Health Care Issues
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Senator Kirsten Gillibrand: Paid Family Leave Insurance in Watertown, NY. (Video from Jan. 24, 2014)
Health Care: Opiod Addiction
Updated February 17, 2018
- Marketplaces Prove Stable Despite Trump’s Attempts to Sabotage Enrollment - Ahead of this year’s health insurance marketplace open enrollment, a variety of analysts had projected marketplace enrollment would decline due to a much shorter open enrollment period; less outreach and advertising aimed at potential enrollees; and political wrangling over repeal of the Affordable Care Act (ACA). A total 11.8 million people signed up for 2018 individual coverage in the ACA marketplaces, fewer than the 2017’s 12.2 million or 2016’s high of 12.7 million. This 4 percent drop in enrollment, however, was not nearly as steep as some had predicted. In fact, the marketplaces appear remarkably stable despite challenges this year. If the Trump administration had not attempted to sabotage the individual market in all states over the past year, 2018 enrollment could have even exceeded last year’s.
- U.S. health care costs up 29% because of obesity - "We have, for the first time, estimated the percentage of health care spending that is devoted to obesity, using microdata for each state," the research's co-author John Cawley told Science Daily. Cawley said that the study found states including New York, California, Arizona and Pennsylvania devoted 5% to 6% of their total medical budget to obesity-related treatments. But other states, like North Carolina, Ohio and Wisconsin, spent more than twice that amount — over 12% of all their health care dollars went toward taking care of people with complications from obesity. Across the country, the study found that medical expenditures — including those paid through private health insurance, Medicare and Medicaid — focused on obesity-related procedures and therapies for adults rose from just over 6% in 2001 to nearly 85 in 2015 — a 29% increase.
- A record number of states see well-being worsen - Despite a booming economy, 21 states saw declines in well-being in 2017, the annual Gallup-Sharecare Well-Being Index found. Fifteen saw declines in 2009 during the Great Recession, the study authors say. Despite the declines in social, emotional and psychological health, researchers saw gains in physical health. Obesity and diabetes figures declined. The percentage of people who exercised for 30 or more minutes for three or more days in the last week hit a record high, while the percentage of people who smoked hit a record low.
- Amazon's Health Care Experiment Shows Exactly Why We Need Medicare for All - In the United States, we rely on private, for-profit insurance companies to finance our health care system. Over 157 million Americans are getting their coverage from employer based plans. Another 21.9 million have purchased insurance individually. The high costs of health care, fueled by the profit motivation in the private insurance system, can be directly linked to the decreased take-home pay for workers; businesses not having capital to expand to new markets, create new jobs, or invest in new technologies; and medical bills as the number one cause of bankruptcy in the United States. While some companies have the resources to do what Berkshire Hathaway, Amazon and JPMorgan Chase are doing, most don’t.
- This is the U.S. county that buys the least healthful groceries - There’s a debate among economists and public health advocates over why communities like Musselshell tend to eat so poorly. For years, advocates have argued that it’s largely a problem of access: Consumers eat junk because they can’t afford healthful foods or find them in their communities. Now, an emerging body of research suggests that some groups of consumers may simply be less interested than others in buying healthful groceries. According to a new working paper from the National Bureau of Economic Research, those groups include consumers who make less money, have less education, possess lower levels of nutrition knowledge and live in certain geographic areas — such as south central Montana.
- Why Desperate Families Are Getting Religion on Health Coverage - Health care sharing ministries have become a more entrenched part of the health care system than anyone could have possibly imagined eight years ago, when they were quietly exempted from Obamacare’s individual mandate penalty. The plans were an afterthought at the time, with only about 150,000 individuals enrolled in the faith-based plans. The exemption was included by Senate Democrats as a seemingly innocuous way to insulate the bill from attacks by Christian conservatives.
- Cuomo announces funding for breast cancer services - As part of the “Get Screened, No Excuses” initiative to improve access to breast cancer screening for New Yorkers, funds are being used to support peer educators in community settings, make patient navigators available to help women with screenings and follow-up care and operate mobile mammography vans in underserved neighborhoods. The statewide programs are intended to reduce barriers to breast cancer screening for women, including those who lack access to preventive health care because they are economically disadvantaged, live in underserved inner cities or live in remote rural areas.
