It's easy to break a patient like Rogelio—Mexican and poor and chronically ill—down to his potassium level and to make medical decisions according to a number. But that's only part of the story of how the undocumented ill are cared for here in Houston. Within this city's history—a history that includes segregation during the 1960s, a large immigrant population, strong economic growth over the past half century, not to mention the world's largest medical center—is the story of how Houston sought local solutions to provide compassionate care to its indigent and undocumented, the latter of which, some might say, have helped the city grow.Dr. Ricardo Nuila reports from the emergency room at Houston's Ben Taub Hospital, where Harris County's undocumented ill can avail themselves of some of the country's best health care: Taking Care of Our Own. [more inside]
Inside the Nightmare Launch of HealthCare.Gov - "Unknown to a nation following the fiasco, McDonough's assignment from the President had boiled down to something more dire than how to fix the site. As the chief of staff remembers his mission, it was 'Can it be patched and improved to work, or does it need to be scrapped to start over? He wanted to know if this thing is salvageable.' Yes, on Oct. 17, the President was thinking of scrapping the whole thing and starting over." (previously) [more inside]
As a result of new coverage under the ACA, many previously uninsured people in eastern Kentucky are giving the nation a glimpse of life under the new health care law.
"Obamacare horror stories" where innocent citizens are losing their insurance and being forced to pay astronomical costs for new plans on the exchanges are being reported by some media outlets. The problem is that most of these stories don't survive further scrutiny. [more inside]
Home Truths: Domestic Workers in California (PDF). 2012's groundbreaking National Domestic Worker Survey was conducted in 14 cities; the sample analyzed in this report includes 631 domestic workers (nannies, caregivers, housecleaners) in four metropolitan areas in California: Los Angeles, San Diego, San Francisco, and San Jose. [more inside]
The New York Times is reporting that state health insurance regulators have approved 2014 prices for individual health insurance (SLNYT) in New York State that are on average 50% lower than 2013 rates. [more inside]
The Oregon Health Insurance Experiment, an outgrowth of Oregon's 2008 lottery to allocate Medicaid slots to eligible residents, has released their second year of results (Previous discussions on the lottery and the experiment). The gist of the results are that they found statisitically significant reductions in catastrophic health care expenditures, improvements in the incidences of depression, and increased use of health care services. They found minimal (and not statistically significant) improvements in the rates of physical health indicators (diabetes and hypertension) they tracked. Because of ethical concerns, there are no other randomized controlled tests on this scale that study the effects of Medicaid and few on the effects of health insurance in general (the only significant one being a RAND study released 30 years ago). Because of the small amount of information available on the topic and the impending Medicaid expansion offered by Affordable Care Act, this study has drawn a lot of attention from political commentators. This will presumably be the last year these results will be published, as the state of Oregon was able to find extra money in 2010 in order cover the rest of its Medicaid-eligible population. [more inside]
the Contraceptive Choice Project finds that free birth control access significantly cuts abortion rates
Free birth control cuts abortion rate dramatically, study finds: "When more than 9,000 women ages 14 to 45 in the St. Louis area were given no-cost contraception for three years, abortion rates dropped from two-thirds to three-quarters lower than the national rate." [more inside]
Obamacare: One Less Reason to Get Married. Erin Gloria Ryan of Jezebel writes: Insurance Marriages had become to the 21st century what shotgun weddings were to jokes about hillbillies. Back in 2004, the LA Times wrote about couples that married for insurance, couples who for varying reasons had not wanted to marry, but who had been driven to marriage by financial necessity. ABC News posted its own roundup of With This Policy, I Thee Wed-style couples in 2008, as did the New York Times. In 2008, 7% of couples who married reported doing so primarily for the insurance benefits. [more inside]
Since she is not truly an emergency patient, she is triaged to the back of the line, and other folks, those in immediate distress, get in for treatment ahead of her. She waits on a gurney in a cavernous green hallway. The “chief complaint” on her chart at Grady Memorial Hospital, in Downtown Atlanta, might have set off a wave of nausea in a hospital at a white suburb or almost any place in the civilized world. It reads, “My breast has fallen off. Can you reattach it?” (via Boing Boing) [more inside]
