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WSJ: ObamaCare Could Reduce Employee Health Benefits
Michael F. Cannon
ObamaCare supporters promised the law’s employer mandate would require employers to provide workers with comprehensive insurance. But they apparently didn’t read the bill very closely. It’s a recurring theme.
According to the Wall Street Journal, employers and employee-benefits consultants have found, and federal regulators now confirm, that the law actually requires most employers to offer no more than very flimsy coverage. Many employers are now exploring the option of offering limited-benefit health plans that cover preventive services and maybe “$100 a day for a hospital visit” but “wouldn’t cover surgery, X-rays or prenatal care.” Indeed, the law could push many employers to reduce the amount of coverage workers receive on the job.
The Obama administration’s reaction demonstrates they had no idea what they were doing. The Wall Street Journal:
Administration officials confirmed in interviews that the skinny plans, in concept, would be sufficient to avoid the across-the-workforce penalty. Several expressed surprise that employers would consider the approach.
“We wouldn’t have anticipated that there’d be demand for these types of band-aid plans in 2014,” said Robert Kocher, a former White House health adviser who helped shepherd the law. “Our expectation was that employers would offer high quality insurance.”
The Law of Unintended Consequences strikes again.
This and other employer responses to the law could make the roll-out of ObamaCare’s health insurance “exchanges” even more of a train wreck.
- To the extent ObamaCare’s employer mandate pushes firms to offer bare-bones plans, premiums for plans offered through Exchanges will rise. The healthiest workers will enroll in their employers’ bare-bones plans, but workers who have expensive illnesses (or with dependents who have expensive illnesses) will seek more-comprehensive coverage through the Exchanges. The influx of sick consumers will increase the premiums for Exchange-based plans. Many of these sick workers won’t receive any premium-assistance tax credits or cost-sharing subsidies because their employer’s bare-bones plan will likely satisfy ObamaCare’s definition of adequate – and because the statute forbids those entitlements in the 33 states that have declined to establish an Exchange.
- Employers are also renenwing their health-benefits contracts early (i.e., before January 1, 2014), which allows them to avoid many of ObamaCare’s regulatory costs for several months. That move could also increase premiums for Exchange-based plans by encouraging workers with high-cost illnesses to seek coverage through Exchanges while healthy workers stick with their employer’s plans.
- Many employers are also considering self-insuring their health benefits, an arrangement in which the employer bears the risk that is usually borne by the insurance carrier and just hires someone (often an insurer) to administer the coverage. This strategy allows also employers to avoid many of ObamaCare’s regulatory costs and could also increase premiums in the Exchanges and small-group market.
Again, the Journal:
Regulators worry that some of these strategies, if widely employed, could pose challenges to the new online health-insurance exchanges that are a centerpiece of the health law. Among employees offered low-benefit plans, sicker workers who need more coverage may be most likely to opt out of employer coverage and join the exchanges. That could drive up costs in the marketplaces.
These are the sort of unintended consequences that ObamaCare’s opponents warned would plague any attempt by Congress to centrally plan one-sixth of the U.S. economy.
View full post on Cato @ Liberty
Health • CDC: 1 In 5 US Children May Have Mental Disorder
CDC: 1 In 5 US Children May Have Mental Disorder
May 18, 2013 10:05 AM
Nearly 1 in 5 children in the U.S. suffers from a mental disorder, and this number has been rising for more than a decade. (Photo credit should read ARMEND NIMANI/AFP/Getty Images)
ATLANTA (CBS ATLANTA) – Nearly 1 in 5 children in the U.S. suffers from a mental disorder, and this number has been rising for more than a decade.
According to a study conducted by the Centers for Disease Control and Prevention, up to 20 percent of American children are suffering from mental disorders such as attention-deficit hyperactivity disorder (ADHD), anxiety, depression and autism.
The CDC’s first study of mental disorders among children aged 3 to 17 also found that the cost of medical bills for treatment of such disorders is up to $247 billion each year.
“This is a deliberate effort by CDC to show mental health is a health issue. As with any health concern, the more attention we give to it, the better. It’s parents becoming aware of the facts and talking to a health-care provider about how their child is learning, behaving and playing with other kids,” said Dr. Ruth Perou, the study’s lead author.