- Doctors Refuse to Treat Trans Patients More Often Than You Think - New federal regulations are intended to help doctors refuse service based on religious or moral grounds. For trans patients, they may make a bad situation much worse. "There's a difference between [not] being willing to provide a service and [not] being willing to provide a service to a certain person," said Mark Wicclair, bioethicist and author of the 2011 book Conscientious Objection in Health Care: An Ethical Analysis. But the recently proposed HHS regulations don’t distinguish between the two, opening the door to provider discrimination against patients on the basis of a variety of classes not protected by federal law, including gender identity and sexual orientation. And because the regulations allow for federal law to trump state laws, the resolution of conflicts between federal and state laws would fall to the courts, potentially threatening state laws that protect sexual minorities from discrimination.
- Unnecessary Medical Care Is More Common Than You Think - A study in Washington state found that in a single year more than 600,000 patients underwent treatment they didn’t need, at an estimated cost of $282 million. “Do no harm” should include the cost of care, too, the report author says. It’s one of the intractable financial boondoggles of the U.S. health care system: Lots and lots of patients get lots and lots of tests and procedures that they don’t need. The group scoured the insurance claims from 1.3 million patients in Washington state who received one of 47 tests or services that medical experts have flagged as overused or unnecessary. What they found should cause both doctors and their patients to rethink that next referral.
- How a Medical Catastrophe Can Bankrupt a Life - I am not one of the 28 million Americans who are completely uninsured, or one of the 45,000 people who die every year for lack of coverage. I am not one of the 3/4 of U.S. citizens who don’t have access to paid sick leave, and I don’t live in one of the 45 states without short-term disability plans. I’m not one of the 30 percent of insured consumers who are slapped with hefty surprise bills after a hospital visit. Which is why I did not become one of the millions of people who default on their medical debt every year, regularly making healthcare bills the leading cause of bankruptcy in this country.
- Amazon, Berkshire Hathaway, JP Morgan wade into health care together - Amazon is diving into health care, teaming up with Warren Buffett’s Berkshire Hathaway and the New York bank JPMorgan Chase, to create a company that helps their U.S. employees find quality care “at a reasonable cost.” The new company will be independent and “free from profit-making incentives and constraints.” The businesses said the new venture’s initial focus would be on technology that provides “simplified, high-quality and transparent” care.
- Koch Groups Move On From Health-Care Fight - Network of pro-GOP donors shifts focus to tax law, protecting Republicans in midterm elections. The billionaire Koch brothers’ political organization spent more than $200 million in the past decade on what official Tim Phillips calls “without question our biggest policy defeat,” the quest to kill the Affordable Care Act. Now, the network of donors is turning its attention to protecting Republican majorities in both chambers of Congress this fall.
- Cuomo order allows pharmacists to give flu shots to children - Pharmacists will be able to administer flu vaccines to children ages 2 to 18 under an executive order signed Thursday by Gov. Andrew M. Cuomo. The order, effective immediately, suspends the section of state education law that limits the authority of pharmacists to administer immunizing agents to anyone under age 18. Public health officials encouraged parents to call pharmacies to schedule a visit.
- Utopic Wellness Communities Are A Multibillion-Dollar Real Estate Trend - Developers increasingly invest in neighborhoods dedicated to holistic health and wellness–and the growing industry is worth $134 billion worldwide. Wellness communities like Serenbe increasingly attract homeowners looking for a refuge from modern life. In North America alone, the market is worth $52.5 billion and is growing by 6.4% annually, according to a new report by the Global Wellness Institute titled Build Well to Live Well: Wellness Lifestyle Real Estate and Communities. Wellness real estate was a $134 billion worldwide industry in 2017, and is expected to grow to $180 billion in 2022.
- Discrimination Prevents LGBTQ People from Accessing Health Care - New data from a nationally representative CAP survey conducted in 2017 underscore the importance of protecting LGBTQ people from discrimination in health care. For example:
- 29 percent of transgender people said that a doctor or health care provider refused to see them because of their gender identity in the past year.
- 22 percent of transgender people reported avoiding or postponing needed medical care due to disrespect or discrimination by staff in the past year.
- 41 percent of LGBTQ people in small towns and rural areas would find it “very difficult” or “not possible” to find alternative services if a hospital refused to serve them.
