Health care

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“A ‘breakthrough’ drug that gives extra months of life to men with advanced prostate cancer has been rejected for use on the NHS.

The once-daily pill was developed by UK scientists at the Institute of Cancer Research (ICR) and trials were partly funded by British charities.

But it has been branded as too expensive by the rationing watchdog the National Institute for Health and Clinical Excellence.

Abiraterone is the latest prostate cancer drug to face an NHS ban despite being proven to extend life for men with advanced disease. Last month another drug – Jevtana – was turned down as ‘not cost-effective’.

It is a fresh blow for doctors and patients who hoped a new era of drugs could lessen the deadly toll of prostate cancer, which has been described in the past as a low-profile ‘Cinderella’ disease.”

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“One of the most fervent promises President Obama made to the American people before his health overhaul law passed in 2010 was “If you like your health care plan, you will be able to keep your health care plan. Period. No one will take it away. No matter what.”

But, even before the law fully takes effect in 2014, health insurers are dropping out of markets in many states, causing millions of people to lose “the coverage they have now,” and tens of millions more surely will follow.

Carriers don’t want to leave the customers and markets they have been serving, often for decades, but they are being forced to walk away from significant investments in many states to cut anticipated losses.

Some of the carriers are leaving because of onerous state regulations, others are victims of a faltering economy, but costly new federal rules and regulations and the many more that are to come as a result of the Patient Protection and Affordable Care Act (Obamacare) are accelerating the exodus.”

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“This edition of Waiting Your Turn indicates that waiting times for elective medical treatment have increased since last year. Specialist physicians surveyed across 12 specialties and 10 Canadian provinces report a total waiting time of 19.0 weeks between referral from a general practitioner and receipt of elective treatment. At 104 percent longer than it was in 1993, this is the longest total wait time recorded since the Fraser Institute began measuring wait times in Canada. ”

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Here’s a look at the Patient Protection and Affordable Care Act’s year in review.

– Jan. 14: Kansas announces its intention to become the 26th state to file suit against the federal government to stop implementation of the health care overhaul.

– Jan. 19: The House of Representatives votes to repeal the health care law.

– Jan. 26: Illinois-based pharmaceutical company Abbott Labs cuts 1,900 jobs “in response to changes in the health-care industry, including U.S. health-care reform and the challenging regulatory environment.”

– Jan. 31: A second federal district judge rules that the law is unconstitutional.

– Feb. 2: All 47 Republican senators vote to repeal the Affordable Care Act, but the measure fails.

– Feb. 16: Health and Human Services Secretary Kathleen Sebelius testifies before the Senate Finance Committee and admits that the CLASS Act, a key portion of the law that was touted as a $70 billion savings, is “totally unsustainable.” But not to worry: Sebelius says her department has the authority to rework the legislation to make CLASS tenable.

– Feb. 18: The House votes to block federal funding to implement the Affordable Care Act. The Congressional Budget Office also estimates that repealing the law would add $210 billion to the combined federal deficits from 2012 to 2021.

– Feb. 22: A federal judge tosses a lawsuit claiming that the Affordable Care Act violates the liberties of those who choose to rely on God to protect and heal them instead of buying health insurance.

– March 3: The House votes to end an unpopular tax paperwork-filing requirement for businesses tucked into the health care law.

– March 23: The law turns one year old. On the same day, the House Committee on Energy and Commerce finds that the temporary Early Retirement Reinsurance Program will spend its allotted $5 billion far earlier than its Jan. 1, 2014 expiration date.

– March 30: The CBO estimates that health care reform will cost $1.1 trillion, an increase of $90 billion from its February estimate.

– May 17: The Daily Caller reports that 20 percent of new waivers from the law have gone to gourmet restaurants, nightclubs and fancy hotels in former House Speaker Nancy Pelosi’s district.

– June 8: A McKinsey & Company survey of over 1,300 private sector employers found that 30 percent of employers would definitely or probably stop offering insurance to their employees after the law is implemented in 2014.

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“A new Obama administration rule could drive out of the market the low-cost, high deductible plans that are supposed to be available under ObamaCare. That would likely mean a sharp jump in taxpayer subsidies.

The problem stems in large part from contradictions in the hastily written health care overhaul.

Starting in 2012, ObamaCare requires insurers in the individual or small group (small business) market to spend at least 80% of premiums on medical costs, leaving 20% for salaries, advertising, fraud prevention, profit, etc. For large groups, this medical loss ratio (MLR) must be 85%.

