(DES MOINES) - Gov. Terry E. Branstad today submitted a letter to Health and Human Services Secretary Kathleen Sebelius to inform the Federal government that Iowa will avoid a costly state-based model and will instead pursue a state-federal partnership to retain autonomy over Iowa's healthcare system and minimize costs. The State will pursue a practical path that prevents Federal intrusion into the State's health insurance and Medicaid operations. The governor's decision comes in response to the December 14 deadline Sec. Sebelius gave states to make a decision. If Iowa did not submit its letter today, the State would have defaulted into a Federal exchange.

Gov. Branstad first stated his guiding principles on health care reform, saying, "Iowans deserve health care reform that improves care, lowers cost and most of all makes people healthier."

The letter is found here and the text is pasted below the release.

In the letter, Branstad outlined the reasons for his decision stating, "...I continue to have concerns that an intrusive Federal exchange would raise costs on individuals and businesses, making it harder for them to create jobs and raise family incomes in Iowa. The State of Iowa intends to minimize the Federal government's intrusion into the regulation of insurance. We will continue to regulate insurance plans in Iowa and retain control over our Medicaid and Children's Health Insurance Plan eligibility.

"If our State loses control of the costs of these programs, other funding priorities like education, public safety and workforce development may be threatened. Maintaining responsibility and operational control will also enable our efforts to modernize health care and to change our payment methods to reward quality and improve Iowans' health instead of procedure volume."

Branstad could choose one of three options: A state-built, state-funded exchange; a state-Federal partnership model; or a full Federal takeover of Iowa's health insurance system.

  • A full State-built, State-financed exchange would cost $16 million annually. Additionally, the Federal government has yet to put forth clear parameters on what would be expected of a state-built, state-financed exchange. For example, Utah already has a state exchange, but it is doubtful regulators will approve it under the Affordable Care Act. Even Massachusetts, whose system was modeled when crafting the Affordable Care Act, is unlikely to meet the requirements put forth by the Federal government without changes to its design. Gov. Branstad believes it would be irresponsible to put the state in this kind of financial and regulatory limbo.
  • A State-Federal partnership will allow the Federal government to pay for initial exchange set-up costs and administer the cumbersome web portal, a federal call center and expensive web interfaces. However, the State would still be able to administer its own health care programs, oversee and regulate the insurance industry in Iowa, and put in place measures that will expand Iowans' ownership of their own health through the Healthiest State Initiative. Gov. Branstad assures Iowans that Iowa will not be forced or bullied into significant costs that sink our budget, and we will continue to maintain the high quality of health care access in Iowa that covers more than 90 percent of our residents.
  • Gov. Branstad believes a full Federal takeover of our insurance, regulatory and health care systems doesn't meet our needs. A quick look at the dysfunction in Washington, DC, underscores concerns of opening the door to the Federal government. Gov. Branstad does not believe it is in Iowans' best interests to have the Federal government interfering in their lives from thousands of miles away.

"Iowa is well positioned to meet the standards outlined by HHS thus far and maintain control of our insurance regulation and Medicaid eligibility responsibilities as allowed under PPACA. Iowa will partner with the Federal government in these areas of a Federal exchange," Branstad concluded.

The text of the letter sent to Sec. Sebelius is as follows:

December 14, 2012

 

The Honorable Kathleen Sebelius

US Department of Health & Human Services (HHS)

200 Independence Avenue Southwest

Washington, DC 20201

 

Dear Secretary Sebelius,

Iowans deserve health care reform that improves care, lowers cost and most of all makes people healthier. These principles guide my actions on health care. Unfortunately, the Patient Protection and Affordable Care Act (PPACA) has not advanced these important principles, which align with the goal I announced last year for Iowa to become the healthiest state in the nation. Our initiative is being led by the private sector, has been endorsed by the public sector and is working to improve the health of our population person by person, community by community.

I have come to realize that a health benefits exchange will not improve the quality of health care, lower the cost of health care or make Iowans healthier. There also remain many questions about intended flexibilities for states and the final regulatory and policy framework in which a state financed exchange would operate. I am not convinced that my State would have the freedom and flexibility needed to design an exchange to meet the health care needs of our people. Additionally, the cost of building and maintaining a state-financed and based exchange, estimated at $15.9 million annually, would not advance the health of Iowans and would not be a prudent option for my State.  Therefore, Iowa will not finance, build and maintain a costly state-based health benefits exchange.

