U.S. readies for Yemen President Saleh, refuses to divulge details
Washington, D.C., United States (AHN) – The United States on Monday confirmed issuance of visa to ailing Yemeni President Ali Abdullah Saleh for a limited time to undergo medical treatment but refused to divulge time-period for which the visa is issued.
“We have issued a visa for Ali Abdullah Saleh,” said Victoria Nuland, the State Department spokesperson, adding, “It is strictly for medical treatment, and our expectation is that he will leave the United States when his medical treatment is complete.”
Asked to comment on the time period for which this visa is issued, Nuland said, “He’s got a visa for the period that he anticipated the medical treatment would last. If the treatment goes on longer and he needs to apply for an extension, he would do that with Homeland Security.”
Yemeni political players are expecting to utilize President Saleh’s absence to move the country “on a concrete transition plan to a more democratic Yemen,” said Nuland, adding, “We do believe that Saleh’s absence from Yemen at this critical juncture might, in fact, facilitate that dialogue and facilitate the transition process.”
Agreeing that, “it might be helpful to the transition process that he’s out of the country now,” Nuland reiterated, “It (the visa application) was not approved for political purposes. It was approved for medical treatment. The timing, we think, is fortuitous, however, and we hope that the Yemenis will use the time well.”
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Analysis: Keys To The Supreme Court’s Health Law Review
Washington, DC, United States (KaiserHealth) – By agreeing today to hear challenges to President Obama’s 2010 health care law, the Supreme Court set the stage for a decision — probably in late June and in the midst of the presidential campaign — that could be among its most important in decades.
The case, which will probably be argued in March on a date still to be announced, is especially momentous because it not only will determine the fate of President Barack Obama’s biggest legislative achievement but also will cast important light on the Supreme Court’s future course under Chief Justice John Roberts on issues of federal government power.
The central issue — but not the only important one — is whether Congress exceeded its constitutional powers to regulate interstate commerce and to levy taxes when it adopted the so-called “individual mandate” at the heart of the health care law.
That provision would require millions of people starting in 2014 to buy commercial health insurance policies or pay financial penalties for failing to do so.
The court also agreed to decide a challenge to the Affordable Care Act’s provision essentially requiring states greatly to expand their Medicaid spending.
The court made clear that if it decides to strike down the individual mandate or Medicaid provision, it will also decide which of the 975-page law’s hundreds of other provisions should go down too, by divining whether Congress would have wanted some or all of them to be effective even without the voided provision or provisions.
Finally, the court agreed to decide whether — as one federal appeals court ruled — the litigation surrounding the individual mandate must be deferred until 2015 because of the 1867 “Anti-Injunction Act,” which bars courts from striking down tax laws before they take effect.
The court allocated an extraordinary five and one-half hours — the most time in many decades for related challenges to a single new law — for argument on all these issues combined.
How The Case Got Here
The court’s announcement Monday centered on a challenge to the law by 26 state governments. The 11th Circuit Court of Appeals in Atlanta voted in August to strike down the individual mandate but to leave standing the rest of the health law, including the Medicaid expansion. All three of the petitions granted today involve that case.
In other action, though, the D.C. Circuit and the 6th Circuit, centered in Cincinnati, have upheld the individual mandate, with opinions supporting the Obama position by two of the nation’s leading conservative judges, the D.C. Circuit’s Laurence Silberman and the 6th Circuit’s Jeffrey Sutton.
Another appeals court, the 4th Circuit, said courts have no power to decide the individual mandate issue until 2015, when the first monetary penalties will be due for failing to comply with the individual mandate to buy health insurance. This decision held that the penalty provision is a “tax” within the meaning of the Anti-Injunction Act, as described above.
If the justices agree that the Anti-Injunction Act applies, this year’s case will be perhaps the greatest anticlimax in Supreme Court history. And, the justices’ assignment of a full hour of oral argument to this question suggests that some take this issue very seriously.
Meanwhile, the purpose of the individual mandate is to force millions of Americans to obtain health insurance — whether they want to or not — in order to offset the costs that health insurers would bear under the health care law’s requirement that they sell insurance to everyone without charging those with especially costly health problems more than healthy people.
