thedailybeast.com
Sorry, Fox News, Trans Health Care Is Affordable
Talk is cheap but providing transgender health care may be even cheaper.

I wish the article had gone into more detail comparing trans-specific coverage costs with other procedures, both common and uncommon, individually and in aggregate, to show how much the cost truly is negligible.

Happy Birthday Medicare

Medicare turns fifty next week. It was signed into law July 30, 1965 – the crowning achievement of Lyndon Johnson’s Great Society. It’s more popular than ever. 

Yet Medicare continues to be blamed for America’s present and future budget problems. That’s baloney. 

A few days ago Jeb Bush even suggested phasing it out. Seniors already receiving benefits should continue to receive them, he said, but “we need to figure out a way to phase out this program for others and move to a new system that allows them to have something, because they’re not going to have anything.”

Bush praised Rep. Paul Ryan’s plan to give seniors vouchers instead. What Bush didn’t say was that Ryan’s vouchers wouldn’t keep up with increases in medical costs – leaving seniors with less coverage.

The fact is, Medicare isn’t the problem. It’s the solution.

Its costs are being pushed upward by the rising costs of health care overall – which have slowed somewhat since the Affordable Care Act was introduced but are still rising faster than inflation. 

Medicare costs are also rising because of the growing ranks of boomers becoming eligible for Medicare.

Medicare offers a way to reduce these underlying costs – if Washington would let it.

Let me explain.

Americans spend more on health care per person than any other advanced nation and get less for our money. Yearly public and private healthcare spending is almost two and a half times the average of other advanced nations.

Yet the typical American lives 78.1 years – less than the average 80.1 years in other advanced nations. And we have the highest rate of infant mortality of all advanced nations.

Medical costs continue to rise because doctors and hospitals still spend too much money on unnecessary tests, drugs, and procedures.

Consider lower back pain, one of the most common ailments of our sedentary society. Almost 95% of it can be relieved through physical therapy.

But doctors and hospitals often do expensive MRI’s, and then refer patients to orthopedic surgeons for costly surgery. Why? Physical therapy doesn’t generate much revenue.

Or say your diabetes, asthma, or heart condition is acting up. If you seek treatment in a hospital, 20 percent of the time you’re back within a month.

It would be far less costly if a nurse visited you at home to make sure you were taking your medications, a common practice in other advanced nations. But nurses don’t do home visits to Americans with acute conditions because hospitals aren’t paid for them.

America spends about over $19 billion a year fixing medical errors, the worst rate among advanced countries. Such errors are the third major cause of hospital deaths. 

One big reason is we keep patient records on computers that can’t share the data. Patient records are continuously re-written and then re-entered into different computers. That leads to lots of mistakes.

Meanwhile, administrative costs account for 15 to 30 percent of all health care spending in the United States, twice the rate of most other advanced nations. 

Most of this is to collect money: Doctors collecting from hospitals and insurers, hospitals collecting from insurers, insurers collecting from companies or policy holders. A third of nursing hours are devoted to documenting what’s done so that insurers have proof.

Cutting back Medicare won’t affect any of this. It will just funnel more money into the hands of for-profit insurers while limiting the amount of care seniors receive.

The answer isn’t to shrink Medicare. It’s to grow it – allowing anyone at any age to join.

Medicare’s administrative costs are in the range of 3 percent.

That’s well below the 5 to 10 percent costs borne by large companies that self-insure. It’s even further below the administrative costs of companies in the small-group market (amounting to 25 to 27 percent of premiums).

And it’s way, way lower than the administrative costs of individual insurance (40 percent). It’s even far below the 11 percent costs of private plans under Medicare Advantage, the current private-insurance option under Medicare.

Meanwhile, as for-profit insurance companies merge into giant behemoths that reduce consumer choice still further, it’s doubly important to make Medicare available to all.  

Medicare should also be allowed to use its huge bargaining leverage to negotiate lower rates with pharmaceutical companies – which Obamacare barred in order to get Big Insurance to go along with the legislation.

These moves would give more Americans quality health care, slow rising healthcare costs, help reduce federal budget deficit, and keep Medicare going.

Let me say it again: Medicare isn’t the problem. It’s the solution.

sputniknews.com
Obamacare Backfires: Insurance Companies Seek to Hike Up Premiums in 2016

Many companies are claiming that new customers who enrolled under the Affordable Care Act (AAC) – commonly referred to as “Obamacare” – turned out to be sicker than expected, leading to increased costs to insurers.