That said, I continue to have concerns that an intrusive Federal exchange would raise costs on individuals and businesses, making it harder for them to create jobs and raise family incomes in Iowa. The State of Iowa intends to minimize the Federal government's intrusion into the regulation of insurance. We will continue to regulate insurance plans in Iowa and retain control over our Medicaid and Children's Health Insurance Plan eligibility. Iowa control of these programs is critical to health care for Iowans, stability for job creators and the fiscal bottom line for our State. If our state loses control of the costs of these programs, other funding priorities like education, public safety and workforce development may be threatened. Maintaining responsibility and operational control will also enable our efforts to modernize health care and to change our payment methods to reward quality and improve Iowans' health instead of procedure volume.

Since the HHS has extended deadlines and continues to issue draft rules and provide further information and guidance to states, Iowa reserves our right to amend our intentions. We also have the clear expectation that our State's rights will be respected and our operational and regulatory control will not be superseded by the Federal government.  Iowa is well positioned to meet the standards outlined by HHS thus far and maintain control of our insurance regulation and Medicaid eligibility responsibilities as allowed under PPACA. Iowa will partner with the Federal government in these areas of a Federal exchange. I hope that you will continue to work with States building all types of exchanges to provide the maximum amount of information needed to fulfill our responsibilities in improving the health of our citizens and implementing health benefits exchanges.

 

Sincerely,

 

 

 

Terry E. Branstad

Governor

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Between Untested Therapies & Intrusive Politics,
RN Says Individuals Must Take Responsibility for Their Health

There's plenty of information about women's physical and health-care needs. Unfortunately, some of it is incomplete, or based on opinion and conjecture, or it's just plain bad information, says registered nurse Iyalode Edwards.

"Women tend to be more vigilant about their bodies than men, and there is a huge marketplace of literature, products, studies, politics and other opinions on women's health," says Edwards, author of "Multiple Orgasms Made Simple: 'How to Do It' Sex Secrets All Women Should Know!" (www.multipleOmadesimple.com).

"Not all of it makes sense."

It's only natural that women are more focused on their bodies than men because women have the more complex anatomy, she says. But old ideas from a society based in patriarchy, along with today's health market issues, can create confusion. Edwards, who has more than 35 years experience as a registered nurse, clarifies three points about which she sees the most misunderstanding among her patients:

• Untested therapies: Several years ago hormone replacement therapy was all the rage, used almost as a cure-all for post-menopausal women suffering a variety of symptoms. After a few decades, however, a large percentage of those women started suffering ovarian and breast cancer, in addition to other complications. More recently, vaccines for the human papillomavirus have been touted to girls and young women as the new preventative measure against cervical cancer. But thousands of girls have experienced a wide range of side effects, including seizures, strokes, dizziness, fatigue, weakness, headaches, vomiting, weakness, joint pain, auto-immune problems, chest pains, hair loss, appetite loss, personality changes, insomnia, tremors and menstrual cycle changes. Be wary of new cure-alls. Adverse effects are sometimes not revealed until they've been in use for a significant amount of time.

• Health through pleasure: A 2011 survey by Jane Magazine found that, while more than 87 percent of men aged 18 to 26 years old experienced orgasm "most or all of the time" during sex, only 46.8 percent of women could say the same thing. Not only could that percentage be much higher for women, it could be more meaningful, too. "The truth is, if you have all your sex organs intact and can achieve the first level of climax, then you can achieve it multiple times during the same encounter," Edwards says. "You just need information, and there has been too much misinformation disseminated." Sexual satisfaction comes with several health benefits, including improved cardiovascular functioning, sounder sleep and a deeper bond with a partner.

• The politics of women's health: As imperative as it is to know more and listen closely to one's body, it is also important to stay connected to current events since women's health care has become a political football, she says. Comments from multiple elected officials seem to be narrowing the definition of rape, and there are many who support limiting women's care in insurance plans, to name a few public debates. "I want women to be more aware of their bodies," Edwards says. "Unfortunately, the rhetoric of many politicians seems to be pointing backward regarding our health."

About Iyalode Edwards, R.N.

Iyalode Edwards is the author of "Multiple Orgasms Made Simple," a straightforward, step-by-step how-to guide that includes physiological explanations for sensations women experience. Edwards is a registered nurse with more than 35 years of experience. She informally interviewed a number of women and physicians as part of her research.

