REDUCING THE COST OF HEALTH CARE BY LIMITING ACCESS TO MUCH CARE FOR MOST PEOPLE RATHER THAN ADDRESS THE MASSIVE HEALTH INDUSTRY FRAUD AND PROFITEERING TO LOWER COSTS? THAT'S A NEO-LIBERAL AND NEO-CON FOR YOU----MAXIMIZING HEALTH INDUSTRY PROFITS. LOWERING THE LONGEVITY IN THE US BY A DECADE!
What is the most prevalent disease vector in the US today? Cancer----why does it look like cancer treatments are hit hardest with the $1 trillion dollar cut to Medicare and Medicaid? It's the most prevalent disease vector and cutting cancer treatment access gets rid of lots of costly health care.
The second reason is that all of the taxpayer-funded cancer research has gone to biotechnology and fighting diseases like cancer through bio-manipulation. Well, health care is now all about profit with the Affordable Care Act and the university as corporate patent pipeline and these newly patented bio treatments must get all the money! AND THEY ARE EXPENSIVE BECAUSE OF THAT. Profit-driven health care via ACA means that medical corporations will not want to encourage radiation therapy which is cheaper-----chemo-therapy for the masses and bio-therapy for the wealthy! Chemo-therapy was the oldest and most damaging of cancer treatments and of course that is where the 80% of Americans being pushed to Medicaid and Bronze will go but with Medicare being dismantled-----there too go seniors that cannot afford all of the supplemental private insurance!
Remember, the Medicare Trusts have been looted with health industry fraud these few decades of trillions of dollars and we simply need to recover this money to the Trusts to have plenty of health care for all. DEMAND EXPANDED AND IMPROVED HEALTH CARE FOR ALL!
Medicare changes threaten access to radiation therapy Oncologists worry that proposed Medicare cuts could result in dramatically reduced access to radiation therapy, even for non-Medicare patients.
by Janet Raloff 2:53pm, September 3, 2009
Many centers offering radiation therapy for cancer could decide to close their doors next year, compromising would-be patients' access to care. ASTRO The organization detailed its concerns, and the justifications for those fears, in a 25-page letter it just sent to the agency that manages the Medicare program.
Medicare's proposed changes “would devastate cancer care,” ASTRO charges. And the expected fallout — nationwide reductions in patient access to radiation therapy — could extend well beyond individuals covered by Medicare.
Of some one million U.S. cancer patients receiving radiation therapy each year, roughly one-third get their treatments outside hospitals, in free-standing radiation-oncology centers. It’s these centers that would be hammered by the proposed changes in Medicare-reimbursement rules, says Dave Adler, assistant director for government relations at ASTRO, which stands for the American Society for Radiation Oncology.
A July 13 announcement by Medicare officials laid out a plan for 2010 to cut by 19 percent its reimbursement to doctors that use medical equipment worth $1 million or more, including most radiation-therapy equipment. In fact, Medicare cuts to many free-standing radiation-oncology centers could exceed 30 percent, ASTRO found, owing to the particular mix of patients treated and the government’s plan to keep Medicare funding largely static.
Clinics that could afford to stay open, despite the cuts, would likely reduce the number of Medicare patients they treat, lay off staff and/or trim other services, according to a July poll of 103 ASTRO members working at non-hospital-based radiation-oncology centers.
The main issue involves equipment-reimbursement rates. It gets a little complicated, but follow me on this because the implications are serious.
The first and most important proposed change would be in the presumed equipment-utilization rate. That’s how much a given machine is used during the course of a 10-hour day. Currently, Medicare assumes that big-ticket devices — like computed-tomography scanners, magnetic resonance imaging devices and the linear accelerators used to deliver beams of radiation to kill tumor cells — are used 50 percent of any given day. However, with a recent sharp increase in the number of imaging procedures conducted, Medicare decided to up the assumed utilization rate for high-cost machines to 90 percent. The effect: Each individual procedure would be reimbursed at a lower rate.
