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Polyclinic Community Health Foundation adds two to board

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Dr. Harold Moore

The Polyclinic Community Health Foundation has added two new members to its board of directors, Dr. Harold Moore and Laurie Stewart.

Dr. Moore is a family practice physician at Country Doctor, a non-profit organization providing health care to the Seattle community. He is the clinical site director at Country Doctor and is also a clinical instructor of family medicine in the Department of Family Medicine at the University of Washington.

Throughout his career Dr. Moore has contributed to community and public health, including participating in a community medicine project “Health Care for the Homeless” in Seattle.

Laurie Stewart

Stewart is the president and CEO of Sound Community Bank – formerly Credit Union of the Pacific – headquartered in Seattle.  With total assets in excess of $330 million, Sound Community Bank serves the Puget Sound region through five branch offices.

She is a board member for the Community Foundation for the Sequim/Dungeness Valley, the Woodland Park Zoo, The Arthritis Foundation and the Washington Banker’s Association (WBA).

In addition to her work in corporate and not-for-profit governance she is also a Court Appointed Special Advocate for Children and a dedicated fund raiser for the Arthritis Foundation Joints in Motion program and the Woodland Park Zoo.

To learn more:

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VM’s Benaroya Research Institute names new Communications Director

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The Benaroya Research Institute at Virginia Mason has named Kay A. Branz as director of Communications.

Branz was previously vice president of Communications and Marketing for the American College of Healthcare Executives based in Chicago.

In that position, she led the organization’s print and online communications efforts, social media initiatives and published Healthcare Executive, a top-ranked magazine for health care leaders.

Her prior experience includes more than two decades of strategic marketing and marketing communications within hospitals, health care organizations and associations.

Branz is the first director of Communications for Benaroya Research Institute (BRI), a new position created to provide leadership for media relations and community outreach efforts to inform the public about BRI, autoimmune diseases, and clinical trials opportunities.

In assuming this role, Branz will also serve as executive director of Communications for the Immune Tolerance Network (ITN), a large federally funded clinical research consortium with a central office in Seattle led by BRI Director Gerald Nepom, MD, PhD.

To learn more:

  • Visit Kay Branz’s Linkedin page.
  • Visit the Benaroya Research Institute’s webpage.
  • Visit the Immune Tolerance Network webpage.
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Dermatologist joins Minor & James

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Dr. Knox

Minor & James Medical, a multi-specialty physician group located in Seattle, Bellevue and Mercer Island, recently added dermatology to its list of specialties.

New Minor & James Medical dermatologist, John M. Knox, M.D., is board certified in dermatology and specializes in skin cancer and all conditions affecting the skin, hair and nails.

The dermatology division will be located at the First Hill Medical Building at 515 Minor Ave. in Seattle. The dermatology clinic is open Monday through Thursday from 8 a.m. to 5:30 p.m.

For more information or to schedule an appointment:

  • Call 206-386-9540.
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How to get you to take your medicine?

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Researchers Still Searching for Ways to Help Patients Take Their Meds

By Becky Ham, Science Writer
Health Behavior News Service

Photo by Pawel

Clinicians have tried a variety of ways to encourage people to take prescribed medicines, but a new research review says it is still unclear whether many of these interventions have been effective.

Many programs to encourage proper medicine use — from counseling to programs that help patients use their own medicines in the hospital to drug fact sheets to prescription-refill reminders — have not been studied well enough yet to determine how well they work, according to Sophie Hill, Ph.D., a research fellow at La Trobe University in Australia and co-author of the review.

Some strategies appeared effective, Hill said, but “what is clear from this accumulated evidence is that there is not one single approach that appears effective across all clinical situations or for all outcomes.”

Hill and colleagues’ review appears in the latest issue of The Cochrane Library, a publication of the Cochrane Collaboration, an international organization that evaluates medical research.

QUESTION FOR READERS:

Do you take your medicine? If not, why not?


Let us know in the comments section.

