This will be the last post for now on health care and I want to follow up with what deregulated health care looks like. Sending health care to the states leads to ending the Federal regulations requiring standardized approaches and expenditures-----equal protection-----and it allows states to chose winners and losers and allows Federal funding to be sent to all kinds of 'innovative' programs. We all know what 'innovative' did for our economy!
There are issues far worse believe it or not with deregulation and that is taking the responsibility for health outcomes away from doctors by creating standards of treatment that all doctor's know cannot meet the needs of individualized health care. That is what Affordable Care Act does under the guise of efficiency. When a doctor is told to take step 1, 2, and 3 in treating people with diabetes for example that doctor is protected against any wrongdoing if he/she fails to take into account a patient's other health factors that conflict with diabetes. That isn't to say that doctors today would allow that to happen-----it says that it will allow doctors to do this to save money and maximize profits.
WHAT THE AFFORDABLE CARE ACT DOES IS SEEK TO END THE CENTURIES OLD PRACTICE OF 'HIPPOCRATIC OATH'----DO NO HARM.
Before ACA doctors were padding the Medicare and Medicaid bills with procedures and medical equipment not needed to gain extra income. Some were dangerous as with cancer treatments and cardiac stents for no reason. Most of it was simple profiteering. This is why health fraud soared and Fee For Service failed to work as it should. Simple oversight and accountability would have stopped this and this is why neo-liberals and neo-cons dismantled public agencies----so fraud and corruption could soar and move trillions of dollars to the top. The problem for the American people now ------
THE INCENTIVE IS NOW TO DENY NECESSARY CARE TO BOOST PROFITS AND THIS WILL BE FAR DEADLIER.
Add to that the complete deregulation----no oversight and accountability ------and health care will be a WILD WEST. I asked an elderly doctor heading to Washington for a meeting of people creating these policies what he thought about people being afraid of going to the hospital because of this deregulation and his response is the neo-liberal and neo-con response----THEN DON'T GO TO THE HOSPITAL---STAY HOME AND TAKE CARE OF IT YOURSELF. This was a doctor folks!
“Do no harm” from the Hippocratic Oath
By rsharma On March 14, 2011 ·
“I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.”–Hippocratic oath
The Hippocratic oath was created several centuries ago to guide health practitioners, then and today. The power of the oath is that it creates a compass for decisions that take place in the intimate interactions between patient and practitioner. My concern is that we are moving farther and farther away from this philosophy by trying the most extreme intervention rather than starting with the least harmful. Unlike our approach in the past, the system is moving away from an escalation process of least harmful therapies to the most invasive to one that starts with the most extreme first rather than last.
Affordable Care Act is tied to the Trans Pacific Trade Pact policies-----look at the statement below:
'State officials participating in the development of formulary rules for Medicare and Medicaid have reacted with alarm about how this proposal could undermine possible gains hard won here in the epic health care reform battle'.
The Affordable Care Act does indeed move lower income patients to procedures that are old and outdated and as the statement above says----sending people to the most extreme intervention. It would be like exposing a person to the brutal cancer treatments with chemo drugs when simple radiation would do the trick. That is where we are going. Already you see PHARMA corporations failing to manufacture much needed drugs because they are no longer profitable enough. People will not receive the latest health procedures----they will receive the cheapest. DO NO HARM-----REALLY?????
KNOW HOW THE PRICE OF NEW PROCEDURES WILL FAR EXCEED OLD? GUESS WHO WILL GET THESE NEW PROCEDURES? NOT THE 80% ON MEDICAID AND BRONZE PLANS!
Is it a coincidence that Melanoma was taken from Medicare coverage just recently?
'In conclusion, the large economic burden of melanoma in patients 65 years or older is comparable to that of other common malignant neoplasms in this population. Although relatively few patients actually die of this condition, the per-patient expenditures have particular significance in late-stage disease. The majority of consumption is attributable to advanced-stage disease and the terminal phase of treatment. If all patients were diagnosed and effectively treated in stage 0 or I, we estimate that the annual direct costs for the population 65 years or older would be between $99 million and $161 million, or 40% to 65% of their current value of $249 million. Policy guidelines for melanoma screening should consider that patients 65 years or older represent an increased risk, and, thus, economic burden, for later-stage melanoma'.
New Cancer Treatments Boost Drug Firms
Jun 4, 2013 8:14am Morning Business Memo:
Cancer specialists and Wall Street analysts agree: A new class of experimental drugs could be a major breakthrough in the war against cancer.
