As promised last month, here is the Spotlight article from Medical Travel Today.com about Ashley Furniture’s foray into Medical Travel for their employees.
In case you missed it, here is the link to part 1 of the article.
A connection of mine today posted a link to a CMS Fact Sheet in which they propose to allow states to define essential health benefits beginning January 1, 2019.
According to the fact sheet, this rule is intended to increase flexibility in the individual market, improve program integrity, and reduce regulatory burdens associated with the PPACA in the individual and small group markets. (See my post, “Regulation Strangulation“)
The rule also includes proposals that would provide states with more options in how the essential health benefits (EHBs) are defined for their state, it would also enhance the role of states related to qualified health plan (QHP) certification, and to provide states with additional flexibility in the operation and establishment of Exchanges, particularly the Small Business Health Options Program (SHOP) Exchanges.
Finally, they propose to permit states to reduce the magnitude of risk adjustment transfers in the small group market to minimize unnecessary burden, and proposes other changes that would streamline the Exchange consumer experience and the individual and small group markets.
What does this really mean?
Anytime the federal government attempts to allow the individual states to determine or define certain social benefits, we end up with a hodgepodge of rules, regulations, costs of impairment, etc.
We know that in certain states, the loss of a body part in one state has an impairment value different from the same body part in another state, according to the ProPublica report .
So when I see that CMS wants to allow states to define what essential health benefits are, we have to ask ourselves, what do they mean by essential, and is one state’s essential health benefits, another state’s burden?
I understand that certain states, particularly so-called “Red” states with conservative governors and legislatures, will be free to decide that certain treatments and procedures are just too expensive for them to cover, or that they violate the ethical or moral sentiments of the community in the state, i.e., abortion, birth control, sexual reassignment surgery, etc.
Allowing states to define and decide what is essential and what is not, may be harmful to the health of many of their citizens, even if it saves the state money.
And I am rather leery of CMS’s desire to “strengthen” the individual or small group markets, because who decides what constitutes strengthening, and who makes those decisions and under what circumstances.
Rather than allowing legislators and governors to decide what medical care their citizens can receive in their state, rather than trying to shore up a market, whether it is the individual market or the group market, we should move to provide all Americans with the same health care and the same medical benefits, coast to coast, under a Medicare for All plan.
Anything less would be worse than what we have now, and would be more costly and more complex and confusing. This rule should be scraped.
From the One Hand Washes the Other department comes the following Spotlight article from Medical Travel Today.com.
Ashley Furniture, based in Wisconsin, is one of the largest manufacturers of home furnishings in the world.
I met Rajesh Rao in 2014 when I attended the Costa Rican Medical Travel Summit in Miami Beach. Rajesh’s company was also instrumental in convincing another furniture manufacturer, HSM in North Carolina, to first send patients to India, then to Costa Rica for medical care. I have written about this in previous posts.
This article is part one, and part two will run next month.
Joe Paduda today gave a very succinct and clear-minded assessment of the fallout of the ending of the ACA subsidies, also known as Cost-Sharing Reimbursement (CSR) payments.
Here is Joe’s article.
It makes perfect sense that what the Orange man said yesterday will do more damage to health care than his false and misleading pronouncements of the past year that the ACA is failing and doing harm.
It is you, sir, who are doing harm. To the poor, to minorities like those in Puerto Rico despite your morning mea culpa, to African-Americans and Latinos, to women, to international agreements and organizations, and to our credibility with our allies and adversaries.
Here is the New York Times article tonight which will appear in tomorrow’s paper.
The Orangutan is blowing up the health care law, and with it, the health care system.
Cutting off subsidies to cover low-income individuals and signing an Executive Order that will create chaos and uncertainty is dangerous, reckless, and despicable.
Not even Gru is that mean-spirited and inhumane.
The Roman Senator Cato the Elder ended his speeches by declaring that “Carthago delenda est”. which means Carthage must be destroyed.
We need a modern Senator to declare that “Trump sit remotus”, means Trump must be removed.
The signing this morning of an executive order by the Orangutan will have, in the opinion of some of the bloggers and politicians, spell disaster for the nation’s health care system.
It will, if carried into action, likely siphon healthy people from the Affordable Care Act-compliant market, continuing a pattern of regulatory actions under the Trump administration that have undermined the ACA.
The rationale for such a move that has been given is that since Congress has not been able to repeal and replace the ACA, an executive order will, piece by piece.
Coupled with the recent budget move to eliminate the CHIP program for children’s health (New York State faces dire consequences if Congress does not act on CHIP), and cut backs to Medicare and Medicaid, the intent here is to privatize health care for some, and eliminate it for others, and to get government out of health care providing altogether.
There are provisions in this order for greater competition, short-term coverage, and lower premiums with less coverage. Why this is better is beyond me, unless the Orangutan is seeking to destroy health care so that single-payer will be the only option.
Cutting healthy people out of the ACA means leaving sick people to struggle with a health care law that many say needs to be fixed, not repealed and replaced. But because the Tea Party ranted and raved before it was enacted, and the Orangutan and the GOP campaigned on getting rid of it, they had no choice but to sabotage it if they could not do so through legislation.
I predict that we will soon see the total collapse of our health care system thanks to this stupid, overreaching, and ill-advised Executive Order. I even read today that the Vice President had to remind the Orangutan to sign the darn thing, something that almost slipped what is left of his so-called mind.
Welcome to Crackerbox Palace.
You all know the story of King Solomon in the Bible where he was called upon to settle a dispute between two women, each claiming to be the mother of a baby. Solomon’s “solution” was to order the baby be cut in half, so that each mother would have half a baby. But when she realized what this would mean, the real mother spoke up and spared the child from being split in two.
Well, something posted today on LinkedIn, sort of reminded me of that story. Rather than paraphrasing it, I am posting the item here for you.
Trump plans to split Obamacare in two
President Trump plans to sign an executive order this week that takes aim at the Obama-era Affordable Care Act, according to sources. Among the changes, the order would give individuals and small businesses in association health plans more options to opt in for lower-cost — albeit less comprehensive — plans not allowed under the ACA, leaving older and sicker individuals with fewer options and pricier premiums. It would also provide short-term insurance for up to a year, reversing the three-month deadline put forth by the previous administration. If the order is signed, the market could divide in two, adding more difficulties to traditional markets under the ACA while opening the door to new types of insurance.
It seems the Orangutan now fancies himself with the wisdom of Solomon in regard to dealing with the “problem” of getting rid of the ACA. Like the two women in the story, the two parties in Congress each claim their own view of health reform, and since neither side is getting their way, the Orange King is doing it for them by signing an Executive Order.
And like the proverbial baby, splitting health care in two solves nothing. But don’t let that stop the Orangutan. He’s the wisest person there ever was, or didn’t you know that?