tag:blogger.com,1999:blog-2047195573424044176.comments2023-10-30T04:42:55.912-07:00JRG Health & Human Services Policy UpdateJohn R. Grahamhttp://www.blogger.com/profile/09420909459359064358noreply@blogger.comBlogger103125tag:blogger.com,1999:blog-2047195573424044176.post-14730340636302511532016-10-18T08:28:47.253-07:002016-10-18T08:28:47.253-07:00Thank you. I don't know a conference, but a bi...Thank you. I don't know a conference, but a bill: The 21st Century Cures Act which would address the problem you mention. It has passed the House, is hung up in the Senate, and may be revisited in the lame-duck session.John R. Grahamhttps://www.blogger.com/profile/09420909459359064358noreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-56084553690051092052016-10-17T15:29:21.271-07:002016-10-17T15:29:21.271-07:00John--
This is an important subject, and should b...John--<br /><br />This is an important subject, and should be repeated about quarterly. The FDA is chronically behind the whole context of healthcare. Isn't there an industry conference to propose substantial changes to the way the FDA conducts its review processes. Of particular interest to me as the rare diseases for which there are too few patients to provide a full control set, and where the treatment is often genetic or related to stem cells or other tissue-based approach. Not a typical chemistry-based drug. Do you know where that is?<br /><br />Cheers...<br /><br />Wanda J. Jones<br />San Franciscowanda j. jonesnoreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-25613222806308777512016-06-30T14:51:35.381-07:002016-06-30T14:51:35.381-07:00John:
This is an important topic. So important t...John:<br /><br />This is an important topic. So important that the topic desires to be a full report/book from your organization. One that can be sent to every elected official and every executive of advocacy groups. Single payer is such a shibboleth that people jump to it without a speck of understanding that it won't work.<br /><br />Offer to analyze any proposed plan and give it a number on a scale of debility. Publicize the list of plans and sponsors with their rankings by relative stupidity. Oops, realism.<br /><br />Wanda J. Jones<br />San Franciscowandawanda J. JoneWnoreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-4575218797477336172016-03-31T08:03:42.066-07:002016-03-31T08:03:42.066-07:00And for ALL of those people covered under the ACA ...And for ALL of those people covered under the ACA our rates have gone up from 20% to 500% per year EACH YEAR so was the whole mess worth it to change ALL of healthcare simply for the few who had previous conditions and were excluded rather then simply requiring the InsCos to remove that clause. There is no way to increase coverage lower deductibles require more services being paid for free and support areas previous never covered AND expect premiums to drop<br />It was a fool's errand to thin it could be done and only a lawyer would come up that type of mathematics. Anyone who Accounting 101 knows if you raise coverage and lower copays and require companies to insure people who were costing them the most to begin with that there was also NO way to lower premiums. So Medicare they could care less Welfare they could care less individuals are now wiped out but don't really affect the voting position so no DC are in the focus sights and employed members are effected but more by the fact that they no longer have full time jobs because the boss won't pay the higher premiums so they lay folks off or flip them to part time<br />Once again the smallest group in the nation trying to financially support the entire rest of the nation and in this case it fell apart. I have patients that were paying $250 per month for single coverage that now are up to $1300 and expecting to increase in Jan 2017 by another 35%<br />NICE JOB ACA!!!! Dr DAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-81180496375316907812016-02-18T06:25:48.750-08:002016-02-18T06:25:48.750-08:00Forbes has a recent story that states the tax cred...<br />Forbes has a recent story that states the tax credit would be "$3,000 for those 50 through 54" ... leaving those over 55 wondering about us.<br /><br />http://www.forbes.com/sites/theapothecary/2016/02/17/believe-it-or-not-the-republican-obamacare-replacement-plan-might-come-together/#13fba1374f89Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-37322955262680255002015-05-19T19:51:15.388-07:002015-05-19T19:51:15.388-07:00The largest consumer between the patient and the p...The largest consumer between the patient and the physician is the health-insurance industry. Today they are creating the barriers which cut off pathways for lower income families to receive health care. Aetna CEO salary went from $13,000,000 to $30,000,000!