New Healthcare Law Provisions Take Effect Amid Controversy

September 1, 2012

By Roger Linnett

This is part of a continuing series, summarizing recently activated benefits that are part of the Afford- able Care Act, commonly known as Obamacare. These new provisions were based on a 2011 report from the Institute of Medicine, the health arm of the National Academy of Sciences, which relied on inde- pendent physicians, nurses, scientists and other ex- perts as well as evidence-based research to develop its recommendations. They take effect at the in- sured’s next policy renewal date on or after August 1.

Increased Access –

With about 7 million uninsured Californians, nearly 20 percent of the population, California will greatly benefit this year because of these new provi- sions:

• As much as $15 billion per year in new federal funding for the state to help imple- mentation.
• “Bridge” insurance programs that now cover low-income people and those with pre-existing conditions will remain in force until health care reform is fully imple- mented.

• Establishment of The California Health Benefits Exchange, which will act as a de- fined marketplace, much like the stock mar- ket, for consumers to buy insurance and apply for subsidies as needed. The ex- change will begin enrolling prospective policyholders in 2014.

Increased coverage –

Forty seven million women, more than 5 million in California, who are now covered by individual or group insurance or Medicare will now be able to schedule preventive screening and counseling with- out incurring any additional out-of-pocket co-pays or deductibles.

Women and their doctors, not insurance compa- nies, will now make decisions about their health needs, increasing the chance of catching potentially serious conditions at an earlier stage and substan- tially reducing the possibility of crushing medical bills for them and their families.

And, although women are the major beneficiar- ies of these new provisions, men and children can also take advantage of covered preventive services that includes flu shots and other immunizations, screenings for cancers, high blood pressure, choles- terol and depression.

The health care law has already helped women gain access to potentially life-saving tests and serv- ices such as mammograms, cholesterol screenings and flu shots without co-insurance or deductibles, and women under Medicare also receive screenings and tests for diabetes and osteoporosis.

The following preventative services for women are now also covered:

• Annual “Well Woman” visits for all women who are sexually active or over age 21, including a physical, Pap test and clini- cal breast and pelvic exams.

• For women who are pregnant or nurs- ing, gestational diabetes screening, breast- feeding support, supplies and counseling have been added to already available tests for Hepatitis B and anemia and folic acid supplements.

• Screening and counseling for domes- tic and interpersonal violence.
• HPV (Human PapillomaVirus) DNA testing for women 30 or older.

• Screening and counseling for HIV/ AIDS and other sexually transmitted dis- ease.
• FDA-approved contraceptive meth- ods, and contraceptive education and counseling.

This last item has caused a storm of controversy, driving opponents of the law to paroxysms of eccle- siastical fervor, claiming government intrusion into religious freedom. Bear in mind, though, that these are the same people who are relentlessly trying to plant their flag in the national vagina.

The Obama administration has said it will make common-sense accommodations with regard to con- flicting religious dogma. Additionally, the admini- stration announced that non-profit, religious employ- ers who do not currently offer contraceptive cover- age would not have to comply with the requirement for a year, and new regulations would be developed and finalized by the end of the year to accommodate religious concerns while ensuring access to these benefits for their employees.

Plus, group health plans and issuers that have maintained grandfathered status are not required to cover these services and certain nonprofit religious organizations, such as churches and religious schools, will not be required to cover these services.

Nevertheless, insurance companies know it is way more cost-effective to prevent a pregnancy than to pay for it.

Lowered Costs and Rebates –

According to a February 2012 brief by the Asst. Sec. for Planning and Evaluation at the U.S. Dep’t. of Health and Human Services called “The Cost of Covering Contraceptives Through Health Insurance”: “When medical costs associated with unintended pregnancies are taken into account, including costs of prenatal care, pregnancy com- plications and deliveries, the net effect on premi- ums is close to zero.” (http://1.usa.gov/zNTGuv)

The brief also found that taxpayers realize a saving of $4 for every dollar spent on publicly- funded family planning.

Because of a provision that went in effect January 1, 2012, called the Medical Loss Ratio (MLR), which was inserted into the health care law by Sen. Al Franken (D-MN), insurers had to issue rebates to policy holders by August 1, if they spent more than 15 percent of premiums on admin- istrative items for companies with more than 50 employees, or 20 percent with fewer than 50 or those with individual policies.

