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Inquirer Daily News

Archive: January, 2013

POSTED: Thursday, January 31, 2013, 6:00 AM
Filed Under: Erica Cohen
(iStockphoto)

How to define when life begins is a question that has plagued societies for centuries. Some view this question in light of religious beliefs whereas others approach it from a purely scientific perspective. Regardless of how the question is framed, it is apparent that varying opinions abound.

Many argue as a religious dictate that personhood begins at conception. Some scientists point out in response that many fertilized eggs never become babies. It is also difficult to determine exactly when conception occurred because sperm can survive in a woman’s body for several days, and it may take several more days for a fertilized egg to implant itself on the wall of the uterus.

In the face of religious and scientific debates, the law is called upon to respond. And its responses are not always consistent.

POSTED: Friday, January 25, 2013, 9:38 AM
Filed Under: Robert I. Field

Will they ever get over it? Congress passed Obamacare almost three years ago. More than 30 attempts at repeal have failed. The Supreme Court has upheld its central provisions. And the presidential candidate who promised to rescind it on day one lost the election.

Yet, Obamacare’s opponents won’t give up. And some of their statements are starting to verge on incoherence.

Two Republican senators introduced yet another bill to repeal part of the law this week. It would rescind the individual mandate, which requires that everyone maintain health insurance. That provision is central to the effective functioning of private markets for individual policies. Without it, people could game the system by waiting until they become ill before purchasing coverage, which would force companies to charge unaffordable rates.

POSTED: Wednesday, January 23, 2013, 6:00 AM
Filed Under: Erica Cohen

Everyone likes to complain about how much money doctors make. Many people hear the word “physician” and equate it with a mansion, BMW, and lavish vacation. But physicians don’t make nearly as much as you think.

After finishing high school, physicians spend a minimum of 11 years in training. Specialized physicians train even longer, sometimes for as long as 20 years. These are years spent making no money while in school, or making very little money during residency and fellowship. And by the time these individuals are “real” physicians, they are already in their mid-to-late thirties and have spent years struggling financially to support themselves and their families.

During the three to seven years of medical residency, physicians in training who abide by the maximum 80-hour-work-week mandated by the Joint Commission make approximately $11 an hour before taxes. Some residents impermissibly work over 100 hours a week, which makes their hourly wage even lower. Many residents travel to numerous different hospitals, cover the cost of their own gas, and even have to pay for parking at the hospitals where they work. Residents pay hundreds of dollars to attend conferences to improve their knowledge in their area of practice and thousands of dollars to study for and take licensing exams.

POSTED: Friday, January 18, 2013, 9:57 AM

Guest blogger Joanna S. Suder, JD, is an attorney working as the Pro Bono Coordinator at Delaware's Office of the Child Advocate. She represents dependent, abused and neglected children while also advancing statewide policy change.

Health insurance exchanges, a keystone of the Affordable Care Act (ACA), create markets through which small businesses and individuals can purchase insurance coverage. The December 14, 2012 deadline for states to decide on whether they will form their own exchanges or default to a federally run version has come and gone. The exchanges will officially begin enrollment in October 2013 for coverage that will begin in January 2014. While many states have been reluctant to commit to their own exchanges, others have been developing plans since the ACA was passed in March 2010.

Exchanges can operate in one of three ways: 1) states can run their own, 2) they can default to a federally facilitated exchange, or 3) they can operate an exchange in partnership with the federal government. Eighteen states and the District of Columbia plan to operate state-run exchanges, bearing the full burden of their development and operation. The majority of states, 25 of them, have defaulted to the federally facilitated exchange. Seven states have said they will operate partnership exchanges.

POSTED: Wednesday, January 16, 2013, 6:00 AM
Filed Under: Erica Cohen
A female patient in a hospital bed with an IV drip in the foreground. Selective focus on the IV drip. (iStockphoto)

“Do everything you can, doctor. Do anything it takes to save him.”

These are the unfortunate pleas that too many patients and their families make when dealing with terminal illness and end-of-life decisions. While the use of advance directives helps alleviate this problem by informing doctors in advance about a patient’s end-of-life wishes, there is still an underlying belief that medicine can cure everyone, even those people with the most terrible prognoses.

