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health care

Steve Carmody / Michigan Radio

A federal court ruling today could affect tens of thousands of Michiganders who got health insurance through Obamacare.

More than 237,000 of the 272,000 Michiganders who signed up for Obamacare selected a plan through the marketplace with federal financial assistance.  The tax credits helped subsidize health insurance payments for low- and moderate-income people.

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DETROIT (AP) - The Detroit and Flint areas are getting nearly $9 million to help train new primary care providers.

Most of the money announced Monday goes to the Detroit Wayne County Health Authority for training in family medicine, internal medicine, psychiatry, pediatrics, obstetrics and gynecology. Flint's Hamilton Community Health Network is getting $900,000 for family medicine training.

The U.S. Department of Health and Human Services says the money is part of $83.4 million in Affordable Care Act funding to support primary care residency programs nationwide. Overall, it will help train more than 550 doctors during the 2014-2015 academic year.

Groceries, including milk, eggs and produce, sitting on a counter.
Lindsey Smith / Michigan Radio

The federal health care exchange for private insurance under the Affordable Care Act closed on March 31. 

The very next day, the attention turned to Healthy Michigan, the state's expanded Medicaid system for some 477,000 low-income Michiganders.

It looks like the state's Healthy Michigan plan is on track for enrollee sign-up.

Don Hazaert is the director of Michigan Consumers for health care, which helps people sign up for the coverage.

*Listen to the full interview above. 

A computer screen showing HealthCare.gov in action.
Steve Carmody / Michigan Radio

That's one of the lessons drawn from a report put out by the law firm Mehri & Skalet.

The author of the report, Jay Angoff, once led the U.S. Health and Human Services office in charge of implementing the Affordable Care Act.

Angoff looked at the amount it cost to set up health care exchanges in each state along with the number of enrollees in each state through March 31, 2014.

By doing that, he came up with a “cost-per-enrollee” for each state’s health care exchange.

Overall, the average cost-per-enrollee was $922. The average cost was higher for states with their own exchanges, and lower in states with the federally-run exchange.

getoverit.org

A basic tenet of the Affordable Care Act is preventive care: Get people into the health care system before disease or disability set in.

But that's highlighting a problem with our medical education system. Medical schools are turning out too many specialists and not enough primary care physicians. Cynthia Canty spoke with Dr. William Strampel, dean of the College of Osteopathic Medicine at Michigan State University. 

Farm in rural Michigan
user acrylicartist / MorgueFile.com

One of the most important aspects of the Affordable Care Act is consumer choice. More choice leads to more competition among insurers, and that can mean lower costs to consumers.

But, as Michiganders shopped for health coverage on the federal marketplace, the amount of choice was not even.

If you lived in Wayne, Oakland or Macomb Counties, you got to choose from 55 insurance plans. If you lived in Delta County in the Upper Peninsula, you were only offered 5 plans, all of them from Blue Cross Blue Shield of Michigan.

Josh Fangmeier is a health policy analyst with the Center for Healthcare Research and Transformation. He joined us today.

Listen to the full interview above.

Steve Carmody / Michigan Radio

A new report says preventable dental treatment is taking a bite out of Michigan hospital emergency room budgets.

The Anderson Economic Group study says in 2011, about 7,000 people with cavities, abscesses, and other preventable dental problems showed up in Michigan ERs.  About 1,000 needed to be hospitalized.

When it comes to support for emergency care services, the U.S. just barely squeaked by with a passing grade, at least according to a new state-by-state report card put out by the American College of Emergency Physicians.

And how did Michigan measure up, you might ask? Well, it turns out we're failing in access to emergency health care. We heard some recommendations about ways to move forward.

Then, we met a woman who’s trying to help people come together to have some uncomfortable, but enlightening, conversations about race, class and more.

And, we spoke with Daniel Howes about Tom Lewand, Detroit’s job czar.

Also, “Saturday Night Live” just hired its first black female cast member in five years. Will this bring more attention to other black comedians?