Nearly two million Californians recently re- ceived almost $74 million in rebates from their health insurers based on 2011 financial records. Individual policyholders received rebates directly. Group policyholders, who paid either part or all of the premiums, are entitled to either a rebate or credit toward future premiums. Consult your em- ployer’s plan administrator for details.

If you have an individual or a group policy and your insurance provider complied with the MLR provision, you probably received a letter in which they congratulated themselves for not ripping you off.

Information for this article was compiled from: whitehouse.gov, kaiserhealthnews.org, aspe.hhs.gov, insurance.ca.gov and healthcare.gov.


Medical Marijuana Dispensaries’ Future Up in Smoke

August 1, 2012

By Anne Alvarez and Greta Cobar

On July 24, L.A. City council members voted unanimously to ban medical marijuana dispensaries citywide. The ordinance did not initially receive a unanimous vote, as Councilperson Paul Koretz (who backed an opposing plan, which would have allowed up to 182 dispensaries that existed prior to 2007) voted against it. However, he changed his vote after council members agreed to advance his proposed plan.

The ban is set to take effect 30 days after Mayor Antonio Villaraigosa signs the bill into law.

The council also voted to instruct city staff to draw up a separate ordinance that would allow 182 dispensaries to remain open. Officials said that proposal, which would grant immunity to shops that existed before the 2007 moratorium on new dispensaries, could be back to the council for consideration in three months.

This new ordinance is similar to one passed two years ago, which was supposed to shutter hundreds of pot dispensaries while capping the number in operation at 70. That ordinance was never enforced, and instead of hundreds of collectives being shut down, in actuality, more opened.

All previous similar ordinances were not enforced, and if history is any indication, this one will be no different. Chances are medical marijuana dispensaries will continue to flourish unabated this time as well. The cost of shutting down successful businesses would not profit anyone, including our police force. Patients would suffer the most, as they would have to travel longer distances to the nearest shop, and fewer shops would most likely result in higher prices.

Bill Rosendahl, 11th District councilperson, who has been an outspoken supporter of medical cannabis, recently admitted to being a medical marijuana patient. He was unable to cast a vote on the July 24 ordinance due to a back injury. However, he posted this statement on his Facebook page: “I support the use of medical marijuana and oppose a total ban on dispensaries in the city. I also believe we need smart regulation to prevent a proliferation throughout the city and to keep dispensaries away from schools and other sensitive uses. I would have voted against the ban, and supported the proposal which will grandfather in some of the 182 of the first generation of dispensaries.”

This decision by our elected city officials has many citizens outraged, including those in attendance, who shouted: “You don’t care about the people!” It is a slap in the face to the thousands of patients that are dependent on medical marijuana for the relief of chronic pain, insomnia, anxiety, depression, migraines, glaucoma, nausea, asthma, hepatitis, fibromyalgia, multiple-sclerosis and anorexia, to name a few. Not to mention the financial strain this will put on thousands of people who are currently employed at the estimated 800 dispensaries city-wide. Thousands of jobs would be lost in the middle of the great recession while the economy is crumbling, with layoffs and foreclosures on the rise. Venice itself is home to over 20 dispensaries, each employing an average of ten people. More than half of those stores are slated to close under the new ordinance.

Council members cited an inability to control the hundreds of medical pot shops that have spread across Los Angeles over the past few years. Nor have they considered that pot is California’s biggest cash crop, responsible for $14 billion a year in sales, dwarfing the state’s second largest agricultural commodity, dairy, which brings in $7.3 billion a year, according to USDA statistics. Clearly there would be no reason for our city to be in financial distress if marijuana collectives where regulated properly. The city council should focus on is a better regulatory system, which could be a huge source of revenue.

