Health Care Reform on Trial: What's at Stake in the Upcoming Supreme Court Arguments

News | Health

Hearings on the Patient Protection and Affordable Care Act begin on March 26. The law has yet to take full force, and key aspects, health experts argue, remain fundamentally misunderstood by the public

By Katherine Harmon ?| March 23, 2012?|

Image: Flickr/kokopinto

The U.S. Supreme Court is a busy place this time of year. So when the justices announced that, starting March 26, they would hear six hours of arguments on the health care reform law?the most time it has dedicated to any one case in decades?the gravitas of the issue became clear to all.

The Patient Protection and Affordable Care Act (PPACA) is perhaps the most profound change to health care since Medicaid was instituted in 1965. "This case deserves the hype it's getting," says Gregory Magarian, a law professor at Washington University in Saint Louis School of Law.

The case is not just a political lightning rod?and whatever decisions emerge from the Court in the early summer will likely do little to diffuse the partisan tensions around the issue. What's really at stake in the case is individuals' access to health care.

Signed into law March 23, 2010, PPACA is expected to expand access to health care to an additional 32 million uninsured people in the U.S.?unless all or part of it is struck down by the Supreme Court.

"If this law's thrown out, I think we're resigned to the status quo, which is a lot of people without access to health care for a long time," says Larry Levitt, an expert at the Kaiser Family Foundation, a nonprofit, nonpartisan policy analysis organization. "I don't think there's any question about what lack of access to health care means: people get treated later, and some people die earlier as a result."

That also means continued health care cost increases, an expenditure that already eats up some $2.6 trillion a year?about a fifth of all U.S. spending.

At issue are two major provisions: the requirement that everyone have health insurance?the so-called individual mandate?and an expansion of Medicaid benefits, which would help more people afford insurance in the first place. "If the Court rejects either or both of those, it would have far-reaching implications for how health care reform would work?or even if the law would work at all," Levitt says. With fewer people insured, premiums would become even more expensive.

One of the unusual things about the legal challenge is that most of the law's big changes have not yet gone into effect, which has muddied the debate about how it will likely affect people's lives in practice. The individual mandate, for example, is not slated to begin until 2014. As more provisions are rolled out, Magarian notes, the law's benefits for individuals will likely become clearer to many. "For a lot of people this law is going to be a desirable thing on a personal level." he says.

From a public health perspective, the only argument against the law is that it should be even more aggressive in ensuring that people have access to affordable health care, says John McDonough, a professor at Harvard University's School of Public Health.

The Court will be hearing arguments about four segments of the law over the course of three days. What is at stake for each of these issues?

Individual health
Much of the outcry about the PPACA has centered on a need to preserve individual rights?that is, no law should require that people get health coverage. But the case before the court, Magarian explains, "isn't about that at all." The question in front of the Court pertains to state rights. "I think that would surprise a lot of people." This confusion, he posits, might be behind some of the recent polls that show about two thirds of Americans favor repealing the whole law part and parcel. As Levitt points out, if the Court overturns the PPACA, the states are well within their constitutional bounds to require their residents to purchase health insurance (as they already do with auto insurance).

Source: http://rss.sciam.com/click.phdo?i=1be868620504602baf84f0aba9ed3960

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US man tells of 'humiliating' arrest in Dominica

In this two picture combo, John Hart, 41, Dennis Jay Mayer, 43, both of Palm Springs, California, are seen in this police booking mug provided by the Dominica Police department, Thursday March 22, 2012. The Southern California men have pleaded guilty to indecent exposure in Dominica following their arrest during a stop on a gay cruise of the Caribbean. Police said the two men were seen engaging in a public sex on a deck of a Celebrity Summit cruise ship by someone on the dock. (AP Photo/Dominica Police department)

In this two picture combo, John Hart, 41, Dennis Jay Mayer, 43, both of Palm Springs, California, are seen in this police booking mug provided by the Dominica Police department, Thursday March 22, 2012. The Southern California men have pleaded guilty to indecent exposure in Dominica following their arrest during a stop on a gay cruise of the Caribbean. Police said the two men were seen engaging in a public sex on a deck of a Celebrity Summit cruise ship by someone on the dock. (AP Photo/Dominica Police department)

SAN JUAN, Puerto Rico (AP) ? A Southern Californian said Friday that he and his partner were taunted, humiliated and subjected to inhumane treatment when they were arrested and jailed after being escorted off a gay cruise in the Caribbean this week.

