By TIM WILLIAMS & DAVID INTROCASO

This past October CMS Administrator Seema Verma announced the agencys Meaningful Measures initiative.[1] Ms. Verma launched the initiative because, she admitted, the agencys current quality measurement programming, widely criticized for years by MedPAC and others, ran the risk of outweighing the benefits. Under Meaningful Measures, CMS will, Ms. Verma stated, put patients first by aligning a smaller number of outcome-based quality measures meaningful to patients across Medicares programs. Since the primary focus of a patient visit, Ms. Verma said, must be the patient, the primary focus of the initiative will be to focus health care quality efforts on what is really important to patients.[2] As an indication of this commitment, immediately after Meaningful Measures was announced the National Quality Forums (NQFs) Measures Application Partnership (MAP) began work reviewing a record number of CMS-recommended Patient-Reported Outcome Measures (PROMs).[3]

There appears to be an ever increasing interest in PROMS in the US. For example, last year The New England Journal of Medicine published three PROMs-related Perspective essays that moreover described initial success by a few early US PROMs adopters. One of these essays also noted that England and Scotland had extensive experience in the use of these measures.[4] Though possibly overstated, we believe providers in the US can benefit from, for example, our experience in the United Kingdom (UK) developing and implementing My Clinical Outcomes (MCO) (at: http://www.myclinicaloutcomes.com), a digital patient reported outcomes measurement and analytics platform that is now used in the treatment of several chronic conditions in a variety of clinical settings across the UK.

MCO was initially developed in collaboration with orthopedic surgeons working in the National Health Service (NHS). These surgeons were seeking a way to systematically follow-up with their patients after joint replacement surgery largely in order to better economize on their use of clinical resources or more appropriately or efficiently identify those patients in need of follow up face-to-face consultations. The web-based platform was developed to work flexibly around existing clinical work flows.

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The Health Care Blog

Letter to Congress on Reauthorzation of Children's Health Insurance ProgramBishop Frank J. Dewane October 4, 2017

Letter to Senate on Replacement for Affordable Care ActCardinal Timothy Dolan, Archbishop William E. Lori, Bishop Frank J. Dewane, and Bishop Joe S. Vsquez, September 21, 2017

Letter to Senate Regarding Protection of Poor and Vulnerable People and the Effort to Repeal the Affordable Care ActBishop Frank J. Dewane, July 20, 2017

Letter to Senate Regarding the Better Care Reconciliation ActBishop Frank J. Dewane, June 27, 2017

News Release: U.S. Bishops Chairman Responds to CBO Report on Senate Health Care BillBishop Frank J. Dewane, June 26, 2017

Action Alert: Tell Your Senators to Insist on Changes to the Better Care Reconciliation Act of 2017

News Release: U.S. Bishops Chairman Reacts to Draft Senate Health Care BillBishop Frank J. Dewane, June 22, 2017

Letter to Senate Regarding Health CareCardinal Timothy Dolan, Archbishop William E. Lori, Bishop Frank J. Dewane, and Bishop Joe S. Vsquez, June 1, 2017

News Release: U.S. Bishops Chairman Calls on Senate to Strip Harmful Proposals from House-Passed Health Care BillBishop Frank J. Dewane, May 4, 2017

Letter to Congress Urging Continued Efforts to Improve Health CareCardinal Timothy Dolan, Archbishop William E. Lori, and Bishop Frank J. Dewane, March 30, 2017

Letter to the House of Representatives Regarding the American Health Care ActBishop Frank J. Dewane, March 17, 2017

Letter to Congress Presenting Moral Criteria for Debate on Health Care PolicyCardinal Timothy Dolan, Archbishop William E. Lori, Bishop Frank J. Dewane, and Bishop Joe S. Vsquez, March 7, 2017

Letter to Congress Urging Bipartisan Efforts to Preserve Gains in Health Care Coverage and AccessBishop Frank J. Dewane, January 18, 2017

Call to Support Legislation ReformingMental Health CareArchbishop Thomas G. Wenski, July 6, 2016

Backgrounder on Religious Liberty and the Freedom to Minister to AllFebruary 2015

Background on Access to Health Care (Medicaid Expansion)February 2013

Resources and Background on HHS Rule and Contraceptive CoverageJanuary 25, 2012

Letter to Energy and Commerce Committee on State Flexibility ActBishop Stephen E. Blaire, May 23, 2011

Cardinal DiNardo Urges Support for 'Respect for Rights of Conscience Act' (Original Letter)April 6, 2011

Permanent Ban on Abortion Funding Long Overdue, Says USCCB in House TestimonyFebruary 8, 2011

Background: Health Care ReformFebruary 2011

Cardinal DiNardo Letter in Support of HR-358January 21, 2011

The Bishops and the Right Exercise of Authority: A Response to Rick Gaillardetz's Commonweal ArticleRev. Thomas G. Weinandy, OFM, Cap., November 1, 2010

USCCB Health Care Reform Summary and Timeline of EventsAugust 26, 2010

Issues of Life and Conscience in Health Care Reform: An Analysis of the "Patient Protection and Affordable Care Act" of 2010May 24, 2010

Bishops Note Way Forward With Health Care, Clarify MisconceptionsMay 21, 2010

Cardinal DiNardo's Letter Urging Congress to Remedy Abortion & Conscience Flaws in Health Care Reform LawMay 20, 2010

Response to America Magazine by USCCB General CounselMay 17, 2010

Factsheet: Abortion Funding in the New Health Care Reform ActApril 12, 2010

Legal Analysis of Patient Protection and Affordable Care Act and Corresponding Executive Order on Abortion Funding and Conscience IssuesMarch 25, 2010

Cardinal George's Statement on Passage of "Profoundly Flawed" Health Care Reform ActMarch 23, 2010

Bishops to House of Representatives: Fix Flaws or Vote No on Health Reform BillMarch 20, 2010

Community Health Centers: Setting the Record StraightMarch 17, 2010

Washington Post Op-Ed by Cardinal DiNardo, Bishop Murphy & Bishop WesterMarch 16, 2010

Statement of USCCB President, Cardinal George "The Cost is Too High"March 15, 2010

"What's Wrong with the Senate Health Care Bill on Abortion? A Response to Professor Jost"March 6, 2010

Abortion Funding in the Senate Health Care Reform BillMarch 4, 2010

Letter to Congress on Eve of Health Care SummitBishop William F. Murphy, Cardinal Daniel DiNardo, and Bishop John WesterFebruary 24, 2010

The Need for Conscience ProtectionJanuary 26, 2010

Letter to Congress to Continue for Genuine Health Care ReformBishop William F. Murphy, Cardinal Daniel DiNardo, and Bishop John WesterJanuary 26, 2010

UPDATED Pulpit Announcement and Prayer Petition | en Espaol

Joint Letter on Health Care to US SenateBishop William F. Murphy, Cardinal Daniel DiNardo, and Bishop John WesterDecember 7, 2009

Joint Letter on Health Care to US Senate | en EspaolBishop William F. Murphy, Cardinal Daniel DiNardo, and Bishop John WesterNovember 20, 2009

Fact Sheet: What does the Stupak Amendment really do?November 12, 2009

Letter to the U.S. Congress on HealthcareBishop William F. Murphy, Cardinal Justin Rigali, and Bishop John WesterOctober 8, 2009

Letter to the U.S. Senate on HealthcareBishop William F. Murphy, Cardinal Justin Rigali, and Bishop John WesterSeptember 30, 2009

Letter to House on Health Care Reform (HR 3200)Cardinal Justin Rigali, August 11, 2009

Issues Related to Coverage of Low Income in Health Care ReformAugust 2009

Legal Immigrants in Health Care ReformAugust 2009

Letter to Congress to Help Reform Health Care, Protect Human Life and DignityBishop William MurphyJuly 17, 2009

USCCB Health Care Statement to CongressBishop William F. Murphy, May 20, 2009

Letter to US Congress on 2009 BudgetBishop William F. Murphy and Bishop Howard J. HubbardMarch 26, 2009

Letter to Congress on SCHIPBishop William F. Murphy, January 14, 2009

Joint Letter Supporting Community Choice ActBishop Nicholas DiMarzio, et. al., June 5, 2007

Letter to Senate Budget Committee on SCHIP, Medicaid, MedicareBishop Nicholas DiMarzio, Rev. Larry Snyder; Sr. Carol Keehan, March 15, 2007

Letter in Support of the Medicaid Community-Based Attendant Services and Supports Act of 2005 (MiCASSA), S. 401/H.R. 910September 13, 2006

Comments on Recommendations of the Citizen's Health Care Working GroupBishop Nicholas DiMarzio, Ph.D., D.D., August 23, 2006

Joint USCCB/CCUSA/CHA Letters to Senators Grassley and Baucus on Medical Treatment for Victims of Hurricane KatrinaSeptember 27, 2005

Letter to Congressman Ralph Regula from Cardinal McCarrickApril 27, 2004

Letter to Senator Arlen Specter from Cardinal McCarrickApril 27, 2004

Letter to EPA on Testing of Pesticides on HumansSeptember 10, 2003

A Joint Letter from USCCB and CHA to Senator Collins on Mercury Reduction Act of 2003May 15, 2003

Children's Health and the Environment Initiative

Letter to Senator Jeffords Endorsing Youth Drug and Mental Health Services ActJune 10, 1999

Comprehensive Health CareJune 18, 1993

Health and Health CareNovember 19, 1981

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Health Care - United States Conference of Catholic Bishops

On May 5, 2016, an esteemed group of physicians unveiled a detailed plan for single-payer health care in the U.S. To read the proposal, please visit pnhp.org/nhi. To read and view media coverage of the proposal, click here. To browse supplemental materials related to the proposal, click here.

