Showing posts with label Obamacare. Show all posts
Showing posts with label Obamacare. Show all posts
Friday, June 29, 2012
Supreme Court Ruling Generates Widespread Reaction During the DIA 2012 48th Annual Meeting
|
Tuesday, May 29, 2012
Should the States set up ObamaCare Exchanges? point-counter point by John Goodman & Linda Gorman
From The Health Care Blog
Under the Patient Protection and Affordable Care Act (PPACA), state governments are expected to set up health insurance exchanges through which individuals will buy their own health insurance, in many cases with substantial subsidies. Should the states comply?
In the following point-counterpoint discussion, Linda Gorman and I give opposing answers to this important question. Leave your thoughts in the comments.
John Goodman: Yes
If the states abdicate their responsibilities under PPACA, the federal government will step in and act in lieu of the state. Under this scenario, states will relinquish all power to make a bad law better. Letting the federal government implement reform almost guarantees bad outcomes.
Linda Gorman: No
Exchanges are required to perform a variety of duties beyond distributing ObamaCare subsidies, and these duties are likely to add significantly to estimated costs. Some of them will damage a state’s business climate by creating new opportunities for crony capitalism. Some require that currently fashionable, but poorly tested, models be forced on health care providers. Some require that state exchanges have expertise equal to private insurers. Others force states to increase the cost of health insurance for people who currently have coverage.
John Goodman continued:
The states should engage in preemptive reform over the next two years. This means enacting responsible, rational reforms — the kind of reforms that they should have enacted all along, in the absence of federal legislation. Where possible, states should try to make their reforms compatible with the new federal law — but only if compatibility does not sacrifice the major goals of the state’s reform.
There are four arguments in favor of preemptive action at the state level:
Under the Patient Protection and Affordable Care Act (PPACA), state governments are expected to set up health insurance exchanges through which individuals will buy their own health insurance, in many cases with substantial subsidies. Should the states comply?
In the following point-counterpoint discussion, Linda Gorman and I give opposing answers to this important question. Leave your thoughts in the comments.
John Goodman: Yes
If the states abdicate their responsibilities under PPACA, the federal government will step in and act in lieu of the state. Under this scenario, states will relinquish all power to make a bad law better. Letting the federal government implement reform almost guarantees bad outcomes.
Linda Gorman: No
Exchanges are required to perform a variety of duties beyond distributing ObamaCare subsidies, and these duties are likely to add significantly to estimated costs. Some of them will damage a state’s business climate by creating new opportunities for crony capitalism. Some require that currently fashionable, but poorly tested, models be forced on health care providers. Some require that state exchanges have expertise equal to private insurers. Others force states to increase the cost of health insurance for people who currently have coverage.
John Goodman continued:
The states should engage in preemptive reform over the next two years. This means enacting responsible, rational reforms — the kind of reforms that they should have enacted all along, in the absence of federal legislation. Where possible, states should try to make their reforms compatible with the new federal law — but only if compatibility does not sacrifice the major goals of the state’s reform.
There are four arguments in favor of preemptive action at the state level:
Sunday, April 22, 2012
Why the Constitution matters in the health care case, from Richmond Times Dispatch
Although most of the commentaries on the Affordable Care Act ("Obamacare") have emphasized public policy issues such as the spiraling cost of health care and the burden placed on the health care industry by uninsured or underinsured people, the legal challenge to the law that culminated in three days of hearings before the United States Supreme Court has forced both defenders and critics of the law to give at least some attention to constitutional issues. This is of enormous significance. The message that these hearings should send, and that the American people need to hear loudly and repeatedly, is that the Constitution matters.
Irrespective of how the Supreme Court rules in the health care case, it will be important for the justices to rest their ruling principally on constitutional issues and not public policy issues. While it is impossible to completely disentangle public policy issues from constitutional issues in the field of modern commerce-clause jurisprudence, it is possible to subordinate public policy considerations to constitutional considerations even in this area of the law, and it will be important for the court to do this.
