Diigo Links

The Healthy Flap: February 19, 2013

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Cigarette Warning Graphic

These are my healthy links for February 19th:

  • California’s Tobacco Control Program generates huge health care savings, study shows -Over a span of nearly 20 years, California’s tobacco control program cost $2.4 billion and reduced health care costs by $134 billion, according to a new study by UC San Francisco (UCSF).Additionally, the study — covering the beginning of the program in 1989 to 2008 — found that the state program helped lead to some 6.8 billion fewer packs of cigarettes being sold that would have been worth $28.5 billion in sales to cigarette companies.
  • When to Retire a Running Shoe -Ryan Hall, one of the world’s best distance runners, used to pride himself on wearing his running shoes into nubs. No more. Now he assiduously replaces his shoes after running about 200 miles in them. He goes through two pairs a month.“I know that my shoes could probably handle a couple of hundred more miles before they are worn out, but my health is so important to me that I like to always make sure my equipment is fresh,” he said.Of course Mr. Hall, sponsored by Asics, does not have to pay for his shoes. Most of the rest of us do, and at around $100 a pair they aren’t cheap. Yet we are warned constantly to replace them often, because running in threadbare shoes may lead to injuries that can take months to heal.

    So here’s a simple question: How do you know when your shoes are ready for those discard bins in gyms? And if you do get injured, is it fair to blame your shoes?

  • States worry about rate shock during shift to new health law -Less than a year before Americans will be required to have insurance under President Obama’s healthcare law, many of its backers are growing increasingly anxious that premiums could jump, driven up by the legislation itself.Higher premiums could undermine a core promise of the Affordable Care Act: to make basic health protections available to all Americans for the first time. Major rate increases also threaten to cause a backlash just as the law is supposed to deliver many key benefits Obama promised when he signed it in 2010.”The single biggest issue we face now is affordability,” said Jill Zorn, senior program officer at the Universal Health Care Foundation of Connecticut, a consumer advocacy group that championed the new law.
  • It’s official: The feds will run most Obamacare exchanges -Friday was a very important day for health policy days. It was the last day for states to tell the federal government whether they wanted any part in running the Affordable Care Act  health exchanges come 2014.
    The federal government did not get many takers. Some of the most closely watched states, including Florida and New Jersey, decided to leave the entire task to the federal government. All told, the federal government will run 26 of the state health exchanges. It  also will partner with seven states, where state and federal officials take joint responsibility for the marketplace. Seventeen states and the District of Columbia will take on the task themselves. Here’s what that looks like in map form, via the Kaiser Family Foundation. 
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Medicare Payment Advisory Commission

ObamaCare Declares War on Doctors

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Think anyone will want to go into medicine? And, who will accept Medicare?

Early retirement for physicians and dentists will mean a very real shortage of medical/dental providers.

Go here and sign the petition.

The worst fears about Obamacare are now being realized in a decision on Monday by the Medicare Payment Advisory Commission (MPAC) established by the law to supervise $500 billion in Medicare cuts.

 MPAC, whose decisions have the force of law, has voted to impose drastic pay cuts on all doctors under Medicare and, by extension, under Medicaid (which tends to follow suit).  The cuts will effectively reduce the real pay for specialists by 50% over the next ten years — including a 25% reduction over the next three years — and cut general practitioners’ pay by one-third over ten years (and that assumes that inflation stays down at 3% a year).

MPAC has ruled that specialists must accept a 6% cut in their fees per year for each of the next three years followed by a seven year freeze in their fees without any adjustment for inflation.  If inflation stays very low — at 3% per year — this cut amounts to an 18% cut in nominal pay and a 50% cut in real pay for specialists.  General practitioners will face a ten year freeze on their pay, reducing their real compensation by one-third assuming ongoing low inflation.  Higher inflation, of course, would make the cuts in real pay even more drastic.
 
The consequences of the MPAC decision will be immediate and drastic:

  • Many physicians, and many more specialists, will refuse to treat Medicare patients.  It will become very, very difficult to see a cardiologist or an oncologist or a gastroenterologist or OB-GYN specialist if you are on Medicare unless you are willing to pay out of pocket or have the kind of health insurance coverage from a private source that would reimburse for their care.
  • More and more medical care will be turned over to nurses or physician assistants, and fewer people will ever get to see a doctor on Medicare.
  • Private health insurers will follow in the footsteps of the Medicare program and likely slash their fees as well.
  • Fewer students will enter medicine, and a major shortage of doctors will reduce the quality of medical care in America drastically.

The MPAC cuts will bring American doctors’ incomes more into line with European doctors who typically earn half or less of what their American counterparts earn — and deliver worse medical care as a result.
 
We have got to stop these MPAC cuts from taking effect.  The very future of Medicare and of our entire health care system is at stake.  If they are allowed to stand, Medicare will become akin to Medicaid or public housing — a program for poor people who cannot afford to pay for medical care from specialists outside the system.

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Medicine

Poll Watch: Southern and Western United States Have Highest Uninsured Rates

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According to the latest Gallup Poll.

Texas residents continue to be the most likely in the United States to lack health coverage, with 27.2% reporting being uninsured in the first half of 2011. At the other end of the spectrum is Massachusetts, where health insurance is required and 5.3% of residents lack coverage. These two states have represented the upper and lower bounds of uninsured rates since Gallup and Healthways started tracking coverage in 2008.

These results are based on 177,237 interviews conducted daily from January through June 2011 as part of the Gallup-Healthways Well-Being Index. An average of 16.8% of all American adults were uninsured in the first half of 2011, similar to the 16.4% in 2010. This percentage, however, has been edging up each year since 2008, at which time 14.8% of adults were uninsured. The percentage of uninsured residents in all states so far in 2011 is on par with 2010, but in most states remains higher than in 2008.

And, the Southern and Western United States have the highest uninsured rates.

States in the South and West continue to have higher numbers of uninsured adults than do those in the Northeast — consistent with what Gallup found in 2008, 2009, and 2010. Eight of the 10 states with the highest uninsured rates in the country are in the South and the other two — California and Alaska — are in the West.

Texas, California, and Florida — all three of which have an uninsured rate higher than 20% — have disproportionately large Hispanic populations, the demographic group Gallup finds to be the most likely to be uninsured.

Uninsured rates are lower in the Northeast, with 7 of 10 states with the fewest uninsured residents located there, as in past years.

The chart:

So, what does this mean?

President Obama’s Affordable Care Act has had little effect on people being insured or not. With the states struggling with budgets, it is difficult to see how many more people can be provided insurance without affecting the people that already have coverage.

Uninsured rates across states in 2011 appear to be relatively stable so far compared with 2010, but remain higher than in 2008. This could be seen as good news at a time when states are grappling with deep budget cuts and the implementation of new regulations and programs required under the Affordable Care Act. However, more than 10% of adults lack healthcare coverage in almost all states, with more than 15% going uninsured in 29 states. The fate of uninsured rates in America remains precarious as numerous states are challenging the legality of the new healthcare law in court.

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