Patient Power

The FDA, Avastin, and your life

Paul Hsieh, MD of Freedom and Individual Rights in Medicine writes:

The Food and Drug Administration (FDA) is on the verge of taking the highly unusual step of “decertifying” the cancer drug Avastin that it had previously approved. In addition to sparking concerns that this is another step towards medical rationing, the FDA’s proposal will worsen another important but less-frequently recognized danger of government-run health care — namely, the politicization of health benefits. Both problems will accelerate under ObamaCare unless our politicians repudiate the principle of government-run health care. …

If you had terminal cancer, who should decide what treatments you may receive during your last few irreplaceable months of life? You, in consultation with your doctor? Or politicians and bureaucrats in Washington, D.C.?

Unless we repeal ObamaCare [HR 3590], get ready for the latter choice.

Read the whole article at Pajamas Media: Avastin and Your Life.

• FDA on your DNA: “You can’t handle the truth!”
• Obama Care: prohibit buying what you want, mandate what you don’t want
• Legal challenges to ObamaCare - updates
• England: “Sentenced to death on the NHS”
• British National Health Service denies care

Posted in prescription drugs | tags: FDA, HR 3590, rationing health care
Comments

Medicaid Rescissions Worse than Private Insurers

THe health control legislation [HR 3590] expands Medicaid eligibility.  John Goodman explains how Medicaid’s denial of coverage are worse than private insurers:

During the year leading up to the final passage of the Patient Protection and Affordable Care Act (PPACA), the White House set up a special Web site and invited all Americans to post their own personal stories about insurance company abuses. During the days leading up to the final vote on the bill, the president and congressional supporters used almost every television opportunity to trot out these cases — sometimes in graphic detail.

Yet, in all the episodes of abuse, do you recall even a single instance where an insurer:

• Arbitrarily dropped coverage for tens of thousands of enrollees with the stroke of a pen — just to save money.
• Dropped entire categories of care — such as dental care or home health care — because it decided these services were too costly?
• Arbitrarily reduced the fees it paid to doctors and hospitals, pushing many out of its network, and leaving its enrollees with serious access to care problems?

Probably not. For a private insurer, each of these activities would be a serious violation of contract. There is one insurer that does these things routinely. It’s called Medicaid and about half of all the newly insured people under the PPACA will be enrolling in it.

Read the whole article on Medicaid rescissions, also published in Kaiser Health News.

• Colorado Medicaid errors far exceed commercial insurers’
• Rescission of health insurance no rationale for government control
• Isn’t it already illegal to drop coverage?
• Obama appoints Donald Berwick: Health Care Rationer-in-Chief
• Medicaid & Medicare drive up insurance premiums

Posted in Medicaid/Medicare/SCHIP, ObamaCare, PPC | tags: Medicaid, ObamaCare fallout, rescission
Comments

Colorado Amendment 63, the commerce clause, & the Constitution

In his article in support of Colorado Amendment 63 (health care choice), Wayne Laugesen writes:

Congress has no authority to require individuals to buy private insurance, which is the basis of the lawsuit filed by states. It has no such authority because the Constitution does not grant it, not by any twisting of any phrase. That might not bother a majority in Congress, but it will most certainly matter to federal judges when they determine which rights belong to whom — based entirely on their interpretation of the Constitution.

I hope he’s correct. Read the whole article in the Colorado Springs Gazette: Amendment 63 protects our freedom.

But the commerce clause of the U.S. Constitution has been interpreted rather liberally - or absurdly.  This Reason.tv video makes this clear:

Re. the above video, Erwin Chemerinsky, the legal scholar who supports the liberal interpretation of the commerce clause, could play Judge Narragansett’s nemesis in the Atlas Shrugged movie that’s in production. (I thought the novel did contain a second judge, but I did not find him listed in the Wikipedia page.)

For more on whether mandatory insurance and the constitution, see my earlier post: Randy Barnett on why mandatory insurance is unconsitutional.

• States sue to block mandatory insurance
• Don’t rely on courts to strike down ObamaCare
• Mandatory insurance unconstitutional - so what?
• Mandatory insurance is unconstitutional
• Amendment 63

Posted in Uncategorized | tags: Ayn Rand, Colorado Amendment 63, Colorado health care choice, Colorado Right to Health Care Choice Initiative, Constitution & health care, mandatory insurance
Comments

Colorado Medicaid errors far exceed commercial insurers’

Look forward to more costly errors at the expense of your tax dollars.  The new health control legislation (HR 3590) expands Medicaid eligibility. Linda Gorman points out that Colorado Medicaid’s error rate in paying claims is much higher than private insurers. Her reference is the 2009 State of Colorado Statewide SIngle Audit.  The section of Medicaid starts on page. 217.

See also: Medicare & Medicaid fraud far exceeds insurance company profits.