And, a Michigan historian gave us a closer look at how Michigan milkweed helped us in World War II.

Also, the Michigan Human Society has a new way to find homes for their animals: social media.

First on the show, how do you best measure the progress of students in Michigan's classrooms and, by extension, the effectiveness of their teachers?

It's one of the thorniest challenges being debated in Michigan education.

For years, the Michigan Education Assessment Program (MEAP) and the Michigan Merit Examination (MME) have been the assessment tools. Now, with the move to the Common Core Standards, it's out with the MEAP and MME and in with the what?

Districts around Michigan are gearing up for an online adaptive assessment test in the spring of 2015.

The Michigan Department of Education says the state has only one option for testing students on the Common Core State Standards for the next three years.

And that option is the Smarter Balanced Assessment – the SBA.

But state lawmakers haven't made that official.

We wondered how districts  are preparing for the SBA or whatever test they're told to administer next year.

William Heath is the superintendent of the Morrice Area Schools and principal at Morrice Junior and Senior High School located in Shiawassee County. He joined us today.

A hospital emergency room entrance.
Steve Carmody / Michigan Radio

How are we doing as a state and as a nation, when it comes to our emergency rooms and access to emergency health care?

According to a report card recently released by the American College of Emergency Physicians, not very well. Michigan received a grade of "D" in access to emergency care.

Why are we failing in access to this life-or-death care in Michigan?

Dr. Michael Nauss is a senior emergency room physician at Henry Ford Hospital in Detroit. And he's a board member of the Michigan College of Emergency Physicians. He joined us today.

Listen to the full interview above.

User: Brother O'Mara / flickr

More Michiganders signing up for health care than expected

"About 112,000 Michigan residents chose a private insurance plan under the federal health care law through January, outpacing what was projected in a government memo last summer," the Associated Press reports.

Juvenile lifer sentencing rules head to the governor's desk

"Michigan lawmakers have given final approval to new sentencing rules after the U.S. Supreme Court struck down mandatory life imprisonment for juveniles. The bills now head to Gov. Rick Snyder for his signature. The legislation applies to future cases and not retroactively to more than 350 Michigan inmates under 18 when they committed crimes," the Associated Press reports.

Lowest amount of money spent on roads in the U.S.: Michigan

"Michigan spends less money per capita on our roads and bridges than any other state in the nation. We spent just $154 dollars per person, according to the 2010 Census," Michigan Radio reports.

CDC / CDC


It takes a lot of heavy lifting to become a physician, a nurse, a dietician or other health-care professional. Long years of coursework and clinical training leave little room to learn other important skills – the kind of skills that can make a health professional an important player in the public policy sphere and prepared to tackle some of our most urgent environmental health challenges.

That's why the Ecology Center is offering a new fellowship program that can train health professionals about effective civic engagement and environmental health risks.

Listen to the full piece above.

The deadline for the Affordable Care Act's open enrollment period is January 31.
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It could happen in a field near an abandoned building in Detroit. Or a now-defunct library in a small rural town.

The locations may differ, but the mission is the same: medical students reaching out to provide health care to uninsured people.

The student-run free medical clinic is an outreach effort that’s offered by most medical schools. Usually, it’s staffed by first and second year med students who are responsible for virtually every aspect of the clinic. An M.D. is on hand to write prescriptions and confirm diagnoses. But it really is these med students who are giving most of the care.

What are the pros and cons of these free student-run clinics?

Jennifer Xu is a medical student at the University of Michigan. She recently wrote a piece for The Atlantic entitled “Letting Medical Students Run The Clinic.” She joined us today to tell us more about it.

Listen to the full interview above.

After years of debate, Congress has sent the almost $1 trillion farm bill to President Obama, and, as usual, opposition to the legislation was a left-right affair. On today's show: Congressman Dan Kildee of Flint joins us to talk about why he voted in favor.