He Details Potential Problems & How Consumers
Can Protect Themselves

Of the 15 toys recalled in the United States so far this year because of the dangers they pose to children, 10 were manufactured in China.

Chinese drywall imported from 2001 to 2007 released sulfur gas that sickened homeowners and corroded wiring, air-conditioning systems and other metal surfaces. Many of those homeowners are still trying to win compensation.

In recent years, U.S. dogs and cats died from eating Chinese pet food made with melamine, and the FDA warned consumers to throw away toothpastes made in China because of the risk they included an antifreeze ingredient.

"The problem is, manufacturers, distributors and consumers alike are attracted to inexpensive goods, and in countries like China, things can be produced cheaply in part because there are fewer regulations regarding quality control," says Joe Veilleux, president of Euromed USA (www.euromedusa.com) and a registered pharmacist.

"That's why I warn people who buy all-natural nutritional supplements not to buy the cheapest products available. If the ingredients in them are not subject to regulatory oversight, they can be dangerous."

The active ingredients in many natural supplements are botanicals - extracts from herbs and other medicinal plants. Some of the dangerous potential problems that can occur without rigorous quality control include :

• Contamination by pesticides and other heavy metals. Exposure to these contaminants can be hazardous to humans and can be present if growing conditions and plant materials are not carefully monitored. Manufacturers who aren't held to government standards may not even check for contamination.

• Radiation exposure. The ground the plants are grown in may have radiation, which is absorbed by the plants. This is another contaminant for which regulated manufacturers carefully test.

• Species misidentification. Slightly different varieties of a plant may have vastly different properties. Black cohosh, for example, is a member of the buttercup family and is used to treat menopause symptoms like hot flashes. Some varieties of the genus Actaea may look similar to Actaea racemosa, but they do not have the same effect and, in fact, can be harmful.

While price can be a red flag for consumers, surprisingly, one sign that a product meets high quality standards is if it comes from a company that incorporates environmental sustainability practices, Veilleux says.

"A company that's making an effort to address issues such as sustainability is farther along in the evolutionary process," Vielleux explains. "A company's first mission will be to provide the best quality of product it can. Once it has achieved that, it looks to improve in other ways, including sustainability, reducing its impact on the environment and social responsibility. But it can't get to step 2 until it has mastered step 1."

Veilleux says a reliable sign that a company is serious about "green" issues is if it has earned ISO 14001 certification.

"ISO stands for International Standardization Organization. Its criteria can be applied and measured uniformly in countries around the world," Vielleux says. "So whether a company's in China or the United States, if it has ISO 14001 certification, you can be assured it takes sustainability and environmental issues seriously."

Euromed's factory in Barcelona earned the ISO 14001 certification in July of this year.

Another way to safeguard yourself is to buy products from major U.S. brands, such as GNC and Whole Foods, Veilleux says.

"The big brands have a lot to lose, so they're not as likely to take chances by obtaining their ingredients from unregulated sources," Veilleux says. "Having their products blamed for a public health crisis would be disastrous to them."

About Euromed USA

Euromed USA supplies standardized botanical and herbal extracts and natural active substances for use in the pharmaceutical, health food and cosmetics industries. By extracting the necessary chemicals, the company can guarantee its products meet the precise chemical specifications necessary. Euromed was founded 40 years ago. Its parent company is the 100-year-old Rottapharm-Madaus corporation based in Italy.

