· Among uninsured 53% face problems paying for healthcare
· Patients forced to work longer, raid savings or cut back on expenses

One in five Americans with health insurance has had problems paying for medical expenses, according to a new survey.

While the number of people with health insurance continues to increase in the US, people grappling with their country’s complex healthcare system are cutting back on household expenses, working more hours and depleting their savings to pay for healthcare.

Continue reading... Reported by guardian.co.uk 18 hours ago.

A coroner's official says a public autopsy isn't planned following the death of a 20-year-old woman at the center of an end-of-life court battle in Reno. A Nevada hospital official says federal patient privacy laws prevent administrators from commenting on the death of a 20-year-old woman at the center of an end-of-life court battle. Saint Mary's Hospital and Medical Center spokeswoman Jamii Uboldi on Tuesday cited the 1996 Health Insurance Portability and Accountability Act, or HIPAA. Family attorney David O'Mara tells The Associated Press that Hailu died Monday at Saint Mary's, where she never awoke from anesthesia after abdominal surgery April 1. Attorney David O'Mara tells The Associated Press that Aden Hailu (AY'-dehn HEHL'-oo) died Monday at Saint Mary's Regional Medical Center, where she never awoke from anesthesia after abdominal surgery April 1. Reported by SeattlePI.com 15 hours ago.

Even only a few days into each January, most of us know the difference between realistic New Years' resolutions and those that will be quickly ignored. For example, I expect I will be able to bring my lunch into the office more often this year, but I won't hold my breath about turning that great idea for a book into a written draft anytime soon. For all our best hopes, some improvements are simply unattainable without much bigger changes.

Frustratingly, the analogy holds for Speaker Paul Ryan and Republican leadership in the House. Instead of bringing Members of Congress from both parties and all parts of the country together to get America's business done, Speaker Ryan has chosen to begin 2016 with yet another attempt to undermine the Affordable Care Act. Worse, he has chosen to add another attack against Planned Parenthood and the funding they receive to serve economically vulnerable women.

Last year saw some important breakthroughs towards returning Congress to what it ought to be: Democrats and Republicans worked together on several pieces of legislation that ultimately became law. Without abandoning their principles or beliefs, both sides worked to find common ground and get the country's business done. Just last month, Speaker Ryan ended 2015 by closing a deal on funding government agencies through the rest of the fiscal year. That deal earned broad, bipartisan support--including from me--for good reason, and I wish we were building on this promising record of success.

Instead, House Republican leaders are returning to the same exasperating political attacks that have defined Congress for the last several years. These efforts to undermine health care reform and attack women's right to access reproductive health care services are fundamentally wrong and prevent Congress from working on the priorities that Americans actually want their leaders to work on.

Despite endless political attacks and some start-up challenges, the Affordable Care Act continues to deliver health coverage for millions of Americans who lacked it before. Young people can stay on their parents' health insurance plans through age 26, people who don't receive insurance through their jobs now have multiple plan options and can earn tax credits depending on their income, and seniors are no longer on the hook for the costs of the prescription drug "donut hole" thanks to the progress the Affordable Care Act has made.

Planned Parenthood's work is similarly compelling. More than three million patients each year get access to cancer screenings, well-woman doctor visits, and a complete set of reproductive health care services. Planned Parenthood is unique in its ability to serve so many women from all walks of life across the country. Their medical professionals and volunteers offer these services despite constant threats and repeated violent attacks, including the recent shooting at a clinic in Colorado Springs, CO.

Undoing health care reform and defunding Planned Parenthood are both bad policy choices that the American people do not support and President Obama will never allow. But this hasn't stopped Speaker Ryan and House Republicans from making this their first work of 2016. It is a sad step in the wrong direction to begin the New Year.

Like a resolution that has little hope of being achieved, these political gambits will look wrong for the country and foolish in hindsight. I only hope my colleagues choose to spend the rest of 2016 more productively. The American people need their business done, and a year would be a terrible thing to waste.

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 14 hours ago.

(AP) — A 20-year-old college freshman whose hospital treatment spurred an end-of-life court battle has died at a Reno hospital while still on life support, her family's lawyer said Tuesday. Aden Hailu, of Las Vegas, died about 4:30 p.m. Monday at Saint Mary's Regional Medical Center, where she never awoke from anesthesia after surgery in April, said David O'Mara, the attorney representing Hailu's father and family. The Washoe County coroner was notified of the death but doesn't plan a public autopsy, said Lynn Sack, aide to Coroner Ellen Clark. Spokeswoman Jamii Uboldi cited patient privacy provisions of the 1996 Health Insurance Portability and Accountability Act, or HIPAA. Saint Mary's said she suffered severe low blood pressure and a lack of oxygen to the brain during the April 1 surgery to remove her appendix and explore the cause of unspecified abdominal pain, according to court documents. Reported by SeattlePI.com 14 hours ago.

As the year comes to a close, economists are looking ahead to next week's December jobs report--the final update on the labor market for 2015. With few year-end economic surprises and the recent Fed interest rate hike behind us, most analysts are expecting steady job growth and a moderate pick up in wages. Here's what we'll be watching for on Friday:
· Non-farm payrolls up 190,000 jobs.· Unemployment rate steady at 5.0 percent.· Labor force participation rate down to 62.3 percent.· Average hourly wages up 2.5 percent from one year ago.
*America's Big Benefits Shift*
Beyond the top-line numbers, one issue we've watched this year is whether America's slow wage growth is partly explained by a shift from wages to benefits. This month, we took a closer look at the official data, which comes from the BLS "Employer Costs for Employee Compensation Survey." Let's look at a few interesting trends we uncovered.

*Trend #1: Benefits are growing faster than wages--and have been for a decade. *
During the past decade, benefits--what economists call "non-wage compensation"--have dramatically outpaced wage growth. This includes monetarily measurable benefits like health insurance, paid vacation, free meals and more. In the 43 quarters since 2005, average U.S. benefits grew faster than wages in all but three quarters, all of which occurred during the tumultuous times of late 2008 and 2009. This trend is illustrated in the top figure below. Whatever is behind America's big shift from wages to benefits, it's been around for more than a decade.

As benefits have outpaced wages, the fraction of workers' pay in the form of benefits rather than wages has been growing over time. This is illustrated in the bottom figure below. It shows the dramatic rise in the ratio of benefits to wages for U.S. workers since 2005. As is clear from the chart, while this trend has accelerated since the end of the Great Recession in 2010, it reflects a longer-term structural shift rather than an ephemeral quirk of the latest business cycle.

