Entries in Health Care (57)


Americans Optimistic about Nation's Health Care

Photo Courtesy - Getty Images(PRINCETON, NJ) -- Public opinion on health care quality and coverage in the US is more positive now than it has been for the past decade.

This is according to the latest Gallup Health and Healthcare poll. The poll found that 62-percent of Americans rate the quality of the nation’s health care as excellent or good. This percentage is five points higher than last year’s figure.

The opinion on health care coverage wasn’t quite as positive, with the poll’s results showing that only 39-percent of Americans rated coverage as excellent or good. This figure stands at just one percentage point higher than last year’s figure.

These figures are the highest ever recorded since Gallup began conducting the poll in 2001.

The poll also found that only 23-percent of Americans are satisfied with the cost of health care in the nation.

Copyright 2010 ABC News Radio


Arizona Budget Cuts Put Some Organ Transplants Out of Reach

Photo Courtesy - Getty Images(MESA, Ariz.) -- As the United States continues debating expanded health care access, the state of Arizona has begun rationing some care it says it cannot afford to give its poorest residents. Beginning on Oct. 1, Arizona's Medicaid program, the Arizona Health Care Cost Containment System, stopped covering seven types of organ transplants, including heart transplants for non-ischemic cardiomyopathy, lung transplants, pancreatic transplants, some bone marrow transplants and liver transplants for patients with hepatitis C.

The reductions made by the Arizona state government were approved by the federal government, according to an Aug. 11 letter from Gloria Nagle, associate regional administrator for the Division of Medicaid & Children's Health Operations. In addition to limiting organ transplants, Arizona also restricted coverage of prosthetics and zeroed out podiatrists' services, preventive dental services, and wellness and physical exams for adult Medicaid enrollees.

"This may be a harbinger of what will evolve in this Obama national healthcare system where the expense of the health system will only be able to be contained by limitation of access," said Dr. David C. Cronin, director of liver transplantation at the Medical College of Wisconsin. "So everybody may be covered, but all services may not be available."

Of Arizona's decision to pull the plug on an insured patient's transplant, he said, "I don't see how that's fair on any level. It's indefensible to renege if the patient did everything they were supposed to do and they don't have another option. You shouldn't try to balance your budget on the backs of the most desperate patients."

Arizona's Republican governor and legislature, who already control the state's purse strings, want even more independence when it comes to determining which health care services Arizona Medicaid patients receive. Indeed, Arizona's newly elected Senate President Russell Pearce has argued for cutting the state's Medicaid program, even if that means Arizona will lose about $7 billion worth of federal grants.

Jennifer Carusetta, chief legislative liaison for AHCCCS, said the state is facing a $1 billion deficit in the program come July 2011. Although Arizona's fiscal year began July 1, the state opted not to implement the cuts until Oct. 1, when it estimated they'd affect about 100 people on transplant lists. However, Carusetta said the state anticipated that only a fraction of them were likely to feel direct effects of the policy change. "We believe that only about 15 percent of those individuals would be able to get a match and secure an organ," she said.

Copyright 2010 ABC News Radio


New Health Care Changes Coming for Seniors on Medicare

Photo Courtesy - Getty Images(WASHINGTON) -- The Medicare open enrollment period kicked off this Monday and seniors can expect to see significant changes in their plans as the new health care law takes shape.

The biggest benefit to Medicare beneficiaries, experts say, is that the law will eventually close the prescription drug coverage "doughnut hole," the out-of-pocket expenses seniors have to incur once they're medicinal costs reach $2,830.

Seniors who fell into the gap this year received a $250 rebate check.  Pharmaceutical companies will begin in 2011 providing a 50 percent discount on brand-name drugs and the "doughnut hole" will eventually be phased out so that enrollees in Medicare Part D drug coverage program will only be responsible for 25 percent of their prescription drug costs by 2020.

The law also eliminates co-payments for preventative screenings such as mammograms and cancer screenings, and makes bonus payments to professionals who have high-quality ratings.

But some provisions in the law have irked several seniors, including one that would increase Medicare payroll taxes on earnings for Americans with higher incomes.

Individuals who make $85,000 or more or couples with an income of at least $170,000 would have to pay higher premiums, starting in 2011.  And the federal premium subsidy will be cut to 74.5 percent, depending on a person's income.

Another provision that has taken heat is one that would effectively reduce Medicare Advantage plans that give enrollees the option to receive their benefits from private health care providers.

Copyright 2010 ABC News Radio


Will Health Care Overhaul Survive Republican Control of the House?

Photo Courtesy - Getty Images(WASHINGTON) -- Since the health care bill passed in March, Republicans have vowed to "repeal and replace" it as a central part of their "Pledge to America."

