Chủ Nhật, 3 tháng 7, 2011
Health Care For All Seasons - Forbes (blog)
Now that requirement doesn’t kick in until 2014, so there had to be a pretty tedious argument about whether there should be an argument. That is whether these people had “standing”. I don’t have a lot of patience with this lawyerly stuff, but I suppose that the government had something of a point when it argued that these people were getting prematurely excited. 2014 isn’t for a while and there is a decent chance that the law will change by then. Or if we are really lucky, you’ll die or move out of the country. Then to really complicate things one of them broke down and bought health insurance. The Court indicated though that it would be better to have the argument sooner rather than later:
In view of the probability, indeed virtual certainty, that the minimum coverage provision will apply to the plaintiffs on January 1, 2014, no function of standing law is advanced by requiring plaintiffs to wait until six months or one year before the effective date to file this lawsuit. There is no reason to think that plaintiffs’ situation will change. And there is no reason to think the law will change. By permitting this lawsuit to be filed three and one-half years before the effective date, as opposed to one year before the effective date, the only thing that changes is that all three layers of the federal judiciary will be able to reach considered merits decisions, as opposed to rushed interim (e.g., stay) decisions, before the law takes effect. The former is certainly preferable to the latter, at least in the current setting of this case.
Even the guy who bought insurane was going to be forced to maintain it after 2014. So everybody is left standing.
Once they decided the subject was worth discussing, they had to go on for a while to come to a conclusion. It basically turns on the Commerce Clause of the Constitution. The argument against the insurance requirement is that it is hard to see how somebody is engaging in interstate commerce by not doing something, like not buying health insurance. The requirement to buy health insurance is, however, an essential component of the whole plan, which does affect interstate commerce:
By regulating the practice of self-insuring for the cost of health care delivery, the minimum coverage provision is facially constitutional under the Commerce Clause for two independent reasons. First, the provision regulates economic activity that Congress had a rational basis to believe has substantial effects on interstate commerce. In addition, Congress had a rational basis to believe that the provision was essential to its larger economic scheme reforming the interstate markets in health care and health insurance.
The other reason that I can’t resist writing about this case is that it let’s me use one of my favorite quotes. As we observe the mental machinations in this litigation, we can be heartened by the words that Robert Bolt wrote for Thomas More in A Man For All Seasons:
God made the angels to show Him splendor, as He made animals for innocence and plants for their simplicity. But Man He made to serve Him wittily, in the tangle of his mind.
View the original article here
Medicare paving way to health care accountability - Chicago Tribune
Under so-called accountable care organizations, health care providers are working to better coordinate the treatment of elderly patients insured by Medicare. Some of the ideas include more electronic record keeping and specialized case managers to keep closer tabs on patients.
The hope is that medical care will improve and costs will be reduced. Medicare would share the savings with providers.The program is voluntary so all patients will continue to get the same benefits under traditional fee-for-service Medicare. Similar programs are popping up elsewhere in the private insurance market, including in the Chicago area, as health plans look for new ways to save money.
But Medicare is moving aggressively under the Affordable Care Act to move away from the existing fee-for-service program, which pays doctors and hospitals no matter how care turns out.
There is some urgency.
Medicare is seen by many policymakers as unsustainable in the long term if it is not reformed, particularly given the rising number of aging baby boomers.
"Over and over again, we have seen that improving how care is delivered to patients is key to reducing the growth in health care spending," says Dr. Donald Berwick, administrator of the Centers for Medicare & Medicaid Services, the federal agency in charge of the programs. "When we improve the coordination of care between providers, reduce duplication of services and avoid medical errors, we can get better outcomes for patients at less cost. The Affordable Care Act has given us the tools to achieve these goals."
Medicare last month ended a public comment period on accountable care organizations, which are expected to begin in January 2012. Many groups are weighing in, including the American Medical Association, which has concerns about whether doctors can afford to make the financial investments needed to create an accountable care organization.
Doctors and hospitals also have complained about flaws in the Medicare initiative on accountable care organizations, such as mandates that put them on the hook to share in Medicare losses from care seen as too costly.
"A well-developed ACO model has the potential to improve care coordination and quality while promoting cost savings," said Dr. Cecil Wilson, AMA immediate past president and an internist.
The AMA has asked the Centers for Medicare & Medicaid Services to revise the model and to allow some flexibility.
Wilson and other doctors attending the AMA's annual meeting last month bemoaned the costs for smaller practices to form or be a part of an ACO.
"We are talking about a whole new restructuring (of a practice)," Wilson said.