Source: BLS "Employer Costs for Employee Compensation Survey".

*Trend #2: Most of the shift toward benefits is at America's big companies.*
Not all U.S. workers are experiencing the shift toward benefits illustrated above. The largest U.S. companies (more than 500 employees) are driving nearly the entire trend. By contrast, benefits have shifted little at the nation's smaller companies with fewer than 100 workers.

The figure below shows the ratio of benefits to wages over time by size of employer, ranging from small businesses with 1 to 49 workers to large corporations with 500 or more employees. The data suggests that big companies drive the trend from wages to benefits. At firms with 500 or more workers, there is a pronounced upward trend in the ratio of benefits to wages since 2004. By contrast, the ratio of benefits to wages has been essentially flat for small and medium-sized employers with less than 100 workers.

The data shows that America's big shift toward benefits is primarily happening within the nation's largest employers.

Source: BLS "Employer Costs for Employee Compensation Survey".

*Trend #3: High-skilled, white collar and union jobs are driving the shift toward benefits. *
Not all jobs are experiencing this overall shift from wages to benefits. It is sharply divided by occupation. Most growth in benefits today is occurring among high-skilled workers in either white collar jobs or in fields with large numbers of union-represented workers such as construction and skilled trades.

The figure below shows occupations with some of the largest and smallest shifts toward benefits in recent years. On the left, are jobs with steady growth in benefits versus wages. This list is dominated by highly skilled professional workers, which include workers in tech jobs, management and finance, as well as heavily unionized jobs in construction and transportation.

In the bottom figure are jobs where the ratio of benefits to wages has been flat or declining. This list is dominated by lower-skilled jobs in service, production, sales, and installation, maintenance and repair where unions are far less prevalent. Although not shown here, unionized workers overall have experienced a much more dramatic shift toward benefits than non-union workers over the past decade, regardless of occupation.

The shift toward benefits is clustered among American workers with the strongest bargaining power in the economy: high-skilled workers and those with organized union representation.

Source: BLS "Employer Costs for Employee Compensation Survey".

*Trend #4: Not all industries are shifting toward benefits from wages. *
While the overall trend toward benefits is up, it is being driven by a handful of industries. The figure below shows U.S. industries with the fastest and slowest growth in the ratio of benefits to wages in recent years.

Overall, the pattern is similar to the view by occupations above. In the top figure are industries with large numbers of skilled, white-collar workers experiencing a greater shift toward benefits. This list includes professional services, insurance, information, and nursing care facilities industries.

By contrast, in the bottom figure are industries relying more heavily on low-skilled jobs that have experienced less of a shift toward benefits in the past decade. This includes the retail, wholesale, accommodation and food services, and administrative and waste services industries, all of which have experienced a flat or declining ratio of benefits to wages in recent years.

Source: BLS "Employer Costs for Employee Compensation Survey".

*Lessons for Workers*
Why are U.S. employers shifting from wages to benefits? There are many plausible theories: tax savings, rising health care costs, competition for key employees, quirks of the business cycle, and more. The goal of our analysis was to look deeper into the data to see if any of these explanations can be ruled out.

Based on the patterns above, it seems unlikely that taxes are driving the shift--there just haven't been large enough tax changes since 2004 to explain the pattern. Similarly, we can safely rule out the theory that this is a cyclical quirk in the data, as the trend began long before the last recession. Similarly, if rising health care costs were the main driver we'd expect the shift to be more widespread among industries.

The most likely explanation may be one of the oldest ideas in economic theory: a concept known as "diminishing marginal utility of income." Workers with low wages care mostly about taking raises in the form of cash. But beyond a certain income level, there's strong evidence from research that workers start caring about other things beyond salary. The "utility" or happiness workers get from an extra dollar of pay falls as incomes rise--and at some point benefits start to look more attractive than a cash raise.

One clear example of this is paid parental leave. This is a benefit that is hard for workers of any income to purchase. Without company-sponsored parental leave, some workers are fearful that time off for family may hurt career prospects. And a higher paycheck won't solve this problem--it's a dilemma faced by both low- and high-income workers alike. But once a specific salary level is reached, it's easy to imagine workers preferring a company-sanctioned parental leave plan to a cash pay raise because it protects their career path while they take time off.

The growing preference workers have to benefits over wages is economic behavior that is likely a major force driving today's shift toward benefits. And it explains why the shift is happening more often clustered among America's most highly sought-after (or well organized) workers. As pay reaches beyond the level needed for the basics, more workers may find themselves earning enough to put pay raises aside and instead negotiate for employer-provided benefits that are hard to buy in the marketplace, but that make huge improvements in the quality of life in the workplace.

To speak with Dr. Andrew Chamberlain about this month's jobs report or labor market trends, contact pr [at] glassdoor [dot] com. For the latest economics and labor market updates, subscribe to email alerts here and follow @adchamberlain.

This article originally published on Glassdoor Economic Research.

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 13 hours ago.

We are beginning to see signs that Congress may be willing to move beyond the partisan divide over the Affordable Care Act (ACA), which hopefully means that we can fix problems with current law, build upon what is working, and continue to make progress in improving our nation's health care system. It is about time.

Nearly six years ago, the ACA was passed and it has made significant headway in cutting the uninsured rate in the country through an expansion of Medicaid for millions of low-income adults, the elimination of pre-existing conditions exclusions and annual or lifetime limits imposed by private health plans, and through the creation of tax credit subsidies to assist millions of other uninsured Americans purchase private health insurance. According to Dan Diamond's analysis in Forbes of recent data from the Centers for Disease Control and Prevention (CDC), "Nearly 16 million fewer Americans were uninsured in early 2015 compared to 2013."

However, beyond that and the extension of the bipartisan and wildly popular Children's Health Insurance Program (CHIP) last March, health policy has been largely stuck in partisan gridlock. Rather than work to fix problems that have arisen with the ACA, many of the opponents of "Obamacare" have insisted "every single word" of the bill be repealed, but that would have the effect of cutting off millions of people from health coverage and disrupting health coverage for millions of others. At the same time, proponents of the law have often displayed knee-jerk opposition to "opening up the legislation" to any changes, even to problems with the law. Gridlock has largely been the result.

