Nevada Starts Obamacare Process

A blog from NPR writer PaulineBartolone had some interesting news for her readers.  The blog takes a close look at how a Republican governor from Nevada is implementing the new Federal Health Care law.  A helpful audio news link about Nevada and its health care push was also available in the blog.  The interesting thing about this is that Nevada was one of the first states to actually join a law suit against the Affordable Care Act.  So how is it that a Republican state like Nevada is offering no resistance?  A little strange, but apparently Nevada has become one of the first states to actually start the process of a health care exchange.  Nevada does have one of the highest rates of unemployed, and uninsured in the country, so this might have been a reason for the early jump, however according to the news link, the state government wanted to avoid federal intervention.  This probably was a good idea on Nevada’s behalf because other Republican states such as Alabama who resisted the new law are now scrambling to put together a plan of their own.

Although the state government of Nevada opposed the new health care plan, a good majority of people wanted it.  As noted in HealthCare.gov many of its citizens say that they feel that they deserve this and that even though the new plan isn’t in full effect yet, differences can be seen already.  The blog provides very interesting facts and points that can be very helpful for citizens who might not know the exact details yet.  This site is a must see for the citizens of Nevada since we now know that Obamacare will be a part of its future.

What is Reasonable and Necessary care?

In an article written by Peter J. Neumann, Sc.D., and James D. Chambers, Ph.D. titled Medicare's Enduring Struggle to Define "Reasonble and Necessary" Care both Drs. Neumann and Chambers say that, Medicare has always covered medical services that are “reasonable and necessary.” As new approaches, drugs and medical technologies have been released, you would think coverage would be based on an objective analysis of outcomes and cost effectiveness. Thats not exactly the case.

Not that Centers for Medicare and Medicaid Services or CMS haven’t tried to be reasonable about “reasonable and necessary.” According to the article, in 1989 CMS specifically proposed that the words “cost effective” could be used to assess new technology. That proved to be too controversial. It later tried “least costly alternative language” for coverage of durable medical equipment and Part B medications.  This too was dismantled by the courts when plaintiffs argued that the term “reasonable and necessary” could only be applied to medical services, not to the costs of those services.

So what does fall under "reasonable and necessary health care? Reasonable and necessary health care costs of each supported child not covered by insurance, including medical, pharmaceutical, vision, dental, orthodontic and mental health costs, shall be shared equally by the parents (unless a different allocation is set forth below), and each parent shall reimburse the other for his or her share of such expenses paid by the other.

Why Medicaid is important to you.

In my recents blogs I have talked about all the benefits of Medicare and Medicaid and why we need insurances like these, but few time has been spent on where all the money is coming from and how it is going to affect us in the future. Of course we know our tax dollars contributes to these insurance programs but what is going to happen when we start needing more and more money.

The Supreme Court affirmed the Afordable Care Act and Medicaid that followed with it. The ACA's intent is to give health care coverage to lower income American's.The problem that I feel the supreme court did was give states the option to opt out of the Medicaid expansion. With all that going on we will most likely see the republican states not continue with Medicaid. Their argument is that they wouldn't be able to afford it without having to raise taxes or make some cuts to higher education. Of course Liberal states will expand.

Regardless of what happens, here are a few reasons why Medicaid matters to every American. Always remember if you are a working American that funding for these programs comes from your paycheck. Medicaid is a growing entitlement program and is very expensive.  Like Medicare it contributes a large segment our a growing debt here in the United States.  We are facing a Fiscal Cliff because of runaway entitlement spending and leaders in Washington must act before the economy tanks.

Medicaid provides a critical safety net program to many older Americans and a significant amount of its spending goes to long term care.  Actually the bulk of the program goes to paying for long term care.  If you ever have had an older relative in a nursing home you will understand. Medicaid expansion being over-turned will have an impact on employers with low-income workers.  If these workers are not insured and now cannot receive coverage in Medicaid, this means they will qualify for a subsidy in a health insurance exchange. So, what these states need to remember is that without programs like Medicaid the businesses in their states might winde up paying more in the long run anyway.

Obamacare meant for white people?

I find it interesting that many people have comments and rude remarks to say about President Obama and his health care interests. I have a friend on Facebook who, like many people, wrote constant comments on Facebook about why Obama should not be re elected and how all he is doing is bad and how all the black and Mexican people only want to vote for him so they can continue getting their free handouts. I am particularly close with this girl and found it odd that she would be saying things like that because her sister is using the free insurance that Romney is trying to get rid of.

My friend who we will call Rose, is a white women in her early 20's who just goes with the flow of what is being said and not with the facts. The comments she brings up are not only racist but incorrect. In a survey by The US Census Bureau 46 percent of white people are uninsured. That is a pretty big chunk of white people. Why is it that when we think of Medicare and health insurance peoples first thought is to blame the blacks and the minorities?

In a recent article by The Associated Press there has been an increase in racial attitudes. The jump has since increased since 2008, which is also the year Obama was elected president. Maybe people just don't like the fact that we have a black president even if his ideas are their ideas and all he wants to do is help. When the Affordable Care Act is fully implemented, 12.3 million more white people will have health insurance than have it today. I think he is helping everyone no matter their color. If Romney would have been elected 24 million white people would have been without health insurance.