On March 3, 2018, medical and health professional students from across the U.S. gathered in New Orleans for the 7th annual Students for a National Health Program (SNaHP) Summit. To access Summit materials, including slideshows and archival video, visit pnhp.org/nola.

PNHP advocates fundamental, single-payer reform of our health care financing system. To join PNHP as a physician, health professional, medical student, or activist, visit pnhp.org/join.

PNHP welcomes the introduction of Sen. Sanders' single-payer legislation as a landmark moment in the fight for single payer. To learn more about the Medicare For All Act of 2017, including PNHP's analysis of how the bill could be strengthened, visit pnhp.org/MedicareForAll.

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Physicians for a National Health Program

A cursory review of all the textbooks, dictionaries, style guides, and news sources in the Anglophone world would reveal a complete lack of consistency in the conventions of how healthcare/health care/health-care (h/h/h) is written. Is anyone elses mind blown that no convention has been developed for how to write about a multi-trillion dollar industry? Mine certainly was. This is my attempt to rectify the lack of clear, well-researched direction on this subject.

If you were to look for an authoritative source on the topic, you would turn up a series of loose sets of rules and meritless rationales for conventions surrounding the veritable word cloud miasma that hovers around our industry. As such, I took to reading through the decisions handed down from the Court of Common Opinion in search of a compelling narrative for how we Anglophones the world over should free ourselves of this embarrassingly debilitating failure of language.

Frankly, this has annoyed the Internet for way too long. Health care is in the top 20% most searched words on Merriam-Websters online dictionary and understandably so. No one is looking up healthcare because its some hard, new word: people are looking up health care because they need to know conventions for how to use and spell it! And as I did yesterday, most people walk away from Merriam-Webster and similar sources with tails between legs, depressed they have to go through yet another day with no direction on whether they are using and writing h/h/h properly.

Michael Millenson recently tried his hand at unraveling this topic. He did a compelling investigational guest piece tracking down the history of usage and spelling for h/h/h on the blogThe Doctor Weighs In. Unfortunately, at the end of the article, Im still head-desking because Michael joins everyone else in what Im calling The Great Healthcare/Health Care Vacillation by not making an argument one way or another for usage and spelling.

The most developed, logical, and applicable set of conventions I have found was developed here by Deane Waldman, MD, MBA on his blog, Medical Malprocess. His refreshing approach is that we should use both healthcare and health care each for different purposes because the need for specificity is so great that no one version of this word/phrase would be sufficient. Here is my interpretation of how he has parsed these words:

health care (noun)

Definition: a set of actions by a person or persons to maintain or improve the health of a patient/customer

Examples:

healthcare (noun or adjective)

Definition: a system, industry, or field that facilitates the logistics and delivery of health care for patients/consumers

Examples:

To put it more simply, Dr. Waldman writes:

Health caretwo wordsrefers to provider actions.

Healthcareone wordis a system.

We need the second in order to have the first.

While this is a thorough and terribly useful set of conventions, the fact remains that in the US the most commonly accepted form in professional writing is health care (the Associated Press feels pretty strongly about it), regardless of the words part of speech and the concepts to which the author means to refer. My problem with this heavy-handed approach is that it flattens the language and allows the speaker and audience to discuss h/h/h with little specificity, leading to generalities made about h/h/h that are not valid for the other forms of the word/phrase/concept. As such, I think that Dr. Waldmans model, which judiciously incorporates both forms, should supplant all of, in my opinion, the half-formed and barely-enforced rules on how to write h/h/h.

You may be wondering why I (and others) care so much about this issue. The short answer is that healthcare has taken on more meaning as a closed compound word to describe the system/industry/field than is captured in the two separate words health and care. Health care does not sufficiently capture the increasing demand for nuance and specificity in referring to topics surrounding the practice and facilitation of services to maintain or improve health. Healthcare represents the political, financial, historical, sociological, and social implications of a system that provides health care to the masses.

As professionals in a fast-paced and demanding field, we should hold ourselves to a high standard of precision and accuracy in our language. More than a few (by that, I mean literally 100%) of the professionals in healthcare have found themselves at some point wondering whether they are writing this word/phrase properly. I say the time has come to end the Great Healthcare/Health Care Vacillation.

It is understandable for many to feel they have neither the time nor resources to dedicate themselves to the pursuit of grammatical perfection. However, our issue here is not simply a lack of differentiation between two words in some obscure intellectual niche. Our issue is that our entire profession, industry, and field lacks a single, unifying convention for how to portray itself to the world. There is no excuse for confusion coupled with a lack of conviction for the need and method to address the problem.

I am not so deluded to think this set of conventions will become common knowledge, but I can hope and pray that those of us tasked with writing about the healthcare system and the evolution of health care in practices will endeavor to establish and monitor a consistent set of conventions about something as powerful and pervasive as our health and the industry that supports it.

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The Final Word: Healthcare vs. Health Care - arcadia.io

Fidelity's calculations include premiums, cost-sharing provisions and out-of-pocket costs associated with Medicare parts A, B and D but does not include other health expenses such as over-the-counter medications, dental services and long-term care. "Estimates are calculated for 'average' retirees, but may be more or less depending on actual health status, area of residence and longevity," according to the release.

Intimidating as retirement health-care figures may be, experts say there are a variety of ways to anticipate them in your overall retirement plan and, potentially, reduce them.

Health savings accounts, or HSAs, can be a smart tool, Stavisky said. These accounts, which are paired with high-deductible health plans, have a triple tax advantage: Contributions are tax deductible, grow tax free and can also be withdrawn tax-free for qualified medical costs.

"Given that $275,000 figure, the odds of you having too much money in a health savings account are pretty limited," he said.

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Expect to spend more on health care in retirement even if you're well - CNBC

Sacramento Bee

Time to get serious about 'health care for all,' says California Assembly leader who blocked it before Sacramento Bee Assembly Speaker Anthony Rendon said Thursday it's time for the state Legislature to have a serious discussion on how to create a universal health care system for all of California. Rendon has been under fire from the California Nurses Association ... Single payer, revived? California lawmakers to hold health care hearings this fallThe Mercury News California lawmakers to hold universal health care hearingsKCRA Sacramento California Assembly Speaker Revives Bid for Universal Health CareCourthouse News Service Long Beach Post all 11 news articles »

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Time to get serious about 'health care for all,' says California Assembly leader who blocked it before - Sacramento Bee

COLUMBUS, OHIO -- Rep. Steve Stivers, R-Ohio, says it was a mistake for House Republicans to try to tackle healthcare reform first this year instead of other topics, including tax reform, and cast doubt on the idea that the Senate would be able to pass any Obamacare repeal bill this year.

"Oh, in hindsight, it's clear," Stivers, the chairman of the National Republican Congressional Committee, told the Washington Examiner when asked if it was a mistake to attempt healthcare reform first. "But it is what it is. You had to do them in some order."

"I would argue healthcare is pretty much..." Stivers said before catching himself. "We're shifting focus," he added, referring to issues like tax reform and other more achievable goals.

When asked if healthcare could resurface, he said it's possible, but said, "I doubt it."

"I think we're moving on to tax reform," he said. "It's time to move on to things we can get done and the Senate can get done. The Senate couldn't pass the skinny repeal bill. It is what it is. It time to move to we have precious time given to us by our voters. We need to focus on the things we can get done."

Stivers said healthcare is a tricky issue for Republicans as 2018 approaches, one that suggests that the GOP is unable to govern. The Senate has been unable to coalesce around a bill since the House passed the American Health Care Act in early May.