Breaking the impasse, Sens. Dean Heller (R-NV) and Martin Heinrich (D-NM) and Rep. Joe Courtney (D-CT) came together on a bipartisan basis to introduce legislation to repeal the High-Cost Plan Excise Tax (otherwise referred to as the "Cadillac tax") in the ACA. The "Cadillac tax" would have imposed a non-deductible excise tax of 40 percent on the value of employer-sponsored health coverage that exceeds certain benefit thresholds: $10,200 for self-only coverage and $27,500 for family coverage in 2018. Although Congress and President Obama did not agree to a full repeal of the tax, they reached an agreement to delay the tax for two years.

In support of the legislation, Sens. Heller and Heinrich argued:
The Cadillac tax will hurt middle-class families who, for reasons outside of their control, have health plans that already or soon will reach the Cadillac tax's cost limits. The tax will force many employers to pay steep taxes on their employees' health plans and flexible spending accounts, and possibly eliminate some employer-provided health coverage plans altogether. Under this tax, deductibles will be even higher and benefits will be reduced even more --putting a strain on middle-class families trying to make ends meet.
Although the term "Cadillac tax" implies it would only impact high-cost, "gold-plated" health plans, in a 2014 Towers Watson survey of employers, 82 percent thought the tax could impact their health plan by 2023. And to avoid the excise tax, an Aon Hewitt survey found one-third of employers were looking to pass-on "higher out-of-pocket costs" in their employee and family health plans.

Consequently, both employers and employees were becoming increasingly concerned about the Cadillac tax. According to Heller and Heinrich:
Organized labor, chambers of commerce, local and state governments, small businesses, and rural electric co-ops have come together to express the same concern: the Cadillac tax needs to be fully repealed or our employees will experience massive changes to their health care.
Another important group that is infrequently mentioned, but who would be disproportionately harmed, are children and those with family coverage. In a 2009 First Focus/Economic Policy Institute analysis by Elise Gould on the impact of excise taxes that were included in various health proposals prior to the passage of the ACA (including those in presidential candidate John McCain's 2008 health plan and President Bush's 2009 budget proposal), tax caps on employer-based family plans were often set for family plans at just two times that of individual coverage. However, since the cost for family coverage has historically been much higher than that, these caps would have more heavily and disproportionately short-changed family coverage.

Recognizing this, the ACA's congressional authors revised the initial legislative limits and set a higher, and yet, still arbitrary cap on family coverage. As a result, the law's Cadillac tax was established at an amount that was 2.7 times the cost for family plans than for single coverage ($27,500 for family plans to $10,200 for individuals) - a wider spread than at the levels set in previous ACA drafts. However, according to a 2015 Kaiser Family Foundation/Health Research & Education Trust (HRET) Survey of Employer-Sponsored Health Benefits, the average premium for family coverage is actually 2.81 times that of single coverage, so the ACA's Cadillac tax would still hit family plans disproportionately.

As an example, Table 1 outlines the impact that the Cadillac tax would have had on a hypothetical company with 100 workers and premiums of $10,300 for individual coverage (50 employees) and $28,910 for family coverage (50 employees) in 2018. Reflecting the average 2.81 family-to-individual cost per plan ratio, both the individual and family coverage would exceed the threshold slightly, but enough to trigger the tax.

As this scenario demonstrates, kids and families would largely bear the brunt of the excise tax. In fact, the taxable amount would be more than 14 times greater for family plans than for individuals. Moreover, in this example, 94 percent of the Cadillac tax would fall upon family plans and, therefore, the children and families enrolled in them.

Although some employers might pay the tax, the more likely scenario is that employers would increase deductibles, limit benefits, or impose higher cost sharing upon families to lower the cost of the insurance coverage below the cap. However, this merely shifts the cost of coverage to families and will make it unaffordable for some, particularly since families already absorb a much higher share of the premium costs in employer-sponsored coverage than individual workers.

According to the Kaiser/HRET 2015 survey, "Covered workers contribute on average 18 percent of the premium for single coverage and 29 percent of the premium for family coverage." Consequently, the average annual worker's contribution toward the premium is $1,071 ($89 per month) for individual coverage and $4,955 ($413 per month), or 463 percent more for family plans.

Since those numbers reflect the average, the disparity is, by definition, even worse than that for half of families. The Kaiser/HRET survey, for example, found that 45 percent of all firms surveyed "contribute the same dollar amount for family coverage as for single coverage." In such firms, 100 percent of the added costs of family coverage are absorbed entirely by the employee.

The share of premiums absorbed by workers is also greater for family plans in small firms or in firms with a higher percentage of lower-wage workers (defined as having at least 35 percent of workers earn $23,000 a year or less): 36 percent and 41 percent, respectively. For many families, these higher premiums along with limited benefits and higher out-of-pocket costs, including rapidly rising deductibles, have had the effect of making health coverage increasingly unaffordable to many families. This is a major reason why 59 percent of adults but just 47 percent of children have health coverage through employer-sponsored health insurance.

Consequently, delaying or eliminating the Cadillac tax is important in protecting when tenuous health coverage some families currently have for their children. This is why First Focus Campaign for Children joined groups like the American Cancer Society Cancer Action Network and the National Association of Counties as members of the Alliance to Fight the 40 in support of the Heller/Heinrich and Courtney bills.

Although support for continuation of the Cadillac tax largely came from some of the law's supporters, the fact is that delay or outright repeal of the Cadillac tax is actually quite consistent with one of the prime objectives of the ACA, which the Department of Health and Human Services explains is to "[m]ake coverage more secure for those who have insurance, and extend affordable coverage to the uninsured." If the Cadillac tax had been allowed to take effect, it would have weakened health coverage for a number of individuals and families.

Furthermore, delay or repeal of the excise tax helps fulfill the Administration's oft-mentioned promise that the law protects and even strengthens current private coverage. As the President said at a Town Hall meeting in Grand Junction, Colorado, on Aug. 15, 2009:
I just want to be completely clear about this. I keep on saying this but somehow folks aren't listening -- if you like your health care plan, you keep your health care plan. Nobody is going to force you to leave your health care plan.
Since the Cadillac tax would undermine private coverage by making it more unaffordable for a rapidly increasing number of families over time, many supporters of Obamacare, including Rep. Joe Courtney, a majority of the 184 cosponsors of Courtney's bill, and Democratic presidential candidates Hillary Clinton and Bernie Sanders, support its repeal.

Many ACA supporters also recognize that, as employers moved to raise deductibles, reduce benefits, or increase other out-of-pocket costs to meet the caps established by the Cadillac tax, they could and some have already, as Michael Hiltzik of the Los Angeles Times explains, "scapegoated Obamacare" for the cost-shifting to employees.

