Friday, March 22, 2013

“Protect our Health, Not Their Wealth” Rally in Albany

Wednesday, March 20 – 60 people rallied in front of Albany Medical Center under the banner, “Protect OUR Health, Not THEIR Wealth.” Speakers and protesters called for “No Grand Bargain” – Hands off Medicare, Social Security and Medicaid,” “Scrap the Cap on Social Security,” “Oppose Privatization of our Public Hospitals and Nursing Homes,” and “Single Payer, Improved Medicare for All.”

A broad coalition representing nurses, physicians, medical students, labor unions, senior citizens, faith groups, grassroots organizations, and Occupy Albany – the driving force behind the event, joined the rally.

Sponsoring organizations:
New York State Nurses Association
Public Employees Federation
Physicians for a National Health Program – Student Chapter
Single Payer NY
Capital District .Area Labor Federation
Albany Central Federation of Labor
The Labor Religion Coalition
Capital District Alliance for Universal Healthcare
Statewide Senior Action
Citizen Action
MoveOn
Occupy Albany

Additional participating unions: AFGE, SEIU, NALC

Thursday, March 21, 2013

How A Patient's Suicide Changed A Doctor's Approach To Guns

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As Health Law Turns Three, Public Is As Confused As Ever

More From Shots - Health News HealthHow A Patient's Suicide Changed A Doctor's Approach To GunsHealthAs Health Law Turns Three, Public Is As Confused As EverHealthHow Ideas To Cut ER Expenses Could BackfireHealthLaw Says Insurers Should Pay For Breast Pumps, But Which Ones?

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Wednesday, March 20, 2013

How Ideas To Cut ER Expenses Could Backfire

More From Shots - Health News HealthHow A Patient's Suicide Changed A Doctor's Approach To GunsHealthAs Health Law Turns Three, Public Is As Confused As EverHealthHow Ideas To Cut ER Expenses Could BackfireHealthLaw Says Insurers Should Pay For Breast Pumps, But Which Ones?

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Monday, March 18, 2013

Affordable Care Act at 3: Consumer Protections

In the past, too many parents had to worry about how they would pay the mortgage or the car payment if their sick children were dropped from insurance coverage. Victims of breast cancer worried about what would happen to them or their families if they reached a lifetime limit on coverage and no longer could afford treatment.

These were real concerns for real people. Because of the health care law, however, they can put these worries aside and know they are getting a better value for their premium dollars.

The Affordable Care Act brings an end to some of the worst insurance industry practices that have kept affordable health coverage out of reach for millions of Americans, especially when they needed it most. Under the health care law, consumers can be confident that their insurance will protect them if they get sick and their families won�t be crushed by medical bills.

As we observe the third anniversary of the President signing the health care law, let me tell you what this means in real terms to many American families:

For Alycia Steinberg of Towson, MD, whose 4-year-old Avey has leukemia, the health care law gives her the ability to focus on her daughter�s health without worrying that she might be denied coverage because of her illness.Tracy Wirtanen-DeBenedet of Appleton, WI, can manage her 10-year-old son�s fight against recurring tumors without worrying about his health insurance being denied or coverage capped at a lifetime dollar limit�the health care law makes lifetime limits illegal.Judy Lamb of Colorado is being treated for breast cancer that has spread to her bones and liver. These treatments cost hundreds of thousands of dollars a year, but Judy says she is no longer �freaked out� by the possibility that her insurer will cut off her treatment by imposing a lifetime dollar cap on her coverage of essential health benefits. Judy is doing so well now, she�s thinking about going back to work as a nurse.

In addition to helping those with great need, the health care law helps us all stay healthy in the first place.

Consumers now have the right to many vital preventive services at no out-of-pocket cost.

According to a new report, about 71 million Americans in private insurance plans received expanded coverage of preventive services, such as mammograms and other cancer screenings, flu shots, and cholesterol checks, at no additional charge in 2011 and 2012.

In addition, insurance plans are now covering without cost-sharing more prevention-related services for women, such as well-woman visits, breastfeeding support and supplies, and gestational diabetes screening. This will guarantee nearly 47 million women access to these vital services at no charge.

Medicare beneficiaries are also eligible for key preventive services at no out-of-pocket cost. Last year, more than 34 million seniors and people with disabilities on Medicare used at least one free preventive service, such as mammograms and cholesterol screenings.

Even more new protections will apply to most plans beginning in 2014. The new protections will prevent insurers from denying coverage because of a pre-existing condition like asthma or heart disease, or charging more because of a person�s gender or occupation. That means an insurer will no longer be able to charge women more than men for the same coverage or charge firefighters, first responders, and others more just because of their jobs. Being a woman will no longer be a pre-existing condition.

The bottom line is consumer protections and preventive services under the Affordable Care Act are giving millions of Americans more for their health care dollars.

And beginning October 1, 2013, qualified individuals will be able to shop for health insurance based on benefits, quality and price through the Health Insurance Marketplace (otherwise known as an Exchange) in their state. Should you need help sorting through your options, the Marketplace will offer experts and tools free of charge to assist you.

The Affordable Care Act is giving you greater control over the care you need and deserve.

Learn more about the key features of the Affordable Care Act at www.healthcare.gov/law/features.

Find out about the Health Insurance Marketplace and sign up for email and text updates at https://signup.healthcare.gov.

Follow Secretary Sebelius on Twitter at @Sebelius.

Saturday, March 16, 2013

Matchmaker, Er, Match Week, Make Me A Doctor

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Affordable Care Act, Jobs, and Employer-Sponsored Insurance: A Look at the Evidence

Since the Affordable Care Act became law in 2010, health care cost growth has been lower than in the past � and lower than was projected when the law passed almost three years ago.

Private health insurance premium growth per person was slower than overall economic growth in 2011, and a new survey by Towers Watson/National Business Group on Health found that the growth in employers� costs for employee health benefits in 2012 was at its lowest in 15 years.

Also, a recent indepth analysis by USA Today found that, �cost-saving measures under the health care law appear to be keeping medical prices flat.�

But ever since the health care law was debated in Congress, we have seen a lot of misinformation, which often leads to misunderstanding of the law itself and how it benefits consumers and businesses, both large and small.

For example, back in October 2010, the Beige Book from the Federal Reserve reported that some employers anticipated increased costs of employee benefits immediately as a result of health care reform, and last week�s Beige Book has been cited by some long-time critics as suggesting jobs are not being created because of employers� uncertainty about how the law will affect them.

However, when assessing the impact on labor markets, there is both analytical and anecdotal evidence that tells the real story. For example, the Congressional Budget Office (CBO) projected that the reduction in labor would be minimal�at roughly half a percent�and would result almost exclusively from employees deciding to retire early or voluntarily work fewer hours.�

There is also a real-life example of how a similar law affected the labor market.� The experience in Massachusetts is consistent with the CBO projections.� Studies found no negative impact on the labor force in the State after it implemented similar reforms in 2006.� In fact, there may have been a shift toward full-time work as workers sought to gain access to their employers� plans to avoid the individual responsibility penalty in the State.

And, last week�s job report suggests that private job growth is strong.� The economy has added private sector jobs for 36 straight months, for a total of nearly 6.4 million jobs during that period.� The service sector � the source of many of the questions about the health care law � led the way in monthly job creation in February.�

In addition, some initial statements made by CEOs about scaling back full-time workers have now been reversed.� For example, the CEOs of chains such as Applebee�s and Papa John�s Pizza have called their earlier statements about reducing hours premature.� The CEO of Darden, owner of chains like the Olive Garden, stated: �As we think about healthcare reform, while many of the Patient Protection and Affordable Care Act�s rules and regulations have yet to be finalized, we are pleased we know enough at this point to make firm and hopefully reassuring commitments to our full-time employees.��

Over time, many provisions of the health care law will work to create a more efficient, higher quality health care system and slow the growth of health care.� This is not just good for the health system, but it is good for American jobs and the economy.�

Friday, March 15, 2013

More Minority Young Adults are Obtaining Health Insurance

Martin Luther King, Jr. once referred to injustices in health as one of �the most shocking and inhumane" forms of inequality. Luckily, health reform is making serious strides in leveling the health care playing field.

