News In Healthcare

A recent arti­cle in the Chicago Sun-Times about how great health sav­ings accounts are was obvi­ously writ­ten by United Health­care or United Health­Group.  The arti­cle explains that it was Golden Rule Insur­ance Co., part of United Health­care, that devel­oped HSAs about 15 years ago and so far its mem­bers have saved $165 mil­lion in their accounts.  The arti­cle goes on to say how great HSAs are for small busi­nesses or the self-employed.  This may be true from a busi­ness point of you.  How­ever, as an indi­vid­ual with a high deductible health plan and a funded HSA, the admin­is­tra­tive has­sle of mak­ing sure I am pay­ing only for what I am sup­posed to be pay­ing for is no pic­nic.  I would like to see an arti­cle on how best to keep track of all of the EOBs, allowed amounts, deductible amounts, account deduc­tions, etc.

At the hear­ing on the 2007 Report of the Board of Trustees of the Medicare Trust Fund, Chair­man Pete Stark opened by say­ing, “Despite the gloom and doom fore­casts and rhetoric from some of my col­leagues, this year’s Trustees report shows that Medicare remains sol­vent and sus­tain­able.”  In regards to the 45% fund­ing warn­ing that was reached for the sec­ond year in a row, Stark said that fig­ure “is lit­tle more than an arbi­trary, hid­den hatchet designed to elim­i­nate Medicare’s enti­tle­ment and con­tinue the march toward pri­va­ti­za­tion .…”   So last week we reported that Medicare will be obso­lete by 2019.  Today we report that Medicare is just fine.  Who and what are we to believe?

Rep­re­sen­ta­tive Pete Stark, Chair­man of the House Ways and Means Health Sub­com­mit­tee, announed that a hear­ing will be held on May 5, 2007 to dis­cuss finan­cial assis­tance pro­grams for low-income Medicare ben­e­fi­cia­ries.    The focus of the dis­cus­sion will be on the cur­rent state of the Part D Low Income Sub­sidy, the Medicare Sav­ings Pro­grams, and oppor­tu­ni­ties to increase enroll­ment and expand eli­gi­bil­ity in these programs.

When post­ing the news sev­eral days ago that BCBS entered into a $128 mil­lion set­tle­ment with physi­cians from across the coun­try, I was not aware that one of the lead coun­sel for the physi­cian groups was Archie Lamb of the Lamb Law Firm.  Why is this rel­e­vant you might ask?  Well, Lamb is one of the attor­neys who led the charge in the unin­sured class action law­suits against for-profit hos­pi­tals all across the coun­try.  In those actions, Lamb teamed up with Richard Scruggs, the very suc­cess­ful lead attor­ney in the tobacco lit­i­ga­tion sev­eral years back, who focused on the non-profit hos­pi­tal sec­tor.   By the way, what hap­pened to those law­suits? 

Well dur­ing a recent visit in Raleigh, NC, the repub­li­can can­di­date said that the plans the demo­c­ra­tic can­di­dates are putting out there, call­ing for manda­tory uni­ver­sal cov­er­age, are basi­cally the start of social­is­tic med­i­cine.  The Wash­ing­ton Post reports that Giu­liani isn’t say­ing that we shouldn’t cover the poor.  He believes we should do so by pro­vid­ing them with vouchers. 

Last week Pres­i­dent Bush par­tic­i­pated in a meet­ing regard­ing Medicare Part D.  Dur­ing the meet­ing, Pres­i­dent Bush declared the Medicare Part D reforms “a great suc­cess.”  He wants to take the prin­ci­ples that worked in that reform and apply them to the over­haul that is nec­es­sary for Medicare and Social Secu­rity.  Those prin­ci­ples are com­pe­ti­tion in the mar­ket­place and trust­ing peo­ple to make deci­sions in their lives.    Kind of sounds like a pre­cur­sor to a plan for high deductibles and health sav­ings accounts in the Medicare arena, doesn’t it? 

Maine is only one of a hand­ful of states bold enough to enact a plan for uni­veral health­care cov­er­age for its res­i­dents.  The Dirigo Health Reform Act of 2003, was intended to pro­vide access to cov­er­age for all unin­sured res­i­dents by 2009.  However, a recent report in the New York Times explains that things aren’t going as smoothy as the Maine leg­is­la­ture had hoped.  There are chal­lenges in get­ting employ­ers to vol­un­tar­ily offer health cov­er­age since Maine has a large rural pop­u­la­tion, sea­sonal employ­ers, and a large num­ber of mom and pop oper­a­tions.   And for those who have obtained cov­er­age, it hasn’t come cheap.   Pre­mi­ums have increased, not become more afford­able, since those who are sign­ing up need sub­stan­tial med­ical care.  But the pro­gram has made progress. Approx­i­mately 5,000 peo­ple have been added to Med­ic­aid and 13,800 have been enrolled in Dirigo­Choice.  As the pro­gram con­tin­ues to evolve, we will have to wait and see if Maine can pull this off.

Ear­lier this week Pres­i­dent Bush was pre­sented with leg­is­la­tion to amend the Pub­lic Health Ser­vices Act and add require­ments regard­ing trauma care.   H.R. 727 , also known as the Trauma Care Sys­tems Plan­ning and Devel­op­ment Act of 2007, will among other things (1) Autho­rize the Sec­re­tary to make grants to improve access to and enhance the devel­op­ment of trauma care ser­vices, (2) Pro­hibits the Sec­re­tary from mak­ing trauma care grants to states unless the state’s emer­gency med­ical ser­vices plan coor­di­nates plan­ning for trauma sys­tems with state dis­as­ter emer­gency plan­ning and bioter­ror­ism hos­pi­tal pre­pared­ness plan­ning, and (3) Allows a study to be done on the state of trauma care and trauma research. 

Arcoxia, Merck’s suc­ces­sor to the arthri­tis drug Vioxx, will not make it to mar­ket.  The FDA voted against approval of the drug because of con­cerns that it could cause as many as 30,000 heart attacks a year if widely used.  The New York Times reports that despite the con­cerns, Arcoxia is on sale in 63 other countries.

At least this one has come to a suc­cess­ful res­o­lu­tion — at least for the physi­cians who filed the suit.  Twenty state med­ical soci­eties have reached a set­tle­ment with the Blue Cross Blue Shield Asso­ci­a­tion and more than 80 state plans in a class-action law­suit over billing and other busi­ness prac­tices.  The agree­ment reached requires the Blues plans to pay more than $128 mil­lion to the physi­cians who con­ducted busi­ness with them.  In addi­tion, the plans will pay mil­lions in legal fees asso­ci­ated with the litigation.