Along with electronic record keeping and systems to submit claims and accept payments from insurance companies, doctors say they need software and systems to collect and share quality data.
Wilson said most doctors practice medicine in groups of fewer than 10, so their offices aren't as well-capitalized as large hospitals. "This should not be solely for hospital physicians," Wilson said. "Physicians are going to need money to start up … and need technical assistance which will add costs."
Despite the AMA's concerns about the accountable care organizations linked to the Medicare program, private health insurance companies are working with medical care providers to create their own versions. Some are up and running.
In Chicago last year, the state's largest health insurance company and the area's biggest provider of medical care developed a program designed to hold doctors and hospitals more accountable for performance and quality service.
The three-year deal between Blue Cross and Blue Shield of Illinois, which has nearly 7 million health plan members, and Advocate Health Care, which operates a network of 10 hospitals and more than 250 clinics throughout Illinois, calls for Advocate to limit rate increases it negotiates with the insurance company.
Text Messages Help Quit Smoking, Highlights Importance of Mentality - International Business Times
Yes, nicotine addiction is partly physical. But the mental aspect of quitting cannot be stressed enough.
A new study found that texting encouraging messages helps people quit smoking. The study, published in British medical journal The Lancet, tracked 5,800 smokers who tried to quit.
For one group, the researchers simply sent text messages thanking participants for partaking in the study. For another group, they sent out encouraging messages.
The following are some of the encouraging text messages sent:
- think you'll put on weight when you quit? We're here to help - We'll TXT weight control and exercise tips, recipes and motivation tips
- TODAY is the start of being QUIT forever, you do it
- This is it! - QUIT DAY, throw away all your fags [cigarettes in British English]
Moreover, the group that received encouraging text messages could text the program in crucial moments.
When they're battling with a bout of physical craving, they can text "crave" and receive something like this: "Cravings last less than 5 minutes on average. To help distract yourself, try sipping a drink slowly until the craving is over."
If they lapse (i.e. cave in and take a smoke) they can text "lapse" and receive something like this: "Don't feel bad or guilty if you've slipped. You've achieved a lot by stopping for a while. Slip-ups can be a normal part of the quitting process. Keep going, you can do it!"
The result is that the quit rate for the group that received the encouraging texts (10.7 percent) was twice the quit rate of those who received none (4.9 percent).
The earliest and arguably most successful advocate of a mental approach to quitting smoking is the late Allen Carr in his classic book The Easy Way To Stop Smoking. His clinics claim a 95 percent quit rate (based on the money back guarantee).
Carr's core message is that smokers don't want to quit largely because they're afraid to give up what they think is a genuine pleasure. Meanwhile, the truth is that nicotine withdrawal makes the body anxious all the time and smoking only relieves that anxiety.
He compared the feeling of smoking to the relief a person experiences when he removes a pair of tight boots he's been wearing all whole day.
Carr believes once the smoker understands smoking in this proper light, he would natural quit.
Cricket Clothes - An Overview
Cricket whites, also known as flannels, include trousers, shirts, jumpers and jockstraps. The word 'flannels' refers back to the material clothing was originally manufactured from. Now more lightweight and accommodating fabrics are widely-used to offer better comfort and support. The top suppliers of superior quality cricket garments focus on combining modern innovations with traditional designs.
Cricket participants prefer to dress in polyester and acrylic sweaters together with delicate, lightweight shirts that are absorbent and intended for easy mobility. Comfortable cricket trousers might be created from durable polyester twill fabric and have waistbands with tie cords and side pockets. Cricket players also wear exclusive underwear and long lasting base layers built to supply outstanding support and comfort.
Along with the obvious shirts, long trousers and caps, some roles demand varying levels of protection including helmets, guards and gloves. Many cricketers also wear caps or sunhats to shield their face and eyes. Protecting the players is an essential part of good quality garments. Each game or training session includes a large amount of rough instances. Since cricket balls are incredibly hard, occasionally they can cause injuries to the players.
For this reason, skilled makers of good cricket clothing use lightweight, breathable materials and the most current technology to obtain the perfect balance between effective protection and freedom of movement. Your individual preference might depend upon whether you value the conventional form of the sport or the more modern image.
At the top level of the game, whatever allows a sportsman to attain a professional degree of performance needs to be encouraged. Cricket boots can assist you avoid injury during play by offering support to the ankles and protecting your toes from being hit by the ball. A pair, just like Asics cricket shoes have spiked soles, for extra grip on the ground, All clothing and equipment can be bought from a cricket shop or online store.
About the Author: