Health Care

Bishops May Not Be the Crooks This Time

AP Images/Luca Zennaro
T amesha Means was only 18 weeks pregnant on the morning of December 1, 2010, when her water broke. In a haze of pain, she called a friend for a ride to the only hospital in her central Michigan county. She had no idea that the hospital, Mercy Health Partners, was part of a Catholic health system. She just knew she needed help. What happened next, contend the plaintiffs in a new lawsuit filed by the ACLU on Means’s behalf , was not just the fault of a doctor, emergency room staff, or even the hospital. The blame goes right to the top—to the U.S. Catholic bishops. According to the lawsuit, over the course of the next 36 hours, Means was never told that her fetus had little chance of surviving. Nor was she told—as she would have been in a secular hospital—that doctors could induce labor or terminate her pregnancy. Instead, Means was twice sent home with painkillers and told to return only if she was having contractions three to four minutes apart. Unaware of the risks of continuing the...

$2,229.11 for Three Stitches? Behold the Wonder of the Free Market.

Eight stitches? That'll be $4,000. (Flickr/Sarah Korf)
Twenty years ago I had my first knee surgery, after tearing some cartilage while skying for a thunderous dunk on the basketball court (or it might have been just falling backward while getting faked out on defense—who remembers the details?). Although I had insurance, I was responsible for a substantial copay, and I vividly recall the one item that stood out among the dozens on the bill. For the two steri-strips that covered an incision—tiny pieces of tape that even today cost about 20 cents retail, and which hospitals buy in bulk so surely cost them just a couple of pennies—I and my insurance company were charged $11, or $5.50 per strip. A miniscule amount in a five-figure bill, but it struck me as the most absurd, since it represented a markup of approximately 10,000 percent, if not more. More recently, I was getting some physical therapy for the same knee, and in what turned out to be a session that wasn't covered by my insurance, a therapist put a piece of kinesio tape around my...

Pot Shots Fired: Recreational vs. Medicinal in Washington State

AP Images/Elaine Thompson
A s Washington begins to accept applications for the state’s first regulated recreational pot shops, cries of protest about its plans for medical marijuana are coming from unexpected quarters: the left. A year after voters put their state on track to become one of the only places in the world where marijuana can be legally owned and sold for purely recreational use, the state legislature still has to decide what to do with its rickety, fifteen-year-old medical-marijuana system. With the Department of Justice’s hawkish eyes trained on the state—determined to ensure that the drug, which is still illegal under federal law—remains under strict control, some bureaucrats and lawmakers are afraid that Washington’s unregulated medical-marijuana system could doom the whole experiment. In October, a working group commissioned by the legislature recommended that lawmakers should fold regulation of medical marijuana into the new recreational system, with a tax break for patients but few other...

The Death Panels Are Coming

Now that Healthcare.gov seems to be working reasonably well (at least on the consumer end), Republicans are going to have to find something else they can focus on in their endless war against the Affordable Care Act. So get ready for the return of "death panels." They never really went away. Those who aren't immersed in the fantasy world in which conservatives move were reminded of that last week, when chronicler of changed games Mark Halperin, the embodiment of most everything that's wrong with contemporary political journalism, did an interview with the conservative news organization Newsmax . When the interviewer mentioned "death panels, which will be coming," Halperin responded, "I agree, it's going to be a huge issue, and that's something else about which the President was not fully forthcoming and straightforward." Halperin didn't explain what lie he imagines Obama told about death panels (perhaps he thinks that when Obama said the government wouldn't declare your grandmother...

The Media Need to Do More to Help People Navigate Obamacare

Thanks, Fox Business Channel!
Yesterday, Tim Noah made a point in an MSNBC appearance that I think deserves a lot more attention. Media outlets have been doing lots of reporting on the problems of the Affordable Care Act rollout. What they haven't done is provided their audiences with practical information that could help them navigate the new system. Of course, most Americans don't have to do anything, since they have employer-provided insurance. But for all the attention we've been paying to the individual market, media outlets haven't done much to be of service. " The New York Times has published the URL for the New York exchange exactly twice," Noah said, "both before October first." My experience in talking to journalists about the publication of this kind of thing—unsexy yet useful information, whether it's how to navigate a new health law or understanding where candidates stand on issues—is that they often think that addressing it once is enough. When you ask them about it, they'll say, "We did a piece on...