The lower court judges who have struck down the mandate have cited as their reasoning the lack of any precedent for Congress to require people to buy a commercial product they don’t want and the government’s failure to show how — if the individual mandate is upheld — a limit enforceable by the courts could be applied to this exercise of congressional power.
As background, the two Supreme Court decisions since’37 that have struck down acts of Congress as exceeding the commerce power, one in’95 and one in 2000, stressed that Congress’ commerce power must be restrained by some principle that could be enforced by the judicial branch of government.
Defenders of the individual mandate stress other Supreme Court precedents suggesting that even economic decisions that have a tiny direct effect on interstate commerce — such as a person’s decision not to buy health insurance — cumulatively have major effects on interstate commerce and thus can be regulated by Congress.
With the court’s announcement today, none of the justices recused themselves from hearing the case. Some conservative opponents of the health care law have suggested that Justice Elena Kagan should recuse herself because of her prior work as President Obama’s Solicitor General. And some liberals have suggested that Justice Clarence Thomas should recuse himself because of his wife Virginia Thomas’s political activities opposing the health care law. But the decision on recusal is left to each individual justice and it would have been announced with today’s order.
Meanwhile, as is customary, the Court announced the grants of review with no comment or indication of the vote. Any four justices can agree to review a case. And, given the importance of the issues, with federal appeals courts divided, today’s announcement was widely expected.
Most but not all Supreme Court experts predict — some very confidently, some cautiously — that the Court will uphold the law. The Supreme Court’s four liberals are certain to uphold the law. They would need only one more vote to prevail. While Justice Clarence Thomas seems a sure vote to strike the law down, Chief Justice John Roberts and Justices Anthony Kennedy, Antonin Scalia and Samuel Alito are harder to call.
A decision in June — or before — would help make the future of health care law a central issue in the 2012 presidential campaign.
Taylor, an author and journalist, is a nonresident fellow at the Brookings Institution.
– Provided by Kaiser Health News.
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Readers Face Multiple Dilemmas About Insurance Coverage, Costs
Washington, DC, United States (KaiserHealth) – This week, we address readers’ questions about health insurance coverage and costs.
My son was denied coverage on the basis that he had been drinking before going to the ER with a broken shoulder. Is drinking a legitimate reason for denial of coverage? John Johnson, Tucson, Ariz.
More From This Series Insuring Your Health
As of 2008, 36 states allowed insurers to exclude coverage for injuries related to alcohol and/or drug consumption, according to research from George Washington University’s Department of Health Policy at the School of Public Health and Health Services.
The practice dates to’47 when, as a way to discourage drinking, the National Association of Insurance Commissioners adopted a model statute that excluded coverage of alcohol-related health claims. More than 40 states and the District subsequently passed such laws.
But as the benefits of drug and alcohol treatment programs became apparent, these laws were recognized as counterproductive, since they discouraged emergency department and other medical personnel from screening people for and counseling them about drug and alcohol abuse. In 2001, the NAIC reversed course and recommended that such laws be scrapped.
My husband had a stroke in December, and the insurance reps refused to discuss his account with me because they didn’t have his signature on a form, and he couldn’t tell them over the phone it was okay to talk to me. And it is MY insurance! They said they had to follow HIPAA [the Health Insurance Portability and Accountability Act, which protects patients' medical privacy]. Is this true? Name withheld, Lawrenceville, Ga.
It’s a common misperception by health-care providers and insurers that HIPAA prohibits them from discussing patients’ medical information with family members, says Deven McGraw, director of the health privacy project at the Center for Democracy and Technology, a civil liberties group that promotes health privacy. “It’s not true; it has never been true,” she says. Unless the patient objects, such information can be shared with family members.
Advance planning documents can help avoid confusion and heartache, say experts. A living will spells out what if any measures you wish to have taken to prolong your life — being put on a breathing machine or on dialysis, for example. A health care proxy names the person you choose to make medical decisions for you in the event that you can’t do so yourself.
In addition, most states have surrogacy laws that assign decision-making responsibility to family members based on their relationship to the patient. Typically, if someone is incapacitated, state law would assign decision-making to the patient’s spouse, says Jay Horton, clinical program manager at the Lilian and Benjamin Hertzberg Palliative Care Institute at Mount Sinai School of Medicine in New York. If there is no spouse, the laws spell out who would be assigned to make decisions instead, based on their relationship to the patient.