• Colorado health care agency under investigation
• Medicaid: poor care, rampant fraud
• Dallas Medicaid patients have trouble finding doctors
• Jared Polis: what’s your real reason for pushing the “public option”?
• Medicaid applicants “don’t get timely benefits”

Posted in Colorado health care, Medicaid/Medicare/SCHIP | tags: Colorado health care, Colorado Medicaid, Linda Gorman, Medicaid, Medicaid fraud
Comments

EMTALA’s perverse incentives

“911Doc” at DocsOntheWeb describes the harms of EMTALA:

If you are unfamiliar with EMTALA or our take on it you can read about it here, but to be brief, EMTALA is an unfunded federal mandate passed in 1986, which, de facto, has made it a crime to tell anyone ‘no’ in the ER. Because of this, the specialists on call have learned to hate the ER. The ER is no longer a place from which one can build a practice, it is, rather, a place that compels you lose sleep, and money. It compels consultants to expose themselves to full malpractice liability EVERY SINGLE TIME they accept a patient from us whether they ever get paid or not.

… the specialists are fed up, and they have figured out how to fight city hall. For years their battle has been against the system or even the ER doc downstairs. But now (oh the genius!) they have turned the bureaucrats game against them. EMTALA and the bylaws, policies, and rules that it has generated are being followed to the letter.

For instance, almost all hospitals have an on-call policy for specialists that require them, if the ER doc requests it, to come in to the ER and evaluate the patient. Well, they can be forced to do this, but in many cases they CAN NOT be forced to treat the patient. Unheard of twenty years ago and before EMTALA, but specialists are now routinely coming in, evaluating the patient, and finding reasons why this particular case is out of their area of expertise, or not appropriate for their care, or not in need of surgery immediately, and the specialists are going home.

…

But how can a surgeon refuse to operate? Well, well… by way of example, consider the lowly gall bladder. When I was in training the gall bladder came out with pain and an abnormal ultrasound. Now it doesn’t. It used to be that surgeons would operate at the drop of a hat because they loved surgery. Not anymore. You see, if a patient with acute cholecystitis can be ‘cooled down’ with fluids and antibiotics, VOILA!, no need to remove it right now. Have the patient follow up with the surgeon as an outpatient. You can’t be sued for an operation you didn’t do.

Then the patient goes to the surgeon’s office a few days later and is no longer under the rubric of EMTALA, therefore, they must pay for their surgery (payment plans are accepted), or have insurance. Still sounds fair right? I mean, who gets surgery for free, right? Well, these folks do NOT follow through with the surgeon because it’s not free, they end up right back in the ER, and on the 28th time they are sick enough to go to the ICU. Some of them die, and they ALL chose to walk the streets with the ticking time bomb in their belly because they wouldn’t pay a single dime for surgery (but they happily pay ATT for their I-phones).

EMTALA compliant? Absolutely. Fair? Yes. Optimal? No. How to force the surgeons to operate? I don’t know… at the point of a gun? Otherwise, there’s no one that can do what they do, not even an attorney

(via FIRM)

• Colorado regulations deny woman coverage
• Mandated insurance…runaway costs…price controls, political rationing
• Colorado SB 61: insurers might deny fewer claims, but at what cost?
• Liberty vs. Newt’s “Top 10 GOP” health care ideas
• Colorado Amendment 56: bad idea

Posted in Policy - National, physicians & medical quality | tags: EMTALA, unintended consequences
Comments

Colorado Amendment 63, risk pools, & health care costs

A July 30 statement from a group calling itself “Colorado Deserves Better” said that Colorado Amendment 63 (Health Care Choice) “would isolate Colorado from health care costs savings by shrinking the risk pool in Colorado.”  This is unlikely, and even so, it’s unethical.

Even if larger risk pools result in cost savings (for whom?), this no justification for mandatory health plans. How about legislation mandating that everyone who buys an iPhone also buy the extended warranty? A warranty is a type of insurance, after all. Mandatory warranties would expands the risk pool, and hence lower the costs of the warranty. But this exploits the people who prefer not to buy the warranty and insure against iPhone-related risks in other ways.

You might counter this by saying that a health plan is different, and that the uninsured are free-riders who increase everyone else’s health plan premiums when they don’t pay. As I’ve written before, this cost-shift from the uninsured is tiny, especially when compared to how much Medicaid and Medicare increase premiums.

Read the rest of this entry »

• Health care costs and health insurance
• Colorado legistlature helps insurers by mandating wasteful preventive care coverage
• Taking Another Look at Swiss Health Care
• Colorado HB 1256 would lower insurance costs
• Will Colorado Authorities Push Anthem to be a Slumlord Insurance Company?

Posted in Colorado health care, PPC | tags: Colorado Amendment 63, Colorado health care, Colorado health care choice, Colorado Right to Health Care Choice Initiative, Linda Gorman, mandated benefits, mandatory insurance, patient-as-customer
Comments

“Don’t say the “the law will reduce costs and deficit.”

“Don’t say the “the law will reduce costs and deficit.” This is the last line on the final slide of a presentation given during a conference call organized by Families USA, a strong supporter of the health control legislation, HR 3590.

