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GOP: Repeal defeat is step toward victory in 2012

by Administrator at Feb 03, 11:14 am

GOP: Repeal defeat is step toward victory in 2012


By LAURIE KELLMAN | Published: 4:09 AM 02/03/2011 | Updated: 3:18 PM 02/03/2011

   
WASHINGTON (AP) — To hear Senate Republicans tell it, the defeat of their attempt to repeal the Democrats’ health care overhaul was really a victory of sorts on the long march to the 2012 congressional and presidential elections.

The repeal effort sank Wednesday along party lines, 51-47, as expected. But in the process, Republicans forced Democrats on the record in favor of President Barack Obama’s signature overhaul and launched what they described as a two-year effort to discredit it in the lead-up to a bid for a second term.

“These are the first steps in a long road that will culminate in 2012, whereby we will expose the flaws and the weaknesses in this legislation,” said Texas Sen. John Cornyn, the party’s campaign chief.

“We think this is just the beginning,” said Republican leader Mitch McConnell. “This issue is still ahead of us.”

What’s certain is that Wednesday’s vote changed nothing about the debate that consumed Congress for two years, dominated the midterm elections and has now moved to the courts.

Two federal judges have ruled the law is unconstitutional, partially or in its entirety, citing a requirement for individuals to purchase coverage and pay a penalty in taxes if they fail to do so. Two other judges have upheld the law.

The controversy is all but certain to be settled by the Supreme Court. Sen. Bill Nelson, D-Fla., announced he would file legislation urging the justices to act quickly.

In spite of the maneuvering and the side-taking, senators overwhelmingly voted to cancel the law’s requirement that businesses, charities and state and local governments file income tax forms for every vendor that sells them more than $600 in goods. That repeal was approved 81-17 after Republicans pointed out it had originally been their idea. Obama said he would accept the change.

Acutely aware that they’ll be defending 23 seats in the next election, Democrats sought to shrug off the GOP’s efforts. Senate Majority Leader Harry Reid, who said earlier in the week he hoped the vote would help Republicans get it out of their systems, called on them to “set aside the battles of the past.”

But even as Reid dismissed the repeal effort, he used stark terms to describe how canceling the overhaul would affect millions of Americans. It would, Reid warned, “kick kids off their parents’ health care” and “take away seniors’ rights to a free wellness check.”

The maneuvering reflected the depth of the controversy that still surrounds one of the most ambitious policy overhauls in recent years.

At its core, the law requires most Americans to purchase insurance, a so-called individual mandate that has become one of the principal points of opposition among Republicans and the tea party activists who propelled them to gains last fall.

The bill’s critics argue the law gave government too large a role in the health care system, will harm Medicare and burden the economy by raising taxes and fees.

At the heart of the debate is a dispute over how the overhaul would affect the federal deficit.

The Congressional Budget Office reported that the law, once it takes effect, would cut federal budget deficits. But Republicans dispute that, arguing that the forecasts rest on spending cuts to Medicare and other programs that will not materialize.

Democrats tried to argue that the policy debate is largely over.

Sen. Barbara Mikulski, D-Md., called the Republican repeal effort “one more hollow, symbolic, pander-to-the-masses amendment.”

“I want to hear their ideas for replacement,” she said.

Republicans made clear they have plenty of ideas for replacement — of Democratic senators, if not the health care reform.

“Yes, we were unsuccessful today, but we do know where everybody stands,” said Sen. Orrin Hatch, R-Utah.

“We’ve made some headway,” said Sen. John Thune of South Dakota.

Read more: http://dailycaller.com/2011/02/03/gop-repeal-defeat-is-step-toward-victory-in-2012/#ixzz1CudljjgQ


The Failed Promises of Government Funded Health Care

by Administrator at Feb 03, 11:02 am

By Frank S. Rosenbloom, M.D.

The health care debate in this country is an old story. It began in 1934 when President Franklin D. Roosevelt attempted to include government-funded health care in his "New Deal" as part of his comprehensive Social Security legislation.  President Roosevelt was very concerned that the Supreme Court might rule parts of his "New Deal" unconstitutional.  He tried to induce Congress to approve increasing the total number of justices on the Supreme Court to fifteen, attempting thereby to circumvent the judiciary and the Constitution by stacking the Court in his favor. 


