Sunday, January 26, 2014

Slow Saturday Special: Obummercare Driving Me Crazy

So is the Globe…. 

"With health law, less-easy access in N.H.; Lone insurer in plan reduces roster of hospitals to keep premiums low" by Tracy Jan |  Globe Staff, January 20, 2014

WASHINGTON — When Nancy Petro needs routine tests to make sure her thyroid cancer and high blood pressure have not returned, the retired gas station attendant and general store clerk must now drive an hour over mountainous roads to seek care, even though there is a hospital just minutes from her home in rural northern New Hampshire.

All of a sudden single-payer looks pretty good, but ju$t for a $econd. I don't trust this government anymore after this naked ca$h grab and handover of the health $y$tem to in$urance conglomerates -- complete with $300 billion bailout written into the bill.

Petro, 62, had been uninsured until January, when she obtained coverage through President Obama’s groundbreaking health law. The benefit, just $26 a month, came with a downside, however.

There seem to be a lot of those with the law.

To keep premiums affordable, Anthem Blue Cross and Blue Shield of New Hampshire, the only insurer in the state offering coverage in the new insurance marketplace, radically reduced the hospitals in its network. Petro’s local provider did not make the cut.

Petro’s case reflects how Obama’s health law has upset the previous balance in the insurance landscape. As new coverage begins this month, most policies sold through the insurance marketplaces offer some type of restricted hospital network in exchange for lower premiums.

Were it not for his pride the abomination that is Obummercare would be scrapped.

Nowhere is the impact on patients and hospitals as extreme as in New Hampshire, say health policy analysts, because of the lack of alternatives to Anthem’s strict network….

Petro, whose only income is Social Security widows’ benefits, said she is grateful for the $628-a-month government subsidy she will receive for insurance coverage through the health reform law. But she notes with jarring irony that she is now one of thousands of New Hampshire’s newly insured who may find it more difficult to get access to care.

Okay, she is one of the lucky ones to have gotten through the website (so far anyway), and the access to care is now more difficult. Can you say failure, folks?

“Now I have to drive 50 miles for blood work when there’s a hospital three miles from my house,” said Petro, who finds wintertime driving perilous, given that it is difficult to reach even her mailbox because of the sheet of ice coating her driveway. “It’s going to be harder to get there and get this done.”

That is not supposed to be there because of global warming. WTF?

********************************

The difficulty in accessing care has sparked outrage and legal action against state insurance regulators that approved Anthem’s plan, as well as electoral volatility with new political ads targeting health reform supporters in Congress.

“Obamacare was sold to Americans with the president saying you don’t have to change your doctor. But in New Hampshire, with the way that the insurance company and the state has allowed it to roll out, that’s simply not true,” said Peter Wright, chief executive of Valley Regional Hospital in Claremont, a Sullivan County hospital excluded from the network….

Not the only lie he told.

The law requires most Americans to obtain insurance by the end of March….

Lisa Guertin, president of Anthem in New Hampshire, said, “We know any change is a disruption, but it’s not a bare-bones network by any stretch of the imagination,” Guertin said. “We’re here to try to put forth products that people will buy and value, balancing access with affordability.”

Another word for that is RATIONING! You know, something they said wasn't going to happen.

*********************************

Charles White, chief administrative officer of Upper Connecticut Valley Hospital, serves the northern part of Coos County. The county has the worst health outcomes in the state because of high rates of smoking, teen pregnancy, alcoholism, and obesity.

The patchwork nature of how the health care law alters markets is illustrated by the differences with neighboring Vermont.

Blue Cross Blue Shield operates as a nonprofit in Vermont, where every hospital is included in the network — including Upper Connecticut Valley Hospital in New Hampshire.

“If I lived across the river in Canaan, Vt., I would have access but if I lived in Colebrook where the hospital is actually located, I would not have access,” White said. “It makes no sense.”

Vermont is trying to go single-payer, and best of luck to them.

***************************

Republicans are gleefully capitalizing on the network adequacy issue and other struggles with implementing health reform in New Hampshire.

Do I look gleeful here, folks, because all I'm feeling is rage. 

Oh, right, I'm not a real Republican, nor am I a registered one.