"I think it worries some people because some American citizens are losing confidence in our ability to get things done," Stivers said. "We need to reclaim their confidence and regain their confidence by getting things done. Healthcare was always the hardest of all the topics we were dealing with. There's just no consensus. We had a plan out there, but it didn't have 218 co-sponsors. It passed the House, but it didn't have the 50 votes needed, plus the vice president, in the Senate."

"In the end, the American people, I think, are willing to forgive us for not getting everything done, but they're not willing to accept us getting nothing done," he said. "It raises the stakes on tax reform. It raises the stakes on infrastructure. It raises the stakes on some welfare reform that we're going to do as part of tax reform. So it makes it important that we get those things done."

His comments come just weeks before Republicans are expected to push a tax reform plan for the first time since 1986. White House press secretary Sarah Sanders said Thursday that there could be an announcement next week on a tax reform proposal from the White House. Lawmakers, including House Speaker Paul Ryan, are also expected to be involved on the issue after they return to Washington after Labor Day.

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NRCC chair: 'Clear' mistake by Republicans to push healthcare reform first - Washington Examiner

In a perfect world, the largest expenses in retirement would be for fun things like travel and entertainment. In the real world, retiree health-care costs can take an unconscionably big bite out of savings.

A 65-year-old couple retiring this year will need $275,000 to cover health-care costs throughout retirement, Fidelity Investments said in its annual cost estimate, out this morning. That stunning number is about 6 percent higher than it was last year. Costs would be about half that amount for a single person, though women would pay a bit more than men since they live longer.

You might think that number looks high. At 65, you're eligible for Medicare, after all. But monthly Medicare premiums for Part B (which covers doctor's visits, surgeries, and more) and Part D (drug coverage) make up 35 percent of Fidelity's estimate. The other 65 percent is the cost-sharing, in and out of Medicare, in co-payments and deductibles, as well as out-of-pocket payments for prescription drugs.

And that doesn't include dental care or nursing-home and long-term care costs.

Retirees can buy supplemental, or Medigap, insurance to cover some of the things Medicare doesn't, but those premiums would lead back to the same basic estimate, said Adam Stavisky, senior vice president for Fidelity Benefits Consulting.The 6 percent jump in Fidelity's estimate mirrors the average annual 5.5 percent inflation rate for medical care that HealthView Services, which makes health-care cost projection software, estimates for the next decade. A recent report from the company drilled into which health-care costs will grow the fastest.

It estimates a long-term inflation rate of 7.2 percent for Medigap premiums and 8 percent for Medicare Part D. For out-of-pocket costs, the company estimates inflation rates of 3.7 percent for prescription drugs, 5 percent in dental, hearing, and vision services, 3 percent for hospitals, and 3.4 percent for doctor's visits and tests.

Cost-of-living-adjustments on Social Security payments, meanwhile, are expected to grow by 2.6 percent, according to the HealthView Services report.

What's really sobering is the impact of inflation on Fidelity's retiree health-care cost estimates over the years. From 2002, when Fidelity first did an estimate, to its latest projection, the number is up 70 percent.

"It's the power of compounding," Stavisky said. "It's great for investing and brutal for health-care costs."

In its 2017 statement, Fidelity brings up a fairly hot topic in health-care circles health savings accounts, or HSAs as a way employers are helping workers manage costs. (Others might describe the plans as shifting more of the rapidly rising costs of health care onto employees.) HSAs are tax-advantaged accounts to which employees can contribute a certain amount of pre-tax dollars each year to use for medical costs. Employers usually kick in some money, too. The 2017 contribution limit for singles is $3,400, and $6,750 for a person with a family.

HSAs usually accompany high-deductible health plans, which are becoming far more common. (For a good comparison of health-care savings account providers, see Morningstar's 2017 Health Savings Account Landscape.) In return for low premiums, employees have high deductibles to cover before insurance kicks in. In 2017, annual deductibles are at least $1,300 for a single person, with a maximum out-of-pocket expense of $6,550. For a family, the minimum deductible is $2,600, with an out-of-pocket cap of $13,100.

Part of the logic behind HSAs is that employees will be better health-care consumers under such plans. And they might, if being an informed, effective consumer weren't extremely difficult and time-consuming in the murky world of American health-care pricing.

And it's not available to everyone. In the real world, high costs and steep deductibles discourage many people from using the health care they've bought, starting a cascade of ills. Staying healthy can be expensive.

On the bright side, financial planners love that HSAs are "triple tax-advantaged." Money goes in pre-tax, earnings on that money aren't taxed, and the money can be used, without being taxed, for qualified medical expenses. If people have the means to pay for health-care costs out of pocket and leave the HSA money growing tax-free, it can be another tax-advantaged way to save for retirement.

Health-care costs will likely keep climbing, so one of the best investments anyone can make is to work at staying healthy, if possible. For a sense of how much health care could cost you in retirement, and how staying healthy can lower those costs, try AARP's health-care costs calculator. It provides a rough cost estimate based on your height, weight, gender, and state. Users can add in various health conditions to see how much they might add to projected health-care costs in retirement, or subtract from them if, for instance, an overweight person slimmed down.

Whether you're 60 or 25 or somewhere in between, the prospect of retirement should be more inspiring cities to visit, languages to learn, books to read, or to write than the anxious business of war-gaming what your health will be like 10 or 20 or 30 years out. But if paying closer attention to your body and mind now means more money for travel and growth and relaxation after a long hard working life, it's not a bad trade-off.

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Retiree health care costs up 6%, new study finds - InvestmentNews

Vermont residents spend more on health care than the national or regional averages, federal data show.

Community Health Services of Lamoille Valley hopes to reverse that trend, at least at the local level, by streamlining services with a new $5.5 million home.

The one-story building scheduled to open in January, will provide one-stop shopping for patients and lower costs, says CEO Kevin Kelley, who noted that the community health organization has not raised its rates for services in a number of years.

We are forward-thinking five, 10, 15 years down the road, because health care is changing, Kelley said, and he hopes the new space will draw additional qualified professionals to the area, making a larger impact on the people that Community Health serves which is currently 69 percent of Lamoille County residents with a primary-care doctor.

Community Health Services is a federally qualified health center thats designed to ensure that Lamoille County residents have easy access to high-quality, timely, comprehensive health care at an affordable price.

It encompasses six diverse medical practices Appleseed Pediatrics, Stowe Family Practice, Morrisville Family Health Care, the Behavioral Health & Wellness Center, Neurological Clinic and the Community Dental Clinic and over the last decade has doubled its staff from 70 employees to 142.

It has also boosted the number of annual patient visits from 14,965 to 17,418. While thats an increase of only 15 percent, it has helped double the organizations annual revenue over the past 10 years to $15.6 million.

As the agency has grown, the organizations five locations across Morrisville have nearly burst at the seams.

We are totally out of space, Kelley said.

The new 27,000-square-foot structure on a 4-acre field the organization owns at 407 Washington Highway, near the current home of Morrisville Family Health Care, should help alleviate the space problem.

And, for patients, it will consolidate the services provided in the five leased buildings into one owned by Community Health Services.

When we lease properties, we cant control increases in costs, Kelley said. But the single building will have a fixed-rate mortgage, be energy-efficient and provide other fixed costs that can reduce the impact on patients.

It will also help alleviate parking problems at Morrisville Family Health Care with 103 new spaces, compared to just 22 at the current building, and allow patients to simply walk across the hall to other services they need.

And if their primary doctor recommends they see a specialist, a conference room will offer telemedicine remote diagnosis and treatment so the patient doesnt have to leave the building.

In the past, Community Health Services has offered telemedicine only for psychiatric care.

The new building will also house Appleseed and the neurology clinic now in the basement of Morrisville Family Health allowing patients with neurological disorders, such as epilepsy or multiple sclerosis, to walk into a first-floor clinic rather than deal with stairs or an elevator.

Eventually, Morrisville Family Health Care will shuffle across the street, increasing its capacity with three exam rooms instead of two, as well as another procedure room, and the medically assisted treatment team, which helps patients with addiction, will increase its capacity in the new building.

Behavioral Health & Wellness will move too, from Northgate Plaza to Washington Highway, in the building where Morrisville Family Health currently lives, creating a hub of patient care centered just across from Copley Hospital.

In the end, only Stowe Family Practice and the Community Dental Clinic will remain at their current locations.

Community Health Services has recently teamed up Appleseed Pediatrics with the Lamoille Family Center to bring a new program Developmental Understanding and Legal Collaboration for Everyone to Lamoille County, ensuring that newborns and their families receive high-quality medical care as well as the social services and community support they need during the first six months of the newborns life.

Its a three-year pilot program, and the Lamoille Valley is one of five communities participating countrywide.

In line with that mission, Community Health Services will bring the special supplemental nutrition program for Women, Infants and Children, which is a federal program not under the health service conglomerates control, into the building for a few days a week.

