In this week’s summary: criticism about the implementation of the ACA from one its chief supporters, a looming labor crisis could have far-reaching ramifications for the care of the elderly and the disabled, and some promising figures on the nation’s infant mortality rate.
Affordable Care Act
U.S. Senator Baucus expressed his displeasure this week over the implementation of the Affordable Care Act. Baucus, who was instrumental in crafting and urging passage of the federal overhaul, is the first top Democrat to publicly voice fears about the rollout of the new health care law. While the ACA is designed to bring coverage to some 30 million uninsured people through a mix of government programs and tax credits for private insurance, Baucus is concerned that the Health and Human Services Department has not done enough to ensure a smooth implementation of the law (New York Times, 4/17).
A new study from Families USA , finds that the majority of tax subsidies to help Americans pay for health insurance under the Affordable Care Act will go to working families. The ACA created state health care exchanges where residents can shop for health insurance policies available in their states. The exchanges are state- or federal-run websites where residents can see a list of plans and whether they are eligible for any subsidies to help them pay for that insurance. The Families USA report finds that families making between $47,000 and $94,000 will receive half the subsidy funding and that 88% of the credits will go to working families. Families USA did not include people who fall below 138% of the poverty line because, in the states that will expand Medicaid, they will not need subsidies.
Health Care Services
A labor shortage is worsening in one of the nation’s fastest-growing occupations—taking care of the elderly and disabled—just as baby boomers head into old age. The Wall Street Journal examines the challenges facing nursing homes and operators of agencies providing home-care services. These entities are already are straining to find enough direct-care workers, who help the elderly or disabled with such things as eating and bathing (Hagerty, 4/14).
A study published this week in The Journal of the American Medical Association, found that hospitals make money from medical mistakes because insurers pay hospitals for the longer stays and extra care that patients need to treat surgical complications. The study is based on an analysis of the records of 34,256 people who had surgery in 2010 at one of 12 hospitals run by Texas Health Resources. Of those patients, 1,820 had one or more complications that could have been prevented, like blood clots, pneumonia or infected incisions. The median length of stay for those patients was 14 days, and hospital revenue was more than for patients without complications ($49,400 versus $18,900). While the study’s authors do not suggest that hospitals were trying to make money by deliberately causing complications or refusing to address the problem, they do suggest that changing the payment system may help to reduce surgical complications.
The Supreme Court heard a case this week that could have far reaching influence on the world of science and medicine. The lawsuit deals with a central issue — whether human genes may be patented. Myriad Genetics, a Utah biotechnology company, discovered and isolated two genes that are highly associated with hereditary breast and ovarian cancer. Myriad patented its discovery, giving it a monopoly over use of the genes for research, diagnostics and treatment. A group of researchers, medical groups and patients sued, challenging the patent as invalid. During oral arguments, the justices signaled that they probably will bar any grants of exclusive and profitable patents on human genes that prevent other scientists from testing these pieces of DNA (AP, 4/15).
The nation’s infant mortality rate fell by 12 percent from 2005 through 2011, a promising pattern that researchers say may be due in part to a decline in premature births. Some of the most striking improvements were in Southern states, which still have higher infant mortality rates than most of the country. These figures were contained in a new report from the Centers for Disease Control and Prevention release this week. The decline in premature births comes after a period of stalled progress on this front. Although the infant mortality rate dropped significantly over the 20th century, it remained static from 2000 to 2005, according the report.