Thứ Ba, 17 tháng 2, 2015

Unanimous vote to expand N.C. Medicaid? Well ...

Jeff Jackson,  a Democratic state senator representing Mecklenburg's District 37,  knows how to have fun with a snow day.

This morning he posted on Facebook that "Due to inclement weather,  I appear to be the only non-security person in the General Assembly this morning.  I feel like I should hurry up and pass Medicaid expansion.  Anything else while I've got the place to myself?


His constituents  --  or at least his Facebook friends -- got a kick out of that,  with more than 100 comments and 500 likes by 9:30 a.m.  He got a long list of requests,  from raising teacher pay to banning puppy mills and legalizing marijuana.

Around 8:30 a.m.,  Jackson started tallying his accomplishments:

Just came back from the Senate chamber. All votes were unanimous.
Medicaid = expanded. Teachers = paid. Film = jobs. What's next?
This is going to be like "Night at the Museum" except at the end we'll have a stronger middle class.

Sen. Jeff Tarte, a Mecklenburg Republican, later posted that he and several GOP colleagues were there working as well.   "Classic example of Democrats 'misrepresenting the facts,' "  Tarte sniffed  before tipping his hand with an "LOL" and an invitation for Jackson to join him for dinner.

By that time the #JustOneLegislator winter fantasy had gone viral.  Mutual Facebook friend Laura Hehn had a suggestion  --  "Work together and make some positive changes!"  --  and even offered a couple of new hashtags: #JustTwoLegislators or #JustTheJeffs.

Losing health benefits? Study blames recession

If your employer provides health insurance,  you're probably paying more for less  --  and wondering who's to blame.  The Affordable Care Act has contributed to rising costs by mandating certain types of coverage,  allowing many adult children to stay on parents'  policies and levying a 2018 tax on high-cost  "Cadillac plans."

But the trend toward reducing benefits and dropping health insurance altogether was in full swing before the act kicked in this year, according to a recent analysis by the University of Minnesota’s State Health Access Data Assistance Center and the Robert Wood Johnson Foundation.

Before to the recession, the research shows that employer coverage was fairly stable.  Between 2004-05 and 2008-09,  for instance,  North and South Carolina,  like most of the country,  saw no significant change in the percent of employers offering health insurance.  But the rates dropped from 2008-09,  the start of the recession,  to 2012-13.  In North Carolina it went from 53 percent to 47 percent,  and in South Carolina from 54 percent to 47 percent.  Most of that decline has come from companies with fewer than 50 employees.




That's consistent with what I've heard.  For instance,  I wrote last fall about Charlotte's Blue Max Materials,  a small employer,  dropping health insurance in the face of rising costs.  Meanwhile,  the owner of Stafford Cutting Dies bumped up deductibles dramatically to cope with skyrocketing costs for a small-business policy.


“Most Americans still get health insurance through their jobs, but this has been declining for more than a decade,” said Katherine Hempstead, who directs coverage issues at the foundation. “It will be interesting to see how that trend evolves now that there are more opportunities for coverage through the individual market and Medicaid.”

The report includes detailed breakdowns for each state.


Thứ Hai, 16 tháng 2, 2015

Sweet Potato Chocolate Spread

What if I told you that 2 tbsp of this spread provides you with all the vitamin A you need in a day? Sounds too good to be true? Well it isn't. Other than being delicious, sweet potatoes are packed with this super important nutrient that keeps your eyes in good condition and your skin beautifully radiant. Plus this recipe is so simple and quick to make and only requires five ingredients! No excuses!




Ingredients:

2 medium-sized, peeled sweet potatoes (380 g)

3 tbsp melted cacao butter or coconut oil

10 dates (100 g)

2 tbsp cacao or cocoa powder

Pinch of salt


How to:

1. Cube the sweet potato and steam until entirely soft and easy to pierce with a fork, approximately 15-20 minutes.

2. Transfer the cooked sweet potato to a medium-sized bowl, add the remaining ingredients and blend with a hand blender until smooth. This could also be done using a food processor.
3. Spoon up the chocolate spread in a mason jar or any airtight container of your choice and store in the fridge.

Enjoy this spread on peanut butter sandwiches, your oatmeal or eat it straight from the jar with a spoon! (That's what I do...)

Chocolate love from Tilda 

Health care is a massive market…

America is spending $3 trillion on health care every year. Does that number include toothpaste? Surely toothpaste is very important to your health. How about baby powder, diapers, condoms, soap, lip balm, nail clippers, detergents, mops, vacuum cleaners, washing machines, smoke detectors, air filters and air bags? How about everything Nike sells, diet books, your gym membership, bicycles, skateboards, everything Sports Authority carries in its stores, and all Weight Watchers products? And then there is quinoa and edamame, spelt, flax, organic kale chips and those scrumptious gluten-free kelp smoothies. You can also count the entire budget of the EPA, the FAA, the CDC, the FDA and the USDA, and while at it let’s not forget the war on drugs, the war on poverty and the war on terror, and of course education and vacation, sunscreen, traffic lights, firefighters, police and those weirdly bluish ice-melting crystals for your driveway. It sure looks like we are spending all our money on caring for our health.

