Reimbursing Doctors for Discussing End-of-Life Care

Medicare may begin reimbursing doctors for discussing end-of-life issues with patients, reports Stateline.

The American Medical Association (AMA) issues annual recommendations to the Centers for Medicare and Medicaid Services (CMS) regarding a number of health care procedures and practices. While CMS is not required to implement the AMA’s recommendations, CMS often uses the recommendations to set reimbursement rates for Medicare and Medicaid. Private insurers also tend to follow the reimbursement guidance.

Medicare, the largest health insurer in the United States, has 50 million beneficiaries. The AMA’s recommendations will focus on reimbursement for doctors who confer with patients about advance care planning in the case of incapacity. If Medicare reimburses doctors for these services, doctors are more likely to sit down with patients and discuss their end-of-life treatment.

Continue reading from NCPA…

Medicaid Expansion Causes 40% More Emergency Room Visits


Medicaid Expansion Causes 40 % More Emergency Room Visits – by Henry W. Burke

March 24, 2014

The Lie:

On 12.15.09, Obama stated:

The final bill [will] make sure that people are getting the care they need and the checkups they need and the screenings they need before they get sick — which will save all of us money and reduce pressures on emergency rooms all across the country.

The Truth:

Startling facts have emerged from the Oregon Health Insurance Experiment.  When Medicaid made health care “free,” these households made 40 % more emergency room visits

The increase in ER usage from Medicaid was solely in outpatient visits.

 Obama’s Emergency Room Lies

Obama made a lot of promises to sell Obamacare that have turned out to be false.  Part of that sales effort involved lies about Emergency Room (ER) use.  The following list of lies was assembled by Forbes contributor Michael F. Cannon.

Barack Obama Stated:


           [O]ne of the areas where we can potentially see some saving is a lot of those patients are being seen in the emergency room anyway, and if we are increasing prevention, if we are increasing wellness programs, we’re reducing the amount of emergency room care…


          [T]hose of us with health insurance are also paying a hidden and growing tax for those without it — about $1,000 per year that pays for somebody else’s emergency room and charitable care…If there are affordable options and people still don’t sign up for health insurance, it means we pay for these people’s expensive emergency room visits.


          The final bill [will] make sure that people are getting the care they need and the checkups they need and the screenings they need before they get sick — which will save all of us money and reduce pressures on emergency rooms all across the country.



          You can’t get those savings if those people are still going to the emergency room.



          [P]eople are no longer going to the emergency room and they now have good health care, they’re now getting preventive care.


Continue reading “Medicaid Expansion Causes 40% More Emergency Room Visits”

Ten Steps for a Market-Oriented Health Care System




The country needs a health care reform plan that would replace Obamacare, while increasing access, lowering costs and improving the quality of care—all the things Obamacare was supposed to do but doesn’t. The principles for creating a consumer driven, market-oriented health care plan that would achieve those goals have been around for years, and a number of Republicans have included them in their various reform proposals. Below we highlight 10 steps that would establish a market-oriented health care system.

1. Establish Tax Fairness

About 156 million Americans get their health insurance through an employer.1 The tax system is the primary reason that the employer-based system survives, when almost all other types of insurance are bought and paid for by individuals. Employer money spent on health insurance is excluded from employees’ income. The Office of Management and Budget estimates the tax exclusion costs the federal government about $170 billion in 2012 in lost income tax revenue and another $130 billion in lost payroll tax revenue.2 Redirecting that tax break directly to the individual, rather than having it flow through the employer, could be both budget neutral and would create a level tax playing field.

President George W. Bush proposed ending the tax exclusion and giving everyone a standard deduction: $7,500 for an individual, $15,000 for a family. As a presidential candidate, Senator John McCain proposed giving workers a refundable tax credit: $2,500 for an individual or $5,000 for a family. Either approach would have gone a long way toward implementing tax fairness because everyone, including the self-employed and employees without employer-provided coverage, would get the same break.

2. Expand Consumer Driven Options Like HSAs

The primary reason Americans spend so much on health care is that comprehensive health insurance insulates them from the cost of care. Health Savings Accounts (HSAs), in combination with a high-deductible health insurance policy to cover major accidents or illnesses, allow workers and their employers to deposit money in a tax-free account owned and controlled by the individual. Patients use their HSA money to pay for allowable small and routine medical care and medications, but they keep it if they don’t use it, giving them a reason to be value-conscious shoppers in the health care marketplace.

Several studies have demonstrated that HSAs lower health care spending without any negative impact on patients’ health.3 Obamacare reduced the number of allowable HSA expenditures; those restrictions should be reversed to allow the widest possible use of HSAs.

Employers Offering Health Accounts

Continue reading here…



Health Care Costs Dropping Due to Health Savings Accounts, Not ObamaCare

President Obama attributes slowing health care costs to the Affordable Care Act, but the slowdown is actually due to Health Savings Accounts (HSAs), says Peter Ferrara, a senior fellow at the National Center for Policy Analysis.

ObamaCare only went into effect this year, while the health cost slowdown began 10 years ago. HSAs were enacted into law in 2003 and they have seen remarkable growth:

  • The accounts grew by a full 22 percent in 2012.
  • Total HSA assets in 2012 were $15.5 billion, and they were projected to grow 22 percent again in 2013.
  • At the beginning of 2013, an estimated 15 million Americans were covered by HSAs, and 20 million Americans were covered by Consumer Directed Health Plans.

At the same time, national health spending growth has dropped to 3.9 percent every year between 2009 and 2011, and to 3.6 percent in 2012. This is nearly two-thirds slower than a decade ago, and it is the slowest rate of increase in health care costs since the 1960s.