- The American Health-Care System Increases Income Inequality - Even with the Affordable Care Act, the premium and payment structure of insurance increases the relative income gap between rich and poor. The researchers didn’t split the survey population up based on insurance status; they instead measured income inequality across the population, both before medical expenses were taken into account and after. They found that income inequality in 2014 actually increased by 1.5 points after medical expenses were subtracted from income. Put another way, poor people spent much more of their income on health care than the richest people did, and as a result around 1.5 percent of all relative income shifted toward the higher earners.
- Increasing interest in telehealth - For people in rural areas, getting to the doctor's office can be a challenge. So the state is working on another option: telehealth, which uses technology to let doctors work with patients remotely. Mary Zelazny, CEO of Finger Lakes Community Health and co-Chair of the NYS Department of Health’s Telehealth Work Group, tells us how it all works.
- Hispanics forgo health services to avoid officials’ attention, advocates say - Hispanic immigrants are not only declining to sign up for health insurance under programs that began or expanded under Barack Obama’s presidency — they’re also not seeking treatment when they’re sick, Daniel Bouton, a director at the Community Council, a nonprofit organization in Dallas that specializes in health-care enrollment for low-income families, and others say. “One social worker said she had a client who was forgoing chemotherapy because she had a child that was not here legally,” said Oscar Gomez, chief executive of Health Outreach Partner, a national training and advocacy organization.
- Fed Up With Drug Companies, Hospitals Decide to Start Their Own - A group of large hospital systems plans to create a nonprofit generic drug company to battle shortages and high prices. Several major hospital systems, including Ascension, a Catholic system that is the nation’s largest nonprofit hospital group, plan to form a new nonprofit company, that will provide a number of generic drugs to the hospitals. The Department of Veterans Affairs is also expressing interest in participating. In all, about 300 hospitals are now included in the group. Other hospitals are expected to join.
- In states that didn’t expand Medicaid, hospital closures have spiked - Nonexpansion states have suffered a significant increase in hospital closures. States that expanded benefits, on the other hand, saw their rate of closures decline. The study, published in Health Affairs, is the first to clearly document the extent of that divergence across the country. Using nearly a decade’s worth of data, researchers found that hospitals in Medicaid expansion states were 84 percent less likely to shutter than facilities in nonexpansion states. Rural hospitals were particularly vulnerable to closure, but kept their doors open in places that extended coverage to more patients, the study found.
- Modeling the Impact of a Single-Payer System in New York State - The intent of the NYH is to provide no-cost coverage to every New Yorker with no out-of-pocket costs and no network restrictions. In 2017, NYSHealth awarded the RAND Corporation a grant to conduct an objective, independent, and rigorous economic analysis of the NYH. Under this grant, RAND will estimate the economic impact for various stakeholders from implementing the NYH, relative to the current system. The analysis will address a range of issues, including how a single-payer system will affect the utilization of health care services; whether administrative and drug and device costs will change; how much taxes will need to increase; any net savings or costs for employers and New Yorkers of different income levels; and the net costs to federal, State, and local governments. A final report summarizing the results and methodology will be published and briefing events will be convened in Albany and New York City for policymakers and other stakeholders.
- Trump administration fires all members of HIV/AIDS advisory council - Months after a half-dozen members resigned in protest of the Trump administration's position on health policies, the White House dismissed the rest through a form letter. The council, known by the acronym PACHA, has advised the White House on HIV/AIDS policies since its founding in 1995. Members, who are not paid, offer recommendations on the National HIV/AIDS Strategy, a five-year plan responding to the epidemic.
- Poll: Nearly one-third of Americans think Trump repealed ObamaCare - More Republicans, 44 percent, believe Trump has repealed ObamaCare, compared to the 27 percent of Democrats and 27 percent of independents who believe he has eliminated President Obama’s signature health-care law. Nearly 40 percent of Republicans surveyed believe Trump hasn’t repealed ObamaCare, compared to 60 percent of Democrats and 45 percent of independents.
- How Big Tech Is Going After Your Health Care - Apple, Google, Microsoft and other tech giants have transformed the way billions of us communicate, shop, socialize and work. Now, as consumers, medical centers and insurers increasingly embrace health-tracking apps, tech companies want a bigger share of the more than $3 trillion spent annually on health care in the United States, too. The Apple Heart Study reflects that intensified effort.
