Why conservatives are so obsessed with guns.

Pa. Director Of Doctors For America Discusses Health Care « CBS Pittsburgh

I will immodestly say I did really well on this show. Mike is a very fair host and always nice to me.

I also did WESA’s Essential Pittsburgh yesterday, June 28:

http://www.essentialpublicradio.org/story/2012-06-28/affordable-care-act-decision-doctors-perspectives-11596

Cheers,

Obama Health Law Seen Valid, Scholars Expect Rejection – Bloomberg

The U.S. Supreme Court should uphold a law requiring most Americans to have health insurance if the justices follow legal precedent, according to 19 of 21 constitutional law professors who ventured an opinion on the most-anticipated ruling in years. Only eight of them predicted the court would do so.

The Ryan proposal compels Americans to buy insurance—just like Obamacare does. – Slate Magazine

Ryan’s roadmap would reshape Americans’ access to health insurance mainly through two provisions, both of which pressure people to purchase private health insurance to an extent and through mechanisms that are materially indistinguishable from the supposedly toxic Obamacare mandate. One of these Ryan proposals—as yet little noticed by pundits or politicians—is almost an exact copy of a provision in the Affordable Care Act. * It would repeal the current exclusion from employees’ income of employer contributions to their health insurance premiums, thus terminating the subsidized employer-sponsored group health regime that covers nearly 60 percent of all Americans. In its place, the Republican plan would substitute a refundable tax credit, to be provided to individuals who purchase health insurance (or to employers who purchase health insurance for their employees). When this new arrangement takes effect in 2022, the tax credit would be set at $2,300 per adult and $1,700 per child, not to exceed $5,700 per family.

Like this Ryancare tax incentive, the “individual mandate” section of the ACA, which the White House calls the “individual responsibility” provision, constitutes a pay-or-play option. Beginning Jan. 1, 2014, when the ACA provision takes effect, individuals who do not qualify for exemption on hardship or other specified grounds, must either carry health insurance or pay a tax penalty as part of their annual income tax filing. The ACA caps individuals’ penalty liability at 2.5 percent of household income above the filing threshold, or a flat dollar amount ranging from $695 to $2,085, depending on family size.

Under both provisions, the result is the same: People who choose to carry health insurance have a lower tax bill than they would if they chose not to. In terms of their respective potential impact on individuals’ bank accounts and tax liability, the manner in which they affect individuals’ financial incentives, and hence the constraining effect on individuals’ financial choices to either buy or forgo health insurance, the two “mandate” provisions are identical. (Indeed, in most cases, the financial difference for the individual taxpayer made by the Republican tax credit would be greater—i.e., more “coercive”—than the ACA tax penalty.)

Eleven Alternatives to Obamacare’s Individual Mandate – Businessweek

The short version:

1. Relabel the mandate to escape the high court’s scrutiny. Give people a tax credit if they do carry insurance, which is functionally the same as penalizing them if they don’t. Sound like a sly evasion? It’s essentially the approach advocated by House Budget Committee Chairman Paul Ryan.

2. Increase subsidies, such as the law’s existing set of tax credits for low-income Americans, to induce more people to sign up voluntarily. This would be along the lines of the enticements in Medicare Parts B (doctors’ and outpatient services) and D (prescription drugs).

3. Use government funds to compensate insurers for the cost of “adverse selection,” in which only sick people sign onto their plans.

4. Have the government and/or employers enroll people into health plans automatically, but with an option to drop insurance. Count on inertia and procrastination to keep them in the system.

5. Require people who go without insurance to sign a form acknowledging that they won’t be able to get back in for five years, even if they have an accident or contract a costly disease and want to get covered right away.

6. Leave it to the 50 states to enact their own mandates under state law, which would not be subject to Supreme Court review.

7. Penalize people who delay enrolling. Charge them more or strip them of the right to buy insurance at a standard rate regardless of preexisting conditions. There’s a precedent in Medicare: People who enroll in Medicare Part B after age 65 pay a 10 percent penalty on their Part B premium unless they have employer-provided health insurance.

There are more, but these are the more reasonable ones…

Sorry, The CBO Did Not Say Health Reform Kills 800,000 Jobs | The New Republic

From Jonathon Chait on the “job killing” myth:

Other provisions in the legislation are also likely to diminish people’s incentives to work. Changes to the insurance market, including provisions that prohibit insurers from denying coverage to people because of preexisting conditions and that restrict how much prices can vary with an individual’s age or health status, will increase the appeal of health insurance plans offered outside the workplace for older workers. As a result, some older workers will choose to retire earlier than they otherwise would. (CBO)

In other words, people who are only working because they desperately need employer-sponsored health insurance will no longer do so. They’re not going on the public dole — they’re just people who have the means not to work full-time and will be free to make employment decisions that aren’t premised upon an individual health insurance market that shuts them out. Some workers will choose to retire early because they now have the ability to buy their own health insurance. This is what Republicans call “destroying jobs.”

Now, CBO does show a very minor effect of higher taxes discouraging the work incentive. But this is a very small portion of what is a fairly small effect to begin with. Basically the analysis shows the effect of giving workers with preexisting conditions access to a health care system that doesn’t lock them into the employer-provided system. Apparently, in the conservative view, being chained to your desk at some big company until you’re 65 and unable to retire or start your own business because the individual market is rife with adverse selection is defined as “freedom.”

