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Thursday, April 10, 2014

HHS Secretary Sebelius resigns

From USA Today
WASHINGTON--After a difficult five years shepherding President Obama's signature health care law, Health and Human Services Secretary Kathleen Sebelius has tendered her resignation, according to two senior administration officials.

Obama accepted the resignation this week and intends to announce that he will nominate Office of Management and Budget Director Sylvia Mathews Burwell to replace Sebelius.

He will make the formal announcement at 11 a.m. on Friday at the White House, according to officials, who asked not to be identified so as not to preempt the president.

In recent months, Sebelius has faced heavy scrutiny after the troubled launch of the federal online insurance marketplace, and has been deluged with Republican attacks over the costs of the Affordable Care Act...
Not sure I'd want that job. Burwell will have a circus confirmation hearing.

John Halamka, M.D., CIO, Beth Israel Deaconess Medical Center & co-chair of the HIT Standards Committee:

“I want to thank Kathleen for the challenging work she’s done that laid the foundation for the years of healthcare reform implementation ahead. During her transition, I’ll stay focused on the road ahead. For me, every day is Meaningful Use, ICD-10 (yes, we’ll finish it), ACA, and HIPAA Omnibus Rule.”


Sebelius Departure from HHS Will Have Negligible Effect on HIT

With all the problems that have plagued the rollout and operation of the federal exchange website, the announcement that Kathleen Sebelius has decided to resign as Secretary of Health and Human Services makes perfect sense. Sebelius is trying to leave on a "high note," timing her resignation with the end of open enrollment on March 31, which marked the milestone of an estimated 7.5 million Americans having signed up for healthcare coverage under the Affordable Care Act.

During her five-year tenure, Sebelius presided over a government behemoth at HHS, helping to usher in a host of new programs expected to improve the quality and efficiency of care. President Obama in 2009 signed the HITECH Act to lay the ground work for an information technology infrastructure to support health reform, which came a year later through the Affordable Care Act.

Now, five years later, about $24 billion has been spent on driving EHR adoption--$22 billion on the Medicare and Medicaid incentive program and $2 billion on other programs--which has resulted in a dramatic increase in EHR use among eligible professionals and eligible hospitals. However, for all her leadership at HHS, Sebelius did not have hands-on involvement in the day-to-day design and implementation of the health IT initiatives that are driving adoption among healthcare providers, and it is for this reason that her departure will have a negligible effect on those ongoing efforts...

FRIDAY, APR 11, 2014 09:17 AM PDT
A pro- single payer doctor’s concerns about Obamacare
Believe me, the right's approach would be much worse. But the underinsured are getting a worse deal than you think


As a single-payer advocate who is also a doctor, I was concerned after the Affordable Care Act was passed that it didn’t do enough to combat rising underinsurance. A recent study by the Commonwealth Fund, which used new data to demonstrate that in 2012 some 31.7 million Americans were underinsured (i.e. insured, but still with heavy additional out-of-pocket health care expenses), argued that the burden of underinsurance will likely lessen as the ACA fully unfolds. But is there really reason for such optimism?

This is a complicated issue with many moving parts, so one way to tackle it (before immersing ourselves in the exhilarating policy literature) is to pose a simpler question: if your family is insured, and someone gets seriously sick, can you not worry about going broke?

The short answer: it depends on how much you have in the bank, and on the “out-of-pocket maximum” established by the ACA for your particular plan. The out-of-pocket maximum is the most that you would have to pay (after premiums) on things like co-pays for medications or deductibles for hospitalizations, and it can go as high as $12,700 annually for exchange plans under the ACA. But doesn’t the law provide protection for lower-income individuals, for instance, in the form of reduced out-of-pocket limits? The answer is yes – but to a lesser extent than we initially thought, even though, somehow, no one informed us that things had changed...
Interesting post. Read all of it. See my 2009 "Pubic Optional." We keep calling it "insurance," but it's still mostly "prepayment" via for-profit intermediaries. As medical economist J.D. Kleinke says, ObamaCare is a "radical expansion of the status quo."

Below, we're gonna keep reading and hearing this stuff ad nauseum for two more years.



See my review of Mario Bunge's historical "Medical Philosphy" in my prior post "Philosophia sana in ars medica sana."

More to come...

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