In April of last year, we released an Action Plan to Reduce Racial and Ethnic Disparities, and already we are seeing how the Affordable Care Act is helping us move towards our goal of a nation free of disparities in health and health care.

Recently, we reported that 2.5 million additional young adults have gained health coverage because of the health care law. It allows young adults to stay on their parents' insurance plans through age 26. And this week, we announced that of this number, 1.3 million are racial and ethnicity minorities: approximately 736,000 Latinos, 410,000 Blacks, 97,000 Asian Americans, and 29,000 American Indian/Alaska Natives have gained coverage because of the law.

These statistics are more evidence that the health care law is taking the critical steps needed to ensure that more Americans get the health coverage they need and deserve � regardless of race or ethnicity.

Thursday, March 14, 2013

Health Insurance Prices For Women Set To Drop

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AHIP Gave More Than $100 Million to Chamber’s Efforts to Derail Health Care Reform

The nation’s leading health insurance industry group gave more than $100 million to help fuel the U.S. Chamber of Commerce’s 2009 and 2010 efforts to defeat President Obama’s signature health care reform law, National Journal’s Influence Alley has learned.

During the final push to kill the bill before its March 2010 passage, America’s Health Insurance Plans gave the chamber $16.2 million. With the $86.2 million the insurers funneled to the business lobbying powerhouse in 2009, AHIP sent the chamber a total of $102.4 million during the health care reform debate, a number that has not been reported before now.

The backchannel spending allowed insurers to publicly stake out a pro-reform position while privately funding the leading anti-reform lobbying group in Washington. The chamber spent tens of millions of dollars bankrolling efforts to kill health care reform.

The behind-the-scenes transfers were particularly hard to track because the law does not require groups to publicly disclose where they are sending the money or who they are receiving it from.

For example, in its 2009 IRS filing, AHIP reported giving almost $87 million to unnamed advocacy organizations for “grassroots outreach, education and mobilization, print, online, and broadcast advertising and coalition building efforts” on health care reform. That same year, the chamber reported receiving $86.2 million from an undisclosed group. Bloomberg’s Drew Armstrong first reported the AHIP-chamber link. The $86 million accounted for about 42 percent of the total contributions and grants the chamber received.

The next year followed a similar pattern. In 2010, AHIP reported giving $16.5 million to unnamed advocacy organizations working on health care reform and the chamber reported receiving about $16.2 million from an undisclosed source, which the Alley has learned was AHIP. The $16.2 million accounted for about 8.6 percent of the total contributions and grants the chamber received that year.

Chamber spokeswoman Blair Latoff would not provide the providence of the $16.2 million donation saying only, “We filed our tax returns for calendar year 2010 in November. Schedule B lists all of our contributions, one of which is $16 million dollars from one entity.”

AHIP spokesman Robert Zirkelbach was similarly vague. He referred the Alley to a statement the group put out in 2010 when AHIP’s $86 million transfer to the chamber was first reported.

“We, like other major stakeholders, invested in advocacy. We supported a number of leading health care advocacy organizations and coalitions that shared our views,” the statement said. “While the new law helps millions of people obtain coverage, it fails to bend the health care cost curve. Health plans are committed to working on ways to make coverage more affordable and minimize disruptions for those who are currently insured.”

An AHIP official did say the $16.5 million spent in 2010 was on advocacy efforts prior to health care reform’s passage and had nothing to do with political spending ahead of the 2010 midterm elections.

The news that insurers gave more than $100 million to help fuel the chamber’s efforts to derail health care reform comes as the nation girds for a Supreme Court decision this month that is sure to reignite the health care reform debate on Capitol Hill and the campaign trail.

Elahe Izadi contributed.

Wednesday, March 13, 2013

I Can See Healthcare From Here

DETROIT � As I wake each morning here in Detroit at the US Social Forum, I glance just a few hundred yards across the way, and I know people have healthcare without regard to financial or other barriers. And it hurts like hell to see the cars �over there� winding along the river inside Canada and know that as I sit here in my own nation, I am without the basic human right to healthcare just because I am an American.

The feeling I get every time I glance that direction is the same one I had when I was a patient in Cuba during the filming of SiCKO. I feel sick to my stomach with anger and sadness and wonder why I have spent the past 25 years of my life fighting for healthcare that in other nations � other rich nations and other poor nations � is long accepted as what people in a civilized society extend to and protect for one another.

I am gut-punched all over again. I want to curl up in a ball on the floor of my room and weep. I want to rage at the top of my lungs until the pain pours out somewhere else. I want to grab my husband and my kitty and a few of my old family photos and go where my life is valued enough to allow me to seek and receive care when we need it. Yes, I admit it. I am sick to death of the excuses for why we cannot extend healthcare to all without bankrupting folks, and I sometime dream of escape from it all.

At the US Social Forum, the potential to gather many voices and many forces together to move toward healthcare justice in this nation may or may not fully materialize. Sometimes the voices at the microphone calling for transformative health reform are as controlling and power-hungry as those who run the for-profit, medical-industrial complex. The loudest voices speak with officious verbiage and self-righteous certainty that can squeeze out the meek or those without the required activist pedigrees. In many movements for social change, there is an intricate power structure that can be hard to understand and even harder to accept.

Those of us who believe that the for-profit health care system � not just the for-profit health insurance industry � must be broken apart to save lives, to save homes, to save families and to save this nation, must get to the point where swimming to the other side of this profit-powered river of healthcare delivery and finally changing this awful, brutal mess means so much to us that we are willing to let it be a people�s movement not its own hierarchical system of political ineffectiveness. The mission must be getting to healthcare for everyone and not who gets us there. We have to throw it all in together if we are ever to change it.

The power of the medical-industrial complex in this nation is that the thieves stay in bed with each other against all forces that would break up their game. Providers simultaneously speak ill of insurance giants but then court the best contracts with them. Even providers who claim to want to see transformative change in the system sue patients into bankruptcy to collect deductibles after those lucrative contracts negotiated with insurance carriers leave some portion of the bill unpaid. It isn�t just their money and raw greed that buys influence over the system of political power, it�s also their intense loyalty to one another and codependence on the sources of their profit margins — not unlike how the mob operates. Break out of the fold, and they�ll break your knees.

And, sadly, thousands and thousands of those who even support single-payer reform in their non-working hours are beholden to the system for their healthy incomes and lifestyles many patients will never attain. It�s hard to trust someone whose collection agency is garnishing your wages when they try to say they aren�t an inside player in this mess with a vested interest in making changes that protect the money they must have to protect the style of living to which they have become so accustomed.

Too often in movements for huge social change � like the health reform movement � we get tied up in the process and who is running the show, which expert is expert enough and who is at the microphone speaking to the lowly, less articulate minions instead of hanging together against the forces that we seek to overthrow. This tragedy is a people�s tragedy, a patients� tragedy, a least-among-us tragedy. If we won�t even value those voices in the process � if we believe the stories and the pain no longer matters � then we do not believe in the basic human right to anything.

I am not sure we can transform the healthcare system in this nation unless we first stand at the edge of the river looking over to healthcare as a basic human right on the other side and share deeply enough the rage and the pain and the frustration of our sisters and our brothers who have been hurting for so long. We must then become united against all forces that would divide us against the primary goal of achieving healthcare for all. We have to rage together against a system that has ravaged so many lives and robbed us of so much human potential along the way � and we must not rage against one another for not having the perfect approach or the perfect pedigree or the perfect PhD or MD or JD.

