Roads around the world will be graced with the various examples of the VW Beetle for many decades to come, but the production of the iconic German auto comes to an end this week. VW will produce the last Beetle model this week at its plant in Puebla, Mexico marking the end of the road for a vehicle that has been in production since 1938. The VW Beetle is undoubtedly an iconic, and historic car, having been part of a never-realized Nazi prestige project. The car was also seen as a symbol of Germany’s recovery after WWII and as a successful symbol of globalization after the iconic car was shipped all over the world.The car was very popular in the US and has an iconic design that is among the most recognizable products of any sort in the entire world. Austrian engineer Ferdinand Porsche was hired for the “People’s Car” project in the Beetle’s early days under a Hitler project that aimed to spread auto ownership around Germany the way the Ford Model T had in America.The US was VW’s most important market outside of Europe with peak sales of 563,522 cars in 1968, about 40% of the automaker’s production. VW ended production of the Beetle in Germany in 1978. However, production continued in Mexico from 1967 through 2003. The new Beetle started production in 1998, and the design was tweaked in 2012.VW has been facing a hard time, of its own doing, with the diesel scandal where its popular diesel cars were caught using bypass software to cheat on emissions tests. The last iteration of the Beetle is the Final Edition, and the last of the 5,961 Final Edition cars is headed for a museum on July 10 to mark the end of production.
Overbilling And Out-Of-Network Care Contribute To Marketplace Tension This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. News outlets examine what providers charge for surgical care. The New York Times: Report Faults High Fees For Out-Of-Network CareThough he was living on $18,000 a year as a graduate student, [Angel] Gonzalez had good insurance and the hospital, St. Charles in Port Jefferson, N.Y., was in his network. But the surgeon who came in to remove Mr. Gonzalez’s gallbladder that Sunday night was not. He billed Mr. Gonzalez $30,000, and an assistant billed an additional $30,000. … A health insurance industry report to be released on Friday highlights the exorbitant fees charged by some doctors to out-of-network patients like Mr. Gonzalez. The report, by America’s Health Insurance Plans, or AHIP, contrasts some of the highest bills charged by non-network providers in 30 states with Medicare rates for the same services. Some of the charges, the insurers assert, are 30, 40 or nearly 100 times greater than Medicare rates (Rabin, 1/31).Meanwhile — Los Angeles Times: Small Surgeries, Huge MarkupsNationwide, some insurers have begun to challenge these bills from outpatient centers. Last year, a unit of insurance giant Aetna Inc. sued several surgery centers in Northern California and accused them of overbilling the insurer more than $20 million. It has pursued similar actions against providers in New Jersey and Texas. Other insurers such as UnitedHealth Group Inc. have filed similar suits in California (Terhune, 1/31).
Bloomberg: California Counties May Lose As Brown Shifts Health CostsCalifornia counties may lose as much as $2.5 billion in state funding over the next three years for indigent health care as the state assumes responsibility under the federal Affordable Care Act, Gov. Jerry Brown said. The most populous U.S. state plans to cut $300 million this year from counties as its [Medicaid] program expands, Brown told local officials yesterday in Sacramento. The governor projected that figure will grow to $900 million next year and $1.3 billion in the year beginning in July 2015 (Nash, 5/29).Boston Globe: New Push To End Inequities In Payments to HospitalsAn unusual alliance led by the state’s fastest-growing health care company and its largest health care union will press for higher payments to community and safety net hospitals, saying Massachusetts faces a widening gulf between the quality of care in affluent and low-income areas. The group, the Massachusetts Healthcare Equality and Affordability League, is being launched Thursday by Steward Health Care System, a for-profit cluster of community hospitals, and Local 1199 of the Service Employees International Union, which represents about 47,000 workers in the state (Weisman, 5/30). MPR News: Evaluating Mental Health Of Crime Suspects A Tough TaskLegislators in Minnesota and around the country have responded to recent mass shootings by passing laws designed to keep guns out of the hands of people who have mental illnesses and may be dangerous. Experts say most people with mental illness are non-violent. Still, each year in Minnesota, dozens of people accused of committing gun-related crimes are evaluated to determine if they are mentally competent enough to stand trial (Williams, 5/29). Idaho Statesman: Idaho Gov. Otter Wants More Personal Accountability In Medicaid Gov. Butch Otter wants to make it harder for people to benefit from Medicaid unless they make healthy choices. It’s one of the options he’s weighing as he ponders whether to add Idaho’s poorest adults to the program. A plan in the works by the Idaho Department of Health and Welfare carries the same theme — personal responsibility — but takes a different path (Dutton, 5/30).Boston Globe: Mental Services For Teens Avert CutsCambridge Health Alliance officials said Wednesday they will not shrink services to children and teens with acute mental illness this year, as they had planned. The hospital system backed off a proposal to consolidate psychiatry units serving children and teens and to cut the total number of beds from 27 to 16, a week after the state Department of Public Health issued a letter saying those services were critical to Eastern Massachusetts (Conaboy, 5/29). Oregonian: Oregon Hospitals Use ‘Grass Roots’ Group To Promote TaxAs a bill renewing the Oregon hospital tax became locked in late-session legislative brinksmanship earlier this month, a lobbying group representing hospitals mobilized support for the tax using a “grass roots” group it set up months ago. A May 13 e-mail went out to followers of the group Our Health Our Community, urging them to click on a link to send a letter to their lawmakers supporting the tax. “Without this bill, critical services to thousands of Oregonians are in danger of disappearing,” it said (Budnick, 5/29).Lund Report: Oregon Medical Association Backs ONA’s Pay Equity Bill For Nurse Practitioners The Senate Health Committee has passed a nurse practitioner pay parity bill that has found consensus between the Oregon Medical Association and the Oregon Nurses Association, bringing to a resolution one of the most divisive issues in the state medical community this legislative session. “I’m so happy we have these two organizations up here in a very nice ‘Kumbaya,'” said Sen. Laurie Monnes Anderson, D-Gresham, the chairman of the Senate Health Committee, before the vote last week (Gray, 5/29). Health News Florida: Health Clinic Offers Free Care To UninsuredFor nearly 25 years, the Brandon Outreach Clinic has provided free health care to people who can’t get care any other way. … Watts says about 80 percent of the people who call the clinic actually qualify for help somewhere else, either through the Hillsborough County Health Care Plan or Florida’s Medicaid program (Watts, 5/30). This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. States: Calif. Counties Stand To Lose $2.5B In Medicaid Shift; Push For Hospital Payment Equity In Mass.
