The Game’s Not Over, and It May Not Even Be The Real Game

Brian Klepper

Posted 6/29/12 on Medscape Connect’s Care and Cost Blog

ImageLike most health law watchers, I was surprised by yesterday’s decision. I’m sure that on this issue, as with everything else, zealous responses will rationalize the result and split the country down the middle.

I expected the Court to be purely partisan, but apparently Chief Justice John Roberts acknowledged the gravity of his role and saw his way clear to support the law with some constraints. Here’s the comment from SCOTUS (Supreme Court of the United States) Blog: 

Salvaging the idea that Congress did have the power to try to expand health care to virtually all Americans, the Supreme Court on Monday upheld the constitutionality of the crucial – and most controversial – feature of the Affordable Care Act. By a vote of 5-4, however, the Court did not sustain it as a command for Americans to buy insurance, but as a tax if they don’t. That is the way Chief Justice John G. Roberts, Jr., was willing to vote for it, and his view prevailed. The other Justices split 4-4, with four wanting to uphold it as a mandate, and four opposed to it in any form.

Continue reading “The Game’s Not Over, and It May Not Even Be The Real Game”

Day Three – The Wrap Up

Merrill Goozner

Posted 3/29/12 on Gooz News

This is what conservative justices will do if they strike down or cripple the health-care law … A court that gave us Bush v. Gore and Citizens United will prove conclusively that it sees no limits on its power, no need to defer to those elected to make our laws. A Supreme Court that is supposed to give us justice will instead deliver ideology. now  – E.J. Dionne, The Washington Post

The insurance mandate was effectively reduced to a bumper sticker by the opponents in their constitutional challenge, and the entire law reduced to little more than an appendage to the mandate. . . The fate of the mandate should not determine the survival of the other elements of the law — like prohibiting insurers from denying coverage to people with pre-existing conditions or charging them higher fees — which can operate without the mandate. – New York Times editorial

Overturning the whole law would be an act of judicial restraint. – The Wall Street Journal editorial

Continue reading “Day Three – The Wrap Up”

If the Supreme Court Overturns the Individual Mandate

Robert Laszewski

 Posted 3/28/12 on Health Policy and Marketplace Review

First, trying to predict how the Court will rule is at best just speculation. I know what Justice Kennedy said both today and yesterday and it certainly doesn’t look good for the Obama administration and upholding at least the mandate.

But I will remind everyone, based upon oral arguments, most Court watchers expected a ruling in favor of the biotech industry on a recent case involving health care patents. “Surprisingly,” the Court ruled against the industry.

Continue reading “If the Supreme Court Overturns the Individual Mandate”

Health Care and the Supreme Court: Prepare Your News Dial

Bradley Flansbaum

Posted 3/25/12 on The Hospitalist Leader

To get a sense of why this case is different and will dominate the news cycle now until the decision in June, appreciate this fact: the time allotted for arguments—the period in which plaintiffs and defendants present their views to the justices—is six, instead of the usual one.  Moreover, the proceedings will transpire not just in one day, but three.  This is substantial.

There are several issues under debate, but the most significant, and the one you have likely heard about, is the individual mandate.  This is the requirement in the Affordable Care Act that all individuals without insurance must purchase it.  The alternative is paying a penalty (but not a tax)–and this is important.  Nevertheless I will revisit that below.  For most people, the mandate is not applicable, as folks with Medicare or Medicaid, or receiving insurance from their employer meet the necessary waiver requirements.

Continue reading “Health Care and the Supreme Court: Prepare Your News Dial”

Defending the Affordable Care Act

Merrill Goozner

Posted 3/14/12 on Gooz News

What will they do? The Supreme Court (more or less) that gave us Bush v Gore in 2000 will later this month hear arguments by states challenging the Affordable Care Act, a.k.a. health care reform. The heart of the legal challenge raised by conservative state attorneys general is whether the individual mandate is constitutional. What happens if the Supremes say no? Does the entire law fall, or just the mandate?

The issue for lawyers is called “severability.” Did Congress when passing the law believe the mandate was necessary to the smooth functioning of the rest of the law? Clearly there are large swaths of the law for which the mandate is largely irrelevant: the physician payments sunshine act (disclosure of drug company payments to doctors); the creation of the Patient Centered Outcomes Research Institute to conduct comparative effectiveness research; the numerous payment pilot projects; and more.

Continue reading “Defending the Affordable Care Act”

2012: A Year of Huge Uncertainty in Health Care Policy

Robert Laszewski

Posted 1/10/12 on Health Policy and Marketplace Review

2013 may be the most significant year in health care policy ever.

But we have to get through 2012 first.

Once the 2012 election results are in there will be the very real opportunity to address a long list of health care issues.

If Republicans win, the top of the list will include “repealing and replacing” the Affordable Care Act. If Obama is reelected, but Republicans capture both houses of Congress, we can still expect a serious effort to change the law. Then there is the granddaddy of all problems, the federal debt. The 2012 elections could well prepare the way for entitlement reform—particularly for Medicare and Medicaid. Even if Obama is reelected, the 2013 agenda will include a serious debate about Republican ideas to change Medicare into a premium support system and block grant Medicaid to the states.

Health IT in 2012: a Dynamic Sector in the Context of a Fiscally-Challenged Health System

Jane Sarasohn-Kahn

Posted 12/20/11 on Health Populi

2012 will be a dynamic year for health information technology (health IT) in the U.S., which I outline in my annual health IT forecast in iHealthBeat, the online publication on technology and health care published by the California HealthCare Foundation. The full forecast can be found here.

The key headlines for you Reader’s Digest abridged fans are that:

  • The Health IT sector will continue to grow jobs in the ongoing Great Depression, particularly in key competencies in data security, analytics, integration, and EHR implementation.
  • There will be more data breaches, and consumers will be justifiably concerned about data security. Government will more consistently implement sharper “teeth” in their punishment of health organizations who leak personal health information.
  • Health IT suppliers will consolidate. The Microsoft-GE combination, announced in December 2011, is a sentinel event in this regard.
  • Health IT start-ups will continue to emerge in 2012, some of which will have sound business models that will be acquired by larger firms to round out their offerings and address, in particular, consumer/patient-facing applications that support health engagement to enhance health outcomes.
  • Connected health, in the form of telemedicine, mobile health, and remote health monitoring to the home will gain traction and business models as health payment moves toward accountable care, medical home, and paying for outcomes.
  • IBM’s Watson is an example of high-powered data analytics, which will get more practical and targeted in 2012. A ripe area for this will be preventing re-hospitalizations, a focus of health reform and Medicare financing.
  • People – patients and providers – live multi-channel, multi-platform lives every day. Thismodus vivendi is translating into health and health care. Patients want online connections with doctors for administration (e.g., Rx refills and appointments), clinical decision making, and communications (e.g., email with practices).

Continue reading “Health IT in 2012: a Dynamic Sector in the Context of a Fiscally-Challenged Health System”