ObamaCare: We Did Not Know What was In It Until It Passed

It did pass, and we still don't know what  is in it.  Each day we learn of waivers, modifications, amendments to 'fix' fatal flaws in the law.  This is the simple part.....getting people to sign on for health coverage....the doorway to health and wellness.

Dates have been set, mandates have been put on hold, insurance policies were cancelled, no wait..Obama says "Kings X", I take that back. Sebelius smiles and goes before congress, non-plussed.  She must be close to retirement so no problem and undoubtedly she will be through with her public service.  I wonder if she has health coverage?

Many of us have tried to take the high road and plan health reform logically analyzing each step as we proceed.  This is almost a futile endeavour, because the landscape is constantly changing.




Secretary of Health and Human Services Kathleen Sebelius testifies at a Congressional panel last week. The White House has outlined a new exemption under the Affordable Care Act

n a last-minute policy change, the Obama administration waived the so-called individual mandate under the Affordable Care Act for people whose individual health insurance policy is being canceled.

The act requires most Americans to have qualified health insurance starting in 2014 or pay a tax penalty, unless they meet one of myriad exemptions. One is if qualifying coverage would cost more than 8 percent of household income (the affordability exemption). Another is they can prove a hardship such as homelessness, bankruptcy, domestic violence, large medical debts, utility shutoff notice or death in the family.

Under new guidance issued late Thursday, the Centers for Medicare and Medicaid Services (CMS) said that having an individual insurance policy canceled now qualifies for the hardship exemption.

The process is not really that simple:

People who qualify for the cancellation hardship exemption have two options:

-- Don't buy coverage and don't pay a fine.

-- Buy a bare-bones catastrophic policy on an exchange. These catastrophic policies do not meet the requirements of the Affordable Care Act, but people who buy them won't owe a fine. Before Thursday's rule change, to buy this policy a person had to be younger than 30 or meet the affordability exemption.

To qualify for the new policy-cancellation exemption, consumers must complete a hardship application, which will let them purchase a catastrophic plan or receive a penalty waiver, according to Centers for Medicare and Medicaid Services. (For the application, see http://1.usa.gov/19YrBnK.)

To purchase the catastrophic policy, they must submit the form, and evidence of a canceled policy, to a company selling such policies in their area.

The announcement came just days before the Monday deadline for enrolling in coverage to start Jan. 1, and insurance companies are not happy.

When Obama announced another policy reversal in November - saying insurance companies could temporarily renew certain policies that were to be canceled because they did not comply with the act - he gave states the option of allowing that or not.

Covered California did not. As a result, most individual health policies in California that are not grandfathered will be canceled Dec. 31.

Some customers of Anthem Blue Cross and Blue Shield of California will be able to keep their non compliant policies until the end of February or March, respectively, under a settlement with the state insurance commissioner.

People with individual plans that are grandfathered, meaning they had them before the act was signed in March 2010, may keep them until the insurance company decides to cancel them.

It appears that nothing is guaranteed as to the roll out. Insurers, providers, hospitals are all nervously watching and waiting. 

The New Public Health Advertising and Social Media

This post today does not reflect approval or disapproval of the Affordable Care Act.   It does point out the means to which the administration has gone to "sell ObamaCare" to the public by riding on the coattails of famous people.


Celebrities and Public Health.

Whether your  favorite celebrity knows anything about health may be open to question.

However given the visibility of celebs such as Angelina Jolie and the topic of breast cancer; or  type II diabetes (such as Tom Hanks) many want to contribute their celebrity either due to a personal involvement with the disease or for charitable purposes.

Somewhat open to question are those who endorse a specific treatment,rather than elevating the public awareness of the disease or treatments.

Celebrities can use their enormous stage presence and visibility to the general public far more than millions of dollars spent by government in public health advertising or announcements.

Who does not know more about HIV and AIDS due to the Bill and Melinda Gates Foundation, or Michael J. Fox and Parkinsonism.



The list goes on.