But another section of the law establishes the actuarial value of plans that can be sold on exchanges, which will cater to individuals and small groups. A bronze plan is allowed to have an actuarial value of 60%, meaning the insurer pays 60% of health care costs and the policyholder 40%. A silver plan can have a 70% value. Lower-actuarial plans tend to have lower MLR requirements.

Insurers offering bronze and silver plans must meet the 80% MLR under the final rule issued by the Department of Health and Human Services this week.

“It will make the carriers think long and hard about offering bronze policies and maybe silver ones,” said Roy Ramthun, an independent consultant for consumer-directed health care.”

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“Recovery: After nearly all the stimulus money has been spent, the Congressional Budget Office now admits it cost more than advertised, did less to boost growth and will hurt the economy in the long run.

In its latest quarterly report on the economic effects of the Obama stimulus, the CBO sharply lowered its “worst case” scenario while trimming many of its upper-bound estimates for stimulus-fueled growth and employment.

The new report finds, for example, that the stimulus may have added as little as 0.7% to GDP growth in 2010 — when spending was at its peak — and created as few as 700,000 new jobs.

Both are down significantly from the CBO’s previous worst-case scenario.

The report also lowered the best-case estimate for added growth in 2010 to 4.1% from 4.2%.

In addition, the CBO says the extra infrastructure money didn’t boost growth as much as it previously claimed, because states reacted by spending less out of their own budgets on highways.

So in other words, the CBO now says it’s possible that the stimulus had virtually no meaningful effect on growth and employment despite its massive price tag.

All this comes after the CBO increased that price tag to $825 billion from its initial $787 billion — a 5% hike.”

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“Voters want the Supreme Court to overturn President Obama’s healthcare law, according to a Quinnipiac University poll released Wednesday.  The survey showed 48 percent support for the court striking down the healthcare law, compared to 40 percent who said the court should uphold it. The divide broke strongly along partisan lines: Seventy percent of Democrats said the court should rule in favor of the law, and 86 percent of Republicans want the court to strike the it.  The court will likely hear oral arguments in March over the law’s requirement that almost all Americans buy health insurance — known as the individual mandate. The justices also will consider whether the law’s Medicaid expansion is constitutional, along with two procedural questions. “

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“The grisly IPAB, one of the most underreported of Obamacare’s myriad of liberty-sapping features, would have the power to cut Medicare spending each year — if Obamacare isn’t repealed first. The dictates of its 15 unelected members would effectively become law. In fact, Congress couldn’t even overturn the IPAB’s decrees with a majority vote in each house and the President’s signature.   Obama has since doubled-down on the IPAB, seeking to grant it even more power to cut Medicare spending than Obamacare would grant it. To be clear, this is in addition to the nearly $1 trillion that the Congressional Budget Office says would be siphoned out of Medicare and spent on Obamacare during the overhaul’s real first decade (2014 to 2023).  Aaron praises the IPAB, although he does admit to having a few problems with it. He thinks that its largely unchecked power isn’t unchecked enough, as the board should be able to order payment reductions for other aspects of medical care that have so far escaped its statutory grant of power. He writes, “I admit that the provisions governing the IPAB are less than optimal. For example, recommendations regarding payments to acute and long-term care hospitals, hospices and inpatient rehabilitation and psychiatric facilities are off-limits until 2020; and those to clinical laboratories are off-limits until 2016. These politically motivated restrictions should be repealed as early as possible so the IPAB’s recommendations can comprehend the delivery system as a whole.”  Aaron says that “the survival and strengthening of the IPAB is of critical importance.”  In a sense, this is unsurprising, given his earlier views, which were captured in a Washington Post story published during the Reagan administration (when Aaron was in his late 40s).  The Post article reads,  “If Americans are serious about curbing medical costs, they’ll have to face up to a much tougher issue than merely cutting waste, says Brookings Institution economist Henry J. Aaron“They’ll have to do what the British have done: ration some types of costly medical care — which means turning away patients from proven treatments.”

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“The country always knew, but for just a bit forgot, that you cannot print money and borrow endlessly. It always knew that bureaucrats were less efficient than employers. It knew that Guantanamo was not a gulag and Iraq was not “lost.” But given the anguish over Iraq, the anger at Bush, the Obama postracial novelty and “centrist” façade, and the Freddie/Fannie/Wall Street collapse, it wanted to believe what it knew might not be true. Now three years of Obama have slapped voters out of their collective trance.

The spell has now passed; and we are stronger for its passing. There is going to be soon a sense of relief that we have not experienced in decades. In short, sadder but wiser Americans will soon be turned loose with a vigor unseen in decades.”
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