Subsequently, government funded health care has been debated in nearly every session of Congress since 1939.


Many people assume that the establishment of Medicare in 1965 was the result solely of Lyndon Johnson's Great Society legislation.  In fact, the establishment of Medicare was the culmination of decades of efforts by progressive liberals, and was seen as a stepping stone to government funded health care for all.  In fact, some of the tactics the government used to pass Medicare were illegal at the time, employing taxpayer money to lobby for political programs.

 

Today President Obama theorizes that a government "option" will increase competition, lower costs, and provide better medical care for larger numbers of people.  In any scientific endeavor the veracity of a theory is determined by whether it is supported by empirical evidence and predictive of future outcomes.  Therefore, we must examine Obama's assertions in light of the available evidence.

 

  • 1. A government health care option will increase competition.
In order to determine whether this is the case, we must review whether government involvement has ever increased competition in the past.  We must remember that the force of law attends government involvement and that the force of law gives an advantage to the government.  For instance, Medicare and Medicaid employ price-fixing, which is illegal for any private organization.  The government decides on the worth of medical services and the providers of those services must comply.  The government therefore utilizes unfair practices to establish a monopoly, transferring costs to the private sector, artificially magnifying the cost of private insurance and hiding the true cost of government coverage.

 

When Medicare was passed senior citizens were promised that Medicare would not prevent them from utilizing private primary insurance if they wanted to. This assurance was false. Private primary health insurance has become all but impossible for persons over 65 to obtain.

 

Medicaid recipients, as well as and those on military health plans, are significantly restricted in their choices. This lack of choice has stifled competition. Contrary to the claims of the current administration, every time government has gotten involved in health care, competition has been suppressed by practices that would be prosecutable if carried out by private companies.  Far from promoting competition, a government plan will eventually eliminate private health care, thereby eliminating all competition.

 

Tom Miller, Director of Health Policy Studies at the Cato Institute, explained:

 

"As fiscal pressures mount, the federal government does not 'negotiate' with medical providers for lower prices for covered services.  It dictates below-market reimbursements with its near-monopoly power as a purchaser of health care for seniors. The full costs of such price discounts eventually reduce access to quality care and hold health care markets hostage to political exploitation."



  • 2. A government option will decrease costs.
It is naïve to believe that increased government intervention will lower the cost of medicine. All past evidence indicates that the reverse is true.  In 1965, the government promised that Medicare part A would cost $9 billion by 1990. The actual cost was more than $66 billion -- over seven times projected costs. There has never been a single large federal social program that has come in at budget or has performed as predicted.

 

Democrats have tried to pin the rising cost of medical care on the private sector. It is, however, government interference and government regulations that have caused the high cost of medical care in the past and that will continue to increase the costs of medical care in the future.  Medicare increases the cost of medical care by shifting federal administrative overhead to the private sector and through oppressive regulation.[i] These practices will undoubtedly accelerate under "Obamacare" as the following chart, using data from the Congressional Budget Office, indicates:




The estimated $1.6 trillion for Obama's proposed legislation will cover only about one third of his claimed 45 million uninsured. If historical precedents and evidence are any indication, the actual costs of the plan could be seven times higher than this estimate. Adding to the fiscal nightmare, Mr. Obama is planning on cutting benefits for Medicare and Medicaid in order to transfer funding to his new health plan. This is another example that government does not contain costs, but shift costs from one program to another.

 

The effect of Obama's program will be to increase taxes on small businesses and further worsen unemployment. This loss of jobs will result in driving people into the government-funded plan. Increasing the costs of the plan would create a vicious cycle of unemployment, increasing costs, rising taxes, and unending dependence on government.

 

  • 3. A government option will improve health care and cover more people.
Mr. Obama's claim of 45 million Americans without medical insurance is completely unfounded.  His health care plan will initially cover about 13 million people. However, nearly 100 million people will be eligible for the proposed government option.  As mentioned above, nothing about the plan would promote increased competition. 

