3681

Yeah, you’re right about that to my recollection as well, and spinning that into “death panels” was nonsense of the highest order.

But the review board I’m thinking of does exist in the bill, right? Given the misinformation that’s around, I can see somebody being honestly confused about what it’s for, despite the fact that it a) is not government run, and b) makes no direct decisions about any individual patient’s care, and c) is not focused on end-of-life treatments.

3682

Oh, maybe. I just didn’t recall it in the context of end-of-life. I certainly support a review board if it’s aimed towards an objective evaluation of procedures vs. results. I call that “science.” Unfortunately my googling is only getting back administrative review boards.

3683

Ah, here we go, it’s the PCORI, I only noticed it because of that great Reddit summary that was posted in the other thread.

Probably as a direct result of the death panels thing, it’s specifically forbidden from making cost judgements on an individual patient:

The law governing the Institute forbids it to develop or employ “a dollars per quality adjusted life year” (or similar measure that discounts the value of a life because of an individual’s disability) as a threshold to establish what type of health care is cost effective or recommended.

3684

Right. But they question was “have it or pay a fine”. If, for some reason, they didn’t enroll in Medicaid, they wouldn’t be fined. And I don’t doubt some people will do just that. Because people do dumb things. But, whatever.

With some of the medicaid expansion being ruled skippable, I’m not sure how that’s going to shake out. And I do wonder how big of a group are either going to be on the bubble or uncovered by medicaid expansion because of state-level resistance.

3685

The people doing the “skipping” on the Medicaid expansion, if any*, are doctrinaire Republican-run state governments.
*Of course, they’ll be turning down free money from the federal government while their citizens are presumably paying federal taxes, so they’ll be shooting themselves (or rather their population of working poor people) in the foot, but they’re probably doing that already in myriad ways, so why not add another if it means scoring points against “Obamacare.”
Divide and rule, that’s the name of the game, and why America’s social safety net is so full of holes vs. postwar Europe’s. Get the “not quite entirely destitute” to resent the destitute and they do half of the rulers’ work for them.

3686

One school of thought is that the governors will cave as soon as all of their hospitals start needing bills paid. Hospitals, and their owners, have a ton of political pull, and they’ll start ratcheting the pressure on the governors to accept the damn money.

3687

The results shown at the end of the quiz are fucking depressing.

3688

Some of the questions, particularly on Medicare are open to debate.

IPAB clearly cuts existing Medicare benefits. you may not call it a death panel but to say that Obamacare doesn’t cut Medicare benefits ignores the entire purpose of IPAB.

They also play fast and lose saying that even though Medicare Part C/Advantage got the hell slashed out of it it, they will still offer the same benefits. That directly contradicts economic analysis by CBO which projects a decrease in MA plans/benefits.

This Kaiser poll is telling people that it believes that major funding slashes doesn’t affect the quality of the service. That’s amazing! Price controls work perfectly.

3689

Can you elaborate, please? This isn’t clear to me at all.

They also play fast and lose saying that even though Medicare Part C/Advantage got the hell slashed out of it it, they will still offer the same benefits. That directly contradicts economic analysis by CBO which projects a decrease in MA plans/benefits.

Ditto. I’m wondering if we’re coming at this w/ different foundational definitions for what constitutes benefits, perhaps?

3690

ipab: non-partisan health medical experts and doctors, appointed by the president for 5-year terms and confirmed by the senate, submit medicare recommendations to improve efficiency and quality of medical care. the suggestions are not required to be enacted but congress are forced to do an actual yes or no vote (unlike the other medicare board currently in existence). theoretically they could james t. kirk it and recommend, “let them die.” but maybe it’ll be more mundane stuff like expansion of trial programs or shifting spending priorities.

the wiki link is actually pretty interesting (to me at least):

Mission

IPAB is tasked with developing specific proposals to bring the net growth in Medicare spending back to target levels if the Medicare Actuary determines that net spending is forecast to exceed target levels, beginning in 2015.
According to official records, the proposals made by IPAB should not include any recommendation to ration health care, raise revenues or increase Medicare beneficiary premiums, increase Medicare beneficiary cost sharing (deductibles, coinsurance, or co-payments), or otherwise restrict benefits or modify eligibility criteria.[10] The Department of Health and Human Services (HHS) must implement these proposals unless Congress adopts equally effective alternatives. The board is also required to submit to Congress annual reports on health care costs, access, quality, and utilization. IPAB must submit to Congress recommendations on how to slow the growth in total private health care expenditures.[11]
Every year on September 1, IPAB must submit a draft proposal to the Secretary of Health and Human Services. On January 15 of the next year IPAB must submit a proposal to Congress. If IPAB fails to meet this deadline, the HHS must create its own proposal. Congress must consider this proposal under special rules. Congress cannot consider any amendment to the proposal that does not achieve similar cost reductions unless both houses of Congress, including a three-fifths super majority in the Senate, vote to waive this requirement. If Congress fails to adopt a substitute provision by August 15, HHS must implement the proposal as originally submitted to Congress.[11]
With regard to IPAB’s recommendations, the law says “The proposal shall not include any recommendation to ration health care, raise revenues or Medicare beneficiary premiums under section 1818, 1818A, or 1839, increase Medicare beneficiary cost sharing (including deductibles, coinsurance, and co-payments), or otherwise restrict benefits or modify eligibility criteria.”[12]

there is some experience in 1983 where hospitals were paid a fixed amount per hospital stay and they managed their money better so the elderly suffered no worse healthwise in preliminary results, while their lengths of stay went down 15% (although they felt they were sent home earlier than they should, leaving some measure of stress on them and their families).