If you would like to voice your opinion against the medical marijuana ban, contact the following elected officials: Bill Rosendahl at 310-575-8461 or councilman.rosendahl@lacity.org; Paul Koretz at 310-289-0353; Jerry Brown at 916-445-2841


Cannabis is in the Weeds

July 1, 2012

By Anne Alvarez

A ban on medical marijuana dispensaries introduced by Councilmember Jose Huizar was approved by the Los Angeles City Council committee on May 29 and final voting was to take place on June 22. However, due to key Council members’ absences, voting was postponed until July 24. Huizar had originally proposed a closure of all dispensaries within city limits. After being pressured by other council members, he amended his proposal to conform with California law, citing “it is within state laws, that permit municipalities to have an ordinance which will allow for collectives to exist.”

The main reason for the large numbers of disparities within the medical marijuana community is that the regulations governing them are unclear and the city has been unable to come up with a plan to monitor them.

Councilmember Bill Rosendahl introduced a counter proposal, which would allow for up to 100  dispensaries to remain open until the state Supreme Court decides whether cities can regulate them. These would be the dispensaries that have been grandfathered in. Rosendahl also suggests that they be taxed. “Dispensaries are proliferating like there’s no tomorrow. The situation has gotten out of control,” said Rosendahl.

Shutting down medical marijuana dispensaries will not stop anyone from using marijuana. It will, however, punish the sick people that are in  need of the relief voters approved over 15 years ago. Forcing law-abiding, medical-card-carrying patients into purchasing their medicine through illicit means, unable to determine whether the marijuana they are about to consume is organic or full of pesticides, whether it’s an Indica or Sativa, could have devastating results. To a medical marijuana patient these distinctions are of great importance.

Cannabis was used as early as 4000 B.C. in Central Asia , with written evidence going back to 2700 B.C. in the pharmacopoeia of  the Chinese emperor Chen-Nong. It  gradually spread across the globe. The public health burden of cannabis use is arguably modest compared with that of alcohol, tobacco, illicit or prescribed highly addictive narcotic drugs (Vicodin, Oxycontin and Soma) to name a few that cause as many as 10,000 overdoses  yearly. According to the Poison Control Center, there has never been a reported death from Marijuana overdose.

During his 2008 campaign, then Senator Obama raised hopes and votes from supporters of medical marijuana by pledging to respect individual state laws. Four years later, his administration has reversed course and massively escalated the federal government’s attacks on medical marijuana and its patients. Recently Obama’s Justice Department has authorized letters from U.S. attorneys across the country threatening to “vigorously” prosecute individuals acting in compliance with state medical marijuana laws. Obama clarified his position on medical marijuana by saying, “I never made a commitment that somehow we were going to give carte blanche to large-scale producers and operators of marijuana and the reason is, because it’s against federal law. I can’t nullify congressional law.”

Indeed Obama can’t change Federal laws on his own. However, he can tell the DEA how to do their job. Obama and members of Congress can reclassify marijuana to make it equivalent to morphine, codeine or Valium, (currently it is a schedule 1 drug on par with heroin, crack and LSD), or they can remove it from federal scheduling altogether. Since taking office Federal authorities have shut down more than 200 dispensaries in California. Meanwhile officials have been busy sending warning letters to cannabis dispensaries throughout the state, calling them “illegal marijuana stores.” Various members of congress are fed up with the hijinks, House Minority Leader Nancy Pelosi being one of them. Stating: “I have strong concerns about the recent actions by the federal government that threaten the safe access of medicinal marijuana to alleviate the suffering of patients in California.” Pelosi has called the matter a “states’ rights issue” and has asked the federal government to respect the wishes of the people in the 17 states that voted to legalize medicinal marijuana. This issue has become as redundant as prohibition, except alcohol destroys your health, marijuana may just improve it.

If you would like to voice your opinion regarding this issue contact the following Council Members:

Jose Huizar @ 213-473-7014 or email Councilmember.Huizar@lacity.org

Bill Rosendahl @ 310-575-8461 or 213-473-7011 via e-mail  councilman.rosendahl@lacity.org

Mitch Englander @ 213-473-7012 or email councilmember.englander@lacity.org

Congresswoman Nanci Pelosi: 414-556-4862  or via mail,  90 7th Street, Suite 2-800 San Francisco, CA 94103


Stop Drinking Soda

May 1, 2012

By Marisa Peck

Sometimes feeling our best involves doing more, and sometime it involves doing less. We are going to focus on a friendly foe in our midst; a culprit who offends both personal health and also the health of our planet. I am talking about our beloved soda pop.