While all these services will still function as separate entities, having one central location will allow for better collaboration on patient care, and pooling resources should provide greater efficiencies and savings.

Now, Kelley and his team are working with Copley Hospital to find any services that can be moved across the street to the health center to provide even further ease of access, especially when the cold winter months could dissuade patients from walking across the street.

Community Health Services is already working with Copley to reduce emergency-room use for primary care by placing a social worker in the emergency department to talk to patients who dont have health insurance or arent being treated by a primary care physician.

So far, 58 percent of the patients the social worker has spoken with have set up primary care physicians, and scheduled follow-up appointments with them instead of with emergency room doctors.

As a federally qualified health center, the organization has been awarded a $1 million federal grant toward the project cost. The Vermont Economic Development Authority has also awarded the project $1.5 million in partial financing; Union Bank is providing the rest of the financing for the building itself.

Community Health Services of Lamoille Valley is kick-starting a campaign to raise $200,000 for ancillary equipment in the new building thats not covered by current funding.

We are reaching out for the first time to the community for funding, Kelley said. Its an opportunity for patients to give back to help sustain health care for the future.

Donations can be made at chslv.org/gift-giving.

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Streamlining health care - Stowe Today

Congressional Republicans are gearing up for a battle over tax reform. Nearly everyone in the caucus would like to slash corporate and individual taxes. But they will need to close some loopholes in the tax code if they hope to offset the revenue they will lose by lowering rates.

One of the sacred cows Republicans ought to target is the "employer exclusion," which exempts employer-sponsored health benefits from income and payroll taxes. By effectively subsidizing health insurance, the exclusion has exacerbated our nation's health cost crisis.

Taxing health benefits would make America's health insurance market fairer and more economically efficient. The exclusion is a relic of the World War II era, when employers began offering workers generous health benefits to get around government wage and price controls.

Before then, most people did not receive health insurance through their jobs. The employer exclusion has since become the single largest break in the tax code. This year, the federal government will forego about $350 billion because of the exclusion.

Businesses understandably want to preserve this loophole, which helps them recruit and retain workers. Employees like the loophole as well. To them, a dollar of tax-free health benefits is worth more than a dollar of taxable income.The exclusion might be popular but it is bad public policy.

First, it is deeply unfair to Americans whose employers do not offer health coverage. Many of these folks do not receive a subsidy to buy their own policies on the individual market.

Second, it distorts the labor market. Over 155 million people receive health insurance through their jobs. By tethering health insurance to employers, the government has made it less likely these folks will seek out new jobs or start their own businesses, since they would have to give up their health plans.

Third, it is highly regressive. In 2016, the top two-fifths of earners received nearly 70 percent of the benefit from the tax break. The bottom fifth of the income distribution, meanwhile, captured one-half of 1 percent of the exclusion's benefits.

Worst of all, the loophole drives up health costs. When employers pick up most of the cost of coverage "first dollar coverage" people have less incentive to consume health care responsibly. This leads to wasteful spending that inflates insurance premiums.

The average employer contribution to a family insurance plan more than tripled percent between 1999 and 2016, rising from $4,247 to $12,865. The explosive growth in premiums has left businesses with less money for wages. Combined salaries, wages, and bonuses increased just 58 percent from 1999 to 2015.

In short, the federal government is sacrificing hundreds of billions of dollars a year to subsidize needlessly lavish health coverage for wealthy folks. It's hard to imagine a loophole more deserving of the axe.

It would be politically impossible to do away with the loophole all at once. But Republicans could start the reform process by capping the exclusion at $8,000 for individual plans and $20,000 for family plans. These limits are slightly higher than the average premium for an employer-sponsored plan. So the majority of workers wouldn't be affected.

To keep up with the gradual rise in healthcare costs over time, these caps could grow at the inflation rate plus 1 percent. Such a reform would not ban employers from offering extravagant health benefits. But it would stop subsidizing such decisions with taxpayer dollars.

Many employers would respond by sponsoring less comprehensive high-deductible plans, and pay workers higher wages instead. These high-deductible plans, especially if paired with tax-advantaged Health Savings Accounts, would encourage workers to shop around for health care. And that would put downward pressure on overall healthcare spending.

It's time for Congress to restore some fairness and fiscal discipline to our health care sector by capping the employer exclusion. Lawmakers could use the tens of billions in new revenue to finance permanent tax cuts that boost economic growth, increase wages, and create jobs.

Sally C. Pipes is president, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her latest book is "The Way Out of Obamacare" (Encounter 2016). Follow her on Twitter @sallypipes.

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GOP can improve health care and lower taxes | Opinion - Sun Sentinel

The Senate health committee announced Tuesday that it will hold two back-to-back hearings on health care September 6 and 7. That will be the first time that Republican and Democratic senators officially gather together to examine potential ways to stabilize the Obamacare marketplace. Witnesses are expected to include governors and state insurance commissioners.

"While there are a number of issues with the American health care system, if your house is on fire, you want to put out the fire, and the fire in this case is in the individual health insurance market," Tennessee Sen. Lamar Alexander, the Republican chairman of the health committee, said in a statement.

Washington Sen. Patty Murray, the top Democrat on the panel, said: "It is clearer than ever that the path to continue making health care work better for patients and families isn't through partisanship or backroom deals. It is through working across the aisle, transparency, and coming together to find common ground where we can."

One of the panel's main concerns -- that many Americans may have no options on the Obamacare exchange in their area in 2018 -- has largely abated. While several large insurers have pulled out of the individual market, others have stepped up to take their place. Only one county in rural Ohio, with fewer than 350 Obamacare enrollees, remains at risk of having no insurer on its exchange next year.

Another key problem, however, remains unresolved. One reason why many insurers are hiking premiums for 2018 and others are fleeing is because the Trump administration won't commit to continue paying a key Obamacare subsidy. Insurers, along with governors and insurance commissioners, have been pressing the administration to guarantee these cost-sharing reduction payments will be made through 2018. It's vital to the stability of the market, they say.

President Donald Trump agreed last week to make the August payment, despite earlier threats to end what he calls a bailout for insurers. He has not made a decision on future payments.

The hearings follow the GOP's failed attempt last month to repeal major portions of the Affordable Care Act, widely known as Obamacare.

House Republicans had passed a bill earlier this year to gut the law, but Senate Republicans were unable to do the same. Despite months-long efforts by Senate Majority Leader Mitch McConnell to rally rank and file members, Sens. Susan Collins of Maine, Lisa Murkowski of Alaska and John McCain of Arizona ultimately voted "no" in a dramatic late-night scene on the Senate floor.

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Senate to begin bipartisan health care push - CNN International

Colorado Gov. John Hickenlooper (left) and Ohio Gov. John Kasich will present a plan that fleshes out a set of principles they wrote about in an op-ed in The Washington Post. Carolyn Kaster/AP hide caption

In the wake of congressional Republicans' failure to pass a health care bill, two governors from different parties are going to bring their own ideas to Washington.

Staff for Colorado Gov. John Hickenlooper, a Democrat, and Ohio Gov. John Kasich, a Republican, are working on a joint plan to stabilize the country's health insurance markets. Kasich told Colorado Public Radio's Colorado Matters that they expect to release it ahead of September hearings in the U.S. Senate. They also intend to get other governors from both parties to sign onto the plan, to show support at the state level.

"We're getting very close. I just talked to my guys today, men and women who are working on this with [Hickenlooper's] people, and we think we'll have some specifics here, I actually think we could have it within a week," Kasich said in a joint interview with Hickenlooper that aired Tuesday.

The plan will flesh out a set of principles the two men wrote about in an op-ed in The Washington Post, in which they said another one-party health care plan is "doomed to fail," just like the Republican plans considered this year. In the op-ed, they asserted that the best place to start reform efforts is "to restore stability to our nation's health insurance system."

Bipartisan health care hearings, including the one the governors will appear at, are set to begin just after Labor Day when Congress returns from its August recess. Lawmakers will be consumed with a number of deadlines involving government funding, though sending health care to the back burner.

"I'm not going to get into specifics with you until we have it all ironed out, but it's not going to be some pie-in-the-sky, way-up-there kind of stuff. There will be things that we will address that will have specific solutions. And one of the things we're finding out is the states do have some power to do some things unique to them, as long as these insurance markets are going to be stabilized," Kasich said.

One specific they agree on and would discuss: changing the Affordable Care Act mandate that employers with 50 or more employees provide insurance coverage. The governors say that number is too low, which deters hiring at small companies.

They also agree that the possibility of national single-payer coverage is not on the table in their discussions.