Politico reports that congressional Democrats shared concerns with Health and Human Services Secretary Kathleen Sebelius that seniors, among others, remain fearful about the health law’s impact on their benefits. Meanwhile, the Los Angeles Times explores a loophole that could allow insurers to avoid some of the law’s provisions for another year and The Associated Press reports the individual mandate exemption has been broadened for Native Americans.Politico: Dems To Kathleen Sebelius: Seniors Confused On ObamacareCongressional Democrats told Health and Human Services Secretary Kathleen Sebelius on Wednesday that Americans are still very confused about the health care law — including older people who worry that Obamacare will change their Medicare. Sebelius went to the Hill for another update with Democrats on Obamacare rollout. HHS this week overhauled its website, focusing more on the exchange enrollment, which starts Oct. 1 (Cunningham and Haberkorn, 6/27).Los Angeles Times: Healthcare Law’s Renewal Loophole Divides Health InsurersAhead of next year’s healthcare overhaul, some major insurers and consumer advocates want California lawmakers to bar companies from renewing most individual policies beyond Jan. 1. At issue is a loophole in the federal Affordable Care Act that enables health insurers to extend existing policies for nearly all of 2014, thereby avoiding changes under the healthcare law (Terhune, 6/26).The Associated Press/Washington Post: Exemption From Health Law’s Individual Mandate Broadened For Native AmericansThe Obama administration on Wednesday broadened an exemption for American Indians from the new health care law’s requirement that virtually every U.S. resident has health insurance starting next year. New rules clarify that people who are eligible to receive medical care through the federal Indian Health Service will be exempt from the requirement to have health insurance or face fines from the Internal Revenue Service. The Indian Health Service, a division of U.S. Health and Human Services, oversees a network of clinics that are required through treaty obligations to serve all patients of Indian ancestry, even if they cannot document their federal tribal status (6/26).CQ HealthBeat: Final Rule On Exemptions Similar To Proposed RuleA final rule released Wednesday that outlines who would be exempt from health law penalties if they don’t have insurance coverage next year largely mirrors the proposal Health and Human Services made in January The 139-page regulation spells out who will be eligible to get certificates showing that they are exempt from the requirement to have health coverage. The penalties are one of the health care overhaul’s most unpopular features (Adams, 6/26).And California Healthline looks at how the Supreme Court’s decision one year ago upholding most of the health law has affected implementation — California Healthline: One Year Later: What’s Changed Since The Obamacare VerdictMuch has changed, certainly, since Chief Justice John Roberts cast the deciding vote to uphold the law. (Beyond those bettors’ account balances, and the existence of InTrade itself, which mysteriously shut down in March.) Here’s a look at how the Supreme Court’s decision on June 28, 2012, affected five hot-button issues related to the health law (Diamond, 6/26). This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. Democrats To Sebelius: Confusion Over Health Law Persists
Viewpoints: GOP Needs To Refine Its Message On Health Law; Battle Over School Lunches This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. The New York Times: The Vanishing Cry of ‘Repeal It’ It was supposed to be so easy this election year for Republican congressional candidates. All they would have to do was shout “repeal Obamacare!” and make a crack about government doctors and broken websites, and they could coast into office on a wave of public fury. … But it has not quite worked out that way. … That sentiment conflicts with the Republican playbook, which party leaders are suddenly trying to rewrite. The result has been an incoherent mishmash of positions, as candidates try to straddle a widening gap between blind hatred of health reform and the public’s growing recognition that much of it is working (6/1). Politico: Running in 2016? Don’t Like Obamacare? Better Offer An Alternative. I am of the view that any candidates thinking about running for the Republican nomination in 2016 have to make clear that while they seek to repeal Obamacare, they also want to put in place a better health care system than the one we had before the law was passed in 2010. It is essential, therefore, that each candidate articulate a set of reforms that can plausibly replace Obamacare and, more importantly, address the challenge of rising health care costs (Lanhee Chen, 6/1). Bloomberg: Dr. Carson Will Find Politics Is Best Left to Politicians [Dr. Ben] Carson, a retired physician at Johns Hopkins Medical Institutions, has become a favorite of the political right as he weighs a run for the Republican presidential nomination. … In his calm, appealing manner, he unleashed a harsh critique of the Affordable Care Act at the National Prayer Breakfast last year, in front of President Barack Obama. He has gone on to call Obamacare “the worst thing that has happened in this nation since slavery,” which, he said, it resembles. He later explained he was talking about any attempt to take away an individual’s control of his or her life. He hasn’t included Medicare in that critique yet (Albert R. Hunt, 6/1). Forbes: Five Alternative Futures For Obamacare [T]here is more uncertainty about what will happen to our health care system over the next five years than at any other time during the more than four decades I have been studying health policy matters. The range of possibilities include full repeal, repeal and replacement post-2016, morphing into “zombie legislation,” Medicare redux and H.J. Res. 263 redux … We can do much better than Obamacare. Put another way: if Obamacare is the best this nation can do, our best days are behind us (Chris Conover, 6/1).The New York Times: Bad Food In School Cafeterias Republicans on a powerful House committee have balked at requiring all schools to serve healthy lunches in the coming school year. The action drew a well-deserved rebuke from the first lady, Michelle Obama, who has focused public attention on combating obesity among young people through exercise and better nutrition. Let’s hope the Senate holds out against such inanity (6/1). The Washington Post: Michelle Obama’s ‘Let’s Move!’ Goes Too Far The first lady’s “Let’s Move!” program and her focus on whole foods (as opposed to fast) and water instead of sodas have been welcome developments. Who better to bring needed attention to such issues? Obama is merely expanding her maternal focus to include all those public school kids whose mothers apparently have forgotten how to make a sandwich. Or whose fathers have forgotten to say, “Get those plugs out of your ears and make friends with the lawn mower” — or whatever its urban equivalent. But, as is often the case with mammoth federal programs, one size does not fit all (Kathleen Parker, 5/30).The New York Times: A Vote On Medical Marijuana The New York State Assembly easily approved a law legalizing medical marijuana last Tuesday, and there appear to be enough votes to pass similar legislation in the State Senate if that chamber’s leaders agree to allow a vote. They ought to do so before the legislative session ends on June 19. The bills would make the drug available, under tight regulation, to patients who, in many cases, do not get relief from other medications (6/1). The Denver Post: Getting Serious On Rx-Drug Overdoses Robert Valuck, professor of pharmacy at the University of Colorado, likens the prodigious task of reducing the country’s non-medical use of prescription drugs to turning an aircraft carrier. “The forces are so large,” he said. Deaths linked to prescription opioid use have doubled in 10 years in Colorado. For that matter, nonmedical use of painkillers is 19 percent higher here than the national average, according to the Centers for Disease Control and Prevention. … One idea that could help became law last week when Gov. John Hickenlooper signed a bill to modify the state’s prescription drug monitoring program to better identify abuse and prevent overdoses (5/30).
Small Business Exchange To Get Soft Launch In 5 States This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. Federal officials will give small businesses in five states an early chance to try out the delayed health insurance exchange for their employees to fix any glitches before the site goes live in other states. Meanwhile, Minn. Gov. Mark Dayton calls the MNsure rollout his “biggest disappointment,” and the Covered Oregon board votes on a new course.CQ Healthbeat: CMS Chief Prepares For Second Open Enrollment PeriodThe second year of open enrollment under the health care law brings its own set of “unique challenges,” the head of the Centers for Medicare and Medicaid Studies said Wednesday. CMS Administrator Marilyn Tavenner provided a few brief glimpses into the second open enrollment period for the law’s insurance exchanges, which will extend from Nov. 15 until Feb. 15, at a forum hosted by the National Institute for Health Care Management Foundation. Tavenner’s agency is tasked with both getting people re-enrolled and getting a new group signed up (Attias, 9/3). The Hill: Soft Launch Planned For Obamacare’s Business Exchange Federal health officials are planning to give small businesses in select states an early chance to try ObamaCare’s delayed health insurance exchange for their employees. The soft launch will begin in five states in late October as the Obama administration works to avoid another disaster in the healthcare law’s second enrollment period. The goal is to fix any problems encountered by users in Delaware, Illinois, Ohio, Missouri and New Jersey prior to Nov. 15, when the SHOP system (Small Business Health Options Program) will go live for all states that elected not to construct their own exchanges (Viebeck, 9/3). St. Louis Post-Dispatch: Missouri, Illinois To Get Early Access To Small Business Health Insurance MarketplaceBusinesses in five states will get an early look at the federal health insurance marketplace for small businesses, the Centers for Medicare and Medicaid announced Wednesday. The states are Missouri, Illinois, Ohio, New Jersey and Delaware (Shapiro, 9/3).Minneapolis Star-Tribune: Dayton Calls MNsure Rollout ‘Biggest Disappointment’Gov. Mark Dayton called the troubled rollout of the MNsure insurance exchange the low point of his first term in a campaign appearance Wednesday, but embraced the program’s successes in extending insurance coverage to those who historically struggled to get it. “I want to apologize for the excessive burdens it’s placed on you, your budgets and your people,” Dayton told a gathering of county officials. “The problems that have afflicted the inception of MNsure are my biggest disappointment in my term as governor. It’s got better, and it will continue to get better, but it still has a ways to go” (Condon, 9/3).The Associated Press: Dayton Apologizes For Troubled MNsure RolloutGov. Mark Dayton apologized to county officials Wednesday for the troubled rollout of Minnesota’s online health insurance exchange, calling the initial glitches with MNsure the biggest disappointment of his first term. But the Democratic governor also staunchly defended the federal Affordable Care Act before a crowd of about 200 county commissioners from across the state, the Star Tribune reported. Dayton, who is running for re-election, appeared at a general session of the Association of Minnesota Counties held in Alexandria. He thanked county leaders for their help with MNsure (9/3). Oregonian: Cover Oregon Board Will Vote Thursday On Whether Health Exchange Goes AwayBuffeted by continuing technological problems, the Cover Oregon board will vote Thursday on a new course for the state’s health insurance exchange – including whether it should even exist. If the board votes to dissolve Cover Oregon, the exchange’s remaining responsibilities — such as a consumer-assistance call center and outreach — would be handed off to state agencies including the Oregon Health Authority and the Oregon Insurance Division (Budnick, 9/3).