Then, Michigan Radio’s political commentator Jack Lessenberry explained why fixing Michigan’s voting system may be harder than you think.

And, medical students are reaching out to provide health care to uninsured people. We spoke with one of these students about free student-run medical clinics.

And, a new mobile and Web app is providing food for hungry children in Grand Rapids.

Also, we spoke to an economist from the University of Michigan about the success of Lyndon B. Johnson’s War on Poverty.

And, the owner of Stonehedge Fiber Mill in East Jordan, Michigan, joined us today to tell us about how she was approached to provide yarn for the Ralph Lauren Olympic closing ceremonies sweaters. 

First on the show, it's Thursday, which means it's time for our weekly check-in with Detroit News business columnist Daniel Howes.

He's been going through Gov. Snyder's proposed budget for the new fiscal year and has decided the governor's got something going for him: what President George Herbert Walker Bush called "The Big Mo."

Daniel Howes joined us today to discuss the issue.

A piggy bank, stethescope and bundle of one dollar bills
401(k) 2013 / Flickr

What's your reaction when the conversation turns to America's soaring health care costs – when you hear that by 2020, just six years from now, our health care spending will hit $4.5 trillion?

Maybe it's all too big, too "macro" for us to absorb on a personal level.

So try this: Should your 92-year-old grandmother undergo coronary artery bypass graft surgery –surgery that costs upwards of $20,000?

What about a girl who's 17 years old? Her leukemia treatments aren't working. Her liver is failing, other organs are failing, she is near death and her family is demanding a liver transplant, which the surgeon proposed, but the HMO refuses to authorize?

These are real-life dilemmas facing doctors, patients, and us.

We want everything modern medicine can offer, but as taxpayers we want health care costs controlled.

Can we achieve both goals?

Leonard Fleck, a professor of philosophy and a medical ethicist from Michigan State University, joined us today.

Listen to the full interview above.

Steve Carmody/Michigan Radio

EAST LANSING, Mich. (AP) - Michigan State University soon will pay out the bulk of $7 million in negotiated health care reimbursements to thousands of union workers.

School spokesman Jason Cody says the payments of more than $1,000 each will show up Friday in paychecks for employees paid every other week, and Jan. 31 for those paid monthly.

The Lansing State Journal reports the employees include roughly 5,800 mid-level managers, police officers, cafeteria workers and others represented by eight unions.

Courtesy of Children First

It's been a little over two weeks since the Affordable Care Act officially kicked in.

How many people have been able to enroll? How many are getting financial assistance to help pay for their plan? And what deadlines do we need to be aware of?

Joining us once more is Don Hazaert, director of Michigan Consumers for Healthcare, one of Michigan's four navigator agencies for the ACA.

Listen to full interview above. 

Fotos GOVBA / Flickr

Cost comparison – it can be an effective way of saving money. Whether it's comparing the price of a cup of coffee – Starbucks versus Tim Horton's, for instance – or comparing gas prices in different parts of the city or state, checking out cost differences is, for many, just part of a regular day.

But what about comparing medical costs? Would you have any idea what, say, a hip replacement might cost at the hospital you go to?

If you could tease out those prices and compare them, you might find yourself wondering: Why do some hospitals in the same city or state charge thousands of dollars more for the same procedure? And why is it so tough to get those prices?

Those are the questions Ilene Wolff, a writer with DBusiness, explored in a recent story.

To compare prices of services at different hospitals, visit healthcarebluebook.comTo look up hospital quality information, visit hospitalcompare.hhs.gov.

Listen to the full interview above. 

A computer screen showing HealthCare.gov in action.
Steve Carmody / Michigan Radio

It was October 1 when the Healthcare.gov website opened for business.The rocky launch of the public portal to the Affordable Care Act has consumed much of the nation's attention and news space.

The December 23 enrollment deadline is at hand. That's when you have to have signed up if you want a policy by January 1.

We wanted to see if the consumer experience with Healthcare.gov has improved - see what problems remain - and find out how many of us have been able to complete applications and actually select a marketplace plan.