<br /><br />Almost all of the publicly traded health insurers reported big increases in revenue and profits last year. The big winners have been the top executives of those companies, led by Mark Bertolini, CEO of Aetna, the nation’s third largest health insurer. Bertolini’s total compensation of $30.7 million in 2013 was 131 percent higher than in 2012. Source-http://www.publicintegrity.org/2014/06/09/14912/skyrocketing-salaries-health-insurance-ceosDavishttps://www.blogger.com/profile/08288698696060272925noreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-28506729923405603972015-05-07T15:29:44.880-07:002015-05-07T15:29:44.880-07:00John, behold the electronic cartel. Correct me if ...John, behold the electronic cartel. Correct me if i'm wrong here, it seems to me that healthcare organizations use the EMR as a means of market capture, holding on to a "book of business" which the patients inside those systems represent.<br /><br />Having designed and deployed such systems, I've heard all the hype about how these systems will improve are, which may be the case, still the temptation to use them to control markets is too tempting to be dismissed.Unknownhttps://www.blogger.com/profile/13975369917993005535noreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-79736578051301056732014-09-13T22:59:17.573-07:002014-09-13T22:59:17.573-07:00This is really a good commentary and the choice of...This is really a good commentary and the choice of a Unicorn as a symbol is very helpful.<br /><br />The wishful thinking of those involved in funding healthcare IT is in many ways having a totally counterproductive effect.<br /><br />We need to find the most compelling business needs for interoperability and then "pull the funding levers" We will be surprised at just how quickly all those "intractable" problems then get solved.<br /><br />Very little progress has been made, certainly not $26 billion worth.Tom Bowdenhttp://www.healthlink.netnoreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-87747318761159144712013-09-27T07:04:38.644-07:002013-09-27T07:04:38.644-07:00All health care decision making is transferred to ...All health care decision making is transferred to bureaucrats. No doctor will understand Obama Care let alone over 25,000 pages of regulations. Health care will be destroyed. Patients will be wards of the state and doctors slaves of the state. The 13th amendment says that nobody will ever be subject to involuntary servitude. Tyranny is nothing less than unbridled power. Dr. Allen Unruhnoreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-74096945597344476622013-09-27T07:02:23.823-07:002013-09-27T07:02:23.823-07:00What doctors get paid does not account for cost of...What doctors get paid does not account for cost of living increases. But the cost of increased regulation of care and paperwork to justify all services for bureaucrats will destroy the quality of care. Obama Care allows our first black president to re-enact slavery. The IRS who pleads the 5th and is unaccountable to anybody is in charge. Tyranny is unbridled power. AllenDUnruhhttps://www.blogger.com/profile/17028475983578086194noreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-61790599671420730902012-05-18T14:38:55.032-07:002012-05-18T14:38:55.032-07:00Thanks for your comments. My opinion - not legal, ...Thanks for your comments. My opinion - not legal, but economic - is that health insurance is not interstate commerce and the Supreme Court's decision in U.S. vs. South-Eastern Underwriters' Assocation was wrong.<br /><br />Health insurance is not "commerce." It is a contract to pay. Physicians and hosptials are largely not engaged in interstate commerce because once a person shows up in your office or hospital they are in your state. Telemedicine is a different issue.<br /><br />Medical devices and drugs are interstate commerce, obviously.<br /><br />But insurance is a contract to pay, not commerce as such.<br /><br />State mandates have not interfered with CIGNA's or AETNA's or WellPoint's or UnitedHealth Group's ability to offer individual and small-group policies in different states.