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The Oklahoma House is poised to pass a cap on non economic damages. The cap would be $250,000. There would be no cap in wrongful death cases or for economic damages. The cap could also be lifted for intentional torts and for gross malpractice. Top
The day after he stated he would allow states not to put in the individual tax mandate, Obama offered states ways to fix their Medicaid problems. He stated that they should negotiate with CMS. He wants people in their own homes and not in nursing homes. Medicaid is the number one problem for Obamacare as it allows many more people to qualify and does not give enough money to the states to care for the people.
The States have already begun to cut Medicaid enrollments. The governors were wary of Obama's offering since it would require a waiver and there have been problems in the past getting such waivers.
The law that all want repealed, the removal of giving 1099 forms to all with over $600 in income, is being contested by Democrats who do not like how the Republicans want to pay for the bill. The Republicans want people who have a rising income over the year and who would not be eligible for subsidies provided by Obamacare in 2014 to pay back tax breaks. The Democrats want to classify this as a tax increase but the CBO classifies it as a spending cut.
One of the major reasons for the high price of healthcare is the federal and state mandates placed on insurance carriers. Texas now wants CT scans for men between the ages of 45 to 75 and women between 55 to 75 to assess coronary artery calcium scores. This would cost about $200 per person every five years. It would then add more to work up those with abnormal or borderline scores where it is not necessary. About 2.4 million Texans would qualify for the tests. No major organization has endorsed such a screening. The only one is SHAPE who represents specialists in cardiovascular medicine and imaging, a small conflict.
Another reason is Pharma. For years pharmacists have compounded a medication given by injection once a week to prevent premature infants. It cost between $20 and $30 per injection. Now the FDA has approved a medication that does the same thing. This costs $1500 per injection. The manufacturer said they would help with some of the cost.
Forty-two US Senators have asked Obama to withdraw Dr. Berwick's name from consideration for head of CMS. He has been in that position since a out of session appointment a year ago when Obama knew Berwick may not be appointed. He now will also not be appointed. He will serve until the end of 2011 unless he resigns first.
To date, there have been over 1000 waivers given to the organizations for a one year exemption from the annual coverage limits of 85% going to medical care.
Maine is the first state to get a waiver of the above provision. Maine gets to keep its current 65% standard for three years. Kentucky, Nevada and New Hampshire have also asked HHS for the same waiver. The problem in Maine is it has only three major insurers and one of them that has 37% of the insured population has stated it will pull out of the state if the national rules are applied. This may destabilize the Maine medical insurance market.
Obama has issued rules that all states may avoid all the federal health care mandates starting in 2017 as long as they match the laws consumer protections and expansion of insurance coverage. This was the individual mandate that was declared unconstitutional by a federal judge could be overlooked. Remember that 2017 is three years after the exchanges and the dreaded expansion of Medicaid kick in.
Sebelius has resorted to stretching the truth to scare Congress from delaying funding of Obamacare. She states incorrectly that this would stop the payments to Medicare Choice plans. The independent CBO refuted Sebelius. She was sent a letter chastising her for the false scare tactic.
The CBO also has stated that if Obamacare is defunded that the deficit will increase about $5.7 Billion over 10 years. That increase in the deficit one can life with. The over one TRILLION dollars that Obama has asked to raise the deficit is another story.
As part of Obamacare the new Board would recommend changes to Congress which would become law if the Congress did not act. England has a Board as well but it determines whether or not a drug gets to be used. They have not allowed Tarceva for lung cancer again. They allow it for the initial treatment of non-small cell lung cancer but would not let it be used for stable disease post chemotherapy.
Obama once stated that the healthcare debate would be open and transparent. That is another thing that was not so. The GOP has asked for details of the meetings between the administration and those groups that supported the bill such as the insurance companies and drug companies. The White House said sorry but they are confidential. Top
UC Irvine is back in the news and still not in a good way. This time it is their dialysis program. The state had a surprise inspection in November, 2010, and found multiple problems with the program that created immediate dangers to patients. They found rusted equipment, unsanitary conditions, failure to monitor patient's fluid, not washing hands prior to touching patients and equipment and no back up generator. The hospital has addressed these issues since but they have so many problems in general. Top
An outside reviewer hired by Blue Shield has found that the rates asked for by Blue Shield to be reasonable. Some may see almost 60% rate hikes in their individual premiums. California may have a different idea.
The Blue Shield policy holders may get a cumulative increase in premiums of up to 80%. This may be 900 people and another 45,000 will be hit with a 50% increase. The reasons are several including under pricing their policies in the past and now making up for it. Also they blame increased use of high price items by the policyholders and state and federal healthcare mandates.
The North Carolina Senate has passed a bill protecting ED physicians by switching from ordinary negligence to gross negligence, wanton conduct or intentional wrongdoing. They also put the non economic damages at $300,000 adjusted for inflation every three years. The state supreme court has tossed out the two prior bills as unconstitutional.
People are doing what they are told. Obamacare was against people having control of their own medical care so they inserted a rule that for medications to be covered under flexible spending accounts a prescription would be needed. People are now going to physicians (an appointment) and wanting prescriptions for over the counter drugs. Physicians are not complying and problems ensue. Top
The AMA has stated that Texas physicians are going into their own pockets to keep their practices afloat. Some 61% of physicians stated their income decreased in the preceding year. In 2010, 33% of the practices with cash flow problems cut employees and 23% either reduced or cut government payers. An additional 5% closed their practices. This bodes poorly for Medicaid and Medicare in the future. Top
DISCLAIMER: Although this
article is updated periodically, it reflects the author's point of view at the
time of publication. Nothing in this article constitutes legal advice. Readers
should consult with their own legal counsel before acting on any of the
information presented.