There are several good reasons for the court to resist any temptation to act like a policymaking or public policy institution in the health care case, something that it has done in the past. The temptation to elevate public policy considerations to a position of primacy will be great since virtually everyone concedes that the health care system, from the point of view of access and quality of care as well as affordability, is not meeting the expectations of many Americans.
Indeed, President Obama challenged the court to uphold the law largely on public policy grounds shortly after the conclusion of oral arguments. It would be unfortunate, however, both for constitutional and pragmatic reasons, if the court decides that another foray into the public policy arena makes sense in this case.
There is no better protection for the court when attacked by the political branches or by the people than being able to assert that "the Constitution made us do it." Preserving an independent judiciary, in turn, is critical to protecting the personal liberties associated with limited government.
To paraphrase the Federalist Papers, "the reservation of particular rights and privileges would amount to nothing" in the absence of an independent judiciary, that is, a judiciary that is free to do its work without fear of political pressure or manipulation.
more...
http://www2.timesdispatch.com/news/commentary/2012/apr/22/tdcomm03-why-the-constitution-matters-in-the-healt-ar-1858288/
Friday, April 6, 2012
Obamacare’s Effect on Drug Spending
This blog post was written by Ben Comer.
Provisions in the Affordable Care Act (ACA) drove out-of-pocket costs down, while increasing drug spending among 19 to 25-year-olds in 2011, according to research published on Wednesday. The decline observed in overall out-of-pocket spending last year was the “first on record,” and was “largely related to the introduction of the ‘donut-hole’ subsidy for Medicare Part D beneficiaries,” a highly-touted element of the ACA, according to the IMS Institute for Healthcare Informatics. While copays for commercial providers and Medicaid were flat (average commercial plan copays increased by $1.14, to $26.10 in 2011), seniors covered by Medicare Part D got the largest break, with average copays decreasing by $2.66 – from $25.97 in 2010, to $23.31 in 2011 – according to the report.
The dip in copay costs for seniors didn’t translate into an increase in volume for chronic or acute medications, however; in fact, patients 65-years and older reduced their drug usage by 3.1%. Prescription use among the same group declined in 2010 as well, by 2.7%, but the last two years represent an inflection from prior years, when “seniors’ usage of medicines grew on average at 4%,” the report found. College-aged patients (19-24 years old), on the other hand, were the only age group to increase their drug usage, by a modest 2%. That increase “coincides with the first full year of implementation of the provision of the ACA allowing under-26-year-olds to stay on their parents’ health insurance,” according to the report.Michael Kleinrock, director of research development at the institute, said on a call with reporters that patients over 65 years old are foregoing the medications they use the most. Drug usage for hypertension, the most common disease among this population, decreased more than any other class of drugs. “This correlates strongly with the economy…seniors are on a fixed income, and costs [of living] are rising,” said Kleinrock on the call. Kleinrock called the development a “tipping point,” adding that seniors are resetting their expectations around how often, and under what circumstances, they will visit a doctor.
Per capita figures adjusted for currency changes showed a 0.5% growth in total drug spending in 2011 – to $320 billion. Other fun facts from the report include:
more...
http://blog.pharmtech.com/2012/04/06/obamacares-effect-on-drug-spending/
Court’s Potential to Goad Voters Swings to Democrats
The prospect arises both because of President Obama’s comments this week implicitly warning the court against striking down his signature domestic achievement, the expanded health insurance law, and because of recent court rulings, chiefly the Citizens United campaign finance decision, and looming cases on immigration and affirmative action that incite passions on the left.
