Tuesday, February 10, 2015

ACA/ACOs and MEASELS.





Health care is a subject that I thought that I had some knowledge but it seems that the politicians know much more. Pontificant Senator Schumer has decided that the government should make measles vaccination free. 

That suggestion was prompted by the recent outbreak which has resulted from parents refusing to have their children vaccinated.

The logic should also include mumps, whooping cough, meningitis, diphtheria, small pox, varicella (chicken pox),Hepatitis B, influenza, polio, pneumonia, rotavirus, papillomavirus, tetanus, and the latest Hepatitis A. All are recommended by CDC for immunization of children up to age 18.



For adults the CDC has schedules for various age groups including “Zoster” (“Shingles”) for adults over 60 who had had chickenpox as a youngster.

As government moves into compulsory universal health care; as the provider for this type of preventative medicine may be an actuality.
Meanwhile we have to deal with the ACA and the fact that Sunday Feb. 15 is the deadline to obtain mandatory insurance through the exchanges. 

There will be help at City Hall on Thursday after 3pm for those who do not understand their choices.

The impact of Obama care is being felt outside of health care; there are more and new forms to fill out in submitting your federal income tax report for outside of health care; there are more and new forms to fill out in submitting your federal income tax report for 2014. The mandatory fines for not having insurance is supposed to be imposed on the 2014 returns.

The subsidy based on income and family size is supposed to be calculated and deducted from the tax. There is a joker that can result in no subsidy; the law as written specifically applies to those exchanges that are State operated. New Jerseyians may not receive any rebate depending on the Supreme Court decision this spring, since the exchange in his state is federally sponsored.

Yes, Obama care has been successful in that the numbers enrolled especially in the Medicaid eligible population has greatly increased. The result has been that facilities and providers have been overtaxed and many refuse to take new patients. Also payments are often only 25% of standard fees and more than 50% of the Medicare schedule.

There is not space  in this blog to discuss the changes in quality in the delivery of provider services.

Another unpublicized insurance change besides increased premiums, is changes in benefits and/or increased co-pays in various policies. One should review closely any renewal policy to be sure that you are getting the same coverage. Of course that advice goes for all types of insurance.

The newest wrinkle of the ACA is the appearance of “ACOs”. Affordable Care Organizations are supposed to be voluntary groups of health care providers and institutions to consolidate information and adjust services all with reduced costs.

The ACOs may be a medication of the HMOs but they seem to be a magnet for Hospitals to form. Could he hospital interests not be the patient’s health but to secure a captive population?

A potential danger of the ACOs is the opening of many more portals for personal information with the greater danger of a breach. 



  

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