Americans for Prosperity, a conservative group, released a television ad targeting Senator Jeanne Shaheen by showing footage of the New Hampshire Democrat on the Senate floor quoting Obama: “You can keep your insurance if you like it.”

Aaaaaah, I'm sick of the finger-pointing, $hit-$how fooley known as politics.

“It’s the lie of the year. And Senator Shaheen kept telling it,” the voiceover says. “Tell Senator Shaheen it’s time to be honest. Obamacare doesn’t work.”

Nope. Can't be. This government is infallible and would never lie.

**************************

Republicans have also targeted US Representatives Annie Kuster and Carol Shea-Porter….

Shea-Porter has spoken about her concerns with Obama and other White House, federal, and state officials….

Yeah, yeah. 

For those not in the know, Shea-Porter originally rode in in 2006 when the Dems took control of the House after the Foley/Hastert scandals. Her campaign pitch was opposition to Iraq and the Bush surge. 

Well, we got a surge, Pelosi put down the antiwar wing of the party, and they lost the House again. I liken it to the Repuglican establishment rejecting me, although it appears I was just a fool. Never again.

--more--"

At least she is getting long-term care:

"State protections still awaited for long-term care; Rules on insurers delayed" by Deirdre Fernandes |  Globe Staff, January 21, 2014

More than a year after Massachusetts passed legislation aimed at curbing the rapidly rising cost of insurance for long-term care, regulators have yet to adopt new rules that would help protect consumers as they buy products to cover nursing homes and similar services.

You have to put the person into abject poverty to put them in one of those horror houses.

Regulations were scheduled to be in place by Oct. 31, but the Division of Insurance missed the deadline and recently extended the process to July 1.

And in the meantime the patients get gouged?

The state’s insurance commissioner, Joseph G. Murphy, said he does not plan to approve premium increases while his agency finalizes rules, but other protections, such as making it harder for companies to deny coverage, will be further delayed.

Oh, okay.

“It’s frustrating to consumers,” said Deborah Thomson, a lobbyist for the Massachusetts chapter of the National Academy of Elder Law Attorneys, which provides legal services for seniors. “Everybody would like some certainty on how this would play out. The sooner they issue the regulations the better.”

Yeah, I'm kind of getting right up there.

*********************

Two national insurance companies, John Hancock Financial Services of Boston and Genworth Financial Inc. in Richmond, Va., said they plan to ask states for premium increases of 6 to 25 percent on some existing policies this year, according to recent earnings reports….

How many millions if not billions they clear last quarter?

Rates have risen rapidly, in part because of an aging population and rising health care costs. But insurers also made mistaken assumptions when they launched the product, leading them to set prices too low….

But Obummer said rates were not going to rise and might even go down! 

You sick and tired of the excuses yet?

--more--"

Well, there are national rules because of Obummer, right?

"Rules for equal health coverage by employers prove elusive; Enforcement of provision in new law being put off" by Robert Pear |  New York Times,  January 19, 2014

WASHINGTON — The Obama administration is delaying enforcement of another provision of the new health care law, one that prohibits employers from providing better health benefits to top executives than to other employees….

They might as well get on their knees and pull cheek for corporate money because that's who they serve. The only damn provision still in place is the TAX PENALTY! Everything else has been waived by the apparent dictator of AmeriKa.

Translating that goal into reality has proved difficult. Officials at the Internal Revenue Service said they were wrestling with complicated questions….

Why doe$ it have to be $0 complicated?

One of the questions facing the IRS is whether an employer violates the law if it offers the same health insurance to all employees but large numbers of low-paid workers turn down the offer and instead obtain coverage from other sources, like a health insurance exchange.

Some health insurance arrangements will almost surely be forbidden, officials said. For example, they said, employers will not be able to provide coverage only to management.

Likewise, the officials said, a company could not provide free coverage to “highly compensated individuals” while requiring other employees to pay, for example, 25 percent of the cost….

Looks like a pretty steep penalty for noncompliance -- or was, anyway.

Under the earlier law, all health benefits provided to highly compensated individuals — with the possible exception of certain executive physicals — are supposed to be provided to rank-and-file em-ployees.