“Historically, the court has been a rallying point for the Republican base, and it is now much easier to imagine that it will be a rallying point with the Democratic base just as much if not more, especially if the court overturns the Affordable Care Act,” said Geoff Garin, a Democratic pollster who works with Priorities USA Action, a group supporting the president’s re-election but independent of his campaign.
for full article,
The Role of Partisanship in the Health Care Reform Challenge
The large interest shown by the public in
the three days of oral
arguments devoted to the constitutional challenge to the Affordable Care Act (ACA)
should be heartening to any fan of the US Constitution. Americans of all stripes
listened to the arguments, learned the precedents and constitutional clauses the
arguments relied on and engaged with the rich history and philosophy surrounding
the Constitution. I doubt Roscoe Filburn, of Wickard v. Filburn fame, would ever have expected his name to
be bandied about by so many people 70 years after his case was
decided.
On the second day of argument, in which the Court took up the question of the "individual mandate," the conservative justices each showed extreme skepticism that the commerce power gives Congress the ability to force people to purchase insurance. Some academics and commentators had gone so far to predict that the argument for the constitutionality of the individual mandate was so easy that even conservative stalwarts like Justice Antonin Scalia would kowtow to the government's arguments. This was rapidly proven to be untrue. Justice Scalia in particular assailed the solicitor general with questions that demonstrated he understood the finely tuned arguments and subtle distinctions of the challengers.
The general anti-ACA tenor of the arguments has opponents of the act cautiously optimistic that the Supreme Court might actually strike down all or part of it. An argument that once had more skeptics than believers now may have more believers than skeptics, and five of those believers might be on the Supreme Court.
for full article,
http://jurist.org/hotline/2012/04/trevor-burrus-health-care.php
On the second day of argument, in which the Court took up the question of the "individual mandate," the conservative justices each showed extreme skepticism that the commerce power gives Congress the ability to force people to purchase insurance. Some academics and commentators had gone so far to predict that the argument for the constitutionality of the individual mandate was so easy that even conservative stalwarts like Justice Antonin Scalia would kowtow to the government's arguments. This was rapidly proven to be untrue. Justice Scalia in particular assailed the solicitor general with questions that demonstrated he understood the finely tuned arguments and subtle distinctions of the challengers.
The general anti-ACA tenor of the arguments has opponents of the act cautiously optimistic that the Supreme Court might actually strike down all or part of it. An argument that once had more skeptics than believers now may have more believers than skeptics, and five of those believers might be on the Supreme Court.
for full article,
http://jurist.org/hotline/2012/04/trevor-burrus-health-care.php
Thursday, April 5, 2012
ACA's Medicaid expansion far smaller than under either Bush
Justice Stephen Breyer seemed unsure of his facts last week.
During oral arguments on the constitutionality of health care reform, he suggested that the law's Medicaid expansion, which will offer government coverage to about 15 million low-wage workers and their families, was smaller than previous expansions – notably, the change of the late 1980s and early 1990s, which brought all poor children under Medicaid's umbrella; and one enacted in the late 1990s and early 2000s that included children up to 200 percent of the poverty level.
"The expansion from 0 to 18 or even 0 to 6 . . . it's pretty hard to argue that they aren't roughly comparable as a percentage of the prior program or as a percentage of GDP (gross domestic product)," he said to Paul Clement, the eloquent litigator who represented the 26 states challenging the Medicaid expansion as unconstitutional coercion of the states. "If I'm right on those numbers, or even roughly right – I don't guarantee them – then wouldn't you have to say, well, indeed, Medicaid has been unconstitutional since 1964?"
http://www.massdevice.com/blogs/massdevice/acas-medicaid-expansion-far-smaller-under-either-bush
During oral arguments on the constitutionality of health care reform, he suggested that the law's Medicaid expansion, which will offer government coverage to about 15 million low-wage workers and their families, was smaller than previous expansions – notably, the change of the late 1980s and early 1990s, which brought all poor children under Medicaid's umbrella; and one enacted in the late 1990s and early 2000s that included children up to 200 percent of the poverty level.
