Sarah Kliff at Vox had a great article on the GOP’s new proposal to automatically enroll people without insurance into high-deductible health plans. Sens. Bill Cassidy (R-LA) and Susan Collins (R-ME) included the idea in their Obamacare replacement plan. The Senate Finance Committee also has a health care plan called the Patient CARE Act that envisions an auto enrollment feature to scoop up the people who don’t buy coverage themselves.

Republicans disagree with a mandate but can agree on automatically enrolling people into a health plan that they did not choose?

A short summary of how the plan would work:

Lawmakers could require insurers to offer products whose premiums match the value of the federal tax credits. If the basic, age-adjusted federal tax credit for a 40-year-old man in a given state is, say, $3,000, then every insurer in the state would have to make a policy available for such customers with a $3,000 premium.

Insurers would adjust the upfront deductibles in these plans as necessary to ensure that the premium equals the credit. Most consumers in the individual market would thus have the option to get an insurance plan with no cost to themselves. This no-premium coverage would necessarily have higher deductibles than costlier options, but it would provide financial protection against expensive medical claims, which is the primary purpose of insurance.

There are major problems with this proposal including that no system exists to track who is uninsured, and it would be tough to build it, and the health care plan would not cover anything.

 

 

Secretary Tom Price had a strange and somewhat incoherent interview with CNN’s Dr. Sanjay Gupta.

Here are the most insane moments of their interview:

#1 – Price refused to admit that it “defies common sense” to strip away $1 trillion from healthcare funding when Trump promised to get all Americans insured with the government’s help.

#2 – Price declared that Medicaid patients are only concerned about losing their Medicaid because they are afraid of something “new.”

#3 – Price struggled to defend efforts to gut the requirement for essential health benefits, which provide coverage for things like hospitalizations, maternity care and prescription drugs, offering such sweeping generalities that the only reply Dr. Gupta could offer was, “I don’t know what that means.”

#4 – Price could not refute Gupta’s assertion that TrumpCare would legalize healthcare “plans that are cheap but useless.”

#5 – Even though the TrumpCare plan he tried to push through Congress would put insurance out of reach for 24 million people and repeal the individual mandate, Price proved himself utterly divorced from realty by agreeing that “absolutely,” everyone should have insurance.

MassLive reported the case of certified nursing aide Parkpoom Seesangrit- guilty of rape for a May 2014 crime at the East Longmeadow Skilled Nursing Center.  Assistant District Attorney Lee Baker said Seesangrit digitally penetrated the 69-year-old victim’s vagina. She was on the dementia unit at the facility and Seesangrit was a certified nursing assistant.

 Seesangrit testified through a Thai interpreter he was changing a diaper for the victim and cleaning her, but did not digitally penetrate her. He acknowledged he told an East Longmeadow police sergeant he used two fingers to penetrate the woman.  Seesangrit said he never touched the woman sexually.

He said he was aware of the nursing facility’s policy that men could not render care to female patients but he chose to change the woman anyway.

Seesangrit admitted his guilt when questioned by an East Longmeadow police sergeant but then denied he did anything inappropriate.

He has been sentenced to up to eight years in prison.

 

The Conservative Review had an article by Logan Albright, a researcher for Conservative Review and Director of Research for Free the People, on the AARP’s multi-year investigation into the practices of America’s nursing homes. Below are excerpts:

In an alarming number of cases, elderly residents have been given powerful and dangerous drugs without their consent. In addition to the illegality and the moral transgressions against the residents’ autonomy, in some cases this practice has had deadly consequences.

Antipsychotic drugs are routinely used in nursing homes, often without good reason. According to research from the University of California, San Francisco, up to one in five patients in 15,500 nursing homes has been inappropriately prescribed a dangerous drug.

Patients are simply an inconvenience to staff, and keeping them drugged up makes them more manageable.  The pretense of “medical care” is used to give legitimacy to what would otherwise be a crime.

