September 18, 2013
New poll results show the
depth of the Obama administration's challenge on the eve of the rollout of the
federal health law's core provisions, as many Americans say they don't
understand the law and don't think it will help them.
A Wall Street Journal/NBC
News poll found that even those lacking health insurance, who are supposed to be
the law's biggest beneficiaries, generally believe it wouldn't do them much
Overall, nearly 70% of poll
respondents said they didn't understand the health-care overhaul passed by
Democrats in March 2010 or only understood a part of it. Only 31% said they
thought the overhaul was a good idea, with 44% saying it was a bad idea and 25%
saying they didn't have an opinion or weren't sure.
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4 ways Obamacare
insurance exchanges could change healthcare
Oct. 1 looms as the
official kick-off date for the Affordable Care Act (ACA), popularly known as Obamacare.
On that date,
consumers may begin shopping for insurance via one of ObamaCare's key components
- health insurance exchanges. The
exchanges will be open to individuals, families, and businesses with 50 or fewer
As of early
September, 16 states and Washington, D.C., are planning to run their own
exchanges, 7 states are planning partnership exchanges with the federal
government and 27 states will default to federally run exchanges, according to
the Kaiser Family Foundation.
exchanges - and more broadly the ACA - will bring big changes for consumers and
insurers, according to a recent viewpoint in the New
England Journal of Medicine written by Henry Aaron, PhD, of the Brookings
Institution, and Kevin Lucia, JD, of
Clueless About Medicare
Policymakers need to create
an educational campaign to help the public understand how Medicare works
financially, according to several health policy experts.
Because of a high level of
misunderstanding about Medicare's financing, lawmakers in Congress are hesitant
to enact changes to the program fearing voter backlash, Bob
Blendon, ScD, and John Benson, MA,
both of Harvard University, wrote in a special report in Wednesday's New England Journal of Medicine.
For example, public opinion
polls show that poor government management (30%), fraud and abuse (24%), and
excessive charges by hospitals (23%) were top reasons voters cited for
Medicare's rising costs. Meanwhile, the cost of new drugs and treatments was the
lowest-ranked reason, with 6% of respondents citing it.
Promote Health Law Where Skepticism Runs Deep
Kimberlain, a 44-year-old paralegal who doesn't have health insurance and never
goes to the doctor for checkups, said that if she had a medical condition, "I
wouldn't know about it." So as she walked around the Hatfield and McCoy Heritage
Days festival here over Labor Day weekend, a health-care booth caught her
Staffers promoting the
state's health-insurance marketplace, which is dubbed kynect and scheduled to
debut Oct. 1 as part of the federal health-care law, explained that Ms.
Kimberlain likely would qualify for subsidies to pay for a private plan or
perhaps for Medicaid coverage.
"I have not heard about
this at all," said Ms. Kimberlain, who lives in Pikeville, a rural Appalachian
town. "It sounds very interesting to me." She worried, though, whether the
subsidies would be enough, as she can't afford to pay more than $100 a
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|Walgreen to Give
Workers Payments to Buy Health Plans
Rising health-care costs
and a climate of change brought about by the new federal health law are
prompting American corporations to revisit the pact they've long had with
employees over medical benefits.
Walgreen Co. WAG
+0.26% is set to become one of the largest employers yet to make
sweeping changes to company-backed health programs. On Wednesday, the drugstore
giant is expected to disclose a plan to provide payments to eligible employees
for the subsidized purchase of insurance starting in 2014. The plan will affect
roughly 160,000 employees, and will require them to shop for coverage on a
private health-insurance marketplace. Aside from rising health-care costs, the
company cited compliance-related expenses associated with the new law as a
reason for the switch.
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Faces Long-Term Care Crisis, Report Says
The U.S. is facing a
long-term-care crisis and needs to do a better job of preparing for it, a new
congressional report says.
Government agencies should
work quickly to better harness public and private resources to best provide and
pay for long-term care as 78 million baby boomers, born from 1946 to 1964, head
into old age at the same time many of their parents are living into their 80s
and 90s, according to the federal Commission on Long-Term Care, which released a
series of recommendations Friday for dealing with the problem.
More than 12 million
Americans now rely on long-term care services in their homes, communities or
institutions to perform what are called daily living activities, such as eating
and bathing, according to the commission.
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2013 Long-Term Budget Outlook
Between 2009 and 2012, the
federal government recorded the largest budget deficits relative to the size of
the economy since 1946, causing federal debt to soar. Federal debt held by the
public is now about 73 percent of the economy's annual output, or gross domestic
product (GDP). That percentage is higher than at any point in U.S. history
except a brief period around World War II, and it is twice the percentage at the
end of 2007. If current laws generally remained in place, federal debt held by
the public would decline slightly relative to GDP over the next several years,
After that, however,
growing deficits would ultimately push debt back above its current high level.