Now that they will assume control of the House of Representatives next year, that GOP mission is among the options they'll have to weigh, health policy analysts say. "Repeal and replace" is unlikely to happen, the analysts agreed, so Republicans may have tough choices ahead.

"Absent a supermajority in both houses of Congress, efforts by either or both houses to reverse the law will most surely be vetoed," said Jay Wolfson, distinguished service professor of public health and medicine at the University of South Florida in Tampa.

Gail Wilensky, an economist and senior fellow at Project HOPE, an international health foundation, said, "The real question is whether the Republican House and the more closely divided by Democratic Senate work to fix aspects that are regarded as particularly troublesome or leave it as is, so that the more egregious parts are more obvious."

Either way, she added, Congress must address at least one issue immediately.

"They need to fix the Medicare physician fee schedule right away," she said. "Starting on December 1, Medicare payments to physicians will drop 23 percent." The cuts are part of a congressional plan to help reduce the budget deficit.

Ken Thorpe, professor of health policy at Emory University in Atlanta, said, "They can do a 13-month extension of that and give Congress time to think how to...[fix the payment system], but it will cost billions to freeze the payment system." 

Copyright 2010 ABC News Radio


Pre-Existing Condition? Baby Denied Medical Coverage While in Womb

Photo Courtesy - The Barnes Family(NEW YORK) -- New mother Kelly Barnes is heartbroken and angry.

She's heartbroken because she has endured what no mother should have to endure. While pregnant with twins, she lost one of them at 30 weeks. The other baby, Kinsleigh, was born with serious heart problems.

But Barnes is angry because her insurance company, Aetna, held up paying thousands of dollars in medical charges. The reason? The insurance company said the newborn might have been suffering from a pre-existing condition.

"Under Aetna's own definition, in order to deny for pre-existing condition, there has to be medical advice or care that was rendered or given," Barnes' attorney, Tom Caldwell, said. "And in this case, of course, that would be real hard, given the fact the baby was still in the womb."

Barnes said she called Aetna hoping for a resolution.

"It's like you're talking to somebody who is reading from a script," Barnes said. "They don't have answers for you based on what you're telling them."

ABC News called the insurance company in September and it claims the pre-existing condition hold-up was a simple coding error and it wasn't paying back Barnes' claims since July. But Barnes said that no one ever told her that, and it wasn't until ABC got involved that all the costs were finally paid.

"It is my personal belief that they will -- they do this to you, expecting you not to follow up with it," she said. "And I'm sure most people don't."

Kinsleigh still needs heart operations, but those Aetna said it will foot the bill. Even so, Barnes said she'll never forget the nightmare that Aetna put her and her family through.

Following the ABC News investigation, Aetna apologized to Barnes.

Copyright 2010 ABC News Radio


Health Insurance Providers Scrap Child-Only Policies

Image Courtesy: ABC News(NEW YORK) -- The move by some health insurance companies to eliminate child-only policies has many questioning whether providers will try to circumvent provisions of the new health care reform law in the future. Politically, it has unearthed old tensions between the Obama administration and health insurers, as new provisions began to take effect on Thursday.

Concerns about the new law have prompted major insurance providers, like WellPoint, Cigna, CoventryOne, and some Blue Cross and Blue Shield companies to stop offering child-only policies, as the Washington Post first reported.

The health care law prohibits health insurers from denying coverage to children with pre-existing conditions, but coverage for children under 19 will now be offered in family plans instead of as a separate policy.  The move itself won't have an impact on a large percentage of the population.  A recent survey by America's Health Insurance Plans found that six percent of individual policies are child-only plans.

Insurance companies say they were forced to drop child-only plans because of higher costs and to keep themselves competitive.

Copyright 2010 ABC News Radio


New Health Care Benefits to Start Thursday, Americans Still Confused

(NEW YORK) -- Starting Thursday, new health care benefits will go into effect in a move that can have an impact on millions of Americans.  Insurance plans renewing on or after Sept. 23 will be required to eliminate lifetime limits on insurance coverage, offer coverage for children with pre-existing conditions, remove lifetime caps on coverage, provide free preventive care and allow young adults up to the age of 26 to remain on their parents' health plans, among other changes.

The Obama administration has ramped up efforts to tout the new law. President Obama will hold a "backyard event" in Virginia on Wednesday at the home of a person who is benefiting from the Affordable Care Act.

But six months after the landmark bill was signed into law, people are still largely unclear about what the changes mean for them as health care remains embroiled in a heated political debate. According to an Associated Press poll released Tuesday, More than half of all Americans believe the changes will raise taxes for most people this year. About a quarter of respondents thought the law would set up panels of bureaucrats who would make decisions about people's health.

Overall support for the health care law also remains low, although it goes up when people are asked about specific provisions, demonstrating the confusion among consumers.

Copyright 2010 ABC News Radio.  Image Courtesy: ABC News

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