A health care reform that’s OK for Oklahoma | NewsOK.com

BY LARRY MINNIX in the Oklahoman

Every day, 10 million elderly and disabled Americans struggle to do things that most of us don’t think twice about, like putting on clothes or getting out of bed. Worse, most of them do not have access to affordable options for specialized care that would allow them to remain independent and productive in their homes and communities.

As the baby boomer generation nears retirement, it’s more important than ever to improve the affordability and accessibility of long-term services and supports. The number of Americans who require such care will increase by 50 percent during the next decade.

Many people don’t realize the lack of support available to them until they face a crisis. Medicare won’t pay for long-term services and supports.

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GOP Argues Insurance Mandate Violates Constitution

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By Scott Hensley

Unable to win the votes on health overhaul, Republicans are eyeing a battle in the courts.

Their strategy? Have the overhaul's requirement that everyone in the country have health insurance declared unconstitutional. If uninsured people don't buy coverage, they would be penalized to the tune of $750 under the Senate bill, for instance.

Republicans are forcing the issue with a Senate vote today on the constitutionality of the mandate. "What's next?" said Sen. John Ensign (R-NV), who's leading the challenge. "Will we consider legislation in the future requiring every American to buy a car? Will we consider legislation in the future requiring every American to buy a house?" he asked, according to the Wall Street Journal.

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'Invisible bracelet' for emergency health alerts? - Boston.com

By Lauran Neergaard, AP Medical Writer

Emergency health alerts for the Facebook generation? The nation's ambulance crews are pushing a virtual medical ID system to rapidly learn a patient's health history during a crisis -- and which can immediately text-message loved ones that the person is headed for a hospital.

The Web-based registry, invisibleBracelet.org, started in Oklahoma and got a boost this fall when the state's government made the program an optional health benefit for its own employees.

Now the Invisible Bracelet attempts to go nationwide as the American Ambulance Association next month begins training its medics, who in turn will urge people in their communities to sign up.
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Senate healthcare bill may be hard to reconcile with House’s

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Los Angeles Times:

As the Senate lumbers toward passage of its healthcare bill, Democrats are looking ahead to the potentially difficult process of reconciling its substantial differences with the more liberal House version—the last major obstacle before President Obama can sign landmark legislation into law. Democrats are hopeful that the momentum generated by the long-awaited Senate vote—and the high political stakes involved in finishing the job—will grease the wheels of negotiations with the House. But after lawmakers enjoy what is left of the holiday season in their home states, they will return to wide and deeply held differences between the House and Senate bills on federal funding for abortion and the liberals' dream of establishing a "public option"—a government plan that would compete with private insurers—to guarantee access to affordable insurance. Negotiators also will have to hammer out disagreements that will determine how quickly the bill takes effect, what taxes will be raised, and other items that reach deeply into every hospital, doctor's office, and home medicine cabinet.

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Pain before gain in health care overhaul | AP | 12/23/2009

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by RICARDO ALONSO-ZALDIVAR

The costs of health care reform being pushed through Congress by Democrats will be felt long before the benefits.

Proposed taxes and fees on upper-income earners, insurers, even tanning parlors, take effect quickly. So would Medicare cuts.

Benefits, such as subsidies for lower middle-income households, consumer protections for all, and eliminating the prescription coverage gap for seniors, come gradually.

"There's going to be an expectations gap, no question about that," said Drew Altman, president of the nonpartisan Kaiser Family Foundation. "People are going to see their premiums and out-of-pocket costs go up before the tangible benefits kick in."

Most of the 30 million uninsured helped by the bill won't get coverage until 2013 at the earliest, well after the next presidential election.
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Ordering from A Restaurant Without a Menu

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by Tom Babinszki

Imagine yourself going to your favorite restaurant. You like the ambience and you immediately find a comfortable spot for your own. Everything is going well until you receive the menu but you can’t read it. Think about it. What would you do? Would you ask the waiter about the available meals? Would you get frustrated and just look for another restaurant?

This is actually a common scenario for blind people. Oftentimes, they would go to a restaurant and they do not get a menu they can read.

How Some Restaurants Help Blind People:
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TIME GOES BY | Reasons to Support the Senate Health Care Bill

by Ronni Bennett

I was surprised at the anger and bitterness in the some of the comments on Monday's post about the Senate Health Care bill. Is it far less than it should or could have been? You bet.

Am I disappointed that President Obama held himself above the fray during the debate and didn't get his hands dirty twisting arms and horse-trading? Absolutely.

Am I furious with the entire Republican contingent who would rather see people die than give an inch to President Obama on any issue? Without a doubt.

However, in the larger picture, something crucial and good has happened: the idea that health care is a commodity to be mined for the profit of a few has lost ground. The idea that health care can be rationed by the ability to pay is no longer acceptable.

Yes, it is true, for the time-being, that private insurers will gain 30 million customers, but they will be severely restricted now from gouging those customers. So let us look at the broad gains contained in the Senate bill.

Within a few broad categories, everyone will pay the same amount for health coverage.

Medicaid will be significantly expanded.

Subsidies for low- and middle-income workers will keep premiums to under 10 percent of their income.

There are caps on out-of-pocket expenses.

There will be no life-time caps on benefits and annual caps will be restricted.

There are limits on emergency room charges for low-income, uninsured patients.

There are new tax credits to help small businesses purchase coverage.
Insurers must take all comers. No longer can benefits be cut off when people get sick, nor can coverage be denied for age, gender and pre-existing conditions.