ACT Today! (Autism Care and Treatment Today!) has launched a new program called ACT Today! SOS to address the needs of individuals with autism who face emergency situations.
NATIONWIDE, DECEMBER 10, 2012 - ACT Today! (Autism Care and Treatment Today!), a national non-profit organization whose mission is to provide care and treatment to children with autism, announces the launch of ACT Today! SOS, a new program aimed to
address the urgent needs of those impacted with autism spectrum disorders (ASD).
"We understand some individuals on the autism spectrum are in immediate and personal danger or harm and are unable to wait up to 12 weeks for a response to their ACT Today! grant request," says Nancy Alspaugh-Jackson, ACT Today!'s executive director. "The ACT Today! SOS program is designed to provide immediate support for families based upon need and the program funds available."
To qualify for an ACT Today! SOS grant, applicants must have an immediate need for treatment or support and if treatment is not found, the applican'ts physical safety is in jeopardy. ACT Today! SOS will fund effective treatments and services to treat ASD and will not fund living expenses, travel, utilities or clothing. Income level of the applicant's family must be below $45,000 per year and the applicant may not have received support from ACT Today! within the past 12 months.
There are currently three families on the ACT Today! SOS wait list.
The Maroni family of New Jersey has three children on the autism spectrum. The fence around their home was completely destroyed by Hurricane Sandy. The chances are now greater for the three children to run away, or "wander," a common trait with children with autism.
Criscent is a nine-year old boy diagnosed with autism and currently living in California with his aunt and uncle. He was beaten and tortured in his home country of Uganda. His aunt and uncle cannot afford to provide Criscent with treatment for his autism.
Elijah is a four-year old boy from Iowa. He suffers from severe autism and needs a padded safety bed to prevent concussions caused by seizures and head banging.
"We are sending out an SOS and asking the community to help us help these families and others like them who are in dire need," says Alspaugh-Jackson. "Starting this week, we will launch the ACT Today! SOS social media campaign, calling on the online community to make a donation, either by texting or on our website."
For more information about ACT Today! SOS and the requirements, visit www.act-today.org/SOS.
About ACT Today!:
ACT Today! (Autism Care and Treatment Today!) is a 501(c)(3) national non-profit organization dedicated to raising awareness and providing treatment services and support to families of children with autism who cannot afford or access the necessary tools their children need to reach their full potential. For more information about ACT Today!, visit: www.act-today.org.

Encourages Everyone in Illinois to Get a Flu Shot During the Holidays to Protect Themselves, their Families and Loved Ones

CHICAGO - December 6, 2012. With the holiday season here and public health officials saying that we're seeing more flu activity this year, Governor Pat Quinn today encouraged everyone six months and older in Illinois to get a seasonal flu shot. To mark National Influenza Vaccination Week from Dec. 2 through 8, the governor rolled up his sleeve and received a flu shot from the state's Public Health Director, Dr. LaMar Hasbrouck.

"Public health officials are warning that this year we are already seeing a higher level of flu activity in some areas of the state than all of last flu season," Governor Quinn said. "In order to stay healthy through the holidays and all winter long, the most important thing you can do is get a flu shot now, so that you don't expose yourself and your family to unnecessary illness."

According to the Illinois Department of Public Health (IDPH), Illinois has seen an increase in flu activity this season. IDPH says that physicians in some areas of the state, including Cook County, are reporting an increase in people with influenza-like illnesses. There have also been recent institutional flu outbreaks and several laboratory-confirmed cases.

"Governor Quinn is setting a great example today," said Illinois Department of Public Health Director Dr. LaMar Hasbrouck. "Getting vaccinated is the single best way for you to protect not only yourself against flu, but your loved ones as well. We recommend everyone six months and older get vaccinated."

According to the U.S. Center for Disease Control and Prevention (CDC), each year an estimated 5 to 20 percent of the U.S. population gets the flu. On average, influenza in the U.S. results in approximately 200,000 hospitalizations and more than 25,000 deaths annually. Flu symptoms may include a fever of 100 degrees Fahrenheit or higher, headache, body aches, exhaustion, chills and weakness. 

The influenza virus can be spread through coughing or sneezing. People can also get the flu by touching objects carrying the virus, such as telephones and door knobs, and then touching their mouth or nose. Public health officials recommend that in addition to getting a flu shot, it is important to practice "the three C's": Clean: properly wash your hands; Cover: cover your cough and sneeze; and Contain: contain your germs by staying home if you are sick.

The CDC says that young children, pregnant women, people with chronic medical conditions and the elderly are at higher risk of complications from influenza. Side effects are mild; some individuals may experience mild flu-like symptoms for a few days after vaccination and/or soreness at the injection site.

For more information about the seasonal flu shot and staying healthy, visit www.idph.state.il.us/flu/ and www.flu.gov

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Coverage in Iowa is lacking

Des Moines, IA- The United States is at a tipping point when it comes to policies that help smokers quit, according to the American Lung Association's ?Helping Smokers Quit: Tobacco Cessation Coverage 2012? report. The annual report provides a  comprehensive review of each state's tobacco cessation coverage and an up-to-date look at federal coverage and requirements
under the Affordable Care Act.

