A divided Clark County Commission rejected a collective bargaining agreement covering 85 percent of University Medical Center's workforce today over concerns about the inclusion of longevity pay for new hires, a benefit that is paid out to long-term employees. The issue: Clark County commissioners considered a new three-year collective bargaining agreement for nurses and other nonmanagement staff at University Medical Center. The vote: A motion to approve the contract failed 3 to 4, with Commissioners Steve Sisolak, Larry Brown, Susan Brager and Mary Beth Scow in opposition.
People on the Oregon Health Plan are making fewer visits to the emergency room and more visits to primary care clinics, according to a new report on Oregon's year-old coordinated care organizations. The Oregon Health Authority says the report shows Gov. John Kitzhaber's overhaul of the state Medicaid program is achieving its goals in reducing unnecessary use of the emergency room. But the figures don't allow for a definitive conclusion about whether the coordinated care organizations are responsible for the shifts. The report looked only at Medicaid patients, so it's unclear if the results were substantially better than other segments of the health care market.
Community health workers have helped Ethiopia reduce child mortality by two-thirds since 1990 and death from malaria, a common disease, by 55 percent. Since their deployment, contraception use among women—from longer-lasting injections to daily birth control pills—has doubled from 15 to almost 30 percent in six years. More than 8,000 miles away in Williamson, West Virginia, 34-year-old Samantha Runyon visits about 15 homes a week to check blood sugar levels and teach people with diabetes how to deliver insulin injections. The nurse, who works in the rural coal mining town where she grew up, is part of a team of four other "patient navigators" at a local nonprofit, the Diabetes Coalition.
If you are buying health coverage in the Colorado ski resort towns, the Connecticut suburbs of New York City or a bunch of otherwise low-cost rural regions of Georgia, Mississippi and Nevada, you have the misfortune of living in the most expensive insurance marketplaces under the new health law. The 10 most expensive regions also include all of Alaska and Vermont and large parts of Wisconsin and Wyoming. The ranking is based on the lowest-price "silver" plan, which is the that the majority of consumers are choosing. These regions, created as part of the health law, range in size from a state to a single county.
The Affordable Care Act is being litigated. Again. Several previous health law cases involved huge issues of constitutional policies. The big 2012 Supreme Court case engaged central questions of modern government: Is it constitutionally permissible to require millions of people to purchase health coverage to stabilize our national health-care market? Is it overly coercive to deploy the federal government's huge Medicaid leverage to induce states to expand coverage? In separate litigation, the Supreme Court is being asked to decide the appropriate boundaries between employers' and employees' religious liberties in deciding matters such as contraceptive coverage.
President Barack Obama said neither he nor members of his administration anticipated the magnitude of the flaws that hobbled the startup of the federal website for people to choose health-care plans under his new law. "I don't think anybody anticipated the degree of problems that you had on healthcare.gov," Obama said in an interview with Fox News yesterday. Now, "it's working the way it's supposed to." Obama didn't answer a question about whether he should fire Secretary of Health and Human Service Kathleen Sebelius because of the mishandled start.