<br /><br />As always, I go back to my original example: The pages of federal law governing life insurance or auto insurance amount to zero, and there is no barrier to auto insurers offering policies in every state, although automobiles themselves are clearly interstate commerce.John R. Grahamhttps://www.blogger.com/profile/09420909459359064358noreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-92207161365298926742012-05-18T13:51:22.519-07:002012-05-18T13:51:22.519-07:00Just listened to the podcast - agree individual-ow...Just listened to the podcast - agree individual-owned policies are key consumer change. I also like the concept of specialty insurers for individuals with chronic conditions (reminds me of predictions back in the 80’s that DRG’s would lead to emergence of specialty hospitals.) <br /><br />As much as I agree with your thinking, I still believe “cross-state” buying of insurance is an idea whose time has come. <br /><br />Yes, the much larger, underlying problem is the cost of medical care; yes, the idea of cross-state purchase of insurance does nothing about this underlying cost; and yes, provider reimbursements that an insurer has negotiated in one state wouldn’t apply in another state. <br /><br />However, it’s also true that current law distorts the insurance markets. States can set their own, independent benefit mandates and states can prohibiting their citizens from buying policies that have fewer mandates and are therefore less expensive; that is, they are prohibited from buying “across state lines.” As a result, some people are obliged to pay more than they need to pay for the insurance they want. <br /><br />The federal government recently argued before the Supreme Court that insurance is interstate business governed by the Commerce Clause. In fact the Supreme Court reached this very same position in the 1940’s. Why then can the states continue to prohibit their residents from purchasing an insurance policy that has been approved for issue in another state? State prohibitions clearly interfere with the interstate business of insurance. Isn’t it time to modify or repeal McCarran-Ferguson?<br /><br />You and I can buy thousands of products - even fertilizer – from vendors in states where we don’t live. Why not insurance? <br /><br />Clearly, it would be far simpler if the states allowed individuals a few simple choices: for example, a policy with all its mandates, or with none. Yeah, that’s gonna happen.<br /><br />Just to be clear, I don't envision this would reduce the cost of medical care by a nickel. But it could, I think, reduce the cost of insurance for many people - and that's why it's worth thinking about.Mike Feehanhttps://www.blogger.com/profile/01537401865554457522noreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-61796881720164794372012-05-16T20:26:17.417-07:002012-05-16T20:26:17.417-07:00John, you make good points regarding the ineffecti...John, you make good points regarding the ineffectiveness of the Georgia law. I certainly agree that this is not THE answer to healthcare reform.<br /><br />At the same time, as someone involved in the healthcare financing business for 40 years, I can tell you that the notion of allowing carriers to do business in all states without compliance with the mandates from each state is certainly part of the solution.<br /><br />I say that with the belief that any government dictates (mandates) be they federal, state or local regarding the types of benefits that must be offered is counterproductive to effective healthcare reform, and are breeding grounds for corruption and crony capitalism.<br /><br />This type of legislation is not going to useful if it is done on a state to state basis. It is too "hit and miss" and therefore not surprising that the Georgia law had failed to created a lot of enthusiasm.<br /><br />You are right that costs vary from state to state for many reasons other than the mandates. That is why the reform must be initiated comprehensively at the federal level.FTimminsnoreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-84005043038981145062012-04-18T05:33:44.451-07:002012-04-18T05:33:44.451-07:00Hey John,that's really nice! Everybody should ...Hey John,that's really nice! Everybody should be aware that it's important to keep a track of their health issues. Nobody can deny the benefits of health insurance but it does mean that you neglecting your <a href="http://www.fitnessrepublic.com" rel="nofollow"> health and fitness </a> problems.Fitness Routineshttp://www.fitnessrepublic.comnoreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-1361535510786658122011-12-15T12:51:40.673-08:002011-12-15T12:51:40.673-08:00Sadly, TN just became the lucky 13th state to adop...Sadly, TN just became the lucky 13th state to adopt oneralphhttp://www.medibid.comnoreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-3923975483505276752011-10-21T22:20:22.552-07:002011-10-21T22:20:22.552-07:00In fairness, in the 696-page document, the actual ...In fairness, in the 696-page document, the actual new rules don't begin until page 623. The first 622 pages are the <i>explanation</i> of how they came up with the new rules.