Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana have drafted the latest Republican attempt to repeal Obamacare. The bill would overhaul or eliminate major sections of the health care law, including its subsidized insurance coverage and Medicaid expansion. Instead, states would receive block grants, or a lump sum of money from the federal government, which they could use largely as they see fit.
How Graham-Cassidy would alter federal funding
Center on Budget and Policy Priorities analysis
The liberal-leaning think tank Center on Budget and Policy Priorities released estimates of how federal funding would change if the bill became law. In its analysis, California would be hardest hit, losing $27.8-billion in funding.
Graham-Cassidy-Heller-Johnson block grant model
Cassidy’s office released its own estimates. Massachusetts takes the hardest hit with a more than $5 billion loss in funding. Overall, Southern states that did not expand Medicaid are poised to receive more in federal funding.
The bill comes after three failed GOP repeal attempts in the Senate, and a proposal from Sen. Bernie Sanders to extend the reach of government subsidized health care to all Americans.
But Republicans are up against a tight deadline. Their budget reconciliation bill, which allows them to overhaul Obamacare with a simple majority, expires on Sept. 30. The deadline could work to Graham’s and Cassidy’s advantage, however, by spurring hesitant Republicans to seize what may be their last opportunity to deliver on their seven-year promise to repeal Obamacare.
And the damage to the heart and blood vessels can occur in youth at blood pressure levels that are below the clinical definition of hypertension in youth.
High blood pressure in youth is defined differently than it is in adults. In childhood, high blood pressure is based on percentiles, rather than blood pressure level. Researchers looked at whether organ damage in teens develops below the 95th percentile, which is the clinical definition of high blood pressure in youth.
Researchers studied blood pressure and measured organ damage in 180 teenagers (14-17 years old, 64 percent white, 57 percent males). They found evidence of organ damage even among the youth categorized as “normal” with blood pressure less than in the 80th percentile. They also found heart and vessel damage in the mid-risk group, which had blood pressures in the 80th to 90th percentiles and the high-risk group, with blood pressures above the 90th percentile.
The Occupational Safety and Health Administration (OSHA) today issued a Notice of Proposed Rulemaking to extend the employer’s responsibility to ensure crane operator competency and enforcement for crane operator certification to Nov. 10, 2018.
OSHA issued a final rule in September 2014, extending the deadline by three years for crane operator certification requirements in the Cranes and Derricks in Construction standard. The final rule also extended by three years the employer’s responsibility to ensure that crane operators are competent to operate a crane safely.
The agency is now proposing an extension of the enforcement date to address stakeholder concerns over the operator certification requirements in the Cranes and Derricks in Construction standard.
Read More: http://snip.ly/l4l6i#http://www.forconstructionpros.com/rental/lifting-equipment/crane/press-release/20974421/occupational-safety-health-administration-osha-proposes-extending-compliance-deadline-for-crane-operator-certification-requirements-to-2018
Lawmakers are back in town and soon the Senate Health, Education, Labor and Pensions (HELP) Committee will once again take up the beast that is healthcare.
Some will be tempted to merely throw more money and the semblance of flexibility into a broken system — we urge them to reject this Band-Aid, and to instead implement real reforms. The ERISA Industry Committee (ERIC) implores Congress not to take this opportunity to protect the employer-sponsored health insurance system, which is the single most common source of health coverage in the nation, providing 178 million Americans with access to healthcare.
Congress is focused on stabilizing endangered exchange marketplaces. ERIC heartily agrees that market stabilization is important for everyone, but addressing the cost sharing reduction (CSR) payments to insurance companies is just a small part of solving the problem.
Last month, ERIC, along with several other organizations, sent a letter to Congress with policy recommendations that would help stabilize the market, while also ensuring the future of affordable employer-provided health benefits.
We recommended Congress should fund CSR payments to improve affordability in the individual market. Congress should also repeal the 40 percent “Cadillac” tax on employer-sponsored health plans, with no new taxes on health benefits. And lawmakers should repeal the health insurance tax on fully insured health plans, which a recent Oliver Wyman study found will cost Americans $22 billion next year alone. They should also enable employers to innovate with Health Savings Accounts (HSAs) and protect the ability of employers to offer uniform benefits to employees and their families — no matter where they live, work, or receive medical care.
Tax relief is key to protecting the employer-sponsored system. Since World War II, the American tax code has encouraged employers to set up quality health plans for their employees by exempting company health benefit expenditures from income and payroll taxes. The Affordable Care Act placed a crippling financial burden on plan sponsors through the employer mandate and the taxes mentioned above.
An easy place to start would be fully repealing the highly unpopular Cadillac tax. It has already been delayed until 2020 and lawmakers have voted to repeal it twice. The first time in 2015 and the most recent during the healthcare votes this past July.
The Cadillac tax will hit more than 50 percent of the workforce within ten years of its implementation, according to a January study by the consulting firm Milliman —that’s 60 million Americans. These employees could see their benefits slashed by thousands of dollar while their salaries stay flat.
Some economists theorize that because of the Cadillac tax, workers might see their pre-tax wages increase as employers switch to cheaper plans. But if that happens, employees would also pay a lot more in taxes, costing 12.1 million employees upwards of $1,000 in higher payroll and income taxes.
In fact, 80 percent of the revenue raised by the Cadillac tax is expected to come from workers paying more income and payroll taxes, according to the Joint Committee on Taxation and the Congressional Budget Office.
Aside from health tax relief, another way to improve the healthcare system is updating consumer-directed health options like Health Savings Accounts (HSAs). The Committee and Congress should raise HSA contribution limits, ensuring that HSA and high-deductible plan beneficiaries have access to supplemental benefits. They should also allow consumers to use their HSAs to purchase over-the-counter medicines while updating rules to ensure those enrolled in HSA-compatible plans can benefit from first-dollar coverage for prescription drugs and other medical products and services likely to prevent or reduce catastrophic episodes in the future.
