ALL OF MARYLAND'S NEO-LIBERALS ARE PUSHING THIS AND THE NEGATIVE EFFECTS OF PROFIT-MAKING WILL BE FELT THE MOST IN A CORPORATE MARYLAND.
WE NEED TO VOTE OUT NEO-LIBERALS-----RUN LABOR AND JUSTICE TO REVERSE THIS MESS AND TO GIVE UNIVERSAL CARE FOR ALL-----it is easy-peasy!
The entire public health sector is being privatized into private non-profits that will hide all of what is happening with public health money......Medicare and Medicaid and public grants. Private non-profits do not provide oversight and we already know there is rampant abuse of patients and fraud throughout the health care system with these reforms. LOW COST SIMPLY MEANS LESS ACCESS TO CARE AND LESS CHOICE IN DOCTORS.
Below you see how this 'health market' is shaking out with Wall Street expecting huge profits as public money hits health businesses giving less care and quality-----AND HIGH PROFITS! What can be better than having people paying for premiums and not be able to afford to access care? Much of this will be public money that could have gone to a simply expansion of an improved UNIVERSAL HEALTH CARE!
Here we go......Illinois, like Maryland is now a raging corporate neo-liberal state....see why we had Obama in the 2008 election disguised as a progressive?---and all neo-liberal states are dismantling public health by privatizing to private non-profits controlled by the wealthy in each area. When public health is made into private non-profits there is no public oversight and no transparency. This is necessary when most people will be denied health access and all kinds of fraud and corruption hit the health industry harder than in the past....if losing more than 1/2 of health spending now can get worse.
Take a look at this video.....
"A Dismantling Of The Human Services System"
From today's Sun-Times piece on the looming state budget cuts:
In some cases, [human service providers] have been told to expect a 50 percent reduction in dollars from Springfield. "It really is a dismantling of the human services safety network right now in Illinois," said Tony Paulauski, executive director of ARC of Illinois, an advocacy group for the disabled.
Gov. Quinn's press conference is still happening as I write this, but it appears that the Department of Human Services budget is facing a reduction of about 20 percent -- on top of the comparable cuts included in last year's budget. Check back later for a more details as we pick apart the Quinn administration's plan.
AS WE SEE HERE...QUALITY OF CARE IS FALLING AND REGULATORS AND OVERSIGHT ARE BEING DISBANDED......THIS IS NOT WHAT A FIRST WORLD HEALTH SYSTEM LOOKS LIKE! Everyone in Baltimore knows how Baltimore Board of Estimates does its competitive bidding!
Critics Question Medicare's Competitive Bidding Program, Set to Begin Saturday
Written by Rachel Fields | December 28, 2010
As Medicare's Competitive Bidding Program gears up for its Saturday launch, critics renew their warnings that the program will put patients in jeopardy, according to a Press-Enterprise report.
CMS will implement the program in nine metropolitan statistical areas during its first round. CMS hopes that these areas will start to see savings of up to 30 percent on certain durable medical equipment, prosthetics, orthotics and supplies beginning Jan. 1.
The government says the process is a necessary change to a program marked by wasteful spending and fraud, according to the report. But critics say the program will close businesses or force suppliers to cut staff, and that Medicare and Medicaid have cut rates so low that winning bidders can't afford to provide the services they promised. Critics fear patients will ultimately suffer when contracts are awarded to financially unstable business who cannot meet patient needs.
At a time when nurses are taking on doctor's duties in these health systems and health care is filling with foreign workers being sent to low-income and elderly care.....they are removing all of the regulators and oversight that held health care providers and staff accountable.
Dissolution of California Board of Registered Nursing Raises Patient Safety Concerns
Written by Jaimie Oh | February 01, 2012
Critics are speaking out after an October veto by Calif. Gov. Jerry Brown led to the formal dissolution of the state's Board of Registered Nursing, which went into effect this year, according to a California Watch report.
The nursing board, which has been in existence for more than 100 years, investigated complaints against nurses and also processed applications for new nurses. Gov. Brown vetoed a bill that would have extended the nursing board's existence until 2016, citing the proposal "would dramatically expand pension benefits for […] board investigators" and makes "no sense fiscally and flies in the face of much needed pension reform," according to a statement.
As a result of the veto, the state's Department of Consumer Affairs was granted authority to oversee the dissolved board's everyday operations. The move has sparked criticism from former members of the nursing board, including the former president Jeannine Graves. Ms. Graves argues the board's disbanding is a disservice to the public as well as nurses, who are entitled to due process if they are accused of any misconduct.
Another former public member of the board, Richard Rice, who served as a former senior adviser to then-Gov. Arnold Schwarzenegger, also criticized the board's dissolution. He argued the move put a stop to the board's ongoing policy work, including more robust legislation that would require nursing schools to teach clinical and classroom skills, according to the report.
However, state government officials said although the board has been dissolved, its work is still being done.
In Maryland, hospitals have at their entrance that if you are brought in and do not have the right insurance.....they will stabilize you and ship you out. What we are seeing all across the country is patient dumping,......ALL DONE FOR HEALTH INSTITUTION PROFIT!