Dennis Jay Mayer, 53, told The Associated Press that he has no doubt they were arrested in Dominica because they were gay. Police said it was because they were seen having sex in public on the balcony of their ship cabin. He said they were not having sex, but were "partially clothed."

Mayer, a retired deputy sheriff, spoke to the AP in San Juan, where he and his partner of 17 years, John Robert Hart, arrived after being released following their guilty plea to indecent exposure.

"The total experience was horrendous," he said. "They told us that they did not like us, that they did not like gay people."

Dominica is among several Caribbean islands that have laws prohibiting sex between men.

The trouble began shortly after the cruise ship Celebrity Summit docked Wednesday morning at Dominica in the eastern Caribbean. Mayer and Hart were in their room when they got a call from a cruise ship official.

"We were summoned that the captain wished to speak to us," Mayer said. "We were caught off guard."

Three cruise ship officials and six Dominica police officers were waiting for them. After police interviewed both men separately, the assistant captain spoke, Mayer said.

"At this time, we are going to eject you from the ship. We have zero tolerance toward your behavior," Mayer recalled him saying.

Police drove them to their headquarters, where they sat on a bench for nearly two hours without legal representation despite repeated requests, Mayer said.

After police took pictures and obtained fingerprints, a high-ranking officer began a nearly four-hour interrogation.

"He said: 'You're being arrested for being gay. We're arresting you for the crime of buggery,'" Mayer said. "He said that other people said that we were engaging in homosexual sex. He repeated that several times. I told him I didn't know why they would say that. I wasn't doing that."

Mayer said he was naked in his cabin and nearly naked on the balcony. "I was less partially clothed than I should have been."

During the interrogation, the police official threatened to take them to a clinic and have them medically examined for proof of homosexual activity, Mayer said.

"He said, you know, we're looking for specific things, fluids, bruising, things of that nature," Mayer said.

After making the threat, the official left the room, then came back saying they had a right to refuse the test, Mayer said.

The two men were charged with indecent exposure and put in a five-by-eight-foot cell to await an appearance before a magistrate.

"The treatment was inhumane," Mayer said. "We were detained for approximately 26 hours, and 19 of those locked in a cement cell, which had no running water, no toilet, no lights. It stunk of feces and urine. It was infested with cockroaches, ants and bugs."

Mayer said police brought in government officials to look at them.

"They paraded many people by to look in on us as if we were some type of animal, which was quite humiliating," he said. "People got great joy in the pleasure of taunting us."

On Thursday morning, police drove them to the courthouse in the capital of Roseau, passing through an angry crowd, Mayer said.

"They were chanting and banging on the police vehicle. They were screaming things," he said. "I've never seen anything like this in my life, other than in movies. Both my partner and I really feared for our safety."

Police drove around the block twice to avoid the crowd and journalists. Officers formed a barricade with their bodies and urged Mayer and his partner to run into the courthouse and not stop.

"It was very frightening," Mayer said.

Once in the courtroom, Chief Magistrate Evaline Baptiste ordered the men to pay a nearly $900 fine after they pleaded guilty to indecent exposure. He called the two men "rogues and vagabonds."

Police then drove them to the airport, Mayer said.

He said he would never return to Dominica.

"I would not spend my money in a country that does not support gay behavior," he said. "Shame on us for not doing our research."

However, Colin Robinson, executive director of a Trinidad-based gay rights group, warned against labeling the entire Caribbean as homophobic. He said a heterosexual couple in the same situation would have been charged as well.