Johns Hopkins University will participate in what President Barack Obama called “the next great American project,” creating an institute for neuroscience research aimed at mapping the brain and perhaps finding cures for its many mysterious ailments. The institute is one of three that will be opened as part of a $100 million collaborative effort, funded largely by one of the private investors behind the Obama Administration’s BRAIN Initiative, aimed at developing a better understanding of how the human brain works. (McDaniels, 10/1) The Associated Press: Issue Of Surprise Medical Bills Stirs Debate At Hearing The University of Maryland Medical System said Thursday that it had completed its acquisition of Timonium-based Riverside Health Inc. and would begin offering Medicare plans for 2016. Separately, Johns Hopkins HealthCare announced Thursday it too would begin offering coverage for seniors through so-called Medicare Advantage plans for the first time. (Cohn, 10/1) Like many blue states, California enthusiastically embraced Obamacare, signing up millions for health insurance. Now, it’s venturing into a potentially costly and controversial new frontier of health policy: offering medical coverage to hundreds of thousands people living in the country illegally. In a matter of months, the number of California counties committed to providing low-cost, government-run medical care to such residents jumped from 11 to 48. And in June, Gov. Jerry Brown signed a state budget that for the first time funds healthcare for such children. (Karlamangla, 10/2) The Medicare fraud trial of Palm Beach County ophthalmologist Salomon Melgen has been postponed until next fall. The delay from its scheduled Feb. 22 date to Sept. 19 is partly due to the need to juggle his federal trial here with one in New Jersey. Melgen and his longtime friend, U.S. Sen. Robert Menendez, face bribery charges in New Jersey. (10/1) The Palm Beach Post: Medicare Fraud Trial For Doc Tied To Sen. Menendez Postponed California Healthline: Court Rules Blue Cross, Blue Shield May Need To Pay State Health Premiums Tax The Baltimore Sun: Johns Hopkins Part Of $100M Initiative To Study The Brain Los Angeles Times: Why Your Doctor Might Start Asking A Lot More Questions The Denver Post: Colorado Access Cuts Medicare Coverage, Workforce Los Angeles Times: As California Goes… But Will Nation Follow State’s Lead On Healthcare For Immigrants? The Baltimore Sun: University Of Maryland, Hopkins To Offer Medicare Advantage Plans In 2016 State Highlights: Pa. Hearing Explores Surprise Medical Bills; Colorado Access Cuts Workforce, Drops Medicare Coverage Options Health care stories are reported from Pennsylvania, Colorado, California, Maryland and Florida. Many residents of Los Angeles County might soon find they are getting more attention and questions from their doctors. That’s because L.A. Care Health Plan — a public health plan in L.A. County with more than 1.8 million members — received a $15.8-million federal grant this week to help change the way physicians interact with patients and deliver care. (10/1) Health insurance provider Colorado Access is axing Medicare coverage for the coming year, leaving about 5,500 senior and disabled customers in search of alternatives. The Denver-based nonprofit also will let go 83 employees who worked for Colorado Access Medicare and its subsidiary Access Health Colorado, chief operating officer Matt Case said. An additional 40 openings will go unfilled. (Wallace, 10/1) Advocates for consumers, insurers, hospitals and doctors clashed Thursday at a hearing on surprise bills for expensive out-of-network health care services sent to patients who thought their treatments were covered by their insurance networks. Insurance Commissioner Teresa Miller, who moderated the informational session, said it not only underscored the complexity of the problem but provided ideas for solving it. (Jackson, 10/1) A state court ruled last week that two health care service plans may need to pay the state’s gross premiums tax because they may qualify as health insurers. The health care service plans -– Blue Shield of California and Anthem Blue Cross — argued that they were regulated by the Department of Managed Health Care, not the California Department of Insurance, and were not insurers subject to the gross premiums tax. (Gorn, 10/1) This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
Around the country, many psychologists and families are noticing an increasing number of children and teenagers with eating disorders that appear to be triggered by school-based obesity-prevention programs, ranging from discussions of healthy food in class to so-called “BMI report cards” that report a child’s body mass index in a letter to parents. (Carrie Arnold, 3/14) Pacific Standard: The Youngest Casualties In The War On Obesity Myelin is the white substance that coats axons, the spokes than connect neurons to one another. A reduction in myelin has been linked to a variety of neurological conditions, including multiple sclerosis and Guillain-Barre syndrome, among others. And a few drugs related to myelin production are already in clinical trials, which means that what was once a parlor game—would you take away the Down syndrome?—may one day be a reality for parents like us. If and when drugs are developed that reverse myelin loss specifically in people with Down syndrome, we’ll join the many other parents of children with brain differences who face similar quandaries. (Amy Julia Becker, 3/15) Vox: Uterus Transplants Are Extremely Risky. Doctors Should Keep Doing Them Anyway. Longer Looks: Medical Mistakes; Overlapping Surgeries; Health Apps Each week, KHN’s Shefail Luthra finds interesting reads from around the Web. Lindsey’s tragedy — after much fanfare — raises the question about whether it’s really worth continuing with the operation at all. Though the doctors in Cleveland have nine additional uterus transplants in the works as part of an ongoing study, the procedure remains hugely controversial. I asked medical ethicists and doctors (including one of the authors of the global ethical guidelines for uterine transplants) for their opinion. They all pointed out that the uterine transplant is a supremely risky operation — but agreed that doctors and willing patients should continue experimenting with them anyway. (Julia Belluz, 3/10) Despite the fact that Laura’s Law was passed in California over 13 years ago, and that 44 other states have similar laws in place, adoption of Laura’s Law has been slow. Most counties who have attempted to adopt the law have faced strong