Viewing posts from: March 2013

President Obama Won’t Balance Budget ‘Just for the Sake of Balance’

Posted March 26, 2013 by ABlume

In a recent interview with ABC News, President Obama rejected calls to balance the federal budget in the next ten years and instead argued that his primary economic concern was not balancing the budget, but rather growing the economy. “My goal is not to chase a balanced budget just for the sake of balance. My goal is how do we grow the economy, put people back to work, and if we do that we are going to be bringing in more revenue,” he said.

Obama rejected legislation proposed by Rep. Paul Ryan that aimed to balance the budget in ten years, saying the Republican House member’s plan “slashes deeply” at programs like Medicaid.

“We’re not gonna balance the budget in ten years because if you look at what Paul Ryan does to balance the budget, it means that you have to voucher-ize Medicare, you have to slash deeply into programs like Medicaid, you’ve essentially got to — either tax — middle class families a lot higher than you currently are, or you can’t lower rates the way he’s promised,” the president told me.

“So it’s really, you know, it’s a reprise of the same legislation that he’s put before.”

“If we controlled spending and we have a smart entitlement package, then potentially what you have is balance — but it is not balance to, on the backs of the poor, the elderly, students who need student loans, families that have disabled kids. That is not the right way to balance,” he said.

To view the full interview, click here.

President Obama: There Is No Debt Crisis

Posted March 20, 2013 by ABlume

By Jonathan Karl, ABC News

There has been no shortage of dire warnings about the mounting US national debt, but President Obama is now offering a different assessment: no big deal.

“We don’t have an immediate crisis in terms of debt,” President Obama said in an exclusive interview with George Stephanopoulos for “Good Morning America.” “In fact, for the next 10 years, it’s gonna be in a sustainable place.”

It’s an assessment that will throw cold water on the latest attempt to achieve a so-called grand bargain to reduce the deficit. After all, a grand bargain would require excruciatingly difficult decisions for both sides — for Republicans, it would mean raising taxes, and for Democrats, cutting future spending on cherished programs like Social Security and Medicare. If there is no crisis, why would either side do it?

So, what happens if this latest effort to reach a deficit agreement falls through? Once again, the president’s answer was, essentially, no big deal.

“Ultimately, it may be that the differences are just too wide” to get a deal, President Obama said. “That won’t create a crisis. It just means that we will have missed an opportunity.”

The president’s reasoning is that the series of 11th hour agreements he has struck with Republicans over the last two years — to prevent a government shutdown, raise the debt ceiling and avoid the fiscal cliff — have resulted in enough deficit reduction to get the debt under control.

“I think what’s important to recognize is that we’ve already cut $2.5- $2.7 trillion out of the deficit,” he told Stephanopoulos. “If the sequester stays in, you’ve got over $3.5 trillion of deficit reduction already.”

By that accounting, we have already achieved nearly all the $4 trillion the Bowles-Simpson debt commission called for back in 2010 — mission (almost) accomplished.

But there are two problems with that accounting:

First, the Congressional Budget Office projects a deficit of $845 billion — that’s lower than the $1 trillion-plus deficits we’ve seen over the past four years and, as a percentage of the total economy, half  the annual deficit of 2009. But, CBO also warns that the deficit is projected to continue rising once again after 2015, adding a total of $7 trillion to the national debt over the next 10 years.

Second, Erskine Bowles and Alan Simpson are now saying we are nowhere near accomplishing the amount of deficit reduction needed to put the government on sustainable path.

“They haven’t done any of the tough stuff, any of the important stuff,” Bowles told me last month. “They haven’t reformed the tax code…they haven’t done anything to slow the rate of health care,  to the rate of growth of the economy, they haven’t made Social Security sustainably solvent. There’s about $2.4 trillion more of hard work we’ve gotta do.”

Allan Simpson went further, calling the failure to control entitlement spending “madness.”

“Ten thousand [Americans] a day are turning 65,” Simpson told me. “This is madness. And life expectancy is 78.1, and in five years will be 80. Who is kidding who? This will eat a hole through America.”

Urgent or not, the president seemed downright pessimistic about bridging the difference between Democrats and Republicans on how to further reduce the deficit.