- Republicans knock holes in Affordable Care Act but don’t demolish the law - Public support for the perennially controversial law has inched up to around its highest point in a half-dozen years. Nearly 9 million people so far have signed up for ACA health plans for 2018 during a foreshortened enrollment season, far surpassing expectations. This dual reality puts the sprawling ACA — prized domestic legacy of the Obama era, whipping post of the Trump administration — at a new precipice, with its long-term fate hinging on the November midterm elections certain to consume Washington once the new year begins. If Democrats win a majority in either chamber of Congress, the law would be protected; a GOP sweep could further embolden repeal attempts.
- New law mandates four year degree for RNs - New York has become the first state to require registered nurses to have a bachelor's degree. Studies have linked more highly educated nurses to improved care and better outcomes for patients. “People have fewer pressure ulcers, they have less urinary tract infections,” Iafrati said. The new law gives registered nurses ten years from the time they obtain their original license to earn a bachelor's or higher academic degree. All current RNS, and those who are enrolled in an associate's degree program or on a wait list to enter a program, are grandfathered in under the new law and will not be required to get a higher degree.
- Double losses for the Affordable Care Act further complicate its future - The measures, pledged to a crucial Republican moderate in exchange for her support on Congress’s massive tax overhaul, would have temporarily restored an ACA subsidy to health insurers that Trump ended this fall and would have given states several billion dollars to help buffer insurance companies from customers with especially high medical costs. Sen. Susan Collins (R-Maine) took Majority Leader Mitch McConnell (Ky.) off the hook in the end, saying she would be satisfied if he brought up the two bills early next year — though it is unclear they will ever surmount a wall of opposition from House conservatives.
- Obamacare signups soar in New York as Trump, GOP aim to end the program - State health officials said Wednesday that as of Dec. 15, 4.18 million people had used New York’s Obamacare exchange to sign up for health insurance, a new high for the program and 700,000 more than last year’s figure. Open enrollment continues through January, but Dec. 15 was the deadline to obtain coverage that begins New Year’s Day. “There is still an appetite for this type of coverage and apparently a growing appetite,” said Bill Hammond, director of health policy for the Empire Center.
- Healthcare Insecurities Keep Workers Locked in Jobs - Last year, 180 million Americans got their healthcare from their jobs. While this may seem like a great employment perk, millions don't seek new opportunities because they're afraid to go without benefits. Today we have an insurance system split largely in two — about 1 on 4 Americans receive either Medicare or Medicaid, while more than half get their care through their jobs.
- In Election Year, Drug Industry Spent Big To Temper Talk About High Drug Prices - It was the biggest surge for the Pharmaceutical Research and Manufacturers of America, known as PhRMA, since the group took battle stations to advance its interests in 2009 during the run-up to the Affordable Care Act. The group, already one of the most powerful trade organizations in any industry, collected $271 million in member dues and other income in 2016. That was up from $220 million the year before, according to its latest disclosure with the Internal Revenue Service.
- Addressing challenges faced by rural hospitals - The Rural Health Council has been around for nearly three decades, but it got a new committment from the state this year with the passage of a bill to make it permanent. The council is made up of health care providers, and will be required to issue biennial reports to the governor and legislature, and work with the Regional Economic Development Councils. And the bill's sponsors say this means more opportunities to address the challenges faced by doctors and hospitals in rural areas. Gary Fitzgerald, President of the Iroquois Healthcare Alliance, joins us to talk more about this.
- When Buying Prescription Drugs, Some Pay More With Insurance Than Without It - In an era when drug prices have ignited public outrage and insurers are requiring consumers to shoulder more of the costs, people are shocked to discover they can sometimes get better deals than their own insurers. Behind the seemingly simple act of buying a bottle of pills, a host of players — drug companies, pharmacies, insurers and pharmacy benefit managers — are taking a cut of the profits, even as consumers are left to fend for themselves, critics say.
- America's healthiest and least healthy states - Massachusetts, Hawaii, Vermont, Utah and Connecticut rank as the five healthiest states, while West Virginia, Alabama, Arkansas, Louisiana and Mississippi rank the least healthy in America's Health Rankings, according to the report by the United Health Foundation. The rankings take into account a variety of health factors, such as rates of infectious diseases, obesity, physical inactivity, smoking and infant mortality, as well as air pollution levels and the availability of health care providers. New York is the 10th healthiest state in the nation, just behind Washington and ahead of Rhode Island.
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