Welcome to the Nexus of Ethics, Psychology, Morality, Philosophy and Health Care

Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy
Showing posts with label The Patient Protection and Affordable Care Act. Show all posts
Showing posts with label The Patient Protection and Affordable Care Act. Show all posts

Wednesday, June 4, 2014

Healthy behavior matters. So are we responsible if we get sick?

By Bill Gardner
The Incidental Economist
Originally published May 30, 2014

I have been warned my whole life that I shouldn’t smoke. The evidence that smoking affects health is overwhelming. Suppose I understand all this, but I smoke anyway. And then I get lung cancer. Am I responsible for what happened to me, given that I was aware of the consequences yet behaved recklessly anyway?

Whether we are responsible for our health affects how we think about health policy. The ACA subsidizes insurance, and thus the cost of health care, for millions of Americans. Many people feel that it is right to care for those who are ill through no fault of own, but they do not understand why they should be responsible when someone becomes sick through reckless behaviour or self-indulgence. Our intuition is that such people are (to some degree) morally responsible for their fate.

The entire article is here.

Friday, May 23, 2014

Architect Of Health Law Says Reform Is 'Never Finished'

The University of New Orleans
Originally published May 7, 2014

Two polls released this week reveal challenges ahead for the Affordable Care Act.

Gallup found the nation’s uninsured rate dropped to 13.4 percent last month, the lowest monthly uninsured rate since the company began tracking it in 2008. But that means 32 million people remain without coverage.

And a Pew Research Center poll shows that 55 percent of Americans disapprove of the 2010 health care reform law, which mandates that everyone have health insurance and that it be made available to even those with pre-existing medical conditions.

The entire story is here.

Saturday, May 10, 2014

UC OKs paying surgeon $10 million in whistleblower-retaliation case

By Chad Terhune
The Los Angeles Times
Originally published April 22, 2014

University of California regents agreed to pay $10 million to the former chairman of UCLA's orthopedic surgery department, who had alleged that the well-known medical school allowed doctors to take industry payments that may have compromised patient care.

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The seven-week trial in downtown Los Angeles offered a rare glimpse into those potential conflicts at a time when there is growing government scrutiny of industry payments to doctors.

Starting this fall, the federal Physician Payments Sunshine Act, part of President Obama's healthcare law, requires public disclosure of financial relationships between healthcare companies and physicians.

The entire article is here.

Sunday, November 3, 2013

Artists and Health Insurance Survey

Taking the pulse of the artist community

Kristin Thomson & Jean Cook, Future of Music Coalition
Originally published October 15, 2013

Here is an excerpt:

This most recent survey confirms what many arts service organizations have known anecdotally for years: the US-based artist community is less likely to be insured than the general population, with cost and affordability as the prevailing factors.

Even more troubling is the finding that those respondents who spend more time or derive
more income from being an artist are less likely to be insured.

  • The more workweek hours spent on art, the less likely respondents are to have health insurance. 
  • The greater percentage of personal income derived from art, the less likely respondents are to have health insurance. 

The findings underscore the conditions experienced by artists; as self-employed or freelance workers with variable incomes, many are simultaneously not eligible for employer-based coverage and have difficulty affording individual health insurance purchased on the open market.

This was an important moment to take a snapshot of artists’ access to health insurance. In 2010, Congress passed the Affordable Health Care Act (ACA), which instituted a number of new protections, tax credits and safety nets for citizens. But, because of this law, health insurance is no longer an option; most Americans will need to secure coverage by 2014.

The entire survey can be accessed here.

Thanks to Deborah Derrickson Kossmann for this survey.

Sunday, August 4, 2013

U.S. sees lower-than-expected Obamacare insurance costs

By David Morgan
Reuters
Originally published July 18, 2013

Hoping to gain the high ground in an escalating war of words over Obamacare, the U.S. administration on Thursday forecast sharply lower than expected insurance costs for consumers and small businesses in new online state healthcare exchanges.

The exchanges represent the centerpiece of President Barack Obama's Patient Protection and Affordable Care Act, and their success could depend on the cost of so-called "silver plans" with mid-range premiums, which are expected to attract the largest number of enrollees.

A report by the Department of Health and Human Services (HHS) said data from 10 states and the District of Columbia shows preliminary 2014 premiums on the lowest-cost mid-range silver plans in those marketplaces to be 18 percent lower on average than earlier administration and congressional estimates.