But doctors die differently than their patients. They often don’t want the fancy treatment, the life-prolonging chemotherapy, or the 2-hour-long cardiac resuscitation (CPR). They know the consequences, and they just say no.

POSTED: Monday, January 14, 2013, 9:49 AM
Filed Under: Robert I. Field

Should the wealthiest country in the world also be the healthiest? It seems logical that it should be, but, alas for us, that is not the case.

Americans enjoy more material wealth than any other major developed nation, but when it comes to health, we lag far behind. Our money can buy many things, but physical wellbeing is apparently not one of them.

The grim details emerged in a report published this week by the Institute of Medicine, a component of the National Academy of Sciences. Americans have shorter life expectancies, higher rates of disease, and higher rates of injuries than citizens of other high-income countries. American males have the shortest life expectancy of 17 nations studied, and females have the second to worst. (Click here for a summary of the Report.)

POSTED: Thursday, January 10, 2013, 2:23 PM
Filed Under: Erica Cohen

The rise in healthcare costs over the past several decades has been astounding. And as they continue to increase, the national deficit grows along with them. The high cost of healthcare impacts the national budget and economy in a variety of ways.

U.S. healthcare spending far exceeds that of any other developed nation. The U.S. now spends 17.6% of its gross domestic product on healthcare, whereas France spends only 11.6% and Australia only 9.1%. Total U.S. health expenditures neared $2.6 trillion in 2010, more than ten times the $256 billion spent in 1980.

Healthcare costs are rising more rapidly than wages. As of 2007, over 60% of individuals who filed for bankruptcy did so due to medical bills, a 50% increase over the percentage who filed for medical reasons in 2001. As many as 75% of those people had health insurance but could not afford medical bills due to gaps in coverage.

POSTED: Thursday, January 3, 2013, 9:00 AM

Guest blogger, J. Nicole Martin, J.D., is an associate attorney at the law firm of Stevens & Lee, P.C.  She focuses her practice on health care law.

Each new year ushers in changes, and recently these have included changes related to health reform. Beginning in 2013, under the Affordable Care Act (ACA) your Flexible Spending Account (FSA) will be limited to a maximum contribution of $2,500 per health plan year.

What does this mean? Those who are eligible through their employer to have an FSA will be limited to contributing up to $2,500, which is not subject to federal income or payroll taxes, for qualified medical expenses. The amount set aside may be spent on items such as medications, medical equipment, co-pays, glasses and contact lenses, and dental devices.

About this blog

The Field Clinic reports and analyzes health care laws, government policies, and political trends that are transforming the care we receive and the way we pay for it. Read more about our panel of bloggers here.

This blog is produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health-policy research and communication organization not affiliated with Kaiser Permanente. Portions of this blog may also be found on Inquirer.com and in the Inquirer's Sunday Health Section.

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Robert I. Field, Ph.D., J.D., M.P.H. Professor, School of Law & Drexel School of Public Health
Jeffrey Brenner, MD Founder of the Camden Coalition of Healthcare Providers, Medical Director of the Urban Health Institute at Cooper University Healthcare
Andy Carter President & CEO, The Hospital & Healthsystem Assoc. of Pa.
Robert B. Doherty Senior Vice President of Governmental Affairs & Public Policy American College of Physicians
Neil I. Goldfarb President & CEO of the Greater Philadelphia Business Coalition on Health
David Grande, MD, MPA Assistant Professor of Medicine at the University of Pennsylvania
Tine Hansen-Turton Chief Strategy Officer of Public Health Management Corporation
Drew A. Harris, DPM, MPH Director of Health Policy Program at the Jefferson School of Population Health
Antoinette Kraus Director of the Pennsylvania Health Access Network
Laval Miller-Wilson Executive Director of the Pennsylvania Health Law Project
David B. Nash, MD, MBA Founding Dean of the Jefferson School of Population Health
Howard J. Peterson, MHA Managing Partner of TRG Healthcare, a national healthcare consulting firm
Donald Schwarz, MD, MPH Deputy Mayor for Health & Opportunity and Health Commissioner for the City of Philadelphia
Paula L. Stillman, MD, MBA Healthcare consultant with special expertise in population health and disease management
Elizabeth A. W. Williams Senior Vice President & Chief Communications Officer for Independence Blue Cross
Krystyna Dereszowska A third-year law student concentrating in health at Drexel
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