THIS WILL GET UGLY FOLKS!
Vanderbilt University Medical Center Faces Allegations of Patient Dumping
Written by Molly Gamble | September 25, 2013
Nashville, Tenn.-based Vanderbilt University Medical Center is facing claims of patient dumping after it allegedly discharged an uninsured patient prematurely, according to a Tennessean report.
A lawsuit working its way through Nashville's circuit court claims VUMC discharged a patient two weeks after he underwent surgeries that saved his legs, which were injured in a motorcycle accident.
The patient, Patrick Miller, was sent Nov. 5, 2010, but returned to VUMC two days later "with an infection so severe that his right leg had to be amputated above the knee," according to the report.
The suit claims VUMC engaged in patient dumping, or prematurely discharging Mr. Miller in light of his uninsured status for economic reasons, according to the report.
VUMC spokesperson John Howser told The Tennessean the hospital consistently runs at or near patient capacity and that VUMC provides more than $370 million a year in uncompensated care, according to the report.
Vanderbilt lawyers have denied deficient care for Mr. Miller or patient dumping, and they have asked for the case to be dismissed. Lawyers also said Mr. Miller's surgery was "very complex" due to the severity of his injuries, according to the report.
We all know how predatory corporations are now----profit-driven health care will be ruthless and people will die!
ASC's are small offices that are allowed to perform minor surgeries that have been done in hospitals. They are pressured to do the work as cheap as possible because quantity is necessary for profit! WHAT DO YOU THINK WILL RESULT?
HEALTH CARE REFORM IS ALL ABOUT MAKING HEALTH INSTITUTIONS MOST PROFITABLE....SENDING ALL THE COSTLY PATIENTS TO THESE SMALL BUSINESS OWNERS NEEDING SHORTCUTS TO STAY PROFITABLE? REALLY?
Moody's: ASCs to Benefit From Declining Hospital Inpatient Surgeries
Written by Bob Herman September 24, 2013
As hospitals continue to record stagnant or falling inpatient surgery procedures, ambulatory surgery centers will see their volumes increase, according to a report from Moody's Investors Service.
Patient utilization in hospitals, especially for elective surgeries, has decreased significantly over the past five years for several reasons. Millions of Americans lost health insurance due to rising unemployment, and those with insurance have been forced to pay more of their healthcare costs through high-deductible health plans.
In addition, private payers, Medicare and Medicaid have been looking for ways to reduce their own costs, and consequently, they have turned to lower-cost ASCs for surgeries. On average, ASCs are reimbursed 57 percent of hospital rates for similar procedures.
Moody's found that from 2007 through 2012, hospital same-facility inpatient surgery cases dropped 0.22 percent per year, on average. At ASCs, same-facility inpatient surgery cases grew between 0.5 percent and 1 percent.
Moody's analysts said the 5,000-plus ASCs in the United States will continue to record growth in surgery cases this year and more years going forward. In particular, the large for-profit ASC companies like AmSurg, Symbion, Surgical Care Affiliates, Surgery Partners and United Surgical Partners International — which together own 14 percent of the ASC market — will fare the best because they can leverage economies of scale and attract more physician joint ventures, which could provide a "steady supply of patient referrals," according to the report.
This is what we have been shouting for two years now.....the costs are low because you won't be able to access. So, you will pay a premium for insurance and then not be able to access anything other than preventative care.
REMEMBER, BABY BOOMERS PAID INCOME AND PAYROLL TAXES FOR DECADES ALL USED TO FUND MEDICAL ADVANCES WE HAVE TODAY.....WE PREPAID HEALTH ACCESS!
Lower Health Insurance Premiums to Come at Cost of Fewer Choices
By ROBERT PEAR Published: September 22, 2013
WASHINGTON — Federal officials often say that health insurance will cost consumers less than expected under President Obama’s health care law. But they rarely mention one big reason: many insurers are significantly limiting the choices of doctors and hospitals available to consumers.
From California to Illinois to New Hampshire, and in many states in between, insurers are driving down premiums by restricting the number of providers who will treat patients in their new health plans.
When insurance marketplaces open on Oct. 1, most of those shopping for coverage will be low- and moderate-income people for whom price is paramount. To hold down costs, insurers say, they have created smaller networks of doctors and hospitals than are typically found in commercial insurance. And those health care providers will, in many cases, be paid less than what they have been receiving from commercial insurers.
Some consumer advocates and health care providers are increasingly concerned. Decades of experience with Medicaid, the program for low-income people, show that having an insurance card does not guarantee access to specialists or other providers.
Consumers should be prepared for “much tighter, narrower networks” of doctors and hospitals, said Adam M. Linker, a health policy analyst at the North Carolina Justice Center, a statewide advocacy group.
“That can be positive for consumers if it holds down premiums and drives people to higher-quality providers,” Mr. Linker said. “But there is also a risk because, under some health plans, consumers can end up with astronomical costs if they go to providers outside the network.”
