Tuesday Tidbits

Reuters reports that the federal government today appealed Judge Vinson's decision holding the Affordable Care Act unconstitutional to the U.S. Court of Appeals for the Eleventh Circuit.  This step was a condition that Judge Vinson placed last week on staying his decision pending an appeal. 

The Washington Post reported today on a new form of medical home -- a group of primary care clinics in Washington state called Qliance that charge patients a "modest" membership fee totaling $700 to $800 on average annually -- the fees vary by age and service intensity. "Routine preventive care and many in-office procedures are free; patients pay for lab work and other outside services "at or near" cost, and they get discounts on many medications."   The article explains that "Under a provision in [the Affordable Care Act], insurers selling plans on the state-based insurance exchanges that will open in 2014 will be allowed to "provide coverage through a qualified direct primary care medical home plan . . . ."  Qliance's vision is to offer its direct pay arrangement in the state health insurance exchanges in combination with wrap around insurance that covers specialist and hospital care.  

Qliance's vision -- let's use the Affordable Care Act to bend the cost curve up -- reminds me of the hopefully satirical title of a recent op-ed in the Journal of the AMA titled "Is Choice of Physician and Hospital an Essential Benefit" under the ACA by Robert H. Brook, MD. The FEHBlog did not choose to shell out $30 to read this article.

The AMA News reports on lobbying efforts by psychologist associations in six states to obtain prescribing rights for their members.   Needless to say, the AMA and the American Psychiatrists Association, among other organizations, have lined up in opposition. While the AMA/APA position strikes the FEHBlog as the stronger argument, the FEHBlog senses a pre-industrial revolution guild dispute feel to the debate.