The Affordable Care Act v. Supreme Court, Round 2

AP Photo/Tony Gutierrez
AP Photo/Carolyn Kaster Y esterday, the Supreme Court agreed to hear two cases questioning the Affordable Care Act's contraception mandate: Conestoga Wood Specialties Corp. v. Sebelius and Sebelius v. Hobby Lobby Stores, Inc . These rulings could have potentially major implications for the rights of American women. Let's consider the issues at hand, one at a time: Does the contraceptive mandate violate religious freedom? The key question in both cases is whether the contraceptive mandate violates the Religious Freedom Restoration Act. This legislation requires any policy placing a "substantial burden" on religious Americans prove that said burden serves a compelling government interest. Both Conestoga Wood and Hobby Lobby contend that the Affordable Care Act's demand that they offer contraception coverage to their employees does not pass the Religious Freedom Restoriation Act's test. But, as the Prospect 's Amelia Thomson-DeVeaux asks , is the mandate actually violating the religious...

The Contraception-Mandate Cases Aren’t Really About Contraception

Ap Images/Tony Gutierrez
Earlier today, the Supreme Court announced that it would hear not one, but two challenges to the Obama administration’s contraception mandate; they’ll be heard together in an action-packed hour of oral arguments sometime in the spring. Both cases deal with conservatives’ ever-growing penchant for anthropomorphizing corporations—this time, the justices will decide whether companies can be exempted from the mandate to provide birth control at no cost to employees because of the owners’ religious beliefs. Oddly enough, neither of the business owners involved are Catholic, even though the first objections to the contraception mandate were raised by Catholic leaders, who didn’t want religiously affiliated hospitals and schools to provide birth control, which the Catholic hierarchy considers taboo. One case— Sebelius v. Hobby Lobby Stores , documented extensively for the Prospect by Sarah Posner earlier this summer —deals with an arts-and-crafts chain owned by evangelical Christians. The...

Are the Obamacare Clouds Breaking?

Flickr/Sean MacEntee
This morning, I was listening to NPR—because yeah, I'm an effete pointy-headed liberal and that's how I roll—and I heard a story about people in California who got insurance cancellation notices, but then wound up getting better coverage and couldn't be happier about it. And the other day there was this story in The Washington Post about droves of poor people in rural Kentucky getting insurance for the first time in their lives—free, through Medicaid—because of the Affordable Care Act. In other words, after spending weeks telling the tales of people losing their health coverage (who in truth could get other health coverage), the media are finally putting at least some attention on the people who are benefiting from the ACA. And encouraging news seems to be breaking out all over. Ezra Klein and Evan Soltas ask , "Is Obamacare Turning the Corner?", noting that Healthcare.gov seems to be working pretty well, at least on the front end. States with well-functioning web sites like New York...

No, the Failure of Obamacare Would Not Lead to Single-Payer

Flickr/Public Citizen
More than a few conservatives are of the opinion that should the Affordable Care Act fail to achieve its goals, it would make the adoption of single-payer health insurance in the United States more likely. The reasonable ones who believe this argue that their side hasn't done enough to come up with ideas to address the very real problems in the health-care system, so if the ACA doesn't work, they don't have much to offer in response. If the question is, "Well now what?" and their response is, "How about making it impossible for you to sue your doctor if he cuts off the wrong leg? And can I interest you in a health savings account?", the American public may well turn to the big-government solution instead. I've spoken to conservatives who think that scenario is a real possibility. Carnival barkers like Rush Limbaugh, on the other hand, are telling the rank and file that the rocky rollout of the ACA was all part of the secret plan: things would go wrong, and then the socialist in the...

Insurance Companies Got You Down? Stupid Obamacare!

White House photo by Pete Souza
It has been said many times over the last few years that now that Democrats successfully passed a comprehensive overhaul of American health insurance, they own the health-care system, for good or ill. Every problem anyone has with health care will be blamed on Barack Obama, whether his reform had anything to do with it or not. Your kid got strep throat? It's Obama's fault! Doctor left a sponge in your chest cavity? Stupid Obama! Grandma died after a long illness at the age of 97? Damn you, Obama! OK, so maybe it won't be quite as bad as that, but pretty close. Here's an instructive case in exactly how this plays out. Take a look at this article that ran in yesterday's Washington Post , telling how in order to keep premiums down and attract customers, some insurers are limiting their networks. "As Americans have begun shopping for health plans on the insurance exchanges," the article tells us, "they are discovering that insurers are restricting their choice of doctors and hospitals in...