 

Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

“Many strategies exist to help people to use medicines safely and effectively, but research in the area is not well organized,” Hill said. “This can make it difficult for policy makers, health professionals and others to find and use the evidence about what works and what does not.”

To bring some clarity to this picture, the Cochrane researchers analyzed 37 systematic reviews on medicine-use interventions. Just over half of the studies reported how effective the interventions were in helping patients take their medications as prescribed.

“Studies consistently show that up to half of patients do not take their medicines as prescribed,” Hill said, making adherence a cause for concern.

Sometimes it’s difficult for patients to adhere to a medication schedule — and sometimes patients deliberately do not take their medicines as prescribed.

Strategies need to address this phenomenon as well, said Rebecca Snead, executive vice president and CEO of the National Alliance of State Pharmacy Associations.

Some patients might stop taking their medications if they do not get “immediate gratification from it,” Snead said. “They may think that all medicine should have that antibiotic, pain-reliever type of effect.”

Others, worried about the costs of prescription drugs, could stop taking their medicines to stay within their monthly budgets. Prescribers often are not aware of this problem, Snead said.

“The reality of it is that a prescriber doesn’t know often what the burden is going to be” for a patient, she said. “He or she doesn’t know about the person’s co-pay, if they have prescription insurance or if the drug is covered on their formulary.”

Simplified doses, assessment of medicines by pharmacists and programs to help patients manage their medicines all showed some promise with regard to adherence and other health outcomes, Hill and her colleagues concluded, but other programs including counseling, reminders and even financial incentives had less consistent effects on medication use.

Very few of the systematic reviews looked at how these strategies fared with children, caregivers and people taking multiple medications for multiple conditions, Hill said.

PHOTO by Pawel

Health Behavior News Service is part of the Center for Advancing Health

The Health Behavior News Service disseminates news stories on the latest findings from peer-reviewed research journals. HBNS covers both new studies and systematic reviews of studies on (1) the effects of behavior on health, (2) health disparities data and (3) patient engagement research. The goal of HBNS stories is to present the facts for readers to understand and use for themselves to make informed choices about health and health care.

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Budget cuts hit community programs for the aged and disabled

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Martha Roherty

States Struggling To Pay For Aged, Disabled Community Programs — A KHN Interview

By Peggy Girshman

Martha Roherty represents people who are facing a perfect storm.

As the executive director of the National Association of States United for Aging and Disabilities, Roherty knows what’s happening to officials in charge of state programs that help older and disabled residents get access to basic services.

For the past few years, they’ve been facing big state budget cuts, layoffs of key personnel and an increasing demand for services. And the situation has done nothing but get worse.

KHN’s Peggy Girshman talked with Roherty at the recent meeting of the American Society on Aging.

Here are edited excerpts of the interview:

What’s happened to these services in the past three or four years?

In addition to the fiscal downturn, [there have been] huge cuts in the non-Medicaid side of long-term services and supports. A lot of those are the softer, pre-Medicaid services you would get, like meals delivered, personal care services, homemaker respite. All of those have been slashed, slashed, slashed, slashed, slashed because they’re not mandatory. They’re not part of the Medicaid program [which funds nursing home stays] and as states have tried to balance their budgets, they’ve had to cut those things. So that’s been a big challenge for us.

It’s the things that allow people to keep their family members at home longer. Or, hopefully, indefinitely

Can you describe how people have used these services over time?

A lot of people who call aging and disability centers for information, the first thing they’ll say is “Mom needs to go into a nursing home.” In fact, when they’ve done the benefits work and the options counseling, they end up needing things like meals delivered and maybe somebody to check on Mom and maybe some light housekeeping. And they never even need to go into the more expensive services.

And, not only that, most of the time the family will accept the cost of doing it. It’s not that they want the government to take care of it, they just don’t even know who to call or what to do. Sometimes it’s even as simple as a home modification. We can put ramps into places and people can stay at home longer.

Is every state seeing cuts this way?

Yes. Unequivocally. Yes. And three years in a row.

