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The Supreme Court’s health care decision: What it does—and does not—mean

By |June 28, 2012|Health Care|

Source Harvard Health Blog

Anthony Komaroff, M.D., Editor in Chief, Harvard Health Publications

The passage of the Patient Protection and Affordable Care Act (which I’ll just call the Law) in 2010 was regarded as a landmark event in U.S. history. Today’s ruling by the Supreme Court, which largely upholds the Law, should also be viewed as a landmark event—whether one agrees with it or not.

Why? Three reasons: Everyone wants health care when they need it. Everyone wants to be spared financial devastation from the cost of that care. And health care accounts for 17% of the total U.S. economy, and is growing at a faster rate than the rest of the economy—putting the rest of the economy under enormous strain.

Before the Law was passed, I saw two huge challenges facing U.S. health care. The first was the fact that so many people did not have health insurance. The second was the high cost of health care.

For decades, the percentage of Americans with health insurance has been lower than in other developed nations. Passage of the Law did not immediately change things. At the time of a survey by the National Center for Health Statistics in 2011, 46 million Americans—15% of the population—had no health insurance. These people lived an automobile accident, a heart attack, or a stroke away from becoming destitute.

Who are they? Relatively few are unemployed adults. People who are chronically unemployed have often been able to get health insurance through Medicaid. In fact, most of the uninsured are working adults whose employers did not provide health insurance. Many are children—often, the children of employed but uninsured adults. A smaller fraction are adults under the age of 65 who are out of the labor force.

Another group of people without health insurance are healthy young adults who have simply decided not to pay for health insurance—and to take their chances. They know that if they become seriously injured or ill, they will receive health care somewhere—effectively paid for by the insurance payments that other people are making. They are “free riders.” In passing the Law, the President and Congress basically said to them, “That’s not fair.” (more…)

Smokers and the obese cheaper to care for, study shows

By |April 5, 2011|Health Care|

Source New York Times

Preventing obesity and smoking can save lives, but it does not save money, according to a new report.

It costs more to care for healthy people who live years longer, according to a Dutch study that counters the common perception that preventing obesity would save governments millions of dollars.

“It was a small surprise,” said Pieter van Baal, an economist at the National Institute for Public Health and the Environment in the Netherlands, who led the study. “But it also makes sense. If you live longer, then you cost the health system more.”

In a paper published online Monday in the Public Library of Science Medicine journal, Dutch researchers found that the health costs of thin and healthy people in adulthood are more expensive than those of either fat people or smokers. (more…)

New Study Reveals: Starting with Chiropractic Saves 40% on Low Back Pain Care

By |November 16, 2010|News|

New Study Reveals: Starting with Chiropractic Saves 40% on Low Back Pain Care

The Chiro.Org Blog


SOURCE:   Insurancenewsnet.Com


A new JMPT study finds that low back pain care initiated with a doctor of chiropractic (DC) saves 40% on health care costs when compared with care initiated through a medical doctor (MD), the American Chiropractic Association (ACA) announced today. The study, featuring data from 85,000 Blue Cross Blue Shield beneficiaries, concludes that insurance companies that restrict access to chiropractors for low back pain treatment may inadvertently pay more for care than they would if they removed such restrictions.

Low back pain is a significant public health problem. Up to 85 percent of Americans have back pain at some point in their lives. In addition to its negative effects on employee productivity, back pain treatment accounts for about $50 billion annually in health care costs—making it one of the top 10 most costly conditions treated in the United States.

The study, Cost of Care for Common Back Pain Conditions Initiated With Chiropractic Doctor vs. Medical Doctor/Doctor of Osteopathy as First Physician: Experience of One Tennessee-Based General Health Insurer, which is available online and will also be published in the December 2010 issue of the Journal of Manipulative and Physiological Therapeutics, looked at Blue Cross Blue Shield of Tennessee’s intermediate and large group fully insured population over a two-year span. The insured study population had open access to MDs and DCs through self-referral, and there were no limits applied to the number of MD/DC visits allowed and no differences in co-pays. (more…)

Kaiser Suspends Policy Change Following ACA Action

By |November 15, 2010|News|

Kaiser Suspends Policy Change Following ACA Action

The Chiro.Org Blog


Source ACA

Kaiser Permanente Mid Atlantic States and Mid-Atlantic Permanente Medical Group (Kaiser) has suspended its decision to exclude cervical Chiropractic Manipulative Treatment (CMT) from coverage. The change came after the American Chiropractic Association (ACA) outlined in a letter to Kaiser the scientific evidence that documents that cervical spinal manipulation is both clinically effective and safe.

ACA took swift action in August when it learned that Kaiser had revised its Chiropractic Manipulation Medical Coverage Policy. Along with the letter outlining the large body of clinical research supporting the effectiveness and safety of cervical manipulation, ACA President Rick McMichael, DC, noted at the time in a public statement that, if allowed to stand, the restriction would be harmful to chiropractic patients and doctors.

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American Chiropractic Association Responds To New Kaiser Policy Excluding Cervical Manipulation

By |August 26, 2010|News|

American Chiropractic Association Responds To New Kaiser Policy Excluding Cervical Manipulation

The Chiro.Org Blog


Source chiroeco.com


Kaiser Permanente Mid Atlantic States and Mid-Atlantic Permanente Medical Group recently revised their Chiropractic Manipulation Medical Coverage Policy to exclude cervical Chiropractic Manipulative Treatment (CMT).

The revised policy states, “Given the paucity of data related to beneficial effects of chiropractic manipulation of the cervical spine and the real potential for catastrophic adverse events, it was decided to exclude chiropractic manipulation of the cervical spine from coverage.”

Last week, ACA sent a letter to Kaiser outlining the extensive data that supports cervical spinal manipulation as both beneficial and safe. The association also released the following statement:

“The American Chiropractic Association is aware that Kaiser Permanente Mid Atlantic States and Mid-Atlantic Permanente Medical Group have revised their Chiropractic Manipulation Medical Coverage Policy to exclude cervical Chiropractic Manipulative Treatment (CMT) from coverage.

This restriction, if allowed to stand, will be harmful to chiropractic patients and doctors. We have contacted Kaiser to express our grave concern over this change, and we await its reply. ACA will expend every effort to encourage Kaiser to reverse this new restriction, and we will keep our members and the profession informed along the way.” – ACA President, Dr. Rick McMichael

Doctors of Chiropractic and Patients Included in UnitedHealth Group Settlement

By |May 6, 2010|News|

Source The American Chiropractic Association

A record-breaking settlement has been reached between the American Medical Association, et al. and UnitedHealth Group—the nation’s largest health insurer— for 15 years of artificially low payments for out-of-network services. More than $350 million has been allocated to compensate impacted providers and subscribers, including doctors of chiropractic and their patients, according to the American Chiropractic Association (ACA).

Affected providers and subscribers should have received mailings from UnitedHealth Group that include an overview of the settlement, instructions for filing a claim for payment and proof of claim forms. Claims for payment must be filed by Oct. 5, 2010. Anyone filing objections to the settlement or opting out of the settlement must do so by July 27, 2010.

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