The entire story is here.

Sunday, July 28, 2013

Poll: Most Americans Don’t Want Congress to Repeal Obamacare

By Alex Roarty
National Journal
July 22, 2013

Americans aren’t ready to repeal Obamacare. But that doesn’t mean they think its implementation is going well.

A majority of adults don’t want to repeal the Affordable Care Act, according to the latest United Technologies/National Journal Congressional Connection Poll, preferring instead to either spend more on its implementation or wait to see if changes are needed later.

But based on recent news that the White House is delaying its employer health insurance mandate, the public appears convinced that the law’s implementation is going poorly. A majority of Americans say the one-year delay is a sign the White House is ill-prepared for a law already facing mounting problems; only slightly more than one-third of adults say putting off the requirement shows the president wants to make sure implementation goes smoothly.

The entire article is here.

Monday, July 15, 2013

The Half-Trillion-Dollar Depression

By CATHERINE RAMPELL
The New York Times
Published: July 2, 2013

Mental illness has been an increasingly significant health concern over the past several decades, but it’s now becoming an economic one too. The number of Americans who receive Social Security Disability Insurance for mental disorders has doubled during the past 15 years. Eliza is now one of an estimated 11.5 million American adults with a debilitating mental illness, on whom the country spends about $150 billion annually on direct medical costs — therapy, drugs, hospitalizations and so forth. But the biggest blow to the overall economy are the many hidden, indirect costs. People with serious mental illness earn, on average, $16,000 less than their mentally well counterparts, totaling about $193 billion annually in lost earnings, according to a 2008 study published in The American Journal of Psychiatry. And many mentally ill workers, who are more likely to miss work, also suffer from what social scientists call presenteeism — the opposite of absenteeism — in which they are very likely to be less productive on the job when they show up.

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Even though tens of millions of people will get more coverage, estimates suggest that only 1.15 million new users will take advantage of mental-health services. A lot of people who will be extended coverage don’t need care; others, fearful of the stigma around mental health, may not take it. What’s more distressing, from both an economic and a social perspective, is that a lot of people who do muster the courage still won’t get the right kind of treatment. About half of Americans who seek care for serious mental illnesses get treatment that does not help them or is not even recommended for their condition.

The entire article is here.

Friday, March 29, 2013

Proof That Obamacare 'Rate Shock' Is An Ugly Insurance Company Deception

By Rick Unger
Forbes - Op Ed
Originally published on March 26, 2013

Over the past few months, the nation’s largest health insurance companies have been hard at work selling a narrative claiming that the Affordable Care Act is about to result in dramatically larger premium costs for a significant number of Americans. Indeed, the warnings have become so worrisome that the massive increases they are predicting have taken on a frightening descriptor all its own—rate shock.

At the heart of the health insurers’ retelling of the Chicken Little story is a regulation promulgated by the Department of Health and Human Services a few months back limiting what a health insurer can charge a 64 year old to three times what they charge a 21 year old. Currently, the average bump for older participants is typically five times that of the younger customers—although there are examples where the increase can reach ten times what is paid by the young immortals buying coverage.

As a result of the lower premium prices that will be paid by older participant, the expectation—one created by the large insurance companies—is that the youngest participants will have to pay significantly more to make up the difference.

Now, The Urban Institute—an organization so clearly bi-partisan that even the most suspicious partisan would encounter extreme difficulty making a case for bias—is out with a study that states that the ‘rate shock’ argument is “unfounded”, particularly when applied to the millions of Americans in the individual market.

The entire Op Ed is here.

The study debunking the "rate shock" rumor is here.

Thursday, March 21, 2013

Report rebuts claim that ACA is unfair to young adults

A Robert Wood Johnson Foundation/Urban Institute analysis says health system reform's coverage provisions will help mitigate the effect of setting new age rating bands.

By Jennifer Lubell
amednews.com
Originally published March 18, 2013

An Affordable Care Act provision that seeks to limit the amount by which insurance premiums can vary based on enrollees' ages won't result in young adults paying unreasonably high premiums, an analysis has concluded.

The impact of the ACA's new formula for setting age rating bands has attracted recent interest in Washington. Starting in 2014 under the law, insurers will be prohibited from selling nongroup coverage to an adult 64 or older for more than three times the premium they would assign to a 21-year-old for the same coverage. This translates into a maximum 3-to-1 premium ratio based on age, which narrows the gap between what younger and older people pay for insurance now.
 