Actress Angelina Jolie explained her decision to undergo a prophylactic double mastectomy to significantly reduce her risk of inherited breast cancer,

      The effects of the so-called "Angelina Jolie effect" even have reached across the pond, where breast cancer charities have reported a four-fold surge in women asking about having their breasts removed since Jolie announced she'd had the procedure, according to Daily Mail. And the number of calls Cancer Research UK's helpline received about a family history of breast cancer increased from 13 in April to 88 in May, the article noted. In response to Jolie's breast cancer media bombshell, doctors acknowledged not all women need genetic testing but all women should discuss it with their doctors, FierceHealthcare previously reported.

Kim Kardashian brought to light the importance of privacy and confidentiality in the health space and protected information by HIPAA.Some hospital employees in Los Angeles may have gone too far in their quest to "Keep Up with the Kardashians" and now have to face the consequences.

Five workers and a student research assistant at Cedars-Sinai Medical Center (Calif.) were fired over privacy breaches involving patient medical records--and there is speculation that the patient was Kardashian, who gave birth to her daughter with rapper Kanye West in a birthing suite at the hospital on June 15, the Los Angeles Times reports. This event publicized HIPAA rules for the public and providers.

News correspondent Amy Robach announced that she has breast cancer and would undergo a double mastectomy--after reluctantly agreeing to have a mammogram live on-air for Good Morning America. Had she followed the United States Preventive Services Task Force 2009 guidelines for screening, it's likely she wouldn't have undergone her first mammogram until a decade later. Robach is just 40 years old and has little history of breast cancer. This brought to life the controversy of statistical evidence for screening for many diseases.

     Obama's camp took to popular comedy site Funny or Die to get the word out about the Affordable Care Act, with skits featuring Jennifer Hudson, Amy Poehler and Olivia Wilde.  Parodying TV's Scandal, Jennifer Hudson plays a "fixer" who offers up the simple (well, it should be simple) solution of signing up for coverage on Healthcare.gov to clients presenting their problems.

     The first lady stepped into the public health spotlight with her "Let's Move" campaign, encouraging schoolchildren to eat healthier foods and exercise daily--she even enlisted Sesame Street characters Elmo and Rosita to help her promote eating fruits and vegetables during an official press conference

    In fact the Obama campaign used many celebs to raise awareness of Health.gov the national website to enroll in the Affordable Care Act. As health care professionals we should not take for granted our knowledge base as compared to the public.  The Obama effort has some very funny videos that made even me laugh, and the ACA is no laughing matter.

Katherine Zeta-Jones revealed she had bipolar disorder back in 2011, shortly after husband Michael Douglas was diagnosed with stage 4 cancer. Zeta Jones commented on her struggle with bipolar ll (which is less severe than bipolar l), in 2011,

And then there have been comments from people such as Jenny McCarthy.  McCarthy told Oprah Winfrey she "graduated from the University of Google," to come to this idea, but she's been spreading her view that vaccinating young children for diseases like mumps results in autism in books, newspapers and on TV--much to the dismay of doctors, scientists, researchers and other celebrities.

No matter what popular culture is influenced by the media for better or worse.

Poll: Americans better understand, still don’t love, health-care reform

Lake forming behind an Ice Dam

The recent melt-down of the Affordable Care Act's opening of the Health.gov website served to cast a spotlight on the entire law.  More than 60% of the public pretend to know what it is about. That is about the same as Congress knew when they voted to enact the bill into law.

Despite and perhaps because of it's sudden visibility and the topic of all news media most know of it's shortcomings and how it was passed with major deceptions on the part of the Democrats, HHS, and President Obama's administration.

According to the Seattle Times, "A poll released today by Harris Interactive dug more deeply into the opinions of the uninsured, who face penalties if they don’t get insurance by March of next year. The survey found that more than one-third of uninsured Americans say they are prepared to make health-insurance choices — but 31 percent said they didn’t know about the health insurance exchanges set up to sell the coverage.

On top of that, 61 percent of the uninsured say they have done “nothing” in the past year to get ready for the Affordable Care Act. More than half say they don’t know what they’re going to do about the requirement that they get insurance."