But employers say they may have legitimate reasons for wanting to offer different benefits to different workers.

Yeah, they want to take care of them$elves and the CEOs!

“Employers should be permitted to provide lower-cost coverage to employees who may not be able to afford the comprehensive coverage being provided to other employee groups,” Wilber said.

Afford what? Companies generally pick up the health tab for the bigwigs. Just because we are sick doesn't mean we are stupid out here. C'mon!

Katie W. Mahoney, the executive director of health policy at the US Chamber of Commerce, said the existing nondiscrimination rules were so convoluted that employers often complied just with the spirit of the law, “rather than with the precise requirements of the regulations.”

That means they didn't comply at all. 

Glad the USCC is looking out for workers -- when they are not getting on businesses’ nerves.

*******************

Kathryn Wilber, a lawyer at the American Benefits Council, which represents many Fortune 500 companies, said The existing restrictions on self-insured health plans are “outdated, inadequate, and unworkable.”

Wow, it REALLY I$ a CORPORATE PAPER of ELITE WEALTH!

*******************

This could eventually be a boon to workers, the administration says.

Eventually? Meaning it is not now like we were told?

--more--" 

At least all your personal health and financial information is protected, right?

"Revamped health care site said to pass security test; Panel hears of internal debate before launch" by Ricardo Alonso-Zaldivar |  Associated Press, January 17, 2014

WASHINGTON — But….

But what?

The maddening technical problems that frustrated consumers for weeks as they tried to sign up for health insurance would pale in comparison if a serious security breach compromised the names, Social Security numbers, incomes, and other personal information of millions of Americans.

Don't worry, you will never know about it.

Republicans on the House Oversight and Government Reform Committee are trying to build a case that the administration recklessly ignored security concerns to meet a self-imposed Oct. 1 deadline for flipping the switch.

They did. They were even being warned by the well-connected firm that created the site and chose to ignore them.

The administration — and Democratic lawmakers— say all issues were addressed through special vigilance instituted just before the launch. While Republicans have raised questions, they have yet to find a smoking gun.

Yuh-huh.

Officials told the committee no attempted attack by hackers has succeeded, although a shadowy group calling itself ‘‘Destroy Obamacare’’ has tried. There have been 13 known inadvertent exposures or disclosures of information.

Oh, Now we have a "ShAdowy group," huh?

The root of the controversy is that the health care site did not get full security testing, as is the usual practice with federal systems before they are put into use.

Sigh.

However, Medicare’s top cybersecurity official testified Thursday that the revamped website passed full security tests Dec. 18, easing her earlier concerns about vulnerabilities. Teresa Fryer, chief information security officer at the Centers for Medicare and Medicaid Services, had initially balked at the site going live.

Oh, I'm feel well now that she is happy.

She said Thursday she would now recommend full operational and security certification for the site….

Related:  Hiding the Hacking at HealthCare.gov  

Yup, it's all fully secure, and even if it wasn't you wouldn't know.

--more--"

Of course, it is all for the children:

"The cost of giving birth at a hospital can vary by tens of thousands of dollars, a price range that is ‘‘largely random’’ and unexplainable by market factors, a California study has found. Health advocates nationwide are calling for more transparency in an industry where pricing variables are largely opaque. ‘‘The market doesn’t work and the system doesn’t regulate it, so hospitals can charge what they want,’’ said Renee Hsia, lead author of the study and associate professor at the University of California at San Francisco’s School of Medicine."

Price-gouging over pregnancies? 

Is there nothing the health in$urance indu$try will not try to make a buck off?

RelatedInfant DNA analysis a boon for treatment

Yeah, X marks the spot in your NSA file.

Also see: 

Berned By the Boston Globe
Tieing Up This Series of Posts

I'm still in the spinning wheel of a waiting room here in Massachusetts:

"Health policy analysts are calling for greater urgency in fixing the state’s broken insurance website, after a report released this week showed Massachusetts far behind in signing people up for new plans under the Affordable Care Act. But, they said, the state is primed to quickly improve its standing compared with other states if it can get the technology working. 

If? IF?

