For the past week, artist Lisa Lozano has been weaving a seven-mile length of red jute through the trees of a 19th-century cemetery in Kingston, N.Y.

Ms. Lozano, who has exhibited large-scale string installations on Governors Island and at New York University, says the commission is vitally important—and not because of the pay (nil) or prestige (debatable). In exchange for her art, she’ll get her teeth cleaned.

The 34-year-old New York artist is one of more than 100 musicians, painters and performers taking part in the second annual O+ Festival in Kingston this weekend. Named for the blood type, the festival allows artists to barter works and performances for health care in the form of back adjustments, blood work, dental fillings and eye exams.

Read more about the bartering of art for health care from the Wall Street Journal.

Says PHC4 in a press release issued today:

Ambulatory surgery centers (ASCs) in Pennsylvania remained financially healthy overall in fiscal year 2010 (FY10), according to a new report from the Pennsylvania Health Care Cost Containment Council (PHC4). The statewide average operating and total margins for ASCs were 26.20% and 26.29%, respectively. The margins remained in the 26.00% to 26.30% range over the last three-year period (FY08 to FY10).

The ASCs’ average total margins among the nine regions in Pennsylvania ranged from a low of 17.66% to a high of 35.04%.

“In general, ambulatory surgery centers in Pennsylvania are thriving,” said Joe Martin, Executive Director of PHC4. “After a decade of considerable growth, the number of ASCs increased only marginally between FY09 and FY10.”

Eight new facilities opened and four closed, for a net growth of only four facilities in FY10. In the period from FY01 to FY09, the number of ASCs increased from 98 to 262, an average increase of 18 facilities per year.

In response, the Hospital & Healthsystem Association of PA released a statement saying that the data in the report continues to raise questions about the ability of the uninsured and people on Medicare and Medicaid to gain and maintain their access to health care.

Writes HAP in a press release:

According to PHC4, there are now 266 ambulatory surgery centers (ASC) in the state, up from 72 ten years ago, far exceeding the number of general acute care hospitals (165). ASC total profit margins have exceeded 26 percent in each of the past three years. This is in part due to the fact that Medicaid accounted for only 4.5 percent of ASC revenue in 2010, compared to 11.8 percent of general acute care outpatient revenue.

“As the congressional deficit-reduction ’super committee’ gets to work this fall, it is imperative that members of the panel—and by extension all members of Congress—understand the pivotal role that acute care hospitals play in providing a health care safety net for our most vulnerable citizens,” said HAP President and CEO Carolyn F. Scanlan. “With ASCs treating healthier, and usually better insured, patients, the financial and clinical demands on acute care hospitals, which are a safety net for all Pennsylvanians, continue to grow.”

“Under the original Affordable Care Act health reform law, hospitals nationwide already have accepted shared sacrifice amounting to $155 billion in payment reductions—$9 billion in Pennsylvania alone,” Scanlan said. “In addition, Pennsylvania’s fiscal year 2011-2012 state budget cut Medicaid payments to hospitals by 4 percent.”

Scanlan noted that these cuts do not include additional cuts imposed by regulations, and she said that the Medicare and Medicaid programs already underpay hospitals, paying less than the cost of care.

“The bottom line for our patients is access,” Scanlan said. “We continue to support maximizing insurance coverage for all Americans, but it cannot be done by reductions to providers, without whom nobody — insured or not — will be able to get care.”

Even during months of stubborn unemployment, the health care industry has provided a solid underpinning, reliably adding jobs in an otherwise dismal environment.

For example, hospitals, nursing homes and the like added about 430,000 jobs during the recession, as the country shed 7.5 million jobs. With the latest government reports showing a meager overall gain of 117,000 jobs in July, health care remained a significant contributor with an additional 31,000 jobs for the month, a tad higher than an average monthly addition of 25,000 health jobs in the last year. Hospitals, which had a slight decline in June, added 14,000 jobs in July.

