Saturday, February 27, 2010
A 21% cut in Medicare payments to physicians is scheduled to start on Monday. While the House has voted to postpone these cuts, the Senate may delay any action. The WSJ Health Blog reports that
[i]n response, the AMA is telling its members what they can do about the lower payments, including closing their doors to new Medicare patients, CNN reports. “To our physicians, we are providing information on their Medicare participation options, including how to remove themselves from the Medicare program,” AMA President James Rohack told the cable channel.
There’s nothing new about these cuts — they have been scheduled to go into effect regularly since 2003. Congress has blinked with a temporary reprieve each time in the past, but hasn’t done so yet this time with the cuts slated to begin Monday. Here’s why:
The House yesterday adopted a one-month delay in the cuts as part of a $10 billion employment bill with various other health provisions. “The legislation, which the Senate may take up next week, would give lawmakers more time to debate the fee cuts,” Bloomberg reported today.
But there could be a big hangup in getting that bill through the Senate in a hurry because Republican Sen. Jim Bunning of Kentucky wants to delay any swift action. That runs counter to what Senate leaders on both sides of the aisle had in mind, but senators can do that. Here’s how Politico describes the messy situation.
The AMA wants a permanent fix to banish the planned cuts in Medicare fees that they think are too low to begin with. There was an effort to include a long-term fix as part of the health overhaul, but we all know that hasn’t happen, at least not yet. So a temporary patch became part of the employment bill, but that hasn’t happened yet, either.
Tuesday, February 23, 2010
Approximately two dozen medical schools have recently opened, or are projected to open, across the country, the most at any time since the 1960s and ’70s. In comparision, only one new medical school was established during the 1980s and '90s. The New York Times explains:
The proliferation of new schools is ... a market response to a rare convergence of forces: a growing population; the aging of the health-conscious baby-boom generation; the impending retirement of, by some counts, as many as a third of current doctors; and the expectation that, the present political climate notwithstanding, changes in health care policy will eventually bring a tide of newly insured patients into the American health care system.
The Association of American Medical Colleges, a trade group, has called for a 30 percent increase in enrollment, or about 5,000 more doctors a year. The association’s Center for Workforce Studies estimates that 3,500 more M.D.s will enter graduate training over the next 10 years, roughly half of the 7,000 international medical school graduates now entering medical residencies in the United States every year, according to Edward Salsberg, director of the center.
If all the schools being proposed actually opened, they would amount to an 18 percent increase in the 131 medical schools across the country. (By comparison, there are 200 law schools approved by the American Bar Association.) And beyond the new schools, many existing schools are expanding enrollment, sometimes through branch campuses. While The Commonwealth is an independent school, many of the other new or proposed schools are affiliated with established universities, like Hofstra, which is teaming up with North Shore Long Island Jewish Medical Center; Quinnipiac University in Hamden, Conn.; the University of California, Riverside; Central Michigan University; and Rowan University in Camden, N.J.
Supporters of the expansion say that having more doctors will improve care, by getting doctors to urban and rural areas where they are needed, by shifting care to primary and family practice physicians rather than expensive specialists, and by reducing long waits for people to see a doctor and get the care they need. But skeptics say that although many parts of the country do need more primary care, American doctors tend to congregate in affluent, urban and suburban areas that already have a generous supply.They say that doctors create demand for their own services, and that nurse practitioners and physician assistants could fill gaps in medical care at a lower cost.
The following job announcements in the agricultural sector were posted on the US Agriculture & Food Law and Policy Blog:
USDA GIPSA: there are three vacancies for attorney positions with US Department of Agriculture's Grain Inspection, Packers & Stockyards Administration. The announcements close on March 8, 2010. Applicants must be admitted to the bar of a state, a U.S. Territory, or the District of Columbia. The vacancies are in three different locations, so separate applications must be submitted for each location the applicant in which the applicant is interested in applying for. The locations and links are: Aurora/Denver, CO-click here or here.; Atlanta, GA-click here or here.; and Des Moines, IA-click here or here.
Monday, February 22, 2010
This just out from the NYT:
President Obama on Monday laid out for the first time a detailed legislative proposal for overhauling health care, largely sticking with the approach passed by the Senate with unified Democratic support in December but making concessions to the House version as well.