If machines were truly being used 90 percent of the time, the sum of a day's lower reimbursements should still cover the capital costs of the pricey hardware. But if actual use of the machines is closer to 50 percent, clinics won’t be able to perform enough procedures to pay back their investment in these machines, much less their upkeep.
And that’s the problem in radiation oncology, Adler explains. An ASTRO-funded survey finds that utilization of its big-ticket equipment — largely linear-accelerator-based units — runs between 18 and 63 percent, depending on the precise technology. Typical utilization for most radiation-oncology systems is below 50 percent.
The reason the proposed rate changes would affect free-standing clinic physicians most: Unlike in hospitals, physicians here own their own equipment. So Medicare reimburses these physician-owners not only on the basis of their doctoring but also for patient use of their clinics’ equipment.
A Medicare Payment Advisory Commission wrote the acting administrator of the federal Centers for Medicare & Medicaid Services, also known as CMS, to say that it “supports CMS’s proposal as it applies to diagnostic imaging machines that cost more than $1 million.” The commission’s 15-page August 31 letter pointed out that it didn’t, however, recommend changing equipment-utilization rates for radiation “therapy” machines.
A second issue plays into the funding problem for radiation oncologists, Adler says. Several organizations, including the American Medical Association, periodically survey physicians on the costs of running their practices. And in some fields, costs have been rising substantially. Not so, the data show, for radiation oncologists. However, because Medicare has a fairly static pot of funds to work from, if costs go up for one field, the agency has to effectively rob Peter (in this case, radiation oncologists) to pay Paul some more.
CMS will announce its final decisions on 2010 reimbursements by early November, Adler says. So there’s still time to lobby Medicare officials — which is what ASTRO is asking its members to do.
Congress is also taking up the issue. Two weeks ago, 63 House members endorsed a letter to Kathleen Sebelius, the Secretary of Health and Human Services, which is CMS’ parent agency. A similar Senate letter is still collecting signatures.
The House letter argues that owing to Medicare’s proposed changes, some radiation oncologists could experience a drop in compensation of up to 44 percent — even as their costs of doing business “have remained relatively stable or experienced modest increases.”
But how much doctors get paid isn’t the real issue here. It’s a patient’s access to therapy. Rural areas are those likely to see radiation-therapy clinics close first. Patients that would have visited nearby clinics daily for several weeks would now have to sign up for commutes of 50 miles or more. “This increased expense and time is a significant barrier to care,” ASTRO notes, citing studies that show a drop off in the chance elderly patients will sign on for radiation therapy as the distance to treatment increases.
Waiting times for treatment also could grow. One radiation oncologist told ASTRO that “Currently there are two practices in my [Lancaster, Pa.] community, a hospital-based practice and my freestanding office. A 20 percent cut would probably cause us to close. This would result in patients waiting for four to six weeks for an appointment at the other practice.”
And when any treatment clinic closes its doors, all would-be patients — young and old, on the government dole or possessing gold-plated insurance — risk losing ready access to life-sustaining care.
Oh, you mean the changes to Medicare with the Affordable Care Act were meant to push seniors from the Federal Medicare program that now cuts access to many ordinary health procedures and lots of ordinary PHARMA just to move them to a private and corporate Medicare Advantage plan to get that ordinary coverage people have always had?
SO THAT IS HOW THEY ARE PRIVATIZING AND ENDING OUR FEDERAL MEDICARE! WHY DIDN'T THEY JUST SAY THAT? NEO-LIBERALS IN CONGRESS NEED TO PRETEND TO BE DEMOCRATS WORKING TO PROTECT SENIORS AND MIDDLE-CLASS-----
If you look at what is happening, the consolidation of the health industry brings hospitals and insurance corporations together so they can fix the prices and costs of care and PHARMA. So, a local hospital Johns Hopkins is partnering with
What are Medicare Part D plans? Medicare Part D plans provide eligible individuals with prescription drug coverage as Original Medicare benefits do not cover most medications. If you do not enroll in a Part D plan when you are first eligible and do not have creditable prescription drug coverage, you may have to pay a late enrollment penalty. Since each plan can vary in cost and the list of drugs covered, it's important to choose the right one for your needs. Complete the form to the left to find an affordable Part D plan in your area.
