Ideas, Opinions, Genealogy, and Book Reviews
Much has been said about the millions of cancelled health insurance policies. Often the insurance company explains that these plans do not meet the standards of the Affordable Care Act (ACA). There are 2 offered fixes. Continue reading “2 keep your health plan plans”
Health care reform (ObamaCare) wasn’t a needless intervention in a well-functioning insurance market. It was designed to address market failure in our health care system
There are problems with the ObamaCare roll-out and the fight over Obama Care gets stranger. Continue reading “The fight over Obama Care gets stranger”
About 2 weeks ago I wrote that Fixing the ACA or Obamacare makes more sense than repeal.
In that piece I mentioned that “I probably would back the repeal of the medical device tax.” but not as part of the current budget fiasco and that we need much more discussion before acting.
For another point of view see Excise Tax on Medical Devices Should Not Be Repealed: Industry Lobbyists Distort Tax’s Impact.
What do you think?
This is the start of an article in yesterday’s Philadelphia Inquirer. And the opening sentence does sum it up well, but there is much more to it. It is Pennsylvania news but the issue is one that could happen almost anywhere and that is certainly worth thinking about.
The Philadelphia nurse charged with assisted suicide for giving morphine to her terminally ill, 93-year-old father has been suspended from her job without pay, run up legal fees of $90,000, and often can’t sleep because she feels so angry and hurt, her husband said in an interview.
In this case, the criminal act appears to be simply handing her terminally ill father his morphine with which he attempted suicide. The morphine had been prescribed for the terminally ill man for pain relief.
The U.S. Supreme Court has ruled that patients have the right to self-administer as much medication as needed for pain, even if it hastens death. But it is apparently still not a right in Pennsylvania.
The suicide may have been successful if the state and not intervened to revive him despite his do-not-resuscitate order and the expressed desire of his health care proxy (his daughter, the Philadelphia nurse later charged with assisted suicide).
The patient did die after several days but I haven’t seen any evidence as to weather the cause of death was the suicide attempt, the treatment, the pre-existing terminal illness, a combination of these, or something else entirely.
This is from another account:
(Pottsville, Pa. – Sept. 17, 2013) Defense attorneys for Barbara Mancini, who faces up to 10 years in prison if convicted of “assisted suicide” for allegedly handing morphine to her dying father, today filed a motion to dismiss the case based in part on two U.S. Supreme Court decisions. In both cases, Washington v. Glucksberg and Vacco v. Quill, the nation’s highest court recognized that states cannot erect legal barriers to aggressive treatment of end-of-life pain and suffering, even when it advances the time of death (for more details, see pages 5-7 of the motion atwww.compassionandchoices.org/pennsylvania-v-mancini/).
I think the state is clearly in the wrong here and I don’t understand why the Pennsylvania Attorney General Kathleen Kane is prosecuting Barbara Mancini. But what do you think about the rights of the patient and his daughter?
If you would like see or sign the online petition to stop this prosecution, please click here.
It seems that ever since the Affordable Care Act (aka ACA or Obamacare) was passed and then passed muster in court, nearly all Republicans have wanted it repealed. The latest efforts involve shutting down the government as we enter a new fiscal year and refusing to raise the debt ceiling so the government defaults on its debts.
Both efforts seem foolish and I have discussed them recently.
I live in Pennsylvania and get emails from Senator Toomey. He discussed his desire to compromise on the government shut-down stand-off by adding 3 amendments to the Senate bill. These amendments did not make it into the Senate bill. I do not think the debate on Obamacare should be part of the government shut-down or debt ceiling debates but these are good discussion points on the law.
The first would repeal the medical device tax that is costing Pennsylvania jobs; the second would provide relief from the infringement on religious liberty in Obamacare; the third would delay the individual mandate for one year.
I probably would back the repeal of the medical device tax. It seems to me the best way to do this would be a a separate bill but now seems a bit rushed. I don’t see much benefit to this tax since I would assume the tax would just be passed along as part of the cost of health care. So there is really no benefit since the users of heath care pay the tax and there well could be a job loss associated with this. But on the other hand with more people insured and using health care there may not be a job loss. I’d like to see more discussion on this point.
Regarding the second suggestion (infringement on religious liberty), I think this is inevitable as long as we insist on standards in health insurance. I think the employer mandate is problematic. The religious objection of an employer may or may not seem reasonable to others. One person may object to contraception and another may object to this or that aspect of health care. A public option would be much simpler here but I don’t think that is what the Senator had in mind.
As to the third point (a 1 year delay), there may be a problem. I assume the insurance companies took the widened risk-pool provided by the mandate into account when setting the rates for 2014. If this is not the case and we do not have additional delays such as a 1 year delay every year, it might be worth discussing this.
The ACA is a complex law with many parts. There are things I like and things I don’t. There seem to be things we could fix now and problems that would not be apparent until parts of the law are implemented. And we certainly could use a reasonable discussion of the pros and cons of parts of this law.
Rather than have a series of political stand-offs to attempt to repeal the law, maybe Congress could work to improve the law.
A few days ago, I remarked on the apparent public disapproval Affordable Care Act (aka ACA or Obamacare) although there are many clear benefits some of which seem quite popular.
I like some provisions and dislike others. I like the idea of universal coverage. The ACA doesn’t get us to universal health care but sure gets us closer. There are certainly things I don’t know and perhaps are unknowable until we try.
So my vote is for fixing the parts of the law that don’t work or cause problems. I think a repeal is foolish. And it is certainly foolish to shut down the government to try to force a repeal.
And even more foolish to fail to increase the debt ceiling and have the United States default on its obligations in an attempt to force the will of some Republicans on the entire county.
