A California appeals court this month ruled that certified registered nurse anesthetists in that state do not need physician supervision to do their jobs.
It’s a clear victory for rural hospitals in California that have complained that requiring physician supervision of CRNAs adds unneeded costs and limits the range of surgery services they can provide.
The Supreme Court struggled Wednesday with a question that looks increasingly significant after conservative justices battered the individual mandate: Should the rest of President Barack Obama’s health care law stand if the requirement to purchase insurance falls?
Most of the justices appeared opposed to throwing out the entire law, but their views on how much to keep in place were murky, and the divisions between conservatives and liberals were not always as clear cut as they were Tuesday.
After three days, the Supreme Court arguments have ended and now we must wait until June or July to learn whether the entire Patient Protection and Affordable Care Act will be struck down, whether the individual mandate will be declared unconstitutional, and if the Medicaid program will be allowed to expand to include millions of potential enrollees.
Five months before Medicare’s hospital readmission penalties take effect, two groups of authors say Congress and the government are taking the wrong approach.
Although the authors make different points, each says that the regulation, embedded in the Affordable Care Act, won’t accomplish its intent. Both are published in Perspectives in Thursday’s New England Journal of Medicine.
A program to pay hospitals bonuses for hitting key performance measures, or dock them if they miss, failed to improve the health outcomes of patients, according to a large, long-term study.
The study could lead to a re-examination of financial incentives in healthcare, as policymakers seek ways to reward results rather than paying doctors and other providers for each service they provide, such as a diagnostic test.
Such an incentive program for hospitals is a key provision of the U.S. healthcare overhaul law that is being challenged this week before the Supreme Court.
Amanda Tarpening doesn’t want the state telling her to vaccinate her child.
And California public health officials don’t want her 17-month-old daughter, who has not been immunized, to fall ill or help spread a vaccine-preventable disease.
It’s a quandary that has physicians frustrated and parents such as Tarpening citing their First Amendment rights.
Three days of Supreme Court arguments have left the fate of the 2010 health care reform law uncertain. What is certain, however, is that health care costs are continuing to eat away at consumers’ budgets.
The typical family of four covered under an employer plan is expected to spend over $20,000 on health care this year, up more than 7% from last year, according to early projections by independent actuarial and health care consulting firm Milliman Inc. In 2002, the cost of health care for the average family of four was just $9,235, the firm said.
The Supreme Court concluded a marathon public debate on health care Wednesday with justices signaling an ideological divide that could topple some or all of the the sweeping reform bill championed by President Barack Obama.
On the third day of oral arguments on legal challenges to the 2010 Affordable Care Act, the justices tackled the question of what would happen if they ruled that the heart of the law, the individual mandate that is its key funding mechanism, was unconstitutional.
After three days of Supreme Court arguments, the questions justices asked the lawyers are the only tea leaves to read, however unreliable. That has led to the belief the fate of the health care law could lie with two justices. Justice Anthony Kennedy’s mixed queries left the most room for him to be seen as a possible swing vote to decide the issue. Chief Justice John Roberts also spoke up for both sides of the issue at times. The four Democratic-appointed justices seemed to champion the law. If they all support it, at least one of the court’s five Republican appointees would still be needed to uphold the law.
U.S. Supreme Court justices indicated during three days of arguments that they may reject the centerpiece of President Barack Obama’s health-care overhaul — its requirement that Americans obtain insurance — and bring down other parts of the law with it. The court concluded its hearings today on Obama’s signature domestic achievement, designed to extend health coverage to 32 million people. After casting doubt yesterday on the insurance mandate’s survival, they tangled on the final day over the consequences such a ruling would have.
The survival of President Barack Obama’s health care overhaul rests with a Supreme Court seemingly split over ideology and, more particularly, in the hands of two Republican-appointed justices. Chief Justice John Roberts and Justice Anthony Kennedy put tough questions to administration lawyers defending the health care law during three days of arguments that suggested they have strong reservations about the individual insurance requirement at the heart of the overhaul and, indeed, whether the rest of the massive law can survive if that linchpin fails.
In morning arguments Wednesday, the U.S. Supreme Court justices wondered aloud whether they would be doing greater harm to Congress’ intent by either striking just one provision or axing the entire sprawling bill.
Three lawyers gave the court sharply different views of the question. Paul Clement, an attorney for critics of the law, including the National Federation of Independent Business, urged the court to follow Justice Antonin Scalia’s apparently preferred path of striking down the entire law if the individual mandate to purchase insurance is deemed unconstitutional.
Several U.S. Supreme Court justices suggested they may leave much of President Barack Obama’s health-care law intact even if they strike down its core requirement that Americans buy insurance. “The bottom line is, why don’t we let Congress fix it” instead of throwing out the entire law, said Justice Sonia Sotomayor during the third and final day of arguments on the health-care law.
Even before the Supreme Court heard arguments about the constitutionality of the federal health care law, President Barack Obama’s campaign had begun targeting key voter groups that might be most affected by a loss.
If the justices rule against the law – an outcome that many think they strongly signaled during arguments Tuesday and Wednesday – the way those slices of the electorate respond could go a long way toward determining the political impact.