"The expansion from 0 to 18 or even 0 to 6 . . . it's pretty hard to argue that they aren't roughly comparable as a percentage of the prior program or as a percentage of GDP (gross domestic product)," he said to Paul Clement, the eloquent litigator who represented the 26 states challenging the Medicaid expansion as unconstitutional coercion of the states. "If I'm right on those numbers, or even roughly right – I don't guarantee them – then wouldn't you have to say, well, indeed, Medicaid has been unconstitutional since 1964?"
http://www.massdevice.com/blogs/massdevice/acas-medicaid-expansion-far-smaller-under-either-bush
Monday, April 2, 2012
Obamacare Court fail could hit pharmas with "double whammy"
If the Supreme Court finds the “individual mandate” provision of the Affordable Care Act unconstitutional, as now seems surprisingly possible, the biopharma industry could be looking at a worst possible outcome situation.
The Court's five-justice conservative-libertarian majority was frequently relentless in their questioning of the mandate at last week's marathon hearings, leading many Court Kremlinologists to put the odds in favor of partial or total repeal. The court could void the mandate, which would blow up the rationale on which PhRMA negotiated $100 billion in drug discounts for federal programs, or it could void the entire law. Either of those outcomes was regarded as unlikely before the hearings. Not anymore.
“PhRMA negotiated an excise tax recognizing it was a give-back taking into account that the industry would likely benefit from that,” said Acorda Therapeutics president and CEO Ron Cohen, MD. “If the individual mandate gets struck down, now you've got a double-whammy, because those thirty-million people aren't going to show up and pay for innovator drugs. So we're still paying into the system, but we don't have the benefit of people having access to medication, which would add costs the system.”
Click here for more.
If Obamacare falls, MassDevice
http://www.massdevice.com/blogs/massdevice/if-obamacare-falls
Until last week, the government's confidence on the constitutionality of the Patient Protection and Affordable Care Act (PPACA) seemed all but certain. Now, they're not so sure it might stand.
Of course, most American's are wondering: "Okay, if it gets repealed, then what?"
First, it is unlikely things will change right away. Many of the changes we've seen in health care with funding of the electronic medical record and forcing the collaboration between doctors and hospitals were created by the earlier economic "Stimulus" package funding, not the PPACA...
Until last week, the government's confidence on the constitutionality of the Patient Protection and Affordable Care Act (PPACA) seemed all but certain. Now, they're not so sure it might stand.
Of course, most American's are wondering: "Okay, if it gets repealed, then what?"
First, it is unlikely things will change right away. Many of the changes we've seen in health care with funding of the electronic medical record and forcing the collaboration between doctors and hospitals were created by the earlier economic "Stimulus" package funding, not the PPACA...
Don Berwick on the Fate of 'Obamacare', RollingStone.com
Fate of 'Obamacare'
A pediatrician by training and a widely respected expert in health care policy, Berwick should have been a lock for the CMS job. But he was a backer of Obamacare; a believer in data and science; a proponent of universal health care; and, worst of all, ...
A pediatrician by training and a widely respected expert in health care policy, Berwick should have been a lock for the CMS job. But he was a backer of Obamacare; a believer in data and science; a proponent of universal health care; and, worst of all, ...
Friday, March 30, 2012
ACA, JOBS Act, National health info, Crowdfunding and the Healthcare Market
PharmTech Talk
American Medical News
Thursday, March 29, 2012
Small business owners mixed over health care law
from CBS News Money Watch
By Alain Sherter
(MoneyWatch) The Supreme Court on Wednesday wrapped up three days of
arguments over President
Obama's landmark health care law, and Vintage Vinyl co-owner Lew Prince is
scared -- that the legal challenge will work. If the Patient Protection and
Affordable Care Act is overturned, "I'll be back in the crappy system I was in
two years ago," says Prince, co-owner of the small St. Louis music store. "We'd
go back to fighting for every inch of coverage every year."
Such fears highlight the division of opinion among small business owners about the health care overhaul. One of the main litigants against the law is the National Federation of Independent Business (NFIB), a Washington trade association that contends the new law will raise its members' costs, burden them with regulations, and kill jobs. Other small business groups argue the opposite, claiming that the law is already lowering costs, expanding firms' insurance options, and easing the process of arranging coverage.