In state fiscal year ‘09, the cuts were not as bad. They were like 5 percent or less, in most of the cases. The next year, they got a little steeper. But they were on top of the cuts they had sustained the year before. So they add up. And now we’re seeing states that are having to make up gaps of 25 percent. And the only thing you can do in that case is to eliminate whole programs. They’re working with significantly reduced staffs because they’ve cut state employees first.

They’re making decisions based solely on the numbers. And so if this program cost x billion or million, and you need to save x billion or million, you just eliminate it.

What’s the role of the health law in all this, as we look down the road?

We picked up 16 million people in Medicaid in 2014 — that’s a lot of extras. We’re assuming that they will have significant health issues. It’s very difficult to stay at that level of poverty and not have health issues.

What we’ve seen in the Massachusetts model, which is a similar model to the national model, was that right at the beginning, those people when they come into the program, they deferred health concerns for a long time so they’re sicker when they first come in and they’re high-cost, sicker patients. That does level out a little bit, but in the beginning, there’s a spike. So that will put additional pressure on the already-pressured states. So I think there’s a nervousness around all of the additional population that’s coming in.

When you think of a year or two or three down the road, what is your biggest worry, or what wakes you up in the middle of the night in a cold sweat?

I really do worry about the state staff. We have lost so many really qualified, excellent state staff to furloughs and to early retirements that the people that know how to trim programs without really trimming services, a lot of them have had to retire. And states don’t have the institutional knowledge to know if you do X, Y can occur. So they don’t see some of the unintended consequences of their actions. And I think that some of the short-sightedness of the state legislatures — that if they don’t get the savings in the first year, they’re not wanting to do programs — that’s very concerning.

I’m hoping that we’ll begin to see the end of the crisis that we’ve been in for the last three years, soon. Because I don’t know how much more sustainable it is.

Can you talk a little bit about the turnover? How many people in these programs are new?

There were 37 governors up for election. We immediately lost about 20 of the state directors. We expect to have a total of 32 who will have transitioned out. It is a political job in most states. That’s a lot of new people. And because we switched parties in 16 states, they went down further and eliminated some of the other political appointments. So some of the institutional knowledge also left during that period. There’s an awful lot of new aging and disability directors trying to learn all of the Affordable Care Act (the federal health care law) at the same time as they deal with the economic crisis.

And is this a field these people know and understand? Are they getting jobs because they’re the best qualified, among the political jobs? Are they coming in with some background?

It is a political position and so the Number 1 criterion is their relationship with the governor. It doesn’t matter if they’re an expert in aging if they can get to the governor and get things done and they’re a good manager. But it does make it a little tough when they don’t know any of the programs.

KHN wants to hear from you: Contact Kaiser Health News

 

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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Seattle Children’s ranked 7th among nation’s best children’s hospitals

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U.S. News & World Report magazine has placed Seattle Children’s Hospital among the nation’s top children’s hospitals for the 19th consecutive year, Seattle Children’s announced today.

The rankings will appear in the  magazine’s annual America’s Best Hospitals issue, which will be on newsstands Aug. 30.

Children’s was ranked:

Children’s also ranked 7th in this year’s honor roll – meaning it’s the 7th highest ranked children’s hospital in the nation.

Other Children’s programs receiving top recognition from the magazine include cardiologypulmonaryorthopedicsneonatologygastroenterology and diabetes.

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Free nicotine patches and gum available to Washington Tobacco Quitline callers

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Washington residents who are ready to quit smoking can now receive at least two weeks of free nicotine patches or gum if they call the state Tobacco Quitline in May or June.

People without health insurance can also get eight weeks of nicotine replacement therapy, up from the usual four.

Washington state residents on Medicaid are already eligible for a 12 week supply.

Along with the free nicotine gum or patch, quitline callers get personalized help from a quit coach, free follow up calls, and a free Quit Kit in the mail.

Calling the quitline can double a person’s chances of quitting, says the Washington State Department of Health, and more  than 160,000 people have called the state quitline since it opened over 10 years ago.

QuitLine and other state anti-smoking initiatives are credited with helping reduce smoking among adults in  Washingtonby about a third since 2000.