In recent months, Hickenlooper and Kasich have appeared on national television shows to advocate for bipartisan health care reform that includes keeping the Medicaid expansion intact, with both took advantage of in their states. The two governors have even entertained running for the White House on a split ticket.

On whether they think health care should be a "right"

John Hickenlooper: I come from the school that I think it is a right. I'm not sure how much health care is included in that right, but some basic coverage.

John Kasich: I don't think that's that important in this. I mean we want everybody to have health insurance. I mean that's how I feel. Is it a right or is it a privilege or whatever? I don't know why that declaration is important ... The question is how do you do it, and that's what we're working on ... Primary care is important. Catastrophic coverage is important. We don't want anybody to get bankrupted because they get sick.

On what to change about the Affordable Care Act first

Hickenlooper: There are several important things, but the probably top one on our list would be this notion of having some sort of reinsurance [using public money to help insure the sickest people] to make sure the high-cost pool is not causing higher rates for all the people seeking insurance on the private markets ... You use reinsurance in almost every type of insurance program to cut off those "hilltops" as we say.

On why this joint effort may gain traction

Hickenlooper: "[The Senate's health committee] is now holding hearings [starting Sept. 5], and hopefully in those hearings we'll get a chance to present, hopefully, what by that point a number of both Republican and Democratic governors think look like good ideas."

The Colorado Matters website has the full transcript.

This story is part of a reporting partnership with NPR, Colorado Public Radio and Kaiser Health News.

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Governors Preparing Bipartisan Health Care Plan For Congress To Consider - NPR

The Bayou State ranks last in a recent survey of healthcare systems. Obesity, poverty, and smoking are just a few of the reasons.

How does your states healthcare system compare with the rest of the nation?

According to a new report from WalletHub, Louisiana has the worst healthcare in the country.

Meanwhile, Hawaii has claimed the best state healthcare title once again.

Last year, Healthline reported on annual healthcare rankings by the United Health Foundation, the nonprofit arm of UnitedHealth Group.

WalletHubs report is similar, but uses its own set of metrics for weighting its rankings.

Their results are similar, despite the different varying methodologies.

WalletHub assigned point values based on three primary scores:

At the top of the list, Hawaii is followed by Iowa, Minnesota, New Hampshire, and the District of Columbia for best healthcare.

On the other end of the spectrum, the worst begin with Louisiana, followed by Mississippi, Alaska, Arkansas, and North Carolina.

Mark Diana, PhD, chair of Tulane University Department of Global Health Management and Policy, told Healthline that while hes not happy with the rankings, hes not surprised by them.

I think its true that its fairly consistent that Louisiana ranks near the bottom in most efforts to evaluate the general health of states, he said. Typically we go back and forth with Mississippi for 49 and 50.

Louisiana is a poor state, and its a very rural state, said Diana. Those two things tend to go hand in hand, and they also go hand in hand with poorer health outcomes.

Recent census data indicate that Louisiana is one of the poorest states in the United States.

Median household income there is only $45,727, meanwhile the states poverty rate is 19.6 percent the third highest in the country behind New Mexico and Mississippi.

To combat this, Louisiana is one of 31 states that have expanded Medicaid coverage under the Affordable Care Act (ACA). Diana regards the expansion as a real success.

About 1.5 million people out of 4.5 million are on Medicaid in Louisiana, he noted. Thats a third of the population.

If you accept, and I do accept this, and I think that most health policy people agree, that having insurance improves access, and if you have access to a usual source of care, whether it's a primary care physician or whatever, that tends to mean that you have better health outcomes, he said.

The state will need to fight for improved outcomes because, along with poverty, major health epidemics are also plaguing Louisiana.

Currently, the state has some of the highest rates of cancer and heart disease in the country.

Louisianas rate of heart disease is mirrored in its rates of obesity and smoking, both of which are above the national average.

I think its also poor diet, says Diana. Louisiana obviously has a reputation for really good food and really unhealthy food.

Community or behavioral elements of healthcare, such as diet and exercise, are factors that will impact a healthcare system, but tend to reside outside the medical communitys direct control, said Diana.

Delivery of medical care acute moments when healthcare is sought out by an individual due to an illness Diana believes is only a smaller element of a states health, dwarfed by many more external factors.

That connection is relevant to the states high cancer rates, which Diana attributes to industry and chemical manufacturing.

Louisiana has a stretch along the Mississippi River just west of New Orleans thats populated with lots of refineries and plants that have earned it the reputation of being called cancer alley, Diana said.

My suspicion is that if you remove those [areas] from the data, we probably would not be in the top any longer. I think thats not a statewide phenomenon, he added.

Diana is also confident that Louisiana is making strides in certain areas of healthcare, even if they arent necessarily reflected in this years rankings.

Infant mortality rates have dramatically improved over the past few years. Diana said thats thanks largely to Medicaid, which has provided insurance to single pregnant women and children.

Diana also said that through the Medicaid expansion, the state is continually looking into improving their programs.

Finally, he stressed that were some of these rankings better controlled for certain outside factors, they could perhaps look different.

In defense of Louisiana, Id argue that some of these things, like poverty and rurality, are very difficult to influence, says Diana. I suspect if we adjusted for the level of poverty or how much rural population there is, we wouldnt look quite so bad.

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Why is Louisiana's Healthcare so Bad? - Healthline

DETROIT Andy Thorburn, a health insurance executive who is plugging $2 million into a bid to replace Rep. Edward R. Royce (R-Calif.), is the latest Democrat pushing the party to embrace single-payer health care even in swing districts. In a video announcement, Thorburn paints thecontest as a referendum on health care, between a Republican who voted for the repeal of the Affordable Care Act and a Democrat who wants to move, eventually, to Medicare for all.

First-time Democratic candidate Andy Thorburn released an ad embracing single-payer health care, in his campaign to replace Rep. Edward R. Royce (R-Calif.). (Andy Thorburn)

In an interview, Thorburn presented himself as a candidate who could debate health care from a position of total awareness. He ran Global Benefits Group, an international insurance company, until stepping back to the board this year.

The part that really bothered me, when Obama first presented his plan,was my friends and colleaguesstarting their arguments by saying: Hey, we have the best medical system in the world. Why change it? I was like, Look, I cant have a serious discussionwith you if you think that. Its the best system if youre rich. But its clearly not the best for everyone. Yeah, the shah of Iran came here for treatment once thats not the standard!

Progressives, who are stepping up their campaigns to promote single-payer legislation and baiting Republicans into attack ads have struggled with California. The states Democratic-run legislature had passed single-payer legislation during the term of Gov. Arnold Schwarzenegger (R), knowing it would be vetoed; a new single-payer bill was bottled up by legislators, kicking off months of intraparty infighting.

Thorburn suggested that the Democrats national single-payer debate could start on different terms.

Im aware of the debate, Thorburn said. Look, the tax burden has to go up, but all youre doing is shifting from one pocket to another. And the end of the day, were paying less money for health care, because thats been the experience of every country that went to this system.

Asked about the effect that universal Medicare would have on the private insurance system, Thorburn acknowledged that it would hurt.

Move as quickly as you can, he said. It would have a negative impact on my business, but it would be relatively small. Almost all the countries that have universal insurance also have competitive supplemental insurance industries. Germany has Allianz, one of the biggest insurers in the world.

On Tuesday night in Detroit, Sen. Bernie Sanders (I-Vt.) and Rep. John Conyers Jr. (D-Mich.) were holding a town hall meeting to promote specific single-payer legislation in Congress Conyerss HR 676, and Sanderss tbd bill. Thorburn said he would study the bills, suggesting he could cut his own path without undermining anything Democrats were doing.

Im not one of those people who thinks [Nancy] Pelosis terrible, he said, referring to the House minority leader, but Im too much of a novice to think I know who should be speaker.

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In a swing district, a Democrat runs on (eventual) single-payer health care - Washington Post

Local health care industry officials on Tuesday said they have enticed a key conference to move to Austin from Atlanta and expect at least 500 top executives to attend next spring.

The third annual Transformation in Health Conference, tentatively scheduled for April or May, relocated to Austin to tap into the regions entrepreneurial and budding health-care ecosystems, the events organizers said.

Austin is a small market, but its an up-and-coming market and has created a reputation that welcomes innovation and supporting innovation, said Fawn Lopez, publisher and vice president of Modern Healthcare magazine, which organizes the conference. We wanted to be in a market thats consistent with the goal and the objective of the transformation summit.

Lopez and her colleagues will coordinate the conference in partnership with the Austin Healthcare Council, which helped draw the event to Austin and announced the deal at a luncheon Tuesday. Gus Cardenas, president of the council, said he expects between 500 and 1,000 executives to attend the two-day event.

This shows the rest of the world we are here, Cardenas said Tuesday morning. Its a small, nascent but growing ecosystem thats looking at new ways of tackling old health problems.