 

Once the government has a monopoly on all health care in America and the costs to the government have skyrocketed, the government will do what it has always done: use its power to ration services and increase taxes.  This will result in inferior medical care for the American people.

 

Once this rationing occurs, there will be no turning back.  The government will be in complete control, as it is with Medicare and Medicaid.  We need only ask Medicare or VA patients about the difficulties they face in trying to obtain payments for their medical care to understand what the end result will be.  Denial of payment for care is simply rationing by another name.  Furthermore, the evidence shows that government funded health care initiated at the state level, such as the programs in Massachusetts and Oregon, have failed miserably. We will likely have to consider the morgue as an integral part of any government health care system in the future.

 

Albert Einstein once defined insanity as doing the same thing over and over again expecting different results.  Mr. Obama's theories are undeniably refuted by historical fact and therefore his projections are unreliable and even dangerous.  There is overwhelming evidence that his health care plan will result in a fiscal and medical care disaster.  More important, his plan would result in a wider unconstitutional expansion of government control over our lives. We must demand real solutions, not the trading of unsustainable benefits for votes, the loss of our liberty, and greater dependence for our medical care -- not on those trained in the healing arts -- but on government and professional politicians.

Health Care Access for All America

by Administrator at Jan 17, 12:47 pm

Health Care Access for All America

Community health centers provide quality primary care at a significant savings for millions of Americans.  Their doors are open to all, including patients with Medicare, Medicaid, private insurance, and those who have no insurance at all.

But 60 million Americans still lack meaningful access to primary health care, dental care, mental health counseling and low-cost prescription drugs. By increasing funding to less than 0.5 percent of overall U.S. spending on medical care, we could provide primary health care to every American who needs it.

Also, there is a serious doctor, dentist and nursing shortage in the United States.  To address this, we must move aggressively to strengthen the National Health Service Corps. The corps provides debt forgiveness and grants for medical and dental students in exchange for practicing in underserved areas.

Senator Sanders has introduced legislation to do just that.  Working with House Majority Whip James Clyburn, Chairman Ted Kennedy and others, Sanders' Access for All America Act would provide access to primary health care to every American.  To read the Sanders-Clyburn op-ed, click here.


The Community Health Centers Program Today:

  • 18 million Americans today are served through 1,100 Federally Qualified Community Health Centers on a $2 billion budget;
  • Established by Senator Ted Kennedy over 40 years ago
  • President Obama’s economic recovery plan invests $2 billion in the program.
  • President Bush significantly expanded the bi-partisan program.
  • Patients are not turned away and payment is made on a sliding scale according to income.
  • Provides doctors, dentists, mental health counselors and low-cost prescription drugs in underserved communities.
  • Like a hub and spoke, most centers have satellite offices or clinics providing greater access to services.
  • Effective and Efficient: the program helps Americans through preventative efforts, treating patients at a community health center rather than emergency room and by addressing illness before hospitalization is needed. 


The Access for All America Act:

  • Over a five year period, the act would expand the program so that every American in a medically-underserved area has access to care.
  • Introduced by Bernie Sanders in the Senate and Majority Whip Jim Clyburn of South Carolina in the House of Representatives.
  • Community Health Center authorization would rise from the current $2.065 billion to $8.333 billion in the fifth year, assuring access to comprehensive primary medical, dental, and mental health care as well as low cost prescription drugs to all 60 million Americans living in medically-underserved areas.
  • The National Health Service Corps authorization would increase over the next five years from the current $125 million to $1.155 billion to train an additional 24,000 loan-repayment and scholarship assignees.
  • The text of the bill is available here.


What the Access for All America Act Achieves by 2015:

  • The number of health centers programs would expand from 1,100 to 4,800
  • The number of people receiving services would increase from 18 million to 60 million.
  • The number of underserved communities would fall to zero.
  • Heath service corps-supported primary care clinicians would grow from 4,000 to 28,000.
  • Savings of between $45 and $80 billion would be achieved by reducing inappropriate emergency room use and unnecessary hospitalization.
  • The Medicaid program would save over $16 billion per year.  Studies show that total costs for Medicaid patients seen at health centers are 30 percent lower (about $1,000 per person) than Medicaid patients seen elsewhere. Health centers now serve 5 million Medicaid patients. 
  • This plan would create 370,000 new jobs in the most economically-challenged communities, based on a study by George Washington University.  The average health center employs about 100 clinical, administrative, and support staff.