The state’s easy-to-use insurance shopping website, overseen by the Massachusetts Health Connector Authority, was a model for the national program. But the site has barely functioned since it relaunched Oct. 1 to comply with the federal law. According to a New York Times analysis, Massachusetts has made the least progress of any state on its sign-up goal, at just 5 percent of its target."

Oh, my, we are LAST, folks! 

I'm bumming because Obummercare destroyed the state health site, and now I'm bumming even more:

"State knew about troubles with health site" by Chelsea Conaboy |  Globe staff, January 25, 2014

No! 

NO! 

NOOOOOOOOOOOO!

Massachusetts officials knew in July, three months before the launch of the state’s ill-fated health insurance website, that the technology company in charge was far behind on building the site and that there was “a substantial and likely risk” it would not be ready, according to a state official’s memo.

And let me guess, they put perfume and a wig on the turd for public presentation.

The website launched on Oct. 1 was incomplete and riddled with errors that frustrated consumers, blocked some from getting coverage, and required the state to move tens of thousands of people whose applications could not be processed into temporary insurance programs.

The head of the Massachusetts Health Connector Authority, which runs the insurance marketplace, was copied on the July memo. But the executive director, Jean Yang, and her staff never told the Connector board during its monthly public meetings that the project was off track, according to meeting minutes.

(Blog editor's face contorts into scowl)

In the first weeks of October, Governor Deval Patrick and officials at the Massachusetts Health Connector, which runs the insurance marketplace, maintained a positive message about the site, saying the glitches were minor and the site would improve over time, particularly as improvements were made to a federal data hub needed for processing applications.

Arrrrrrrrrggggh!!

The federal insurance website, developed by the same tech company, CGI, had gotten off to a bad start, too.

Related: States Agree CGI Computer Software Sucks 

Also see: Obamacare Website Company Had Ties to Obama Fundraising, Michelle Obama 

At lea$t $omething is healthy and working well.

The July memo and another written by Dr. Jay Himmelstein, the University of Massachusetts Medical School professor in charge of managing the contract for the state, show state officials were aware the website problems were far more serious.

Then maybe they didn't actually lie, but they omitted what they knew, and that is just like lying. It's obscuring and obfuscating need-to-know information. 

Makes you sick, doesn't it?

Himmelstein, who is also director of the New England States Collaborative for Insurance Exchange Systems, wrote to CGI again on Oct. 25. He asked to begin a mediation process. The company had failed to deliver on its contract, he wrote, and the university would explore its “options to mitigate damages to the Commonwealth.”

By the end of November, it was clear to the public that problems with the state website were more than just glitches. Some customers were unable to complete an application online because the website locked them out of their accounts or delivered confusing error messages, and they were spending hours waiting for customer service.

What was authority thinking, no one would notice? Crossed their fingers and prayed it would work knowing it was $hit? Or do they really just not give a damn?

The university, which provided the memos to the Globe late Thursday, did not release the company’s responses to Himmelstein. Representatives for the University of Massachusetts, Patrick’s office, and the Connector did not make anyone available to be interviewed for this report…. 

They only talk to the media when they are using them to push the agenda, and I'm so glad the propaganda pre$$ has the acce$$ bloggers do not.

Connector spokeswoman Alex Zaroulis said in an e-mail [that] the Connector and other state agencies are working to hold CGI accountable to its contract….

Why do they have to do that? Why can't they make a decent product to begin with?

The company continues to update the website with fixes and is committed to improving the website’s performance, CGI spokeswoman Linda Odorisio said in an e-mail….

Why didn't it work in the first place?!?!

--more--"

At least I don't have to worry out where I am:

"Some regions of the state appear to be bastions for healthy aging, with relatively few seniors plagued by chronic health problems, while other areas are rife with challenges, according to the report and an interactive website commissioned by the Tufts Health Plan Foundation, in collaboration with the Massachusetts Health Policy Forum at Brandeis University. A number of small towns in Central and Western Massachusetts had a disproportionate share of seniors reporting no chronic conditions, the report shows, while several large cities in the southeastern part of the state have unusually high numbers of older residents with multiple health problems."

Green Acres is the place for me!