Commercial soft drink products typically contain water that is stolen directly from people who need it, in some part of the world that the corporate giants think you don’t care about. That water is then mixed with high fructose corn syrup or aspartame.  High fructose corn syrup is widely known to cause obesity, diabetes, mood swings, insomnia, chronic fatigue, and it can depress the immune system making you more vulnerable to disease. Aspartame was approved for use amid very shady circumstances the day after Ronald Reagan’s inauguration in 1981. Monsanto’s subsidiary GD Searle had previously been denied approval for use of the product because aspartame had caused brain tumors in lab rats. But this time around, when the committee voted to again deny the application by 3-2, Reagan’s new FDA commissioner Arthur Hayes appointed a 6th member to vote in Monsanto’s favor, and then broke the tie himself allowing Monsanto the use of aspartame in consumer products. Less than two years later, Hayes left the FDA and went to work for Monsanto’s public relations team. Further studies of aspartame have only raised more questions regarding its safely. But in the meantime, it is in our diet sodas. Also in our sodas, both diet and regular, are artificial colorings that are proven to cause cancer. The Center for Science in the Public Interest has petitioned the FDA to ban the use of these artificial colors, but so far there has been no response.

As if the soda itself were not bad enough, there is all that packaging it comes in. It takes a huge amount of energy (OIL) to produce the plastic and aluminum bottles that contain the 15 million gallons of soda we Americans purchase every year. We recycle less than one fifth of these items. The rest go into landfills or directly into the ocean. There are also all the crates and plastic wrappings that are used during the many stages of transportation (more OIL) the soda has to go through before it gets into our hands. Let’s not even get started about how plastic bottles release hormone mimicking chemicals into the beverages… but if you’re interested you can Google it!

So this month’s health tip is to stop drinking soda. Save the money you would have spent on soda and invest that money in a water filtering pitcher and a canteen that you can fill up and keep with you. At fast food restaurants they will always give you a free cup for water and even fill up a to-go cup for you at the drive through window. So no excuses, even when you’re on the run! We are lucky to live in a part of the world where clean water is readily available, and smart enough to know that our bodies deserve the best. Drink to your health. Cheers to you!


Health Care Coming This Year!

January 1, 2012

By Roger Linnett

The following is part of a continuing series, summarizing the benefits that will go into effect in 2012 as part of the Affordable Care Act. Unless otherwise noted, benefits take effect as of Jan. 1. As in the previous article, benefits are categorized under three headings:

Increasing Access to Affordable Care

Accountable Care Organizations-   

Any patient who has multiple doctors probably understands the frustration of lost or unavailable medical charts, duplicated medical procedures or having to share the same information over and over with different doctors. ACOs are designed to lift this burden from patients, while improving the partnership between patients and doctors in making health care decisions.

Medicare beneficiaries whose doctors participate in an ACO will still have a full choice of providers and can still choose to see doctors outside of the ACO. Patients will have access to information about how well their doctors, hospitals or other caregivers are meeting quality standards in five key areas:

  • Patient/caregiver experience of care
  • Care coordination
  • Patient safety
  • Preventive health
  • At-risk population/frail elderly health

According to the analysis of the proposed regulation for ACOs, Medicare could potentially save as much as $960 million over the next three years.

Alleviating Disparity in Healthcare-

Not all Americans have equal access to health care. Low-income Americans, racial and ethnic minorities often have higher rates of disease, fewer treatment options and reduced access to care.  They are also less likely to have health insurance. The Affordable Care Act will help reduce disparities by making improvements in:

Preventive care  

1-Medicare and some private insurance plans will cover recommended regular check-ups, cancer screenings and immunizations at no additional cost to eligible patients.

2-New investments for community health teams to manage chronic diseases such as diabetes, kidney disease, heart disease and cancer.

3-New funds for home visits for expectant mothers and newborns to reduce Infant mortality and post-birth complications.

Diversity and cultural competency 

Health plans will be required to use language services and community outreach in underserved communities, particularly in Hispanic communities, which have high numbers of uninsured.