"Things are not as bleak as the journalists in the U.S. like to paint the Caribbean as being," he said.

Associated Press

Source: http://hosted2.ap.org/APDEFAULT/cae69a7523db45408eeb2b3a98c0c9c5/Article_2012-03-23-CB-Dominica-Gay-Cruise-Arrests/id-a5373e7b0bb14f03b37b36d702fc5f0f

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Santorum: Might as well have Obama over Romney

Republican presidential candidate, former Pennsylvania Sen. Rick Santorum shakes hands after speaking to USAA employees during a campaign stop at USAA, Thursday, March 22, 2012, in San Antonio. (AP Photo/Eric Gay)

Republican presidential candidate, former Pennsylvania Sen. Rick Santorum shakes hands after speaking to USAA employees during a campaign stop at USAA, Thursday, March 22, 2012, in San Antonio. (AP Photo/Eric Gay)

SAN ANTONIO (AP) ? Presidential candidate Rick Santorum on Thursday said Republicans should give President Barack Obama another term if Santorum isn't the GOP nominee and for a second day compared rival Mitt Romney to an Etch A Sketch toy.

Santorum reiterated an argument he has made before: The former Massachusetts governor is not conservative enough to offer voters a clear choice in the fall election and that only he can provide that contrast.

"You win by giving people a choice," Santorum said during a campaign stop in Texas. "You win by giving people the opportunity to see a different vision for our country, not someone who's just going to be a little different than the person in there."

Santorum added: "If they're going to be a little different, we might as well stay with what we have instead of taking a risk of what may be the Etch A Sketch candidate for the future."

Santorum was referencing Romney adviser Eric Fehrnstrom's comment Wednesday that "everything changes" for the fall campaign. "It's almost like an Etch A Sketch," he said on CNN. "You can kind of shake it up and we start all over again."

The remark reignited criticism of Romney as the type of politician who will say or do anything to win.

Romney, who made no public appearances Thursday, issued a statement expressing disappointment "that Rick Santorum would rather have Barack Obama as president than a Republican."

"This election is more important than any one person. It is about the future of America," he said. "Any of the Republicans running would be better than President Obama and his record of failure."

Rival Newt Gingrich tweeted: "Rick Santorum is dead wrong. Any GOP nominee will be better than Obama."

During his speech to employees of USAA, a San Antonio-based insurance and financial services firm, Santorum briefly held up an Etch A Sketch and said his positions don't change like etchings on the toy, which are erased with a shake. He could be seen fiddling with the toy's knobs in the intervals between questions from audience members.

Addressing reporters afterward, Santorum lit into Romney for saying "I'm going to run as a conservative."

"He didn't say 'I am a conservative.' He said 'I'm going to run as a conservative.' So what do you do, you just sort of decide what you're going to be for the elections?" Santorum asked. "No one can accuse me of that. People say, 'Well, you can't win because of that.' No, I will win because of it."

Santorum said his brand of political authenticity will play well in Texas because "people are looking for someone who is real, someone they can relate to, not someone who can get in front of an audience and say whatever they want."

The Texas primary has been pushed to May 29 because of litigation over redistricting maps drawn by the Republican-dominated state Legislature. Santorum said he expects to win Saturday's primary in Louisiana and added, "The race will not be over when Texas comes around."

"You'll have the opportunity here, in the state of Texas, to speak very loudly about what kind of leader you want in this country," he said.

Santorum said he speaks with Texas Gov. Rick Perry before scheduled campaign stops in the state. Perry sought the GOP nomination but left the race in January and endorsed former House Speaker Newt Gingrich.

"This is an important state for us," Santorum said. "I've already spent a lot of time, I've already done a lot of campaign events in Texas. More than anybody else, I suspect."