The river and a bridge are all that physically separate me today from healthcare as a basic human right and the travesty of healthcare as a privilege of the sufficiently privileged. But the river of social and political change that separates me from healthcare as a basic human right is potentially much more difficult to bridge, unless we embrace and lift all voices. Raising millions of voices for change requires valuing what those voices have to offer to the chorus. All voices in, no voices out.

I am sick to death of fighting this terrible system to secure healthcare for my husband and myself. That struggle has consumed much beyond our health and our meager wealth. I don�t ever again want to glance across the way and see relief and know it could have been ours in this nation if only we�d fought the right enemy.

Research ties economic inequality to gap in life expectancy

ST. JOHNS COUNTY, Fla. � This prosperous community is the picture of the good and ever longer life � just what policymakers have in mind when they say that raising the eligibility age for Social Security and Medicare is a fair way to rein in the nation�s troublesome debt.

The county�s plentiful and well-tended golf courses teem with youthful-looking retirees. The same is true on the county�s 41 miles of Atlantic Ocean beaches, abundant tennis courts and extensive network of biking and hiking trails.

The healthy lifestyles pay off. Women here can expect to live to be nearly 83, four years longer than they did just two decades earlier, according to research at the University of Washington. Male life expectancy is more than 78 years, six years longer than two decades ago.

But in neighboring Putnam County, life is neither as idyllic nor as long.

Incomes and housing values are about half what they are in St. Johns. And life expectancy in Putnam has barely budged since 1989, rising less than a year for women to just over 78. Meanwhile, it has crept up by a year and a half for men, who can expect to live to be just over 71, seven years less than the men living a few miles away in St. Johns.

The widening gap in life expectancy between these two adjacent Florida counties reflects perhaps the starkest outcome of the nation�s growing economic inequality: Even as the nation�s life expectancy has marched steadily upward, reaching 78.5 years in 2009, a growing body of research shows that those gains are going mostly to those at the upper end of the income ladder.

The tightening economic connection to longevity has profound implications for the simmering debate about trimming the nation�s entitlement programs. Citing rising life expectancy, influential voices including the Simpson-Bowles deficit reduction commission, the Business Roundtable and lawmakers on both sides of the aisle have argued that it makes sense to raise the eligibility age for Social Security and Medicare.

But raising the eligibility ages � currently 65 for Medicare and moving toward 67 for full Social Security benefits � would mean fewer benefits for lower-income workers, who typically die younger than those who make more.

�People who are shorter-lived tend to make less, which means that if you raise the retirement age, low-income populations would be subsidizing the lives of higher-income people,� said Maya Rockeymoore, president and chief executive of Global Policy Solutions, a public policy consultancy. �Whenever I hear a policymaker say people are living longer as a justification for raising the retirement age, I immediately think they don�t understand the research or, worse, they are willfully ignoring what the data say.�

A Social Security Administration study several years ago found that the life expectancy of male workers retiring at 65 had risen six years in the top half of the income distribution but only 1.3 years in the bottom half over the previous three decades.

In 1980, life expectancy at birth was 2.8 years longer for the highest socioeconomic group defined in a research study than the lowest, according to a report by the Congressional Budget Office. By 2000, the gap had grown to 4.5 years.

Continue reading…

Regardless Of High Court, No Return To Old Days For Parts Of Health System

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Affordable Care Act is Working to Bring Down Health Care Costs

Before the Affordable Care Act passed, the dramatic rise in health care costs put access to health care coverage out of reach for many Americans. With many people no longer able to afford coverage, the cost of uncompensated care in hospitals rose and those costs were passed along to people that could afford coverage. And, at the same time, health care�s share of the nation�s economy was growing rapidly.�

Three years later, the Affordable Care Act is working to bring down health care costs.

The law includes innovative tools to drive down health care costs.� It incentivizes efficient care, supports a robust health information technology infrastructure, and fights fraud and waste. ��After decades of growing faster than the economy, last year, Medicare costs grew by only four-tenths of a percent per person, continuing the trend of historically low Medicare growth seen in 2011 and 2010.

Major progress in Medicare is sparking smarter care in the private market, and it�s working to bring down costs in the private market. Overall health-care costs grew more slowly than the rest of the economy in 2011 for the first time in more than a decade. And just last week, USA Today reported health care providers and analysts found that �cost-saving measures under the health care law appear to be keeping medical prices flat.�

Even though the health care law is working to bring down costs, critics continue to claim the law is too expensive.� In reality, the law is fully paid for, and according to the independent Congressional Budget Office, the law reduces the deficit over the long term.� The facts show that employers, patients and our federal budget can�t afford to roll back the law now:

Fully repealing the Affordable Care Act would increase the deficit by $100 billion over ten years and more than a trillion dollars in the next decade.� It would also shorten the life of the Medicare Trust Fund by eight years.Health care spending grew by 3.9 percent in 2011, continuing for the third consecutive year the slowest growth rate in fifty years.Health-care costs grew slower than the rest of the economy in 2011 for the first time in more than a decade.The proportion of requests for double-digit premium increases plummeted from 75 percent in 2010 to 14 percent so far in 2013.Medicaid spending per beneficiary decreased by 1.9 percent from 2011 to 2012.Medicare spending per beneficiary grew by only 0.4 in fiscal year 2012.Slower growth is projected to reduce Medicare and Medicaid expenditures by 15 percent or $200 billion by 2020 compared to what those programs would have spent without this slowdown, according to CBO.

At the same time the law is driving down cost growth, the Affordable Care Act is strengthening coverage and expanding coverage.� Thanks to the law, more than 34 million people with Medicare received a no-cost preventive service.� And, over six million Medicare beneficiaries received $5.7 billion in prescription drug discounts.�

Some have proposed turning Medicare into a voucher program--undercutting the guaranteed benefits that seniors have earned and forcing them to pay thousands more out of their own pockets.� If we turn Medicare into a voucher program, our system doesn�t have any incentives to be more efficient and lower costs.� Instead, as costs rise, vouchers will leave seniors to pay more and more out of their own pocket. �

The health care law is working to lower costs, increase efficiency, and deliver better patient outcomes � without cutting costs at seniors� expense.� In recent years, we have seen dramatic slowing of the growth of federal health care programs.� The best approach to reducing our deficit is to continue implementing common-sense reforms.� The health care law is putting us on the right path to make Medicare and Medicaid stronger, more efficient and less costly.�

Tuesday, March 12, 2013

Ryan Budget Proposal Echoes Obamacare While Rejecting It

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Providing Better, More Coordinated Care Through Pioneer ACOs

Anyone who has multiple doctors probably understands the frustration of fragmented and disconnected care: lost or unavailable medical charts, trouble scheduling an appointment or talking to a doctor, duplicated medical procedures, or having to share the same information over and over with different doctors.

Accountable Care Organizations (ACO�s) are designed to lift this burden from patients, while improving the partnership between patients and doctors in making health care decisions. People with Medicare will have better control over their health care, and their doctors can provide better care because they will have better information about their patients� medical history and can communicate more readily with a patient�s other doctors. Doctors in ACOs aren�t penalized for spending more time with patients � they�re rewarded for it.

Starting today, provider groups from across the country will get support in providing better, more coordinated health care through an initiative called the Pioneer Accountable Care Organizations (ACO) Model. This initiative will advance the best practices of primary care doctors, specialists, hospitals and other providers in coordinating care for patients with Medicare.

There are 32 leading health care organizations from across the country that will participate in this new initiative made possible by the Affordable Care Act.� They represent health system leaders in innovation, providing highly coordinated care for patients at lower costs. This initiative will help some of our nation�s best health care systems become even better.

For example, Sharp Healthcare has taken innovative steps toward engaging patients in their care through a patient portal.� In this portal, patients can get information about their care, and easily access information about their health and steps they can take to keep themselves healthy.� By empowering patients to know more about their care, Sharp is partnering with their patients to make the best possible decisions about their health.