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A Robert Wood Johnson Foundation report prepared by the Urban Institute acknowledges that tighter ratios will lead to increased premiums for younger adults and lower premiums for older adults. However, the study projects that other ACA coverage provisions will mitigate the negative effects that young people may experience from the new age rating bands.
 

Tuesday, March 19, 2013

UnitedHealth Sued by Over Mental Health-Care Access

By Christie Smythe
Bloomberg News
Originally published March 11, 2013

UnitedHealth Group Inc. (UNH) was sued by the New York State Psychiatric Association and mental-health patients over claims the insurer violated laws barring unequal coverage for psychiatric conditions.

UnitedHealth, the second-largest U.S. health insurer, has maintained “unjustifiably stringent medical-necessity criteria and pre-authorization requirements for mental-health services,” the plaintiffs said in a complaint filed today in federal court in Manhattan.

The company denied or limited access to psychotherapy and other mental-health treatments for patients suffering from conditions including psychosis, chronic depression, and anxiety disorders, according to the 102-page complaint, which seeks to represent all customers of the company facing similar situations.

The entire article is here.

Friday, March 1, 2013

Federal Government To Run Insurance Marketplaces In Half The States

By Phil Galewitz and Alvin Tran
Kaiser Health News
Originally published February 15, 2013

It's official. The Obama administration will be running new health insurance marketplaces in 26 states— including the major population centers of Texas, Florida and Pennsylvania.

The federal government had hoped more states this week would agree to form a partnership exchange—the deadline to apply was Friday—but the offer was largely rebuffed. New Jersey, Ohio and Florida, several of the biggest states that had not declared their intentions, officially said no late in the week.

"I have determined that federal operation of the Exchange is the responsible choice for our state," New Jersey Gov. Chris Christie, a Republican, wrote in letter Friday to Kathleen Sebelius, secretary of the Department of Health and Human Services.

For consumers, it should make little difference whether the new Internet sites are run from state capitals or Washington, D.C. But federal regulators hoped states would shoulder some of the work and stakeholder groups such as hospitals and insurers wanted states to help as well. The exchanges will open for business Oct. 1.

The entire story is here.

Editorial Note: Since Kaiser Health News reported this information, Florida Gov. Rick Scott now accepted the federal government's assistance to set up the health exchange for Florida.

Tuesday, February 19, 2013

Impending rules will guide equality for mental health

By Kelly Kennedy
USA Today
Originally published February 6, 2013

Regulations to be issued this month on the type of mental health coverage insurers must provide under the 2010 health care law may elevate mental illness to the status it needs, mental health experts say.

"Mental health solutions aren't likely to have an impact on this kind of violence," said Jennifer Mathis, deputy legal director of the Bazelon Center for Mental Health Law. "But we have a broken mental health system, and this is an opportunity to rectify that. You take your opportunities where they are."

Since the shooting of 26 people at Sandy Hook Elementary School in Newtown, Conn., President Obama has signed several executive actions designed to identify and help those with mental illness.
He has called for a discussion about mental health and has vowed to issue final rules this month that extend mental health parity to everyone who has health insurance under the health care law, also known as the Affordable Care Act.

Those regulations would go into effect in January, and though the specifics of those rules are unknown, advocates have clear ideas of what they'd like to see parity look like.

"In a broad-speaking way, we want to see parity be about what outcomes are, not specific tit-for-tat," said Debbie Plotnick, senior director of state policy at Mental Health America, a non-profit group that promotes mental wellness.

The entire story is here.

Monday, December 5, 2011

Pa. proceeds with creating state-run health insurance exchange


By Don Sapatkin and Marie McCullough
Philadelphia Inquirer Staff Writers

After months of study, the Corbett administration said Tuesday that it was moving forward with a key - and widely supported - option offered by the federal health-care overhaul: a state-run insurance exchange.

Exchanges have gained neither the high-profile status nor the derision aimed at other parts of President Obama's program. But they are expected to transform the arduous process of buying health insurance for millions of people who get coverage individually or are covered by small businesses.

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"While the governor believes that the law requiring the purchase of health insurance is unconstitutional, we must be prepared if the Supreme Court does not strike down the law," said Rosanne Placey, state Insurance Department spokeswoman. Plus, she said, "the governor recognizes that doing nothing would result in a federally run exchange, which is not the best option for Pennsylvania."

Read the entire story here.