Health care providers for underserved communities 

Increased funding for community health centers, which provide comprehensive health care for everyone no matter how much they are able to pay. The new law will support 16,000 new primary care providers.

Improving Quality and Lowering Costs - 

1-For those enrolled in Medicare Part D, in 2012 the lower limit of the “donut hole” increases from $2840 to $2930, after that Medicare will cover 50% of brand-name drugs and 14% of generics until your total out-of-pocket cost reaches $4,550. Medicare then covers 95% of all further drug expenses until the end of the year.

2-The law institutes a series of changes to standardize billing and requires health plans to begin adopting and implementing rules for the secure, confidential, electronic exchange of health information, reducing paperwork and administrative burdens, cut costs, reduce medical errors and, most importantly, improving the quality of care. Effective October 1, 2012

3-The law also establishes a hospital Value-Based Purchasing program (VBP) in Original Medicare. This program offers financial incentives to hospitals to improve the quality of care. Hospital performance is required to be publicly reported, beginning with measures relating to heart attacks, heart failure, pneumonia, surgical care, health-care associated infections, and patients’ perception of care. Effective October 1, 2012

4-The law creates a voluntary long-term care insurance program – called CLASS — to provide cash benefits to adults who become disabled. According to Health and Human Services Secretary Kathleen Sebelius implementation of this program will be delayed,effective October 1, 2012

 

Insurance Company Accountability

Insurance discrimination will be banned, so people who have been sick can’t be excluded from coverage or charged higher premiums.  Women will no longer have to pay higher premiums because of their gender. New funding will be available to collect information on how women and racial and ethnic minorities experience the health care system, leading to improvements that will benefit these groups.

 

Information for this article was compiled from: whitehouse.gov., kaiserhealthnews.org., and healthcare.gov.     


Breast Cancer Event on Abbot Kinney Blvd, Oct. 7

October 1, 2011

By Janet Gervers

The Harlot Salon is hosting a Breast Cancer Fundraiser on Friday, October 7, 6-10 p.m. with proceeds donated to the National Breast Cancer Foundation. The event will occur during the popular Abbot Kinney 1st Fridays event in Venice and will consist of three fun ways to honor Breast Cancer Awareness Month and the loved ones that  are affected  by this horrible disease.

In 2011, an estimated 230,480 new cases of invasive breast cancer will be diagnosed in women. Sadly, over 39,000 will perish from this deadly disease.

Chances are we all know someone whose life has been touched by breast cancer. Marylle Koken, stylist and owner of The Harlot, is a survivor herself, but sadly lost her professional mentor to the disease almost two years ago. Several of  the other stylists at the salon have similar stories. According to stylist Amanda Jones, “This is the motivation behind hosting a fundraising event and making it the best possible!”

The Fundraiser consist of 3 inspiring activities, titled the Goddess Bazaar:

• Silent Auction - There will be dinners from top Abbot Kinney restaurants, framed art work, personal training services, organic facials and hair services from The Harlot Salon and more.

• “Think Pink” Styling Station - A station where guests can get a pink feather, a pink hair strand and/or pink nail polish applied for donations as well.

• Belly Dancing Classes - Val Macias, the receptionist at the salon is a dancer and will teach mini (15 minutes) Belly Dancing classes to guests for a donation.

All proceeds from the Fundraiser will be donated to the National Breast Cancer Foundation. There is an $8 (cash only) entry at door.

The Harlot Salon is a new business with a feminine, edgy, provocative environment, where naughty meets nice. The Harlot and is a tucked away location on the north east side of Abbot Kinney Blvd. (close to Venice Blvd.) in a cottage behind the e-Cookie clothing store.

For more information, please see:

www.abbotkinney1stfridays.com/p/ak-spotlight.html


Health Care in 2011

January 1, 2011

By Roger Linnett

The following is part of a continuing series, summarizing the benefits that will go into effect in 2011 as part of the Affordable Care Act, which President Obama signed into law on March 23, 2010. The first article appeared in the September, 2010, issue. Unless otherwise noted, benefits take effect as of Jan. 1.