Razing Arizona Women's Health Care

AP Images/The Fort Worth Star-Telegram/ Dave Kent
L ike Napoleon forging into the Russian winter, anti-choice politicians are loath to give up on abortion restrictions, however minor, until the Supreme Court forces them to. On Wednesday, Arizona Attorney General Tom Horne asked the Supreme Court to reinstate a law that would strip Medicaid funding from doctors and clinics who perform abortions. Poor women already can’t use federal dollars to cover abortion procedures—that’s been illegal since the late 1970s. The law, which was struck down by the Ninth Circuit Court of Appeals in August, instead would prevent the state’s abortion providers from being reimbursed by Medicaid for providing any kind of care to low-income women, whether it’s breast exams, cervical cancer screenings, or contraceptive services. The law’s supporters allege that public money is trickling into abortion providers’ pockets because they offer preventive care services, enabling them—however indirectly—to perform more procedures. If it hadn’t been overturned, the...

America, Where Even the Desperately Ill Say They're Healthy

More graphy goodness like this inside.
The Organisation for Economic Cooperation and Development has released their latest health indicators report , and while you may not find 200 pages of charts and graphs on cross-national health comparisons as fascinating as weirdos like me do, let me just point to a couple of interesting things. Most of the findings will be pretty familiar to people who have followed the health-care issue in the last few years, but there's at least one thing that surprised me, which I'll get to in a minute. First though, I have to point to this graph, which shows just what an outlier the United States is in terms of what we spend on health care and what we get. It shows the relationship between spending and life expectancy: OECD As you can see, there's a strong relationship between health spending and life expectancy—for everyone except us. Japan, for instance, has a life expectancy of 82.8, compared to our 78.7, despite the fact that they spend less than half as much per capita as we do. But here's...

No, Ladies—Birth Control Pills Won’t Make You Go Blind

AP Images/Jens Kalaene
Over the course of the past day or so, you may have seen some alarming news: Long-term use of birth control pills, according to a study released at the Annual Meeting of the American Academy of Ophthalmology , may be linked to glaucoma, one of the leading causes of blindness in the US. If you happen to be one of the more than 80 percent of women who has used oral contraceptives during her life, you’d be forgiven for feeling a little nervous. Long-term contraception is pretty much unavoidable for sexually active women who would rather not get pregnant. The researchers, undoubtedly aware that a link between birth control and blindness would make millions of women just a tad uneasy, were careful to emphasize that their findings are not conclusive. One of the lead authors told NPR that women shouldn't stop using birth control pills based on this study, adding that a lot more work needs to be done to find out if this apparent connection is real or just a coincidence. But most media reports...

How Both Republican and Democratic States Are Helping Obama

Last week, President Obama announced a "fix" to the problem of people in the individual health-insurance market getting cancellation notices from their insurance companies: he'd allow the insurers to offer those substandard plans for another year. Does he want the fix to work? We can't read his mind, but depending on how you define "work," it would be better for the Affordable Care Act's ultimate success if it didn't. As things have played out over the last few days, there are reasons that as a political problem this could fade. As you may know, insurance markets are governed by officials in each state. If a state's insurance commissioner doesn't want to allow the substandard plans to be sold, he or she can say no, no matter what the President might want. A few of those insurance commissioners—from Vermont, Rhode Island, and Washington state—have already said they won't allow it. So what you have here are heavily Democratic states not supporting Obama. But here's the key to the story...

How Republicans Lost the Chance to Win Obamacare

AP Photo/Dylan Lovan
AP Photo/The U.S. Centers for Medicare & Medicaid Services T he argument for the national government administering things over the states has always been summed up, I thought, by an old James Carville joke: I’ll race you from Disneyland to DisneyWorld. I get to take the federal roads. That joke, however, has been turned upside down by implementation of the Affordable Care Act (ACA). The whole sequence has been weird. After all, the law—as a concession to moderate Democrats who feared Republican attacks about a federal-government takeover—wound up asking the states, and not the federal government, to run the exchanges. But Republican-led states refused to do so. When the federal-run Healthcare.gov crashed, the odd result is that the current winners of the federalism battle—which is often waged, at least rhetorically, by Republicans dead set on keeping the feds out of their local government—are Democratic states such as California and New York where things are running reasonably...

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