This special nicotine patch and gum offer ends June 30, 2011, or when supplies are gone, so people who are ready to quit should call soon.

To learn more:

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Low autopsy rates leave questions unanswered

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Decline In Autopsies May Obscure Understanding Of Disease

By Michelle Andrews

Television crime shows have helped popularize autopsies, but in reality these postmortem exams are becoming rarer every year. Today, hospitals perform autopsies on only about five percent of patients who die, down from roughly 50 percent in the 1960s.

That’s unfortunate, say experts, because details about the cause of death can be illuminating for both families and hospitals, even if they don’t turn up an undiagnosed ailment or other new information about the cause of death.

 

Detail: The Anatomy Lesson of Dr. Nicolaes Tulp. Rembrandt 1632

Kristine Johnson’s father, Nathan Johnson, developed early-onset Alzheimer’s disease and died last August, five years after having received that diagnosis at age 52. He worked as a lineman for a power company near the family home in Waterford, Conn., and had on occasion been injured by powerful jolts of electricity, says Kristine, who is 36.

She hoped that an autopsy would provide some answers, possibly related to injuries he sustained on the job, about why he developed Alzheimer’s at such an early age. (Most people who develop Alzheimer’s do so after age 65; only about 5 percent of cases are early-onset.)

In 1998 the Journal of the American Medical Association reported that autopsy results showed clinicians misdiagnosed the cause of death up to 40 percent of the time.

Unfortunately, the autopsy didn’t give them any new clues, and she and her brother, Nathan Jr., 39, are left wondering about their own risk, since family history often plays a role in the disease.

Even so, she said she thinks it was worthwhile to attempt to shed light on her father’s disease through an autopsy. “Anything we can do to help discover the cause and fight this horrendous, nasty disease, we’ll do it.”

Autopsies play a critical role in helping to advance understanding of the progress of a disease and the effectiveness of various treatments. At the same time, they may identify medical conditions that clinicians and high-tech imaging miss or misdiagnose.

For example, Elizabeth Burton, deputy director of the autopsy service at Johns Hopkins Hospital in Baltimore, recalls that when she autopsied a 50-year-old alcoholic patient, what appeared to be cirrhosis of the liver was actually cancer.

Autopsies can also reveal a range of conditions with hereditary implications, from cancer to cardiovascular disease, says Burton, who is a physician.

Current research is scarce, but in 1998 the Journal of the American Medical Association reported that autopsy results showed clinicians misdiagnosed the cause of death up to 40 percent of the time.

With the increasing use of high-tech imaging equipment, “maybe the error rates are better now,” says George D. Lundberg, who wrote the JAMA piece while he was the editor of that journal. (He is now an editor-at-large at MedPage Today, a medical news Web site.)

Until 1970, hospitals had to autopsy at least 20 percent of their patients in order to remain accredited. Once that requirement was dropped, autopsy rates began to fall, due to lack of direct funding, fear of litigation and increasing reliance on technology as a diagnostic tool, among other reasons.

More From This Series: Insuring Your Health

As autopsies have become rarer, so has research comparing diagnoses before and after death. Today, about 40 percent of hospitals don’t perform autopsies at all, says Burton, who is an expert on autopsy trends.

When an autopsy is requested, the pathologist first conducts an external examination of the body to look for injuries and signs of disease. Then the pathologist makes two incisions, one at the back of the head and one in the chest and stomach area, and takes samples of organs, tissue and blood, among other things. The pathology team does a microscopic analysis of the samples and may do genetic, drug and other tests as well. They write a report explaining their findings. The whole process takes the better part of a day.

In the case of an unnatural death — a homicide or an accident, for example — the state medical examiner or coroner may require an autopsy. But in cases where there’s no evidence of foul play or unnatural death, the decision to request an autopsy is up to physicians and family members of the deceased.

In theory, the federal government pays hospitals to perform autopsies through the fixed payments it makes to the Medicare program. In practice, however, those funds generally don’t trickle down to the pathology department. But in general if a family requests an autopsy, a hospital will often conduct it at no charge.