Commentary: Affordable Care Act a life-saver for ‘Susan.’ | www.palmbeachpost.com

DFA’s Dawn Harris Sherling, M.D, illustrates the very real consequences of life with and without health care access…

As the court debates forcing people to buy broccoli and other theoretical legal nonsense, I worry about my very real patients. Unlike the supermarket, very few of us willingly enter the health care marketplace. One day, when we least expect it, we will be flung into it by cancer, heart disease, infection or an accident. We may have led lives to encourage it. We may have done nothing except to have very bad luck. And we can only hope that, unlike Susan, when we are at our lowest the last thing we will have to worry about will be our health insurance.

Small Business Majority | Small Business Owners’ Views on Implementing the Affordable Care Act

Key findings:

Only a third of small business owners want the Supreme Court to overturn the Affordable Care Act; a plurality of 50% would like it upheld, with minor or no changes. This support grows after learning more details about the law’s key provisions:
Only 34% of small businesses want to see the healthcare law overturned, while 50% want it to remain intact with, at most, minor changes. After learning more about its specifics, only 28% want to see it repealed and a 56% majority want it to be kept, as is or with minor changes. A 55% majority say they want it upheld because we need to make sure everyone has health coverage.

Figure 1: After learning about the law, support for the Affordable Care Act grows

There has been a lot of talk about the nation’s health care reform law, the Patient Protection and Affordable Care Act. Which one of the following statements comes closest to your point of view when it comes to this law.

After everything you read, which one of the following statements comes closest to your point of view when it comes to the nation’s healthcare reform law, the Patient Protection and Affordable Care Act.

By an 8:1 margin, entrepreneurs say they’d consider using a state health insurance exchange, and they favorably view many possible features of the exchange:
A 66% majority of small business owners say they would use their state exchange or at least consider using it, compared to 8% who say they would not consider using it when they provide benefits. By wide margins, entrepreneurs find a host of possible features of the exchange very appealing. By a 2:1 ratio, small business owners support their state applying for federal funds to set one up.

The Never Ending Health Reform BS Machine

Just at the beginning of the month, I posted at the Doctors for America Blogabout a couple of ridiculous email campaigns that will not die, in spite of how ridiculous they both were and are.

A friend sent me another one this morning, which is actually a YouTube video (link below). The video is based on previously debunked BS email that was going around in 2009, as noted by Snopes. At the time, Politifact covered it, and you can read the debunking here.

Sent: Saturday, May 5, 2012 4:57 AM

Subject: THIS WILL KNOCK YOUR SOCKS OFF!! Please WATCH!!!

More details on your healthcare bill.

Please watch the entire video…. Then forward it to everyone you know.

http://www.youtube.com/watch_popup?v=HcBaSP31Be8&vg=medium (10:29)!

What is most astounding to me is that you can have a steaming pile of BS, like the original letter, and then take the time and effort to turn it into a video without, apparently, using The Google to see if any of it is true! Who does this stuff?

Medicaid payments to primary-care doctors will rise under new regulation – The Washington Post

Medicaid payments to primary-care doctors will rise under new regulation – The Washington Post: Primary care doctors could get a pay raise next year for treating Medicaid patients, under a rule announced by the Obama administration Wednesday.

The proposed regulation implements a two-year pay increase included in the 2010 health-care law. The increase, effective in 2013 and 2014, brings primary care fees for Medicaid, which covers indigent patients, in line with those for Medicare, which insures the elderly and some disabled patients.

Although Medicaid is jointly funded by states and the federal government, the pay boost would be covered entirely with federal dollars totaling more than $11 billion over the two years it would be in effect.

Congress automatically appropriated those funds when it adopted the health-care law, so it will not need to act now.

However, the provision is among hundreds that could be instantly nullified if the Supreme Court decides to overturn the law in its entirety when it rules on the constitutional challenge. The court heard arguments on the case in March, and a decision is expected late next month.

The pay raise is one of several attempts in the law to address a fundamental challenge in U.S. health-care: Because primary care doctors focus on preventive care, they offer the best hope of curbing the nation’s health spending. Yet they are paid far less than specialists, contributing to a shortage of primary care doctors that is projected to grow with the aging of baby boomers, the retirement of physicians and an expected influx of more than 30 million Americans who will gain insurance through the health-care law beginning in 2014.

– Sent using Google Toolbar

Medicare to Expand Competitive Bidding on Equipment – NYTimes.com

Medicare to Expand Competitive Bidding on Equipment – NYTimes.com:

Medicare officials estimated that competitive bidding for home medical equipment would save more than $42 billion in the next 10 years — $17 billion for beneficiaries and $25.7 billion for the Medicare program.

Ms. Sebelius said the savings showed the value of the health care overhaul signed into law by President Obama in 2010.

The competitive bidding program was established, with support from many Republicans, under a 2003 law that added a prescription drug benefit to Medicare. In 2008, Congress temporarily delayed the program and terminated supplier contracts that were in effect. The 2010 law expanded the program.

Medicare has historically used a fee schedule to pay suppliers. Officials gave this example of the savings: Under the fee schedule, Medicare would have paid $2,080 for an oxygen concentrator last year, and the beneficiary would have paid 20 percent, or $416. By contrast, with competitive bidding, Medicare paid about $1,395, and the beneficiary paid $279.

– Sent using Google Toolbar