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5 posts from April 2017

04/28/2017

The Current Status of Employer-Based Insurance: A Conversation with James Gelfand (May 3rd)

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Considering the debate over the past five months about repealing the ACA (and more generally reforming the Medicare program via premium support),  it is worth remembering that approximately 55% of non-elderly Americans, or 155 million, still receive their health care coverage via their employer.   In addition, as of 2016 the ACA requires employers with over 50 employees to either offer health benefits or face a financial penalty.   The question remains what is the future of employer based insurance coverage, both for employees and retirees) if, for example, the ACA's "employer shared responsibility" provision and/or the employer tax exclusion (addressed in the ACA by the so called "cadillac tax") is repealed. 

During this 25 minute discussion Mr. Gelband briefly describes ERIC's mission/work, identifies what methods large employers are using to continue to offer employee coverage, how retiree coverage is being addressed, how employers are incenting providers to deliver quality care, ERIC's view of much debated HRAs (Health Risk Assessments) and wellness programs and his organization's position on the employer tax exclusion.  (Listeners may recall I interviewed Dr. Joe Antos last August 5th on the tax exclusion.)

Mr. James Gelfand is Senior Vice President of Health Policy at ERIC where he works to develop and advance public policies to James Gelfand's Headshot support the ability of employers to design and administer health plans.   Previously, Mr. Gelfand was the Director of Federal Affairs at the March of Dimes Foundation.   Prior to, he served as Associate Director for Luntz Global Partners.  He served on Capital Hill as Counsel to Senator Olympia Snowe, on the Senate Small Business Committee and to Senator Tom Coburn.   Mr. Gelfland also was for four years a lobbyist for the US Chamber of Commerce.   Mr. Gelfand received his JD from the George Washington University Law School and his undergraduate degree from Northwestern. 

For more information on ERIC go to: http://www.eric.org/.

04/18/2017

CMS' "Market Stabilization" Rule Goes Final: My Comments (April 17th)

For those carefully following the ACA state marketplaces, i.e., the viability thereof, here's an update to my March 22 THCB essay (four posts down).  This one is titled, "The Strange Making of the 'Marketplace Stabilization' Rule," at: http://thehealthcareblog.com/blog/2017/04/17/the-strange-making-of-the-marketplace-stabilization-rule/.   The CMS rule is at: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2017-Press-releases-items/2017-04-13-2.html.

 

04/12/2017

"Teeth: The Story of Beauty, Inequality & the Struggle for Oral Health In America," A Conversation with the Author, Mary Otto (April 12th)

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 As former DHHS Secretary Louis Sullivan wrote in support of this work, "Mary Otto brings history, policy and painful personal realities together in this compelling and engaging book about our nation's highly preventable epidemic of oral disease.  Teeth should be read by every policy maker and health professional who believes we can and must ace to reduce the current barriers to dental care."  (Listeners of this podcast may be also interested in related interviews with Burton Edelstein, DDS, from April 2013 and my interview with the American Dental Association's Dr. Marko Jujicic from January 2016.) 

During this 22 minute conversation, Ms. Otto discusses the impetus for her work, i.e., the 2007 death of a 12-year old Maryland resident, Deamonte Driver, from an abscessed tooth, she discusses efforts to integrate oral health with overall physicial health, the problems of substantial racial/ethnic disparities in oral health in light of the industry's increasing financial interests in provided cosmetic dentistry, the battle between dentists and mid-level providers, e.g., dental hygienists, over the latter's efforts to improve oral health primary and secondary prevention and the possibilities for improved oral health coverage moreover for adults under both Medicare and Medicaid.   

Ms. Mary Otto is the oral health topic leader for the Association of Health Care Journalists.  She began writing about oral health Ottoat The Washington Post, where she worked for eight years covering social issues, including health care and poverty.  Ms. Otto is a resident of Washington, DC.  