Our doctor recommended that my husband get a preventive colonoscopy since it had been five years since his last one. The doctor found two benign polyps and removed them. Our [health] plan was to cover 100 percent for a preventive colonoscopy. Because the doctor removed the polyps during the procedure, it is now not covered. We have to pay the deductible, and the balance owed. I can assure you that many, many people will not have this procedure done (as I will not) when they are made aware of the additional costs involved. Pam Nevin, Rutherfordton, N.C.
Under the new federal health law, Medicare beneficiaries and members of new private health plans starting this year can generally receive free colonoscopies to screen for colon cancer if they meet age and other criteria.
Unfortunately, like you, others have been hit with sometimes substantial charges if a growth or mass called a polyp is discovered during a routine screening colonoscopy they thought would be free. Once a preventive procedure turns into a diagnostic procedure or other type of treatment, providers can charge you for it under the new law. According to the interim final rules: “A plan or issuer may impose cost-sharing requirements for a treatment that is not a recommended preventive service, even if the treatment
results from a recommended preventive service.”
Some experts have expressed concern that colonoscopy charges raise questions about what other newly free preventive services might incur similar hidden costs. Fortunately, it doesn’t appear that it will be a widespread problem, says Stephen Finan, senior director of policy for the American Cancer Society’s Cancer Action Network. The reason: Colonoscopies appear to be the only procedure covered under the new guidelines for free preventive care where both prevention and diagnosis happen during
the same procedure. Usually they’re separate, as when something suspicious turns up on a woman’s mammogram. In that case, a separate procedure such as a biopsy would be scheduled to diagnose the problem, says Finan. “Colonoscopy is a very unique scenario,” he says.
Got a question for Michelle Andrews to answer in a future column? khnquestions@kff.org
– Provided by Kaiser Health News.
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Customers Urge Boycott Of Frito-Lay For Scrapping Compostable Bags
Washington, DC, United States (AHN) – Frito-Lay customers are calling for a boycott because of the company’s decision to stop using biodegradable bags for most of its SunChips products due to complaints over the noise the groundbreaking packaging makes.
Texas-based Frito-Lay will resume using traditional plastic bags for five of six of its SunChips flavors. Specially-marked 10.5 ounce bags of the original flavor will continue to have the 100 percent compostable bags.
The company, which is a unit of PepsiCo, said it is working on a new biodegradable packaging that takes into account customer feedback, including the level of noise created by the bags.
Customers, however, filled Frito-Lay’s Facebook and Twitter pages with angry comments about how the company was “pander[ing] to a ridiculous request” and proving its compostable packaging was a mere “marketing ploy.”
Customers who wanted the bags to be kept argued there were obvious alternatives such as transferring the chips to a bowl or reusable plastic container. Many made clear they would stop buying SunChips and called for others to do the same.
“I will no longer buy SunChips, or any Frito Lay product for that matter. You caved too easily!!!!!,” Melody L. Martin commented.
“We saw the Sun Chips commercial… before we saw that commercial we had never eaten or bought a single Sun Chip,” said Kristofer Hoch on Wednesday. “As of this day, our compost pile contains probably 100 or more empty bags of Sun Chips; all in various stages of break-down. As of this day, I’ll never buy another bag of chips from Frito-Lay, UNLESS you bring back the compostable bags.”
Frito-Lay sought to “set [customers'] minds at ease” by saying it was still committed to biodegradable packaging.
The compostable bags are made of plant-based sugar carbon instead of petroleum-based carbon. They were launched last year, earning praise for Frito-Lay for introducing a first in the global snacks industry. The company, however, suffered an 11 percent drop in sales of SunChips over the past fiscal year.
Many customers had complained about the the noise of the new packaging, and one even created a Facebook page, “Sorry But I Can’t Hear You Over This SunChips Bag,” that had more than 47,000 fans.
The noise created by the packaging was disruptive and may offset any environmental gains, customer said.
“We have small children who nap during the day and go to sleep earlier than we do at night, and the bag has actually woken them up before,” Michael said in a discussion on Frito-Lays Facebook page. “So after purchasing we immediately transfer the chips to a large plastic Ziploc bag thus negating the gain made by the more biodegradable bag.”
Customers also reported other issues with the bag, such as tearing too easily and failing to keep chips fresh as long as the old packaging.
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