Health Centers in Vermont Today

  • About one in eight Vermonters – more than 80,000 patients – now receive care at a Federally Qualified Health Center regardless of income or insurance coverage.  Read more here.
  • Since 2002, the number of health center organizations in Vermont has expanded from two to seven, with a total of twenty-nine sites across the state.  See the list here.
  • A new, first-of-its-kind “Community Health Pharmacy” has opened in Colchester which will be able to provide the lowest cost prescription drug prices in the country. It is a cooperative endeavor run by the health centers in Chittenden, Washington, Lamoille, Essex-Caledonia, and Franklin-Grand Isle counties.  Patients visiting these health centers can order their prescriptions electronically at the center, and receive discounted drugs by mail at home the next day.  Read more here.
  • As part of the cooperative pharmacy initiative, the Plainfield Health Center is using a dispensing machine as a satellite to the pharmacy.  Read more here.
  • In March of 2009, Springfield Medical Center became the first already-operating hospital in the nation to become a federally-qualified health center.  The hospital will be the largest center in the state.

Priority Area: Access to Quality Health Care

by Administrator at Jan 17, 12:41 pm

The Burden of Insufficient Access to Quality Health Care

In its 2001 report, Crossing the Quality Chasm: A New Health System for the 21st Century, the Institute of Medicine defined quality as "the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge." Access to quality care is important to eliminate health disparities and increase the quality and years of healthy life for all New Yorkers. Patients who are women, older, members of racial and ethnic minorities, poorer, less educated, or uninsured are less likely to receive needed care, primarily because they lack access to care. These disparities are growing . Although having insurance increases access to the health care system, it is not sufficient to ensure appropriate use of services or care that is of high quality. This priority area addresses two key components of a well functioning health care system that ensures access to quality health care for New Yorkers: 1) enrollment in health insurance; and 2) access to and delivery of preventive health services and primary care that are shown to improve overall health.

Objectives

  • By the year 2013, increase the percentage of adult New Yorkers with health care coverage to 100%.* [Baseline: 86.5%, BRFSS, 2006]
  • By the year 2013, increase the percentage of adult New Yorkers who have a regular health care provider to 96%.* [Baseline: 85.0%, BRFSS, 2006]
  • By the year 2013, increase the percentage of adult New Yorkers who have seen a dentist in the past year to 83%.* [Baseline: 71.8%, BRFSS, 2006]
  • By the year 2013, increase the percentage of cancer cases diagnosed at an early stage of disease in New York residents to at least:
    • 80% for breast cancer. [Baseline: 64%, NYS Cancer Registry, 2000-2004]
    • 65% for cervical cancer. [Baseline: 52%, NYS Cancer Registry, 2000-2004]
    • 50% for colorectal cancer. [Baseline: 40%, NYS Cancer Registry, 2000-2004]

    * Healthy People 2010 Objective

In addition to the Prevention Agenda objectives, the DOH’s Office of Health Insurance Programs has established the following three objectives to increase access to quality health care:

  • By year 2013, increase the percentage of managed care enrollees who have controlled their high blood pressure to:
    • 70% for commercial enrollees. [Baseline: 58 percent, 2007 Managed Care Plan Performance]
    • 70% for Medicaid enrollees. [Baseline: 60 percent, 2007 Managed Care Plan Performance]
  • By year 2013, increase the percentage of diabetic managed care enrollees whose blood sugar levels are in good control to:
    • 50% for commercial enrollees. [Baseline: 44 percent, 2007 QARR data]
    • 45% for Medicaid enrollees. [Baseline: 38 percent, 2007 QARR data]
  • By year 2013, increase the percentage of adult managed care enrollees who were not prescribed an inappropriate antibiotic for bronchitis to:
    • 30% for commercial enrollees. [Baseline: 24 percent, 2008 eQARR]
    • 35% for Medicaid enrollees. [Baseline: 28 percent, 2008 eQARR]

Indicators for Tracking Public Health Priority Areas

Each community's progress towards reaching these Prevention Agenda Objectives will be tracked so members can see how close each community is to meeting the objectives.