That last item deserves a bit of explanation – it involves two issues: denial of coverage and denial of care for pre-existing conditions. Both are banned for children and adults as of 2014 when the exchanges, where people will purchase insurance, go into effect.

A dispensation has been carved out for children who, as soon as a bill is signed into law, cannot be denied CARE for pre-existing conditions. That means if you already have insurance covering a child, a company cannot deny a claim for anything they might now label a pre-existing condition.

Not good enough? True. But better than what we have now.

There is another immediate gain for Medicare beneficiaries. The size of the doughnut hole in prescription drug coverage (Part D) is reduced by $500 for 2010. Additionally, beginning on 1 July 2010, low- and middle-income elders enrolled in Part D programs who fall into the doughnut hole will receive a 50 percent discount on brand-name drugs and biologics.

Not good enough? Yes. But better than 2009.

For a century, during seven different presidential administrations before this one, health care reform has been attempted and failed every time. Given that history, we have made remarkable progress this year. The bill is far from perfect and it will take many years, perhaps a couple of decades, for it to become comprehensive, fair to all and for the private profit system to be deemed unacceptable.

But we have a beginning. Listen to Eugene Robinson writing in the Washington Post yesterday:

“[L]et's consider the measure's one great virtue: For the first time, we will enshrine the principle that all Americans deserve access to medical care regardless of their ability to pay. No longer will it be the policy and practice of our nation to ration health care according to wealth...

“For anyone who believes it is shameful that the richest, most powerful nation in the world cares so little about the health and welfare of its citizens, this is the moment. It should be seized, not squandered.”

TIME GOES BY | Reasons to Support the Senate Health Care Bill

What a Big House You Have, Grandma - The New Old Age Blog - NYTimes.com

By PAULA SPAN

Ever since Laura Marsh moved in with Marjorie Marsh in Orange County, Calif., she has kept an eye on things. Ms. Marsh calls from work to be sure Mrs. Marsh is fine. When Ms. Marsh gets home — she works late hours as an emergency medical technician — she checks to see that the house is securely locked and that Mrs. Marsh is safely in bed.
.....
Lots of daughters provide this kind of backstopping for their elders, and sometimes it is easier to do when they share a household. But Laura Marsh isn’t Marjorie Marsh’s child; she is her granddaughter. She was just 19 when they became housemates; now she’s 23. “It’s really been a blessing,” Marjorie Marsh said.

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Postscript: The Astor Trial - The New Old Age Blog - NYTimes.com

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A judge has sentenced Anthony D. Marshall, only child of the late philanthropist and socialite Brooke Astor, to one to three years in prison for looting his mother’s fortune as she slipped into the confusion of Alzheimer’s disease.

“What would she say if she were here?” Justice A. Kirke Bartley Jr. demanded in State Supreme Court in Manhattan. Mrs. Astor died at age 105 in 2007. “Would she blanch at the spectacle?”

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Medicare Advantage Reforms: Comparing House and Senate Bills

by Brian Biles and Grace Arnold

ABSTRACT: The Medicare Advantage (MA) program, which enables Medicare beneficiaries to enjoy private health plan coverage, is a major element of the current health care reform discussion on Capitol Hill—in large part because payments to MA plans in 2009 are expected to run at least $11 billion more than traditional Medicare would have cost. While the pending Senate and House bills both endeavor to reduce these extra MA payments,their approaches are different. The bills also differ on other aspects of reforming the MA program, such as plans’ allowable geographic areas, their risk-adjustment systems and reporting requirements, their potential bonuses for achieving high-quality care and providing good management, and their beneficiary protections. This issue brief compares the above and other provisions in the House and Senate bills, which have a common overall goal to improve the value that Medicare obtains for the dollars it spends.

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Parkview Medical Center: Underscoring the Importance of Communication in Pneumonia Care

Parkview Medical Center is one of the top-performing hospitals in the country in the pneumonia process-of-care measures, or "core," measures. The core measures, developed by the Hospital Quality Alliance, relate to achievement of recommended treatment in four clinical areas: heart attack, heart failure, pneumonia, and surgical care. In addition to performing strongly in the pneumonia care core measures, Parkview has achieved 99 percent compliance in the heart failure core measures. Hospital leaders credit the organization's strong performance in pneumonia care to the regular communication and reinforcement provided by quality improvement staff. Concurrent review in particular is relied on as an opportunity to provide real-time education and reminders to providers at the point of care. Those interviewed also emphasize that the hospital leaders are willing to try anything in the name of improving patient care.

Mapping the State of the Art: Integrating Care for Vulnerable Older Persons

Looking across jurisdictions nationally and internationally, the Canadian Research Network for Care in the Community conducted a scoping review in 2008, which explored 47 models of integrating health and social care for older persons. This report presents the findings of the review and distills key learning points that help enable a better understanding of the institutional and system level characteristics that underpin successful integrating community based care efforts for vulnerable older persons.

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Home Care Law Blog: Update on Health Care Reform and Home Health - The Ghost of Christmas Future

NAHC has sent out an update to its members on the effects to home health and hospice of the Manager's Amendment that is currently working its way through the Senate. LIke the Ghost of Christmas Future in A Christmas Carol, it paints a pretty bleak picture. (I apologize for the Christmas Carol references, but I thought I would try to distract from the bad news with a Christmas theme.) According to NAHC, the Manager's Amendment will do the following:

Specifically, the amendment makes the following changes to the home health portions of the overall health reform package:
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