"Over the next year key decisions will be made by the federal government and the states about whether or not they will help save lives, prevent disease and reduce health costs," said Micki Sandquist, Executive Director at the American Lung Association in Iowa. "We know that the vast majority of smokers want to quit, but the complex web of state and federal coverage for effective quit smoking programs and treatments prevents too many from getting the help they need. States and the federal government can reduce the enormous health burden of tobacco use by providing access to these proven interventions."

The American Lung Association report shows that the federal government has missed several key opportunities to improve access to quit smoking medications and counseling. The record for the states is mixed, but far too many fail to ensure coverage.

The report's key findings are:

Medicaid Coverage:

Two states provide comprehensive cessation coverage: Indiana and Massachusetts; two states provide NO cessation coverage: Alabama and Georgia; four states provided new counseling benefits for pregnant women in 2012: Colorado, Kansas, North Dakota, and South Dakota; and Connecticut and Tennessee announced new benefits for everyone in 2012 that are close to comprehensive.

State Employee Health Plan Coverage:

Four states provide comprehensive coverage: Illinois, New Mexico, North Dakota, and Rhode Island;

Zero states provide no coverage; and Florida, Georgia, Nebraska and New Jersey added new cessation benefits for state
employees in 2012.

Investment in State Quitlines:

Telephone quitlines are also an essential part of any state's tobacco cessation efforts. As more and more smokers want to quit, the majority of states are not providing adequate funding for their quitlines.

Only two states?Maine and South Dakota?currently invest in quitlines at or above the recommended amount. This is a critical lost opportunity for people who are trying to quit.

Federal Coverage:

On November 26, the U.S. Department of Health and Human Services (HHS) published a proposed rule that requires the Essential Health Benefit coverage mandated by the Affordable Care Act to cover preventive services, including tobacco cessation.  However, because HHS has not yet defined what insurers must include as part of a tobacco cessation benefit, the Administration missed a crucial opportunity. Now, each state can choose its own benchmark plan, which will then serve as the Essential Health Benefit standard for plans in that state's health insurance exchange. Until HHS officially defines a comprehensive tobacco cessation benefit, it has missed a crucial opportunity to provide many smokers with new access to help quitting, and to establish tobacco cessation as a truly essential health benefit for all health insurance coverage.

Iowa policymakers can now help smokers quit by including comprehensive tobacco cessation benefits as they implement state health insurance exchanges and Medicaid expansions.

Tobacco use is the leading preventable cause of death in the United States. The economic costs in the U.S. due to tobacco total $193 billion annually. Providing comprehensive quit-smoking treatments is crucial in both saving lives and curbing health costs - one recent study showed that providing this help has a 3-to-1 return on investment.

"Giving all smokers access to a comprehensive cessation benefit is not only the right thing to do, it's the smart thing to do," said Sandquist. "The bottom line is that quitting smoking saves lives and saves money."

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Editor's Note: Available as a standalone graphic is ?Tobacco Cessation Treatment: What is covered??? the American Lung Association's breakdown of what the biggest health insurance programs cover for tobacco cessation and how the Affordable Care Act changes coverage.

About the American Lung Association in Iowa: Our mission is to save lives by improving lung health and preventing lung disease. With your generous support, the American Lung Association is "Fighting for Air" through research, education and advocacy. For more information about the American Lung Association or to support the work it does, call 1-800-LUNG-USA (1-800-586-4872) or visit www.LungIA.org.

PEORIA, Ill. (Dec. 4, 2012) ? The holiday season is here, and with it comes the exchange of gifts amongst family and friends. But many hospital patients have a gift on their wish list this year that only generous hearts can give: a blood donation.

Once the hustle and bustle of the holidays subsides, the American Red Cross reminds people to give one last gift ? give blood. A blood donation can be the most meaningful gift of the season.

As many as 44,000 blood donations are needed every day across the country to meet the needs of patients. Make an appointment to donate by visiting redcrossblood.org or calling 1-800-RED CROSS.

Upcoming blood donation opportunities:

Carroll County
Dec. 29 from 8 a.m. to 12 p.m. at First Presbyterian Church, 502 Third St. in Savanna, Ill.

Clinton County
Dec. 20 from 10 a.m. to 4 p.m. at Lyondell Chemical Co., 3400 Anamosa Road in Clinton, Iowa

Henry County
Dec. 20 from 10:30 a.m. to 5:30 p.m. at Kewanee Hospital, 1051 W. South St. in Kewanee, Ill.
Dec. 26 from 2-6 p.m. at First Christian Church, 105 Dwight St. in Kewanee, Ill.

