Today in America, we have more than 27 million people without any health insurance. Millions more who have employer-based insurance are being fleeced by skyrocketing premiums and prescription drug prices, and they are often thrown off those private plans when they change or lose jobs.
This is great for the 64 health care CEOs who were paid $1.7 billion in 2017. But this is an economic and medical emergency for millions of Americans. The good news is that we have a very straightforward solution that draws from our own country’s past success: We can guarantee health care as a right to all by expanding Medicare, the most popular and successful program in American history.
R. Lopez moved to the United States from Mexico when she was 3. By the time she was in high school, the aspiring Spanish teacher from Oxnard needed glasses to drive and to see the whiteboard in her classes.
Although her family’s low income qualified her for government-funded health coverage, she wasn’t eligible for full-scope Medi-Cal for much of her childhood because she lacks legal status.
California Gov. Gavin Newsom wants the state to provide health coverage to low-income young adults who are in the country illegally, but his plan would siphon public health dollars from several counties battling surging rates of sexually transmitted diseases and, in some cases, measles outbreaks.
Insurers and healthcare providers warned the CMS that federal regulations aren’t the reason insurers steer clear of selling plans across state lines.
The CMS issued a request for information in March on how to eliminate barriers on insurers’ ability to sell cross-border plans, reviving an idea that was a pillar of President Donald Trump’s 2016 campaign. The agency also asked whether Farm Bureau insurance plans or short-term, limited duration plans could help facilitate the sale of individual market plans.
Accountable care organizations are more likely to stay in the Medicare Shared Savings Program if they achieve bonuses, even if it’s just once, according to a new study.
The analysis, published Monday in Health Affairs, found that the risk of an ACO leaving the Medicare program is cut by more than three-quarters if they receive shared savings for at least one performance year. Overall, 30% of the 624 ACOs that participated at some point in the first five years of the program left. The findings come a few months after the CMS overhauled the program, which will force ACOs to take on risk sooner. Since then, concerns have been raised about whether or not ACOs will join or stick with the program.
It’s early morning in an operating theater at Providence Hospital in Portland, Ore. A middle-aged woman lies on the operating table, wrapped in blankets. Surgeons are about to cut out a cancerous growth in her stomach.
But first, anesthesiologist Brian Chesebro puts her under by placing a mask over her face.
“Now I’m breathing for her with this mask,” he says. “And I’m delivering sevoflurane to her through this breathing circuit.”
A survey of 200 physicians under the age of 35 showed that 56% reported unhappiness with the current state of medicine. That number didn’t seem surprising to me at first. I was not particularly “happy” at the time of reading this survey either.
I’ve aspired to become an oncologist for as long as I can remember. In oncology, despite my inability to cure, I can always try to heal. I form connections with patients and their families as they embark on a journey that is quite often their last. I learn from my patients as much as, and at times more than, they learn from me.
But all of this is overshadowed by a sense of heaviness that I frequently encounter as I enter the clinic room. That sense of heaviness hits when a patient tells me of the time when they were placed on a “brief hold” for more than half an hour in order to reach someone to get a prescription refilled or reschedule an appointment. Or when their insurance refused to cover the drug that I had prescribed to them. It is when I hear that clinic visits or treatments are not scheduled due to insurance authorization delays. Or when I’m asked about the cost of drugs and end up having to explain how nobody really knows.
Health insurance companies are standing in the way of many patients receiving affordable, quality healthcare. Insurance companies have been denying patient claims for medical care, all while increasing monthly premiums for most Americans. Many of the nation’s largest healthcare payers are private “for-profit” companies that are focused on generating profits through the healthcare system. Through a rigorous approval/denial system, health insurance companies can dictate the type care patients receive. In some cases, this has resulted in patients foregoing life-saving treatments or procedures.
Kaiser Permanente will soon launch a new care network that connects the system’s more than 12 million members to community services that address their social needs.
The Thrive Local initiative will be integrated into Kaiser’s electronic health record, and will be rolled out regionally this summer, though the first location hasn’t been announced yet. Over the next three years, the health system will make it available throughout the entire system.
The program will allow healthcare providers and caregivers to connect patients with community resources that can help them address needs such as food insecurity or housing instability from an array of not-for-profit, public and private social services.