This is, in part, why some opponents of Obamacare actually opposed the delay of the Cadillac tax. In a recent Op-Ed, Mike Needham of Heritage Action for America correctly pointed out that the excise tax "forces employers to cut back the coverage that they offer" and that its repeal would help "stabilize Obamacare." However, since he opposes the ACA, Needham argued against delaying or repealing the Cadillac tax because leaving in place such "adverse effects" would help undermine the law.

Since the Cadillac tax was delayed for two years, this debate will need to be revisited prior to 2020. Fortunately, with bipartisan extension of CHIP last spring and the Cadillac tax's delay, Congress seems to be beginning to show important signs of moving past the partisan divide to a better place where we can once again work, on a bipartisan basis, toward improving our nation's health care system.

For children, the CDC estimated in early 2015 that less than 5 percent of our nation's children were uninsured - down from 14 percent in 1997 when CHIP was first enacted into law. In fact, since CHIP's passage, the uninsured rate for kids has been cut by nearly two-thirds.

To continue that progress, we should simultaneously reject proposals, such as Medicaid block grants or the Cadillac tax, that would destabilize the progress that has been made in recent years, while continuing the march toward the "Finish Line" goal of ensuring every child in America has comprehensive, child-centered, quality health coverage.

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 12 hours ago.

WASHINGTON (AP) — Rep. Steve Israel of New York, a member of the House Democratic leadership in his eighth term in Congress, said Tuesday he will retire at the end of this year. "Simply put, it's time to pass on the torch," Israel said in a statement announcing the unexpected move.

Israel, 57, is a top ally to House Minority Leader Nancy Pelosi of California, and serves as her chair of policy and communications, a position she created for him.

He's among those seen as a possible successor to Pelosi. But in a statement Israel said it is time to pursue new passions and develop new interests, and spend more time writing his second novel, a satire about the gun lobby.

He said that by retiring in a presidential election year he will help ensure that his district stays in Democratic hands because of the high Democratic turnout in a presidential year. Israel represents northern Long Island and eastern Queens, and his district is narrowly divided between Democratic and Republican voters.

"It has been an incredible and humbling opportunity to serve my community. I am grateful to my family, friends, staff, and most of all - the people of New York," Israel said. "While I will miss this place and the people I have had the privilege to serve, I am looking forward to spending more time home and frequenting my beloved New York diners. Simply put, it's time to pass on the torch."Friendly and outspoken, Israel has been an able spokesman for his party but has broken with President Barack Obama on some issues, including the Iran nuclear deal. He led efforts to elect Democrats to the House as chairman of the Democratic Congressional Campaign Committee.

But with Democrats in the minority and Pelosi and other top Democrats in the House showing no immediate signs of moving on, Israel's path for advancing in the House was unclear.

"Congressman Israel's deep understanding of the concerns and aspirations of the American people have been invaluable to the Congress and to our country," Pelosi said. "America's working families have always had a champion in Steve Israel."

In his statement Israel cited his work on behalf of New York veterans and military families, including securing $8.3 million in back pay, as his proudest achievements.

"I considered this decision deeply, but ultimately, I want to be a team player and ensure that my district, which is the only competitive district in House Democratic leadership, remains in the hands of Democrats when I leave," he said.

In an interview with the website PJ Media earlier this year, Israel described his upcoming second novel, "Big Guns," as a satire on the gun lobby. He said the premise was that a Republican-controlled Congress would require all Americans to own a gun as a life insurance policy, similar to the requirement in Obama's health law for all Americans to carry health insurance.

*Also on HuffPost: *

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 10 hours ago.

A few years back, many predicted that requiring businesses to offer their employees health coverage or pay a penalty would be ruinous for companies across the nation. The provision, often called the Employer Mandate, reached full implementation on New Year's Day with little fanfare or protest, along with a raft of changes to plans offered by Covered California, the state's health insurance exchange. Reported by San Jose Mercury News 10 hours ago.

Here is the surest way to enjoy the peace of mind that comes with having health insurance: Don't get sick. Reported by TwinCities.com 7 hours ago.

These are my health care predictions for 2016: Prediction No. 1: Your beloved PPO is becoming extinct. This was a bold prediction I made back in 2013, and while it still hasn't come true yet, give it time. It may not even be in 2016, but I can guarantee you, the PPO is going the way of the dinosaurs. Here's why. They cost too much and there is no way to keep all you PPO lovers from over-using health services. By now, you already know that I'm the No. 1 PPO lover in America -- along with some of… Reported by bizjournals 3 hours ago.

Washington D.C., Jan 6, 2016 / 03:47 am (CNA/EWTN News).- Religious sisters should not be forced to choose between caring for the poor and obeying their conscience, the Little Sisters of the Poor told the Supreme Court in a recent legal brief, adding that this is what the government is demanding of them through the HHS mandate.

“As Little Sisters of the Poor, we offer the neediest elderly of every race and religion a home where they are welcomed as Christ,” said Sister Loraine Marie Maguire, mother provincial of the Little Sisters of the Poor.

“We perform this loving ministry because of our faith,” she continued, adding that the Little Sisters “cannot possibly choose between our care for the elderly poor and our faith, and we shouldn’t have to.”

Sister Maguire’s comments came Jan. 4, as the Little Sisters filed their Supreme Court brief against the federal contraception mandate.

The case will be heard this Supreme Court term as part of a bundle of cases against the administration’s contraceptive mandate. Representing the Little Sisters and several other plaintiffs in the case is the Becket Fund for Religious Liberty, which filed the brief before the court on Monday.

At issue is a mandate from the Department of Health and Human Services requiring employers to offer health plans covering free contraception, sterilization and some drugs that can cause early abortions.

The Obama administration established narrow religious exemptions for houses of worship and their affiliated groups, but many religiously-affiliated charities, non-profits, and businesses that morally objected to the mandate were required to abide by it.

In response to widespread protest and lawsuits from hundreds of plaintiffs across the country, the administration later offered an “accommodation” to certain objecting religious non-profits, under which they could notify their insurer of their conscientious objection, and the insurer would then fund the coverage.

Critics charged that the financial costs for the objectionable coverage would still be passed on to the employers, and the groups said they would still be forced to act against their religious beliefs by having to “facilitate access” to the services.

Many religious non-profits – including charities, schools, and dioceses – took their cases against the mandate to court. The Little Sisters lost their case at the Tenth Circuit Court of Appeals in July 2015 after the court ruled that the “accommodation” offered to the sisters did not substantially burden their sincerely-held religious beliefs.