Insurers say that with a smaller array of doctors and hospitals, they can offer lower-cost policies and have more control over the quality of health care providers. They also say that having insurance with a limited network of providers is better than having no coverage at all.
Cigna illustrates the strategy of many insurers. It intends to participate next year in the insurance marketplaces, or exchanges, in Arizona, Colorado, Florida, Tennessee and Texas.
“The networks will be narrower than the networks typically offered to large groups of employees in the commercial market,” said Joseph Mondy, a spokesman for Cigna.
The current concerns echo some of the criticism that sank the Clinton administration’s plan for universal coverage in 1993-94. Republicans said the Clinton proposals threatened to limit patients’ options, their access to care and their choice of doctors. THEY ARE RIGHT!
At the same time, House Republicans are continuing to attack the new health law and are threatening to hold up a spending bill unless money is taken away from the health care program.
In a new study, the Health Research Institute of PricewaterhouseCoopers, the consulting company, says that “insurers passed over major medical centers” when selecting providers in California, Illinois, Indiana, Kentucky and Tennessee, among other states.
“Doing so enables health plans to offer lower premiums,” the study said. “But the use of narrow networks may also lead to higher out-of-pocket expenses, especially if a patient has a complex medical problem that’s being treated at a hospital that has been excluded from their health plan.”
In California, the statewide Blue Shield plan has developed a network specifically for consumers shopping in the insurance exchange.
Juan Carlos Davila, an executive vice president of Blue Shield of California, said the network for its exchange plans had 30,000 doctors, or 53 percent of the 57,000 doctors in its broadest commercial network, and 235 hospitals, or 78 percent of the 302 hospitals in its broadest network.
Mr. Davila said the new network did not include the five medical centers of the University of California or the Cedars-Sinai Medical Center near Beverly Hills.
“We expect to have the broadest and deepest network of any plan in California,” Mr. Davila said. “But not many folks who are uninsured or near the poverty line live in wealthy communities like Beverly Hills.”
Daniel R. Hawkins Jr., a senior vice president of the National Association of Community Health Centers, which represents 9,000 clinics around the country, said: “We serve the very population that will gain coverage — low-income, working class uninsured people. But insurers have shown little interest in including us in their provider networks.”
Dr. Bruce Siegel, the president of America’s Essential Hospitals, formerly known as the National Association of Public Hospitals and Health Systems, said insurers were telling his members: “We don’t want you in our network. We are worried about having your patients, who are sick and have complicated conditions.”
In some cases, Dr. Siegel said, “health plans will cover only selected services at our hospitals, like trauma care, or they offer rock-bottom payment rates.”
In New Hampshire, Anthem Blue Cross and Blue Shield, a unit of WellPoint, one of the nation’s largest insurers, has touched off a furor by excluding 10 of the state’s 26 hospitals from the health plans that it will sell through the insurance exchange.
Christopher R. Dugan, a spokesman for Anthem, said that premiums for this “select provider network” were about 25 percent lower than they would have been for a product using a broad network of doctors and hospitals.
Anthem is the only commercial carrier offering health plans in the New Hampshire exchange.
Peter L. Gosline, the chief executive of Monadnock Community Hospital in Peterborough, N.H., said his hospital had been excluded from the network without any discussions or negotiations.
“Many consumers will have to drive 30 minutes to an hour to reach other doctors and hospitals,” Mr. Gosline said. “It’s very inconvenient for patients, and at times it’s a hardship.”
State Senator Andy Sanborn, a Republican who is chairman of the Senate Commerce Committee, said, “The people of New Hampshire are really upset about this.”
Many physician groups in New Hampshire are owned by hospitals, so when an insurer excludes a hospital from its network, it often excludes the doctors as well.
David Sandor, a vice president of the Health Care Service Corporation, which offers Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma and Texas, said: “In the health insurance exchange, most individuals will be making choices based on costs. Our exchange products will have smaller provider networks that cost less than bigger plans with a larger selection of doctors and hospitals.”
Premiums will vary across the country, but federal officials said that consumers in many states would be able to buy insurance on the exchange for less than $300 a month — and less than $100 a month per person after taking account of federal subsidies.
“Competition and consumer choice are actually making insurance affordable,” Mr. Obama said recently.
Many insurers are cutting costs by slicing doctors’ fees.
Dr. Barbara L. McAneny, a cancer specialist in Albuquerque, said that insurers in the New Mexico exchange were generally paying doctors at Medicare levels, which she said were “often below our cost of doing business, and definitely below commercial rates.”
Outsiders might expect insurance companies to expand their networks to treat additional patients next year. But many insurers see advantages in narrow networks, saying they can steer patients to less expensive doctors and hospitals that provide high-quality care.
Even though insurers will be forbidden to discriminate against people with pre-existing conditions, they could subtly discourage the enrollment of sicker patients by limiting the size of their provider networks.
“If a health plan has a narrow network that excludes many doctors, that may shoo away patients with expensive pre-existing conditions who have established relationships with doctors,” said Mark E. Rust, the chairman of the national health care practice at Barnes & Thornburg, a law firm. “Some insurers do not want those patients who, for medical reasons, require a broad network of providers.”