In America, we spend $3 trillion every year on medical care, not health care. Medical care is what you get mostly from doctors and nurses, mostly in hospitals or clinics, and mostly when you are sick or hurt. Medical care is most often associated with pain, suffering and fear, and is something most people, most of the time, don’t use, don’t need and don’t want. The new thinking says that if we could spend less money on medical care, we could spend more on Bluetooth enabled holographic toothpaste, and that this is a good thing. After all, most of our $3 trillion is spent on a small fraction of sick and elderly citizens, most of whom will never get better anyway. Wouldn’t it be more fun to spend our money on nice things for the majority who is basically healthy, so they can be even healthier, and perhaps forever healthy?

Also $3 trillion is too much money to spend on regular people, who truth be said can’t really afford it anymore, because according to none other than J.P. Morgan, “US labor compensation is now at a 50-year low relative to both company sales and US GDP”, while “[corporate] profit margins have reached levels not seen in decades”, and miraculously “reductions in wages and benefits explain the majority of the net improvement in margins” [emphasis in the original]. When your wages and benefits are at a 50 year low relative to GDP, courtesy of the general plutonomy, and your medical care expenses are at an all-time high relative to the same GDP, courtesy of the medical-industrial plutocrats, you have two basic choices. Start a revolution, or let yourself be wooed by the thieves. Revolutions are hard and very inconvenient for consumers, so sit back and be wooed.

Medical care is sick care. Sick care sounds depressing, and sick care is expensive. Sick care is what happens where health care fails. Health care is cheap and pleasant. Better health care will obviate the need for sick care. Ergo, we should invest heavily in health care right here, right now, and quit funding exorbitantly priced products and services for sick care, because soon, very soon, there will be no sick people. For some, midlife crisis means buying a red Porsche, for Google owners it means spending $1.5 billion on the fountain of youth. For Peter Thiel, it means actually becoming immortal. For CVS pharmacies it means changing the company name to CVS Health. For Apple it means releasing a plebian version of the fountain of youth called simply Health. And for the rest of us, it means paralyzing fear.

The best is behind us. The American Century is over. Ebola is going to kill us all, and if not Ebola then the measles will. And if not disease, then surely we will fall prey to the toddler invasion from Guatemala, or the long-range nuclear missiles of the Russian Empire, or the marauding bands of sociopaths roaming the Arabian desserts in Toyota pickup trucks, raping and decapitating everybody in their path, not to mention the global ice age descending on Boston with the fury of a theory scorned. History teaches us that every great nation has to fail and every governance model is destined to perish and all societies will eventually disintegrate. Today is our turn to die. But then the drums begin to bang and the stars fall from the sky, the moon turns red with blood and the trumpet sounds its call.

Behold the vision of the saints as they go marching in, masterfully weaving the Narcissistic obsessions of the young and healthy with the helplessness and impotence imposed on the marginalized masses. An Apple a day keeps the doctor away. We will solve all your medical care problems caused entirely by your failure to be healthy. We will manage your wellness, your food, your activity, your thoughts, your desires and your disillusion, and we will make sure that you function within optimal parameters. We will take preventive actions at the very first sign of malfunction, long before it becomes sickness or injury. We will keep you, your children and your children’s children, healthy and productive. This is our solemn promise to you and we may even keep it, if you obey us and always do right. As the sign that you are keeping this promise, you must strap this bracelet on every man and boy in your family, and yes, of course dear, womenfolk too.

Here is a free app if you agree to swallow our drugs, and here is a free test if you let us decide what to do with the results, and here is a free toaster if you get a mortgage, and here is free health insurance letting you have any doctor or hospital you want, as long as it’s the one we picked for you. Here is your freely elected representative, programmed to say what you want to hear, on a soft bluish background because we know from your genomic sequence that bluish colors engender your trust in us. No sweetie, we don’t think you’re stupid, but you are weak and frightened. We are just trying to do what’s best for you and we appreciate your input, your tweets, your blogs, your amusing comments, your die-ins and even a little arson and looting, if done in good taste. One day you will be grateful for our guidance and the limits we are setting for you now. Or maybe not, but by then you’ll all be dead anyway, so frankly darling, we don’t give a damn.

Thứ Sáu, 13 tháng 2, 2015

So you got insurance. Will it help?

As the 2015 push for health-insurance enrollment winds down, the next challenge grows ever clearer:  Insured people who can't afford medical care.

The New York Times Sunday Review carried an article titled  "Insured, but Not Covered."  Reporter Elisabeth Rosenthal explores trends in insurance and health care that are leaving people with insurance unable to find doctors or pay bills.

Her conclusion:  While the Affordable Care Act has brought coverage to roughly 10 million Americans and eliminated  "some of the more egregious practices of the American health insurance system that left patients bankrupt or losing homes to pay bills,"  the law has also adopted policies that "may in some ways be undermining its signature promise:  health care that is accessible and affordable for all."