As in the previous article, benefits are categorized under three headings:

Improving Care and Lowering Costs

• To start closing the “Donut Hole”, seniors who reach the coverage gap in their prescription drug coverage will receive a 50 percent discount for “Medicare Part D”-covered, brand-name prescription drugs. The discount will increase annually until the gap is closed in 2020.

• Certain free preventive services, such as annual wellness visits and personalized prevention plans for seniors on Medicare begin.

• A new Center for Medicare & Medicaid Innovation will be established to find new ways to improve the quality of care and reduce the rate of growth in health care costs to patients for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP).

• The Community Care Transitions Program will help high-risk Medicare beneficiaries, who are hospitalized, avoid unnecessary readmissions by coordinating care and connecting patients to services in their communities.

• The Independent Payment Advisory Board will begin operations to develop and submit proposals to Congress and the President aimed at extending the life of the Medicare Trust Fund.  The Board will focus on ways to target waste in the system, reduce costs, improve health outcomes for patients and expand access to care.

Administrative funding becomes available October 1, 2011.

 

Increasing Access to Affordable Care

• The new Community First Choice Option allows States to offer home- and community- based services to disabled individuals through Medicaid instead of institutional care in nursing homes. Effective October 1, 2011

 

Holding Ins. Companies Accountable

• To help bring down health care premiums, the new law generally requires that, at least 85% of all premiums for large employer plans, and at least 80% of the premiums from individual and small employer plans, must be spent on benefits and quality improvement. If insurance companies do not meet these goals, because of excessive administrative costs or profits, they must provide rebates to consumers.

• Today, Medicare pays insurance companies that provide Medicare Advantage (MA) over $1,000 per person more, on average, than is spent per person in traditional Medicare. This results in increased premiums for all Medicare beneficiaries, including the 77 percent who are not currently enrolled in a Medicare Advantage plan. Over the next three years overpayments to MA providers will decrease to eliminate this discrepancy. People enrolled in a Medicare Advantage plan will still receive all guaranteed Medicare benefits. (Medicare Advantage is actually not Medicare at all. It is private insurance paid for through Medicare, but the insurers charge Medicare 14% more than an individual would pay, in exchange for “enhanced services”, such as a spa membership or free glasses. The Obama administration intends to phase out MA, saving the government an estimated $156 billion over ten years.)

Information for this article was compiled from: whitehouse.gov, kaiserhealthnews.org, healthcare.gov, and The Center on Budget and Policy Priorities – cbpp.org.   b

 


New Healthcare Law Provisions Take Effect

September 1, 2010

By Roger Linnett

Many new aspects of the Patients Protection and Affordable Care Act, which the president signed on March 23, 2010, are now in effect and much more soon will be. The major features of the new law are:

  • It makes insurance more affordable by providing the largest middle class tax cut for health care in history, reducing premium costs for tens of millions of families and small business owners who are priced out of coverage today.
  • It helps 32 million Americans afford health care who do not get it today.
  • Under the plan, 95% of Americans will be insured.
  • It sets up a new competitive health insurance market giving millions of Americans the same choices of insurance that members of Congress have.
  • It brings greater accountability to health care by enumerating practical rules to keep premiums down and preventing insurance industry abuses and denial of care.
  • It will end discrimination against Americans with pre-existing conditions.
  • It will reduce the deficit by somewhere between $30 billion and $100 billion over the next ten years – and by as much as $1 trillion over the second decade – by cutting government overspending and reining in waste, fraud and abuse.

Here is a breakdown of the new provisions in three areas; 1) Consumer Protections, 2) Improved Quality at Lower Costs and 3) Increased Access:

Consumer Protections

Effective March 23rd -

  • An easy to use website comes online to compare health insurance coverage options and choose the the best plan for them, with ongoing improvements as data from insurance companies and public input make it more comprehensive.

Effective September 23rd -

  • Insurance companies are prevented from denying coverage to children with pre-existing conditions. In 2014, this prohibition extends to everyone.
  • Rescission, i.e., dropping people from coverage when they get sick is banned, except in cases of fraud.
  • It will be illegal to use errors on applications or technical mistakes to deny coverage.
  • Imposing lifetime dollar limits on essential benefits like hospital stays is prohibited.
  • A sharp restriction of the use of annual dollar limits on patient coverage. In 2014, all annual limits will be prohibited.
  • A simplified way to appeal (to either the insurer or to an outside board), if the company denies coverage or a claim is established.