Theres nothing were working on that has the same potential as health care innovation, Austin Mayor Steve Adler said at the luncheon. The possiblities are especially significant for Austin, Adler said, because the city is getting into this in such a big way as the health care industry is undergoing significant changes.

Prior summits drew executives from a broad range of health care companies, Lopez said in a phone interview last week. By bringing together physicians, administrators, suppliers and other stakeholders, the conference could identify ways individuals and organizations were transforming the health care industry.

As an example, Lopez noted the ongoing transition to a model that pays for better overall patient outcomes, rather than a fee paid every time a doctor performs a procedure. That shift is forcing the industry participants from hospitals to physicians to equipment suppliers to rethink their business interactions.

So physicians might not be able to dictate the equipment or supplies they use if those supplies cost a lot more but dont produce better results. Lopez said. That means the companies that supply those products and services now have to participate in efforts to provide greater value.

They now have to get on the same page with the administration as far as cost containment is concerned, she said. If they cant help customers save money and deliver quality care at a lower cost, theyre not going to get a seat at the table.

The conference brings all those industry officials together to discuss new ways to improve care, lower costs and increase efficiency, she said. With the move to Austin, the summit will add new matchmaking opportunities designed to bring together health care startups and investors, Lopez said.

Cardenas and other local officials said Central Texas, despite its relatively small health care industry, is a natural environment for thinking about new innovations in health care systems, operations and especially technology.

The University of Texas at Austin Dell Medical School has a stated goal to transform health care delivery and systems. An emerging innovation zone near the school is being developed to help foster startups and companies and to help bridge the innovation at the school to the Austin business and residential community.

And earlier this month, Merck, Sharpe & Dohme Corp. officially said it will build its fourth global information-technology innovation center in Austin. The global pharmaceutical company expects to create at least 600 local jobs in the coming years.

People are seeing we have the brain trust, the infrastructure thats in place and the ability to be able to move forward quickly because of an entrepreneurial type of thinking and acceptance of new ideas, Cardenas said.

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Austin lands conference focused on health care innovation - MyStatesman.com

Its no secret that Democrats want to turn the 2018 midterms into a referendum on Republican efforts to overhaul the health care system. The bigger mystery is how Democrats can do so most effectively.

On Tuesday, the Democratic Senatorial Campaign Committee offered one of the more innovative attempts yet, deploying an advertising strategy that is relatively new to the digital content creators and even newer for political party apparatuses.

The spot, which will target voters in Arizona, Florida, Indiana, Missouri, Montana, North Dakota, Nevada, Ohio, Pennsylvania, and West Virginia. Instead of a traditional thirty-second clip, it optimizes viewer experiences by breaking the advertisement into six-second increments. And instead of being presented all at once on a single website, those six-second increments follow a user as he or she travels around the Internet. In other words, viewers will see the first part of the ad as they begin their day at thedailybeast.com. They will then see a second portion of the ad as they move on to a different website; and then a third portion of the ad as they go to yet another page.

This less disruptive format has been deployed by content providers seeking to grab viewer's attention in an age of Snapchat and short attention spans. But a DSCC official says this is the first time this cycle that they or any other committee has utilized the format. Google helped the committee utilize its technology, the official said.

In the spots released on Tuesday, the committee enacts a text conversation between a child and his or her mother, as they find themselves in an emergency room needing stitches. By the second clip, its revealed that the family has no insurance. By the third clip, it is pointed out that the Republican senator being targeted in the ad cast a vote that, it is suggested, slashed their insurance.

As a factual matter, the advertisements have their holes. The Republican-authored health-care bill never became law, despite the fact that the GOP senators being targeted by the DSCC voted for their nearly passed bill. A stronger argument would be that the Trump administration has made insurance more expensive because of its sabotage of Obamacare. But the DSCC is invested in regaining control of the Senate, not in unseating the president.

Still, the GOP-authored bill was projected to swell the ranks of the uninsured in addition to elevating premiums for the elderly and sick. And that is the message that DSCC is hammering home, now in a more innovative, digitally savvy way.

The Republicans health care plan is striking Americans in their everyday lives and in their most challenging moments -- spiking their costs and stripping away coverage they are depending on so that big insurance companies can get another tax break, said David Bergstein of the Democratic Senatorial Campaign Committee. This message reaches voters over a series of direct and compelling spots that tell the story of how the GOP agenda has hurt Americans and their families.

The DSCCs bumper flock ads are part of a larger, six figure, digital ad buy that has also featured six-second bumper YouTube ads and full screen Google takeover ads.

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Dems' New Health Care Ads Literally Follow You Online - Daily Beast

* WCIAS Mark Maxwell interviewed Chris Kennedy the other day. Click here to watch it all, but heres an excerpt

MAXWELL: Your recent polling, your internal polling, said you were a frontrunner, but yet its a big fight. Youve got a long way to go. Seven other candidates gunning for that top spot, and theres a lot of money in this race. JB Pritzker has $21 million already that hes self-funding in his campaign. Are you going to be able to catch up there? Hows fundraising going lately? I know you brought on Bill Daley.

KENNEDY: Yeah, Bill Daleys been incredible, and well have the resources to compete. Im not worried about the money.

MAXWELL: Are you going to cut a check?

KENNEDY: If you look at the number of donors we have, the number of volunteers, the support across the state is incredible. I know Im ahead in the polls, but Im gonna run this like, uh, like Im the underdog and I think thats an important message to people as well.

Bill Daleys arrival was announced on July 19th

It was a bad quarter, no question about it, Daley told me. There was a lot of political outreach. (But) there wasnt even a finance committee, just a committee of stakeholders.

Fixing that is the first thing on his agenda, Daley said. A full finance committee is being assembled (Daley declined to disclose any names), with an initial meeting set for next week. Lists of fundraising targets will be assembled, and regular calls and contacts made, he continued. Some of that will involve the candidate himself. Chris has to spend more time on it.

Since then, Kennedys campaign has reported just $34,700 in contributions. Now, he could be holding back his deposits in order to make a big splash at the end of the quarter. But youd think a candidate whos been under fire for not raising enough money would want to get out in front of that story by rolling out some big donors.

* On to healthcare

MAXWELL: I want to ask you about healthcare for a minute because a lot of the candidates are weighing in. There was a recent fight over single payer, public option. And I want to see if I can get you to weigh in here. What direction would you like to see the country, and what direction would you like to see the state of Illinois go in how it provides healthcare for people?

KENNEDY: I think there are, there are, there are great examples to us around the country. I dont think we need to invent it all ourselves in Illinois. I think if you at what happened under Governor Romney in Massachusetts and the expansion of Medicaid there and the ability for the state to provide great coverage to people at all economic levels.

MAXWELL: Weve expanded Medicaid in Illinois. One in four residents in this state are on Medicaid.

KENNEDY: And I think we can continue to do that, and in effect migrate towards a single payer system. I think we need to free up Medicare and Medicaid to negotiate pricing.

MAXWELL: That sounds like a slow incremental process youre describing, migrate towards single payer. How long do you think that would take?

KENNEDY: I dont know. But I think were moving, were moving in that direction. Its clear to me that thats where well end up, both as a state and as a country over time. And we ought to be on the front-burner here in Illinois.

MAXWELL: Youre describing it as inertia, something thats already on the track, and maybe a spectator. Would you push that faster?

KENNEDY: Oh, Id definitely push it faster, absolutely. And I think we should continue to expand as best we can by negotiating with the federal government what, uh, what issues and who can be covered in Illinois, then do a better job recruiting people who havent signed up to sign up for the available care in our state now. And I think thats how we get full coverage for everyone. Theres coverage, I mean, the fact is that were just handling it poorly. People are getting sick and going to emergency rooms, and it doesnt have to be like that. The problem with the state is largely we look so, we look inward and not outward, and we ought to look to other states and see what great outcomes are occurring there. We could provide better coverage and better healthcare for people in our state.

MAXWELL: So you mention Massachusetts, RomneyCare. Its a deep blue state there. Theyve had some trial balloons and things on the national healthcare scene. Any other states or any other practices that youve seen in relation to how youd lower drug prices or how you would make medicine more affordable for average Americans?

KENNEDY: I think some of the things theyve done in California are helpful. And California, places like California and Texas have massive populations, and theyve begun to negotiate. And I think we can create a consortium with other states, cooperate. I know that were competitive with the people in Indiana and Wisconsin and Iowa, but we can work with them and create regional competition, or regional buying power, that allows us to use the market to drive down pricing.

Im not sure I completely follow, but OK.