Mercer County
Dec. 18 from 12-6 p.m. at VFW Hall, 106 SW Third Ave. in Aledo, Ill.

Scott County
Dec. 18 from 9 a.m. to 1 p.m. at Mel Foster Co., 3211 E. 35th St. Court in Davenport, Iowa

Whiteside County
Dec. 18 from 1-5:15 p.m. at River Bend Senior Center, 912 Fourth St. in Fulton, Ill.
Dec. 19 from 2-6 p.m. at Rock Falls Blood Donation Center, 112 W. Second St. in Rock Falls, Ill.
Dec. 26 from 10 a.m. to 2 p.m. at Rock Falls Blood Donation Center, 112 W. Second St. in Rock Falls, Ill.
Dec. 26 from 11 a.m. to 3 p.m. at River Bend Senior Center, 912 Fourth St. in Fulton, Ill.
Dec. 27 from 3-7 p.m. at Rock Falls Blood Donation Center, 112 W. Second St. in Rock Falls, Ill.

The need is constant. The gratification is instant. Give blood.®

Shop the Holiday Giving Catalog:  The 2012 Holiday Giving Catalog at redcross.org/holiday has even more charitable gift ideas. Shoppers can buy food and shelter for disaster victims, phone cards for members of the U.S. armed forces or vaccinations for an entire village, among many other gifts. Catalog purchases come with greeting cards for loved ones, letting them know a donation was made in their name.

How to donate blood
Simply call 1-800-RED CROSS (1-800-733-2767) or visit redcrossblood.org to make an appointment or for more information. All blood types are needed to ensure a reliable supply for patients. A blood donor card or driver's license or two other forms of identification are required at check-in. Individuals who are 17 years of age (16 with parental consent in some states), weigh at least 110 pounds and are in generally good health may be eligible to donate blood. High school students and other donors 18 years of age and younger also have to meet certain height and weight requirements.

About the American Red Cross
The American Red Cross shelters, feeds and provides emotional support to victims of disasters; supplies about 40 percent of the nation's blood; teaches skills that save lives; provides international humanitarian aid; and supports military members and their families. The Red Cross is a not-for-profit organization that depends on volunteers and the generosity of the American public to perform its mission. For more information, please visit redcross.org or join our blog at http://blog.redcross.org.

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WEST DES MOINES, IOWA - Dec. 3, 2012 - Farmers, like many self-employed Iowans, are concerned about the rising costs for health care and the changing environment of health care regulations. To kick off Iowa Farm Bureau Week Dec. 2 - 8, the Iowa Farm Bureau Federation (IFBF) has added a new benefit partner to help members qualify for an average of over $4,000 in tax savings to reduce out-of-pocket and health insurance premium costs.

BASE, a third party benefit administration company headquartered in Adel, Iowa, will work with Farm Bureau members who are self-employed or small business owners to customize a benefit plan for their specific needs and ensure the plan is in compliance with government regulations. More than 70 percent of self-employed are able to qualify for tax advantaged plans, regardless of how their business is structured.  BASE will also offer exclusive savings to Iowa Farm Bureau members on these plans, providing another tool in Farm Bureau's suite of supplemental health care benefits designed to ease the pinch of rising costs.

"As farmers, we depend on our certified public accountant to provide us with every legitimate tax deduction we can get. That's why we've been using the BASE Health Reimbursement Arrangement (HRA) to deduct our medical expenses each year," said Joanne Piercy, a farmer in Lenox. "With such a great tax savings each year, we'll continue to take advantage of the BASE HRA as long as we're farming."

Iowa Farm Bureau members who own a farm or business and pay for health insurance premiums or out-of-pocket health care costs or are looking to provide an additional benefit to employees should contact BASE at (866) 550-5525 to see if they qualify. For more information, go to www.BASEonline.com or www.iowafarmbureau.com.

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It's doubtful that the country will be popping bottles of champagne on January 1, 2013?we can't afford it. But we will be throwing confetti printed by the Federal Reserve over a cliff.

As of November 27, 2012, the country's debt was $16.279 trillion?just $115 billion below the $16.394 trillion statutory ceiling. The Treasury predicts that borrowing will reach the current limit near the end of December 2012. Right around the Mayan calendar "end date" of 12-21-12.