SO, THE CHANGES IN MEDICARE FOCUS ON ALL THE PREVENTATIVE CARE YOU NEED WITH GROWING RESTRICTIONS TO ACTUAL HEALTH CARE AND PHARMA!
LETTER: Be aware of Medicare coverage changes
MyCentralJersey 12:08 a.m. EDT October 29, 2014(Photo: AP)
Seniors and other Medicare beneficiaries should be aware that this year — perhaps more than any year in the past — is an important one to pay attention to their Medicare coverage options during the Open Enrollment Period (Oct. 15-Dec. 7). And that’s because of the Affordable Care Act (ACA).
The ACA brings with it notable changes to Medicare, from more preventive care benefits to changes in costs, and beneficiaries need to understand both the upside and downside of such changes to best evaluate their options during the Open Enrollment Period.
Adding to the challenge of this year's Medicare changes is broader confusion around the ACA itself. UnitedHealthcare conducted a survey in 2013 called the Medicare Made Clear Index and found that 76 percent of people ages 60 and older say they have a “fair” or “poor” understanding of the ACA.
Thus, the Open Enrollment Period becomes an even more critical time of year because, for most Medicare beneficiaries, it’s their one annual opportunity to make changes to their Medicare coverage. After all, Medicare is not one-size-fits-all.
I encourage the more than 121,000 Medicare beneficiaries in the New Brunswick area and their caregivers to take advantage of this annual opportunity to make sure they have a Medicare plan that will meet their needs for the year ahead. People can shop for and compare plans in their area at www.Medicare.gov.
Debra Kaplan-Lewis is the regional vice president of UnitedHealthcare Medicare & Retirement in New Brunswick.
Guess who the most neo-conservative and profit-driven health corporations would chose as its consolidation partner? It's mirror image of a health insurance provider of course. All of this health consolidation that mirrors the bank consolidations of the Clinton era bring back memories of how to take a first world quality of life to third world levels thanks to institutions like Johns Hopkins! As we are already seeing Kaiser will bring to Hopkins an immediate maximization of health exposure and it brings to Baltimore the restriction of access as Hopkins becomes more and more selective as to what health plans will be accepted-----whether you will be able to come to this hospital with an ordinary Federal Medicare coverage or will you be required to have that Medicare Advantage privatized Medicare to go to Hopkins? We all know that answer-----Hopkins is the driver of privatizing Medicare and Medicaid and Maryland's TV ads this Medicare season is one private Medicare plan after another. BYE BYE MEDICARE says Johns Hopkins and Maryland neo-liberals and neo-cons.
WHEN YOUR LABOR AND JUSTICE ORGANIZATION LEADERSHIP BACKS NEO-LIBERALS AS IN MARYLAND ASSEMBLY AND NEO-CONS RUNNING AS DEMOCRATS IN BALTIMORE CITY----THIS IS WHAT THEY ARE SUPPORTING! RUN AND VOTE FOR LABOR AND JUSTICE IN ALL PRIMARIES!
News Feature | August 5, 2014
Johns Hopkins, Kaiser Permanente Form Strategic Healthcare Collaboration
By Christine Kern
Kaiser Permanente and Johns Hopkins Medicine recently announced an enhanced strategic collaboration designed to bring care closer to home, improve quality of care, and better serve communities.
Kaiser Permanente and John Hopkins Medicine plan to expand on an existing relationship between the health care organizations to improve quality of care for patients. With plans to couple Johns Hopkins Medicine’s research cachet and Kaiser Permanente’s population health prowess, the two health giants have announced a new “strategic collaboration.”