Medicare beneficiaries aligned with Seton Health Alliance in Central Texas will continue to have access to four After Hours Clinics, where patients can be seen in a clinic setting staffed by physicians after regular hours. Services available 24 hours a day will include phone nurses, online education resources, online appointment requests and online bill-pay.

Under this model, ACO�s take greater risk and get greater rewarded than in the Medicare Shared Savings Program for how well they�re able to improve the health of their Medicare patients and lower health care costs. We�ll test several different models to determine which best meets the goals of better care and reduced growth in costs.

Selected Pioneer ACOs include physician-led organizations and health systems, urban and rural organizations, and organizations in various geographic regions of the country, representing 18 States and the opportunity to improve care for 860,000 of Medicare beneficiaries.

For the final list of participating Pioneer ACOs and more information about the Pioneer ACO Model, check out our fact sheet is posted at or you can visit this page.

For more information about the CMS Innovation Center, visit innovations.cms.gov.

Monday, March 11, 2013

Katie Beckett Defied The Odds, Helped Other Disabled Kids Live Longer

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Targeting Single-Payer Advocates

President Obama�s Patient Protection and Affordable Care Act sucks. It isn�t change in the dysfunctional American health care system that any one should believe in or defend. And yet that is exactly what liberals and progressives are doing. Led by spin doctors at The Nation, they�re spinning ObamaRomneyCare (ORC), and that�s what it should be called, as if it were a step in the right direction. As if it were the only outcome of the national health care reform debate in 2009.

The individual mandate that compels millions of people to purchase unaffordable underinsurance and then punishes them with a fine if they don�t, and the transfer of $447 billion in tax payer money to the health insurers were deal breakers for advocates of a single-payer, national health care system. It doesn�t make sense to give the corporations that cause the health care crisis more profits and power in exchange for a modest expansion of Medicaid and a series of mostly rhetorical reforms that the insurance industry and employers are already undermining. It�s no different than giving the bankers responsible for crashing the world financial system billions of dollars in bail out money. How�s that working for Americans?

Single-payer (SP) supporters opposed the passage of ORC and the Supreme Court decision forcing people to buy expensive, malfunctioning products from corporations that bankrupt, deny care or kill them. Many expressed �relief� at the decision to uphold ORC. That feeling was ephemeral as the implications of the Medicaid decision rippled across the country. The Supreme Court ruled that threatening to withdraw Medicaid funding from states that failed to expand their programs was coercive �economic dragooning.� But why isn�t the individual mandate �economic dragooning?�

Seven Republican governors already said they would opt out and dozens are taking a wait and see approach. The liberals told us we had to support ORC if only because 17 million people would get coverage through Medicaid. Now that reform is being scaled back. The Medicaid debacle illustrates why health care reform has to be federally funded and national in scope.

It�s useful to quote Obama on health care before he was president. He actually got it. Candidate Obama said that forcing the uninsured to buy insurance was like forcing the homeless to buy homes and he added, �I don�t have such a mandate because I don�t think the problem is that people don�t want health insurance, it�s that they can�t afford it.�

Senator Obama in 2005: �I happen to be a proponent of a single-payer, universal health care program. I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its gross national product on health care, cannot provide basic health insurance to everybody.�

Any reform that leaves 23 million people uninsured, that proudly excludes undocumented immigrants, and doesn�t cover abortion (watch Obama�s speech on health care to Congress in 2009, it�s sickening) doesn�t deserve one shred of support.

SP activists consistently called out Obama�s hypocrisy and challenged him to do the right thing. Liberal, Democratic astroturf organizations like Health Care for America Now (HCAN) worked overtime to convince people that there was no �political will� in Washington for SP. Groups like HCAN always surface when movements for fundamental reform rise. Their job is to dumb down expectations and channel activist�s energy into incremental reforms that help the fewest people and don�t threaten the power or the profits of the status quo. HCAN wasn�t an ally in the struggle for single-payer, they were a deliberate obstacle to it.

The Nation has published a bevy of articles that blindly and breathlessly spin ORC, gloss over its fatal flaws, and bully those who criticize it. The election fear factor has ramped up their dishonest defense of ORC. Now it�s all about reelecting Obama and who gives a damn that his �signature� legislation is unraveling.

David Cole who calls the uninsured �free-riders,� tied himself into a Gordian knot explaining why it was constitutional to force people to buy private health insurance. Is it a tax or is it a penalty? Who cares? It�s wrong either way. If a Republican president wanted the Supreme Court to uphold the individual mandate (say Bush or Romney) he would�ve argued the opposite. Apoplectic, Cole would have thundered: �How dare those Republicans mandate us to buy health insurance!� Cole constantly derides SP advocates with the nonsensical and irksome phrase, �Don�t make the perfect the enemy of the good.� But a single-payer system is not perfect. It�s simply good because it solves the health care crisis.

Katha Pollitt�s article, �Obamacare (s) for Women� is positively gushing about ORC. She thinks that �Progressive women should be more enthusiastic about Obama.� Pollitt admits upfront, though, that Obama �compromised abortion right out of health care reform.� But somehow that�s okay for one of the nation�s leading feminists. She lists seven ways that ORC will help women but every single one of them is under sustained attack and could be reversed. And gender rating hasn�t ended. In the new insurance exchanges, large group plans with more than 100 employees will be allowed to continue this sexist practice.

Wendell Potter is leading the attack on SP activists. In his article, Health Care Advocates: Time to Bury the Hatchet, he pejoratively calls members of Physicians for a National Health Program (PNHP) and Health Care NOW! �die-hards.� He writes ��we are still furious at the president and the Democrats for their baffling decision not to give single-payer legislation a decent hearing and for compromising too early and too often, in their view, with the special interests.� Damn right single-payer supporters are angry! And so are millions of Americans who don�t support ORC and not because they�re Republicans or Tea Party nut jobs. No doubt many are Democrats. They want a government funded health care system that eliminates the role of private, for-profit insurers.

Potter, whose book Deadly Spin chronicles the chicanery of his former employer Cigna brilliantly, ought to be a leading voice against ORC because as he writes, �It�s a windfall for the insurers.� As an ex-insider who spun PR daily, including the denial of a liver transplant to 17-year-old Nataline Sarkisyan who died, Potter has written some of the most powerful exposes and made compelling arguments for why the insurance industry must be put out of business. Period. He explains how there isn�t one reform these killers can�t gut or get around. And yet there he was on the steps of the Supreme Court providing commentary for Democracy Now! on why ORC had to be upheld. His former bosses at Humana and Cigna must have relished the delicious irony: Potter denounces the insurers and then Potter defends the Supreme Court decision giving the insurers constitutional rights, billions in subsidies and a mandate to rip off millions of new, coerced customers.

Potter charges SP advocates with failing to create a strategy, but that�s not true. For two decades PNHP has been organizing physicians and educating them about single-payer � no easy job given doctor�s vociferous opposition. Because of PNHP�s tireless work and the uncompromising leadership of Dr. Quentin Young, a majority of physicians now support a government financed health care system. That is a huge triumph! PNHP has over 18,000 members and is growing.

Health Care NOW! has a strategy of grassroots, community organizing. Throughout 2009, dozens of chapters across the country organized meetings, marches, demonstrations and �bird dogged� politicians. Hundreds of activists were arrested in a series of sit-ins at insurance company headquarters. Our movement took a quantum leap forward but unfortunately it wasn�t large enough to win single-payer.

This is our die-hard strategy: build a large civil rights movement for health care justice that forces whatever party is in power to enact a single-payer, national health care system. There is no short cut. And there is no compromising on the necessity to abolish the health insurance industry.

And where was Wendell Potter during all this activism? He was working with HCAN for the public option and then for passage of ORC. Potter made our job harder � not only did SP advocates have to fight Obama administration promises and lies, we had to wage a fight against the well funded, toxic influence of HCAN that consistently told people single-payer was off the table, so give it up.