Apocalyptic prophecies aside, there are a number of things that are scheduled to expire at the end of 2012. One is the Medicare "Doc Fix," which postponed until Dec 31 the day that the rates at which Medicare pays physicians will decrease by 27 percent. Another is the "Bush tax cuts." On January 1, all income tax, estate, and capital gains tax rates will go up substantially, and millions more people will be subject to the Alternative Minimum Tax.

Then there are new taxes, compliments of the Patient Protection and Affordable Care Act (PPACA or ObamaCare), some of which take effect in 2013. These include the Medicare surtax on so-called millionaires and billionaires, i.e., individuals making more than $200,000 a year ($250,000 if married), and a new 3.8% tax on capital gains and dividends, interest, and other passive income. The now infamous penalty-that-is-really-a-tax kicks in for those who don't buy government-approved health insurance in 2014. Another revenue-raising measure is a cap of $2,500 on previously unlimited Flexible Spending Accounts. This discourages Americans from taking personal responsibility for medical spending instead of relying on third-party payments.

And January 2 could ring in sequestration, that is, automatic budget cuts. The Budget Control Act of 2011 (BCA) authorized the President to increase the debt ceiling by $2.1 trillion in exchange for some $917 billion in cuts, from 2012 to 2021, in "discretionary"?that is, nonentitlement?programs such as defense, education, national parks, the FBI, the EPA, low-income housing assistance, medical research, and many others. Unless Congress and the President agree to modify or repeal the BCA, spending reductions of some $109 billion per year with half coming from defense budget and half from nondefense are triggered. Sequestration for Medicare payments to health care providers and health plans is limited to 2%.

The President does not want cuts to his signature law, the inappropriately named Patient Protection and Affordable Care Act (PPACA). It is, however, a financial disaster. The Congressional Budget Office (CBO) has projected a cost of $1.4 trillion over 10 years, but if we look at history, such projections are meaningless. In 1967, the House Ways and Means Committee said Medicare would only cost $12 billion in 1990. The actual cost was $110 billion. In 2010, total Medicare expenditures were $523 billion. Medicare spending has been forecasted by the CBO to increase to $922 billion in 2020.

Just the IRS and HHS costs to implement the PPACA, $20 billion over 10 years, exceed the House's initial estimate for all Medicare spending. And how can we afford a vast new entitlement when the CBO admits in an Oct 1 report, CRS Report R41390, that "even maintaining current funding levels for existing programs with an established appropriations history may prove a challenge under growing pressure to reduce federal discretionary spending."

In the PPACA, there are about 100 new programs with noble-sounding names or goals: for example, the program to facilitate shared decision making, culture change (to patient-centered care), the Elder Justice Coordinating Council, the Offices of Minority Health, and the Offices on Women's Health. But none have been evaluated for effectiveness before we start pouring money into them. Under the circumstances, I think we should add more funds to the newly minted Centers of Excellence for Depression.

Fortunately, the PPACA's discretionary provisions are subject to the congressional appropriations process, which can potentially defund a program. Additionally, appropriations are needed for administrative costs associated with even exempt programs. Thus, Congress has the power to back off from the PPACA contribution to the cliff, if it has the will to do so.

The cliff, however, is not going away. Cliff diving, anyone?

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http://www.aapsonline.org/

The Early Childhood Coalition is hoping the generous Holiday spirit in the Quad Cities will help the group get a new digital eye exam machine this fall

(Moline, IL)  The Early Childhood Coalition (ECC) has been coordinating efforts to offer monthly free Early Learning Screenings for children 4 months to age five at various locations throughout Rock Island County for years.  The group also has spent a decade offering vision, hearing and overall developmental screenings.  Now it wants to make the screenings more effective and quicker.  This can be done with a new digital vision camera called the "Spot", manufactured by Pediavision.

The Secretary of the ECC, Lisa Viaene, says the current camera the group is using, the 'Photo Screener' is becoming obsolete and the film is no longer being produced.  Viaene says the new camera will cost almost eight thousand dollars and she is reaching out to the community for assistance in securing the funds.   Since the group began their monthly screenings in September of 2002 more than 2,200 children have been screened.  Viaene says with the new camera thousands more children will be served.  She says when vision problems are found early children will be more successful throughout their lives.
***The media are invited to hear more information on the new camera on Monday, December 3 at 9:00 at the Early Childhood Coalition/AOK office (4341 18th Avenue Rock Island).

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