of the very maladies that undermine our healthcare system’s ability to perform at its highest level.”10 An attempt to implement the Medisave model in another large Asian city, Shanghai, failed.11
Most health systems are shaped by the conditions in place when they were created, and Singapore’s is no exception. The Medisave scheme is part of a larger insurance scheme, the Central Provident Fund, created in 1955, during British rule, to provide old age benefits. The features of that fund, created for an entirely different purpose, have been carried forward into the funding of healthcare. As Haseltine notes, Singapore has managed to make it work, but only as one small part of an extremely complicated system involving extensive government intervention. This is a point that is lost among those politicians and think tanks engaged in the current campaign to denigrate the English NHS when they advocate medical savings accounts as a solution here.12