The sisters applied for and received an injunction from the mandate in August, and in November the Supreme Court agreed to hear their case along with the other plaintiffs.

Pope Francis offered a gesture of support for the sisters when he made an unscheduled stop Sept. 23 at their Jeanne Jugan Residence for the low-income elderly in Washington, D.C. during his U.S. visit. The visit was meant as a “sign of support” for the sisters as the Supreme Court was considering taking their case, director of the Holy See Press Office Fr. Federico Lombardi later confirmed to the media.

Ultimately, the brief claims that the government is violating federal law by speaking for the sisters in saying that the accommodation is compatible with their religious beliefs.

The federal law in question, the 1993 Religious Freedom Restoration Act, provides that when a government action violates a person’s sincerely-held religious beliefs, the burden of proof is on the government to establish that the action furthers a compelling state interest and is the least-restrictive means of doing so.

Furthermore, though the government may disagree with the person’s religious objections, it may not determine for that person that his conscientious objection is groundless, the brief says.

The administration “wants petitioners to do precisely what their sincere religious beliefs forbid –and it is threatening them with draconian penalties unless they do so,” the document states. “The government’s refusal to acknowledge as much is nothing more than a forbidden attempt to secondguess petitioners’ sincere religious beliefs that the actions the government has demanded of them would constitute sin.”

Additionally, the fact that the administration exempted some employers from the mandate for other reasons undermines their claim that contraception coverage is a compelling interest, since they are not requiring all employers to provide it, the brief claims.

For instance, the health care law exempted “grandfathered plans,” or certain health plans that existed before the law was passed, from having to follow the preventive services mandate, even though it required those plans to offer other coverage benefits, the brief says.

This means that many current plans offered by companies with 200 or more employees are exempt from the contraception mandate, while small businesses with 50 or less employees are exempt from having to provide health insurance altogether.

Furthermore, houses of worship – even those that do not object to the mandate – are exempt from it, meaning that a church could refuse to provide contraception coverage simply out of convenience and not face a penalty.

“If its interests were truly compelling, the government would not exempt the employers of tens of millions of employees from the mandate for mere administrative convenience,” the brief states.

“All we ask is that our rights not be taken away,” Sister Maguire said. “The government exempts large corporations, small businesses, and other religious ministries from what they are imposing on us – we just want to keep serving the elderly poor as we have always done for 175 years.”

  Reported by CNA 1 day ago.

This story is part of our month-long “Work Well” initiative, which focuses on thriving in the workplace -- staying healthy and free of anxiety even in the midst of difficult work conditions. The series presents creative solutions you can use to take care of yourself as you take care of business. You can find more stories from this project here.

The way we work doesn’t really seem to be working. 

Americans are working longer and harder hours than ever before. Eighty-three percent of workers say they’re stressed about their jobs, nearly 50 percent say work-related stress is interfering with their sleep, and 60 percent use their smartphones to check in with work outside of normal working hours. It’s no wonder that only

13 percent of employees worldwide feel* *engaged in their occupation.

Glimmers of hope, however, are beginning to emerge in this bruising environment: Americans are becoming aware of the toll their jobs take on them, and employers are exploring ways to mitigate the harmful effects of stress and overwork. Yet much more work remains to be done.

The modern work world is a “broken and antiquated system,” according to Anne-Marie Slaughter, author of Unfinished Business: Men Women Work Family.

“For many Americans, life has become all competition all the time,” Slaughter wrote in a September New York Times opinion piece, “A Toxic Work World.” “Workers across the socioeconomic spectrum … have stories about toiling 12- to 16-hour days (often without overtime pay) and experiencing anxiety attacks and exhaustion. Public health experts have begun talking about stress as an epidemic.”

Dr. Emma Seppälä, scientific director of Stanford’s Center for Compassion and Altruism Research and Education and author of The Happiness Track, agreed. 

“When you look at what's going on, there’s so much stress,” she told The Huffington Post. “What we're seeing is that people are working longer hours, and there's less boundaries between work and personal life because of technology. Even when people go on vacation, a large percentage them check in with work.”

To call stress an epidemic isn’t hyperbole. The 83 percent of American employees who are stressed about their jobs -- up from 73 percent just a year before -- say that poor compensation and an unreasonable workload are their number-one sources of stress. A 2014 study from the University of Montreal and Concordia University also found that workplace stressors including demanding bosses, unrealistic deadlines, long hours and low pay are contributing to rampant stress and burnout.

And if you suspected that the workplace had gotten more stressful than it was just a few decades ago, you're right. Stress levels increased 18 percent for women and 24 percent for men from 1983 to 2009, according to Carnegie Mellon data.

Stress is also starting earlier in life, with some data suggesting that today's teens are even more stressed than adults. And the anxiety levels of the average high schooler today are as high as that of the average psychiatric patient in the early 1950’s, according to another estimate.

Stress is taking a significant toll on our health, and the collective public health cost may be enormous. Occupational stress increases the risk of heart attack and diabetes, accelerates the aging process, decreases longevity, and contributes to depression and anxiety, among myriad other negative health outcomes. Overall, stress-related health problems account for up to 90 percent of hospital visits, many of them preventable. Your job is “literally killing you,” as the Washington Post put it.

It's also hurting our relationships. Working parents say they feel stressed, tired, rushed and short on quality time with their children, friends and partners, according to a new Pew Research Center survey.


“The boundaries are so blurred that work and life have become one in the same."

Seven in 10 workers say they struggle to maintain work-life balance, according to a survey conducted last year. As technology (and with it, work emails) seeps into every aspect of our lives, work-life balance has become an almost meaningless term.

“The boundaries are so blurred that work and life have become one in the same,” Seppälä told HuffPost.

Add a rapidly changing economy and an uncertain future to this 24/7 connectivity, and you’ve got a recipe for overwork, according to Phyllis Moen, a University of Michigan sociologist who studies careers, families and well-being.

“There's rising work demand coupled with the insecurity of mergers, takeovers, downsizing and other factors,” Moen said. “Part of the work-life issue has to talk about uncertainty about the future.”

 

*An Outdated Model*

These factors have converged to create an increasingly untenable situation with many employees overworking to the point of burnout.

Gustavo Tanaka, co-founder of Brazilian start-up incubator Baobba Lab, put it bluntly: “No one can stand the employment model any longer.”