The CDC data was collected between 1994 and 2011, and it shows that the number of children being diagnosed with mental disorders has been steadily growing. The study did not conclude exactly why the numbers are increasing.
More research is needed to determine the specific causes of mental disorders, said Dr. Perou, and that greater awareness could lead to an uptick in diagnoses. A host of environmental factors, including chemical exposure and poverty, also can affect a child’s mental health, she said.
The study also found that girls were more prone to depression and alcohol abuse than boys, and that 6.8 percent of U.S. children are affected by attention-deficit hyperactivity disorder.
http://atlanta.cbslocal.com/2013/05/18/ … -disorder/
Statistics: Posted by yoda — Sat May 18, 2013 9:39 am
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Obamacare Train Wreck? Washington Post: Obama Administration “has gone hat in hand to health industry executives.”
Obamacare looks increasingly like a disaster. It could be Obama’s Iraq War. (Sadly it’s even more expensive.) Senator Baucus, a Democrat, recently said he saw an Obamacare “train wreck coming down.”
Then he announced his retirement.
Obamacare, which was forced through against the will of a majority of Americans according to polling at the time, has the potential to get very ugly indeed. And the law has only gotten more unpopular with time. Things are going so badly that Kathleen Sebelius now has to beg for funds from health industry executives (you know the people who wrote large parts of the law) to get the thing off the ground.
In other words she is playing the crony card, giving industry another chance to show which companies really want to play ball with the government, and of course reap (potential) benefits.
Thing is we may be past that point Ms. Sebelius. And as Baucus saw, you and the administration are running out of track.
(From The Washington Post)
“It sounds like the people she’s going to are people that are being regulated by her agency, I think that is definitely problematic,” said Meredith McGehee, policy director for the Campaign Legal Center. “That’s not a statement about the value of the law, but it’s a statement about using the power of government to compel giving or insinuate that giving is going to be looked at favorably by the government.”
View full post on AgainstCronyCapitalism.org
Health • UK Nursing Homes On The Brink As Bailiffs Move In
Care homes on the brink as bailiffs move in
Emily Dugan , Cahal Milmo Sunday 28 April 2013
Record numbers of care homes and providers are in crisis as they struggle to service a £5bn debt mountainAFP
Thousands of Britain’s most vulnerable elderly people face rising bills and the prospect of forced relocation from struggling care homes, because record numbers of providers are slipping into administration.
The total of private care home operators going bust grew by 12 per cent in the past 12 months. The annual rate of failures among private providers has more than doubled since the economic crisis began, with 250 residential care operators shutting.
Councils, a vital source of income for private-care providers, are slashing referrals and now seeking to shut their own facilities to meet savings targets. Andy Burnham, the shadow Health Secretary, called the wave of closures a “crisis”.
Providers are said to be caught in a perfect storm of diminishing income while struggling with fixed costs and debts left behind from their rapid expansion during the economic boom. Campaigners claim it will be elderly people – many dementia sufferers – who suffer.
Mr Burnham warned that the closures were part of a wider collapse in social care driven by spending cuts imposed on town halls. One authoritative study places the amount cut from Britain’s adult social services at up to £2bn.
Meeting the rocketing costs of social care for elderly and disabled people is a challenge that is expected to dog governments for decades to come.
Ten million people in the UK are now aged over 65 and their number is expected to have nearly doubled to around 19 million by 2050.
http://www.independent.co.uk/news/uk/ho … 91828.html
Statistics: Posted by yoda — Sun Apr 28, 2013 8:36 pm
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Health • Outbreak: Frightening H7N9 Study:
Outbreak: Frightening H7N9 Study: “Authorities Should Definitely Be Alarmed and Get Prepared for the Worst-Case Scenario”
Mac Slavo
April 25th, 2013
SHTFplan.com
While U.S. Center for Disease Control and Prevention director Tom Frieden suggests there is no cause for panic over the H7N9 influenza strain and says that Americans, “go about their daily lives,” this unusually dangerous virus has concerned officials at the CDC to such an extent that they are rapidly working to develop an effective vaccine in the event it makes its way to North America.
According to the World Health Organization, the H7N9 bird flu virus is one the most lethal influenza strains ever identified. The first case appeared in China in late February and has since spread to scores of others, with at least 109 cases having been reported to WHO thus far, 22 of which have resulted in death. This amounts to a kill rate of 20%. These are laboratory confirmations, so in all likelihood there are hundreds, perhaps thousands, of others who may be infected with the virus that haven’t received medical attention.