Health Care Efficiency and Affordability Law for New Yorkers Phase 9 (HEAL 9) - Local Health Planning Initiatives Grant Program

The Department awarded 18 grants to support collaborative local health planning efforts, with the goal of developing an accessible, affordable, high-quality and cost-effective health care delivery system. These 18 awardees are engaged in innovative approaches to health planning that identify and prioritize community health needs and result in recommendations for aligning the health care delivery system with those needs.

Data and Statistics

Access to Quality Health Care

Health Insurance Coverage

The number and percent of New York State residents without health insurance are presented in a NYSDOH report entitled, Profile of the Uninsured in New York State in 2008, and are highlighted below. This profile is based on data from the 2008 Annual Social and Economic Supplement to the Current Population Survey (CPS), released by the U.S. Census Bureau on September 10, 2009 and analyzed by NYSDOH staff, except as noted in the final section.

Basic Rates and Counts

  • In 2008, 14.1% of the state’s population was uninsured, about 2,720,000 people.
  • The rate for children under 19 was 7.4%, with 343,000 uninsured.
  • The rate for adults 19 to 64 was 19%, with 2,310,000 uninsured.
  • These rates are below the comparable values for the nation, which were 15.4% for all, 10.3% for children under 19, and 20.3% for adults 19 to 64.
  • The 2008 estimate of uninsured NYS residents is about 201,000 higher than in 2007.
  • The NYS and national uninsured rates for adults in 2008 were about the same as they were five years earlier. The NYS rate for adults increased in 2008, returning to its 2006 value. The uninsured rate for children in NYS was notably lower in 2008 than it was five years earlier, and the sharp decline in 2008 reversed the three consecutive annual increases.
  • Uninsured rates were higher in NYC than in the rest of the state.

New York City

  • Most (55.6%) of the state’s uninsured live in NYC, with 1,512,000 uninsured in 2008.
  • The uninsured rate in NYC was 18.2%, compared to a rate of 11.1% for the rest of the state.
  • The NYC rate for children (7.9%) was somewhat higher than the rate in the rest of the state (7.0%). Among non-elderly adults, the NYC uninsured rate (24.6%) was substantially higher than the rate in the rest of state (14.6%).
  • The 2008 estimate for NYC is about 144,000 more than 2007, accounting for about 70% of the 201,000 statewide increase.
  • The 2008 estimate for NYC was 11% higher than in 2007, compared to a 5% increase in the rest of the state.

Demographics and Disparities

  • Half of the uninsured (49.8%) are in the 19 to 39 year age group, with 29.5% in the 19 to 29 year age group. The rest are divided among children (12.6%), those aged 40 to 49 years (16.3%), and those aged 50 years and older (21.3%) [(50-64: 18.8%, 65+: 2.5%)].
  • Racial/ethnic “minorities” are about 58.6% of uninsured, but only about 39.6% of population.
  • The proportion of New Yorkers who were uninsured in 2008 was 9.7% for non-Hispanic Whites; 19.3% for African-Americans; 23.7% for persons of Hispanic origin; and 17.5% for others.
  • About 22.6% of NYS uninsured are poor (see U.S. Census Bureau’s poverty definition).
  • The proportion of poor who were uninsured in 2008 (22.5%) was higher than in 2007 (20.7%).
  • More than a quarter (26.6%) of NYS uninsured are not U.S. citizens; 36.7% of non-citizens were uninsured.

Eligibility for Publicly Funded Coverage

  • NYSDOH estimates that 90.9% of the state’s 343,000 uninsured children under age 19 (311,000 children) are now eligible for publicly subsidized health insurance.
    • About half (51.3%) of those eligible children qualify for Medicaid and the remaining for Child Health Plus (CHPlus).
    • About 47,000 of those children are eligible because of the recent expansion of CHPlus eligibility to 400% of FPL.
    • Another 31,000 uninsured children above 400% of FPL are eligible to enroll in CHPlus without public subsidy by paying the full state-negotiated monthly premium rate.
  • NYSDOH estimates that 37.4% of the state’s 2.31 million uninsured adults, or 865,000 people, are eligible for public health insurance programs.
    • About three-quarters (75.1%) of those eligible adults qualify for Medicaid and the rest for Family Health Plus.