The drugs, still in early testing by Merck and Bristol-Myers Squibb, help the immune system detect otherwise-invisible cancer cells and attack them. Shares of both companies rose more than 3 percent Monday. In small samples of advanced melanoma patients, the new drugs shrank tumors and extended lives of patients with advanced melanoma.
The data on drugs that are being developed by major pharmaceutical firms were the talk of a five-day conference of cancer specialists in Chicago, hosted by the American Society of Clinical Oncology. The antibody drugs enable the patient’s immune system to identify tumor cells that otherwise would evade detection because they have the equivalent of an invisibility cloak. Once the cancer cells are “uncloaked,” powerful immune system cells called T cells can target and destroy the cancer cells.
The promising results, while in small patient studies, pumped up shares of Merck and Bristol-Myers to multiyear highs as several stock analysts issued encouraging reports stating that the drugs seem effective and had relatively minor side-effects, mostly diarrhea, fatigue, itching and rashes. A few patients developed lung inflammation.
UBS Securities analyst Marc Goodman wrote that Merck’s strong results from its study and its program for testing its drug against lung, breast, bladder and other cancers “should enable it to be very competitive in this potentially large and exciting space.”
“Bristol-Myers stole the show,” Barclays Capital analyst Tony Butler wrote to investors. “Most startling was the estimated one-year overall survival rate of 82 percent.” Some patients in Bristol-Myers’ study had their tumors shrink even after they stopped taking the drug, indicating its effects endure, at least for a while.
What we are now dealing with is the private profitability of procedures vs the welfare of patients. Public universities and NIH/NCA research is all taxpayer funded and this is what kept health treatment costs down. Now, universities are corporations patenting procedures and wanting profits for research paid for by taxpayers. SEE WHY HEALTH COSTS ARE SKY-ROCKETING?
Who first corporatized public universities to make patenting profitable? Neo-liberals like Clinton and Obama super-sized that sending hundreds of billions to build these patent-crazy corporate university structures.
THIS IS WHY COSTS FOR NEW MEDICAL BREAKTHROUGHS ARE SOARING AND IT IS WHY THE AFFORDABLE CARE ACT KEEPS PEOPLE FROM ACCESSING THE 'BRAND NAMES'.
DEPENDING ON THE TYPE OF MEDICARE YOU HAVE?
Folks, everyone pays payroll taxes and people have always received the same access. Now we have Medi-Gap and Medicare Advantage and Affordable Care Act moves Medicare further to private hands with income as the basis of access -----
When a doctor is forced to stop treatment because of cost----BYE BYE HIPPOCRATIC OATH. University of Maryland used to be the source for low-income treatment and now it does not allow people any access to standard care beyond a threshold. People are now sent home to die from treatable disease.
How Does Medicare Pay For Cancer Treatment?
When trying to discern exactly how will Medicare pay for cancer treatment there are some important facts you need to know. First the payment method may different depending upon the type of Medicare you actually have. For example if you have primary insurance through them, you will probably see them pay the majority of the bill, leaving you with some sort of deductible. If you have supplemental with them, they will pay some of what the primary insurance doesn’t. There is also the possibility that you have any combination of the two at varying levels.
Facts When You Have Primary Insurance Through This System
If you do have primary insurance then there is a good chance you will need to know about the yearly limits. These limits can effect your care in two different ways. First there is the amount that they will pay for each treatment. That means that they may pay 80% of the cost of one visit, while you must make up the rest. Another thing to remember when determining how will Medicare pay for cancer treatment is what happens when the total yearly limit runs out.
What To Do If The Yearly Limit Runs Out
There is usually a set amount that the system will pay for one year, for one type of treatment. If you surpass this limit, Medicare will not pay anymore. You will either have to pay for treatment out of pocket, or have a supplemental form of insurance to pay these costs. Determining how will Medicare pay for cancer treatment doesn’t have to be difficult once you understand these simple facts. Being prepared is the best way to ensure you have adequate coverage, even if diagnosed with cancer
Health Information Privacy
The Office for Civil Rights enforces the HIPAA Privacy Rule, which protects the privacy of individually identifiable health information; the HIPAA Security Rule, which sets national standards for the security of electronic protected health information; the HIPAA Breach Notification Rule, which requires covered entities and business associates to provide notification following a breach of unsecured protected health information; and the confidentiality provisions of the Patient Safety Rule, which protect identifiable information being used to analyze patient safety events and improve patient safety.
Why is data encryption not required by HIPAA?
Data encryption has been suggested as a requirement for health care organizations, but the medical industry has objected saying that encryption would be an unfair financial burden. The HITECH Act changed the HIPAA data breach rules by making encryption a “get-out-of-jail-free card.” If you use encryption then lost data is not reportable.