Now, the Blue Cross Blue Shield Association – which provides insurance to over 100 million Americans – wants to increase its rates by an average of 23% in Illinois, 25% in North Carolina, 31% in Oklahoma, 36% in Tennessee and 54% in Minnesota, the New York Times reported.

In Oregon, insurance commissioner Laura N. Cali approved 2016 rate increases for Moda Health Plan (a 25% increase) and LifeWise (a 33% increase). Moda and LifeWise, which are the largest and second-largest plans in the state, respectively, combine to cover more than 220,000 people.

“This Is My Child”: A Religious Perspective on Health Care for All

In my faith tradition, we have a story about Jesus’ baptism. At this point in his life, Jesus has not started his ministry – no sick people have been healed, no one has walked on water, five thousand people have yet to be fed with loaves and fishes. Before any of his work challenging the brutal economic and military oppression of his people by the Roman Empire, Jesus goes to his cousin, John, and is baptized in the Jordan River. The heavens open up and the voice of God says: “This is my child, with whom I am well pleased.”

As a child, I thought that the voice of God was warning everybody: “Yo – this is my kid, don’t mess with him. This kid is gonna do some impressive stuff. Watch out.” Now my understanding of God is different, my understanding of oppression is different, and my own hope in the redemptive message of this story is greater. Today, my faith guides me to hear God calling each human a beautiful, valuable creation. Before a career is chosen, an income earned, an insurance status achieved, each person has worth.

Keep reading

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“How much is a human life worth?” Deanna Fei’s memoir “Girl in Glass” attempts to answer this question by documenting how the premature birth of Fei’s daughter in October 2012 set into motion a series of “catastrophic” events that climaxed when Tim Armstrong, CEO of AOL, blamed the company’s increase in health care costs on “distressed babies.” One of these babies, Fei soon realized, was her own; her husband worked for Huffington Post, which had been acquired by AOL in 2011.

The mother of the “distressed baby” shamed by Tim Armstrong tells Salon what happened after the media firestorm

motherboard.vice.com
Why I Had to Buy My Wife's Inhaler on the Dark Web
You can buy a range of prescription medicines online for a fraction of the cost.

Jackie has to use a maintenance inhaler twice per day, every single day, and will continue to use it for the rest of her life. Even with that maintenance inhaler, she sometimes still needs to use a different rescue inhaler to make it through the night when her asthma symptoms can be more pronounced. Without using these two types of medicine every day she could have an asthma attack, be hospitalized, or die. Given that a person with severe asthma could literally die without these inhalers, you would expect insurance companies to price them low enough for anyone to afford. It would be pretty unethical, or at the very least irresponsible, to charge a premium for them. Right?

Wrong. Many common medicines that people need (such as those prescribed for ADHD, anxiety, depression and many, many other things) are made very affordable, according to an insurer’s drug tier list. Asthma inhalers, however, are not.

Several months ago, Jackie found that her maintenance inhaler was running low. We had just obtained health insurance through Kentucky’s health care exchange and, while it wasn’t the most expensive plan, it certainly wasn’t cheap. Our monthly bill was high, but we thought the coverage was worth it.I should mention that Jackie specifically picked a plan with low prescription co-pays .Imagine our surprise when the total for her inhaler, with insurance applied, turned out to be around $300. Money was very tight at that time; we just couldn’t afford the inhaler without falling behind on other necessities like utilities and groceries. It was Jackie’s idea to check on the dark net.

It hadn’t occurred to me to look for an inhaler on the dark net until Jackie suggested it. She doesn’t really know much about the markets beyond things I’ve told her, but she asked me one night if you could buy inhalers on them. I got online, opened the Tor browser that is the gateway to the darknet, and pretty soon I found exactly the same maintenance inhaler—same brand, completely identical—that we needed to replace. The price was $30 with shipping.

The inhaler finally arrived intact after a couple weeks. It was in a completely unremarkable cardboard box. The only reason we recognized it as the inhaler was because of the country listed in the return address. It was hidden within multiple layers of packaging in the box to hide it from prying eyes. I honestly feel that a more illicit substance could easily have slipped through customs by being packaged the same way. The inhaler itself was completely legitimate and identical to what our local pharmacy would have given Jackie. The only difference was the price, and the fact that a crime had to be committed to get it.

Fortunately, Jackie has since found a way to obtain her maintenance inhaler without breaking the bank or the law, thanks to a helpful doctor and, of course, not our insurance company. However you feel about health care in the United States, I hope we can all agree that life saving medicine should be affordable. I make a pretty decent salary and we have good health insurance. I shouldn’t have to commit a crime to get the medicine my wife needs, and there are plenty of people with severe asthma who are in a much worse place financially than we are and yet still wouldn’t qualify for Medicaid. The majority of those people have never even heard of a dark net market and certainly wouldn’t know how to use one. What are they supposed to do?