Such fears highlight the division of opinion among small business owners about the health care overhaul. One of the main litigants against the law is the National Federation of Independent Business (NFIB), a Washington trade association that contends the new law will raise its members' costs, burden them with regulations, and kill jobs. Other small business groups argue the opposite, claiming that the law is already lowering costs, expanding firms' insurance options, and easing the process of arranging coverage.
What's impact on N.J. if health care law overturned?
Written by
Bonnie Delaney, Asbury Park Press, Staff Writer
Bonnie Delaney, Asbury Park Press, Staff Writer
Love it or hate it, the Affordable Care Act has already helped New Jersey’s senior citizens save an estimated $95 million by closing the Medicare prescription plan doughnut hole. As of last June, 2.5 million young adults nationwide have gained coverage through a provision that requires employers and health insurers to allow them to stay on their parents’ plans until they turn 26.
But those popular components of the act — as well as many others like guaranteed coverage for people with pre-existing conditions — could be lost if the U.S. Supreme Court strikes down the 2010 law passed by Congress and challenged by 26 states as unconstitutional, said Joel C. Cantor, director of the Rutgers Center for State Health Policy and a professor of public policy at Rutgers...
BEHIND THE NEWS
An August 2011 report by the Rutgers Center for State Health Policy, headed by Joel C. Cantor, said the following estimates of changes in coverage could be expected with implementation of the Affordable Care Act:
• The number of uninsured in New Jersey will decline from 14.5 percent of the non-elderly population to 8.6 percent, increasing the number of covered people by about 444,000.
• The non-group health insurance market will gain the most covered individuals, increasing from 2.8 percent of the non-elderly to 7.6 percent, an increase of about 362,000 people. Of those enrolled in non-group coverage after reform, more than half would be eligible for federal tax credit subsidies.
• Medicaid/NJ FamilyCare also will expand substantially under reform, increasing from covering 13.6 percent to 16.7 percent of the non-elderly in the state, an expansion of about 234,000 individuals. More than half of this projected increase will be non-parent adults (132,000), although it is projected that the number of enrolled children will also increase.
• The percentage of people with employer-sponsored coverage will decline slightly.
Scott Brown and Elizabeth Warren spar over medical device excise tax in federal health care law
From MassLive.com
As the United States Supreme Court wraps up three days of arguments over the Constitutionality of the health care mandate in the Patient Protection and Affordable Care Act, a medical device excise tax included in the sweeping legislation is being debated in the U.S. Senate race on Massachusetts.
Republican U.S. Sen. Scott Brown's campaign criticized its chief Democratic rival Elizabeth Warren for her support of the health care law on Wednesday, charging that the 2.3 percent medical device tax included in it would hurt the more than 400 medical technology companies in the Bay State.
If the Supreme Court strikes down the health care mandate in the coming weeks, it could kill the overall legislation, including the medical device tax. But if the legislation stands, Brown says the tax will result in jobs being lost in Massachusetts.
For full article: http://www.masslive.com/politics/index.ssf/2012/03/scott_brown_and_elizabeth_warr_2.html
Health system reform: Abstract debate inside Supreme Court as protest signs dominate outside - amednews.com
See link for complete article:
Washington --Away from the emotional atmosphere outside the U.S. Supreme Court, justices in their three days of oral arguments on the national health system reform law focused on the constitutional and legal issues. Philosophical discussions among the justices about markets, mandates and tax code were more common than talk of patients, preexisting conditions and access to medical care.
The heart of the justices’ review was the law’s individual mandate, the provision requiring nearly all Americans to obtain insurance by 2014 or pay a penalty. That was the primary line of attack by states and employers that want to see the statute overturned, and justices in their questioning appeared evenly split along ideological lines on whether the federal government can compel the purchase of a commercial product.
