by odonata98
Week of November 15, 2010
State budget problems are so dire and rising health care costs so worrisome that some states are considering what may have been unthinkable just a year or two ago — opting out of the federal Medicaid program. The New York Times reported last week that Texas (see below) and a handful of other states are considering doing exactly that, especially given that federal health care reform will expand (as of 2014) the number of residents who are eligible for the state-administered health care program. In South Carolina, state officials there are considering not paying Medicaid claims as of March 2011 unless they can secure permission to run at a deficit. Some state leaders concede dropping Medicaid could have a devastating effect on their local economies, making such a course unlikely. The fact that it’s on the table, however, speaks volumes about the growing problem of runaway health care costs, and the need to develop systematic solutions in the way that the Patient Protection and Affordable Care Act (PPACA) addressed access issues. Easy To Insure ME has the answers
Health Care Reform Implementation
For more detail about the ongoing implementation of the new health care reform law and its potential impact on you, read a new edition of our Eye on Implementation feature.
Federal
With Congress on recess last week, there is no Federal summary for this week.
States
ALASKA: A state health commission created by the legislature this year has begun reviewing rapidly rising medical costs and patterns of health care pricing among providers. Alaska’s health care costs are rising faster than the national average. The commission held its first meeting in Anchorage October 14 and 15 after its members were appointed by Gov. Sean Parnell. Most members of the panel were on an earlier health care task force, but this panel has five new members, including two state legislators. In an effort to provide the Commission with relevant cost and quality data, Aetna has forwarded several relevant studies and documents produced by its Public Policy Department.
CALIFORNIA: The state is yet again facing a massive budget deficit — .4 billion projected for 2011, according to the nonpartisan Legislative Analyst Office (LAO). Governor Arnold Schwarzenegger will call a budget special session starting December 6 to resolve the current-year .1 billion deficit. Next year’s budget process will be impacted by two propositions passed during the November election. Voters approved Proposition 22, which limits the state’s ability to borrow money from local governments, and they also approved Proposition 26, which makes it harder to raise fees. It also rolls back fees that were passed by less than a two-thirds vote this year. The LAO estimates these two propositions will create a billion hole in the budget. Democrat Governor-elect Jerry Brown, who campaigned on a pledge of no new taxes, will release his budget proposal in early January.
NEW JERSEY: Last week the Assembly Financial Institutions & Insurance Committee took up legislation that clarifies out-of-network payment responsibilities under health benefits plans, requires certain coverage and procedure disclosures to consumers, and revises procedures for changes to managed care plan contracts. After more than two hours of testimony, Chairman Schaer used his discretion to withhold formal action on the bill. In his comments the chairman noted, “The rising cost of health coverage is crowding out other socially important efforts for government and resulting in economic stress for employers.” Led by the New Jersey Hospital Association and Medical Society, the provider community was virtually unified in its opposition to the legislation. The business community, NJ Association of Health Underwriters, and a large contingent of trade unions expressed their support for the bill. Aetna, along with other commercial plans, remains concerned about provisions in the bill concerning non-participating, hospital-based physicians and the ability of out-of-network providers to waive member copayment, coinsurance, or deductibles. Aetna will continue to closely monitor the legislation.
TENNESSEE: The Tennessee Insurance Exchange Planning Initiative has announced the members of two newly created Technical Advisory Groups (TAGs). Members of these groups will provide expertise on specific analytical questions to help in the state’s insurance exchange planning process. The state is in the process of deciding whether it will operate a health insurance exchange. Mark Schmidt, Aetna Market President, Southeast, has been appointed to the Governor’s TAG for State Insurance Exchange Planning. The members of the Actuarial/Underwriting TAG and the Agent/Broker TAGs will provide expertise on specific analytical questions to help in the state’s insurance exchange planning process. The volunteer members of each TAG will meet in Nashville this fall and winter. Members of the Agent/Broker TAG will provide a detailed inventory of options for state decision-makers and then post any resulting discussion papers. Once additional information is received from the federal government, the state also intends to convene TAGs of health care providers, consumer representatives, and marketing and outreach experts.