Don Hazaert joined us today. He's the director of Michigan Consumers for Healthcare. It's one of four navigator agencies in our state for the Affordable Care Act.

You can find the agencies here.

Hazaert said, no question, there have been significant frustrations with the enrollment process, but that has changed since December 1. The Healthcare.gov website is working much better. Hazaert says those people who have signed up since December 1 have had a much smoother experience, especially those signing up with a new account.

Navigators are still trying to work with those individuals who started the process prior to December 1. We asked so of our listeners about their experiences with signing up for health care coverage.

Tom is 57 and lives in Ann Arbor and has been out of work for a year and a half. He's been paying for health insurance out of pocket for himself and his wife. It's been very expensive. His insurance company helped him sign up on Healthcare.gov. He received a subsidy to help him cover his costs. His online experience was good. 

"The price of the new policy is about half the price of the old policy and the deductible is about half as well, so I'm in a win-win situation as far as that's concerned," said Tom.

Diane Kay is 33-year-old attorney from Brighton, MI. She had a job change and hasn't been insured since 2007. She has a pre-existing condition so insurance companies wouldn't cover her, or it was prohibitively expensive. She's still paying back a lot of debt she incurred from a stay in the hospital. She got insurance through Healthcare.gov in November and said the process was not difficult.

Sasha Acker is 22-year-old social worker from Kalamazoo. She works part-time and doesn't get insurance from the company she works for. She had an extremely frustrating experience with Healthcare.gov, but was eventually able to sign up for coverage. She's excited to have insurance but has not been able to log back in to make her first payment. 

"I called in about six times, and they told me basically that since they made a bunch of upgrades to the website some of the accounts got corrupted and people can't access them anymore. Nobody has a solution for me," said Acker.

Don Hazaert with Michigan Consumers for Healthcare says Acker will need to make a payment before the start of the New Year to get her insurance.

He says her frustration is most likely with the 800 number she's calling and that he suggests she get in touch with a health care navigator in Michigan.

Hazaert says in 2014, they look forward to moving the conversation away from a troubled website to the benefits of the Affordable Care Act.

*This story was informed by the Public Insight Network.

A computer screen showing HealthCare.gov in action.
Steve Carmody / Michigan Radio

More Michiganders are signing up for health insurance through the federal Affordable Care Act.

Problems with the federal website made it difficult for people to sign up initially.

In Michigan, fewer than 1400 people signed up in October. But after a website overhaul, more than five thousand Michiganders completed the process in November.

Screen shot from healthcare.gov

President Obama said that glitches in the healthcare.gov website would be fixed by November 30. Now that that deadline has passed, we wanted to check back in to see how the website was running.

I tried to apply for coverage on October 1, the day the marketplace opened, which didn't work

Though I checked back several times in the last two months, there were still a lot of glitches. I tried accessing my old application yesterday, and still there were problems. The website hung when I was trying to choose the amount of tax credit I apply toward my coverage.

Let's start over, shall we?

NPR reported that a lot of people who weren't able to shop for coverage are now able to because of a "reset button."

Earlier this week we hosted an Issues & Ale event on the Affordable Care Act, and almost 150 people attended.

For everyone who was not able to attend, here are some of the main takeaways from the panel discussion with Marianne Udow-Phillips, the Director of the Center for Healthcare Research & Transformation, Don Hazaert, the Director of Michigan Consumers for Healthcare, and Melissa Anders, a statewide business reporter with the MLive media group in Lansing.

What should people understand about the Affordable Care Act?

People should understand first of all that the Affordable Care Act is not a website, nor is it a "catchall for everyone's anxieties about health care," according to Hazaert, as many people have concerns about health care that have nothing to do with the Affordable Care Act. It is a law.

“This law is a law that is, in some ways, an incremental change to health care. It’s building on the existing non-system,” said Udow-Phillips. “We have a complicated and convoluted current system of health care, the law doesn’t fix that.”