Improved Quality at Lower Costs

Effective March 23rd -

  • Small businesses are eligible for tax credits to help them provide insurance for their workers. The first phase provides a credit of up to a 35 percent of the employer’s contribution. In 2014, tax credits will cover 50 percent of premiums. Small, non-profit organizations may receive up to a 25 percent credit.
  • Seniors, who this year fall into the gap in Medicare Part D prescription drug coverage known as the “donut hole”, will receive a $250 rebate. In 2011, a 50 percent discount on prescriptions begins.
  • A new $15 billion Prevention and Public Health Fund will invest in such proven prevention programs as smoking cessation and decreasing obesity.
  • Medicare investigators, who returned more than $2.5 billion to the Medicare Trust Fund in FY 2009, will receive additional resources to further reduce fraud and waste in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP).

Effective September 23rd -

  • New and existing Medicare plans that make specified changes will cover preventive services, bringing relief to millions of seniors for whom preventive care means early identification of disease and greater opportunity for treatment and recovery. In 2011, Medicare eliminates all co-pays and deductibles for these services.

Increased Access

Effective March 23rd -

  • Young people are allowed to remain on their parents’ insurance policy until their 26th birthday, unless offered insurance at their work. Most insurance companies already offer this.
  • A transitional high-risk-pool program provides new coverage options to individuals who, because of a pre-existing condition, have been uninsured for at least six months. States have the option of running their own temporary high risk pool. If a state chooses not to do so, a National pool will be established by the Department of Health and Human Services.
  • Funding to expand the number of primary care doctors, nurses and physician assistants, through scholarships and loan repayments for primary care doctors and nurses working in under-served areas. Doctors and nurses with student loans will also receive tax relief if they practice in communities with a shortage of health care providers.
  • $250 million in new grants for states that have or plan to implement measures that require insurance companies to justify their premium increases. Insurance companies with excessive or unjustified premiums may be ineligible to participate in the new health insurance exchanges beginning in 2014.
  • States will receive increased federal matching funds for covering low-income individuals and families on Medicaid.
  • A $5 billion program to maintain affordable care has been created targeted at Americans who retire before they are eligible for Medicare( age 65) or are without employer-sponsored insurance, until more affordable coverage is available through the exchanges in 2014, Previously, many had seen their life savings disappear due to current exorbitant rates.

Effective January 1, 2011 -

  • New funding will be allocated over the next 5 years to support the construction of, and expand services at, community health centers, allowing these centers to serve some 20 million new patients across the country.

Future legislation is working its way through Congress to extend and improve on the new law. For example, should the “public option” provision that allows Americans to join a national, single-payer program be enacted in the future, the savings in costs for both consumers and health care providers could be greatly improved, leading to further deficit reductions, while improving patient services.

Not waiting for a national program, many states are looking into starting their own single-payer programs. Congress is also in the process of creating legislation that will gradually lower the eligibility age for Medicare, which will further improve coverage and reduce patient’s expenses.

Data for this article was compiled from the following:

WhiteHouse.gov,

KaiserFamilyFoundation.org, ModernHealthcare.com and the SeniorCitizensJournal.org.


Nearly half of Venice homeless have serious health problems

May 1, 2010

St. Joseph’s Center has released a one-year update on its health vulnerability report on Venice homeless people. The study has been expanded to include those living in vehicles. Interviews show that 31 percent had been housed in Venice before becoming homeless.

Last year, St. Joseph’s surveyed 222 people living on Venice streets and determined that 44 percent of them were medically vulnerable. Medical problems included frostbite/hypothermia from exposure (20 individuals), cirrhosis/end stage liver disease (15), end stage renal disease or dialysis (10), HIV/AIDS (2), more than three emergency room visits in last three months (66), and the dreaded tri-morbid, that is, simultaneous psychiatric, substance abuse and chronic medical conditions (75).