opposition by mental health consumers, legal organizations and advocates from underserved and marginalized communities. The organization Disability Rights California has lobbied heavily against the law since 2002, threatening to sue counties that implemented Laura’s Law, saying assisted outpatient treatment doesn’t work. (Linda Childers, 3/15) The California Health Report: As More California Counties Implement Laura’s Law, Advocates Push Back The Economist: Things Are Looking App The Atlantic: A Pill For Down Syndrome There are now around 165,000 health-related apps which run on one or other of the two main smartphone operating systems, Apple’s iOS and Google’s Android. PwC, a consulting firm, forecasts that by 2017 such apps will have been downloaded 1.7 billion times. However, the app economy is highly fragmented. Many providers are still small, and most apps are rarely, if ever, used. (3/12) Medical errors kill more people each year than plane crashes, terrorist attacks, and drug overdoses combined. And there’s collateral damage that often goes unnoticed: Every day, our healers quietly live with those they have wounded or even killed. Their ghosts creep into exam rooms, their cries haunt dreams, and seeing new patients can reopen old wounds. (Sarah Kliff, 3/15) Vox: Fatal Mistakes This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
Sen. Patty Murray (D-Wash.) on Wednesday called for reviving bipartisan efforts to reach a deal to fix ObamaCare after an agreement she was part of collapsed last year. “Mr. Chairman, I’m really hopeful that we can revive discussions in the new Congress and find a way past the ideological standoffs of the past,” Murray said to Sen. Lamar Alexander (R-Tenn.), her Republican partner in forging last year’s deal, at a hearing on health care costs. (Sullivan, 11/28) CQ: Senate Fight Between Friends Slows Bipartisan Health Bills Medicare ‘Buy-In’ Proposal — A Toned Down Alternative To Single-Payer — Gains Momentum With Moderate House Democrats Under the proposal, anyone aged 50 to 64 who buys insurance through the health-care exchanges would be eligible to buy in to Medicare. While some Democrats are eager to work on the plan, others from the left-wing of the party view it as too incremental. Elsewhere on Capitol Hill: Sen. Patty Murray (D-Wash.) wants to work on a bipartisan fix to shore up the health law, a spat between lawmakers endangers chances of two health measures getting passed this year, and Democrats shift focus from health message with eye on 2020. The Hill: Dem Senator Murray Calls For Trying Again On Bipartisan ObamaCare Fix An unusual spat between Senate GOP sponsors of two bipartisan House-passed health measures might threaten the bills’ chances of clearing Congress this year. Both bills would normally be candidates to pass the Senate by unanimous consent so they would not take up much floor time, but objections from each member on the other’s bill is preventing that. One of the sponsors hopes his bill will be added to a year-end spending package. (Siddons, 11/28) This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. Democrats built a midterm electoral wave by centering their message around health care. But since the Nov. 6 election, many Democratic ads have shifted focus from protecting health insurance to protecting special counsel Robert Mueller. …Focusing on health care made sense during the fall campaign, when Democratic candidates were seeking support form independents and Republicans, along with their own voters. Polls consistently showed health care was a top issue for midterm voters. Having leveraged that broad-based appeal to make big midterm gains in Congress and statehouses, 2020 presidential hopefuls are now targeting grassroots activists, whose support will be critical in the upcoming presidential primaries. (Green, 11/29) Momentum is building among House Democrats for a more moderate alternative to single-payer health-care legislation. The legislation, which would allow people aged 50 to 65 to buy Medicare, is being championed by Rep. Brian Higgins (D-N.Y.), who supported House Minority Nancy Pelosi (D-Calif.) for Speaker in exchange for a commitment to work on his bill when Democrats take control of the House early next year. (Weixel, 11/29) The Hill: Dem Single-Payer Fight Set To Shift To Battle Over Medicare ‘Buy-In’ Bloomberg: Looking Toward 2020, Democrats Shift Focus From Health Care To Mueller
CQ: Health Chairman Backs Surprise Bills Remedy, But Senators Divided Modern Healthcare: Alexander Supports In-Network Guarantee To End Surprise Medical Bills An MRI is one of those standard tests that doctors order routinely. But the price you’ll pay can be unpredictable. Sometimes the price tag depends on where you live: It could reach $10,000 in San Francisco. Or be as low as $1,000 in St. Louis — if you’re willing to haggle. And the kind of imaging center you choose often makes a difference: Was it a fancy specialty hospital linked to a university or a standalone facility at the mall? (Weissmann, 6/19) The chair of the Senate health committee showed his support for the so-called “network matching” policy to end surprise medical bills, a proposal sharply opposed by specialty physician groups and the hospitals that employ them. In a committee hearing on Tuesday, Sen. Lamar Alexander (R-Tenn.) said the policy, under which hospitals would have to guarantee to their patients that any doctor they see is in-network, is the one he “instinctively liked the best.” (Luthi, 6/18) There was also broad support among the witnesses for some of the legislation’s transparency measures, especially the creation of a nongovernmental nonprofit organization to collect claims data from private health plans, Medicare and some states to create what’s called an all-payer claims database. That could help policymakers better understand the true cost of care, these experts told the committee. (Bluth, 6/18) Providers such as doctors and payers such as insurers agree that there should be an end to surprise medical bills — a hot-button issue that President Donald Trump wants to address through legislation this summer. But their disagreement over how to settle payment disputes has been the central sticking point in negotiations over a ban on surprise bills. Alexander declined to tell reporters if he would move forward with the in-network guarantee approach. “We’ll see,” he said after the hearing. Sen. Patty Murray, D-Wash., the panel’s top Democrat, similarly declined to say if she supports an in-network guarantee. Washington Governor Jay Inslee, a Democrat who is seeking the party’s White House