The Health Care Report

Understanding the Health Care Reform

LifesciNYC: May 2012



5/8 6PM Riverside Chat with Eric Schadt, NYC TechConnect

5/23 6PM Identifying Drug Targets for Alzheimer’s and Other Neurological Diseases, Rockefeller University Bridge to Better Medicine

Panels and discussions
5/4 1PM Startup Roundtable, NYEBN

5/8 6PM Leveraging the…

(Source: lifescinyc)

On the Affordable Care Act

The NYT gives a nice summary of the supreme court’s hearings on the Affordable Care Act (PPACA) here.

On March 26, the Supreme Court began three days of hearings on challenges to the constitutionality of the Affordable Care Act, the health care reform bill pushed by President Obama and passed by Congress in March 2010 over bitter Republican opposition.

It is one of the most significant cases heard by the court in decades, with implications for the presidential race as well as the future of health care coverage. The decision, due in late June, is also likely to be a major factor in shaping the legacy of Chief Justice John G. Roberts Jr., as well as Mr. Obama, whose signature domestic initiative is on the line.

As Smartphones Become Health Aids, Ads May Follow

An interesting bit from the NYT:

With smartphones changing the culture in so many ways, more and more young people are using their mobile devices to keep track of their health, and the trend is not going unnoticed by advertisers.

Older patients often use their PCs to look up side effects of medications, said Dr. Audrey K. Chun of Mount Sinai Hospital.

Young adults are much more likely than older people to have a smartphone and to use it to look for health information, according to the Pew Internet and American Life Project, which surveys technology trends. And their health concerns differ markedly from those of older people.

Nearly 100 million Americans own a smartphone, but “younger people use them very differently,” said John Mangano, a vice president of comScore, an online research firm. Three of the top five symptoms searched for on Yahoo Mobile in January were early pregnancy, herpes and H.I.V. None of these symptoms showed up among the top searches on desktop computers, which are more likely to be used by older people.

The most popular symptom searches on PCs included gastroenteritis, heart attacks, gout and shingles, Yahoo said, adding that the encyclopedic medical symptoms checker on WebMD was the most popular site of its kind among PC users. On WebMD, the top symptoms searched for in January were muscle strain, gastroenteritis and irritable bowel syndrome.

Older patients often use their desktops to look up side effects of their medications, said Dr. Audrey K. Chun, a geriatrician who heads Mount Sinai Hospital’s Martha Stewart Center for Living in Manhattan. For example, George Yourke, 79, a retired architect, said he used his iMac to learn more about injections prescribed for his knee.

Healthcare goes mobile and the money/ads follow…

Supreme Court needn't fear healthcare law's individual mandate provision

An interesting op-ed on the recent hearings: 

The Affordable Care Act faced a possibly fatal challenge last week when the constitutionality of its individual mandate provision was argued in the Supreme Court.

Much of the terrain was easy going. Neither the justices nor the lawyers doubted that the healthcare and healthcare insurance markets involve interstate commerce — insurance and healthcare providers are usually national or at least regional operations, folks who cross state lines get sick and must be cared for away from home regularly, and people are often unable to relocate to another state for fear of losing employer-based coverage. Nor was it disputed that the mandate was sincerely motivated by and closely related to the regulation of these interstate markets. Those two conclusions are usually sufficient to justify the exercise of congressional power under the commerce clause of the Constitution.

Health Insurers: We'll Deny Coverage For Pre-Existing Conditions If Health Mandate Is Repealed

The insurance industry argues that premiums are likely to skyrocket without the individual mandate in place to aid in pushing millions of new enrollees into the marketplace, as healthy people will be less likely to buy insurance, while insurers will still be required to sell policies to all applicants. In fact, a repeal of the individual mandate would increase insurance premiums by 25 percent, according to a study released by the Robert Wood Johnson Foundation.

“The insurance reforms would have to change if the mandate were struck,” said Justine Handelman, vice president of legislative and regulatory policy for the Blue Cross and Blue Shield Association trade group.

Health-insurance officials say that if the mandate is repealed, “their first priority would be persuading members of Congress to repeal two of the law’s major insurance changes: a requirement to cover everyone regardless of his or her medical history, and limits on how much insurers can vary premiums based on age.” Their next step would be to “set rewards for people who purchase insurance voluntarily and sanction those who don’t.”

Other possible alternatives to the individual mandate that insurers are weighing:

- Penalize those who enroll outside of short annual windows; deny treatment for specific conditions, especially right after a policy is purchased

- Reward certain insurance buyers, such as offering much lower premiums for younger and healthier people

- Expand employers’ role in automatically enrolling employees for health insurance

- Urge credit-rating firms to use health-insurance status as a factor in determining individuals’ ratings

(Source: sarahlee310)


‘New And Dangerous Power’: Supreme Court To Judge HealthCare ( hcr ) Mandate

Facepalm: Employers and the Pill, Continued....


Per my earlier post, Kevin Drum at Mother Jones takes a look at the changing employer-based system:

Most Americans simply have no clue how bizarre it is that we rely on employers to provide health insurance for most people. We’ve all grown up in this sytem, so it seems completely…

Could this decline also be expedited by the creation of Health Insurance Exchanges? How would that effect the quality of health insurance? Would we tend to ‘under-cover’?