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-26811072303574316022011-10-21T14:26:40.689-07:002011-10-21T14:26:40.689-07:00NOt at all: What I'm stating is that it should...NOt at all: What I'm stating is that it should not take almost a thousand new pages of rules to revoke obsolete rules!<br /><br />Thanks for taking the time to comment.John R. Grahamhttps://www.blogger.com/profile/09420909459359064358noreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-21473286845970890312011-10-21T06:08:29.129-07:002011-10-21T06:08:29.129-07:00so you are saying that all those changes designed ...so you are saying that all those changes designed to make it easier for hospitals to run their own affairs are wrong?HSNYhttps://www.blogger.com/profile/05021000254288159704noreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-52574761960881010022011-10-07T15:40:31.108-07:002011-10-07T15:40:31.108-07:00This is a good common sense Blog. Very helpful to ...This is a good common sense Blog. Very helpful to one who is just finding the resources about this part.It will certainly help educate me.Argan Oilhttp://www.puradoroil.comnoreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-43256651079568949672011-08-31T22:21:45.645-07:002011-08-31T22:21:45.645-07:00given that Windsor is a pretty well to do city, it...given that Windsor is a pretty well to do city, it's shocking they've used Detroit as a safety valve for SO many things - from emergencies to majorly complex disorders. <br /><br />On both sides of the border, health care needs to be reformed!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-68522681745782127512011-07-20T10:11:24.072-07:002011-07-20T10:11:24.072-07:00I hear you, but I think I've been too tough on...I hear you, but I think I've been too tough on the carriers. That is, I think they'll be able to pivot when the time to repeal and replace comes.<br /><br />If their investments in Health Benefits Exchanges mean that they are more prepared for the individual market to be the market of first resort, rather than a residual market, they may weaken their resistance to tax reform that gives individuals, not employers, the tax benefit for owning health insurance.<br /><br />I'm just an optimist by nature.John R. Grahamhttps://www.blogger.com/profile/09420909459359064358noreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-16952545420596136582011-07-20T07:26:22.803-07:002011-07-20T07:26:22.803-07:00John, no doubt UHC is keeping quiet about its lobb...John, no doubt UHC is keeping quiet about its lobbying efforts "post" PPACA, probably because it hopes there to not be a "post" PPACA.<br /><br />I'm not sure about Wall Street in general but you can be sure That UHC is not addressing a world without PPACA because they have so much invested in it already. Besides, whatever replaces PPACA is sure to be less profitable for the BUCAs.Frank Timminsnoreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-38552185204166723072011-07-01T18:52:30.363-07:002011-07-01T18:52:30.363-07:00John, thank you for this post.
Don't forget...John, thank you for this post. <br /><br />Don't forget that PPACA requires the federal government to step in with a federal solution for those states who are not ready. HHS decision time on which states will be ready is supposed to be before year-end 2012. <br /><br />A "failure to launch" state-based exchanges in a timely fashion, given the significant taxpayer subsidies they promise, is probably not an option for the Obama Administration - just as failure to deliver Medicare Part D Rx in a timely fashion to 44MM Medicare beneficiaries was not an option for Leavitt and others in the Bush Administration. <br /><br />Jack TowarnickyJack Towarnickyhttps://www.blogger.com/profile/08875925574586454646noreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-54794727036035118862011-06-27T02:08:27.231-07:002011-06-27T02:08:27.231-07:00it would be a great Health care resolution for Ame...it would be a great Health care resolution for America.health screening in singaporehttp://www.asiahealthpartners.com/noreply@blogger.comtag:blogger.com,1999:blog-2047195573424044176.post-16936327930429821562011-06-23T12:13:19.649-07:002011-06-23T12:13:19.649-07:00John, the "Clinton" model for cleaning u...John, the "Clinton" model for cleaning up Medicaid would certainly be an improvement. I assume Coburn's "capped allotment" puts a ceiling on the Fed's contribution to the obligations of the states. It is a step in the right direction.<br /><br />I would hope at some point a voucher program directly to the recipient would be the ultimate answer. In fact, IMO, a tax credit/voucher program should not only replace Medicaid, but Medicare and healthcare reform for the rest of the population as well.ftimminsnoreply@blogger.com