nomination, signed legislation last month with a different approach to banning surprise bills, which would use a third-party arbitrator if a payer and provider could not agree on payment. (McIntire, 6/18) In other health care costs news — In Debate Over What To Do About Surprise Medical Bills, Alexander Hints At Support For In-Network Guarantee Although many lawmakers agree that patients need to be protected from surprise medical bills, there are different ways that could go and many stakeholders who have strong opinions on what the solution should be. At a hearing on Wednesday, Senate Health, Education, Labor and Pensions Committee Chairman Lamar Alexander said that requiring hospitals to guarantee that any doctor a patient sees is in-network is the strategy he “intrinsically liked the best.” But the future of any legislation is still unclear. Kaiser Health News: Senators Agree Surprise Medical Bills Must Go. But How? Kaiser Health News: ‘An Arm And A Leg’: Can You Shop Around For A Lower-Priced MRI? This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
Twitter Bloomberg News Reddit ← Previous Next → January 31, 20199:13 AM EST Filed under News Economy More What you need to know about passing the family cottage to the next generation Output from the energy industry fell 0.6 per cent, Statistics Canada said. Lower production of petroleum and coal also drove a 0.5 per cent decline in manufacturing in November, the third drop in four months.Getty Images Canada’s economy contracted for the second time in three months on lower energy production, the clearest evidence yet of a soft patch that’s expected to linger through the first part of this year.Gross domestic product declined 0.1 per cent in November, Statistics Canada said Thursday from Ottawa, matching the median forecast in a Bloomberg survey of economists.Bank of Canada Governor Stephen Poloz signalled earlier this month he will take longer to add to his five interest-rate increases since the middle of 2017 because of signs of setbacks to growth. The weakness, even if temporary, illustrates risks to an economy that needs business spending to take over from consumers who are burdened by record debts. Is Canada headed for a recession? The numbers leave the Bank of Canada “decidedly on hold for the next couple of quarters,” Avery Shenfeld, chief economist at CIBC World Markets, said in a note to investors.The central bank predicts the annualized pace of growth will slow to 1.3 per cent in the fourth quarter of 2018 and again to 0.8 per cent in the first three months of this year. The economy is expected to rebound after that on strong job creation and business spending, with policy makers saying interest rates will still likely move higher over time.Output from the energy industry fell 0.6 per cent, Statistics Canada said. Lower production of petroleum and coal also drove a 0.5 per cent decline in manufacturing in November, the third drop in four months. Wholesaling fell by 1.1 per cent led by machinery and equipment, and construction fell for the sixth straight month to the lowest since the middle of 2017.Tumbling prices for Alberta oil late last year led the provincial government to impose production cuts that began in January. Alberta Premier Rachel Notley and Canadian Prime Minister Justin Trudeau are facing pressure before elections this year to develop stalled pipelines and send crude overseas rather than accept lower prices in the U.S. market.Retail spending remained weak in November, with a 0.3 per cent decline led by a 2 per cent drop in car sales. Retailing has declined by 1.2 per cent over the last year, the only major industry besides construction to shrink over that period.There was some evidence the weakness may not last. Transportation and warehousing was dragged down by a postal strike that ended around the end of the month, and Statistics Canada also said there were maintenance shutdowns at some auto assembly plants and offshore oil sites on the east coast after a storm.With assistance from Erik HertzbergBloomberg.com Canada’s economy shrinks for the second time in three months GDP numbers leave Bank of Canada ‘decidedly on hold for the next couple of quarters’, says economist Recommended For You’We were experiencing headwinds’ — Canopy Growth stock heads south on poor sales ramp-upDefining the future of Canadian competitiveness: How partnerships between industry and educational institutions can help lead the way forwardTrans Mountain construction work can go ahead as National Energy Board re-validates permitsDavid Rosenberg: Deflation is still the No. 1 threat to global economic stability — and central banks know itBank of Canada drops mortgage stress test rate for first time since 2016 Featured Stories 21 Comments Comment advertisement Join the conversation → Share this storyCanada’s economy shrinks for the second time in three months Tumblr Pinterest Google+ LinkedIn Sponsored By: Facebook Email Greg Quinn
Audi e-tron (wallpaper 2,560x – click to enlarge) Audi e-tron (wallpaper 2,560x – click to enlarge) Audi e-tron (wallpaper 2,560x – click to enlarge) Audi e-tron (wallpaper 2,560x – click to enlarge) You can find more wallpapers in our Wallpaper Wednesday series.*Images can be enlarged to width of 2,400, 2,560 or greater Audi e-tron (wallpaper 2,560x – click to enlarge) Audi e-tron (wallpaper 2,560x – click to enlarge) Wallpaper Sunday: Tesla Model 3 Performance Audi e-tron (wallpaper 2,560x – click to enlarge) Audi e-tron (wallpaper 2,560x – click to enlarge) Audi e-tron looking sleek in high-resolution.Despite just being revealed last night, the Audi e-tron is already in production, so the first copies will soon hit the streets in Europe. Before that happens, please feel free to put your favorite wallpaper of the e-tron on the desktop.We like the rather plain, Audi-ish design here and think that it will sell quite well, considering it starts at below $75,000.More wallpapers Audi e-tron (wallpaper 2,560x – click to enlarge) Source: Electric Vehicle News Audi e-tron (wallpaper 2,560x – click to enlarge) Wallpaper Wednesday: Jaguar I-Pace – Our Top 25 Images Wallpaper Wednesday: Mercedes-Benz EQC 400 4MATIC Audi e-tron (wallpaper 2,560x – click to enlarge) Audi e-tron (wallpaper 2,560x – click to enlarge) Author Liberty Access TechnologiesPosted on September 18, 2018Categories Electric Vehicle News Audi e-tron (wallpaper 2,560x – click to enlarge) Audi e-tron (wallpaper 2,400x – click to enlarge) Audi e-tron (wallpaper 2,400x – click to enlarge) Audi e-tron (wallpaper 2,560x – click to enlarge) Audi e-tron (wallpaper 2,560x – click to enlarge)