Medical student Gregory Shumer studied the electronic health record and scooted his laptop closer to the diabetic grandfather sitting on his exam table. “You can see,” he pointed at the screen — weight, blood sugar and cholesterol are too high and rising. The man didn’t reveal he was too nearsighted to see those numbers, but he’d quietly volunteered that he’d been ignoring his own health after his wife’s death. The future-Dr. Shumer looked away from the computer for a sympathetic conversation — exactly the point of Georgetown University’s novel training program.
The decline in deaths from all cancers combined continued in the USA from 2004-2008, but a major government report highlights a worrisome rise in cases linked to obesity and inactivity.
Although the overall rate of new cancer cases is declining, the report confirms research showing that excess weight and a sedentary lifestyle are risk factors for one-quarter to one-third of common cancers in the USA. About one-third of adults — almost 78 million — are obese, roughly 30 or more pounds over a healthy weight.
A federal appeals court says it won’t reconsider a ruling that allows bone marrow donors to be paid for their donations like blood donors.
In December, the 9th U.S. Circuit Court of Appeals overturned a decades-old government practice that made such compensation a crime.
The court said a technological breakthrough makes the process of donating bone marrow nearly identical to giving blood plasma.
Building for months, rhetoric on both sides of the federal health care law went into overdrive this week as the nine U.S. Supreme Court justices weighed the legality of the measure. Expect three months of second-guessing before the court rules by the end of June. When that occurs — and pundits take a magnifying glass to the fine print of the decision — California will have to decide whether the train already left the station here or not.
The health reform law passed by a Democratic Congress and President Obama two years ago appeared to be in more jeopardy than ever today after the last of three days of hearings at the US Supreme Court.
While Tuesday’s hearing left the impression that the court might vote narrowly to strike down a key part of the law — the mandate requiring individuals to buy insurance — supporters had hoped that the court would leave the rest of the law, or most of it, in tact.
Nothing much changes for Americans’ medical care while the Supreme Court mulls the fate of President Barack Obama’s health care law. The wait might take three months. Decisions can come anytime, but complex cases argued in the spring often emerge near the end of the session, in late June. In the meantime, parts of the law already in effect won’t change. That includes the provision that lets young adults stay on their parents’ insurance until they turn 26 and a requirement that health plans cover preventive care without charging a co-pay.
U.S. Chief Justice John Roberts will probably ask each of his eight Supreme Court colleagues gathered in an oak-paneled room tomorrow where they stand on the law that would expand health insurance to at least 30 million Americans and affect one-sixth of the economy. The secret, preliminary vote, following the court’s standard practice, will kick off three months of behind-the- scenes deliberations on the fate of the law.
A top Obama administration lawyer on Wednesday offered a last-ditch appeal to Supreme Court justices not to overturn the sweeping health care law by telling them Congress made a “judgment of policy” that they should respect. Quoting the Constitution’s preamble, Solicitor General Donald Verrilli said the law helps “secure the blessings of liberty” for more than 40 million uninsured people and frees them from worries over bankruptcy if a loved one gets a cancer diagnosis.
No U.S. HHS secretary has ever cut off Medicaid funding for a state that refused to abide by the conditions for federal matching money in the healthcare program for the poor and needy.
But that doesn’t mean no secretary has ever threatened to do so.
Arguments in Wednesday’s afternoon session before the Supreme Court centered on the question of whether the federal government was acting in an illegally coercive manner by threatening a state’s entire Medicaid funding if the state didn’t refused to expand eligibility for the program to Americans at 138% of the federal poverty level.
The Affordable Care Act, which had its last day of Supreme Court hearings today, is not the first choice of county Republicans – or Democrats – according to an OC Political Pulse poll.
Democrats polled prefer a universal single-payer plan – something akin to Medicare for all, with 73 percent wanting that approach. Those who stopped short of preferring a single-payer plan but thought an insurance mandate was necessary amounted to 22 percent of the 63 Democrats casting votes.
The U.S. Supreme Court this week heard an unprecedented three days of arguments on the constitutionality of the Patient Protection and Affordable Care Act. The justices will decide by June whether the legislation, which includes a requirement that virtually every American buy health insurance by 2014 or pay a penalty, passes constitutional muster.
Is the ‘individual mandate’ of health care reform constitutional?
In the United States, we have 2.3 doctors for every 1,000 people, but in places like Tanzania, Africa, there is only one doctor for every 20,000 people.
Our medical students and residents are increasingly committed to going to economically poor nations to volunteer and provide health care. They are willing to live in very primitive conditions in exchange for having a chance to do things in those countries that they could not do back home.
However U.S. Supreme Court justices rule on the landmark Patient Protection and Affordable Care Act, one thing is clear. The oral arguments revealed little understanding of the 49.9 million Americans who lack insurance, and why they are uninsured.
Justice Antonin Scalia wins the supreme prize for clueless and callous comments.
On the moral and legal obligation of doctors to treat people who turn up without insurance – say, after a heart attack or a car accident – the main cause of cost-shifting to the rest of us, Justice Scalia questioned the very idea of providing them with health care. “Well, don’t obligate yourself to that,” he said.
In 2009, when someone asked Nancy Pelosi a question implying that health reform legislation might be unconstitutional, she replied: “Are you serious?”
Pelosi wasn’t alone. At the outset, many legal scholars considered the challenge to the Affordable Care Act (ACA) both “implausible” and “frivolous.”
But over the next two years, the notion that state courts might strike down the ACA took on a life of its own.