The hospital can also arrange for one to be conducted elsewhere if it doesn’t perform them. Many hospitals will also perform autopsies on former patients gratis for some designated period of time regardless of where they died.

A small minority of hospitals these days charge families for autopsies, says Gregory J. Davis, a professor of pathology and laboratory medicine at the University of Kentucky. At $3,500 to $6,000 each, this can be a big deterrent. “In essence what they’re saying is, ‘We don’t want to do this,’ ” he says.

Disagreement within the family over whether to ask for an autopsy can create other hurdles. When Alan Schiller’s father died at home in his bed of unknown causes a few years ago at age 85, Schiller, former chairman of pathology at Mount Sinai School of Medicine in New York, didn’t object when his brother said he didn’t want an autopsy to be done.

His brother felt, as people often do, that their father had suffered enough and shouldn’t, even in death, have to undergo another procedure.

Looking back, however, Schiller has mixed feelings. “I didn’t fight it . . . but I had some guilt,” he says. “We never really knew what terminated my father.”

KHN wants to hear from you: Contact Kaiser Health News

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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How the GOP budget plan would cut Medicaid funding

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Study Details How GOP Budget Plan Would Cut States’ Medicaid Funding

By Phil Galewitz
KHN Staff Writer

Eight states – including Florida, Colorado and Georgia – would lose more than 40 percent of their federal funding for Medicaid over the next decade under the House Republicans’ plan to repeal the 2010 federal health law and convert Medicaid into a block grant program, according to an analysis of the plan’s effects on states released today.

The study found that under the plan authored by House Budget Chairman Paul Ryan, R-Wis., states would lose an average of 34 percent of their federal funding for Medicaid. The drop in funding would range from 26 percent in Washington, Vermont and Minnesota to 44 percent in Florida and Wyoming.

The study was released by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured and conducted by researchers at the Urban Institute. (KHN is an editorially independent program of the foundation.)

The health overhaul passed last year increases eligibility in 2014 for Medicaid to anyone with earnings under 133 percent of the federal poverty level, or $14,484 for an individual, with the federal government picking up at least 90 percent of the Medicaid expansion in the first decade, including 100 percent of the expansion the first few years.

The GOP’s 2012 budget, which passed the House last month in a vote along partisan lines, would save the federal government $1.4 trillion in Medicaid spending over 10 years, including $610 billion from the repeal of the health law and $750 billion from the move to make Medicaid a block grant program.

That would be a 34 percent reduction over planned Medicaid spending under current law – including the health overhaul – and 22 percent less than under the existing program, according to the Kaiser study.

States that currently have the tightest Medicaid income eligibility rules and the highest proportion of poor people would gain the most under the Medicaid expansion in the federal health overhaul, and they would be the biggest losers under the Ryan plan, the report said.

States that currently have the tightest Medicaid income eligibility rules and the highest proportion of poor people would gain the most under the Medicaid expansion in the federal health overhaul, and they would be the biggest losers under the Ryan plan.

Under the health law, 16 million additional Americans would be expected to join Medicaid starting in 2014. Medicaid today covers about 50 million low-income Americans, mostly children and pregnant women. It also covers millions of poor people in nursing homes.

As a result of the cuts in funding in the Ryan plan, the Kaiser analysis estimates that between 31 million and 44 million fewer people would be enrolled in Medicaid in the next decade. Most would be left without insurance coverage.

“Under the House Budget plan, the Medicaid block grant would reduce and cap federal Medicaid spending, substantially reducing states’ ability to provide coverage to low-income Americans,” Diane Rowland, executive vice president of the foundation and executive director of the Kaiser Commission on Medicaid and the Uninsured, said in a statement. “The repeal of the ACA combined with the adoption of the Medicaid block grant would add millions more to the number of uninsured Americans and compromise Medicaid’s role as the health safety net in the next recession.”