Like President Obama, the health insurance industry has a �kill list.� Nataline Sarkisyan was on it. Currently, 84,000 people die every year because they lack access to health care. They�re on the kill list. We need to sharpen the blade of the hatchet and cut the head off the corporations that kill for profit.

Helen Redmond writes about health care and the war on drugs. She can be reached at: redmondmadrid@yahoo.com

Her new documentary about health care is called: The Vampires of Daylight: Driving a Stake Through the Heart of the Health Insurance corporations. Website: thevampiresofdaylight.com

Sunday, March 10, 2013

Countdown to Affordable Health Insurance

January is the perfect month for looking forward to new and great things around the corner.

I�m feeling that way about the new Health Insurance Marketplace. Anticipation is building, and this month we start an important countdown, first to October 1, 2013, when open enrollment begins, and continuing on to January 1, 2014, the start of new health insurance coverage for millions of Americans. In October, many of you�ll be able to shop for health insurance that meets your needs at the new Marketplace at HealthCare.gov.

This is an historic time for those Americans who never had health insurance, who had to go without insurance after losing a job or becoming sick, or who had been turned down because of a pre-existing condition. Because of these new marketplaces established under the Affordable Care Act, millions of Americans will have new access to affordable health insurance coverage.

Over the last two years we�ve worked closely with states to begin building their health insurance marketplaces, also known as Exchanges, so that families and small-business owners will be able to get accurate information to make apples-to-apples comparisons of private insurance plans and, get financial help to make coverage more affordable if they�re eligible.

That is why we are so excited about launching the newly rebuilt HealthCare.gov website, where you�ll be able to buy insurance from qualified private health plans and check if you are eligible for financial assistance � all in one place, with a single application. Many individuals and families will be eligible for a new kind of tax credit to help lower their premium costs.�If your state is running its own Marketplace, HealthCare.gov will make sure you get to the right place.

The Marketplace will offer much more than any health insurance website you�ve used before. Insurers will compete for your business on a level playing field, with no hidden costs or misleading fine print.

It�s not too soon to check out HealthCare.gov for new information about the Marketplace and tips for things you can do now to prepare for enrollment.� And, make sure to sign up for emails or text message updates, so you don�t miss a thing when it�s time to enroll.

There is still work to be done to make sure the insurance market works for families and small businesses. But, for millions of Americans, the time for having the affordable, quality health care coverage, security, and peace of mind they need and deserve is finally within sight.

Saturday, March 9, 2013

Protecting Physicians and People with Medicare

One of the most important relationships people have is with their doctor.� They rely on them for treatment when they are sick, counseling on ways to stay well, and for help navigating our complex health care system.� But, unfortunately, a problem in Medicare�s payment system for doctors threatens that relationship and seniors and people with disabilities� regular access to their doctor.

In 1997, Congress passed a law that was intended to slow the growth in Medicare spending so that the program would remain financially solvent. There were many good things in that law but one piece of it has proved to be problematic. A new formula � known as the Sustainable Growth Rate or SGR � was supposed to make sure we didn�t overpay for doctors� services.� Instead, it has resulted in the potential for huge cuts in Medicare fees that would not be good for doctors or patients.�

For nine years in a row, Congress has enacted legislation to override large payment cuts to physicians. But lawmakers haven�t acted to get rid of the SGR and replace it with a formula that works. Since he took office, President Obama has called for a �permanent fix� to the SGR that would avoid this annual exercise. While we stopped the cuts scheduled for 2010 and 2011, we are now faced with the prospect of a 29.5 percent cut in 2012.

Today, the Centers for Medicare & Medicaid Services (CMS) issued proposed rules that spell out how this cut is calculated and warned that if Congress does not act in time, doctor fees will be slashed come January 1. We cannot � and will not � let this happen.

In his proposed budget for fiscal 2012, the President again called for getting rid of the SGR and he identified savings to pay for that change for the next two years.� In his fiscal framework, the President identified additional savings that would pay for a 10-year fix.

For too long, we�ve been putting a Band-Aid on a wound that needs a permanent fix to heal.�And we are committed to fixing this problem, once and for all. �

At CMS, we are working every day to make Medicare a system focused on three major aims � better care, better health, and lower costs through improvement.� To achieve this, physicians need to know what Medicare will pay and patients need to know that they can continue to see their doctors. �This is the system 48 million people with Medicare need and the system we want to preserve for years to come.�

Today happens to be the 45th anniversary of the implementation of Medicare. There couldn�t be a better time to begin renewing our commitment to the people it serves and the physicians who care for them.

Read the press release here.

Website Tests How Political Opposites Actually Discuss Differences

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Friday, March 8, 2013

To Save A Life, Odds Favor Defibrillators In Casinos

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For Midwife, 71, Delivering Babies Never Gets Old

March 6, 2013

Listen to the Story 7 min 31 sec Playlist Download Transcript  

Editor's Note: This video contains a scene of childbirth that includes graphic imagery and explicit language.

Credit: John W. Poole/NPR

Increasingly, people are continuing to work past 65. Almost a third of Americans between the ages of 65 and 70 are working, and among those older than 75, about 7 percent are still on the job. In Working Late, a series for Morning Edition, NPR profiles older adults who are still in the workforce.

Sometimes you can't retire even if you want to. For Dian Sparling, a certified nurse midwife in Fort Collins, Colo., there's no one to take over her practice. But at 71, she's finding that staying up all night delivering babies is harder than it used to be.

Sparling founded an obstetrics and gynecology practice called Womancare 31 years ago. During her career, she has delivered around 2,000 babies. Last year, she decided she'd retire from that part of her job, though she continued to see patients in the office. She didn't miss being on call � the person who's awakened in the middle of the night when a patient goes into labor.

"When you're on call, you just can't really plan for anything. You just need to be available, both physically and your heart and soul available, to do midwifery work. And when it's an unknown, I think it's a little bit more draining," Sparling says.

A few months ago, one of the other midwives in her practice had to take an extended medical leave. So Sparling had to go back to being on call.

Enlarge image i

Dian Sparling, a certified nurse midwife in Fort Collins, Colo., recently went back to being on call.

John W. Poole/NPR

Dian Sparling, a certified nurse midwife in Fort Collins, Colo., recently went back to being on call.

John W. Poole/NPR

"It would be horrible if I had to do this and stay up all night and didn't love what I do," she says.

'A Wonder To Behold'

It's just past daybreak at the hospital's birth center, and Sparling has been here since 4 a.m. with patient Amanda Trujillo, who is about to deliver her third baby. It's her second with Sparling as her midwife. The two are comfortable with each other. The atmosphere is relaxed. Sparling tells Trujillo to just be patient a little while longer.

When Sparling leaves Amanda and goes out to the nurses' station in the birth center, her spiky white hair sets her apart from her younger colleagues. Nurse Kathy Clarkson makes a point of telling her she was missed during her brief semi-retirement.

"We're glad that you're back working again, Dian," Clarkson says. "When you retired, we were all crying."

Nurse Julie Christin says that as a midwife, Sparling works more closely with women in labor than do most MDs.

"Physicians rely on us to do a lot of the labor support," Christin says. "But Dian spends a lot of time with her patients when they're in labor. I like that, because then she's involved and can make decisions quicker, and does what the patient wants to do, which is good."

Sparling is "in tune with them emotionally as well as physically," Clarkson says.

And then it's time for Sparling to get back in tune with Trujillo, who's ready to start pushing. Her husband, Isaiah, supports one leg, and delivery nurse Keri Ferguson supports the other.