The Senate HELP Committee must also look at value-based healthcare options, which are ways plan sponsors and consumers can spend healthcare dollars smarter. Earlier this year, The ERISA Industry Committee and the Pacific Business Group on Health launched the DRIVE Health Initiative, a campaign to accelerate economic growth by controlling health costs and improving quality through the rapid adoption of value-based healthcare. The initiative calls for targeted deregulation and the use of market-based purchasing strategies by Medicare and other federal health programs.
Fixing healthcare is not easy. As lawmakers move forward in crafting new legislation, they must be sure it protects the employer-sponsored system that has provided affordable, quality coverage to more than half of the population for decades and allow for continued improvement and innovations.
If they don’t, the employer-sponsored health insurance system could be in jeopardy, creating a much bigger problem than that of the ACA exchanges.
James Gelfand is the senior vice president for health policy at The ERISA Industry Committee (ERIC). ERIC is the only national association that advocates exclusively for large employers on health, retirement and compensation public policies at the federal, state and local levels.
Staff at the Gauteng Department of Health provincial head office are without equipment to do their work after the Sheriff of the Court attached two truckloads of furniture on Thursday following a failure by the department to pay court-ordered damages related to a hospital negligence case. By ORATENG LEPODISE.
If you walk into several offices at the provincial health department’s head office at the Bank of Lisbon building in downtown Johannesburg, you are likely to find administrative staff sitting on the floor.
On Thursday the sheriff arrived at the offices and removed two truckloads of furniture from four floors in the building in a bid to force the department to settle payment of a R6.2-million negligence claim awarded against it.
The negligence claim relates to a protracted legal battle between the department and the parents of a child who suffered brain damage during birth at the Pholosong Hospital in December 2009. The seven-year legal battle drew to a close on March 8 with a cost order being awarded against the department.
But it is yet to settle.
“It is a terrible injustice that this case has dragged on for more than seven years, with further suffering for the child and her family, and now the department delays further,” said Jack Bloom, the DA’s Gauteng Shadow MEC for Health.
On Thursday, according to the writ of attachment, the sheriff removed:
• 400 desks;
• 600 chairs ;
• 400 computers;
• 200 filing cabinets ;
• 50 printers ;
• 10 fridges;
• 10 microwaves; and
• three lounge suites
Asked by Daily Maverick to comment on the attachment of its furniture, its impact on the health department staff to do their work and on the department’s failure to pay the negligence claim, department spokesman Prince Hamnca said: “All I am willing to say is that we are concerned that the furniture has been taken from the offices, but that was a court order from the Sheriff.”
“I am appalled that the department has yet again disregarded a court-ordered payment,” said Bloom, while accusing the Gauteng Health MEC, Gwen Ramokgopa, of downplaying the effect of the removal of truckloads of furniture.
An employee at the department and branch secretary of the National Health, Education and Allied Workers Union, Charles Phasa, said the working conditions were “very bad” as everything with any value was taken.
“This is not something new. Every year the sheriff comes in and the department waits until the 11th hour to negotiate some sort of way to cover their payments, but this time around it is just too much,” Phasa said.
According to Phasa the department has urged its workers to be patient while it attempted to address the issue.
The health department finds itself in a pool of debt which includes outstanding payments to suppliers and medical negligence cases and in May this year faced a R10.9-billion funding gap as budgeted funds were all taken up by salaries, accumulated debt and payments for negligence.
Medical negligence claims have increased significantly in recent years. From just over R8-million paid out by the Gauteng Department of Health in 2010/11, almost R154-million was paid out by the same department in 2013/14. Contingent liabilities for medical malpractice (money that the department would have to pay should all medical negligence claimants be successful in their claims) in 2016 in Gauteng sat at over R13-billion.
Bloom said the Gauteng Provincial Government was being destabilised by the endless financial woes of the Health Department, which faces a potential medico-legal liability of more than R13-billion and owes large sums to suppliers as well.
“Delays in payment also add to the costs as a 10.5% penalty interest is charged – in this case, this amounts to more than R300,000,” Bloom said. DM
Photo: Gauteng premier David Makhura speaks at a Gauteng township economy revitalisation summit in Soweto, Tuesday, 7 October 2014. Picture: Werner Beukes/SAPA
Despite US legislation in 2010 that moved the country closer to achieving universal healthcare, costs have continued to rise and nearly 26 million Americans are still uninsured according to the Congressional Budget Office.
As Republicans decide whether to repeal or replace the struggling healthcare policy, how does the existing US healthcare system compare with those in other countries?
Broadly speaking, the World Health Organization (WHO) defines universal health coverage as a system where everyone has access to quality health services and is protected against financial risk incurred while accessing care.
A brief history of the healthcare systems used today
Among the 35 OECD member countries, 32 have now introduced universal healthcare legislation that resembles the WHO criteria.
Spending compared with life expectancy
Life expectancy in the US is still lower than other developed countries, despite health funding increasing at a much faster pace.
Who provides healthcare and how is it paid for?
How healthcare is funded has a direct effect on the level of healthcare people have access to.
How could the US healthcare system change?
Donald Trump ran on a campaign to repeal and replace the Affordable Care Act, popularly known as Obamacare, but discord among Republicans has highlighted the political challenges faced with implementing a healthcare system, much less trying to change it.
With millions still uninsured and the financial burden of healthcare still quite high, the current US policy falls short of the WHO threshold.
Thus far, separate bills introduced in the House and the Senate were estimated to see steep increases in the number of uninsured from current levels.
Estimated uninsured under existing and proposed healthcare plans