BATON ROUGE, La. (AP) — Leaders of several Louisiana public school systems called on state officials Monday to relax coronavirus quarantine rules that have sent thousands of students home from school because they have been in close proximity to someone who tested positive for COVID-19.
School superintendents from Ascension, West Baton Rouge, Rapides and Livingston parishes said too many students are missing in-person classroom instruction because they have been sent home for 14 days to quarantine.
Hologic CEO Steve MacMillan says women are ‘putting everyone else ahead of themselves’ during pandemic and not having important tests done.
In a historic win for all Americans on Thursday, President Trump issued a final rule requiring health insurers to post the prices they have negotiated with hospitals, medical facilities, and doctors. Under this rule, health care consumers, including employers sponsoring workplace coverage, can finally know prices before they receive care. This action will increase competition, lower prices, and save American families money.
Combined with the Trump administration’s already finalized hospital price transparency rule, which requires hospitals to publish the secret rates they negotiate with insurance companies as well as the cash payments they will accept, Thursday’s announcement will usher in a transparent health care sector with less need for the middlemen that have capitalized on patients’ misfortune.
Once these rules delivering complete health care price transparency take effect (January 1, 2021 for the hospital rule and one year later for the insurance rule), we can expect our economy to come roaring back, and our beleaguered health care system to rebound as well.
Knowing the real prices of health care and coverage beforehand will be a huge boon for all Americans–patients, workers, employers and taxpayers.
HEALTH INSURANCE FOR MILLENNIALS, GEN Z, MOST LIKELY TO BE AFFECTED BY PANDEMIC
Together the rules will unleash a real market in health care, usher in competition and choice, dramatically lowering the costs of care and coverage. Fewer dollars going to health care and more going to wages, jobs and small businesses in our local communities will help boost our nation’s economic recovery.
When complete health care price transparency is in place, patients, consumers, and employers will be able to better shop for health care, and high-tech innovators will eagerly develop tools to help consumers access and compare prices. Better informed buyers of health care will take advantage of the huge price variation that exists in the current, opaque market.
For instance, a recent study from the respected RAND Corporation found employer-sponsored plans are paying hospitals two-and-a-half times more than Medicare pays for the same procedure. Since almost all hospitals accept Medicare, those government rates are by definition “acceptable,” which means hospitals are price-gouging workers and employers, and growing rich at the expense of the middle-class.
US MILITARY WON’T ADMINISTER CORONAVIRUS VACCINES, HEALTH OFFICIALS SAY
Insurance companies are no better, reaping huge profits as health care costs have soared. The average premium for an employer-provided family health insurance plan in 2020 jumped to $21,300–a 55 percent increase over a decade earlier. During that same time, deductibles more than tripled.
Last year I co-authored a study with health economist Larry Van Horn, it found that cash prices are, on average, 39 percent lower than the insurers’ negotiated rates for the same care. Throughout the country, businesses have saved 30 to 50 percent on health care costs by directly contracting with price transparent doctors and medical facilities, leaving insurers out of the equation.
Medicare beneficiaries do not have to rely exclusively on Medicare for their healthcare coverage. People can use other insurance plans to allow them access to more services and lower their healthcare spending.
If someone has two different forms of coverage, the primary payer covers most costs, and the secondary payer then steps in to cover some or all remaining expenses.
With Medicare, secondary payers contribute to copayments and coinsurance. Usually, Medicare is the primary payer, although sometimes it can act as the secondary payer.
This article looks at Medicare as a secondary payer and how it works with other insurers. It also discusses the benefits of having two insurers and who pays first. It then looks at how the claims process works with both primary and secondary payers.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
A person can choose to have more than one insurance plan to cover their healthcare costs and Medicare works with other insurance providers to give people comprehensive coverage.
Each insurance pays their share of the healthcare service or products that someone receives.
Medicare secondary payer (MSP) means that another insurer pays for healthcare services first, making them the primary payer.
The secondary payer covers some or all of the remaining costs that the primary payer leaves unpaid.
When someone has two insurers, they benefit from broader healthcare coverage. Each insurer could cover services that the other does not, such as dental care, eye examinations, or alternative health therapies.
As an example, a primary insurer may offer prescription drug coverage, meaning that a person with original Medicare would not need a separate Medicare Part D plan or a Medicare Advantage plan that includes prescription drug coverage. This could lower a person’s overall healthcare costs.
If someone needs to stay in a hospital or a nursing facility for a long time, they may find it beneficial to have two insurers. For example, an individual’s primary insurer would pay up to their limits, and Medicare Part A benefits would kick in much later, extending the coverage period.
Having two insurance plans could mean a person has two monthly premiums. For most Medicare beneficiaries, this means they have the standard Part B premium, plus the premium for the primary insurer.
Careful consideration of the overall costs could mean a person’s expenses increase or decrease with a secondary insurance plan, but since a secondary payer could cover most out-of-pocket expenses, a person may find they save money despite paying two premiums.
A federal judge on Tuesday dismissed a lawsuit against Gov. Gavin Newsom and San Joaquin County and Lodi officials that had been filed by the owner of three Sacramento-area gyms after officials ordered the shutdown of fitness centers last spring because of COVID-19.
