I tend not to quote the Motley Fool, but I haven't seen this argument elsewhere, so:
The Supreme Court's role in deciding the fate of the ACA probably isn't over despite last year's ruling. Multiple cases are winding their way through lower-level courts. One, in particular, stands out as a quite serious challenge for the ACA, in large part because it hinges on the initial Supreme Court determination that the individual mandate is a tax.
Heavy use of the world's most popular herbicide, Roundup, could be linked to a range of health problems and diseases, including Parkinson's, infertility and cancers, according to a new study.
The peer-reviewed report, published last week in the scientific journal Entropy, said evidence indicates that residues of "glyphosate," the chief ingredient in Roundup weed killer, which is sprayed over millions of acres of crops, has been found in food.
Big KRIT might be my favorite rapper for the hooks, and a good hook is enough to fulfill Dick Clark's necesssary and sufficient conditions for great music ("it's got a good beat, and you can dance to it"). Lupe puts together some pretty great hooks too, though. And when he matches them with his best topical lyrics like above and here, I think he's not just the best rapper but maybe the most important artist in Americn popular music. Disclosure: he also makes the kind of authority hating statements (more) that are dear to my heart. Read below the fold...
he ACA era is the fourth time health care pundits have “discovered” engagement. The first was HMOs, in which doctors were supposed to help patients maintain their health (hence the name) but which devolved into a cost-containment tool. The second was disease management, which involved connecting people with chronic disease to live nurses on the phone. That didn’t engage people. Third, wellness was supposed to accomplish the same thing for a much broader pool, engaging people through a combination of bribery (called “incentives”) and coaching. That not only failed to work, but it turns out virtually all wellness vendors who claim cost savings are simply making up results. As was extensively chronicled in Why Nobody Believes the Numbers, anyone with any basic understanding of study design would find these alleged results to be hilariously transparent lies, in the case of at least one major carrier quite purposefully designed to fool benefits consultants. These vendors have invariably found that the cost of engagement exceeds the benefits.
So perhaps the fourth time, engagement will be a charm, because it involves risk-bearing physician practices and medical homes and electronic medical records. Well, that’s been tried too. On a large scale, North Carolina Medicaid has attempted for more than a decade to engage members through a statewide medical home. Following years of cost overruns and massively high per capita spending, the program – maintained until now only because the proponents paid several sets of consultants to lie for them – is being dismantled by the state if the governor’s plan goes through. Even so, physician practices should be more successful in engagement – the patients know and trust them to begin with – but they would have to be very successful in reducing utilization to cover the very high costs of one-on-one face-to-face engagement.
Engagement isn’t even always automatically the right answer. I have blogged previously about how I am a non-engaged patient because the things that my doctor has wanted me to do have been absurdly expensive and not-evidence based…and yes, I am in a risk-bearing PCMH with an electronic medical record. Sometimes the patient is wise not to engage.
Notwithstanding that type of negative experience with engagement (not my first), there is probably some marginal benefit to engagement (and in the Medicare population, probably substantial benefit) but this obsession with engagement takes our eyes off some of the bigger cost drivers of overdiagnosis, overtreatment, and expensive new technologies of marginal value.
Not to mention medical errors, which may be the most pervasive, debilitating and expensive issue of all.
Lots of linky goodness there. Use this the next time anybody tries to peddle the "informed consumer" argument. But the real killer argument is below: Read below the fold...
CMS and the other implementing agencies (the Departments of Labor and Treasury) continue to issue guidance on specific issues, slowly but steadily moving the implementation ball forward..... The agencies are extending to plan years beginning in 2014 a number of enforcement safe harbors originally announced as lasting only for one year, and are continuing an enforcement policy that “will continue to be marked by an emphasis on assisting [just like OCC!] rather than imposing penalties on) plans, issuers and others that are working diligently and in good faith [ha ha ha] to understand and come into compliance with the new law.” The agencies continue to excuse closed blocks of business from the SBC [Summary of Benefits and Coverage] requirement, thus making it less likely that enrollees in closed blocks will find a better deal elsewhere. Finally, they extend their “anti-duplication” policy to student health plans, so that if, for example, the health plan insurer provides an SBC to a student, the school is excused from also having to provide it.