Mr. Obama's proposal is the opening act to a week of high drama around health care that will culminate on Thursday, when the president convenes Democrats and Republicans at an all-day televised health care "summit" at Blair House. The White House is hoping the session can jump start the stalled health bill.
Seton Hall University School of Law’s Leuven-Geneva Program in Health, Intellectual Property and International Law combines a broad-based introduction to the laws, policies and institutions of the European Union (EU) with a unique, interdisciplinary examination of cutting-edge issues in intellectual property, pharmaceutical development and global public health. The Program will consist of two courses. European Union Law, a two-credit course,will be taught mainly at the Leuven Institute in Leuven, Belgium and will include a special trip to Luxembourg to visit the European Court of Justice. Students will also visit some of the main EU institutions in Brussels, such as the European Parliament and Commission.The goal of this part of the Program is to introduce students to the essential principles and institutions of the EU and to explore firsthand the challenges facing this unique confederation of different languages and cultures. For the Geneva component of the Program, students will study Health and Intellectual Property Law in a Global Environment, a four-credit course, co-taught by one intellectual property law professor and one health law professor. The course will be conducted in collaboration with Geneva-based international organizations involved in health and intellectual property law issues, including theWorld Health Organization, UNAIDS, theWorldTrade Organization and the World Intellectual Property Organization. Students will work on a series of case studies related to the work of these organizations, both in the classroom and in on-site meetings with organizational representatives. In addition to students from the Seton Hall Program, the Geneva component of the Program will also be open to students from the University of Zurich Ph.D. program in Biomedical Ethics and Law.
More information about the program is available here: http://law.shu.edu/Students/academics/studyabroad/Geneva/index.cfm
An article published this week by Health Affairs finds that the causes of Medicare spending growth have changed dramatically over the past two decades.
Twenty years ago, most of the increases were due to inpatient hospital services, especially for heart disease, but recent annual increases are the result of outpatient treatment of chronic conditions such as diabetes, arthritis, hypertension, and kidney disease, say Kenneth Thorpe of the Rollins School of Public Health at Emory University and coauthors.
This study analyzed data about disease prevalence and about level of and change in spending on the ten most expensive conditions in the Medicare population from 1987, 1997, and 2006. The data were drawn from the 1987 National Medical Expenditure Survey (NMES), and the 1997 and 2006 Medical Expenditure Panel Survey (MEPS). Among the key findings: heart disease ranked first in terms of share of growth from 1987 to 1997. However, from 1997 to 2006, heart disease fell to tenth, while other medical conditions -- diabetes the most prevalent -- accounted for a significant portion of the rise. Furthermore, the authors postulate that increased spending on diabetes and some other conditions results from rising incidence of these diseases, not increased screening and diagnoses.
Sunday, February 21, 2010
Janene R. Finley (Augustana College, Department of Accounting) & Amanda M. Grossman (Murray State University, Department of Accounting) have published Equity in Reforming the Tax Treatment of Health Insurance Premiums, 34 Seton Hall Legis. J. 1 (2009). Hat tip to Paul Caron at Tax Prof Blog who provides this part of the Introduction:
This Article evaluates the inequities in current and proposed tax treatments of health insurance premiums, and proposes a potential solution to eliminate such inequities. Part II of this Article discusses the historical tax treatment of health insurance premiums. Part III describes the current tax treatment and analyzes its advantages and disadvantages. In Part IV, different proposed changes in the tax treatment of health insurance premiums are discussed, as well as the advantages and disadvantages of those proposals. Part V illustrates how the proposals fail to account for the inequity between single and family plans and sets forth a legislative alternative that rectifies this inequity. This alternative solution is a tax cap equivalent to the amount of the premiums paid for a single health insurance plan for employees, with the excess included in taxable income. Single individuals that pay for their own policies, including self-employed individuals, would be allowed to deduct from gross income the amount paid for a single health insurance plan or an equivalent amount if a family plan is purchased. Married individuals filing a joint return would be able to deduct an amount up to the value of two single plans. Finally, Part VI describes the proposed solution in terms of both equitable tax treatment and social policy.