In the last 24 hours officials in Taiwan confirmed the first case of the virus outside of China. The patient was originally hospitalized on April 12, but confirmation of the virus did not come until nearly two weeks later, suggesting that the official numbers and the reality on the ground are starkly different.
Moreover, as reported by WHO, half of the H7N9 cases identified are individuals who have had no prior contact with poultry.
If true, this would be strong evidence that H7N9 has already achieved “human-to-human transmission,” turning it into a “nightmare influenza” that might already be spreading across the population.
That status is not proven yet, however, and more observation is needed before such a conclusion could be substantiated.
“If H7N9 were to stably adapt to humans, it would probably meet with little or no human immunity,” writes Peter Horby from Nature.com. “Detecting and tracking a partially human-adapted H7N9 virus in a city as vast as Shanghai or Beijing would be difficult; tracking a fully adapted virus would be impossible. And it could easily spread nationally and internationally.”
Source: Natural News
While transmission between humans is not yet confirmed, the South China Morning Post cites a frightening study that suggests the virus is mutating at an alarming rate:
The new bird flu could be mutating up to eight times faster than an average flu virus around a protein that binds it to humans, a team of research scientists in Shenzhen says.
Dr He Jiankui, an associate professor at South University of Science and Technology of China, said yesterday that the authorities should be alarmed by the results of their research and step up monitoring and control efforts to prevent a possible pandemic.
…
“It happened in just one or two weeks. The speed may not have caught up with the HIV, but it’s quite unusual for a flu.”
The fast mutation makes the virus’ evolutionary development very hard to predict. “We don’t know whether it will evolve into something harmless or dangerous,” He said. “Our samples are too limited. But the authorities should definitely be alarmed and get prepared for the worst-case scenario.“
It’s impossible for the general public to know how this virus has mutated. Government officials in China are not sharing any specific details, and as noted, there are significant delays between the time a patient enters the hospital and when the virus is confirmed as H7N9.
Furthermore, if this virus has become transmittable by way of human to human contact it’s likely that government officials, in an effort to prevent panic, will wait as long as possible before they disseminate information to the public.
There is not much we can do unless we know it’s coming. The evidence thus far indicates the virus is continuing to spread. We really don’t know if it has gone human-to-human, and we may not know until it’s too late.
The Chinese study cited above suggests that authorities start preparing for a worst-case scenario.
We suggests individuals do the same and take steps now to prepare for a pandemic.
Stay up to date with information as it becomes available. If it’s confirmed that humans can pass this to each other, then avoid densely populated areas, especially schools, sporting events or any public gatherings. A 20% kill rate is not something to gamble with, so avoiding external human contact should this go critical is key to survival.
With the ease of travel across the globe, it won’t take long at all for this virus to appear in every major city on the planet.
The Black Death wiped out nearly one-third of Europe’s population in the mid 1300?s (incidentally, this plague reportedly started in China). The Spanish Flu infected half a billion people across the globe and killed upwards of 50 million in the early 1900?s.
It’s only a matter of time before the next mass pandemic makes its way across the world, and all of our technological advancements and modern day implements will be powerless to stop it.
http://www.shtfplan.com/headline-news/o … o_04252013
Statistics: Posted by yoda — Thu Apr 25, 2013 9:41 pm
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WSJ: ‘Roofer Union Calls for Repeal of Obama Health Law’
Michael F. Cannon
Take it, Janet Adamy:
A labor union representing roofers is reversing course and calling for repeal of the federal health law, citing concerns the law will raise its cost for insuring members.
Organized labor was instrumental in getting the Affordable Care Act passed in 2010, but more recently has voiced concerns that the law could lead members to lose their existing health plans. The United Union of Roofers, Waterproofers and Allied Workers is believed to be the first union to initially support the law and later call for its repeal.
“After the law was passed, I had great hope…that maybe the rough spots would be worked out and we’d have a great law,” said Kinsey Robinson, international president of the union, which represents 22,000 commercial and industrial roofers…
Mr. Robinson says the union’s concerns about the law began to pile up in recent months after speaking with employers.