U.S. Tesla Sales In December 2018 Up By 249% Chinese Tesla Model 3 Spotted With Proper GB/T Connector Source: Electric Vehicle News Tesla Model 3 Mid Range Now Listed With More Electric Range For good things you always have to wait a bitThe DriveGuy de took the Tesla Model 3 Performance for a test drive to check out whether it’s a car worth waiting for. The answer is quite encouraging.Model 3 exceeds expectations and was called a segment leader. The driving experience is enjoyable, while the minimalist interior is claimed to be surprisingly good.See Also “This is the Tesla Model 3 Long Range Performance! It’s the car we have been been waiting quite some time for! Now that it’s here, I want to discover everything that the Long Range offers, how it fairs for Canadian buyers and, most critically, what is it like to drive?Let’s find out together!” Author Liberty Access TechnologiesPosted on January 3, 2019Categories Electric Vehicle News
Elon Musk joined the mayor of Shanghai and other local government officials for a ground-breaking ceremony at the site of Tesla’s new Chinese plant.Tesla plans to invest around $2 billion in the facility, which is expected to have a capacity of about 500,000 vehicles per year. The company hopes to finish initial construction this summer and quickly begin producing Model 3 vehicles there. “We think with the resources here we can build the Shanghai Gigafactory in record time, and we’re looking forward to hopefully having some initial production of the Model 3 towards the end of this year and achieving volume production next year,” Musk said at the event. Source: Electric Vehicles Magazine Source: Reuters Tesla’s Gigafactory 3 will be China’s first wholly foreign-owned car plant, a reflection of the country’s recent moves to open up its auto market. Local production is seen as a necessary move for Tesla, not only to minimize the impact of the ongoing US-China trade war, but to help it fend off competition from domestic EV startups such as Nio, Byton and XPeng. “Affordable cars must be made on same continent as customers,” Musk recently tweeted.“Shanghai Giga will produce affordable versions of 3/Y for greater China,” tweeted Musk. “All Model S/X & higher cost versions of Model 3/Y will still be built in US for [the worldwide] market, [including] China.”Shares in Chinese suppliers to Tesla, including Tianjin Motor Dies and VT Industrial Technology, rallied following Musk’s tweets.
There are positives with electric.A staggering number of companies—most of which are start ups—are coming up with their vision of the electric motorcycle. While the technology continues to evolve, it has already come a long way from its first inception on the market.It’s not perfect yet, however, a people tend to focus on the “negative” aspects of an electric vehicle: the limited range and long charging times are usually the biggest deterrents when the higher price points aren’t the first obstacle. Let’s highlight the positives of owning an electric bike. Here are five reasons why you should.More E-Bikes Source: Electric Vehicle News Lightning Teases New Long Range, Low Price Electric Motorcycle The perksThere’s a number of perks to owning an electric motorcycle. Of course, right off the bat, there are government incentives that allow you to reduce the purchase price of the bike. You can get a rebate at the federal level, but also from your state.Beyond the numbers, some areas also offer added bonuses for electric vehicles, including HOV lanes access, exemption from emission inspections, charging station installation rebate, tax exemptions, and more.The maintenanceIf you aren’t the hands-on type of rider or if you’d rather have as little maintenance to do on your bike as possible, consider an electric model! Without any fluids and fewer mechanical parts to worry about, electric motorcycles are a good way to ride about worry free.Obviously, there are certain components that will require some occasional love, but there won’t be any oil to change or leaking gaskets to fix.The accessibilityWe can all agree that part of what makes a motorcycle fun to ride on is the control the sequential transmission offers us. For some people, however, it’s an added stress, as demonstrated by the plumetting manual car sales.If having to synchronize clutch and gear levers actions has been a factor of stress for you, the switch to electric motorcycles is all the more easier—e-bike don’t have manual transmissions. The bike does its own thing electronically. All you have to do is twist the throttle and hit the road.The savingsThis has been one of the biggest selling points for electric motorcycles for years now: “fuelling” up on electricity is cheaper than filling up on gas.On Zero Motorcycles’ site, the company calculated that the most you would have to pay for a full charge is roughly $2.02 for the SR F14.4 with a power tank. How much does filling up your car cost?The funOh, the fun! This is probably the most convincing argument for owning an electric motorcycle. Even if you don’t cough up the money to own a performance-oriented Energica or Lightning, any electric motorcycle can be a lot of fun to drive.Remember what we said earlier about the absence of a clutch and gear transmission? Because everything is processed electronically, it makes accelerations almost instant and takeoffs, that much more fun. Try it, you’ll understand what we mean. New Zero Motorcycles SR/F Specs Leave Harley-Davidson In The Dust NXT Rage Electric Motorcycle: The Next Thing? Author Liberty Access TechnologiesPosted on March 2, 2019Categories Electric Vehicle News
Source: Charge Forward Toyota has been dragging their feet on new vehicle technology for some time now, seemingly happy to continue selling their antiquated gas-powered fleet, with no battery electric vehicles and only one plug-in hybrid and one fuel cell vehicle (powered by 95% fossil-sourced hydrogen) across their entire lineup.But if you watch their recent ads, the deceptiveness of which we’ve covered before, you wouldn’t know this. Because they continue to misleadingly advertise their “self-charging” “hybrid electric Corolla” as if it’s anything other than a 100% fossil-powered gas guzzler. And in case it wasn’t apparent already: “self-charging” is not a real thing, as the entire concept violates the basic laws of physics. more…Subscribe to Electrek on YouTube for exclusive videos and subscribe to the podcast.https://www.youtube.com/watch?v=V1zk7Eb8r-s&list=PL_Qf0A10763mA7Byw9ncZqxjke6Gjz0MtThe post Toyota’s anti-EV ads aren’t just deceptive, they also push science illiteracy appeared first on Electrek.