After a Zoom hearing in Sacramento federal court, U.S. District Judge John A. Mendez agreed to requests by the defendants that the lawsuit be dismissed and found that the coronavirus pandemic was so dangerous that officials were within their authority when they first ordered the closures.
The orders were “a constitutional response to an unprecedented pandemic,” Mendez said.
Attorney John Killeen argued for the state that since Newsom’s original stay-at-home orders the state has loosened restrictions on fitness centers, including allowing some outdoor exercising and indoor workouts in San Joaquin County at 10% of capacity.
“A number of restrictions have been lifted,” Mendez said.
“I just don’t see any basis for allowing this lawsuit to go forward in the district court,” he added.
The suit was brought by Sean Covell, owner of Fitness System gyms in Land Park, West Sacramento and Lodi, and argued that the shutdown orders violated the Constitution and were costing his operations huge amounts of revenues and lost memberships.
The lawsuit was one of numerous complaints filed by fitness centers, churches and businesses against orders Newsom and health officials issued to combat the spread of COVID-19.
The lawsuits have largely been unsuccessful, although some are pending and yet another involving gyms in Dixon and Sacramento was filed in federal court in Sacramento on Monday.
Sam Stanton has worked for The Bee since 1991 and has covered a variety of issues, including politics, criminal justice and breaking news.
(Bloomberg) — Hong Kong will ease some social distancing rules and announced plans for mandatory testing of people with symptoms and specific groups as India’s daily infections fell below 40,000 for the first time in more than three months.
Eli Lilly & Co. said a U.S.-run clinical trial of its experimental antibody therapy will end while AstraZeneca Plc’s vaccine candidate produced a robust immune response in elderly people. New research from the U.K. suggests antibody responses may diminish over time.
The latest surge in U.S. coronavirus cases sent the S&P 500 Index to its biggest drop in a month. An infection spike that started with younger Americans is now moving to older communities.
Global Tracker: Cases top 43.4 million; deaths exceed 1.15 millionU.S. ‘surge’ virus testing targets asymptomatic peopleCovid Fear Is Back and Driving Markets Again: John AuthersP&G’s new Lysol competitor wins EPA approval to fight virusAmericans see record flu shot demand in first season with CovidU.S. recovery’s surprise strength linked to aid, quick reopeningVaccine Tracker: Vaccine trials restart, providing hope
Subscribe to a daily update on the virus from Bloomberg’s Prognosis team here. Click CVID on the terminal for global data on coronavirus cases and deaths.
Hong Kong to Relax Some Social Distancing, Bars to Stay Open Later (2:52 p.m. HK)
Hong Kong will allow more people to sit at the same table in bars and restaurants as well as letting them stay open later.
From Friday, restaurants will be allowed to stay open until 2 a.m. with six people permitted at a table, up from four, Secretary for Food and Health Sophia Chan told a briefing on Tuesday. Bars also will be open later with the limit on patrons doubling to four per table.
Hong Kong also eased its rule mandating face masks for people exercising at indoor venues but a four-person limit on public gatherings will stay for another week.
Earlier, Chief Executive Carrie Lam said the city would re-open public beaches as the Asian financial starts legislative work on mandatory Covid-19 testing for specific groups including people with symptoms.
Bulgaria Posts Record High New Cases, Deaths (2:08 p.m. HK)
Bulgaria reported record numbers of new cases, deaths and patients in intensive care, putting fresh pressure on the country’s health-care system.
The Balkan country reported 2,243 daily coronavirus cases, the first time new infections topped 2,000, as well as 42 deaths. The numbers come as Prime Minister Boyko Borissov is recovering at home after testing positive for Covid-19.
Dubai in Talks on London Air-Travel Agreement to Boost Demand (12:15 p.m. HK)
A plan to open up air travel between Dubai and London is ready and could be implemented once approved by the respective governments, according to the head of the emirate’s airport operator.
Testing and quarantine requirements have been agreed by hubs and airlines, Paul Griffiths, chief executive officer of Dubai Airports, said in an interview. Whether they move forward lies
Regarding Drs. Scott Gottlieb and Mark McClellan’s “Where Do I Go to Get My Covid Antibody Cocktail?”(op-ed, Oct. 19): They are right regarding the need for the government to prime the pump to stimulate the development of private infusion clinics for Covid patients. However, they overstate the associated problems.
Infusion clinics are quite simple, requiring only a room, one registered nurse, four patients and IV poles. Infusion pumps are generally not necessary. The big issue is the Centers for Medicare & Medicaid Services’ payment scheme for professional services, which is in the range of $60-$70 per infusion, regardless of how long it takes (many exceed four hours for allergy and neurology services). Hence, the profit in such centers hinges on the split between the cost of the drug and the amount a payor gets reimbursed for it. In such circumstances, volume is the key to financial stability.
If CMS will change its reimbursement methodology to reimburse professional services by the hour infused, and reimburse for drugs with modest profit for the provider, there will be no shortage of clinics.