“I am prepared to do some tough stuff. Neither side’s gonna get 100 percent. That’s what the American people are lookin’ for. That’s what’s gonna be good for jobs. That’s what’s gonna be good for growth,” President Obama said. “But ultimately, it may be that the differences are just too wide. It may be that ideologically, if their position is, ‘We can’t do any revenue,’ or, ‘We can only do revenue if we gut Medicare or gut Social Security or gut Medicaid’ — if that’s the position, then we’re probably not gonna be able to get a deal.”

More bad news about racial disparities in healthcare

Posted March 14, 2013 by ABlume

By Karen Kaplan, LA Times

Many studies have documented the fact that patients of color are less likely to receive the same quality of medical care as whites, and that those differences often translate to worse health outcomes. The pattern holds up even after taking into account demographic factors such as income, education and health insurance status.

To figure out why this is, a group of researchers from Yale University’s School of Public Health and the Urban Institute focused on 133,821 patients who were treated for one of 10 surgical procedures at hospitals in New York City or the adjacent counties of Westchester (to the north) and Nassau (to the east) between 2001 and 2004.

The researchers picked New York City because of its diversity of ethnic groups and abundance of hospitals. They picked the 10 procedures – for breast cancercolorectal cancergastric cancer,lung cancer, pancreatic cancer, coronary artery bypass graft, angioplasty, abdominal aortic aneurysm repair, carotid endarterectomy and total hip replacement – because prior studies have shown that surgeons and hospitals who perform them more often produce better outcomes.

The study, published Monday in the journal Archives of Surgery, found that, “For all 10 procedures, white patients were more frequently treated by both high-volume hospitals and surgeons than were black, Asian and Hispanic patients.

”Averaging all procedures together, white patients benefited from both high-volume hospitals and high-volume surgeons in 37.6% of cases, compared to 20.6% of cases for black patients, 24.4% of cases for Asian patients, and 25.5% of cases for Latino patients, according to the study.

When the researchers took demographic and health variables into account, they found that blacks were less likely than whites to be treated by high-volume surgeons in high-volume hospitals in nine out of the 10 categories. The corresponding figure for Asians was five out of 10 categories, and for Latinos it was four out of 10, the study found.

The results showed a “persistent pattern” of racial disparities that “play out differently for different minority groups,” the authors wrote. But the study “does not support the common suggestion that health care disparities are driven primarily by differences in socioeconomic status,” they added. For instance, Asians were most likely to be either uninsured or on Medicaid, although they came from neighborhoods with higher socioeconomic status than blacks or Latinos.

Also, for half of the procedures, some racial groups got the same treatment as whites while others did not. That suggests that different factors may be at work for each minority group and each kind of health problem, they wrote. But the researchers weren’t able to pinpoint what those causes were. They did have some ideas, though.

Although New York City is a melting pot, it also anchors one of the five most segregated metropolitan areas in the country, according to U.S. census data. On top of that, only 9.5% of surgeons and 22% of hospitals in the study were classified as “high-volume,” and those hospitals may be clustered in neighborhoods populated by whites, they wrote. (To test this theory, it would be useful to see whether white and minority patients treated in a given hospital were equally likely to be treated by a high-volume surgeon.)

Another theory is that white patients are more likely to be referred to high-volume hospitals and surgeons  because they “have access to better-informed referral networks,” the researchers wrote. But New York state has tried to even the playing field by publishing “report cards” on hospitals and surgeons. Since the program began in 1991, more black patients have been going to higher-quality surgeons for coronary artery bypass grafts, though the levels are still lower than for whites.

Affordable Care Act – Applying Just As Painful As Filing Taxes

Posted March 12, 2013 by PHaynes

Applying for benefits under PPACA (the Patient Protection and Affordable Care Act) will prove as difficult and involved as filing your income taxes is.

The draft application has been made available for stakeholders to comment on.  It runs fifteen (15) pages for a three-person family. The online version has twenty-one (21) steps, some with added questions.

At least three (3) major federal agencies, including the IRS, will scrutinize your application.  And, that’s just the first part of the process—which lets you know if you qualify for financial help.  [What is still unclear is how they’ll check on what is or what is not offered by your Employer and what you may be asked to pay for that coverage].  The next step is—You have to pick a health plan!