The insurer, which operates its own medical centers, and the top academic medical center plan to collaborate on education and research endeavors, share best practices, and develop new health care models. They will work to improve patient safety and treatment outcomes while reducing costs.
“Kaiser Permanente is committed to providing high-quality health care and service, while also leading the nation in making health care more affordable for Americans,” says Kaiser Permanente Chairman and CEO Bernard J. Tyson. “This enhanced collaboration with Johns Hopkins will help us deliver on that commitment and continue to meet the evolving health needs and expectations of our members, patients and customers.”
BUT THE ARTICLE ABOVE SAYS KAISER IS MAKING HEALTH CARE MORE EXPENSIVE!
Officials say they will collaborate on patient care by sharing data from electronic medical records and developing better health care models based on evidence of what's worked best. Kaiser will work closely with Suburban Hospital in Bethesda, which is part of the Johns Hopkins network.
“Health care today requires partnership among forward-thinking health care organizations,” says Paul B. Rothman, MD, dean of the medical faculty and CEO of Johns Hopkins Medicine. “Through a strategic collaboration with Kaiser Permanente, we will be able to cultivate the human and intellectual capital found in both organizations to significantly improve the safety and quality of care while enhancing the patient experience.”
“This is a commitment for these two organizations to work on tangible projects related to quality, affordability and service,” Kim Horn, president of Kaiser Foundation Health Plan of the Mid-Atlantic States Inc. is quoted as saying by The Baltimore Business Journal. No financial terms have been disclosed.
Collaboration between providers and payers is not a new idea, but forging their brands in this way could have a significant impact on transforming health care delivery from patient volume to patient outcome, which is a transition in healthcare being tested throughout the industry.
I THOUGHT THIS WAS CALLED FORMING A MONOPOLY
“This is more evolutionary than revolutionary,” said Jay Shiver, a health administration professor at George Mason University and a former executive at Sibley Hospital, which is part of Johns Hopkins. “You’re talking about two of the premier organizations in their domain. This has potential because of who is involved.”
So, Johns Hopkins decision to partner with Kaiser Permanente was done to make Hopkins more profitable and leads to higher prices as has happened out on the West Coast. Since Kaiser's model has nothing to do with cost containment and actually leads in corporations and public health trusts being charged more for health care-----
DOES THIS SOUND LIKE A PUBLIC INTEREST MERGER OF WHAT IS STILL A CATEGORY OF NON-PROFIT HEALTH INSTITUTION NAMED JOHNS HOPKINS!
Of course not-----it has as a goal to allow Hopkins and whatever consolidation of health businesses to have a monopoly in health care where they can charge what they want, deny any coverage they want, use people's personal health data any way they want.
HOW CAN THAT NOT BE BAD PUBLIC POLICY? INDEED, MARYLAND HAS THE MOST PRIVATE AND PROFIT-DRIVEN HEALTH SYSTEMS IN THE NATION THANKS TO HEALTH POLICY WRITTEN BY JOHNS HOPKINS.
Lowering health costs is all about making sure people die early from the first encounters with chronic disease vectors says a Johns Hopkins spokesperson. Meanwhile, we thank the American people for allowing us to loot the Medicare Trusts and Medicaid to build what is now a global health corporation. WE'RE STILL FRIENDS AREN'T WE?
This is what has happened with neo-liberals and neo-cons passing the most Republican of health policy. We simply need to demand that these state systems be made public with Expanded and Improved Medicare for All while rebuilding oversight and accountability to recover the trillions of health industry fraud to replenish our Public health Trusts and to turn some of these private health institutions into the public hospitals they really are!
Critics blast Kaiser's dominance for blocking efforts to cut costs
July 31, 2013 | By Dina Overland
Once considered the untouchable model of integrated care, skillfully managing both hospitals and health plans, Kaiser Permanente has earned its share of critics in the last few months, most recently over whether the insurer is an obstacle to lower healthcare costs.