A key culprit is the boom in high-deductible policies,  which allow employers and private buyers to reduce premiums by agreeing to much higher out-of-pocket costs.



For instance,  HealthSherpa recently sent along an analysis of  14,000 North Carolina health insurance purchases made on the company's web site,  which provides an alternative path for buying subsidized plans on the ACA exchange.  Those buyers had an average household income of about $20,400 and bought policies that averaged $70 a month for the buyer,  with the government kicking in an average of $381 a month.

But the average deductible per enrollee was $3,969 and the average out-of-pocket max was $5,745.  Can you imagine anyone making less than $21,000 a year being able to save $4,000 to $6,000 to cover those costs?  Reality is,  even paying a couple of hundred dollars may be daunting enough to discourage people from going to the doctor's office.

A recent report from The Commonwealth Fund showed that the number of people skipping care because of costs declined in 2014,   the first time since the question was added to the fund's health insurance survey in 2003.  But while the numbers fell significantly compared with 2013,  the year before the ACA took effect,  the report estimates that 66 million Americans,  or 36 percent of adults, still skipped an office visit,  test,  treatment or prescription because they couldn't afford it.
ontinue reading the main storyBut by endorsing and expanding the complex new policies promoted by the health care industry, the law may in some ways be undermining its signature promise: health care that is accessible and affordable for all.

Thứ Ba, 10 tháng 2, 2015

Health activist moves from Obama's home to Tar Heel state

One of the best-known health care activists from President Obama's home state has recently moved to North Carolina.

Jim Duffett,  longtime director of the Illinois Campaign for Better Health Care,  relocated to Chapel Hill in August,  drawn by milder winters and job opportunities for his wife,  an oncology nurse.  In Illinois he spent 30 years working for affordable care and patient rights,  eventually building a coalition of 300 groups representing health care,  faith,  labor and various communities.
Duffett

"One fond memory is having had the honor of working with Obama on health care reform in Illinois during Obama's years as a (state) senator,  and now,  'knowing he is the president and still knows you,'  "  Duffett said in an interview with The  (Champaign)  News-Gazette.

Duffett,  a proponent of a single-payer insurance system,  has connected with the NAACP-led Forward Together Moral Movement and is looking for work in advocacy here.  He says he's still getting up to speed on North Carolina's health care scene,  but sees some similarities with his old turf.  Both states have powerful political opposition to Medicaid expansion,  he said,  and Illinois'  2013 approval was hard-fought and narrowly won.  In North Carolina,  he says,  he hopes to build alliances with some of the hospital,  medical and business interests that united with more traditional anti-poverty groups in Illinois.  "There's definitely going to have to be a bit more base-building,"  he said,  though the Moral Monday protests  "are definitely galvanizing folks."


Thứ Hai, 9 tháng 2, 2015

Burr leads push to repeal and replace Obamacare

U.S. Sen. Richard Burr is taking a lead role in the latest push to replace the Affordable Care Act with a more market-driven approach to health reform.  The North Carolina Republican joined two other committee chairs last week in introducing a new version of a prior  "repeal and replace" plan.

Burr
The Patient Choice,  Accountability,  Responsibility and Empowerment Act  (Patient CARE) would repeal the coverage mandate that's part of the ACA and revamp the subsidized marketplace that helps low-income people buy health insurance.  The act,  co-authored by Sen. Orrin Hatch of Utah and Rep. Fred Upton of Michigan,  would use the marketplace to replace Medicaid expansion,  allow interstate insurance purchases and revamp the tax break for employer insurance.

Avik Roy,  author of a leading plan to reform the ACA piece by piece,  offers an in-depth look at how the new Patient CARE Act compares with the prior version and with his own plan.  He's a fan of the Burr-Hatch-Upton bill,  even though he contends his own plan is more practical because it doesn't require repeal of the ACA.

"Both plans would offer better health outcomes for the poor,  by allowing those on Medicaid to obtain tax credits for the purchase of private health insurance and health savings accounts,"  Roy writes.  "Mostly importantly,  both plans would cover more people than Obamacare,  because they would drive down the cost of health insurance for those who can't afford it today."

For a more skeptical take,  read this piece by the Huffington Post's Jeffrey Young and Jonathan Cohn.


"Republicans promote these changes as increasing  'choice'  and  'flexibility'  in insurance,  claiming that they will result in less federal spending and that younger adults will pay lower prices,"  they write.  "But each of these proposed changes would carry other consequences as well.  Policies without full benefits,  including  'junk'  plans and mini-med policies,  would return to the market.  The same pricing practices that reduced premiums for 25-year-olds would jack them up for 60-year-olds,  putting insurance out of reach for many older Americans."

The Brookings Institution also offers a pro and con perspective.  Stuart Butler gives the plan  "two cheers"  as a viable plan for  "addressing the impasse over the ACA and achieving health coverage goals that are widely shared,"  while Henry Aaron says it moves in the wrong direction by creating more holes in the health care system.