The roofers’ union’s current insurance plan caps lifetime medical bill payouts at $2 million for active members and $50,000 for retirees. Next year, the plan has to remove those caps in order to comply with the health law. Other aspects of the retiree plan must become more generous in order to meet the law’s minimum essential coverage requirements next year. All that will increase the cost of insuring members, Mr. Robinson said, and has prompted the union to weigh eliminating the retiree plan.
Adding to those cost concerns is a new $63-per-enrollee fee on health plans that pays insurers to cover people with pre-existing conditions next year. Looking ahead to 2018, when the law levies an excise tax on high-value insurance plans, Mr. Robinson predicts that at least some of the union’s plans will get hit by it…
Over time, Mr. Robinson says, his optimism that regulators or lawmakers would address the union’s concerns diminished. “I don’t think they are going to get fixed,” he said. On Tuesday, the union called for a repeal of the health law or a complete reform of it.
Will the last ObamaCare supporter please turn off the lights?
View full post on Cato @ Liberty
Health • Dr. Gosnell’s "House of Horrors"
Dr. Gosnell’s "House of Horrors"
How to Murder the Innocent, Defenseless, and Undefended—and Make Big Bucks Doing It!
- Jim ONeill Saturday, April 13, 2013
16
“He was supposed to puncture the lower back of the baby’s skull and insert a tube to suck out its brains before it was fully delivered. Instead, he just delivered the baby alive and then killed it, which is illegal. …[He] killed live, viable, moving, breathing, crying babies. He killed them by cutting their spinal cords after their mothers had delivered them…” —Tom McLaughlin “The Women’s Medical Society”
If you are unaware of the trial taking place in Philadelphia, Pennsylvania of the abortion doctor (I use the term “doctor” loosely) Kermit Gosnell, I am not surprised. Our feckless, spineless, corrupt and statist-driven media have done their best to sweep it all under the rug. Hear no evil, see no evil when it comes to their sacred cows you know.
Dr. Gosnell is on trial for murdering infants. You see, instead of killing them inside their mother’s body (legal), he killed them outside of their mother’s body (illegal). The website “Pundit & Pundette” reported the testimony of an assistant who worked for Dr. Gosnell describing one of the murdered infants: “It was ‘screeching, making this noise’ that ‘sounded like a little alien,’ she said. It ‘really freaked me out,’ she said, causing her to leave the room.
‘Making this noise…like an alien?’ That’s called crying. It’s what human babies do when they’re in distress, in this case, the ultimate distress. The ‘aliens’ here are the inhuman monsters who caused that distress. So…if a baby screams during an outside-the-uterus ‘abortion,’ does it make a sound? Or, to put it another way, if an abortionist goes on trial for murdering infants, but the media refuses to cover it, is it really happening? And does America care?”
Hard for America to care when America doesn’t know—and America won’t know if the MSM has its way. This point was driven home by Fox News analyst Kirsten Powers in a recent article of hers in “USA Today” (kudos to “USA Today” for printing it).
“Infant beheadings. Severed baby feet in jars. A child screaming after it was delivered alive during an abortion procedure. …Let me state the obvious. This should be front page news. …The deafening silence of too much of the media, once a force for justice in America, is a disgrace.”
A disgrace indeed, but unfortunately par for the course these days—“we the people” have come to expect such skewed myopic tunnel-vision from our media/propaganda outlets. Thomas Lifson describes their blatantly prejudiced attitude succinctly: “They are whoring out their journalistic principles and desperately suppressing information that is harmful to their ideological positions.”
The inimitable Mark Steyn opines that “The U.S. media’s unanimous agreement to see no evil is sick and totalitarian. A very small consolation is that, with news judgments like these, the wretched American press is doing a pretty good job of sawing through its own neck.”
Speaking of “sick and totalitarian,” this would be an opportune time to tie together the various topics of Nazi fascism, eugenics, population control, Margaret Sanger, narcissistic amorality, “civilized” barbarism, and the like—but as I was writing this article it occurred to me that simply getting the word out about the evil that has been committed takes precedence over other concerns, so…
As we near the end of this article I might mention that the Philadelphia D.A. estimates that Dr. Gosnell made between $10,000 to $15,000 a day from his abortion mill (that does not include the money he made from the illegal sale of prescription drugs, which was considerable, but does not concern us here). And before anyone leaps to his defense as a “champion of women’s rights,” I suggest you look over the D.A.‘s report in that regard. For example:
“One woman…was left lying in place for hours after Gosnell tore her cervix and colon while trying, unsuccessfully, to extract the fetus. Relatives who came to pick her up were refused entry into the building; they had to threaten to call the police. They eventually found her inside, bleeding and incoherent, and transported her to the hospital, where doctors had to remove almost half a foot of her intestines.”