While few experts can predict how the stock market’s gyrations and government cutbacks this month will affect the health industry, several health industry analysts warn that the sector is showing signs of economic sluggishness that has long kept other business sectors beleaguered.

The situation has led many in the health industry to caution that it cannot be relied upon to keep hiring workers. “It’s not realistic to believe that we’re going to continue to generate job growth when you’re speaking about Medicare and Medicaid reductions in the hundreds of billions of dollars over the next few years,” said Daniel Sisto, president of the Healthcare Association of New York, which represents the state’s hospitals and health systems.

Read more from the New York Times

State legislators are concerned that a new program in the healthcare reform law will reopen a series of problems that states tackled years ago.

The National Conference of Insurance Legislators is worried about the law’s new long-term-care insurance program, known as CLASS.

NCOIL President George Keiser, a Republican state lawmaker in North Dakota, said the group is worried that the U.S. Health and Human Services Department eventually will have to raise premiums for the CLASS program significantly, driving people away from buying long-term-care insurance.

CLASS is slated to begin collecting premiums before it pays out benefits, to help ensure it has enough money on hand to cover claims for long-term care, such as nursing-home stays. But Keiser said HHS hasn’t done enough to make sure that CLASS’s premiums will be high enough to cover its costs.

For the rest of the story, read The Hill

Health-care and defense lobbyists are quickly gearing up for a major lobbying and public relations campaign in response to this week’s debt-limit deal, which could force hundreds of billions of dollars in cuts for two of Washington’s most powerful industries.

The compromise bill that averted a government default this week includes $1.2 trillion in mandatory cuts over the next decade if Congress can’t agree on a broader deficit reduction plan by December. Most of that amount targets the Pentagon and Medicare providers.

The arrangement has set off alarms among major defense contractors, hospital firms and others that would stand to lose billions if Congress doesn’t decide on a different plan. The first focus of the nascent lobbying campaign will be a bipartisan“supercommittee”to be named later this month that will attempt to hash out a compromise, according to lobbyists, trade groups and others involved in the effort.

The message from both industries will be similar: Any massive reductions will hurt national priorities and undermine job growth.

“It will be a full-court press to work with the committee to make our views known,” said Richard Pollack, executive vice president of the American Hospital Association, whose members would lose an estimated $50 billion a year in Medicare payments under the trigger scenario. “Our hospitals are in every congressional district in the country. Our patients are Republicans and Democrats. We are very concerned about where this is going to go.”

For the rest of the story, go to The Washington Post

The Supreme Court was asked on Wednesday to hear a challenge to the health care overhaul law, raising the possibility that the justices could rule on the matter by next summer, just months before the presidential election. Similar requests are likely to follow, and it is not clear which if any of them the court will agree to hear.

The petition submitted Wednesday was an appeal from a divided decision last month by a three-judge panel of the United States Court of Appeals for the Sixth Circuit, in Cincinnati. The decision was the first appeals court ruling on the constitutionality of the law, the Patient Protection and Affordable Care Act.

The decision was also notable because Judge Jeffrey S. Sutton, a prominent conservative judge who had served as a law clerk to Justice Antonin Scalia, joined the majority in upholding the law. Additional decisions on the constitutionality of the law are expected soon from other federal appeals courts, including ones in Atlanta and Richmond, Va.

The Sixth Circuit case was brought by several individuals and the Thomas More Law Center, which describes itself as a defender of “America’s Christian heritage and moral values.” They argued that a provision of the law, which requires the purchase of insurance in some circumstances, exceeds the powers granted to Congress by the Constitution.

For the rest of the story, read The New York Times

Supporters of the healthcare reform law say there are major flaws in a new survey of small businesses. 

They say the study, released Monday by the National Federation of Independent Business, mischaracterized key policies in the healthcare law. The NFIB survey said employers will be more likely to quit offering health benefits if large numbers of employees choose to pass up the employer-based coverage and instead buy a plan through the newly created insurance exchanges.

But few employees will likely have that option, critics of the survey note. 