https://docs.google.com/viewer?a=v&q=cache:QoT30QvS9aUJ:www.bls.gov/opub/mlr/1986/08/art4full.pdf+&hl=en&gl=us&pid=bl&srcid=ADGEEShDIqshReroTNCo5ojHk6dtP0ru_DYg0-1NUgDxDfcBQjWy3BpXaDQsZKMAUCaZv8tcxzXi8vIXf6X983YuIxU9wEVZAFePh0XdZBd1eKG8ACfzz97AHbXhmBKvyiAVtEv6LpFf&sig=AHIEtbRSGl5TujLzBHMP_FUTNOv23MSW7A&pli=1

3691

I get this email from my ex-wife. She has a son from another father with a heart condition. Apparently she requires two separate health insurance plans to cover everything for this kid. One for new conditions and one for… pre-existing? Who knows the details. Anyway, she concludes this email with, “If Obama asshole stays in office, I’ll need to go get a second job to pay for the medical bills.”

Mind blown.

Because Romney repealing the ACA would somehow be beneficial to a single-income* mother and with a child with a heart defect…?

Fox News. The most powerful propaganda machine since Joseph Goebbels?

  • as far as the IRS is concerned, anyway
3692

Unbelievable!

3693

Wow, with a reality-distortion-field like that, sounds like it’s a good thing she’s your EX-wife.

3694

Fiery meteorite of awesome:

http://www.nytimes.com/aponline/2012/07/24/us/politics/ap-us-health-care-overhaul-costs.html?_r=1&hp

President Barack Obama’s health care overhaul will reduce rather than increase the nation’s huge federal deficits over the next decade, Congress’ nonpartisan budget scorekeepers said Tuesday, supporting Obama’s contention in a major election-year dispute with Republicans.

I was personally fine with it costing 100-200B extra per year, but this is sweet news indeed.

3695

There are some tax increases in there. If they repeal it, they’ll lose like $1T in taxes. Obama care costs like $800B or something. So if they repeal it we end up down $200B.

3696

This won’t matter to many people. They assume the CBO is biased (except in cases where it agrees with them).

3697

Which is so true, because prior to this report people in my office were using the previous CBO report to bolster their anti-obamacare stance. Need to go see how they respond to this…

3698

Obama you Socialist bastard!!! Effective today:

Well-woman visits, including an annual check-up for adult women to get recommended preventive services, and additional visits if women and their doctors determine them necessary.

Contraception and contraceptive counseling: Women will have free access to all FDA-approved contraceptive methods, sterilization procedures and patient education and counseling without a co-pay. Most workers in employer-sponsored plans are currently covered for contraceptives.

Gestational diabetes screening for women 24 to 28 weeks pregnant, and those at high risk of developing gestational diabetes. Women who have gestational diabetes have an increased risk of developing type 2 diabetes in the future and the children of women with gestational diabetes are at increased risk of being overweight and insulin-resistant during childhood.

HPV DNA testing every three years for women who are 30 or older, regardless of Pap smear results. HPV screening has been shown to help reduce the prevalence of cervical cancer.
Annual sexually transmitted infections (STI) counseling for sexually-active women. Such sessions have been shown to reduce risky behavior in patients; only 28 percent of women aged 18-44 years reported that they had discussed STIs with a doctor or nurse, according to HHS.

HIV screening and counseling for sexually-active women. From 1999 to 2003, the Centers for Disease Control and Prevention reported a 15 percent increase in AIDS cases among women, and a 1 percent increase among men, suggesting an increased risk for women.

Breastfeeding support, supplies, and counseling for pregnant and postpartum women, including access to comprehensive lactation support and counseling from trained providers, as well as breastfeeding equipment.

Interpersonal and domestic violence screening and counseling for all adolescent and adult women. An estimated 25 percent of U.S. women report being targets of intimate partner violence during their lifetimes and screening will lead to interventions to increase their safety.

3699

How horrible that we’re finally seeing some social progress in this country after an approximate 30-year hiatus! No doubt we’ll all be living in cardboard boxes within the year thanks to these radical policies. ;-)

3700

Of course, as we all know the contraceptive mandate is exactly the same as Pearl Harbor and 9/11.