TEXAS: Several Republican lawmakers are proposing an unprecedented solution to the state’s estimated billion budget shortfall: dropping out of the federal Medicaid program. The Heritage Foundation, a conservative think tank, estimates Texas could save billion between 2013 and 2019 by opting out of Medicaid and the Children’s Health Insurance Program, dropping coverage for acute care but continuing to fund long-term care services. With 3.6 million children, people with disabilities and impoverished Texans enrolled in Medicaid and CHIP, the Texas Health and Human Services Commission will release its own study on the effect of ending the state’s participation in the federal match program. Some lawmakers say not being able to reduce benefits or change eligibility to cut costs is “bankrupting our state.” State Rep. John Zerwas, an anesthesiologist who authored the bill commissioning the Medicaid study, said early indications are that dropping out of the program would have a tremendous ripple effect monetarily, and he worries about who would carry the burden of care without Medicaid’s “financial mechanism.” Currently, the Texas program costs billion per biennium, with the federal government footing 60 percent of the bill. As a result of federal health care reform, millions of additional Texans will become eligible for Medicaid. Lawmakers want to examine whether Medicaid enrollees could be served more cost efficiently with better outcomes in a state-run program.
WASHINGTON: Governor Chris Gregoire says she gets the message following the recent elections, and as a result has announced that she will seek supplemental budget cuts of million before the end of the year. Voters signaled a strong aversion to additional tax hikes to balance the budget by recently passing initiative 1053, which restores the two-thirds vote requirement for the legislature to raise taxes, and initiative 1107, which repeals a tax on bottled water and carbonated beverages. Also, voters rejected initiative 1098, which would have instituted a state income tax. Among the programs Gregoire is considering for possible cuts is the state’s Basic Health Plan. The Governor said she is open to the idea of a one-day special session if there is agreement with legislative leaders on quick action.
This is a short video about Mental Health and it’s statistics. Once I know whether or not this Video has made the impact I want to have on People I will consider making a better Video.
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check basil buntings qualifications. top academic right. meet the man in a clinical setting, the bloke is worse than bad, he is harming patients. this i have observed first hand. he has/is treating my daughter. it would appear he does not consider a fact is a fact until he recognises it as so. the harm his written observations cause in legal situations like family court, are outrageous. when questioned he becomes hyper defensive of procedural diagnostics, but avoids the question. sound familiar?
i htink they should just be equals they may need more help…. but helping them only makes it worse makes them not be able to help themselves
instead of throwing mental health sufferers in hospitals, they should have more programs stressing diet and exercise, and medication should be kept at a minimum, because it leads to weight gain.
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but its not quite as easy trying to deal with this. I been through depression, and in away I’m still going through it… . honestly I don’t know what got into me but there is good people out there thats willing to help- I hope we find it – you are not alone!
@Ragnarok187 when my computer *STOPS* ( made a grammatical error) being an asshole to me.
@Ragnarok187 cheers I’ll have a search for them when my computer is being an asshole to me.
@Ragnarok187 You didn’t understand what I meant, what I meant was, if 2 peer reviewed articles contradict each other, one of them will eventually be found false, I’ve yet to hear of either being found false, so it looks like we’ve made a moot point.
@vikeyev1 Do you really think that all peer reviewed articles will agree with one point of view? Cause that’s just idiotic. The reason for research is (and should always be) to examine if claims hold true, and to check other alternative/opposite perspectives. I’ve found peer reviewed articles in textbooks, but can’t always find them on a single database. You might wanna try searching more than just the single APA database, cause PsychINFO DOES show those 3 I mentioned as being peer reviewed.
@vikeyev1 The references are ‘Psychology and the status quo’ (Prilleltensky, 1989). ‘Shaping the intimate: Influences of the experience of everyday nerves’ (Healy, 2004). ‘The myth of mental illness’ (Szasz, 1960). ‘The bio-bio-bio model of madness’ (Read, 2005). ‘DSM-III and the politics of truth’ (Schacht, 1985). ‘Diagnosis’ (Boyle, 1999). Prill, Read and Schacht ARE peer reviewed, but not every database shows all articles. I couldn’t find the others either on the single database I searched.
@vikeyev1 Okay, you misread, it’s good you can accept that. It takes a big man to accept when he’s wrong or made a mistake. You abused me for no reason. As for the articles you’ve read, yes, you’ll find many articles contradict each other. If you’ll read Healy (2004), like I mentioned, up to 75% of articles may be ghost written (his claim, not mine) . A vast majority are funded by the drug companies, so no way would they publish articles that show their meds to be ineffective.
@Ragnarok187 Not only that a name and year are not adequate information as their tends to be multiple people of the same name publishing articles in the same year, at least quote the name of the article.