Instead, it is designed to fill in the gaps, not fix it. Under the Affordable Care Act, more people will get coverage, but there will be people who end up paying more.

Also, do not wait until the website is fixed to start thinking about health care.

“There’s lots of information out there right now to help you understand what your choices are,” said Anders. “You actually can go on the website . . . and click on a link that will show you what the plans are in Washtenaw County, or wherever you’re from, and will tell you what the prices are and what you might be eligible for.”

The health plans themselves also have good websites that allow you to compare information.

Can you keep your current health care if you like it?

There has been a lot of confusion over this. Ultimately, it is up to your state insurance commissioner to decide how to implement the policy change. In Michigan, we are still waiting to hear back from our state insurance commissioner about this.

It is also up to the insurance companies. So even if the commissioner approves, individual insurance companies can still decide whether or not to extend their plans.

People on Medicare will see no change under the Affordable Care Act. Employer plans will also stay mostly the same.

The big changes will be in the individual market.

“People are paying an enormous amount right now for very bad coverage, and people are very unhappy,” said Udow-Phillips. “We did a survey last year of citizens in Michigan, and people who had coverage that they bought themselves through the individual market, 44% of them said they were happy with their coverage.”

That is lower than people with any other type of health care. Under the Affordable Care Act, more people in the individual market will get better coverage for less.

Who still won't be covered?

Undocumented immigrants will not be receiving any coverage under this law. In fact, they were purposely excluded.

Additionally, people who are exempt from penalties may not have insurance, or people may choose to pay the penalties rather than get insurance.

There are a number of other circumstances which allow for exemptions. People who cannot afford insurance, people in prison, and people who cannot have health care due to their religious beliefs will be eligible for waivers.

To hear the full discussion and the Q & A session that followed, click the audio above.

Patricia Drury / Flickr

To call Detroit’s legacy costs underfunded would be, well, an understatement.

According to the city’s numbers, Detroit’s pension and retiree healthcare funds are about $9.2 billion short.

But Detroit is not the only Michigan city with major legacy costs — not by a long shot.

Legacy costs, or costs undertaken by local government for future use, have been taken on by more than 280 of Michigan’s 1,800 communities, according to data compiled by Bridge Magazine.

And while Detroit has the highest amount of total unfunded legacy cost, the per capita numbers show a slightly different picture.

use: dougwoods / Flickr

Yesterday, the Department of Heath and Human Services released a detailed enrollment report on the number of people who looked for insurance coverage from October 1 to November 2.

The number of people who enrolled in coverage is low.

According to the report, 23,987 applications were completed in Michigan. Of those completed applications, only 1,329 enrolled in a plan.

What's the difference between 'completed application' and 'enrollment?'

Steve Carmody / Michigan Radio

More than 436,000 Michigan residents will qualify for tax subsidies under the Affordable Care Act, according to a report released today from the Kaiser Family Foundation.

According to the study, 17 million Americans are eligible for tax credits that will lower their cost of coverage.

Most of those eligible folks come from states with high populations: Texas, for instance, is estimated to have over 2 million residents who would qualify for subsidies.

California’s not far behind with $1.9 million.

Michigan is home to five national parks and there are lots of open spaces where you can camp, hunt and enjoy nature. But, yesterday, an Oklahoma Senator recently said two Michigan landmarks are a prime example of wasteful federal spending. We found out what’s behind the senator’s reasoning and whether there is some truth to his concerns.

 Then, we took a look at a new proposal by a group of Democrats in the Michigan House that would require the state to determine the actual cost of educating a public school student in Michigan. That got us thinking, shouldn't we already know?  We also spoke with Michigan writer Donald Lystra about his new collection of short stories. And, Ann Arbor now has its own Death Café, organized by funeral home guide Merilynne Rush. She stopped by to tell us more about it. But, first on the show, ever since the government unveiled its healthcare.gov website, the headlines surrounding the Affordable Care Act have been about the problems with the way the site was designed and the extreme difficulty Americans have had in getting on the exchange. But what about the Americans that don't need healthcare.gov? The ones who already have plans? To those consumers, President Obama has been saying this since 2009:

“If you like your current insurance, you will keep your current insurance. No government takeover, nobody’s changing what you’ve got if you’re happy with it.”