Eligibility for Employment-Based Coverage

  • The CPS does not provide data on the availability of private insurance. However, it has found that private insurance coverage in general and employment-based coverage specifically were essentially unchanged between 2007 and 2008. The CPS estimates that 11.3 million NYS residents were insured through employment-based programs in 2008.
  • Another federal survey (MEPS-IC) found that employment-based coverage was available to about two-thirds (71%) of the estimated 7.5 million private-sector workers in NYS in 2008. The remaining one-third worked in firms that have no health insurance program (9.6% of workers) or were not eligible for their company’s program (21.5% of workers).
  • More than three-fourths (78%) of workers in NYS who were offered employment-based health insurance through their company’s program, according to the MEPS-IC.
  • In smaller firms (under 100 employees), 57.2% of workers had the opportunity to enroll and about 72.1% of those given the opportunity did enroll in the company’s plan.

County Estimates of the Number of People who are Uninsured

Every year, the Census Bureau estimates each state’s uninsured population using data from the Current Population Survey (CPS). These national and state estimates are the most-widely cited source in discussion of the likely impact and costs of healthcare reform proposals and trends in coverage. However, the CPS files do not provide estimates by county. To satisfy the need for county estimates of the uninsured, the Census Bureau developed a national regression model based on tax information, Medicaid enrollment, food stamp caseloads, and population estimates.

This year, the Census Bureau also released direct estimates of the uninsured for 38 NYS counties with at least 65,000 residents, as part of its American Community Survey (ACS). The CPS and ACS provide two different estimates of the uninsured in New York State. We believe the CPS provides the most useful estimate of the uninsured statewide. Since the ACS county estimates are derived from a local population survey instead of a national regression model, we believe they provide a more valid picture of the distribution of the uninsured across the state.

In recent years, the New York State Department of Health has allocated the statewide CPS results into counties based on the Census Bureau’s national regression model. Our procedure ensures that the counties sum to the statewide CPS findings that are used in most other contexts. For this year’s allocation we relied on the ACS data when available (counties of 65,000 or more), and resorted to the regression model to allocate the remaining uninsured into the 24 counties that were not estimated in the ACS. The results of our allocation of the CPS-estimated uninsured children and adults are included in tables below. The following is a table for the estimated number of people who were uninsured in 2008 by county of residence.

New York State Department of Health Programs

New York’s Public Health Insurance Programs

New York State provides free and low-cost health insurance for children and adults through Child Health Plus, Medicaid and Family Health Plus. These programs provide New Yorkers with coverage for a wide range of medical services, including regular check-ups, hospital care, outpatient care, prescription drugs, emergency care, lab tests, x-rays, mental health services and much more. Learn more about these health insurance programs:

Enrollment in New York’s Public Health Insurance Programs

More than two million of New Yorkers covered are children and teens with approximately 1.7 million enrolled in Medicaid and nearly 390,000 in Child Health Plus. Learn more about enrollment by program and county :

Where to Sign-up for Health Insurance Coverage

To enroll in Child Health Plus, Medicaid and Family Health Plus, families and individuals will need to fill out an application and provide proof of age, identity, home address, income and citizenship or immigration status for everyone applying.

Families and individuals can apply for Medicaid and Family Health Plus at their Local Department of Social Services/local Medicaid office or through a facilitated enroller. Families with children who may be eligible for Child Health Plus may apply with a directly with a participating Child Health Plus health plan. Across New York, over 100 organizations and 21 authorized health plans have staff, called facilitated enrollers, to help individuals and families apply for Child Health Plus, Medicaid, or Family Health Plus. Facilitated enrollers screen the applicant for the appropriate program, help individuals and families complete the application, gather the required documentation, and follow-up to ensure they complete the application process. Facilitated enrollers are available to help during the work day, evenings and weekends.