The House Republicans have shown the ability to manufacture a crisis when there is no need. It is a shame they can’t direct their efforts at solving the problems of the country.
It appears that there is considerable public opposition to the Affordable Care Act (aka Obamacare). House Speaker John Boehner cited this opposition to Obamacare in calling the House bill to to fund federal agencies past Sept. 30 and defund Obamacare.
I think saying a majority of Americans oppose Obamacare is an over simplification and wrote a bit about that.
I find it rather hard to believe that a majority wants to go back to a system where insurers can deny coverage because of pre-existing conditions (or they believe the applicant is likely to make too many claims). Or a system that allows insurers to place caps on benefits so if you develop a serious condition the policy just pays until a certain point and you are stuck with any bills after that point.
How can we conclude that a majority oppose the law when other surveys show many people just don’t know much about the law?
I have previously written about the governmental see-saw on medicaid expansion in Pennsylvania. My understanding was the Feds paid 100% for 3 years, eventually falling to 90% (so the state is stuck with 10% in the long-term). But whether or not the state participates the residents still pay the tax for medicaid expansion in the other states.
As far as I could tell Gov. Corbett was against the Medicaid expansion in Pennsylvania but had not reached a final decision. The legislature went back and forth on it. It seemed to me the needy in Pennsylvania would be the losers. But things may be looking up!
Gov. Corbett would like to use these funds to provide private health coverage rather than add to the state’s Medicaid program. But this requires federal approval. Read the full article here. And more details are to follow.
It seems to me that it a good idea to try different methods of delivering services. If this works our well, it could be a model for other states to deliver medicaid services. So I’m eagerly awaiting more details and hearing the federal response.
I read today that the House of Representatives is going to try to repeal ObamaCare for the 37th time.
I’m kind of on the edge of my seat here. Will it pass this time? Did it pass all 36 times before?
How long will it take House Republicans to realize that the Affordable Care Act or ObamaCare has been law for a few years and there is no chance of repeal unless the Republicans take over in the Senate and maybe the White House. Wouldn’t their time be better spend in trying to fix parts of the law they find especially objectionable? Or trying to be constructive?
What if repealing ObamaCare actually will increase the deficit as the Congressional Budget Office (CBO) predicted. Will the Republicans agree to raise taxes to make their plan deficit neutral? Or will they cut elsewhere?
The Patient Protection and Affordable Care Act of 2010 (PPACA), commonly called the Affordable Care Act (ACA) or Obamacare, is controversial. Republicans consider it anti-business; Democrats not so much. But is it really more pro-business or anti-business than our present system ?
Employer-provided health insurance began during World War II as a way of getting around wage controls on businesses. Currently most of the insured under 65 have employer-provided insurance. Obamacare is similarly dependent on employer-provided insurance. Sort of a doubling down on the idea by mandating that employers provide insurance or pay a penalty.
But is employer-provided insurance a good thing? Or would we be better off if the insurance was provided by another method ? And how do we pay for it ?
So many questions. Are there good answers? What do you think?
The good news is 2012 saw the lowest increase in in health insurance costs for employers since 1997. That is certainly good news for employers. But the bad news is that this is largely the result of switching employees to lower cost plans. Almost certainly, bad news for employees. These finding are in a press release by Mercer , who conduct the National Survey of Employer-Sponsored Health Plans. More details are in the press release and even more in the detailed report.
Here are a few more articles on this I’ve run across:
Businessweek even suggests some employers may drop health-care coverage .
Since the trend among employers seems to be to lower costs and decrease benefits (or increase the employee’s share), I am wondering if our dependence on employer-provided health benefits as part of the Patient Protection and Affordable Care Act (ObamaCare) is such a good idea.
A few days back I asked, “If we had a true National Health Insurance plan in the US, would it be pro-business or anti-business?
But still no answers or comments. It seems to me that compared to or present system, which is largely based employer-provided insurance, another system or systems could both increase coverage and allocated costs in a less harmful way to our economy.
Our present system directly adds a cost to the employer. I don’t recall where I saw it but a good example that sounds reasonable to me is that the cost of health insurance adds thousands of dollars to each car produced by American car makers. I would think this cost would put US companies at a large disadvantage in competing internationally. Also there would be competitive advantages and disadvantages within the US.
So a true National Health Insurance plan in the US would appear to have many advantages for our economy. If that is the case, other questions such as “How do we pay for it?” or “What does this plan look like?” follow.
But let’s not jump ahead but just consider one question at a time. Is National Health Insurance good for the economy?
What do you think?
I have a question on US National Health Insurance:
If we had a true National Health Insurance plan in the US, would it be pro-business or anti-business? Currently we are basing things mainly on employer-provided insurance. I would think the cost of that would put companies at a disadvantage in competing internationally. Also there would be competitive advantages and disadvantages within the US.
Would a true National Health Insurance plan in the US put all companies on a level playing field with both other US companies and rivals in countries where there is National Health Insurance?
What do you think?
Just 2 short notes today.
1. The Sequester is nearly upon us. The consequences have been much covered in the press. Long lines at airport security, cut-backs in air traffic control, military cuts, fewer food inspections, and many more. Additionally the cut-backs seem likely to hurt the economy which is only slowly recovering from the recession.
I see little movement toward a solution. In fact, both house of Congress took a week off last week, leaving only a few days to solve this.
2. Heath care reform (aka ObamaCare) is in place. Some find aspects they dislike or that they think will harm the economy. The only call I hear from these groups is “repeal” or “repeal and replace”. Since we have already passed health care reform and it has passed constitutional muster, why not work to fix those part that you disagree with?