The patience of consumer groups is wearing thin as the agencies continue to accommodate insurer and employer complaints and demands rather than push ahead aggressively with a pro-consumer agenda.
But all the consumer groups are captured by the Democrats. So I assume it will take a long, long time for their patience to wear through completely. Read below the fold...
Submitted by DCblogger on Fri, 04/26/2013 - 4:56pm
Harry Reid is the worst, that absolute worst senate leader ever. He is oblivious to the mounting humanitarian crisis in our country. He has no sense of urgency, nor does he give any indication that he cares about anything except remaining in the senate, preferably as majority leader, but whatever.
Nevada has been one of the worst hit by the foreclosure crisis, but he won't life a finger to help his own constituents. He is horrible. Horrible, horrible, horrible.
You can't just blame Obama for everything, the entire Democratic party is one big FAIL. Read below the fold...
A committee aide told ZDNet on Thursday that Rockefeller believes the Senate will not take up CISPA. The White House has also said the President won't sign the House bill.
Staff and senators are understood to be "drafting separate bills" that will maintain the cybersecurity information sharing while preserving civil liberties and privacy rights.
And we were also told that the suspects threw IEDs. Did they? We were also told the suspects were wearing what appeared to be suicide vests. Were they? Alternet:
Now, almost a week after the Tsarnaev brothers fought a rolling street battle with dozens of heavily armed police officers, we learned Wednesday night that they had only a single handgun, according to sources who spoke with ABC News and the AP, something that directly contradicts what officials had previously said.
Set off in a public space a couple of crude, homemade bombs that you appear to have made using a recipe on the Web, and the state will make you Public Enemy Number One. To ensure you are caught and punished, there are virtually no lengths to which the authorities won’t go. They’ll assemble a multi-agency task force overnight, calling on some of the enormous investments in hardware, intelligence, and manpower that have been made since 9/11. They’ll haul in anybody who might be remotely connected to the crime scene, and, if necessary, shut down an entire city. Once you’re caught, they’ll interview you in your hospital bed without reading you your legal rights and then charge you with using W.M.D.s. If you weren’t born in this country, there will even be talk about changing the immigration laws.
If you systematically shoot a classroom full of defenseless six-year-olds and blow off your own head, things proceed rather differently. To be sure, you, or your memory, will be hated and vilified. But the political system, in hock to the N.R.A., will classify you as a nut whose deadly actions have few or no policy implications. (With the demise of the gun-control legislation, that’s what it did with Adam Lanza.) Life and politics will go on as normal. The President will probably visit the scene of your outrage and say consoling things to the families of your victims. He’ll mean what he says, but he won’t be able to do much about it, and nobody will ask why the F.B.I. or the C.I.A. didn’t realize you were such a menace to society and lock you up preëmptively. Crazed shooters, after all, are something we’ve grown used to.
Probably because there's money to be made selling fear, and there's no money to be made regulating guns. Read below the fold...
Ms. Tsarnaeva expressed some of her greatest anger when one questioner said Dzhokhar had told officials that the brothers were motivated by an extreme interpretation of Islam. She said Dzhokhar’s lawyers had assured her that he could not yet speak or write.*
“Where does this information come from?” she shouted.
Barry Grey in "American democracy in shambles" writes:
With the implementation of a state of military siege against the population of Boston last week, the American ruling class has crossed a historical, legal and political Rubicon.
The die is cast and the sun is setting on the democratic forms of rule that have existed in the United States for the past two centuries.
WASHINGTON -- Sen. Tom Harkin (D-Iowa) has put a hold on the nomination of Marilyn Tavenner to run the Centers for Medicare and Medicaid Services (CMS), vowing to block her appointment because of the Obama administration's planned use of specific funds related to the Affordable Care Act (ACA). ...
"The prevention fund works. Thanks to this funding, more children are being immunized, more people are quitting smoking, more communities are fighting chronic disease, more people are being screened for hepatitis C," Harkin told Health and Human Services (HHS) Secretary Kathleen Sebelius at a budget hearing Wednesday morning. "Robbing prevention when we know these efforts can improve people's health and lower healthcare costs goes against the very mission of health care reform."
Doesn't Harkin know the midterms are coming up? And that if ObamaCare moves from Manageable Clusterfuck to Outright Clusterfuck the Democrats might do as well as they did in 2010? Read below the fold...