MELBOURNE, Australia — A COVID-19 outbreak in the north of Melbourne has led health authorities in Australia’s Victoria state to hold off on any further easing of restrictions in the beleaguered city.
Victoria Premier Daniel Andrews withheld any announcement on an easing on Sunday as the state awaits results on 3,000 people who were tested in the city’s north in the past 24 hours.
He described it as a “cautious pause” – not a setback – to rule out there wasn’t widespread community transmission linked to the cluster.
Among the current restrictions are mandatory wearing of masks and no traveling beyond 25 kilometers (15 miles) from home. At the start of the second wave of cases two months ago, Andrews instituted an overnight curfew and shut down most businesses.
“I know it is frustrating,” Andrews said. “I know people are keen to have a long and detailed list of changes to the rules. It is not appropriate for us to do that now.”″
Victoria reported seven new coronavirus cases on Sunday, with six linked to the latest outbreak, which involves 39 people across 11 households.
No additional deaths kept the state toll at 817 and the national toll at 905.
HERE’S WHAT YOU NEED TO KNOW ABOUT THE VIRUS OUTBREAK:
— Surging coronavirus colors White House race in closing days
— Europe, US watch case totals grow, debate new restrictions
— Colombia reaches 1 million confirmed coronavirus cases
— Iran’s supreme leader has urged authorities to prioritize public health above any economic or security concerns, amid the Mideast’s worst outbreak of the coronavirus. Iran’s death toll from the global pandemic topped 32,000 this week.
— Pope Francis met with the Spanish prime minister Saturday at the Vatican, which has had a rash of COVID-19 infections confirmed in recent days, but neither man used a face a mask during the public part of their meeting.
— Poland’s President Andrzej Duda has tested positive for the coronavirus; apologizes to those in quarantine because of contact, including Poland’s recent French Open winner.
— Police force in England says it will try to stop people from leaving Wales, which has started a 17-day lockdown to slow a surging rate of coronavirus infections.
Follow all of AP’s coronavirus pandemic coverage at http://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak
HERE’S WHAT ELSE IS HAPPENING:
COLOMBO, Sri Lanka — Sri Lankan authorities have terminated a number of passenger trains and widened the curfew as COVID-19 cases related to a new cluster at a garment factory continue to surge.
The Railway Department canceled at least 16 trains — mostly ran through busy office hours — after the number of commuters declined due to the curfew imposed in many parts of the country.
More than a dozen villages are isolated in densely populated Western province, which includes capital Colombo.
Authorities last week closed the island’s main fish market on Colombo’s outskirts after 49 traders tested positive for the coronavirus. By Sunday, the number of cases from the fish
BOISE, Idaho (AP) — Moments after hearing an Idaho hospital was overwhelmed by COVID-19 patients and looking at sending people as far away as Seattle for care, members of a regional health department board voted Thursday to repeal a local mask mandate.
“Most of our medical surgical beds at Kootenai Health are full,” Panhandle Health District epidemiologist Jeff Lee told board members in the state’s third most populated county.
Scientists have hit out at the government’s refusal to enforce shielding rules for the most vulnerable as COVID cases continue to rise.
Advice published last week stated that the more than two million people who shielded during the peak of the pandemic do not yet need to shield again – despite what tier their area is in.
But the move triggered a backlash among experts and some charities, which said vulnerable people may feel forced to go to work.
Dr Stephen Griffin, associate professor in the school of medicine, University of Leeds, described recent numbers, which showed the highest daily figure for cases, as a “worrying trend”.
He said: “Critically, I am aghast that shielding remains paused. Whilst it saddens me to see that this is once again our only recourse to protect those most vulnerable to COVID, they must be enabled both socially and financially to protect themselves once more.
“Whatever transpires as a result of policy, it must be accompanied by a return to the commitments made earlier this year. Most importantly, testing must be overhauled.”
His comments come after deputy chief medical officer Jonathan Van-Tam expressed concern for the rate of change in infections among the over-60s across the nation.
He said at a press conference on Tuesday: “I really want to emphasise that it is the over-60s that really worries us most because these are the people who become severely ill with COVID-19, they are more likely to be admitted to hospital, if they are admitted to hospital they stay in hospital for longer and sadly they are more difficult to save.”
Watch: Hundreds of thousands ‘could be told to shield’
Griffin hit out at the government’s testing programme, and said there was “no evidence” that the tier system for local lockdowns worked in bringing down numbers.
Arguing for tougher restrictions, Griffin said: “It is difficult to understand why urgent action is not being taken on a national level, as advised by Sage, independent Sage and many other observers.
“This is a UK wide problem. If we wait for other areas to reach prevalence as we are seeing in the north of England then the situation will be grim indeed.”
He added: “The pain of the previous lockdown has been squandered, the summer has been wasted. The commitment to suppressing cases and organising effective testing was not met.”
Oxford University scientists this week shared a model that identifies the most at-risk people from the disease.
Mark Woolhouse, Professor of Infectious Disease Epidemiology at Edinburgh University, said the research showed that shielding just 5% of those people could reduce deaths by as much as 75%.
The government have said that rather than force vulnerable people to stay at home – risking feelings of isolation and fearful of leaving the