For Application Assistance:

It is important to know that New Yorkers must renew their Child Health Plus, Medicaid and Family Health Plus coverage annually. Children and adults are enrolled in their health insurance for about one year. Before the year is over, they will receive a packet in the mail from their local Medicaid program or their Child Health Plus plan. This form must be completed and returned. If the renewal is not submitted on time or requests for additional information are not returned, the consumer will lose coverage.

Strategies - The Evidence Base for Effective Interventions

Access to and receipt of clinical preventive services and primary care

Managed care plans that serve those who are publicly insured focus on arranging preventive health care for their members. They provide members with a medical home for themselves and their families. A new initiative in the Medicaid program will reward providers with increased reimbursement if they meet DOH medical home standards which are designed to build greater accountability into physician practices. Achieving medical home certification should also benefit other non-Medicaid patients in physician practices as it would allow for better tracking and follow-up of all patients.

To ensure that the quality of care being provided throughout the state adheres to current clinical standards, the Office of Health Insurance Programs measures and publishes information on health plan performance including screening rates for breast cancer, cervical cancer and colorectal cancer. In addition, the DOH has new initiatives designed to ensure that patients with certain conditions such as breast cancer or obesity receive surgical treatment at high volume providers who have better outcomes. The DOH also works with health plans that conduct annual Performance Improvement Projects (PIPs). The PIPs are small scale research projects designed to test various system changes as a way of improving care. Many of them have focused on improving rates of preventive health screenings among their members.

County Strategies and Partners Matrix

The County Strategies and Partners Matrix for Access to Quality Health Care was compiled from the 2010-2013 community health assessments submitted in 2009 by 36 local health departments. It describes how local health departments collaborate with hospitals and community organizations to plan and address this priority to improve population health outcomes.

Reports for Quality of Care

Medicaid Managed Care Performance Improvement Projects. 2009-2010 Pediatric Obesity-Summary of Projects (This summary describes 2009-2010 projects by managed care providers targeted at reducing childhood obesity.)

Evidence-based Strategies for Helping People Get Enrolled

The organizations listed below feature some of the most recent research and literature on the issue of the uninsured, health care coverage, and access to care.

Return on Investment

Making the Case for the Importance of Health Insurance

Health insurance can make a difference for a lifetime. Health insurance affects how individuals receive necessary medical care, where they go for care, and their overall health. In addition, health insurance impacts a person’s financial well-being. There are a number of resources documenting the impact of health insurance on access to care for children and adults, as well as the financial implications of not having health insurance. Below are highlights from current research about the consequences of not having health insurance:

Impact of being uninsured on access to care for adults

  • More than 50% of uninsured adults have no regular source of care.
  • Uninsured are more likely to delay or forgo needed care, which can lead to more serious health problems and can result in hospitalizations for avoidable conditions.
  • Uninsured individuals are four times more likely to delay or forgo needed care than the insured because they anticipate high medical costs for their care.
  • The uninsured are twice as likely as those who are insured to be unable to pay for basic family needs, such as food and housing, due to medical bills.
  • With continuous health coverage, premature mortality rates can be decreased by up to 25% among uninsured adults.

Impact of health care coverage on access to care for children and pregnant women

  • Uninsured children are less likely to get routine well-child care, have worse access to health care, and use medical and dental services less frequently than insured children.
  • Uninsured women are more likely to have poor outcomes during pregnancy and delivery than are insured women.
  • Uninsured pregnant women have a greater likelihood of maternal complications, infant death and low birth weight.

Partners

Resources for Other Health Care Coverage Options

Federal Health Care Reform in New York State

Family Health Plus Buy - In Program

Healthy New York

Medicare Benefits

Medicare Part A and Part B

NY Connects: Choices for Long Term Care

More Information

Office of Health Insurance Programs
Division of Coverage and Enrollment
Division of Quality and Evaluation
Email: bhp03@nyhealth.gov or rxb16@nyhealth.gov
Voice: 518-486-9012/212-417-4500

CT State-Wide Health Care Facilities and Services Plan Advisory Body

by Administrator at Jan 17, 12:40 pm

 

 

composite picture depicting a nurse examing an infant, a mother and son, a nurse with an adult patient and doctors performing laser surgery

 

 
CT State-Wide Health Care Facilities and Services Plan Advisory Body
 
 
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