I will conclude with a sobering thought. The police originally raided Dr. Gosnell’s “House of Horrors” because he was overprescribing oxycontin—not because he was murdering infants. One wonders how many other “Dr. Gosnell’s” there are spread across the country, flying under the radar—how many other “Houses of Horror” funded by our taxpayer dollars.
http://canadafreepress.com/index.php/article/54458
Statistics: Posted by yoda — Sat Apr 13, 2013 8:40 am
View full post on opinions.caduceusx.com
Ohio, Missouri Introduce the Health Care Freedom Act 2.0
Michael F. Cannon
Ohio Reps. Ron Young (R-Leroy Twp.) and Andy Thompson (R-Marietta), and Missouri Sen. John Lamping (R-St. Louis County), have introduced legislation—we call it the Health Care Freedom Act 2.0—that would suspend the licenses of insurance carriers who accept federal subsidies through one of the Patient Protection and Affordable Care Act’s (PPACA) health insurance Exchanges. At first glance, that might seem to conflict with or otherwise be preempted by the PPACA. Neither is the case. Instead, the HCFA 2.0 would require the IRS to implement the PPACA as Congress intended.
Here’s why. Under the PPACA, if an employer doesn’t purchase a government-prescribed level of health benefits, some of its workers may become eligible to purchase subsidized coverage through a health insurance “exchange.” When the IRS issues the subsidy to an insurance company on behalf of one of those workers, that payment triggers penalties against the employer. Firms with 100 employees could face penalties as high as $140,000.
Congress authorized those subsides, and therefore those penalties, only in states that establish a health insurance Exchange. If a state defers that task to the federal government, as 33 states including Missouri and Ohio have done, the PPACA clearly provides that there can be no subsidies and therefore no penalties against employers. The IRS has nevertheless announced it will implement those subsidies and penalties in the 33 states that have refused to establish Exchanges. Applying those measures in non-establishing states violates the clear language of the PPACA and congressional intent. See Jonathan H. Adler and Michael F. Cannon, “Taxation Without Representation: The Illegal IRS Rule to Expand Tax Credits Under the PPACA,” Health Matrix: Journal of Law-Medicine 23 (2013): 119-195.
Whether legal or illegal, those penalties also violate the freedoms protected by the Health Care Freedom Amendment to Ohio’s Constitution, and Missouri’s original Health Care Freedom Act, which voters in each state ratified by overwhelming majorities. The Ohio (HB 91) and Missouri (SB 473) bills would protect employers and workers from those penalties, and thereby uphold the freedoms enshrined in Missouri statute and Ohio’s Constitution, by suspending the licenses of insurance carriers that accept those subsidies.
The question arises whether the PPACA would preempt such a law. It does not. The HCFA 2.0 neither conflicts with federal law, nor attempts to nullify federal law, nor is preempted by federal law.
The HCFA 2.0 concerns a field of law—insurance licensure—that has traditionally been a province of the states under their police powers. In preemption cases, courts “start with the assumption that the historic police powers of the States were not to be superseded by the Federal Act unless that was the clear and manifest purpose of Congress.” Wyeth v. Levine, 129 S. Ct. 1187, 1194-95 (2009). Courts then must determine whether the state law in question is nevertheless trumped by express or implied federal preemption.
Express Preemption
The PPACA does not expressly preempt state powers to determine the conditions for licensure. On the contrary, it expressly reaffirms those powers. Section 1321(d) provides that the Act preempts only those state laws “that … prevent the application of the provisions of this title.” 42 USC § 18041(d). At the same time, the PPACA requires that in order to sell through an Exchange, health insurance issuers must be “licensed and in good standing to offer health insurance coverage in each State in which such issuer offers health insurance coverage under this title.” 42 USC § 18021(a)(1)(C)(1). This requirement shows the PPACA does not preempt states’ powers to determine the conditions for licensure. Quite the contrary: the Act’s nod to state licensure shows that the states’ exercise of those powers does not “prevent the application of the provisions of this title.”