Reports Ben Smith at Politico:

Key White House allies are dramatically shifting their attempts to defend health care legislation, abandoning claims that it will reduce costs and the deficit and instead stressing a promise to “improve it.”

The messaging shift was circulated this afternoon on a conference call and PowerPoint presentation organized by FamiliesUSA — one of the central groups in the push for the initial legislation. The call was led by a staffer for the Herndon Alliance, which includes leading labor groups and other health care allies. It was based on polling from three top Democratic pollsters, John Anzalone, Celinda Lake and Stan Greenberg

Read the whole article: Dems retreat on health care cost pitch.

See the Wall Street Journal’s editorial on it:
Who’s ObamaCare’s Daddy? Now even liberals are denying paternity.

I really don’t like the term “liberal” to refer to left-wing authoritarians. But “left-wing authoritarian” is a mouthful.

• Health care “reform” barely reduces government deficit
• Democrats’ health reform: higher taxes, premiums, & deficit
• Why health care bill won’t reduce the deficit
• Health care bills fail to meet Obama’s promises
• Senate passes health care bill. Is the battle over?

Posted in ObamaCare, PPC | tags: budget deficit, Families USA, federal deficit, HR 3590, ObamaCare fallout
Comments

Repeal ObamaCare by choking off its funding

Sally Pipes argues:

With each passing week, it looks more and more like Republicans will retake control of Congress this fall. The latest Gallup poll gives the GOP a six-point edge. Rasmussen puts the Republican lead at seven points.

Even if Republicans take back Congress, they won’t be able to undo the Democrats’ legislative accomplishments right away. President Obama will be able to protect his signature achievements – like health reform – with his veto pen for as long as he calls the White House home.

But the GOP need not wait for a presidential victory in 2012 to begin repealing Obamacare. If Republicans assume congressional control this fall, they can – and should – start the repeal process as soon as the new Congress is seated in 2011 by refusing to fund the programs and initiatives created by the new law.

Read the whole article in Human Events: Repeal Obamacare by Choking Off Its Funding.

As I noted yesterday, this echoes my earlier post: ObamaCare: “debunk & defund” if you can’t repeal & replace.

• ObamaCare: “debunk & defund” if you can’t repeal & replace
• Advice to Ken Buck & other candidates: aim to repeal ObamaCare, not just revise
• Don’t rely on courts to strike down ObamaCare
• Republicans shouldn’t complain about ObamaCare
• Health care “reform” is all politics now

Posted in ObamaCare, PPC | tags: HR 3590, repeal ObamaCare, Republicans & health care
Comments

Advice to Ken Buck & other candidates: aim to repeal ObamaCare, not just revise

Republican candidate for U.S. Senate Ken Buck has said that ObamaCare (HR 3590) is wrong.  In Human Events, Sally Pipes of the Pacific Research Institute makes the case that “lawmakers need to scrap the measure in its entirety” and that “incremental revisions just won’t do.” Some excerpts:

Incremental revisions just won’t do. This 2,400-page law is the biggest entitlement since the Great Society. A wide-ranging program that puts one-sixth of our economy in the hands of politicians and bureaucrats can’t be fixed through a little tinkering. Lawmakers need to scrap the measure in its entirety.

Time is of the essence. Obamacare works like a one-way ratchet. Dismantling the huge new bureaucracies established by the measure will be effectively impossible once they’ve taken root.

Read the rest of this entry »

• ObamaCare: “debunk & defund” if you can’t repeal & replace
• Obama Care: higher taxes & premiums, poverty trap for low-wage workers
• Repeal ObamaCare by choking off its funding
• ObamaCare unconstitutional in ways New Deal is not
• AP on health bills: “meaningful negotiations occur behind closed doors”

Posted in ObamaCare, PPC, Policy - National | tags: Colorado elections 2010, health care bureaucracy, HR 3590, Ken Buck health care, repeal ObamaCare
Comments

Health care innovation: good and bad

John Goodman of the National Center for Policy Analysis has an excellent column abut health care innovation. He summarizes:

Wherever there is third-party payment [insurance, a health plan, Medicare, Medicaid], the goal of innovation is to produce more products that qualify for reimbursement, even if the effects on patient outcomes are only marginal. Wherever there is no third-party reimbursement, innovators are focused on ways to lower cost and raise quality.

Goodman provides many examples of innovation that benefits patients. Just imagine how much more there would be if patients paid more than 12% of all health care expenses. Read the whole article: Where Are the Innovators in Health Care Delivery?

• Colorado Amendment 63, risk pools, & health care costs
• Health “reform” vs. medical technology & innovation
• Health care bill punishes medical device innovation
• What abortion costs can tell us about medical care costs
• The Deadly Tax on Medical Innovation

Posted in PPC, insurance, tax code, HSAs, physicians & medical quality | tags: free-market health care brief, medical technology and innovation, patient-as-customer
Comments