I need a pill:

"Curb on seniors’ drugs protested; Medicare change would restrict choice; Antidepressant makers see a threat to profits" by Tracy Jan |  Globe Staff, January 25, 2014

WASHINGTON — New rules proposed by the Obama administration to limit the array of antidepressants and other prescription drugs currently available to millions of seniors have set off an intense round of lobbying by patient advocates clamoring to preserve access and by pharmaceutical companies eager to preserve profits.

Turns out the elderly are as pocketbook prey as much as the kids.

Under the proposed guidelines for Medicare prescription drug benefits, seniors who currently have access to about 57 antidepressants and anti-psychotics could see their choices dwindle to 15, according to a pharmaceutical industry-backed group.

It took me a long time to realize the propaganda pre$$ was in bed with the pharmaceutical indu$try. Must have had my mind clouded.

Federal officials have said the policy change would save $720 million over five years, between 2015 and 2019. By proposing the change, the Centers for Medicare & Medicaid Services said it also aims to rein in over-prescribing of some expensive drugs.

But doctors get a cut of that pre$cription in the form of pharmaceutical company kickbacks.

“This rule would severely limit the choice physicians have to work with their patients to figure out which medications work best for them,” said Andrew Sperling, chief lobbyist for the National Alliance on Mental Illness, a Washington-based mental health advocacy organization that is heavily funded by pharmaceutical companies. “It troubles me that CMS would move forward with something like this without any scientific basis, just to save a dime.”

It took me a long time to realize the propaganda pre$$ was in bed with the pharmaceutical indu$try. Must have had my mind clouded.

The changes, made in accordance with the Affordable Care Act, underscore the numerous decisions still to be made that will have profound effects on drug companies and the public as Obama’s health insurance law plays out…. 

Just forget all the exemptions and waivers he handed out.

The Centers for Medicare & Medicaid Services said the rules change could also curb what it says is an overprescription of antipsychotics driven by profits. Because nearly all “protected” drugs, no matter how expensive, must be covered under the current rules, the industry spends billions each year marketing directly to doctors and patients. If the proposed changes go into effect, manufacturers of branded drugs will be pressured to lower prices in order to be covered by a plan, the agency said.

The agency also believes the new rules would limit the misuse or abuse of drugs that are not medically necessary.

“We are concerned that requiring essentially open coverage of certain categories and classes of drugs presents both financial disadvantages and patient welfare concerns,” the agency wrote in its proposed rules published Jan. 10 in the Federal Register….

Consumer advocates also fear that the changes could result in seniors and other Medicare beneficiaries not receiving the specific drugs that they need….

Despite protests from patient advocates and the pharmaceutical industry, health economists say the changes make fiscal sense.

We are back to that again! The government always seems to have enough money for its staff, Wall Street, Israel, and the AmeriKan war machine, though.

Jonathan Gruber, an MIT economics professor and director of the health care program at the National Bureau of Economic Research, said the decision comes down to weighing the benefits of allowing insurers to more competitively choose the lowest-cost drug options with making sure patients have the options that work for their individual cases.

“We have to start restraining our spending on health care. It’s the single most important long-run fiscal issue facing our nation,” Gruber said. “At the end of the day, the government cannot provide all things to all people.”

Oh, but they will provide some things to some people. 

"The deal buoyed Wall Street investors. Guggenheim Partners, a financial services firm, concluded that as a result overall Pentagon spending will remain relatively the same for the next several years before it begins to grow once again, at about 2.5 percent per year."

"A strong stock market and better business climate have continued to concentrate American wealth in the top 1 percent of earners." 

It is government policy that did that!

Representative Richard Neal, the dean of the Massachusetts all-Democrat delegation, said he has concerns about the proposal and its potential impact on the state because biotechnology companies pump billions of dollars into the Massachusetts economy each year.

Enough about THIER HEALTH! What about ours?

“What are the immediate consequences to this critically important regional industry? These are some of the concerns I intend to raise with the administration at the earliest opportunity,” said Neal, who sits on the Ways and Means Committee, which has jurisdiction over Medicare.

Representative Tim Murphy, a Pennsylvania Republican and chairman of the House Energy and Commerce Oversight Subcommittee, met with Marilyn Tavenner, Centers for Medicare & Medicaid Services administrator, last week to discuss his concerns about the rule change.