Effective January 1, 2013, United States insurers will now be required to make a variety of medical procedures and medications available without copay as part of President Barack Obama's Affordable Care Act. Although the availability of prescribed birth control without copay is likely to have the widest effect, the plan also includes breast pumps for nursing mothers, an annual well-woman examination, and testing for gestational diabetes and the virus that causes cervical cancer, as well as other services related to women's health. [more inside]
"We raise rates only when absolutely necessary to pay the accelerating cost of medical care for our members"
Blue Shield of California seeks rate hikes of as much as 59% for individuals. 'Insurer says the increases result from fast-rising healthcare costs and other expenses resulting from new healthcare laws. The move comes less than a year after Anthem Blue Cross tried and failed to raise rates as much as 39%.''Nearly 1 in 4 of the affected customers will see cumulative increases of more than 50% over five months.''Michael Fraser, a Blue Shield policyholder from San Diego, learned recently that his monthly bill would climb 59%, to $431 from $271.''Anthem's attempt to raise rates by up to 39% led to national outrage and helped President Obama marshal support for his healthcare overhaul. The insurer was ultimately forced to back down, accepting maximum rate hikes of 20%.' [more inside]
House passes Healthcare reform. All that's left is voting on a reconciliation package for the senate to sign. But the house has passed the senate bill, which means this is basically a done deal. [more inside]
"In May, 2002, Jerome Mitchell, a 17-year old college freshman from rural South Carolina, learned he had contracted HIV. The news, of course, was devastating, but Mitchell believed that he had one thing going for him: On his own initiative, in anticipation of his first year in college, he had purchased his own health insurance. Shortly after his diagnosis, however, his insurance company, Fortis [now Assurant Health], revoked his policy. Mitchell was told that without further treatment his HIV would become full-blown AIDS within a year or two and he would most likely die within two years after that." [more inside]
Will marry for health insurance. "They're not going to pass health-care reform, so what are my options? Friends and I were joking, and one friend said,'Well, you could always marry some guy who has a good policy.' And I thought, You know what. That's crazy. That's unbelievable, but it's my only option." [more inside]
State of the debate filter: Harry Reid is looking like a giant waffle iron. Congress is getting crushed with phone calls. A G.E. healthcare exec, says "Shit or get off the pot already." The insurance industry says, "Back up off a deez!" And people aren't wavering in their support of a public option. [more inside]
"We're a demonstration project, if you would, of all the things that can go wrong at once." "You know Yolanda, I think most people watching this interview think to themselves that if they get cancer and they don't have health insurance that somebody’s going to take care of them," Pelley remarked. "No, no, there's nobody to take care of you," she said. [more inside]
MexCare offers "An Alternative Choice for the Care of the Unfunded Latin American National." [more inside]
Two years since Massachusetts instituted major statewide healthcare reform, the statistics are coming in. 340,000 residents, roughly half the state's previously uninsured, are now insured. The state says that 95% of its population is now covered, based on Department of Revenue estimates. However, a large portion of them are enrolled through state-subsidized insurance programs, and those program's rate of enrollment have far outpaced estimates. This has led lawmakers to forsee a budget shortfall. Premiums and co-pays are going up, cigarette taxes have increased, and a cost control proposal is making its way through the legislature. Assessments have been all over the map.
The state of Oregon is holding a health insurance lottery where 91,000 hopeful enrollees will be competing for a couple thousand spots under the Oregon Health Plan, the state's Medicaid program. OHP was created to cover those who made too much to enroll in traditional Medicaid but too little to afford market healthcare, and this development comes as a result of budget cuts and a subsequent enrollment closure in July of 2004. It's a far cry from the universal health care coverage that the plan was suppose to lead to, and marks a dramatic turn for the state's once-ambitious health care reforms.
(Previously in dystopic health care developments)
(Previously in dystopic health care developments)
The ultimate in outsourcing. Welcome to India, where you can visit the Taj Mahal and get a new knee, all for under $10,000, airfare included. Of course, it's not just for Canadians whose health care system, while free, sometimes necessitates lengthy waits for important surgical procedures. The uninsured in the US and other nations are a potential market as well. And there's potential for medical tourism destinations in the US as well.