“We are reaching our limits. People working with big corporations can't stand their jobs,” Tanaka wrote in a Huffington Post blog on Dec. 16. “People want out. They want to drop everything. Take a look on how many people are willing to risk entrepreneurship, people leaving on sabbaticals, people with work-related depression, people [experiencing] burnout.” 

It’s not only unsustainable for workers, but also for the companies that employ them. Science has shown a clear correlation between high stress levels in workers and absenteeism, reduced productivity, disengagement and high turnover.

"I think we're at a tipping point in the sense that this is no longer sustainable,” Seppälä said. “We're seeing that approximately 75 percent of workers are disengaged, and it’s costing the economy an enormous amount of money in stress and turnover.”

Too many workplace policies effectively prohibit employees from developing a healthy work-life balance by barring them from taking time off, even when they need it most, such as when they become parents or caretakers, or when they fall ill.


"I think we're at a tipping point in the sense that this is no longer sustainable."

The U.S. trails far behind every wealthy nation -- and many developing ones -- that have family-friendly work policies including paid parental leave, paid sick days and breast-feeding support, according to a 2007 study from researchers at Harvard and McGill University. The U.S. is also the only advanced economy that does not guarantee workers paid vacation time, and it's one of only two countries in the world that does not offer guaranteed paid maternity leave (the other is Papua New Guinea).

But even when employees are given paid time off, workplace norms and expectations that pressure them to overwork often prevent them from taking it. Full-time employees who do have paid vacation days only use half of them on average, according to a 2014 survey from Harris Interactive. 

Karen Firestone, CEO of Boston-based finance firm Aureus Asset Management, recently documented a bizarre phenomenon in her office. She noticed that employees were slipping away for “stealth vacations.” Reluctant to take any time off, when people did take off for a day or two off, they would keep it quiet and not communicate their schedule with others on the team.

Firestone chalks it up to American workers’ vacation-phobia, the unfortunate result of factors including “an aversion to piles of work on return, the fear of being replaced, or a ‘martyr complex’ that holds that the office can’t run smoothly without me.”

 

*The Challenge of Constant Connectivity    *

Our modern workplaces also operate based on antiquated time constraints.

The practice of clocking in for an eight-hour (or longer) workday is a hangover from the days of the Industrial Revolution, as reflected in the then-popular saying, “Eight hours labor, eight hours recreation, eight hours rest.”

We’ve held on to this workday structure -- but thanks to our digital devices, many employees never really clock out. Today, the average American spends 8.8 hours at work each day, and the the majority of working professionals spend additional hours checking in with work during evenings, weekends and even vacations.

The problem isn’t the technology itself, but that the technology is being used to create more flexibility for the employer rather than the employee, according to Moen. In a competitive work environment, employers are able to use technology to demand more from their employees rather than incentivizing workers with flexibility that benefits them. 

“There's one new kind of flexibility, and that's the employer's flexibility to hire or fire at will,” she said. “That's at odds with the mental health of employees. And when there are fewer employees, the ones who survive are expected to work harder -- plus, they work harder because they want to show that they shouldn’t be laid off.”


When there are fewer employees, the ones who survive are expected to work harder -- plus, they work harder because they want to show that they shouldn’t be laid off."

Theresa Sullivan, a sociologist at the University of Virginia, has referred to such corporations that demand too much commitment from their employees, as “greedy institutions.”

“Many workplaces are becoming greedier, and their increasing greediness is abetted by several factors—high unemployment rates, relentless cost-cutting, and continuous connectivity,” Sullivan wrote in a paper published last year in the journal Sociological Inquiry, adding that constant connectivity is the “greatest enabler of greediness.”

In a study published in the Journal of Occupational Health Psychology last year, psychologists coined the term “workplace telepressure” to describe an employee’s urge to immediately respond to emails and engage in obsessive, ruminating thoughts about returning an email to one's boss, colleagues or clients. The researchers found that telepressure is a major cause of stress at work, which over time contributes to physical and mental burnout.

Of the 300 employees who participated in the study, those who experienced high levels of telepressure -- which was largely predicted by their workplace culture and expectations -- were more likely to agree with statements assessing burnout, like "I have no energy for going to work in the morning," and to report feeling fatigued and unfocused. Telepressure was also correlated with sleeping poorly and missing work.

Harvard Business School professor Leslie Perlow, author of Sleeping with Your Smartphone, explains that when people feel the pressure to be always “on,” they find ways to accommodate that pressure -- including altering their schedules, work habits and interactions with family and friends.

Perlow calls this vicious cycle the “cycle of responsiveness”: Once bosses and colleagues experience an employee’s increased responsiveness, they increase their demands on the employee’s time. And because a failure to accept these increased demands indicates a lack of commitment to one’s work, the employee complies.

“Being caught in this cycle has profound implications not just for our work lives but also for our work processes,” Perlow wrote in Harvard Business Review in 2013. “When we are trapped, we don’t think about better, faster, and more effective ways of working. Rather, we just keep working more and more, perpetuating and amplifying the bad intensity in our work — those unnecessary iterations, the lack of communication and alignment, the last-minute, late-night changes and those weekend ‘emergencies’ that get in the way of doing our best at work and having time for life outside of work.”

A study published in the Journal of Management examined the ways that technology changes the traditional temporal structure of work, blurring the boundaries between work and personal life. The researchers found that employees who were more ambitious and cared about their work were more likely to meet these expectations to be "always on" -- and also to experience more work-life conflict.

 

*Fixing What’s Broken  *

To address skyrocketing employee stress levels, many companies have implemented workplace wellness programs, partnering with health care providers that have created programs to promote employee health and well-being.

The Centers for Disease Control and Prevention recently declared that workplace wellness has become a “vital piece of a healthy lifestyle.” Workplace wellness programs were even included in the Affordable Care Act in 2014, which created new incentives for employers to create healthy workplaces and support wellness programs.

Corporate wellness programs are “our biggest hope for fixing a national health crisis,” according to Cortney Rowan and Karuna Harishanker, design strategists at Altitude, a Massachusetts-based product innovation firm.

Some research does suggest that these programs hold promise. A study of employees at health insurance provider Aetna revealed that the roughly one quarter of those who took in-office yoga and mindfulness classes reported a 28 percent reduction in their stress levels and a 20 percent improvement in sleep quality. These less-stressed workers gained an average of 62 minutes per week of productivity, which the company estimates to be worth $3,000 per employee per year.


“What we're trying to do is change the conditions of work that are creating the stress."

While yoga and meditation are scientifically proven to reduce stress levels, these programs do little to target the root causes of burnout and disengagement.