CBO projects that federal debt held by the public would reach 100 percent of GDP
in 2038, 25 years from now, even without accounting for the harmful effects that
growing debt would have on the economy (see the figure below). Moreover, debt
would be on an upward path relative to the size of the economy, a trend that
could not be sustained indefinitely.
CBO Budget: http://www.cbo.gov/sites/default/files/cbofiles/attachments/44521-LTBO_0.pdf
Alarm on Drug-Resistant Bugs
Antibiotic-resistant bacteria cause at least two million illnesses and 23,000
deaths a year in the U.S., according to the CDC.
And without concerted
action, "the medicine chest will be empty" when doctors attempt to treat such
infections, CDC director Thomas Frieden, MD, told reporters.
"If we are not careful,"
Frieden said, "more and more patients will be thrust back to a time before we
had effective drugs."
CDC Report: http://www.cdc.gov/features/AntibioticResistanceThreats/index.html
53% of Doctors
While data shows there's
been an uptick in hospital employment for physicians, more than half still work
for themselves, an AMA survey finds. The number of physicians in solo practice,
however, has dropped.
Conventional wisdom says
physicians in private practice are a dying breed.
The narrative says
physicians are flocking to employed arrangements with hospitals and larger
physician practices as health reform and compensation models push the healthcare
industry away from fee-for-service and toward economies of scale, quality
outcomes and population health.
An American Medical
Association report released this week, however, suggests that the demise of private practice physicians may be
overstated [PDF]. "To paraphrase Mark Twain, the reports of the death
of private practice medicine have been greatly exaggerated," AMA President Ardis
Dee Hoven, MD, said in prepared remarks.
Alignment in the New Shared Risk Environment
This Intelligence Report
offers proprietary survey results on critical topics in healthcare, powered by
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Inflation Is at Slowest Pace in 50 Years
Medical prices are rising
at their slowest pace in a half century, a shift in the health-care industry
that could provide relief to government and businesses' budgets while also
signaling consumers are being left with a larger share of the bill.
Prices of some medical
procedures, such as hip and knee replacements, vary greatly. Shown, patients
recovering from such surgeries in Delaware.
The prices paid for medical
care in July rose just 1% from a year earlier, the slowest annual rate of growth
since the early 1960s, according to Commerce Department data. Health-care
increases now trail overall inflation, which itself has been historically slow
in recent years.
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|Layoffs coming to
Cleveland Clinic in plan to reduce budget by $330 million
-- The Cleveland Clinic has told workers they will be laying off an unspecified
number of employees as part of an overall, sweeping cost-reduction
Clinic CEO Dr. Toby
Cosgrove discussed the looming cuts and changes in a Wednesday morning
Clinic spokeswoman Eileen
Sheil denied circulating rumors that employees were told there would be 3,000
She said any layoffs will
be part of a multi-year plan to cut $330 million from the Clinic's
Codeine linked to
increased pain sensitivity
Frequent and large does of
codeine may increase sensitivity to pain and fail to offer the same relief as
morphine, according to a study presented at the 2013 International Headache
Congress in the US.
Researchers from the
Discipline of Pharmacology at The University of Adelaide in Australia conducted
what they say is the world's first experimental study to compare both codeine
and morphine in order to determine their pain-relieving and pain-increasing
The Pains of Chronic Opioid Usage
Dr. Laxmaiah Manchikanti
and R. Joshua A. Hirsch were fetured on the Agency for Healthcare Research and
Quality website hosted by the US Department of Health and Human
The invited commentary
fulfilled the following objectives:
- Describe the appropriate initial assessment of patients with chronic
- List the most common errors made in prescribing opioids for non-cancer
- Outline appropriate monitoring for patients prescribed opioids for
- Appreciate the need to risk stratify patients on opioids for
Read the spotlight case
|State Society News
Meeting Begins This Friday
The California Society of
Interventional Pain Physicians' 4th Annual Meeting starts this Friday, September
20 thru Sunday, September 22. It will take place at the Terranea Resort in Rancho
Palos Verdes, CA.
There is still time to
register online at www.casipp.com
Onsite registrations are
also welcome. Don't miss out on this informative and exciting state
Societies of Interventional Pain Physicians Schedule Symposium
is now open for the Pain Medicine Symposium, 2013, which is set for Thursday,
November 7, 2013-Sunday, November 10, 2013 at the Hyatt Regency, Jersey
the great success of the 2012 program, this program again will be a joint effort
between the New York and New Jersey Societies of Interventional Pain Physicians.
The curriculum is presented by Course Directors: Sudhir Diwan, MD and Peter
Speakers will be Sanjay Bakshi,
MD, Sudhir Diwan, MD, and Peter Staats, MD.
Click here to register for the
NYNJSIPP Pain Symposium.
Click HERE for more
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