Murphy, a clinical psychologist, has sponsored a mental health bill that would, in part, ensure that patients continue to have full access to all antidepressant and antipsychotic medication, and plans to seek cosponsors among Massachusetts Democrats.

Wow, "rare" biparti$an$hip!

The public will have until March 7 to submit comments to the Medicare agency; the rules are expected to be finalized by May. 

I think you have my comments already.

--more--"

I'm having a flashback:

"More in US are using antipsychotic drugs; Doctors often give them milder disorders" by Richard A. Friedman  |  New York Times, September 25, 2012

NEW YORK -- Abilify and Seroquel, two powerful antipsychotics, are the fifth- and sixth-best-selling prescription drugs in the United States. In 2011 alone, they and other antipsychotic drugs were prescribed to 3.1 million Americans at a cost of $18.2 billion, a 13 percent increase over the previous year, according to the market research firm IMS Health.

I've seen the ads for Abilify, and already know about Seroquel.

The rates of serious psychiatric disorders such as schizophrenia, bipolar disorder, and severe major depression have been stable in the adult population for years. So how did these and other antipsychotics  get to be so popular?

Until recently, antipsychotic drugs were used to treat a few serious psychiatric disorders. But now, these powerful medications are prescribed for conditions as varied as very mild mood disorders, everyday anxiety, insomnia, and even mild emotional discomfort.

Thorazine, the first real antipsychotic, was synthesized in the 1950s; not just sedating, it also targeted the core symptoms of schizophrenia, like hallucinations and delusions. Later, it was discovered that antipsychotic drugs also had powerful mood-stabilizing effects, so they were used to treat bipolar disorder, too.

Hmmmm. At about the same time the CIA was experimenting with mind control through drugs and other methods. 

Then, starting in 1993, came the so-called atypical antipsychotic drugs like Risperdal, Zyprexa, Seroquel, Geodon, and Abilify. Today, there are 10 of these drugs on the market, and they have generally fewer neurological side effects than the first-generation drugs.

Originally, scientists believed the new drugs were more effective than the older antipsychotics against such symptoms of schizophrenia as apathy, social withdrawal and cognitive deficits. But several recent large randomized studies failed to show that the new antipsychotics were any more effective or better tolerated than the older drugs.

This news was surprising to many psychiatrists — and obviously very disappointing to the drug companies.

Then pre$cribe them one of their pills.

It was also soon discovered that the second-generation antipsychotic drugs had serious side effects of their own, namely a risk of increased blood sugar, elevated lipids and cholesterol, and weight gain.

And the possibility of violent outbursts resulting in deaths.

They can also cause a potentially irreversible movement disorder called tardive dyskinesia, though the risk is thought to be significantly lower than with the older antipsychotic drugs.

Nonetheless, there has been a vast expansion in the use of these second-generation antipsychotic drugs in patients of all ages, particularly young people.

The number of annual prescriptions for atypical antipsychotics rose to 54 million in 2011 from 28 million in 2001, a 93 percent increase, according to IMS Health.

Wow, that's almost double!

One study found that the use of these drugs for indications without federal approval more than doubled from 1995 to 2008.

Meanwhile, the combined spending on print and digital media advertising for these new antipsychotic drugs increased to $2.4 billion in 2010, up from $1.3 billion in 2007, according to Kantar Media. Between 2007 and 2011, more than 98 percent of all advertising on atypical antipsychotics was spent on just two drugs: Abilify and Seroquel, the current best sellers.

Of course we all know advertising does not work.

The original target population for these drugs, patients with schizophrenia and bipolar disorder, is actually quite small: The lifetime prevalence of schizophrenia is 1 percent, and that of bipolar disorder is around 1.5 percent.

And WHO is BENEFITING?

--more--"

Also see:

Court extends order shielding nuns from health law’s contraception rule

Couldn't get it up because of the antipsychotics.

More illnesses are tied to smoking
Antismoking efforts said to have saved 8 million lives

How can they know that? How can they prove that? It's just something the agenda-pushing do-gooders can point to slap themselves on the back about what a great job they are doing.

I'm sorry, folks, but this is no longer a healthy thing for me to do.