These are the issues that people like my friend aren't looking close enough at. The rash idea that our tax money is going to waste on blacks and minorities needs to change. If you mad about where our money is going to look at your families and close friends and ask yourself how are they getting their health insurance? How would they survive if they weren't getting some help? How can you support someone who is trying to take something away from you rather than supporting someone who is only trying to help? Of course now white people don't have to worry about losing their insurance, at least for another four years.

Is That Kid Healthy?

I couldn't help but read this blog today about kids and there health problems in todays world.  I was just expecting another boring blog on how kids are becoming obese and we need to stop feeding them fast food, but I was wrong. A Doctor who writes occasionally for the Health Care Blog, had some very intriguing things to say.  Im sure almost everyone had heard a parent complain about childhood obesity, and to be quite honest it can get a little boring after a while.  However Dr. Lawrence Rosen changes that by taking us through a little day in the life of her pediatric practice.  He gives us some interesting insight on how the health of children has dramatically changed over the past few years.  To the surprise of Dr. Rosen, he helped a child who come to his annual check up, and found that he was actually a perfectly healthy little boy.  Dr. Rosen was a little surprised by this because it had been the only child he had seen all week that was actually healthy.  Dr. Rosen is so used to helping children who are sick that this threw him off guard.  There are a few things that I found alarming in this blog that Dr. Rosen wrote. First that of all the kids he saw during the week only one was healthy, so what does that say about the current health situation with them.  Second, was that Dr. Rosen actually gets paid more by coding in to the insurance companies that the child was sick, and providing them certain care for what ever they were sick for.  Why are these insurance companies paying more to doctors for sick kids than healthy kids?

It's true, sick kids seem like they are popping up more frequently.  Pediatricians like Dr. Rosen are seeing this pattern of sick children more and more often.  So why is this?  It could be for many reason.  Children seem to have no immune system any more.  There bodies cant fight off the simple cold or flu that it used to.  We as a society have grown to listen to the media, and are so aware of all the germs and viruses there are out in the world that we need a defense system for everything.  We have pills that fight colds, pills that prevent colds, pills that prevent for everything.  We use hand sanitizer for every little thing, and we push this onto our kids.  So naturally when they go into an environment such as a school playground, they are bound to get sick from something.  Im not saying that the generation before didnt get sick, but I believe that because society was not aware of all the germs and viruses around us our immune system was more prone to fighting them back and was not caught by surprise like the immune systems of todays children.

So how is it that Doctors like Dr. Rosen gets paid more for a patient visit regardless if the child is healthy?  A doctors visit to a pediatrician isnt like seeing a specialist.  The doctor should get paid evenly across the board, regardless if the child was in for a check up, or if the child had a cold. Dr. Rosen said he wasn't complaining that he would get paid more because more children were sick, nor would most people who were in his shoes, but he did find it strange that insurance companies paid him more by entering a certain code basically stating that the child was sick.  This certainly does not say much about our insurance companies, but it makes one wonder that if all doctors are reporting that if in fact a child was truly ill, or if he was adding the sick code for the insurance companies just to get paid more.

Obamacare After the Election

So what can we expect now that we know the results of the presidential election when it comes to Obamacare?  We now know that President Obama has won a second term,  but many of us wonder what lies ahead?  A blog named Beyond Healthcare Reform had some very interesting facts on what to expect in regards to the next four years, and also after.  We know that with Romney losing, there will be no major overhaul in health care.  The Republicans left in power of course will still try to place a barrier, but they just might be fighting a loosing battle.  According to what the Beyond HealthCare Reform blog is stating, a backlog of proposed regulations implementing health reform by the Department of Health and Human Services is expected to be released.  Also states are required if they have not already to announce if they will implement health insurance exchange.  So needles to say that with the future of the presidency locked in for another guaranteed four years, the Department of Health, and many other departments, and local state governments are now scurrying to adjust for major health care changes. 


Another interesting blog provides some great information on how the states will proceed with the new Obamacare plan.  PharmExecBlog is stating that all states must report to the federal government what there state health exchanges will be.  This is a vital to the federal government because the states they are responsible for handing over services to 30 million new medicaid individuals.  This is not going to be an easy task, as there has already been outrage from some of the states, some even have vowed to refuse Obamacare at all cost.  Needless to say these upcoming weeks will be very interesting.

Whos going to take over the Senate?

The Afordable Care Act could depend on the number of senates in each state. In the article, "The Future of Health Reform May Turn on Senate Races", written by Maggie Mahar she expresses her concern following the presidential election. Mitt Romney alone could not overturn Obamacare.It would take the republican senate to overturn it and as of right now they are still in control of the senate. 51 republicans to the 47 democrats.

Maggie states that if the republicans take the senate, " the two chambers could pass legislation that would eliminate the premium subsidies designed to make health insurance affordable for middle-income and low-income families, bring an end to Medicaid expansion, and rescind the individual mandate that everyone buy insurance or pay a tax." This is not a good thing.

Maggie goes on to say that if Obama wins this election then the democrats will only need to pick up four more seats in the senate to take over control and Obama will be able to veto most attemps from the republicans to get rid of the health care reform anyway. Of course, if Romney wins then this could mean the end of Obamacare and a whole new type of health care programs. Although, Maggie does suggest a third option that could happen and that is if Romney wins but the democrats still find a way to take over the senate. This is an unlikely to happen, but is still an option. So now its up to you to decide which healthcare you want.