Continue reading “Health Care Costs Dropping Due to Health Savings Accounts, Not ObamaCare”

Obama Hits New Low On Healthcare

A strong majority disapprove of President Obama?s handling of healthcare, according to a Quinnipiac University poll released on Tuesday. According to the survey, 60 percent disapprove of how the president has handled the issue, against only 36 percent who approve. That?s down from last month, when 52 percent said they disapproved and 43 percent said they approved. It?s also the worst margin for the president since Quinnipiac began polling the question.

The White House has struggled to defend Obama’s 2009 claim that people could keep their old health insurance under ObamaCare as thousands of people received notifications that their insurance companies were dropping their plans.

Read more…


A Thanksgiving Miracle

From:  Gary L. Bauer,  Campaign for Working Families

We are getting reports from all over the country of a possible Thanksgiving miracle. Truly, something appears to have happened once believed to be impossible.

On farms in Iowa and in gritty working class neighborhoods in Pittsburg, from sunny L.A. to windy Chicago, we have seen reports that at Thanksgiving meals across the nation, lost sheep came home. As families gazed in wonder in home after home, former “Obamabots” renounced their indoctrination and admitted they had been wrong when they bought into the doubletalk from our community organizer-in-chief.

Sure, these conversions aren’t quite a “road to Damascus” experience and backsliding is still possible. But from unemployed college graduates to recently insurance-deprived consumers, the “faith” in “O” has collapsed. God bless America!



Insurance Company’s will be required to ‘Share Wealth’

Old Honey Pot

Obamacare Has A Honey Pot To Buy Insurance Company Support, And Obama Will Need It

After his Obamacare apology tour press conference last Thursday, President Obama summoned 15 insurance company executives to the White House the next day hoping to persuade them to pick up the pieces of his tattered health care law that just a month ago he claimed was good insurance (it was just the website that was a problem, you see).

Meanwhile, the Department of Health and Human Services (HHS), which is the agency responsible for implementing both the website and Obamacare, released a letter to all 50 of the state insurance commissioners, who oversee insurance within their respective state, explaining in a little more detail (just over two pages) what the president really meant. (Washington, DC, had a commissioner, but he was fired within 24 hours of criticizing the president’s proposal.)

The most interesting part of the letter is the last paragraph, which essentially says, “Stick with us here and we’ll be funneling you the big bucks.”

Continue reading from Forbes…

Here is what we can expect in the near future with Obamacare…

Slow Regulatory Approval in Canada Hinders Cancer Survival

Slow regulatory and reimbursement approvals in Canada are affecting cancer survival, says Dr. Nigel Rawson, a pharmacoepidemiologist and president of Eastlake Research Group in Oakville, Ontario, Canada.

More than 5,000 patients could have been negatively affected by delayed federal regulatory and provincial reimbursement approval for five new oncology drugs approved in Canada between 2003 and 2011 for the treatment of advanced solid tumors.

  • If each of these patients had received the drugs and achieved the median survival benefit identified in each drug’s pivotal randomized clinical trial, a total extension in survival over standard therapy of 1,696 patient-years would have resulted.
  • The monetary value of this extension in life was estimated to be between $339.2 million and $559.6 million.
  • Each drug received approval from Health Canada between 205 and 591 days after the U.S. Federal Drug Administration approval, and the time required to review each drug was 1.5 to 4.5 times longer in Canada than in the United States.


Hold Democrats Accountable for the Obamacare Lie

Beyond the Obamacare Website Fiasco

Obamacare’s computer glitches have reduced the president’s eponymic health-care plan to fodder for late-night TV comedians. But in some ways the president is fortunate that the computer fiasco is obscuring the even bigger and more consequential problems facing the law.

For example, there’s the problem with keeping your current insurance.  Millions of Americans are finding out that, even if they like the plans they have now, they are being kicked off because those plans do not meet the requirements of Obamacare.

  • Florida Blue, for example, is canceling nearly 300,000 policies, about 80 percent of its individual policies in the state.
  • Kaiser Permanente in California has sent notices to 160,000 people – about half of its individual business in the state.
  • Highmark in Pittsburgh is dropping about 20 percent of its individual-market customers, while Independence Blue Cross, the major insurer in Philadelphia, is dropping about 45 percent.

Meanwhile, in the group market, we are seeing companies begin to drop insurance for their workers.

  • Roughly 160,000 workers at Walgreens are losing their coverage.
  • So are some 20,000 part-time workers at Home Depot, and roughly 15,000 spouses of workers at UPS.

Being forced to change plans means that many Americans will not be able to keep their current doctors. Insurance plans available on the exchanges – and in most states the selection of available plans is extremely limited – have been rapidly dropping doctors and hospitals from their networks.

  • In Illinois, Blue Cross and Blue Shield said that at least some of its plans will no longer include Rush University Medical Center or Northwestern Memorial Hospital in their networks.
  • In California, most insurers won’t include UCLA Medical Center, and none will include Cedars Sinai.
  • In New Hampshire, WellPoint, the only insurer participating in the exchange, covers just 14 of the state’s 26 hospitals, and has dropped about a third of the physicians who used to be part of its network.

The network downsizing is not confined to the exchanges either.  Comparisons of exchange premiums with those found prior to October 1 show that premiums are higher now in at least 45 states, in some cases as much as 256 percent higher. As predicted, the young and healthy are seeing the biggest increases.

It may not be long before Obamacare supporters look back longingly to the days when the health-care law was just a bad joke.

Michael Tanner, “Beyond the Obamacare Website Fiasco,”  Cato Institute, October 30, 2013.