Share on WhatsApp Shares00 Share on Facebook This article is more than 11 years old Roy Keane yesterday explained his reasons for putting Liam Miller on Sunderland’s transfer list, saying the midfielder’s main failing was being late for training.Despite seeing Miller become one of Sunderland’s most important players in their battle against relegation, Keane revealed ahead of tomorrow’s crucial game at bottom-of-the-table Derby that he could no longer tolerate the Republic of Ireland international’s time-keeping.In his first season as manager of Sunderland last year, Keane instructed the driver of the team bus to leave without three first-team players before a trip to Barnsley and dropped them from the starting line-up because they were a minute late for the scheduled departure. But the former Manchester United captain has come down even harder on Miller.”It’s not a question about Liam the lad and it’s nothing to do with him as a player,” said Keane. “He is a talented boy but I’m employed by Sunderland and I have to do what is right for Sunderland. We need every player we can. But I have to look at the bigger picture for this club. I have to look at his team-mates, players who come in regularly on time and train, the supporters who spend a lot of money up and down the country.”I don’t go around with a stick, threatening people. We have given players the benefit of the doubt but enough is enough. There comes a time when you have to say ‘Move on’. Liam is very happy here but if you can’t get in on time for training then it doesn’t matter if he is happy or unhappy.”In the past Keane has been protective of Miller, a player once viewed as his natural successor at Manchester United. The two men hail from Cork and Keane was highly critical of the former Republic of Ireland manager Steve Staunton this season for failing to select Miller for the national team.”He is a Cork man, like me, and I have looked out for him on a number of occasions,” said Keane. “But there’s no room for sentiment. I have been more than fair.”Whether Miller will leave this season on loan remains to be seen and it may be that the decision to put him on the transfer list is shock therapy. “As long as he is under the roof [and] he is working hard, he might get an opportunity,” Keane added. “It [his career] is not over. If I don’t get the calls from other clubs, he keeps training well and is on time, he will be in my thoughts.”Miller’s agent, Eamon McLoughlin, denied his client had behaved unprofessionally, insisting that, although the 27-year-old was late to training three times in the past week, two of those were out of his control because of accidents on the A19. “If the punishment fitted the crime Liam could accept this more easily but he doesn’t think it does,” he said. “He’d still love to play for Sunderland but that is obviously not his decision to make.”Keane goes to Derby seeking his first league away win this season after equalling the club record by losing 10 games in a row. But the manager is confident that the attitude in his squad will provide the basis for Sunderland to stay in the top flight.”If you haven’t got that, you have got nothing,” he said. “If you want to be a top footballer, you have got to have drive and passion. That has no doubt helped us in a lot of games when sometimes our quality has let us down.” Share on Twitter Share on Pinterest Thu 28 Feb 2008 19.04 EST Share on LinkedIn Soccer Share via Email Keane says patience snapped with Miller over lateness Topics Soccer Sunderland news Reuse this content Simon Williams Share via Email This article is more than 11 years old Share on Facebook First published on Thu 28 Feb 2008 19.04 EST Share on Messenger Share on Twitter
The Dodd-Frank Act enacted in July 2010 contained whistleblower provisions applicable to all securities law violations including those under the Foreign Corrupt Practices Act.In this prior post from July 2010, I predicted that the whistleblower provisions would have a negligible impact on FCPA enforcement. As noted in this prior post, my prediction was an outlier (so it seemed) compared to the flurry of law firm client alerts that predicted that the whistleblower provisions would have a significant impact on FCPA enforcement. Many FCPA Inc. participants seemed so eager for a marketing opportunity to sell compliance services, that some even called the generic whistleblower provision the FCPA’s “new” whistleblower provisions.Whatever your initial view on how the whistleblower provisions may impact FCPA enforcement, it was previously noted that the best part of the whistleblower provisions were that its impact on FCPA enforcement could be monitored and analyzed because the SEC is required to submit annual reports to Congress.Recently, the SEC released (here) its annual report for FY2016 and, like the prior five years, FCPA “tips” continue to be a minor component of the SEC’s whistleblower program.Specifically, according to the SEC’s report, of the 4,218 whistleblower tips received by the SEC in FY2016, 5.6% (238) related to the FCPA.As noted in this similar post from last year, of the 3,923 whistleblower tips received by the SEC in FY205, 4.7% (186) related to the FCPA. As noted in this similar post from two years ago, of the 3,620 whistleblower tips received by the SEC in FY2014, 4.4% (159) related to the FCPA. As noted in this similar post from three years ago, of the 3,238 whistleblower tips received by the SEC in FY2013, 4.6% (149) related to the FCPA. As noted in this similar post from four years ago, of the 3,001 whistleblower tips received by the SEC in FY2012, 3.8% (115) related to the FCPA. In FY2011 (a partial reporting year) of the 334 whistleblower tips received by the SEC, 3.9% (13) related to the FCPA.Since the program began, the SEC has received 18,334 tips and 4.6% (860) related to the FCPA.Another interesting figure to note is that the 860 FCPA tips have yielded perhaps only 1 whistleblower bounty paid in connection with an FCPA enforcement action. This represents a paltry .1% yield. Stated differently 99.9% of FCPA “tips” received by the SEC have not yielded a whistleblower bounty.The above paragraph uses the term “perhaps” because, as highlighted in this prior post, an Australian media report regarding the BHP Billiton enforcement action is the only information in the public domain suggesting that a whistleblower bounty has been paid in connection with an FCPA enforcement action. However, as highlighted in the post, the report is questionable given that the SEC’s investigation of BHP Billiton began in 2009 – a year prior to the whistleblower provisions being enacted into law.Regardless, I stand by my prediction, now 6.5 years old, that Dodd-Frank’s whistleblower provisions will have a negligible impact on FCPA enforcement.Indeed, it is no longer a prediction but a fact.
Username Password Not a subscriber? Sign up for The Texas Lawbook. Remember me The Supreme Court of Texas recently upheld a 55-cent-per-pack tax on the makers of discount cigarettes, finding the Legislature had a rational basis to distinguish between small manufacturers and Big Tobacco companies that settled with the state in 1998 . . .You must be a subscriber to The Texas Lawbook to access this content. Lost your password?