Ms. Otto's volume is available via Amazon at: https://www.amazon.com/Teeth-Beauty-Inequality-Struggle-America/dp/1620971445.   A review of her work appeared in the March 23rd issue of The New York Times, at: https://www.nytimes.com/2017/03/23/books/review/teeth-oral-health-mary-otto.html?_r=0.   An executive summary of Surgeon General David Satcher's 2000 report, "Oral Health In America," noted during this conversation, is at: https://www.nidcr.nih.gov/datastatistics/surgeongeneral/report/executivesummary.htm

04/04/2017

Essay: "The Child Sexual Abuse Conspiracy" (March 31st)

Listeners may recall The Healthcare Blog (http://thehealthcareblog.com/) posted last June 4th my essay, "About Hastert's 'Known Acts': The Indifference is As Disturbing as the Crime" (at: http://thehealthcareblog.com/blog/2016/06/04/about-hasterts-known-acts-the-indifference-is-as-disturbing-as-the-crime/).  

Last Friday, THCB posted, "The Child Sexual Abuse Conspiracy."  Using the recent Larry Nassar/USA Gymnastics case I argue organizations that employ predators, political leaders in DC, the professional medical community and others continue to, de facto, conspire in ignoring the problem.  Again, per the CDC's ACEs study, one in four girls and one in six boys are raped/molested.  The essay is at: http://thehealthcareblog.com/blog/2017/03/31/the-child-sexual-abuse-conspiracy/

 

04/03/2017

What Was Discussed at February's "Climate and Health" Meeting: A Conversation with Dr. Jonathan Patz (March 31st)

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In mid-January the CDC abruptly canceled a three-day "Climate and Health Summit" the Center had been planning for months.  The meeting was intended to discuss public health risks caused by the climate crisis and steps being taken to reduce the emissions of carbon dioxide and other greenhouse gases or its adverse consequences on human health.   (It was speculated the meeting was canceled because the CDC did not want to run afoul of the incoming president who has repeatedly called climate change a “hoax” perpetrated by the Chinese.)   The American Public Health Association (APHA) and others however went ahead and held a one-day meeting on February 16 titled,"Climate and Health" at the Carter Center in Atlanta.  The meeting was keynoted by former Vice President Al Gore.   Dr. Jonathan Patz, the Director of the Global Health Institute at the University of Wisconsin-Madison, was one of the meeting's organizers and participants.    

During this 24 minute conversation Dr. Patz discusses how the meeting came about and what was accomplished, e.g., he summarizes the afternoon's panels that discussed what's being done to reduce green house gas emissions.  He also discussed how to better involve the professional medical community  and how to effectively communicate the reality of the climate crisis. 

Dr. Jonathan Patz is the Director of the Global Health Institute at the University of Wisconsin-Madison.  He is a professor and the John P. Holton Chair in Health and the Environment with appointments in the Nelson Institute for Environmental Studies and the Department of Population Health Sciences.  For 15 years, Dr. Patz served as a lead author for the United Nations Intergovernmental Panel on Climate Change (or IPCC)—the organization that shared the 2007 Nobel Peace Prize with Al PatzGore.  He also co-­chaired the health expert panel of the U.S. National Assessment on Climate Change, a report mandated by the Congress.  Dr. Patz has written over 90 peer-reviewed articles, a textbook addressing the health  the health effects of global environmental change and co-edited the five volume Encyclopedia of Environmental Health (2011).  He has been invited to brief both houses of Congress and has served on several scientific committees of the National Academy of Sciences.  Dr. Patz served as Founding President of the International Association for Ecology and Health.  He is double board-­certified, earning medical boards in both Occupational/Environmental Medicine and Family Medicine.  He received his medical degree from Case Western Reserve University (1987) and his Master of Public Health degree (1992) from Johns Hopkins University.

A webcast of the February 16 meeting is at: https://www.climaterealityproject.org/health.  Listeners are particularly encouraged to listen to Vice President Gore's 30 minute keynote address.  

For more information concerning the Medical Society Consortium on Climate and Health go to: https://medsocietiesforclimatehealth.org/.

Since I mention during the discussion the Obama administration's 2016 "The Impacts of Climate Change on Human Health in the US: A Scientific Assessment," a review of the paper is, again, at: http://altarum.org/health-policy-blog/nature-bats-last-a-warming-earth-will-exact-adverse-health-effects-but-our-responsibilities-are.