So why, then, then are some 2 million Americans - about 140,000 in Michigan - getting cancelation letters from their insurers over the past couple of weeks?

Marianne Udow-Phillips directs the Center for Healthcare Research and Transformation, a non-profit partnership between the University of Michigan and Blue Cross/Blue Shield of Michigan. She joined us today.

Marianne Udow-Phillips is Director of the University of Michigan's Center for Healthcare Research.
user mudowp / Twitter

Ever since the government unveiled its healthcare.gov website, the headlines surrounding the Affordable Care Act have been about the problems with the way the site was designed and the extreme difficulty Americans have had in getting on the exchange to shop for health insurance.

But, what about the Americans that don't need healthcare.gov? The ones who already have plans? Some 14 million consumers buy their own insurance individually.

And to those consumers, President Obama has been saying this since 2009:

“If you like your current insurance, you will keep your current insurance. No government takeover, nobody’s changing what you’ve got if you’re happy with it.”

So why, then, are some 2 million Americans - about 140,000 in Michigan - getting cancelation letters from their insurers?

Marianne Udow-Phillips directs the Center for Healthcare Research and Transformation, a non-profit partnership between the University of Michigan and Blue Cross/Blue Shield of Michigan. She joined us today.

Listen to the full interview above.

DETROIT (AP) - Changes in federal and state health care laws have created huge growth for Michigan's largest Medicaid HMO.

The Detroit News reports that growth at Meridian Health Plan is also benefiting Detroit and Grosse Pointe Park because of developments financed by the family that runs Meridian.

Jon Cotton is chief operating officer of Meridian Health Plan. It was founded as Health Plan of Michigan in 1997 by his parents, David and Shery Cotton.

He says the changes in health care are creating opportunities that won't be seen for another century.

photo by Anna Strumillo Phuket - Thailand / www.fotopedia.com

The state and federal healthcare exchanges are, of course, a big chapter in the overhaul of the American healthcare model - a model that's very different from many other countries around the world.

The BBC's Alice Castle has lived in the U.S. and the United Kingdom. She's had the experience of being pregnant in both countries.

Click the audio above to listen to her unique perspective on the American healthcare system.

Something good happened yesterday, something smart and rational that will help improve people’s lives. This was not typical of the day, mind you. Actually, yesterday was a day of supreme irrationality in federal, state and local government.

Nationally, the government shutdown continued, with Republicans vowing to take the nation over a cliff unless Democrats agree to defund the Affordable Care Act. This happened on the same day that millions rushed to sign up for health insurance plans.

User: Brother O'Mara / flickr

Shutdown could cost Michigan $18 million a day

"Michigan’s budget chief says the federal shutdown could cost the state $18 million dollars a day in lost funding. Budget Director John Nixon says he does not expect that to happen unless the shutdown lasts more than two weeks. He says, after that, pre-funding for some big programs will run out," Rick Pluta reports.

Delays in Medicaid sign up

"The Michigan Department of Community Health is still working to start early enrollment to help people sign up for Michigan's expanded Medicaid program. Michigan's Medicaid expansion also still needs to be approved by the federal government. That means hundreds of thousands of low-wage Michiganders could have to wait weeks or months to enroll," Jake Neher reports

The state to take over Detroit's Belle Isle

"The state of Michigan has signed a deal to lease Detroit’s Belle Isle. Governor Snyder and emergency manager Kevyn Orr have both approved the 30-year plan. The Michigan Department of Natural Resources will run Belle Isle as a state park, saving Detroit an estimated $4 million a year in maintenance costs," Sarah Cwiek reports.

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