This is what the meta-data super-computers are all about-----Hopkins has one on its campus and it collects all personal data for industrial spying and for just plain selling data for profit. It's just fine as Trans Pacific Trade Pact allows global corporations to operate in the US in any way that allow profit. TPP makes it impossible for you and I to copy a page from Hopkins' website but Hopkins as a corporation can sell and distribute our personal information any way it wants.
This ends HIPAA-----there is now no privacy. I talked with a friend who was unsettled by the fact that while at a health institution he was standing next to doctors talking right out in public and by coincidence the person they were discussing-----was someone he knew. THIS WAS UNHEARD OF BEFORE THE DISMANTLING OF REGULATIONS SUCH AS HIPAA!
States’ Hospital Data for Sale Puts Privacy in Jeopardy
By Jordan Robertson Jun 5, 2013 12:01 AM ET
Hospitals in the U.S. pledge to keep a patient’s health background confidential. Yet states from Washington to New York are putting privacy at risk by selling records that can be used to link a person’s identity to medical conditions using public information.
Graphic: Your Not-So-Anonymous Medical Records
Consider Ray Boylston, who went into diabetic shock while riding his motorcycle in rural Washington in 2011. He careened off the road and was thrown into the woods, an accident that was covered only briefly, in the local newspaper. Boylston disclosed his medical condition and history to a handful of loved ones and the hospital that treated him.
After Boylston’s discharge, Washington collected the paperwork of his week-long stay from Providence Sacred Heart Medical Center in Spokane and added it to a database of 650,000 hospitalizations for 2011 available for sale to researchers, companies and other members of the public. The data was supposed to remain anonymous. Yet because of state exemption from federal regulations governing discharge information, Boylston could be identified and his medical background exposed using only publicly available information.
“I don’t really feel that the public has a right to read up on my medical history,” said Boylston, who is 62 and a veteran. “I feel I’ve been violated.”
Photographer: Joshua Roberts/Bloomberg Divya Shroff, associate chief of staff at the Veterans Administration Hospital, left,... Read More
He agreed to share his story when contacted by Bloomberg News.
The potential for a patient’s hospital record to be made public by anyone buying data compiled by states adds to ways privacy is vulnerable in an age of digitized health record keeping and increasingly sophisticated hacking.
This is very boring but I want to include it because these health system disclaimers are now looking like your cell phone disclaimers with pages of details requiring the signing away of all of your rights in order to use what is an essential service. That is what is happening with hospitals and health systems and their rights to now do anything they want with your data.
YOU WANT TO USE OUR HEALTH SYSTEM THEN SIGN AWAY ALL YOUR RIGHTS AND PROTECTIONS!
This looks a lot like Johns Hopkins disclaimer although Hopkins comes right out and says it-----
YOU CAN REQUEST YOUR INFORMATION NOT BE SHARED BUT WE WILL DO WITH IT WHAT WE WANT.
This is what deregulated health care looks like. None of the laws protecting patients and their privacy matter anymore.
HIPAA NOTICE OF PRIVACY PRACTICES FOR PERSONAL HEALTH INFORMATION(PHI)OF GROUP HEALTH PLANS OF THE STATE OF MICHIGAN
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUTYOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This notice gives you information about the duties and practices to protect the privacy of your medical or health information for each group health plan for state employees and retirees that is administered and self-insured by the State of Michigan (“Plan”). Each Plan is sponsored by the State of Michigan (“Plan Sponsor”). Each Plan is required by law to maintain the privacy of protected health information and to provide enrollees with a notice of its legal duties and privacy practices with respect to protected health information. Each Plan provides health benefits to you as described in your summary plan description. Each Plan receives and maintains health information in providing these benefits to you. Each Plan hires business associates to help provide these benefits. These business associates also receive and maintain health information related to you in the course of assisting each Plan.The effective date of this notice is April 14, 2003.Each Plan is required to follow the terms of this notice until it is replaced. Each Plan reserves the right to change the terms of this notice at any time. If a Plan amends this notice, the Plan will send a new notice to all subscribers covered by the Plan. Each Plan reserves the right to make the new changes apply to all your health information maintained by the Plan before and after the effective date of the new notice.When a Plan may use or disclose your medical or health information without your consent or authorizationThe following categories describe when a Plan may use or disclose your medical or health information without your consent or authorization. Each category includes general examples of the type of use or disclosure, but not every use or disclosure that falls within a category will be listed:Treatment. For example, a Plan may disclose health information at your doctor’s request to facilitate receipt of treatment.Payment. For example, a Plan may use or disclose your healthinformation to determine eligibility or plan responsibility for benefits; confirm enrollment and coverages; facilitate payment for treatment and covered services received; coordinate benefits with other insurance carriers; and adjudicate benefit claims and appeals.
