Tag Archives: Health Care

Election Surprise: Health Care Galvanizes Voters

A voter casts his ballot at Hillsboro Old Stone School on November 7, 2017 in Purcellivlle, Va. (Katherine Frey/The Washington Post via Getty Images)

Health care appears to have played an unexpectedly robust role in Tuesday’s off-year elections, as Democrats swept statewide races in Virginia and New Jersey and voters told pollsters it was a top concern.

The health headline of the night came in Maine, where voters by a large margin rebuked Republican Gov. Paul LePage and approved a referendum  expanding Medicaid under the Affordable Care Act. Maine is one of 19 states that has not expanded the program to people with incomes up to 138 percent of the federal poverty line, or about $16,600 for an individual. An estimated 70,000 to 90,000 Mainers could gain insurance under the expansion.

The Legislature has passed similar bills five times, but LePage vetoed each one. And despite Tuesday’s outcome, he held firm in his opposition. The governor announced Wednesday that he would not implement the expansion, which he said would be “ruinous” for the state’s budget, unless it is fully funded by the Legislature.

Medicaid expansion might also be back in play in Virginia. Voters there not only elevated Democratic Lt. Gov. Ralph Northam to the governorship, they may have steered Democrats to a takeover of the state House of Delegates, which has been the primary source of opposition to Gov. Terry McAuliffe’s efforts to expand Medicaid. As of Wednesday morning, Democrats had picked up 15 of the 17 seats they would need to take over the majority with several races too close to call or requiring a recount.

And while it was not a headline issue in the governor’s race, health care proved decisive to Virginia voters, according to exit polls funded by a pool of media organizations.

Health care was by far the top issue for voters, according to the poll, which asked voters which of five issues mattered most to them. Nearly 4 in 10 said health care was the issue most important to their vote, followed by gun policy at 17 percent, taxes at 15 percent, immigration at 12 percent and abortion at 8 percent. Among those voters who cited health care, 77 percent voted for Democrat Northam, making it his strongest issue by a wide margin.

The fallout will depend on who holds which views, said Rodney Whitlock, a former GOP Senate staffer. If health care is a top concern for Democrats, “that doesn’t have a lot of meaning for Republicans,” he said. But if independents are the ones who see health as a salient voting issue, “that means much more.”

But Robert Blendon, a professor of health policy and political analysis at Harvard University, said the election results suggest that health care has again become a positive for Democrats. “You don’t have to say you love the ACA, but that you don’t want to drop millions of people” from coverage, he explained.

In New Jersey, voters said they were more concerned with state issues, with property taxes and corruption topping the list of topics they told exit pollsters drove their votes. But health care was third.

Still, the election results likely hinged on a host of concerns, warned Drew Altman, president and CEO of the Kaiser Family Foundation. Health issues are still strongly viewed through partisan lenses, he said, and the voting probably was more of a referendum on President Donald Trump than on health care. But the results in the Maine referendum could have repercussions beyond that state, showing that Medicaid expansion is “far more popular” than Republicans have acknowledged. (Kaiser Health News is an editorially independent program of the Kaiser Family Foundation.)

In Ohio, voters defeated what some called a confusing ballot measure aimed at limiting prescription drug prices to no more than the amount paid by the Department of Veterans Affairs. A similar measure was voted down in California last year.

Trump shocked — shocked! — by health care complexity

From The Week:

President Trump admitted he was floored by how “complicated” the health care system is when speaking Monday at the National Governor’s Association meeting at the White House. “It’s an unbelievably complex subject,” Trump said, while outlining the plans his administration has come up with to repeal and replace ObamaCare. “Nobody knew that health care could be so complicated.”

Trump explained that his team has come up with a solution that gives states “the flexibility they need to make the end result really, really good for them.” But “statutorily” and because they “have to know what the health care is going to cost,” Trump explained, health care has to get sorted out before he can go ahead with his tax cut plan — though he promised that will be “major, it’s going to be simple, and the whole tax plan is wonderful.” “It’s actually, tax cutting has never been that easy, but it’s a tiny little ant compared to what we’re talking about with ObamaCare,” Trump said, deeming the Affordable Care Act a “failed disaster” that’s “no longer affordable.”

Who could have guessed that a $3.2 trillion expenditure that makes up over 17% of GDP could be so complicated? I mean, who’da thunk?

Obamacare allows people to buy health insurance. But many then can’t afford to use it.

Another sign that we need single-payer health care:

More than a quarter of adults who bought health insurance on exchanges created under Obamacare skipped important doctor visits and medical tests because they could not afford to pay, a study published Thursday by Families USA found. Among low- and middle-income adults, the proportion of people who avoided care was even higher, at nearly one-third.

More than 14 million people in the United States gained health insurance through Obamacare, landmark legislation officially known as the Affordable Care Act that was passed in 2010. Nearly 12 million people signed up for health coverage plans on exchanges created under Obamacare, according to the website ACAsignups.net.

