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.
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…
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
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.
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.
Small businesses allowed ‘grandfathered’ plans which face fewer requirements. Such plans are not required to cover or provide the following:
- Preventive care without cost-sharing
- Essential Health Benefits
- Internal/external appeals process for contesting coverage decisions
- Direct access to OB/GYN without referral
Small Business Options Program (SHOP exchange) will provide an exchange for small business employers purchase plans and offer additional services.
While there will be tax credit subsidies offered to alleviate the burden of small business employers, some small businesses may face penalties in 2014 if coverage provided to employees is not adequate.
Computerized patient records are unlikely to cut health care costs and may actually encourage doctors to order expensive tests more often, a study published on Monday concludes.
Industry experts have said that electronic health records could generate huge savings — as much as $80 billion a year, according to a RAND Corporation estimate. The promise of cost savings has been a major justification for billions of dollars in federal spending to encourage doctors to embrace digital health records.
But research published Monday in the journal Health Affairs found that doctors using computers to track tests, like X-rays and magnetic resonance imaging, ordered far more tests than doctors relying on paper records.