Industry advocates and family aid agencies fear that consumers will be overwhelmed and will simply give up.  Early indications from Administration officials indicate that the application form is still being refined, which is welcome news.  But, anyone who thought the process would be as simple as making a purchase on Amazon.com can give that idea up.

Links:

Additional Links & Resources

Growth of Health Care Spending Remains at Historic Low

Posted March 12, 2013 by ABlume

By Kathleen Sebelius, Secretary of Health and Human Services

Today, we got some very good news when the official numbers for health care spending were released. New statistics from the Centers for Medicare & Medicaid Services show that the overall growth in health spending was at a historic low for the third year in a row. According to the annual Report of National Health Expenditures, total U.S. health spending grew 3.9 percent in 2011. That’s the same rate of growth as in 2009 and 2010, and in all three years spending grew more slowly than in any other year in the 51 year history of the report.

As a share of our nation’s Gross Domestic Product (GDP), overall health care spending also remained the same as in the previous two years—17.9 percent. This contrasts sharply with the pattern of the last thirty years, when health spending as a share of GDP grew by about 0.3 percent per year.

A number of provisions in the health care law that will help control costs and spending are still being implemented, but the statistics show how the Affordable Care Act is already making a difference. Growth in total private health insurance premiums remained low in 2011 at 3.8 percent. And the net cost ratio (which takes into account overhead and profits) for individual health polices declined thanks in part to the new 80/20 rule, which requires insurers to spend at least 80 percent of premiums on health care or provide rebates to their customers.

The health care law takes other steps to save money for consumers. One provision of the law, called rate review, prevents insurance companies in all states from raising rates with no accountability or transparency. These new standards ensure that insurance companies justify their actions if they want to raise rates by 10 percent or more. So far, rate review has helped to save Americans an estimated $1 billion on their premium bills.

But there is still more to do. I strongly urge the states, our partners, to continue the work to hold insurance companies accountable by reviewing and building the capacity to deny unreasonable health insurance rate increases. The Affordable Care Act made $250 million available to states for this important work, and 43 states, the District of Columbia and five territories have started to put this funding to good use. The next deadline to apply for these valuable resources is February 1, 2013, and I encourage states to take advantage of this opportunity so we can all work to save consumers money and bring more transparency, competition, and accountability to health insurance markets.

The Affordable Care Act helps us to avoid the runaway growth in health care spending of the last decade, keep down costs for consumers, and ensure better health and better access to health care for millions of Americans.

Growth Opportunities in China, New Labor Violation Penalties in Vietnam, and more…

Posted March 4, 2013 by ABlume

GLOBEX Update Health & Benefits

China Remains Source of Multinational Growth Opportunities

According to a recent report, China’s health-care sector is expected to rise at an extraordinary rate, from $357 billion in 2011 to a projected $1 trillion in 2020. The country continues to be an attractive and fast-growing marketplace offering lucrative opportunities for multinational companies. Although experts are optimistic about growth opportunities, competition among multinationals is expected to stiffen as companies position themselves in the market. Improvements in the country’s infrastructure, advancements in insurance coverage and developments in technology and innovation are some of the leading factors that continue to draw multinational corporations.

Vietnam Looks to Impost New Penalties for Labor Law Violations

Vietnam is considering introducing new penalties for companies violating Labor Law codes. These penalties could include increased fines for those found in non-compliance of, for example:

  • Sexual harassment
  • Post-maternity leave demotions or pay cuts
  • Excessive probation periods
  • Dismissal on the basis of marriage, pregnancy, or maternal leave
  • Violation of working hour laws
  • Cutting salaries of employees without prior notice or prior discussion with the trade union
  • Paying lower than the regulated overtime wages

Healthcare Costs Continue Double Digit Rise in Most Regions

According to a recent survey, all regions of the world with the exception of Europe experienced increases in health care costs of between 10.2% and 11% for both 2011 and 2012. Meanwhile in Europe, the average medical trend has steadily decreased over the last several years, from 9.9% in 2009 to 8.1% in 2012 due to social austerity and strong cost management measures. Costs in the UK and Russia continued to rise, however, with the UK trending at 10% and in Russia at 12% due to the difficulties of obtaining and managing credible data in that country. Other findings of the survey include an increase worldwide in the numbers of healthcare insurers, products and employer sponsored plans as well as a continued growth in wellness initiatives.