But more than half of the adults who bought such plans had deductibles of $1,500 or more, Families USA, a Washington nonprofit organization focused on health care, found. A deductible is the cumulative amount a person has to spend on health care before his or her insurance company starts to pay. Despite receiving tax credits to help offset the cost of coverage, these deductibles were prohibitively expensive.

“Simply having health insurance is no guarantee that consumers can afford to pay for health care,” the report noted. When people decided to forgo medical care, fees that would have to be paid out-of-pocket were a major contributing factor, the report, which surveyed adults with lower- and middle-income levels, found. The report did not include people who had health insurance through Medicaid or those who had health insurance through their employers.

Overall, the Affordable Care Act made health insurance and health care itself more affordable, in part by subsidizing the cost through tax credits to those who qualify. But for some Americans, it was not affordable enough, the report showed. Of adults who were insured for a full year, 25.2 percent did not get necessary medical care, including tests, treatments and medications. Of lower- to middle-income adults, 32.3 percent reported not getting care they needed.

It’s all well and good that people can actually sign up for health insurance they would not otherwise have. But it’s kind of pointless if those people have deductibles so high they don’t even go to the doctor.

If you think you don’t have to care, you should. One of the main points of the fight over Obamacare was to get as many people as possible onto health insurance of some sort so that the taxpayers don’t keep footing the bill for uninsured people who get sick or have accidents. It was also to get people going to the doctor so that potentially serious problems might be caught before a minor problem turns into a more serious (and more expensive) ailment.

We will eventually need single-payer health care. If our leaders can get over the health care gridlock that almost consumed Obamacare, and manage to get the health establishment on-board. That might be a tough job. One of the chief reasons health care costs are out of control is not so much waste by each consumer — although that plays a part — as much as it is the simple fact that there is a lot of money to be made on health care and a lot of vested interests don’t want to see that gravy train disappear.

Via: Is Obamacare Working? Quarter Of Americans Who Bought Health Insurance On Exchanges Couldn’t Afford Medical Care (International Business Times)

Via: What is Single Payer? (Physicians For A National Health Program)

How far can you be into heart failure and still be walking around? About 90%.

At least that’s how far I was into heart failure when I walked under my own power into the emergency room at Advocate Illinois Masonic Medical Center (MMC) on October 13.

When I last posted I informed all of you that I had a terrible bout of pneumonia. And I thought that was it. Except it didn’t get better with meds. It got worse. Much worse.

So much so that I went back to Howard Brown, my primary care health center in Chicago. I’m still not quite sure why, but a doctor there thought I should have an EKG.

After the first one the EKG tech and the doctor exchanged concerned looks and she said to run it again. Apparently it was just as worrisome the second time around because they told me I needed to go to the emergency room at MMC.

I rejected the idea of an ambulance — remember all I thought I had was an intractable case of pneumonia — and hopped into a taxi and asked the driver to take me to the emergency room at MMC.

Cardiac Catheterization Lab
Cardiac Catheterization Lab

The taxi driver, being nice, said he hoped nobody I knew was too terribly sick, to which I said, “It’s not somebody else. It’s me,” after which he quickly asked me in a roundabout way whether I was going to drop dead in his taxi. Admittedly that would be a bummer.

I said no, that I felt fine, and then he took me to the wrong hospital.

We finally made it to MMC where I was checked in for tests, which led to an echocardiogram, which led to three cardiologists standing at the foot of the bed in the ER looking incredulous that I made it to the hospital under my own power and that I was still even conscious.

My heart was pumping at 10% capacity. Put the opposite way, 90% of my heart was not working properly.

A few days later and I was discharged last night.

Some mysteries remain, the first one being how I was still walking around. My docs finally decided it was because my underlying state of health was so good, my body was efficient enough to still make me mobile with only 10% cardiovascular capacity. If I were an obese smoker who never exercised, things would have been much worse. And it would have gotten much worse had someone at Howard Brown not had the idea to give me an EKG.

The other mystery is why my heart was giving out. We will never know the exact answer. But my cardiologists have conjectured:

I have had a heart valve murmur since birth. That might have been the likely beginning of this, along with the fact that the virus that gave me pneumonia also attacked my heart and made a chronic condition gravely acute.

Whatever it was, they think it happened fairly recently — within the last two weeks — since the chances that I would have walked around or even survived for long with only 10% heart pumping capacity are not good.

Whatever the reasons, I feel lucky to have had friends who came to visit me. You are the best.

What now? I’m taking nine new medications. If I take these as I should and watch my diet, this will likely be enough to repair most or all of the damage to my heart. I was lucky to have been within taxi distance of a Level One Cardiac Trauma Center with a staff of top cardiology doctors and nurses. I cannot say enough good things about this hospital.

My personal training days are over for a bit, but I can live with that.

Back to regular blogging this afternoon.

Advocate Illinois Masonic Medical Center