@Ragnarok187 Firstly I misread the part about chemical imbalance, secondly, your claiming that those are peer reviewed articles stating that the DSM is bullshit and that the medications don’t actually help, which is quite funny because that directly contradicts the peer reviewed articles I quoted. So someone here is full of shit and I can guarantee you it sure as hell ain’t me.
Lastly I searched through on APA and couldn’t find any of them.
@vikeyev1 You asked me for info for what I claimed, and one of the things I mentioned was the chemical imbalance, now you’re throwing abuse cause I mentioned something you asked me to give info on? And you claim none of it is peer reviewed. Prilleltensky, Read, and Schacht ARE peer reviewed, and I believe the others are too but couldn’t find them on PsychInfo. So none is peer reviewed you said, when clearly they are (at least 3 on the database I searched). So, by your reckoning, those ARE truth.
@Ragnarok187 Neuropsychological status of bipolar I disorder:
impact of psychosis (about the? impact of a history of DSM–IV-defined psychosis on the neuropsychological status of participants)
Psychosis Endophenotypes in Schizophrenia and Bipolar Disorder (about the link between bipolar and schizophrenia)
@Ragnarok187 WHEN IN FUCK DID I SAY IT WAS A CHEMICAL IMBALANCE YOU FUCKING DOLT!!!
Secondly none of that is peer reviewed, it hasn’t gone through the rigorous and brutal process that IS the peer review process. The peer review process weeds out the bullshit and leaves what is essentially the truth.
Here’s a couple peer reviewed articles you can search for,
The Neuropharmacology of Psychosis (about the therapeutic benefits of medication in Schizophrenia and Bipolar Disorder)
@vikeyev1 cont… (again). “Dominant scientific paradigms often act to silence the dissent of critics rather than stimulate critical thinking” (Healy, 2004). “Science is no longer simply a way of satisfying the curiosity of the individual scientist: It has become a means of accumulating political power by particular interest groups” (Schacht, 1985). “has shown a clear bias in supporting the interests of the powerful and the status quo” (Prilleltensky, 1989)
@vikeyev1 cont… You can also look up Thomas Szasz. Also, name for me 1 medical test that shows a ‘chemical imbalance’. There are none. Not a test to point to one disorder, but a test to show a chemical imbalance. And if there is an ‘imbalance’, tell me what a ‘balance’ looks like. There are no reports that can show either. The imbalance thing was a hypothesis that’s just been repeated so often people accept it. It’s used to support the medical model, which supports the use of drugging people.
@vikeyev1 Which bit exactly? The DSM is written by psychiatrists. Psychiatry is almost completely bought out by drug companies (Read, 2005). Up to 75% of papers may be ghost written and omit negative info (Healy, 2004). Healy also stated that ‘disorders’ are marketed, which increased drug sales as awareness increased. The creation of medical paradigms creates demand for drugs. The literature consistently fails reliably identify underlying ‘symptoms’ of diagnostic groups (Boyle, 1999)
@Ragnarok187 Do you have any citations for anything you just claimed?
Are the people who supposedly “discovered” all of this even qualified to say so?
Why has none of this been published in the peer review literature?
@DaRkLyDrEamiNg000 Actually their have been many scientific studies into the therapeutic benefits of medication into the mentally ill. I quoted about 5 or 6 of them to another idiot on another video. Removing the stigma of mental illness, that was the one. It’s people like you that just can’t let go of the stigma. Mental illness is not something you can change just by deciding “hey, I’m gonna think and do differently today”, that’s not the way it works.
@olddonno1 The government don’t know jack shit about physical health let alone mental health. Look at the pathetic state of the hospital systems in America, Australia, New Zealand and Britain. The government needs to smarten up in a lot of areas and this is one of the big ones.
The term ‘mental illness’ has no basis. The DSM is a book of lies, which is the book that lists all these so called ‘illnesses’. New ‘disorders’ get added by a vote, which isn’t very scientific. People experience these problems yes, but it is not a chemical imbalance (there are NO tests to show an imbalance), and it is not a disease or illness. These are behaviours that are labeled purely to profit from and control people.
@Lonaye14 Im sorry ur husband commited suicide. I dont believe the system
helped, in fact i think they encoureged! Sorry but i was in a similar situation, i nearly lost my daughter and il never forgive the state!
@london1155555 Yea the mentally ill need lookin after eh? Ive looked after dementia sufferers for many years but where this self rightious bull come from? U think more money might make them feel better and improve there life?
The money being spent in goverment is outrages, my korsakoff sufferers are happy, it takes more than money to do that.