Republican governors, asking for greater flexibility to design Medicaid programs as their states face massive budget gaps, have supported the Ryan plan for Medicaid block grants. In a letter to Ryan last month, they said, “We appreciate the many innovative reforms this budget will demand; the current path forward is unsustainable. … Chairman Ryan, your Medicaid proposals are far superior to those envisioned in the PPACA.” The governors, upset with the new healthcare reform law’s requirement for states to maintain Medicaid eligibility standards until 2014, said block grants would provide states with the flexibility to tinker with the safety net for the poor in a responsible way.

Democrats who control the Senate and President Barack Obama oppose the Ryan plan.

Hospitals would also be losers in the Ryan strategy. The report found hospitals could expect their Medicaid payments to drop by as much as 38 percent by 2021.

Currently, states and the federal government share the cost of Medicaid, with the federal government paying about two-thirds and the states one third of the total national spending. The percentage varies by state, however.

Under the House plan, states would get increases in federal funding based on general inflation — which tends to rise more slowly than health inflation — and for changes in population size. Currently, the federal match has no such limits.

The other states that would see a more than 40 percent reduction in federal Medicaid payments are Wyoming, Alaska, Oregon, Nevada and Delaware, the study said.

According to the Congressional Budget Office, the Ryan plan would lead to big reductions in most states’ Medicaid allotments: Within a decade, states would get about a third less money than they would otherwise receive by 2022 and by nearly half in 2030.

To make up for huge reductions in federal funding under the Ryan plan, states have to either have to contribute far more of their own money, or, more likely, use their new flexibility under the block grant to cap enrollment, substantially scale back eligibility, and curtail benefits for seniors, people with disabilities, children, and other low-income Americans who rely on Medicaid for their health care coverage.

Rep. Ryan

Ryan’s plan –- though it would not achieve a balanced budget year to year until 2040 and would allow the debt to rise to 70 percent of the gross domestic product by 2022 –- would bring the debt down to 64 percent, just above its current level, by 2030, down to 48 percent by 2040, and then dramatically down to 10 percent by 2050.

The Kaiser findings closely mirrored a recent report by the left-leaning Center on Budget and Policy Priorities, which found the House plan would have cut federal Medicaid funds to most states by more than 25 percent by 2009 and to several of them by more than 40 percent if it had been in effect starting in 2000.

The center found Arizona would have been hit the hardest, receiving 52 percent less in federal Medicaid funding over the 10-year period. The five states that would have experienced the largest percentage reductions — Arizona, Nevada, New Mexico, Alaska and Florida — would have experienced average cuts of 39 percent over 10 years and average cuts of 47 percent in 2009.

The five states with the smallest reductions would have been cut an average of 9 percent over the 10-year period and 17 percent in 2009, according to the center’s study. These states are Connecticut, the District of Columbia, Nebraska, New Hampshire and North Dakota.

We want to hear from you: Contact Kaiser Health News

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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Medicare forecast gloomier-than-expected

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By Phil Galewitz and Mary Agnes Carey
KHN Staff Writers

Medicare will start running out of money in 2024 — five years earlier than projected last year — as a result of the sluggish economic recovery, the program’s trustees reported today.

The outlook for the federal health insurance program that covers 47.5 million elderly and disabled Americans is a dramatic shift from last summer. That’s when the trustees, including Treasury Secretary Timothy Geithner and HHS Secretary Kathleen Sebelius, proudly projected that the new health law had extended the solvency of the program by 12 years from 2017 to 2029.

Medicare faces serious financial challenges over the next few decades as the aging population and rising costs push expenses higher while the employer and employee tax revenues that fund the health insurance program struggle to keep pace. Last year, the total cost of the program was $523 billion.

Medicare Expenditures as a Percentage of the Gross Domestic Product

Swings in the predictions about the financial health of Medicare are common year to year. But the latest scorecard puts renewed pressure on the administration to find ways to improve the economy and make sure its experiments in the health law to lower health costs can actually work, said Deborah Chollet, a senior fellow with Mathematica, a nonpartisan research firm. “The general health of the economy is crucial” to the future of the Medicare fund, she said.