“Most of the intervention research that has been funded by the federal government and others is focusing on changing the individual -- meditation and yoga and things like that, looking at how you can deal with stress better,” Moen said. “What we're trying to do is change the conditions of work that are creating the stress, so that we can reduce the stress.”

The conditions creating the stress, according to the data, are long hours, unrealistic demands and deadlines, and work-life conflict.

Moen and her colleagues may have found the solution. In a 2011 study funded by the National Institutes of Health’s Work Family and Health Network, she investigated the effects of implementing a Results Only Work Environment, or ROWE, on the productivity and well-being of employees at Best Buy’s corporate headquarters in Minnesota.

For the study, 325 employees spent six months taking part in ROWE, while a control group of 334 employees continued with their normal workflow. The ROWE participants were allowed to freely determine when, where and how they worked -- the only thing that mattered was that they got the job done. The employees could decide if they wanted to work from home, start the day at 11 a.m., miss meetings (so long as a team member covered for them), or make any other personal accommodations as they saw fit.

The results were striking. After six months, the employees who participated in ROWE reported reduced work-family conflict and a better sense of control of their time, and they were getting a full hour of extra sleep each night. The employees were less likely to leave their jobs, resulting in reduced turnover. They were even more likely to go see a doctor if they needed to.

It’s important to note that the increased flexibility didn’t encourage them to work around the clock. "They didn't work anywhere and all the time -- they were better able to manage their work,” Moen said.  

“Flexibility and control is key,” she continued. “Many workers really feel like they cannot manage if they don't have more control over their work time.”

Another study, this one focussed on IT workers at a Fortune 500 company, found that when people were given greater control over when and where they worked, they reported experiencing significantly less work-family conflict over a six-month period and said that they felt less overwhelmed at work. 


People thrive in their jobs and become more fully engaged when they are given autonomy."

Seppälä agreed that flexibility can increase productivity and engagement while reducing burnout and work-life conflict. 

"Research shows that people thrive in their jobs and become more fully engaged when they are given autonomy," she said. "Allowing employees flexibility gives them a sense of autonomy."

 

A New Corporate America

Slowly but surely, things are beginning to change. Many companies across the country are implementing more family-friendly workplace policies and taking various measures to support employees' work-life balance. 

We may look back on 2015 as something of a tipping point for parental leave in the U.S. More and more corporations -- particularly in the tech world -- began upping their parental leave companies, in turn putting pressure on their competitors to do the same. 

Companies including Netflix, Microsoft, Facebook, Amazon and Goldman Sachs led the charge. Even the City of New York stepped up, announcing last month that it would double the length of paid parental leave (to a total of six weeks) for some 22,000 of its employees. Many companies are offering improved flexible family leave programs, according to a recent report from Lean In and McKinsey & Co. Unfortunately, more than 90 percent of male and female employees said they were reluctant to take advantage of these programs for fear of hurting their careers.

This sad statistic highlights the fact that creating new policies simply isn’t enough. If policy changes aren’t supported by cultural shifts, employees won’t feel comfortable following the new policies -- so for any real change to take place, leaders and managers have to model these new behavioral norms.

“Each good policy, even if adopted by the employer, can be undermined by subtle efforts to dissuade workers from using them,” Sullivan writes. “The manifest reasons can be numerous… pressing work deadlines; internal threats of reorganization and layoff; external threats from competitors, shareholder actions, mergers or acquisitions.”

Slowly, corporate cultures can be changed. Moen is optimistic about our ability to use technology to fix the biggest obstacles to employee well-being.

“Technology can be a double-edged sword -- it’s certainly increases workplace pressures, but it can also be a part of the solution,” she said. “It depends on whether we're focusing on the employer’s flexibility or the employee’s flexibility.”

In the meantime, regardless of what your employer has to offer, there are some measures that anyone can take to improve their wellness at work. *Click here to learn more. *

The Huffington Post’s “Work Well” series is also part of our "What's Working" solutions-oriented journalism initiative.

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Exclusive Conference Designed to Promote Best Practices and Generate New Ideas across the Industry

Wilmington, Del. (PRWEB) January 06, 2016

Emily Woodson, CFP®, partner at The Financial House and registered representative of Lincoln Financial Securities, recently attended the annual Barron’s Top Women Advisors Summit, an exclusive conference aimed at sharing best practices, generating new ideas across the industry, and advocating the value of advice to the investing public. Held on December 2 – December 4 in Palm Beach, Fla., the conference was attended by Barron’s “Top 100 Women Financial Advisors” and a select group of 400 additional female advisors representing the top level of performers within participating firms.

Attendees participated in peer-led sessions sharing wealth management strategies and heard from recognized keynote speakers from both inside and outside the industry.

“I am honored to have been part of a conference that recognizes high-performing women advisors,” said Woodson. “This is a growing field for women both as advisors and investors. The Barron’s conference offered a great opportunity to share ideas and knowledge on products, strategies and trends that will impact all of our clients.”

“Learning never ends for a financial advisor,” added Woodson. “We need to be well-versed on evolving products and strategies and on what’s going on in the world around us in order to guide our clients. It’s our responsibility to provide accurate information and use our knowledge so that clients can invest confidently.”

Woodson has been in the financial services industry since 2009. She serves on the Advisory Board for Lincoln Financial Securities and on the Delaware Board of the National Association of Insurance and Financial Advisors (NAIFA). She is a member of the Society for Financial Services Professionals (SFSP) and is a qualifying member of the Million Dollar Round Table (MDRT), an elite worldwide organization of financial professionals.

Woodson received a bachelor of arts degree from the University of Colorado and a master of education degree from Wilmington University. She holds the professional designations of CERTIFIED FINANCIAL PLANNER (CFP®) and holds FINRA series 7, 63 and 65 registrations, as well as licenses in life and health insurance.

The Financial House is located at 5818 Kennett Pike, Wilmington, Del.

About Lincoln Financial Network
Lincoln Financial Network is the marketing name for the retail sales and financial planning affiliates of Lincoln Financial Group and includes Lincoln Financial Advisors Corp. and Lincoln Financial Securities Corp., both members of FINRA and SIPC. Consisting of almost 8,500 representatives, agents, and full-service financial planners throughout the United States, Lincoln Financial Network professionals can offer financial planning and advisory services, retirement services, life products, annuities, investments, and trust services to affluent individuals, business owners, and families. Reported by PRWeb 21 hours ago.

