It has finally come to pass: I'm having Obamacare conversations in my personal life.
All it took was a highly publicized national debacle!
Because I've been stressing how complicated the law and its many regulations and administrative decisions are, you will not be surprised to hear that the conversations don't tend to be short or simple.
But anyway, it's a step in the right direction, I'd say. Obamacare is a big deal for America, and it should be getting substantive cultural discussion. Should have been for quite a long time now, I'd say.
Are you sensing increased interest among your colleagues and employees? I'd be interested to know.
There's still a long way to go, though. I know, because on my Facebook feed, Obamacare is still dwarfed by posts about vaccinations.
Pardon me while I go and have a good long sigh.
An Oregon health system has reportedly received partnership or merger offers from seven different health care organizations. I wonder how unusual that is. Given that most health care systems are not that open about their negotiations, it's hard to tell. But then again, every time I talk to people about health care consolidation, I hear that it's not nearly finished yet.
For a quick overview of health care alliances that have already been formed locally, check out my story from last month: Health systems here rush to form alliances — but not with each other. If I had any spare brain space on health care, I'd probably spend it on guessing what form the further consolidation will likely take here.
Take a brief respite from Obamacare and read this moving piece by Messiah College professor Larry Lake: "Comfort Food: No one brings dinner when your daughter is an addict."
If Pennsylvania House Bill 1621 became law, it would be the first of its kind in the country. According to this article, it was probably prompted by the Highmark-UPMC scuffles and would require hospitals operating as part of an integrated delivery network to contract with "any willing insurer" without requiring that the insurer agree to any contractual provisions that would restrict access to hospital facilities (i.e., steering provisions, anti-tiering provisions, etc.). Any dispute with the insurer over reimbursement rates would have to be submitted to binding arbitration if the parties were unable to reach an agreement, with a default reimbursement rate being established in accordance with the rate paid by insurers under Obamacare to non-participating providers when providing emergency services.
Any guesses as to how hospitals and insurers feel about that?
As these reports tend to, "Impact of the Homecare and Hospice Industry on Pennsylvania's Economy" has a lot of numbers. I've gone cherrypicking for the most dramatic ones, and here are the fruits of my labors. I'll refer to home health aides as HHAs and personal care aides as PCAs.
• Demand for homecare and hospice care in Pennsylvania has outpaced hospitals and nursing homes every year for more than three decades, and employment is expected to grow by another 70 percent in the next seven years.
• Pennsylvania ranks third in the nation with the largest employment of HHAs and fifth for employment of PCAs.
• The projected employment growth for home health aides and personal care aides in Pennsylvania by 2020 is 32.3 percent and 27.9 percent, respectively.
• To provide hospice care in a person's home for one day costs $152, compared to $1,960 for one day in a hospital or $252 for one day in a nursing home.
• The $22 billion impact of the homecare and hospice industry stands in contrast to the $2.1 billion contributed by the professional sports industry, $4.5 billion by the State System of Higher Education and $23.5 billion by the nursing home industry. The homecare and hospice industry's impact is projected to reach $30 billion in 2020.
Same approach, different study.
• Treatment costs are the top reason people stop taking medications. An estimated $213 billion is lost each year in the U.S. due to wasteful or unnecessary treatment linked to lack of adherence and medication mismanagement.
On a more local note, the Lancaster Chamber of Commerce & Industry's 2013 prosperity indicators report — prepared with the Lancaster County Community Foundation, United Way of Lancaster County and the County of Lancaster — has some health stuff. Here's a tiny preview to get you to go and look at the rest.
• Reflecting changes in the workplace, the percentage of residents with health insurance (84.6) has been decreasing since 2006.