When life saving medicine is out of reach to those who need it, something has to change. I don’t see that change coming anytime soon unfortunately. All I know is that health care is broken in this country and until it’s repaired, maybe it’s not such a bad thing that dark net markets exist.

‘You lie!’ Joe Wilson was right, CA Senate votes to open O’care to residents here illegally

The California Senate has voted to expand Medi-Cal, California’s Obamacare exchange, to, you guessed it, illegal immigrants. 

From San Jose Mercury News:

A first-in-the-nation bill aimed at expanding health care for illegal immigrants sailed through the Senate on Tuesday even as some lawmakers acknowledged that thousands of legal residents are having to struggle to access health care through the state’s Medi-Cal program.

In a 28-11 vote, a newly pared-down version of Senate Bill 4 by Sen. Ricardo Lara, D-Bell Gardens, would let undocumented Californians buy health insurance with their own money through the state’s Covered California exchange if the state is given a waiver by the federal government. It would also allow anyone age 18 and under to enroll in Medi-Cal regardless of immigration status – and let undocumented immigrants age 19 and up enroll in Medi-Cal if there’s money provided in the state budget.

“We are here today trying to address this critical issue that is vital to the success of our California: … providing care to our undocumented community,” Lara told colleagues before the vote. “The time has come for us to lead.”

Read the Rest

If you’ll remember, Joe Wilson was excoriated by the progressive media for shouting “You lie!” during a SOTU address where Obama promised that this wouldn’t happen.

Joe Wilson knew it was a lie, I knew it was a lie, you knew it was a lie, and anyone who could predict that the sun was going to rise in the morning knew it was a lie. Nevertheless, it was like totally racist to say it, you guys.

It should be noted that this bill allows illegal immigrants to only buy unsubsidized health insurance. But how long before that changes? Furthermore, because these immigrants are “undocumented”, they’re not under the mandate like the rest of us. So why would they sign up? Allow Forbes to explain:

…the overwhelming number of illegal residents who would sign up for unsubsidized coverage that would otherwise be unaffordable for them would be the people who would find a way to pay a few hundred dollars in premiums in order to get thousands of dollars in coverage—the sick who could literally make money off the deal.

In other words, only sick people will sign up. And an insurance company whose only clients are sick people, cannot stay in business long (unless they increase their premiums…a lot).

We can argue all day about our immigration system and the proper role of government as it pertains to foreign citizens, etc. I believe there is room for rational debate in this area. But one thing is for certain, open borders cannot coexist with a welfare state. It is utterly unsustainable.

reason.com
Senior Obamacare Official Becomes Top Health Insurance Lobbyist
The move is a reminder that Obamacare is a joint operation between the government and the health insurance industry.

In January, Marilyn Tavenner stepped down from her position as the head of the Centers for Medicare and Medicaid Services (CMS).Tavenner was one of the administration officials most involved with the flopped launch of Obamacare’s federal health insurance exchange—the administration sent her to Congress to apologize—and her agency crafted thousands of pages of regulations ordered up under the law.

Essentially, Tavenner played the role of Obamacare’s caretaker within the administration, helping to craft its many tedious rules and procedures while serving as a public face when implementation failed.

Earlier this week, news broke that Tavenner would be joining America’s Health Insurance Plans(AHIP), the health insurance lobbying group, as chief executive. Tavenner, in other words, will continue to be Obamacare’s caretaker—only now she’ll be operating from the private sector.

At this point, though, “private sector” is practically a misnomer.

Obamacare does not nationalize health insurance, but it turns the industry—already subject to extensive, (though mostly state-based) mandates and regulations—into a kind of quasi-public utility: a heavily subsidized, federally regulated product, with profit margins capped and rates subject to regulatory review, sold through government designed and run marketplaces to people who are required by law to buy the product.

Tavenner’s move not only highlights the link between government and industry, but strengthens it. As Philip Klein writes at The Washington Examiner, Tavenner “has a web of connections within the Obama administration and an intimate knowledge of how it works. But her being at AHIP is also valuable for the administration, because it means that the insurance industry’s main lobbying group will now be headed by a cheerleader for Obamacare.”

Under Obamacare, health insurance is nearly as much a product of government as it is of the private sector—a joint operation conducted in tandem by a revolving cast of public officials and private sector interests.