Most people who buy coverage through the exchanges will get a government subsidy to help make insurance more affordable. But subsidies aren’t available to anyone whose company offers a healthcare plan that costs less than 9.5 percent of his or her income.

So the NFIB survey’s question is backward, the law’s supporters argue — employees would head to the exchanges if their companies quit offering healthcare, rather than employers dropping coverage because their employees aren’t taking it.

For the rest of the story, read The Hill

As many legislatures around the country have finished their work for the year, fewer than one-fourth of states have taken concrete steps to create health insurance marketplaces, a central feature of the federal law to overhaul the U.S. health-care system.

A total of 43 states, meanwhile, have made fresh cuts to Medicaid, even as lingering unemployment and diminishing access to private coverage continue to drive up the number of Americans turning to the public insurance program for the poor.

Taken together, these trends highlight the ground-level challenges that health care poses to states. A year after Congress passed the biggest revisions to the health-care system since the 1960s, states are grappling with their own versions of the fiscal and ideological battles that still are roiling Washington.

States that have moved gingerly so far on health exchanges have not necessarily rejected the idea outright. Only one, Louisiana, has told the federal government it does not intend to build an insurance marketplace for its residents. In states that refuse, the law allows the federal government to step in.

Read the rest of the story at The Washington Post

Death stares at James Dean.

As a funeral director, he embalms bodies and counsels grieving relatives. As a man with advanced prostate cancer, he contemplates his death as the illness spreads and zaps his energy.

Dean, 62, of Bellevue, a tall man with a silver beard, received a controversial vaccine in October that cost $93,000 and reportedly gives patients a chance to live an average of four months longer. His insurer, Highmark, paid for the treatment — an expense Dean admits he wouldn’t have covered himself.

“Heck no, I’m not going to pay $93,000. I don’t have that money,” Dean said.

The costly vaccine, called Provenge, is the subject of debate among federal regulators, drug companies and patient advocacy groups.

Dean’s decision to receive the vaccine — because it cost him nothing, even if the benefit was limited — underscores the prevalence of aggressive and high-priced treatments in America when death looms, an investigation by the Tribune-Review found. In some cases, patients don’t want treatment but receive it because doctors say it’s the right thing to do.

Many experts warn that pricey treatments with the possibility of limited or no benefit for patients in their last weeks of life need to be evaluated because of skyrocketing health care costs and dissipating money for Medicare and Medicaid.

“Our public insurance programs and subsidies cannot afford to pay for treatments that are very expensive but produce minimal health benefits,” said Katherine Baicker, professor of health economics at Harvard School of Public Health. “The tough policy question is how to draw the line. What health benefit is just too small to warrant the expense?”

Read the rest of the story at the Pittsburgh Tribune-Review

Pittsburgh Tribune-Review shares the story:

Carol Holland checked her hair in a hand-held mirror, draped a bag of lollipops over the side of her wheelchair and rolled out of her room to begin her daily routine of passing out candy to residents at Heritage Place, a Squirrel Hill nursing home.

“Good morning, dear,” she sang out to Agnes Mondry, who lives in a room on the third floor. “I’ve got a sucker for you. I’ll see you later, honey.”

For 23 years, Holland worked at a nursing home in East Liberty. Although she appears at ease in Heritage Place, a skilled nursing facility that traditionally houses the elderly, she hardly fits in: At age 48, Holland is the youngest resident here.

“I got used to taking care of people. Never thought I’d have to be taken care of,” said Holland, who came to Heritage Place in January after surgery. She is undergoing rehabilitation on her ankle.

In Pennsylvania and across the country, more younger people are ending up in nursing homes.

According to an analysis of statistics compiled by the Centers for Medicare and Medicaid Services, the percentage of under-65 residents in nursing facilities has risen steadily since 2002. That year, 11.7 percent of the nation’s nursing home population was younger than 65. In 2006, the number rose to 13.6 percent, and by the end of 2010 it was 14.9 percent, the statistics show.

Read more from Pittsburgh Tribune-Review