Even Geithner acknowledged that the health law won’t do enough on its own to control rising health costs — a common complaint of Republicans who have been pushing for repeal of the health overhaul. “We must go beyond the Affordable Care Act and identify additional reforms,” he said.

Sebelius said the a new patient safety initiative, announced recently by administration officials could save Medicare $10 billion over the next 10 years.

The trust fund covers Part A of the Medicare program, which pays for hospital costs. In 2010, payroll taxes that support the fund took in $182 billion, about $2.5 billion less than expected, and have fallen short each year since 2008.

Another factor hurting Medicare’s future solvency: The trustees estimate people who are 65 now will live 2.4 months longer than projected a year ago. While that’s good news for beneficiaries, it means higher costs for the program.

Social Security, which faces some of the same pressure, will remain solvent until 2036—one year earlier than projected last year, program trustees said.

AARP Executive Vice President John Rother said lawmakers must look at more than just Medicare to find ways to reduce health care spending. “While provisions of the Affordable Care Act are helping to control spending in Medicare, far more must be done to reduce costs throughout the health care system and extend the Medicare trust fund for [hospitals] for the long term,” he said.

Some Republicans said that five fewer years of solvency for the Medicare trust fund demands that Congress take steps now to control spending. “Today’s report makes it clearer than ever that doing nothing is not an option,” House Ways and Means Chairman Dave Camp, R-Mich., and other panel subcommittee chairmen said in a statement. “The failure to act means current, as well as future beneficiaries, will face significant cuts even sooner than previously estimated.”

But Senate Finance Committee Chairman Max Baucus, D-Mont., had a different interpretation, saying the report shows that the health law’s provisions governing Medicare are necessary. “Health reform strengthened Medicare by cutting wasteful subsidies to private insurance companies and helping doctors save money by increasing coordination, and these improvements extended the life of the program by more than a decade,” Baucus said.

The report’s findings come as the parties are debating what role Medicare spending should play in reducing the federal deficit.

In last fall’s campaigns, Republicans accused Democrats of stripping hundreds of billions of dollars from the program to fund the health law’s subsidies for insurance coverage and Medicaid expansion.

President Barack Obama and Democrats returned the favor last month when House Budget Committee Chairman Paul Ryan, R-Wis.,unveiled his plan to reduce the federal deficit, in part by converting Medicare to a “premium support” program where the government would pay a set amount per beneficiary.

Obama and Democrats, citing an analysis from the nonpartisan Congressional Budget Office, said the Ryan plan would force seniors to pay more for their medical care. Last week, House Republican leaders backed away, suggesting sweeping changes like the Ryan proposal won’t become law this year. This week the message shifted again, with House Speaker John Boehner, R-Ohio, and Senate Minority Leader Mitch McConnell, R-Ky., insisting that Medicare changes must be part of the negotiations over raising the federal debt ceiling.

Separately, the administration has also released a state-by-state analysis about how the health law is benefitting Medicare recipients. Health care providers who took payment cuts in the law in exchange for new customers are sure to rebel against further reductions.

And with the 2012 elections just 18 months away, Democrats and Republicans may be reluctant to strike a deal on Medicare, preferring instead to make each party’s plans for the program a central focus of campaigns where control of the White House and Congress are at stake, pointing to 2013 as the year for a deficit deal.

We want to hear from you: Contact Kaiser Health News

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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Romney Defends Mass. Health Plan: ‘Right For The People Of My State’

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In a major speech today at the University of Michigan Medical School, Mitt Romney defended the health reform law he signed while governor of Massachusetts.

And, he used a PowerPoint presentation to lay out a very different vision for what he would do if he becomes president, which includes reliance on more market-based competition among insurers and health care providers.

Here are the slides from the talk:

Romney Slides1


This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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The ABC and Ds of skin cancer detection–Health Tips from The Polyclinic

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Although this is Melanoma and Skin Cancer Detection and Prevention month, to protect yourself against these common cancers you should take time every month to check your skin for new or changing moles, says Dr. Don Kern, a dermatologist at Seattle’s Polyclinic.