Jeb Bush Wants You To Work Harder, But He Doesn't Want You To Have 'Benefits And Stuff' (VIDEO)

Jeb Bush Wants You To Work Harder, But He Doesn’t Want You To Have ‘Benefits And Stuff’ (VIDEO)

I don’t know how it’s possible, but instead of being the sane Bush, as we were promised, Jeb is Mitt Romney redux. A couple of weeks ago, Bush stuck his silver foot in his mouth by saying that people need to work longer hours. The problem with that is that since Reagan, we do work longer hours but we don’t get paid for them. That didn’t go over well, but Bush doubled down anyway and on Wednesday,…

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GAO audit: Obamacare’s $2 billion web site can’t detect fraud

Only the federal government would build the most expensive web site in history and then neglect to equip it with necessary fraud prevention.

From the AP:

Phony applicants that investigators signed up last year under President Barack Obama’s health care law got automatically re-enrolled for 2015. Some were rewarded with even bigger taxpayer subsidies for their insurance premiums, a congressional probe has found.

The nonpartisan Government Accountability Office says 11 counterfeit characters that its investigators created last year were automatically re-enrolled by HealthCare.gov, even though most had unresolved documentation issues. In Obama’s terms, they got to keep the coverage they had.

Six of those later were flagged and sent termination notices. But GAO said it was able to get five of them reinstated by calling HealthCare.gov’s consumer service center. That seemed to be a weak link in the system.

The five bogus beneficiaries who were reinstated even got their monthly subsidies bumped up a bit, although GAO did not ask for it. The case of the sixth fake enrollee who appealed was under review.

HealthCare.gov does not appear to be set up to detect fraud, GAO audits and investigations chief Seto Bagdoyan said in prepared testimony for a Senate Finance Committee hearing Thursday. A copy was provided to The Associated Press.

HealthCare.gov’s document-processing contractor “is not required to seek to detect fraud,” said Bagdoyan. “The contractor personnel involved in the document-verification process are not trained as fraud experts and do not perform antifraud duties.”

Administration officials told GAO there has been “no indication of a meaningful level of fraud” in the program, Bagdoyan said.

Federal health care subsidies go directly to insurers, so the money does not end up in the bank accounts of individual enrollees. But health insurance is a valuable product in and of itself, with the cost of family coverage averaging close to $17,000 a year.

Read the Rest

“In Obama’s terms, they got to keep the coverage they had.” Really, AP? You’re taking what is arguably Obama’s biggest lie (and there are a bunch of them) out of context now? Nice.

But I digress.

The unending level of government incompetence is not what amazes me. What amazes me is how people can see its incompetence every day and still want more of it.

Why the Labor Movement Matters in the Fight for Single-Payer Health Care

Our goal can be easily guessed by our name: “Students for a National Health Program.” We are a group of students who believe the United States should implement a national, universal, single­-payer health care system. Whatever you’d like to call it, such a system would entail that all citizens of the United States essentially pay into a national health insurance program for all other citizens. Everyone would chip in, nobody can opt out, and everyone gets covered for non­elective health care. Several other developed nations have successfully implemented such a health care system,­ Canada and the United Kingdom being perhaps the most representative countries. Our goal is simple, and we know based on the example of other countries, that our goal will also work.

So, of course, the more difficult question is, how do we get there? Based on what I have seen so far in the single-­payer movement, we’ve been employing the following “classic” approaches: reaching out to physicians, medical students, medical residents, and public health professionals in an attempt to educate and enlighten them on the pros and cons of our current capitalist health care system versus a national (some would even say “socialist”) one. Of course, these are good, tried and true approaches, and the single-­payer movement would certainly fail without them.

However, I’d like to propose an additional focus for our efforts: reaching out to and standing in solidarity with organized labor­ – that is, workers organized in labor unions.

Keep reading

khn.org
My Experience With Obamacare
>> See Sorensen's "An Open Letter To The Supreme Court" Jen Sorensen's political comics appear in a variety of publications around the country. She is the winner of the 2014 Herblock Prize an...

Within 45 minutes, my husband and I had a Silver plan from Blue Cross Blue Shield of Texas for $316/mo, thanks to the subsidies. This was $166 less than what we’d been paying with the lowest deductible I’d ever had.

Mind you, we’re married, taxpaying homeowners – not quite the ne’er do-wells ACA opponents like to conjure up.

anonymous asked:

I think I might need to be checked in for mental health stuff, but I'm pretty certain my insurance doesn't cover that and I know we can't afford it. I don't know what to do. I don't feel like I have any friends I can go to, to talk to about this or just about the stuff bothering me in general. They've all ditched me in the last couple months.

I’m putting this out to my followers because I have no experience with it. Anyone have ideas for anon to be able to afford to be checked in for their mental well being? Or a way to work within the system????