Kevin Drum argues that employer-based health insurance ‘Makes. No. Sense. And dozens of countries around the world have shown that there are better, less expensive, more universal ways of providing medical care’, but I’m not sure how I feel about it just yet. I say this while being covered by a generous corporation, so I understand that I’m biased. However, if this option becomes swapped out for cheaper DIY insurance plans that can be purchased piece-meal on a health insurance exchange, I think many ‘healthy’ individuals like me may err on choosing less coverage which could have a host of other unwanted consequences.

Something to think about…

Elizabeth Fowler on the Healthcare Reform

On February 7, Elizabeth Fowler, the special assistant to the president for healthcare and economic policy, spoke the Yale MBA students about critical changes within the healthcare reform. She is particularly well suited to speak to these points because she helped to write the bill as chief health counsel for the Senate Finance Committee.

Some key points she mentioned:

1) Progress made so far

  • Pre-Existing Condition Insurance Program (PCIP), which will provide insurance for those with pre-existing conditions until the law makes it illegal to discriminate again such people in 2014
  • Early Retiree Reinsurance Program and new rules for insurance companies, including bans on lifetime benefit limits, restrictions on annual limits, and coverage for children under 26

2) Progress in the future

  • Health Insurance Exchange (HIX - not to be confused with HIE, Health Information Exchange)
  • Accountable Care Organizations

Big moves on the Health Care Reform Bill this week

Health-Care Reform’s Road Map Through the House

Updated 5:02 p.m.
By Ben Pershing
The health-care reform bill embarks on its final journey through the House this week, beginning Monday at the Budget Committee and ending, supporters hope, with a vote on final passage on the House floor by the weekend.

Though some elements of Democrats’ procedural strategy have yet to be decided, the basic plan is clear: The House will approve the same reform bill that was passed by the Senate in December and will vote on a package of amendments — dubbed the “reconciliation bill” after the budgetary process that will be used to create it — that would then need to be passed by the Senate.

Here is the three-step process expected to unfold this week:

Step 1 (Monday)

The House Budget Committee got the ball rolling Monday by approving, on a 21 to 16 vote, the reconciliation bill.

But that vote wasn’t on the actual changes to the health-care bill that Democrats want to make. Instead, the committee voted on what’s known as a “shell bill” — a measure whose contents will be erased later in the process and replaced with the guts of a new bill. Why? Because under the instructions written into last year’s budget, the reconciliation process must use a measure written no later than Oct. 15, 2009.

The Budget Committee is now considering a series of “motions to instruct” the Rules Committee — legislative recommendations from Republicans and Democrats that are totally symbolic and nonbinding, but can be used to score political points.

After the Budget Committee approves the reconciliation measure, the Rules Committee must wait at least two days before it takes up the bill, technically so members have time to review it.

Step 2 (Wednesday/Thursday)

Once the requisite two days have passed, the House Rules Committee begins the real work of creating the reconciliation bill.

That panel — on which Democrats have a 9 to 4 membership advantage — will swap out the old reconciliation language sent by the Budget Committee, substituting the actual amendments that have been crafted in consultation with Democratic leaders, chairmen and the White House.

The committee will also write a rule setting the terms of debate, likely choosing one of two options.

The first option would be to have a vote on the rule, then a vote on the original Senate bill and then a vote on the reconciliation bill.

The second option — dubbed the “Slaughter solution” after Rules Committee Chairman Louise Slaughter (D-N.Y.) — would use what’s called a “self-executing rule,” under which the House would “deem” the original Senate bill passed after the House votes on the rule for debate.

In other words, the House could pass the original Senate bill without lawmakers actually taking a stand-alone vote on it. Then the House would vote on the reconciliation measure.

Under either option, the House is also likely to vote on a Republican “motion to recommit” on the reconciliation measure, which would represent the GOP’s proposal for a substitute bill.

Step 3 (Friday/Saturday/Sunday?)

The House votes, following one of the two scenarios explained above. If the Senate bill passes (or is “deemed” passed by the House), then it goes to President Obama for his signature, regardless of what happens with the reconciliation bill.

If the reconciliation measure passes the House, then it goes to the Senate for a vote as early as next week. That chamber could pass the reconciliation bill as is, or it could amend the measure, sending it back to the House again.


Popular Mechanics: How Text Messages Could Change Global Healthcare

Chris Sweeney raises the question whether low tech SMS programs used by nonprofits like Medic Mobil could revolutionize global health.

Josh Nesbit sees a bright future for the cellphones that most of us see as antiquated. The 24-year-old Nesbit is the CEO of nonprofit Medic Mobile, and this startup exec’s vision is to take those chunky Nokias and other phones of the recent past—the kind that most Americans threw out or relegated to the junk drawer long ago—and use them to radically change how health care is delivered in developing nations.

These old phones don’t have the touchscreens and slick software features of our shiny new smartphones. But they can text, and in Nesbit’s eyes, a simple technology like text messaging is a tool that can be used to track disease outbreaks, help first responders quickly locate victims after disasters, and more.

Full Text of Document