As you may recall, it’s been rough going since the Oct. 1 launch of online insurance markets created to enroll people in individual insurance plans. The federal site, which serves 36 states, essentially wasn’t working for weeks and only really kicked into gear over the last week or so. Washington state’s site had some hiccups, then got itself sorted out, but in the past few days has been down again for software fixes.

Added to those technical glitches like a bee sting on a raging sunburn was the outcry by folks who learned their individual and family insurance plans were being canceled at the end of the year. People felt betrayed by President Obama’s promise that if you liked your health care plan, you could keep it.

A survey conducted and released last week by Gallup found that only 37 percent of Americans approve of the Affordable Care Act or would like to see it expanded while 52 percent want it revised or repealed (the rest are undecided).

The crazy thing — given all of the recent attention to the problems with the roll out of the health-insurance exchanges — is that public opinion hasn’t changed a whole bunch from the same Gallup survey nearly three years ago. In January 2011, 37 percent of those surveyed approved of the ACA while 57 percent did not.

So it begs the question: How and Why was the ACA passed into law?

Many think this was a major move toward consolidating control of healthcare costs, and giving government a major role in 1/6th of the American Economy. It effectively destroys a major freedom of choice of what Americans buy in a market place.

How could public opinion remain so constant despite the tumult in recent news? It could come down to politics.

The Seattle Times teamed up with the Elway Poll in September to take the ACA pulse of Washington residents. It turned out that public opinion on health-care reform largely hewed with political leanings.

In that survey, 80 percent of Democrats approved of the Affordable Care Act, while 80 percent of Republicans did not.

This may reflect more upon the discordance between Democrats and Republicans overall, including budget difficulties which are also severe given the expanding national debt.  Republicans are vehement about corraling the national debit, which will again take canter stage in March 2014.

CMS AND ONC ACT TO SLOW DOWN THE HEALTH TRAIN EXPRESS

The Center for Medicare Services and the Office of the National Coordinator are responding to the intense "push back' from providers, insurance companies, health consultants and others. Realizing the debacle of  Healthcare.gov may be a tremor of impending catastrophic health reform failure they have chosen to 'back off' and delay several major milestones for HIT.

Numerous mandates for the Affordable Care Act have been delayed due to what seems to be a systemic overload of HHS and other regulatory agencies that go beyond the Affordable Care Act.

1. Individual Mandate
2. Last date of enrollment on Healthcare.gov pushed back to December 23rd for a January 1 2014 enrollment. (Is this another pipe dream?  7 days from enrollment to eligibility with authentication of finances?..Another example of fantasy planning by Obama and his administration..

These delays are only the tip of an iceberg upon which the Titanic Obamacare ship founders.

Early on in 2010 shortly after the Affordable Care Act became law, the DOJ warned about employer sponsored health plans.  Rather than the Health Benefit Exchange impacting on only five percent of the population, the actual numbers willl be much greater perhaps as great as 80% excluding public programs.

Google me

Google Health (GH) could be the event of the decade in advancing health care reform — not just healthcare information technology (HIT) reform,
The "ultimate" PHR????
Google Health (GH) could be the event of the decade in advancing health care reform — not just healthcare information technology (HIT) reform, but health care system reform. GH promises simultaneously to create AND dominate the market for next generation personal health records (PHRs). There is nothing else in our solar system or in the entire universe like it.
II. GH’s Anticipated Technology Model
We’ve been provided a number of clues about the technology model that GH is likely to develop:
Patient centric
A personal health URL
Automated data mechanisms to gather and store PHI
Interoperable technical standards: XML and the Continuity of Care Record (CCR) standard
A user interface
Appropriate security and confidentiality measures
Value added functionality (over time)
What do you think???

What's New??

Okay, I have submitted to my urge to upgrade the RHIO blog to something a bit more diverse and expand the scope of it to include other interesting health related information. With this transition to ver 2.0 of blogger.com, comes the ability to do some fancier things such as RSS feeds and other techno-marvels I can name but clearly go beyond the capability of my 1943 CPU. This is merely a test posting you have found after being referred from the old blog site.
All future posts will be made to "Health Train Express".