“ It would be horrible if I had to do this and stay up all night and didn't love what I do.- Certified Nurse Midwife Dian Sparling As Amanda Trujillo works, her husband, Sparling and Ferguson cheer her on and report on the baby's progress. First his head emerges. Then his shoulders. And finally, there is a new little person named Samuel in the world, though at nearly 9 pounds, maybe not so little. "There he is, Amanda," Sparling says. "Reach down here and grab your baby." Samuel is born just before 10 a.m. Sparling has been at the hospital for six hours. And she's jazzed. "People have asked me, 'Does this feeling after a delivery ever get old?' Absolutely not," she says. "It's a wonder to behold, and my adrenaline stops pumping about two hours after a delivery. And then I can go to sleep." But it takes her twice as long to recover from an all-nighter as it used to. Her closest friends worry about her. Sparling is long divorced. Her two sons live back East, so this group of friends are the ones she refers to as her "support people." "We think she should be retired, but she doesn't think she can," says Sparling's friend, Wayne Peak. "She's our age and we're retired and we like to travel and relax a whole bunch, and she's on call and has to stay up in the middle of the night and deliver babies. That's not good." More In This Series Working Late: Older Americans On The Job When A Bad Economy Means Working 'Forever' Working Late: Older Americans On The Job For One Senior, Working Past Retirement Age Is A Workout Working Late: Older Americans On The Job At 85, 'Old-School' Politician Shows No Signs Of Quitting

Another friend, Nancy Grove, says she was not happy when Sparling first told her she was going back to being on call.

"Once I stopped thinking about myself and started thinking a little more about Dian, I really wanted to support her in what she wants to do, needs to do, because she's a very valuable asset in our community," Grove says.

A Line In The Sand

Sparling has reassured her friends that she will not keep delivering babies forever. In a way, she longs for retirement � from deliveries, from the office, from work. But that would mean finding someone to take over her practice and run it the way she believes it should be run. For instance, no patient is turned away because of lack of insurance or inability to pay.

"The truth of the matter is this is not a money-making business," Sparling says. "It makes our salaries. It makes our health care insurance payments for ourselves, it pays for our malpractice insurance, which is required by the state and also by our hospital. We can exist and pay for ourselves, but it doesn't make money."

Sparling says that at 71, she realizes time is not on her side. As much as she loves her work, she wants to pursue the other pleasures of life.

"One of which is travel. There are so many places in the United States and the world that I would love to go," Sparling says. "And one is taking piano lessons. I was given a piano at age 7 by my grandmother, and really never made proper use of it and practice. And you need time to do that."

Sparling has given herself deadlines for retiring before. None have stuck. But she's still trying.

"And now I guess I can draw a line in the sand and say it's going to be [at] 75, I will no longer be seeing patients in the office," she says.

But she acknowledges that maybe a line in the sand isn't the best metaphor. She says, "you know how sand flows."

Share Facebook Twitter Email Comment More From Working Late: Older Americans On The Job Around the NationFor Midwife, 71, Delivering Babies Never Gets OldAround the NationAt 85, 'Old-School' Politician Shows No Signs Of QuittingAround the NationWhen A Bad Economy Means Working 'Forever'EconomyWorking Late: In Tough Economy, Retirement Gets Pushed Back

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Thursday, March 7, 2013

Celebrating Healthier Patients and Stronger Communities

Today we are celebrating the work of the National Health Service Corps in communities across the country.� This year�s theme is �Healthier Patients, Stronger Communities,� and that theme is reflected in the work that our NHSC providers do every day.

The National Health Service Corps helps improve access to health care in communities that need it most. �It provides financial support for doctors, nurses and other health care providers as well as students training for a career in primary care.� This financial support in the form of loan repayment and scholarships allows clinicians who are passionate about serving in our communities the ability to pursue jobs in primary care disciplines without the burden of overwhelming debt.�

Now, thanks to investments made by the Obama Administration there are close to 10,000 National Health Service Corps �doctors, dentists, nurse practitioners, physician assistants, mental and behavioral health specialists, and other health providers treating more than 10.4 million people throughout the country.� In fact, the number of providers serving in the NHSC has nearly tripled from 3,600 since the start of the Obama Administration. �And, while Corps members commit to working for at least two years in high need areas, more than 82 percent decide to stay beyond their initial commitment, helping ensure more Americans get the care they need.

I am also excited to announce that this year, the health care law has invested almost $230 million in the NHSC through 4,600 loan repayment and scholarship awards to clinicians and students who are committed to working where they are needed most.

Today, we celebrate Corps Community Day to honor the important work of National Health Service Corps members who are bringing their talents to communities that need health care providers.� To those of you who are serving in the Corps or will serve, I want to say thank you. Thank you for the work you do each and every day to ensure that Americans get the primary care they need and deserve to lead healthy lives.

For stories from National Health Service Corps clinicians, please visit: http://nhsc.hrsa.gov/corpsexperience/memberstories/index.html� or http://nhsc.hrsa.gov/corpsexperience/40clinicians/index.html

Wednesday, March 6, 2013

Just Say No To The 'Cinnamon Challenge'

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Why ER Docs In The Big Apple Won't Replace That Painkiller Prescription

More From Shots - Health News HealthHear That? In A Din Of Voices, Our Brains Can Tune Into OneHealthWhy ER Docs In The Big Apple Won't Replace That Painkiller PrescriptionHealthInfections With 'Nightmare Bacteria' Are On The Rise In U.S. HospitalsHealthA Costly Catch-22 In States Forgoing Medicaid Expansion

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Doctor Pay: Where The Specialists Are All Above Average

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Tuesday, March 5, 2013

With PSA Testing, The Power Of Anecdote Often Trumps Statistics

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Rising Costs: A Health Care Challenge For Democrats

by Julie Rovner for NPR –

For Democrats, passing the new health care law may have been the easy part. Now that it’s the law, everything that happens in health care, whether due to the Patient Protection and Affordable Care Act or not, is their responsibility.

“The Democrats have guaranteed that the American health care system is going to be affordable. They put it in the title of their bill,” health policy analyst Bob Laszewski said. “So everything that happens after March 23, 2010 [the day President Obama signed the measure] is theirs. They own it.”

Democrats came under fire from Republicans on Monday for the latest set of regulations they issued. The new rules lay out which insurance plans can remain as is when new consumer protections and other requirements take effect.

“This rule reflects the president’s policy that Americans should be able to keep their health plan and doctor if they want,” Health and Human Services Secretary Kathleen Sebelius said.

But plans won’t be able to remain “grandfathered” if they raise premiums too much, or cut too many benefits. Sebelius said the idea was to create a balance, “to make sure the grandfathered plans still have the flexibility they need to make reasonable changes, but also making sure that insurance companies don’t use this additional flexibility to take advantage of their customers.”

Republicans, however, were quick to point out that by the department’s own estimates, many insurance plans would not qualify to remain unchanged.

Despite repeated promises by President Obama to the contrary, said Senate Minority Leader Mitch McConnell (R-KY), “the government is about to change the plans most Americans have. Here’s one more promise the administration has broken on health care and one more warning Republicans issued on this bill that’s been vindicated.”

What Republicans don’t say is that plans that do have to change will have to offer more, rather than fewer, benefits and consumer protections. That includes things such as free preventive services and guaranteed direct access to obstetrician/gynecologists for women.

But most of those new benefits won’t take effect for another three years. What makes Democrats more immediately vulnerable is what’s going to happen to people’s health insurance costs next year. They’re going up.

At least that’s the finding of a new report from the consulting group PricewaterhouseCoopers.

“I think you can expect to continue to see significant increases in what you pay for your health care,” says Mike Thompson, a principal with the firm and the study’s lead author.

In order to cope with a projected medical inflation rate of 9 percent next year, Thompson says, he expects that employers will load more costs onto workers, both through higher deductibles and by replacing flat co-payments with percentage coinsurance. In other words, rather than paying a flat $20 fee to see a doctor, more workers will be expected to contribute 20 percent of that doctor’s bill.

Both Thompson and Laszewski say next year’s rising costs aren’t due to the new health law. And none of the new law’s provisions intended to restrain health spending have yet to take effect. But those are subtleties likely to be lost on most of the public. They’re simply going to wonder why their costs keep going up.