This year’s report included those living in vehicles, and surprisingly showed a greater proportion, 46 percent, were medically vulnerable, that is, had a high mortality risk. The sample size was smaller, just 48 individuals. The new report found that only 2 percent of veterans living in vehicles receive Veterans Administration benefits. But 40 percent of those interviewed reported being the victim of a violent attack since becoming homeless. Slightly more than 30 percent received some income from social security programs, while nearly 15 percent earned payments for recycling cans and bottles.

Even with only preliminary findings, the St. Joseph’s survey contradicts those who have the image of homeless people as outsiders who are a threat to the better off population of Venice. Instead, an image emerges of a physically ill group who are often the victims of violence in the community.

In addition to the exposure to the elements that comes with homelessness, they are also coping with serious medical and mental conditions, while fending off harassment from police and irate homeowners. In light of this report, those who advocate a “carrot and stick” approach to men, women and children, including the seriously ill, should think twice about their hostility and change their policy to a “carrot and care” approach.

You can view the St. Joseph’s report at: http://tinyurl.com/29rzan7

–Jim Smith


Medical Marijuana Debated in Venice – and L.A.

December 1, 2009

By Maureen Cotter

VENICE – On November 5 the public was invited to join the Neighborhood Council (VNC) for a debate on new regulations controlling medical marijuana. It was held in the Westminster Elementary School on Abbot Kinney Blvd. The subject matter attracted a full house. While we waited for the meeting of the Venice minds to begin, I sampled the food provided by J’s Kitchen. What, no pot brownies? The muffins and other delicious food provided by this organic restaurant would have to do.

Mike Newhouse, VNC President chaired the meeting. He explained the public’s input was needed in helping to adopt some guidelines regarding medical marijuana dispensaries. Anyone who wished to speak had up to two minutes to express their thoughts.

De De Audet, past president of VNC, posted a sample of the city of Los Angeles’ fourth attempt at an ordinance on this subject.

Councilmember Rosendahl’s Deputy, Arturo Pina, spoke on his behalf: “It is the view of the Councilman that the chronically ill should not be deprived of their medicine. It should be regulated and taxed.”

Assistant City Attorney Jane Usher reminded us that the rules change almost daily, “This is a murky cesspool.” In 1996, in the state of California, we voted to allow medical marijuana to be provided to the chronically ill. It was to be provided by a collective of at least four people and this did not include sales for profit. She pointed out it is against state and federal law. But within this cesspool, the city is trying to adopt some guidelines. At this point in time the Los Angeles D.A.’s office and the City Attorney want to shut down the dispensaries.

The audience was asked by Newhouse for a show of hands of those favoring legalizing marijuana. Everyone in the room raised their hands. Then he asked who was not in favor and not one hand went up. A collective laugh could be heard. A man shouted, “That’s why we live in Venice.”

At the present time, there are four dispensaries in Humboldt County. San Francisco has 22. Venice has 30, eight are licensed. Los Angeles has an estimated 800 to 1,000. There are about 15,000 liquor stores. When asked how many doctor certificates have been issued, Usher responded she had no idea, as certificates are not recorded. How many dispensaries should be allowed? The general consensus was to let the market decide.

Hours from 10 am to 8 pm were debated. It was pointed out that other retail stores are not held to the same restrictions. Most agreed the stores should be kept at least 1,000 feet away from a school. The current city ordinance would limit the number of plants at a dispensary to 100, or five pounds, and a video camera must be running at all times. Records must be kept. The records and video must be turned over to the police if asked, without a search warrant. Most attendees frowned upon the idea of each dispensary using only pot grown on its premises.

The two hour discussion was conducted without people getting angry and all suggestions were recorded. Hats off to Mike Newhouse for the way he conducted the meeting. I went home to watch it on the Channel 11 news. Get ready Venice, may the best dispensaries win.

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And in Los Angeles

The City Council was still debating a medical marijuana ordinance at press time. However, it appears that most of the draconian measures that might have forced the closing of all Venice dispensaries have been dropped. These include requiring dispensaries to grow the pot they sell. “Contributions” may end up as a euphemism for sales.

Also at issue are capping the number of dispensaries, and defining how far they must be from churches and schools.

According to Nate Kaplan in Bill Rosendahl’s office there may not be a final ordinance until next year. Call Rosendahl at 311 if you have input.



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