While sun protection and avoidance of peak hours are the best ways to prevent skin cancer, early detection is your next line of defense and can offer the best chance for successful treatment, says Dr. Kern.

Often a loved one can more easily notice suspicious moles or growths in hard to see places, like the back of your thighs, middle of your back, behind your ears, buttocks, and the back of your neck.

Dr. Kern

“Although your wedding vows didn’t say so, checking your partner for new or changing moles should be among the promises you make,” Dr. Kern said..

If looking at moles solo, mirrors can make it possible to check out otherwise “blind spots” for growths, said Dr. Kern, and be sure to check the soles of your feet, back of arms and even between your toes.

How can you identify a suspicious mole from a benign mole?

Dr. Kern suggests that you use the ABCDs to help determine if the growth might be cancerous. If you notice a mole that exhibits any of the following features, it should be examined by a physician.

Look for:

  • Asymmetrical shape? A common mole should by symmetrical, whether it’s oval or round.
  • Border is irregular or poorly defined? The border of a noncancerous mole should be smooth like a balloon—not jagged like the coast of Maine.
  • Color of the mole is varied? Two shades of a color counts as two colors in this case.
  • Diameter greater than 6 mm? The diameter shouldn’t be larger than a pencil eraser.

But even if the mole doesn’t display any of the ABCDs, it may still need to be examined by a physician, said Dr. Kern.  “Most moles appear on our skin by early adulthood, and once a mole develops, it shouldn’t change in size, shape, height, or color. If you notice a new mole or a growth that appears to be growing or changing, get it looked at.”

Skin cancer affects the lives of more and more people each year; but with better awareness, diligent screening, and prompt treatment, outcomes can be greatly improved for many people, he said.


The Polyclinic is made up of more than 160 physicians, including internal medicine, family medicine, OB/GYN, pediatrics, and 23 additional medical and surgical specialties.  Since its inception in 1917, The Polyclinic’s mission has been to promote the health of its patients through high-quality, comprehensive and personalized care.  For more information, visit www.polyclinic.com.

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Ouch! Child gets a shot.

Stricter rules for school vaccine exemptions — Everett Herald

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Ouch! Child gets a shot.Everett Herald reporter Jerry Cornfield today writes about new legislation that will make it tougher for parents to obtain exemptions to Washington State laws requiring their children be vaccinated before attending public schools.

Under the old rules, to obtain an exemption parents only had to sign a certificate indicating that they object on medical, religious or philosophical grounds.

Proponents of the new law say the ease with which exemptions could be obtained is one reason why Washington has the highest vaccine exemption rates in the country.

Cornfield writes:

Under the new law, which takes effect July 22, those exemption certificates must be signed by a health care professional such as a pediatrician, licensed naturopath, licensed physician assistant or advanced registered nurse practitioner. This does not apply to those who belong to a church with teachings that preclude a health professional from providing medical treatment to the child.

To learn more:

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Why your stitches cost $1,500 — Part One

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The United States has fallen behind other nations, failing to provide affordable health care to its citizens. Americans spend $477 billion a year MORE on health care than other advanced countries.

So why do we pay so much compared to other wealthy nations?

This infographic produced by the website Medical Coding & Billing is part one in a two part series which dissects the state of the U.S. health care system and presents some alarming numbers.

To see the second infographic of the series go here.

 

Why Your Stitches Cost $1,500 - Part One
Via: Medical Billing And Coding

 

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Aging

Why your stitches cost $1,500 — Part Two

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The United States has fallen behind other nations, failing to provide affordable health care to its citizens. Americans spend $477 billion a year MORE on health care than other advanced countries.

So why do we pay so much compared to other wealthy nations?

This, the second of two infographics produced by the website Medical Coding & Billing, looks at some of the facts and myths about our health care costs.

To see the first infographic go here.

 

Why Your Stitches Cost $1,500 - Part Two
Via: Medical Billing And Coding

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