American society is now at a stage in which unproven allegations of mental incompetence can be used to rob our fellow human beings of their liberty and their dignity, with only the opinion of a so-called expert required to do so. And while the legal team of the AARP has won some commendable victories in exposing wrongful death and mistreatment of the elderly, these cases only scratch the surface of the deeper problem.

The elderly do not cease to be human. Their rights are not forfeited when they reach a certain age. That they should be so misused against their wills is a damning indictment of a system that ought not be possible in “the land of the free.”

 

A new study conducted by researchers at Brigham and Women’s Hospital, an affiliate of Harvard Medical School, has found that the number of medical malpractice claims paid by physicians have substantially decreased over the last two decades. The study, entitled “Rates and Characteristics of Paid Malpractice Claims Among U.S. Physicians by Specialty, 1992-2014,” is one of the first of its kind, as it analyzes and categorizes the data by medical specialty.

The study, published online by the American Medical Association’s medical journal, JAMA Internal Medicine, was conducted for the purpose of characterizing by specialty the trends in medical malpractice claims paid on behalf of United States physicians. The National Practitioner Data Bank, a centralized database of paid medical malpractice claims, was utilized by the researchers to gather data from 1992 to 2014. All dollar amounts were adjusted to 2014 dollars using the Consumer Price Index.

The researchers found that over the course of the twenty-two year time period, the overall rate of medical malpractice claims paid on behalf of all United States physicians decreased by 55.7 percent.

The research indicated that the most common allegations of malpractice were misdiagnosis (31.8 percent of all claims), errors related to surgical procedures (26.9 percent), and treatment-related mistakes (24.5 percent). Approximately 32 percent of all paid claims involved the death of a patient.

 

The Healthcare Finance News reported the settlement between Prestige Healthcare and the U.S. Department of Justice.  Based in Louisville, Kentucky, Prestige is an owner and operator of nursing homes in several states.  Prestige Healthcare has agreed to pay the federal government nearly $1 million to resolve allegations that it violated the False Claims Act in a scheme to falsely bill Medicare for unnecessary genetic testing, according to the U.S. Department of Justice.

Nursing home operators such as Prestige place orders with clinical laboratories for medically necessary diagnostic laboratory tests for their residents. In order to be considered medically necessary and thus reimbursable under Medicare, the laboratory test must be ordered by the physician treating the resident.

The allegations charge Prestige with failing to ensure that physician orders were obtained for the genetic testing prior to its being conducted, and that Prestige physicians were not aware of, and did not agree with, the medical necessity of the testing.

The United States alleged that in 2014 Prestige was approached by an entity known as Genomix, which claimed that it could perform genetic testing on Prestige’s Medicare residents in order to ascertain whether those patients were properly metabolizing their medications. The federal government alleged that in 2014 and 2015, Prestige provided Genomix with insurance and personal medical information, as well as access to patients in nursing homes in several states for purposes of conducting the testing. Genomix conducted the testing by taking cheek swabs of each Prestige patient and then sending the cheek swab to a laboratory for analysis.

Prestige failed to ensure that its patients were informed of the testing prior to its being conducted, and provided with the opportunity to decline the testing.

The DOJ said the lack of physician orders and patient consent was discovered during a survey conducted by state regulators in late 2015.

 

The Department of Health and Human Services told the New York Times it intended to continue making “cost-sharing reduction” payments, which compensate insurance companies that cover low-income customers in the exchanges established by Obamacare. Eliminating the payments would make premiums spike by about one-fifth, or cause insurers to get out altogether.  Already, the uncertainty is prompting some insurers to drop out for 2018. Some 7 million people, or 58%, of those who signed up for Obamacare coverage for 2017 qualify for these cost-sharing subsidies.

But President Donald Trump is threatening not to reimburse health insurers for covering low income people as a way of forcing the passage of Trumpcare.  In an interview with the Wall Street Journal, Trump said health care remained a top priority for him, but that he was still undecided about whether his administration would fund what are known as cost-sharing reduction payments, which reduce deductibles and co-payments for lower-income people.