“I myself would not have called it the ‘affordable’ health care act,” Laszewski says. “I think that’s making a promise you’re not likely to be able to keep.”

Monday, March 4, 2013

Carrying 'Dreams': Why Women Become Surrogates

April 17, 2012

Listen to the Story 5 min 1 sec Playlist Download Transcript   Enlarge image i

Since NPR's Marisa Penaloza spoke with Macy Widofsky, she has been deemed a good candidate for surrogacy and matched with a couple.

Courtesy of Macy Widofsky

Since NPR's Marisa Penaloza spoke with Macy Widofsky, she has been deemed a good candidate for surrogacy and matched with a couple.

Courtesy of Macy Widofsky

Last in a four-part report

Surrogacy is an idea as old as the biblical story of Sarah and Abraham in the book of Genesis. Sarah was infertile, so Abraham fathered children with the couple's maid. Today, there are many more options for people who want to grow their families � and for the would-be surrogates who want to help.

Macy Widofsky, 40, is eager to be a surrogate.

"I have very easy pregnancies. All three times have been flawlessly healthy, and I wanted to repeat the process," she says, "and my husband and I won't be having more children of our own."

Widofsky sits in the lobby of a fertility clinic in Reston, Va., where she's being tested to find out if she's a good candidate. Surrogacy runs in her family: Her mother was a surrogate when Widofsky was 12, and the experience left a mark.

"I was very impressed then that she was willing to help a family out this way, and I didn't realize at the time how uncommon that was," she says.

Widofsky's mom did what's called "compassionate" surrogacy, meaning she wasn't paid. Some women do it for family or a friend. Today, though, most surrogates get between $20,000 and $25,000 to bear a child for someone else.

Why One Surrogate Wanted To Help

Whitney and Ray Watts are the parents of 3-year-old J.P. Whitney carried twins for Susan and Bob de Gruchy.

Enlarge image i

Surrogate Whitney Watts with her son, J.P., and husband, Ray. She says she was motivated to help others have a family because her own parents had infertility problems.

Courtesy of Whitney Watts

Surrogate Whitney Watts with her son, J.P., and husband, Ray. She says she was motivated to help others have a family because her own parents had infertility problems.

Courtesy of Whitney Watts

"To me, being a surrogate � it's like you're carrying someone else's dreams," she says.

That's part of what could make some people scratch their head. After all, it's easier to believe that a woman would give up a child from her womb for money rather than a desire to help.

Whitney, 25, says her parents went through infertility nightmares, and that gave her determination to help someone make a family. She says she didn't think about bonding with the baby.

"It was [in vitro fertilization]. It was their embryos," she says. "You just know they are not yours. You're just keeping them for a time to let them grow and then give them back to their parents, because they were never my babies. It's just my uterus that's keeping them."

Not Doing It For The Money

Sitting next to each other, 27-year-old Ray looks adoringly at his wife; they finish each other's sentences when they speak. The Wattses say they were looking for a couple they could connect with.

"It was very important to us to have a relationship with them," Whitney says. "Yes, it's a business contract in a sense, but it's so much more than that." Her husband agrees.

"Had Susan and Bob just wanted to pay money and get a kid, that would have been a deal breaker right away," he says.

Read More From This Series Making Babies: 21st Century Families Gifting Birth: A Woman Helps Build Other Families Making Babies: 21st Century Families Surrogacy Experts Help Navigate Murky Legal Waters Making Babies: 21st Century Families Ties That Bind: When Surrogate Meets Mom-To-Be Making Babies: 21st Century Families Legal Debate Over Surrogacy Asks, Who Is A Parent?

The Watts say the health of the pregnancy � and ultimately of the twins � relied on the relationship developed by the couples.

Crystal and John Andrews live in Bel Air, Md., with their three kids. They are done building their family, but Crystal wants to be pregnant again. She says she feels "special" when she's pregnant. She decided to become a surrogate, and her family is onboard.

She says explaining surrogacy to her children wasn't hard.

"Ms. Becky wanted to bake a pie," she told them, "and she had all the ingredients. She got her pie together, went to put it in the oven, and her oven was broken."

Are You Doing Good If You're Getting Paid?

The issue of money, though, is real. It makes some people feel uneasy because motherhood is not typically financially compensated. Whitney Watts says she looked into compassionate surrogacy � doing it for free � but it didn't feel right.

"I would do compassionate [surrogacy] for a friend, but not for someone I don't know, through an agency," she says. "It wouldn't feel appropriate ... because you don't know what you are going to do until you get there."

Whitney says she didn't want to put her family through financial stress. As it turned out, she spent 55 days on bed rest at the hospital.

Elaine Gordon, a clinical psychologist in Los Angeles, counsels couples on family-building, including surrogacy, and on the issue of payment.

"I think people automatically feel that if money is involved then there is no altruism involved, and that's not necessarily true," she says. "We are all compensated for the work we do, and we still want to do good work even though we are compensated."

Gordon says many surrogates tell her the experience of having a child for someone else is so powerful that they want to do it again.

Share 0Facebook Twitter Email Comment More From Making Babies: 21st Century Families HealthGifting Birth: A Woman Helps Build Other FamiliesAround the NationCarrying 'Dreams': Why Women Become SurrogatesMaking Babies: 21st Century FamiliesWho Is A Parent? Surrogate Technology Outpaces LawAround the NationTies That Bind: When Surrogate Meets Mom-To-Be

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New Online Tool Gives You More Information about Premium Increases

For too long, when it came to health insurance, consumers were left in the dark. In the past, insurance companies could often raise your rates without any transparency or accountability. Many insurers were under no obligation to give you any explanation as to why they felt an increase was necessary. Thanks to the Affordable Care Act, this is changing.

Starting today, you will begin to have more information about your health insurance premiums. This year, in every State and for the first time ever, the Affordable Care Act requires insurance companies to publicly justify their actions if they want to raise rates by 10% or more.

Today, we posted the first set of explanations from insurance companies. Right here on HealthCare.gov.

We�ll update the site with more information from other insurers as it comes in so you can see why insurance companies think they should raise your rates. On our website, you will also have the opportunity to submit comments and share your views on the proposed rate increase.�Please send your comments to ratereview@hhs.gov.

At the same time, independent experts will determine whether or not the increase is reasonable.

This process is known as �rate review.� �It makes the health insurance marketplace more transparent and holds insurance companies accountable. It promotes competition that can drive down costs. And we know rate review works:

Oregon forced an insurer, Regence, to lower its request for a rate hike by nearly 10% for 60,000 enrollees after public hearings and scrutiny.Connecticut�s Insurance Department rejected a 20% rate hike by Anthem.North Carolina saved beneficiaries $14.5 million by reducing a rate increase request from the State�s Blue Cross Blue Shield plan.And, Aetna scrapped a proposed 19% rate increase in California after a close review found math errors that undermined the need for the hike.�

Insurers are also now required to spend most (80% or 85%) of the dollars you put toward insurance on your care � instead of on advertising or big CEO salaries � so you can get more value for your money. This is known as �medical loss ratio.� If they don't spend at least 80 cents of every premium dollar you pay on your health care, they must refund the difference to you. Consumers will start receiving these rebates next year.

We, in partnership with States, are taking a good, hard look at why insurance companies are seeking to raise your rates, why your premiums might be going up, and making sure these decisions are public and justified.

This is just a start, and over time we will be posting these requests as they come in.� Be sure to check back, though, as we�ll be updating the website regularly.

And if you see your insurance company�s rate and don�t like its reason for raising it, you may be able to take your business elsewhere.� Check out your options on HealthCare.gov.

AIDS In Black America: A Public Health Crisis

July 5, 2012

Listen to the Story 37 min 3 sec Playlist Download Transcript   Enlarge image i

Dr. David Ho, an HIV/AIDS specialist, draws blood from Magic Johnson, one of the people featured in Endgame: AIDS in Black America.