Originally posted here:

Kennedy talks money, healthcare - The Capitol Fax Blog (blog)

Senate Majority Leader Mitch McConnellMitch McConnellTrumps isolation grows Ellison: Trump has 'level of sympathy' for neo-Nazis, white supremacists Trump touts endorsement of second-place finisher in Alabama primary MORE (R-Ky.) acknowledgedMondaythat Congress's next steps on healthcare are unclear after Republicans failed to repeal ObamaCare.

"Obviously we had a setback on the effort to make dramatic changes on ObamaCare. The way forward now is somewhat murky," the Senate GOP leader said at a Chamber of Commerce event inKentucky with Treasury Secretary Steven MnuchinSteven Terner MnuchinLiberal coalition launches 'Stop Trump Tax Cuts' website Trump touts infrastructure order, but veers off message Looming debt limit fight rattles Wall Street MORE.

A GOP push to pass a "skinny repeal" of ObamaCare failedin a dramatic 49-51 vote before the August recess. A broader repeal proposal and a measure to repeal and replace theAffordable Care Actsimultaneouslyalso failed to get enoughvotes to pass inthe Senate.

McConnell added that lawmakers were "going to see" whatnegotiationsbetween Sens. Lamar AlexanderAndrew (Lamar) Lamar AlexanderTrump to make ObamaCare payments to insurers for August CBO: ObamaCare premiums could rise 20 percent if Trump ends payments CBO to release report Tuesday on ending ObamaCare insurer payments MORE (R-Tenn.) and Patty MurrayPatty MurrayCBO to release report Tuesday on ending ObamaCare insurer payments OPINION | Progressives, now's your chance to secure healthcare for all McConnell open to bipartisan deal on health insurance payments MORE (D-Wash.), the top two members of the Senate's healthcare committee, aimed atstabilizingthe individual health insurance market could produce.

"We have ... collapsing individual insurance markets around the country. Requests to continue to subsidize the insurance companies. It's a pretty controversial subject to subsidize insurance companies without any reforms," the GOP senator said.

He added that Democrats "have been pretty uninterested in any reforms," but the two parties will need to try to negotiate when they get back to Washington next month.

"So when we get back after Labor Day we'll have to sit down and talk to themand see ... what the way forward might be," he said.

Alexander and Murray are expected to holda series of bipartisan Health Committee hearings next month.

Their goal is to craft an insurance stabilization bill by mid-Septemberthat is expected to include money for ObamaCare's cost-sharing reduction payments, which President Trump has threatened to cut off.

McConnell has previously acknowledged that the next steps on healthcare are unclear afterRepublicans campaigned for years on repealing and replacing the Obama-era law.

If the Democrats are willing to support some real reforms, rather than just an insurance company bailout, I would be willing to take a look at it, McConnell toldreporters earlier this monthahead of the annual Fancy Farm Picnic.

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McConnell: Path on healthcare 'murky' - The Hill (blog)

Democrats are heading toward a new phase in the battle over healthcare as they brace for a tough midterm election cycle.

With the GOP's ObamaCare repeal push largely on ice, Democrats are shifting their focus from defending the Affordable Care Act to pitching their own healthcare ideas.

The long-shot proposals have little chance of passing with Republicans in control of both chambers of Congress and the White House.

But the competing measures could feed into the ongoing fight about the partys future as Democrats search for a path out of the political wilderness.

Establishing a Medicare for All single-payer program will improve the health of the American people and provide substantial financial savings for middle class families. It is the right thing to do. It is the moral thing to do, Sanders wrote in a Guardian op-ed.

Echoing his upstart presidential campaign last year, the Vermont senator is asking supporters to sign up as a citizen co-sponsor of the forthcoming legislation, arguing that its time to wage a moral and political war against a dysfunctional healthcare system.

Sanders put universal healthcare at the center of his bid for the Democratic nomination, and the idea has gained traction amid a progressive resurgence within the party.

Many of Sanderss potential opponentsin a 2020 presidential primary including Democratic Sens. Kamala Harris (Calif.) and Cory BookerCory Anthony BookerBooker: Republicans can't force new healthcare plan 'down our throats' Bill targets lead in schools drinking water Batman v Superman star pushes Cory Booker for president MORE (N.J.) have voiced some support for a government operated healthcare system. Sen. Elizabeth WarrenElizabeth WarrenWarren: Education Dept lawyer may have violated conflict-of-interest laws Congress should think twice on the Israel Anti-Boycott Act Sanders plans to introduce single-payer bill in September MORE (D-Mass.) told The Wall Street Journal that its time for the next step. And the next step is single-payer.

Marissa Barrow, a spokeswoman for the Progressive Change Campaign Committee, said Democrats should embrace a big and bold agenda heading into the next election.

Were looking to make Medicare for all one of the big issues on the campaign trail, she said. We see it as an issue that could help unite the Democratic Party.

But Sanderss Senate colleagues who are running in red states have kept the proposal at arm's length.

Democratic Sens. Joe ManchinJoe ManchinOPINION | 5 ways Democrats can win back power in the states Trump's Democratic tax dilemma Manchin eyed as potential pick for Energy secretary: report MORE (W.Va.), Joe DonnellyJoe DonnellyTrump's Democratic tax dilemma FEC 'reform' a smokescreen to weaponize government against free speech It's time for McConnell to fight with Trump instead of against him MORE (Ind.), Jon TesterJon TesterWhy 'cherry-picking' is the solution to our nations flood insurance disaster Trump signs Veterans Affairs bill at New Jersey golf club It's time for McConnell to fight with Trump instead of against him MORE (Mont.) and Heidi HeitkampHeidi HeitkampTrump's Democratic tax dilemma It's time for McConnell to fight with Trump instead of against him The real litmus test is whether pro-life democrats vote for pro-life legislation MORE (N.D.), as well as Independent Sen. Angus KingAngus Stanley KingSen. King: If Trump fires Mueller, Congress would pass veto-proof special prosecutor statute Senate heading for late night ahead of ObamaCare repeal showdown Overnight Healthcare: Four GOP senators threaten to block 'skinny' repeal | Healthcare groups blast skinny repeal | GOP single-payer amendment fails in Senate MORE (Maine), joined with Republicans to vote against a single-payer amendment from GOP Sen. Steve Daines (Mont.) late last month.

Heitkamp said Congress needs realistic solutions and that Dainess maneuver which was expected to fail was a political stunt.

We need realistic solutions to help fix our healthcare system. ... The decision was made in 2010 to go with a market-based system the question is how we improve the system we have, Heitkamp said in a statement.

Sen. Claire McCaskillClaire McCaskillSenators push for possible FCC enforcement over Lifeline fraud Democrat senator: Trump has elevated Kim Jong-Un to the world stage It's time for McConnell to fight with Trump instead of against him MORE (D-Mo.), who like most Democrats voted present on the GOP amendment, also told constituents she would not support a single-payer proposal.

Im going to disappoint a lot of you. ... I would say if a single-payer came up to a vote right now I would not vote for it, McCaskill, who is up for reelection next year, told constituents during a town hall earlier this year.

McCaskill added she would support allowing individuals who only have one option on the ObamaCare exchanges to buy into Medicare or Medicaid instead.

Democrats face a tough Senate map in 2018, with 10senators running for reelection in states carried by Trump. The nonpartisan Cook Political Report shifted three of those races West Virginia, Indiana and Missouri to toss up and North Dakota from likely D to lean D this week.

A spokesman for Sanders said he didnt yet have an estimate for how many members of the Democratic conferencewould support the forthcoming legislation. One hundred and sixteen House Democrats are backing a separate House bill from Rep. John Conyers (D-Mich.) the first time a majority of the House Democratic Caucus has supported the proposal.

Democratic leadership is trying to walk a fine line in the looming healthcare fight as they balance the competing interests of different wings of the party.

Senate Minority Leader CharlesSchumer (D-N.Y.) has put myriad options, including single payer, on the table.

We're going to look at broader things single payer is one of them, he told ABC News. Medicare for people above 55 is on the table. A buy-in to Medicare is on the table. A buy-in to Medicaid is on the table.

Overall, 33 percent of Americans believe healthcare should be a single payer setup, according to a Pew Research Center poll from late June, compared to 52 percent of Democrats and 64 percent of liberals.

The poll also found that roughly 60 percent believe the government is responsible for making sure all Americans have health insurance.

The coming fight over healthcare is the latest example of a vocal progressive wing trying to flex its muscle and push the Democratic Party to the left in the wake of the 2016 presidential election.

When Sanders introduced a bill to raise the federal minimum wage to $15 a key issue between himself and primary opponent Hillary ClintonHillary Rodham ClintonAssange meets U.S. congressman, vows to prove Russia did not leak him documents High-ranking FBI official leaves Russia probe OPINION | Steve Bannon is Trump's indispensable man don't sacrifice him to the critics MORE 30Democratic senators signed on to the bill, compared to five supporters for a similar bill in 2015.