The payments were the subject of a House lawsuit under House Speaker John Boehner, which argued the Obama administration did not have the authority to make the payments without congressional approval. The lawsuit is still ongoing.
Senate Minority Leader Chuck Schumer slammed Trump’s comments, saying, “This cynical strategy will fail. President Trump is threatening to hold hostage health care for millions of Americans, many of whom voted for him, to achieve a political goal of repeal that would take health care away from millions more,” the New York Democrat said in a statement.
South Carolina Republican Rep. Mark Sanford told the Post and Courier last month that White House budget chief and South Carolina native Mick Mulvaney, a former House Freedom Caucus member, delivered a message to him from Trump that Trump hoped Sanford voted against the health care bill so the President could support a primary challenger against him.
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Bobby Glenn Tweed was admitted to a nursing home in January 2013.  While diagnosed with dementia, Tweed, 78, was still a vigorous man. But without his family’s consent, Tweed was given dangerous psychotropic drugs that are known to be fatal among older patients with dementia. In 10 months, he was dead.

The AARP reported the that with the help of AARP Foundation lawyers, Tweed’s family settled a wrongful death lawsuit against the nursing home and others that were responsible for caring for their father. Terms of the settlement are confidential.

The dangerous overuse of psychotropic drugs in nursing facilities received widespread national attention from an AARP Bulletin investigative report in the July-August 2014 issue.

“After that story, we started hearing from people all over the country whose loved ones suffered because they had received these drugs often without consent,” said Kelly Bagby, senior attorney with AARP Foundation Litigation.

“These lawsuits are among the efforts of AARP Foundation to help address this nationwide health crisis,” Bagby said. “Unfortunately, what happened to Mr. Tweed has happened to countless others.”

The practice is done for the convenience of understaffed nursing homes where the care is inadequate, according to experts.

 

The Dallas News and WISHTV had articles on the malicious treatment of residents at Windsor Nursing and Rehabilitation Center of Duval.  A nursing-home employee recorded an elderly woman being made to rub feces on her face and shared the cruel video on social media. Footage shared on Snapchat shows someone tickling the woman’s nose as she sleeps, causing her to rub her face, KXAN-TV reports. Her hand appears to be smeared with feces. A second photo shows someone tickling the sleeping woman’s nose with a tissue or feather apparently prompting her to reach up and touch her own face with her dirty hand, which a third photo also shows.

Jasmyn Long, who saw the videos Monday, told KVUE-TV that she knew the man who posted them.  “I really can’t believe there are people out there that find that kind of stuff amusing,” Long said. Long said she responded to the man, who told her he wasn’t worried about losing his job.

A fiery online exchange shows someone offended by the pictures writing: “Imagine if that was your parents…”

The employee responded: “Who gone make me loose [sic] my job surely not you!” When KXAN went to the man’s home, his family said they had no comment.

Then a young man came back outside, responding to KXAN’s questions about the man’s whereabouts and if he would answer why the photos were posted.

“He’s sleeping. We don’t have time for that,” the man said.

The Texas Department of Aging and Disability Services said that the center had notified it of the incident.

 

 

 

 

CNN reported that Paul Ryan does not want to work with Democrats to repair the Affordable Care Act despite Trump’s attempt to blame Democrats for failing to work with the Republicans. White House press secretary Sean Spicer said President Donald Trump is “absolutely” willing to work with Democrats on a way forward on health care.

“If this Republican Congress allows the perfect to become the enemy of the good, I worry we’ll push the President to working with Democrats. He’s been suggesting that much.”
“What I worry about, Norah (O’Donnell), is if we don’t do this, then he’ll just go work with Democrats to try to change Obamacare — and that’s hardly a conservative thing,” he said.
House Speaker Paul Ryan says he has no interest in working with Democrats on getting health care legislation passed, disputing a suggestion by the White House to reach across the aisle and bypass conservative House Republicans.