Renata Simone Productions/Frontline

Dr. David Ho, an HIV/AIDS specialist, draws blood from Magic Johnson, one of the people featured in Endgame: AIDS in Black America.

Renata Simone Productions/Frontline

Of the more than 1 million people in the U.S. infected with HIV, nearly half are black men, women and children � even though blacks make up about 13 percent of the population. AIDS is the primary killer of African-Americans ages 19 to 44, and the mortality rate is 10 times higher for black Americans than for whites.

More on HIV/AIDS Health Treating HIV: From Impossible To Halfway There Author Interviews 'Tinderbox': How The West Fueled The AIDS Epidemic Health HIV Spikes For Young Gay Black Men In U.S.

February 28, 2006

Saving The Heart Of The Crescent City Add to Playlist Download  

A new Frontline documentary, Endgame: AIDS in Black America, explores why the HIV epidemic is so much more prevalent in the African-American community than among whites. The film is produced, written and directed by Renata Simone, whose series The Age of AIDS appeared on Frontline in 2006.

On Thursday's Fresh Air, Simone is joined by Robert Fullilove, a professor of clinical sociomedical studies at Columbia University's Mailman School of Public Health, and chairman of the HIV/AIDS advisory committee at the Centers for Disease Control and Prevention.

"When I started doing this work in 1986, roughly 20 percent of all of the people in the United States who were living with AIDS were African-American," Fullilove tells Fresh Air's Terry Gross. "The most recent statistics from the Centers for Disease Control indicate that 45 percent of all the new cases of HIV infection are amongst African-Americans. ... If we continue on the current trend, in the year 2015, especially in the South, it will probably be the case that 5 to 6 percent of all African-American adults who are sexually active will be infected with the virus."

Endgame explores how politics, social factors and cultural factors allowed the AIDS epidemic to spread rapidly in the African-American community over the past three decades. The film � shot in churches, harm-reduction clinics, prisons, nightclubs and high school classrooms � tells personal stories from children who were born with the virus, public health officials and educators who run HIV clinics, and clergy members around the country, many of whom have been divided on their response to the epidemic.

The film also explores how the war on drugs in the 1980s and 1990s affected the spread of HIV in communities where large percentages of African-American men were incarcerated.

Enlarge image i

Alabama is one of only 33 states that mandates HIV education in high schools. Among those states, students receive an average of 2.2 hours of education, and most focus on abstinence.

Frontline/Renata Simone Productions

Alabama is one of only 33 states that mandates HIV education in high schools. Among those states, students receive an average of 2.2 hours of education, and most focus on abstinence.

Frontline/Renata Simone Productions

"A large number of marriageable men were taken out of the community," Fullilove says. "When you have this kind of population imbalance, many of the rules that govern mating behavior in the community are simply going to go out the window. The competition for a man becomes so extreme ... all of the prevention measures [like condom usage] that we've been trying to create over the last 30 years go out the window."

Only 3 percent of the federal domestic dollars spent on HIV go toward prevention, according to Simone.

"We still have a long way to go in policy terms," she says. "What I tried to do in the film is help a general audience see that this is an epidemic not just of drug users and people who are sex workers. This is an epidemic that affects people who make you think, 'But for the grace of God, there go I.' There's a 64-year-old grandmother, there's a woman who works in a restaurant, there's Magic Johnson. ... Right now, today in 2012, this is an epidemic of people that we recognize and, if our lives were any different, we could be."

Web Resources Columbia University: Robert Fullilove Interview Highlights � Robert Fullilove

On how AIDS, once called Gay-Related Immune Deficiency (GRID), was presented in the media during the early days of the epidemic

"The name itself gave rise to the notion that this was something that was affecting Americans from a particular community, identified by their sexual preference, separate and apart from folk in black communities like Harlem or Watts were experiencing themselves. The presentation in the press was of a white epidemic."

On secrets in the African-American community

"We were so much afraid of what it meant to have what was happening in the slave quarters revealed to those who were empowered to direct every aspect of our lives. So we became secretive, because if there was dissension, if there was anger, the last thing you wanted to do was to make it public. To make it public was to be punished. So it created the notion that silence was indeed golden. And to the degree that carried over well after slavery had ended, that did us a fundamental disservice when the epidemic began."

On the decision to treat drugs and addiction as a criminal justice problem and not as a health problem

"Sharing needles for intravenous drugs was a primary means by which many people became infected. It is especially important, in the African-American community, to understand that in the late '80s and early '90s, roughly 40 percent of the cases of AIDS were basically identified among people whose major risk behavior was intravenous drug use. Between 1970 and 2010, we made a practice of making the war on drugs, which meant we were locking up the folks who were at greatest risk for being exposed to this virus."

On prisons

“ Recognizing that the problem exists but not making moves to prevent terrible things from happening, like the transmission of HIV, means that more than anything else, we had a situation where prevention could have worked. We didn't seize the opportunity, and in failing to seize the opportunity, we're now living with the consequences.- Dr. Robert Fullilove "The simple fact that we're not taking appropriate public health measures to prevent the transmission of this virus means that in the very beginning of the epidemic, prisons became places where the virus had to have become transmitted freely. The danger, of course, in this kind of discourse is to demonize and stigmatize prisoners. I think it's probably more important to think about putting the onus for taking public health measures to prevent this kind of tragedy from happening on the folk who are responsible for running the prisons. Recognizing that the problem exists but not making moves to prevent terrible things from happening, like the transmission of HIV, means that more than anything else, we had a situation where prevention could have worked. We didn't seize the opportunity, and in failing to seize the opportunity, we're now living with the consequences." On the attitude in some black churches "In 1964, I was part of something called Mississippi Freedom Summer. I was a field secretary for the Student Nonviolent Coordinating Committee. I worked in a number of counties in Northern Mississippi, and really got a sense of the importance of the church and its capacity to galvanize community support around, for example, getting people to register to vote. When I started doing research and community work in HIV in the 1980s, I, like many folk working in the black community, went first to the church and said, 'Hey, we have another problem that really requires the galvanization of all elements of the community. You're the only institution left standing that really has the capacity to bring us all together. Let's get all this work done.' And what we were met with was an enormous amount of resistance. There were many, many folk who were clear about the importance of what we were doing, but they were in the minority. The vast majority were either unaware or uninterested or worse, were extremely homophobic � saw this as a gay problem that had nothing to do with them and were much more likely to engage in the kind of preaching [that was harmful] than just about anything else." On the Affordable Care Act "It's thought that maybe 20 percent of all African-Americans who are living with HIV/AIDS don't know that they're infected. And they don't know that they're infected because they haven't been tested. If the act is successful in increasing the rate at which people get regular checkups, become aware of their status and enter treatment, then I think we're going to see an important change in the direction of the epidemic. It's sad to say that prevention, right now in the U.S., is neatly characterized by the phrase: 'Treatment is prevention.' If you're in treatment and your viral load has been lowered, you're very unlikely to pass the virus onto someone else. It means we've taken a step back � we've acknowledged that there are some folk that are already infected, and the best we can do is make sure they don't infect someone else. That's a real tragedy compared to where we were in the 1980s, when we thought keeping folk from being infected in the first place was going to be our primary goal and objective." Share 628Facebook 75Twitter Email Comment More From AIDS: A Turning Point HealthA Walk Through The AIDS Conference's Global VillageHealthCost Of Treatment Still A Challenge For HIV Patients In U.S.HealthThe Value Of HIV Treatment In CouplesEuropeGreece's Latest Crisis: Rising HIV Cases

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Saturday, March 2, 2013

White House Tries Again To Find Compromise On Contraception

More From Shots - Health News HealthHealth Insurers Brace For Consumer Ratings In Some StatesHealthA Mother's Death Tested Reporter's Thinking About End-Of-Life CareHealthSacrificing Sleep Makes For Run-Down Teens � And ParentsHealthChange In Law May Spur Campus Action On Sexual Assaults

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