The four questions before the court
When U.S. Supreme Court justices rule on the health system reform law, probably in June, they will make decisions on four distinct questions.
- Does the Anti-Injunction Act prevent justices from ruling on the law’s individual mandate until after 2014?
- Did Congress have the authority under the Commerce Clause to require individuals to obtain health coverage or pay a penalty?
- If the individual mandate is struck down, must any or all of the law’s other provisions be struck down, too?
- Does the law’s requirement that states pay a portion of a Medicaid expansion or give up all federal Medicaid funding represent unconstitutional coercion?
Did Bloggers Kill the Health Care Mandate? - The Atlantic
Did Bloggers Kill the Health Care Mandate? - The Atlantic (see link for complete article)
Studies Have Shown...
The arc of the academic literature about public opinion and Supreme Court outcomes is long, but it bends, unlike most academic literatures, towards an actual conclusion. Taken as a whole, studies suggest that context matters, and that political atmosphere affects decisions over time.
The studies take one of two basic approaches. The first focuses on elite opinion and smacks of social psychology. According to Kevin McGuire, political science professor at UNC, this school of thought says that judges, like members of any subculture, care about what people like themselves think.
McGuire pointed to one study that compared Democratic and Republican appointees who were living in Washington with those who came to Washington from outside the Beltway. Among the four different categories (Republican/Democrat, Living in Washington/Living outside Washington), only Republican appointees from outside Washington, suddenly immersed in the liberal elite legal social circles, showed a "marked tendency" towards ideological drift: Whether at the middle-school lunch table or at Katherine Graham's dinner table, people conform to their peers. (McGuire suggests this phenomenon may be in decline, though, due to the 30-year rise of elite conservative legal culture through organizations like the Federalist Society.)
NBC's Andrea Mitchell Praises 'Highly Regarded' Cuban Health Care System Indoctrinating U.S. Med Students | NewsBusters.org
This is an interesting article. See the link for all details.
Mitchell proclaimed: "As the U.S. debates health care....We went back to the Latin American medical school here to talk to American medical students about what they're learning about medicine, about Cuba, and about themselves." That soon became disturbingly apparent as student Cynthia Aguilera gushed: "...after graduating with no debt, no worries about paying off loans and having to get a high-paying job, we can return to our communities [in the U.S.] and work in them and try to uplift them the same way that Cuba uplifted us."
Fellow medical student Heather Ross declared: "...usually when you enter medical school they tell you, 'Okay, we hope you can hold on to your ideals.' Here they actually teach you ideals from day one, in hopes that you will be a physician who will go into you're community and become a leader as well as change agent for improving your community."Law School forum probes health law, Yale Daily News
For complete article:
As the Supreme Court hears arguments for and against the Affordable Care Act, two professors from Princeton University and the Harvard Kennedy School of Government came to Yale to speak about health care reform in the United States.
At the talk, Amitabh Chandra, an economist and professor of public policy at Harvard, discussed specific problems with the nation’s health care system, such as inefficient coverage and costly treatments. Paul Starr, a professor of sociology and public affairs at Princeton and former Pulitzer Prize winner, focused on issues that are currently before the Supreme Court, and explained his personal concerns that the ACA may be knocked down by the court.
Known to many as “Obamacare,” the ACA was signed into law in March 2010 and is the largest piece of health reform passed since Medicare was created in 1965. Proponents of the bill applaud it as long-overdue legislation, while dissidents say it oversteps the powers of Congress and will be ineffective. These arguments have also been made along strict party lines, with Democrats largely in support of the bill and Republicans mostly against it.
Starr spoke about the ACA’s controversial government mandate that requires all American citizens with sufficient resources to purchase health insurance fulfilling basic requirements. He said lawmakers would have benefited from advocating an automatic enrollment policy with an opt-out option rather than the mandate. Such an option he said would have prevented constitutional problems, he said, and still decreased the uninsured population because research has shown that people rarely opt out in similar situations.
Subscribe to:
Posts (Atom)