Associated Press

Source: http://hosted2.ap.org/APDEFAULT/3d281c11a96b4ad082fe88aa0db04305/Article_2012-03-22-Santorum/id-12b132ef37234b0e8d37b6fa682b37aa

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Wyoming Spring Football Updates

We have one spring football practice in the books and there are already a few updates. First off in this video it is great to see the team in action and watch Brett Smith throw the ball. That is certainly a positive sign that he is able to grip and throw the ball right now even after his thumb surgery. Trey Norman has several nice catches, he is certainly one to keep an eye on this spring.

Position Changes

A few more players will be lining up different spots on defense.

• Mark Nzeocha is moving from outside linebacker to strong safety. He was originally a safety last winter before moving to linebacker.
  
• Ben Durbin is making the move from defensive tackle to defensive end. With the return of Patrick Mertens the Pokes have more tackles than spots available. Defensive end should be a good fit for Durbin who is 6-3 272lbs.
• Junior Jeff Rouche is moving from linebacker to defensive end.
  
• Luke Anderson played a hybrid linebacker/safety position for much of 2011. Look for him to stick at free safety now.
  

Seems like the Cowboys are trying to distribute athletes from stronger positions to help fill in some gaps at other spots. They have a surplus of defensive tackles and needed depth at defensive end. With Ghaali Muhammad and Oliver Schober back at linebacker then they were able to help out the secondary with Nzeocha and Anderson. Luke Ruff is going to limited in his work this spring.

According to Robert Gagliardi there are also a few changes to 2012 recruiting class. CB Dylan Muscat swapped again and decided to attend Penn instead of Wyoming. So that leaves one more scholarship open this year.

QB Tommy Thornton is going grayshirt and then enroll in 2013. He will only take a few classes in September and enroll full-time and go on scholarship in January. So Wyoming will have just three scholarships quarterbacks for 2012: SO Brett Smith, JR Colby Kirkegaard and FR Jason Thompson.

Source: http://www.cowboyaltitude.com/2012/3/23/2896688/wyoming-spring-football-updates

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A structured, independent exercise regimen can reduce the need for therapy

Public release date: 21-Mar-2012
[ | E-mail | Share ]

Contact: Kayee Ip
ip@aaos.org
847-384-4035
American Academy of Orthopaedic Surgeons

Below is a news summary of an orthopaedic research study appearing in the March 21, 2012 issue of the Journal of Bone and Joint Surgery (JBJS), as well as the issues' full Table of Contents. A Structured, Independent Exercise Regimen Can Reduce the Need for Therapy Following Meniscus Surgery

The treatment of meniscus tears in injured workers is associated with less favorable outcomes and higher utilization of clinical services. "Disability, Impairment, and Physical Therapy Utilization in Workers' Compensation Patients after Arthroscopic Partial Meniscectomy," is a study appearing in the March 21, 2012 issue of the JBJS, which investigates the effects of a recommended, self-regulated exercise program on the number of physical therapy visits and patient outcomes.

• The study reviewed the success of 164 primary arthroscopic meniscectomies (the surgical procedure to remove torn areas of the two, wedge-shaped pieces of cartilage that acts as shock absorbers in the knee joint) on 155 injured workers. The patients in a "control group" receiving traditional supervised physical therapy , were compared to a separate "study group" that received a written referral specifying the exact number of approved physical therapy visits, a kit containing equipment with a booklet illustrating 25 exercises, and the prescribed rehabilitation protocol outlining the philosophy, expected subjective and functional outcomes, and specific weekly goals.
• One year following surgery, there was a 40 percent reduction in the median number of physical therapy visits in the study group, compared to the control group. There was no difference between the two groups in the time before workers were released to light duty, full duty, or claim closure; and no difference in impairment or complication rates.
• The author of the study believes that the results support the implementation of a structured, independent exercise protocol as a way to reduce physical therapy costs without negatively affecting strength, knee motion, or disability rates in workers' compensation patients undergoing arthroscopic meniscectomy.