But red-state incumbents arent the only Democrats worried about embracing single payer.

Sen. Dianne FeinsteinDianne FeinsteinTrump's Democratic tax dilemma Feinstein: Trump immigration policies 'cruel and arbitrary' The Memo: Could Trumps hard line work on North Korea? MORE (D-Calif.) received pushback at a town hall in San Francisco when she said told constituents that she wasnt there on single payer.

Asked if he could support a single-payer system, Sen. Tim KaineTim Kaine Violent white nationalist protests prompt state of emergency in Virginia Republicans will get their comeuppance in New Jersey, Virginia Spicer signs deal with top TV lawyer: report MORE (D-Va.), Clintons vice presidential pick, noted Sanders would be introducing a bill but that he has a different view about what we ought to do.

I want people to have more options, not fewer. ... I would like to explore a circumstance under which there could be a public option, like a Medicare Part E for everybody that you'd have to buy into, Kaine, who is also up for reelection next year, told ABC News earlier this month.

Democratic Sens. Debbie StabenowDebbie StabenowHead of McConnell-backed PAC: We're 'very interested' in Kid Rock Senate campaign Juan Williams: Trump and the new celebrity politics Senate Dems unveil trade agenda MORE (Mich.), Tammy BaldwinTammy BaldwinClub for Growth endorses Nicholson in Wisconsin GOP primary Senate Dems unveil trade agenda Group pushes FDA to act on soy milk labeling petition MORE (Wis.) and Sherrod BrownSherrod Campbell BrownOvernight Finance: House passes spending bill with border wall funds | Ryan drops border tax idea | Russia sanctions bill goes to Trump's desk | Dems grill bank regulator picks Dems grill Trump bank regulator nominees Senate Dems launch talkathon ahead of ObamaCare repeal vote MORE (Ohio), who are each up for reelection in states carried by Trump, are offering legislation that let Americans between the ages of 55 and 64 buy into Medicare.

Barrow called the move a positive step, though the end game is either a single-payer system or a state-by-state or federal Medicare option for everyone.

Sanders has also acknowledged that with Republicans in control of Congress, his bill is unlikely to pass. He outlined three steps to take in the meantime: passing legislation to get the public option in every state, lowering Medicaid eligibility to 55 and lowering the cost of prescription drugs.

But he is also prepared to take his argument for a broader single payer bill into Trump territory. Hell hit the road with stops in Indiana, Ohio and Michigan to discuss healthcare and the economy, including a rally with Conyers where theyre expected to discuss Medicare for all.

Barrow added that the Progressive Change Campaign Committee is already reaching out Capitol Hill offices and will keep up their effort through 2018 and beyond to get Democrats to wrap themselves in the flag of Medicare.

If you go into a red state its a super, super popular program in red states, blue states and purple states, she said. Its going to be a winning issue in 2018 especially in those red and purple states.

Read more from the original source:

Democrats prep for next round of healthcare fight - The Hill

Consider this a rallying cry: Hospitals, health systems and networks need to join forces, organize, come together as a community, to proactively fend off hackers, hacktivists, organized criminals and other emerging threats all trying to penetrate healthcare entities to either steal patient data or, worse, destroy it altogether.

Its not just WannaCry, Petya, NotPetya, ransomware in coffee makers (yes, that appears to have really happened) or the newest malware strain, either. Yes, they all startled the industry, if not the world, for a flash. And theyre legitimate threats.

But the greater danger is that CISOs, CIOs and their shops regardless of how tech-savviness, how many specialists they boast or even the number of attacks their ace security team has detected, blocked or survived every single healthcare organization must protect against the next big attack even though there is literally no way to know what it will look like or from where it will come.

[Register Now: Upcoming HIMSS Healthcare Security Forum]

To be fair, this is happening. Some hospitals are working together just not nearly enough. Security frameworks, information sharing centers, industry trade groups already exist.

Its time to start operating as a healthcare infosec community because security is only going to get harder.

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Tom Ridge, the first U.S. Secretary of Homeland Security and former Pennsylvania Governor, said that a community approach has worked in other industries.

Can it succeed in healthcare?

Yes, yes, Ridge said. Yes and the information sharing and analysis centers proved to be very helpful in financial services and energy-related industries. That is a great platform within which to share best practices, to share threat information.

Healthcare has an ISAC of its own, too, the NH-ISAC and Denise Anderson is its President.

Obviously we'd love to see as many people situationally aware as is possible, Anderson said.

In response to Petya, for instance, Anderson said NH-ISAC had a core team of subject matter experts working to collaboratively determine what the problem was and then craft a mitigation strategy. Members, in turn, can take that strategy and put it, or parts thereof, into action.

Thats just one recent example, of course. And Penn Medicine Associate CIO John Donohue said the opportunities to collaborate with other healthcare organizations to improve Penns own security posture are significant.

As we begin to shift more to a proactive cybersecurity stance, timely and accurate intelligence becomes the name of the game, Donohue said.

Penn, for its part, taps into what Donohue described as a network of peers for real-time intelligence on zero-day malware and other trending threats.

That practice is going to become increasingly important as hospitals have more and more apps and devices to protect.

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Depending upon which estimate you prefer, somewhere between 5 and 10 million new devices hook up to the internet every day.

Cyber Threat Alliance President Michael Daniel, who served as the White House Cybersecurity Coordinator for President Obama, said that cyberspace is the only environment expanding on a daily basis and that, in turn, makes the security problem both harder and bigger.

As the number of devices grows, so does peoples reliance on them, and the potential damage that can be done when they are attacked expands as well.

They are much more heterogeneous than we saw in the past, Daniel added. Its not just desktops or laptops, but now its mobile devices and Fitbits, refrigerators, and cars, light bulbs and all the so-called internet of things.

Lets calculate for a minute. A greater variety and number of apps and devices, more new types of cyberattacks, even more adversaries than ever before, and no suggestion that any of those will let up in the near future.

Heres one more to add.

I'm not sure anyone has a true handle on all of the organizations involved in healthcare out there, said NH-ISACs Anderson. Hospitals are not the only organizations that are vulnerable. Dentists, small physician practices, labs, radiological and therapy providers are all very rich targets because they are small and don't have many resources.

The sum of those realities is a pretty grim picture: Healthcare information security is difficult today and its only going to get harder from here.

Not only hospital management but the boards of directors need to embrace the fact that the industry is vulnerable and they really have to prioritize securing IT systems.

Ridge pointed out that hospital IT and security executives should be aware that the world is in a digital war and its not just nation-state against nation-state. Organized cybercriminal groups, hackers and hacktivists, lone wolf attackers are all dangerous.

Corporate leadership, Ridge said, not only hospital management but the boards of directors need to embrace the fact that the industry is vulnerable and they really have to prioritize securing IT systems.

Ridge said a security framework, such as the one National Institute of Standards and Technologys offers, is a baseline. NIST is one option, HITRUST is another.

In addition to the frameworks, the Department of Health and Human Services Health Cybersecurity Communications and Integration Center, the InfraGard cyber health working group and industry trade groups including Healthcare IT News owner HIMSS, as well as the Medical Group Management Association and the American Medical Association, all make certain resources available.

Lee Kim, Director of Privacy and Security at HIMSS, said the combination of frameworks, associations, government groups could be the virtual glue binding together the infosec community healthcare needs.

Penns Donohue said as threats continue accelerating, he finds himself participating more and more in the intelligence sharing community.

As a result of this collaboration Penn Medicine has been able better prepare for vulnerability exploits and minimize the impact of malware attacks, Donohue said.

Healthcare needs to do with its IT systems what financial services, telecom and energy have already done. Be preemptive, not reactive.

The frameworks and sharing tools exist but, of course, so do challenges.

Picking one among the various resources itself can be confusing, if not inhibitive, HIMSS Kim said. Cost is another issue.

But the biggest obstacle is simply not knowing what information to seek and share or how to make that happen and the same goes for what not to share.

Ridge, who is now chairman of consultancy Ridge Global, added that healthcare should emulate other industries.

Healthcare needs to do with its IT systems what financial services, telecom and energy have already done, Ridge said. Be preemptive, not reactive.

Indeed, it has become a necessity for the healthcare industry to overcome those barriers to participation on the way to safeguarding patient information and care delivery for the patients and their families that infosec, IT and medical professionals serve.

We need to be more coordinated as a sector, HIMSS Kim said. Otherwise, we, too, will be pwned!

Twitter:SullyHIT Email the writer: tom.sullivan@himssmedia.com

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Hospitals must band together to beat hackers - Healthcare IT News