Health Care Operations.
For example, a Plan may use or disclose your health information to conduct quality assessment and improvement activities; underwriting, premium rating, or other activities related to creating an insurance contract; dataaggregation services; care coordination, case management, and customer service; auditing, legal, and medical reviews of the Plan; and to manage, plan, or develop a Plan’s business.
A Plan or its business associates may use your health information to contact you with information about treatment alternatives or other health-related benefits and services that may be of interest to you.
To Business Associates.
A Plan may disclose your health information to business associates that assist the Plan in administrative, billing, claims, and other matters. Each business associate must agree in writing to ensure the continuing confidentiality and security of your health information.
To Plan Sponsor.
A Plan may disclose to the Plan Sponsor, in summary form, claims history and other similar information. Such summary information does not disclose your name or other distinguishing characteristics. A Plan may also disclose to the Plan Sponsor that you are enrolled in or dis-enrolled from the Plan. A Plan may disclose your health information to the Plan Sponsor for authorized administrative functions that the Plan Sponsor provides for the Plan. The Plan Sponsor will not use or disclose your health information for employment-related activities or any other benefit plan
As Required by Law.
A Plan may use or disclose your personal health information for other important activities permitted or required by state or federal law, with or without your authorization.
These include, for example:•To the U.S. Department of Health and Human Services to audit Plan records.•As authorized by state workers’ compensation laws.•To comply with legal proceedings, such as a court or administrative order or subpoena.•To law enforcement officials for limited law enforcement purposes.•To a governmental agency authorized to oversee the health care system or government programs.•To public officials for lawful intelligence, counterintelligence, and other national security purposes.•To public health authorities for public health purposes.
Each Plan may also use and disclose your health information as follows:•To a family member, friend or other person, to help with your health care or payment for health care, if you are in a situation such as a medical emergency and cannot give your agreement to a Plan to do this.•
To your personal representatives appointed by you or designated by applicable law.•
To consider claims and appeals regarding coverage, exclusion, cost, and privacy issues.•For research purposes in limited circumstances.•
To a coroner, medical examiner, or funeral director about a deceased person.•To an organ procurement organization in limited circumstances.•
To avert a serious threat to your health or safety or the health or safety of others.Uses and disclosures with your permission
Each Plan will not use or disclose your health information for other purposes, unless you give a Plan your written authorization. If you give a Plan written authorization to use or disclose your health information for a purpose that is not described in this notice, then, in most cases, you may revoke it in writing at any time. Your revocation will be effective for all your health information a Plan maintains, unless the Plan has taken action in reliance on your authorization.
You may request in writing that a Plan do the following concerning your health information that the Plan maintains:•Put additional restrictions on a Plan’s use and disclosure of your health information. A Plan does not have to agree to your request.•
Communicate with you in confidence about your health information by a different means or at a different location than a Plan currently does. Your request must specify the alternative means or location to communicate with you. A Plan does not have to agree to your request.•See or receive copies of your health information. A Plan may charge a reasonable fee to cover expenses associated with your request. In limited cases, a Plan does not have to agree to your request.•Amend your health information.In some cases, a Plan does not have to agree to your request.•Receive a list of disclosures of your health information from a stated time period during the prior years (but not before April 14, 2003) that the Plan made for certain purposes. This listingwill not include disclosures made to you; for treatment, payment, or health care operation purposes; or other exceptions. In some cases, the Plan may charge a nominal, cost-based fee to carry out your request.•Send you a paper copy of this notice. You may also download a copy of this notice at the Employee Benefits Division section of www.michigan.gov/mdcs.To exercise any right described in this notice or for a detailed explanation of the fee structure for possible fees for receiving information, please contact the Privacy Official at the address, e-mail, or phone number listed below.
If you believe your privacy rights have been violated by the Plan, you have the right to complain in writing to the Plan or to the Secretary of the United States Department of Health and Human Services. You may file a written complaint with the Plan at the address listed below. We will not retaliate against you if you choose to file a complaint with the Plan or the Department of Health and Human Services.Contact officeTo request additional copies of this notice or more information about Plan privacy practices, please contact the Privacy Official for the state group health plans at the following Contact Office:Contact Office: Michigan Civil ServiceCommission, Privacy OfficialTelephone: (517) 373-7977 or (800) 505-5011 Fax: (517) 373-3174E-mail: MCSC-HIPAA@michigan.govAddress: 400 South Pine Street, P.O. Box 30002, Lansing, MI 48909Revised: 4/30/2013