Implied Preemption
Nor does the PPACA imply preemption of the HCFA 2.0’s use of those powers. The Supreme Court recently observed that “[i]mplied preemption analysis does not justify a ‘free-wheeling judicial inquiry into whether a state statute is in tension with federal objectives.’” Instead, the Court’s “precedents ‘establish that a high threshold must be met if a state law is to be pre-empted for conflicting with the purposes of a federal Act.’” Chamber of Commerce of the United States v. Whiting, 131 S. Ct. 1968, 1985 (2011).
First, that high threshold cannot be met here, because the HCFA 2.0 effectuates, rather than conflicts with, Congress’s purpose. The PPACA clearly provides, and Congress clearly intended, that the above-mentioned subsidies and employer taxes would take effect only in states that establish an Exchange. The HCFA 2.0 would prevent the IRS from applying, in Missouri and Ohio, subsidies and taxes that Congress did not want the IRS to apply in states like Missouri and Ohio. The bill is thus consistent with Congress’ purpose, and therefore not preempted by the PPACA.
Second, the PPACA in no way whatsoever mandates that these subsidies must exist in every state. The Act specifically guarantees, “No individual, company, business, nonprofit entity, or health insurance issuer offering group or individual health insurance coverage shall be required to participate in any Federal health insurance program created under this Act … or in any Federal health insurance program expanded by this Act … and there shall be no penalty or fine imposed upon any such issuer for choosing not to participate in such programs.” 42 U.S.C. § 18115. Individuals, employers, and health insurance issuers are free to refuse these and other subsidies, just as states retain the power to block them if they violate public policy of the state. The Supreme Court has held that states may adopt safeguards for individual liberty that exceed federal protections. PruneYard Shopping Center v. Robins, 447 U.S. 74, 83 (1980). Ohio’s Health Care Freedom Amendment and Missouri’s existing Health Care Freedom Act are two such safeguards.
Third, like physician assisted suicide in Oregon, which the Supreme Court ruled could not be preempted by federal law, the power of states to determine the conditions of licensure for insurance carriers cannot be displaced by implied preemption without “effect[ing] a radical shift of authority from the States to the Federal Government to define general standards of medical practice in every locality.” Gonzales v. Oregon, 546 U.S. 243, 275 (2006).
As noted above, the HCFA 2.0 is not preempted by the PPACA precisely because it would require the IRS to apply the PPACA as written. The most interesting aspect of the debate over this legislation is that ObamaCare supporters do not want the PPACA to be implemented as written. What does that tell us?
Editor’s note: This post was co-authored with Christina Sandefur, a staff attorney at the Goldwater Institute’s Scharf-Norton Center for Constitutional Litigation, and is cross-posted at the Goldwater Institute’s blog.
View full post on Cato @ Liberty
What Is Public Health?
David Boaz
“If vitamin D does lower blood pressure in African-Americans, it can have a significant public health impact,” [nephrologist John] Forman says. [NPR]
No. It might have widespread impact on individuals’ health. But that’s not what “public health” should mean.
The meaning of “public health” has sprawled out lazily over the decades. Once, it referred to the project of securing health benefits that were public: clean water, improved sanitation, and the control of epidemics through treatment, quarantine, and immunization. Public health officials worked to drain swamps that might breed mosquitoes and thus spread malaria. They strove to ensure that water supplies were not contaminated with cholera, typhoid, or other diseases. The U.S. Public Health Service began as the Marine Hospital Service, and one of its primary functions was ensuring that sailors didn’t expose domestic populations to new and virulent illnesses from overseas.
Those were legitimate public health issues because they involved consumption of a collective good (air or water) and/or the communication of disease to parties who had not consented to put themselves at risk. It is difficult for individuals to protect themselves against illnesses found in air, water, or food. A breeding ground for disease-carrying insects poses a risk to entire communities.
But a health problem is not a public health problem just because it’s a widespread health problem. Obesity, riding a motorcyle without a helmet, and getting too little Vitamin D may be bad for an individual. But the individual who engages in these activities isn’t endangering me. It may well be a good idea for African-Americans – and others – to get more Vitamin D in order to reduce high blood pressure. But that’s health advice for individuals, not a public health issue.
View full post on Cato @ Liberty