March 21, 2012 JBJS Full Table of Contents

Randomized Clinical Trial of Rotating Platform and Fixed Bearing Total Knee Arthroplasty: No Clinically Detectable Differences at Five Years
Efficacy of Surgical Preparation Solutions in Lumbar Spine Surgery
Short-Term Complications of the Laterjet Procedure
Comparative Effect of Orthosis Design on Functional Performance
Revision Posterior Cruciate Ligament Reconstruction Using a Modified Tibial-Inlay Double-Bundle Technique
Outcome of Lower-Limb Preservation with an Expandable Endoprosthesis After Bone Tumor Resection in Children
Outcomes Following Distal Humeral Fracture Fixation with an Extensor Mechanism-on Approach

###

The Journal of Bone & Joint Surgery has been the most valued source of information for orthopaedic surgeons and researchers for over 100 years and is the gold standard in peer-reviewed scientific information in the field. JBJS is published twice a month online and in print. Abstracts are available online at (http://www.jbjs.org). Contact Michelle Hache for general information on JBJS at mhache@jbjs.org

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?

AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.

Public release date: 21-Mar-2012
[ | E-mail | Share ]

Contact: Kayee Ip
ip@aaos.org
847-384-4035
American Academy of Orthopaedic Surgeons

Below is a news summary of an orthopaedic research study appearing in the March 21, 2012 issue of the Journal of Bone and Joint Surgery (JBJS), as well as the issues' full Table of Contents. A Structured, Independent Exercise Regimen Can Reduce the Need for Therapy Following Meniscus Surgery

The treatment of meniscus tears in injured workers is associated with less favorable outcomes and higher utilization of clinical services. "Disability, Impairment, and Physical Therapy Utilization in Workers' Compensation Patients after Arthroscopic Partial Meniscectomy," is a study appearing in the March 21, 2012 issue of the JBJS, which investigates the effects of a recommended, self-regulated exercise program on the number of physical therapy visits and patient outcomes.

• The study reviewed the success of 164 primary arthroscopic meniscectomies (the surgical procedure to remove torn areas of the two, wedge-shaped pieces of cartilage that acts as shock absorbers in the knee joint) on 155 injured workers. The patients in a "control group" receiving traditional supervised physical therapy , were compared to a separate "study group" that received a written referral specifying the exact number of approved physical therapy visits, a kit containing equipment with a booklet illustrating 25 exercises, and the prescribed rehabilitation protocol outlining the philosophy, expected subjective and functional outcomes, and specific weekly goals.
• One year following surgery, there was a 40 percent reduction in the median number of physical therapy visits in the study group, compared to the control group. There was no difference between the two groups in the time before workers were released to light duty, full duty, or claim closure; and no difference in impairment or complication rates.
• The author of the study believes that the results support the implementation of a structured, independent exercise protocol as a way to reduce physical therapy costs without negatively affecting strength, knee motion, or disability rates in workers' compensation patients undergoing arthroscopic meniscectomy.

March 21, 2012 JBJS Full Table of Contents

Randomized Clinical Trial of Rotating Platform and Fixed Bearing Total Knee Arthroplasty: No Clinically Detectable Differences at Five Years
Efficacy of Surgical Preparation Solutions in Lumbar Spine Surgery
Short-Term Complications of the Laterjet Procedure
Comparative Effect of Orthosis Design on Functional Performance
Revision Posterior Cruciate Ligament Reconstruction Using a Modified Tibial-Inlay Double-Bundle Technique
Outcome of Lower-Limb Preservation with an Expandable Endoprosthesis After Bone Tumor Resection in Children
Outcomes Following Distal Humeral Fracture Fixation with an Extensor Mechanism-on Approach

###

The Journal of Bone & Joint Surgery has been the most valued source of information for orthopaedic surgeons and researchers for over 100 years and is the gold standard in peer-reviewed scientific information in the field. JBJS is published twice a month online and in print. Abstracts are available online at (http://www.jbjs.org). Contact Michelle Hache for general information on JBJS at mhache@jbjs.org

---

[ | E-mail | Share ]

?

AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.

Source: http://www.eurekalert.org/pub_releases/2012-03/aaoo-asi032112.php

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