Oakland, Calif.-based Kaiser is now the dominant insurer for employers, with more than 40 percent of the market throughout the state. Some say this control has led to Kaiser refusing to negotiate rates with companies or explain why it continues to increase premiums, reported the Los Angeles Times.
For example, Kaiser has raised premiums 34 percent in the last five years for the city of Los Angeles, charging employees with families $1,306 a month, which is 10 percent higher than the $1,176 Anthem Blue Cross charges for the same plan.
"We are held hostage to Kaiser," Miguel Santana, the top budget official and administrative officer for Los Angeles, told the LA Times. "Kaiser takes us for granted, and the frustrating thing is they are not willing to have a discussion about their increases."
As a result of these concerns, legislation making its way through the California legislature is receiving strong support. The bill, SB 746, would require insurers disclose more details about rate increases for large employers and how they spend money. It already passed the state Senate and is waiting further action in the Assembly next month.
Kaiser said it already provides employers with detailed medical cost information, and it can't be compared to competitors because of its unique operating model. Employers and lawmakers are "trying to force us to report information in the same fashion as every other health plan, which basically breaks us apart at the seams," Teresa Stark, Kaiser's director of government affairs, told the LA Times.
Critics also have recently voiced concern about whether Kaiser intentionally priced its premiums high to prevent expensive consumers from applying.
To learn more:
- read the Los Angeles Times article
The Heritage Foundation worked hard to get its health insurance mandate passed but it took neo-liberal Obama and Congress to do it under the guise of using the money to fund health care for the poor. As we watched Republicans in Congress pretend to hate this-----since Republican voters were the ones the most against it-----it took a Republican Supreme Court Roberts to state that a mandated insurance coverage could be made. What will happen is that Americans will be forced to buy this insurance as prices for it rise and people will not be able to afford to use the insurance they now pay premiums for. The insurance industry profits estimate hundreds of billions in profits immediately while American families are finding that having insurance and accessing health care are two different things. Preventative care only for 80% of Americans is the goal.
History of the Individual Health Insurance Mandate, 1989-2010 Republican Origins of Democratic Health Care Provision Heritage Foundation's 1989 report is considered to be the conceptual origin of the health insurance mandate. The concept of the individual health insurance mandate is considered to have originated in 1989 at the conservative Heritage Foundation. In 1993, Republicans twice introduced health care bills that contained an individual health insurance mandate. Advocates for those bills included prominent Republicans who today oppose the mandate including Orrin Hatch (R-UT), Charles Grassley (R-IA), Robert Bennett (R-UT), and Christopher Bond (R-MO). In 2007, Democrats and Republicans introduced a bi-partisan bill containing the mandate.
In 2008, then presidential candidate Barack Obama was opposed to the individual mandate. He stated the following in a Feb. 28, 2008 interview on the Ellen DeGeneres show about his divergent views with Hillary Clinton:
"Both of us want to provide health care to all Americans. There’s a slight difference, and her plan is a good one. But, she mandates that everybody buy health care. She’d have the government force every individual to buy insurance and I don’t have such a mandate because I don’t think the problem is that people don’t want health insurance, it’s that they can’t afford it. So, I focus more on lowering costs. This is a modest difference. But, it’s one that she’s tried to elevate, arguing that because I don’t force people to buy health care that I’m not insuring everybody. Well, if things were that easy, I could mandate everybody to buy a house, and that would solve the problem of homelessness. It doesn’t."
By 2010, the Patient Protection and Affordable Care Act (PPACA), sometimes referred to as "Obamacare,” had passed in both the House and the Senate with no Republican votes. On Mar. 23, 2010 President Obama signed the act containing an individual mandate into law. On Jan. 5, 2011, Republicans in the US House of Representatives introduced The Repealing the Job-Killing Health Care Law Act (HR 2) to repeal the PPACA. One of their main arguments for repeal was that the health insurance mandate was unconstitutional.
The two charts below provide a brief timeline of the legislative history of bills containing an individual health insurance mandate as well as the policy origins of the individual health insurance mandate.