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FARGO, N.D.--(BUSINESS WIRE)--The Healthcare Trends Institute (HTI) will sponsor a webcast to discuss the results of a national survey regarding healthcare benefits trends, including defined contribution and insurance exchanges, wellness and healthy lifestyle programs and incentives, reform legislation such as the 2016 health insurance mandate for small employers and the 2018 Cadillac tax, and more. This free webcast scheduled for Wed., Feb. 3, 2016, at 11:00 A.M. CST will feature the following Reported by Business Wire 20 hours ago.

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"The junk merchant doesn't sell his product to the consumer, he sells the consumer to his product. He does not improve and simplify his merchandise. He degrades and simplifies the client." -- William S. Burroughs (Naked Lunch)
Heroin is the dark, dirty secret of America today. Few people recognize the devastation wrought by this drug across wide swathes of America and across the border in Mexico. Media coverage has been inexplicably muted and even more strange is the lack of opinion on the causes of this unprecedented epidemic.***Let's start with some cold, hard numbers:
· 4.2 million people in the United States have used heroin at some point in their lives.
· 517,000 currently fulfill the criteria for heroin dependence.
· The CDC stated that 11,000 deaths from heroin overdose occurred in 2014 .
· Furthermore, between 2010 and 2014 deaths from heroin overdoses have quadrupled.
· New Hampshire has already set a record for heroin overdose related deaths in 2015 and even West Coast states that had been spared the heroin scourge are seeing record numbers of fatalities from heroin overdose.
· In 2010, the heroin market in America was estimated at27 billion. Since the number of estimated heroin dependent users has risen from approximately 335,000 to 517,000 it would not be speculation that this would be approaching40 billion, a number hitherto only associated with marijuana, a drug used by up to 20 million Americans.
· Heroin has become the most lucrative product of the Mexican cartels and Mexico has replaced Afghanistan as the main supplier of heroin to the United States. These cartels are estimated to be doing40 billion worth of business in marijuana, heroin and cocaine in the United States.
· By some estimates 55 percent of the 164,000 homicides in Mexico since 2007 have been those killed in turf wars and assassinations of suspected police informers as a consequence of this drug trade. This is roughly equal to the number of combined deaths that have occurred in Afghanistan and Iraq during the same period.
· To conclude the heroin stats, the last reliable figures for what heroin costs to the economy were in the tune of 21 billion. The year was 1996.

***This does not even begin to tell the story of the human and emotional cost that heroin addiction places on individuals, families and treatment providers. Being the parent, spouse or child of a heroin user is a never-ending nightmare, swinging between being enraged at the individual and terrified for their lives.

So what has led to this resurgence of a drug that had since the 1980s largely been replaced by cocaine, methamphetamines and benzodiazepines? To begin answering this question, let's look at another set of statistics, these even more disturbing than the ones related to heroin.

"Heroin is the dark, dirty secret of America today."

An estimated 20,000 people fatally overdosed on prescription opioid painkillers in 2014 which is 9,000 more deaths than those from heroin overdose. An estimated 2.1 million people are addicted to prescription painkillers. The number of opioid painkiller prescriptions dispensed has risen from 43.8 million in 2000 to 89.2 million in 2010, an increase of 104 percent.

This increase in prescriptions has not corresponded to any improvement in pain control or disability outcomes. What it has clearly corresponded to is the deadly march of heroin across America.

Let me illustrate this with one variation of the same story that I have heard from more patients than I care to recall:
John experienced a rotator cuff injury while playing football. He was prescribed a month's supply of Percocet which he ran out of in three weeks. He told his doctor he was still in excruciating pain. He was given a higher dose which he promptly ran out of in three weeks. His doctor cautioned him about the risk of opioid addiction but offered another month's worth of Percocet.

The next time he returned to his physician he was told that he was abusing the medication and refused further prescription. John experienced withdrawal and spoke to a friend of his who he used to buy marijuana from. The friend told him he knew someone who could sell him Percocets for $5 a pill.

John bought Percocet for over a year from this man but by this time his tolerance to Oxycodone had increased to the point that he needed to take up to 40 pills a day. He had also developed liver damage from the massive amounts of Tylenol in the Percocet. He could no longer afford the Percocet and spoke to his dealer who told him there was a guy he knew who could sell him heroin for $10 a bag.

John now shoots up two to three times a day.
This story can be repeated every day in every town, in every county, in every state across America. The heroin epidemic cannot be curbed until the epidemic of prescription painkillers is halted. Since the spike in the use of these drugs does not seem to correspond to any improvement in treatment outcomes, it is high time doctors, hospital administrations, pharmaceutical companies, health insurance companies and medical technology companies collaborated on coming up with alternatives.

In any case, the 25.3 million Americans who struggle with intractable chronic pain are enough of a reason to improve methods of non-narcotic pain control, their delivery to the target population as well as their affordability.

"Whether in physical or emotional pain, it is a pill we look to for answers. ... We have forgotten how to respect our bodies, yet we try and make them do whatever it is we wish them to do."

Beyond the prescription opioid factor, it is also time to confront the cultural phenomena that predispose Americans to drug addiction. The supply of drugs, both prescription and illicit, exists because the demand keeps increasing. Chronic pain may arise from unavoidable injuries or illnesses in some cases but in most it is a culmination of obesity, lack of exercise and not putting in the hard work necessary to deal with acute pain and injury.

Whether in physical or emotional pain, it is a pill we look to for answers. Sadly, modern medicine is teaching us to do so. The deluge of opioid painkillers is only one example; the field of psychiatry has become such that prescribing medication is effectively a first line treatment bypassing lifestyle change, exercise, psychotherapy and building a social support system.

But the process starts long before any pathology. We have forgotten how to respect our bodies, yet we try and make them do whatever it is we wish them to do. We kickstart our nervous systems with caffeine. We calm them down with alcohol. We jolt them with "raves" and "pharm parties"; we have reached a point where teenagers think it is "cool" to throw a collection of prescription pills in a bowl and enact a chemical Russian Roulette.

This requires introspection and reflection. This requires education.

*This must change.*_______________________Need help with substance abuse or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.

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WASHINGTON -- At long last, congressional Republicans have honored a pledge to conservatives and repealed President Barack Obama's landmark health care reform plan. Sort of.

A mere 2,116 days after Obama signed the Affordable Care Act, the House voted 240-181 Wednesday on a Senate-passed measure to eliminate the most important parts of Obamacare. 

Republican leaders are portraying the move as a promise fulfilled after dozens of previous House votes to repeal, defund or otherwise trash the Affordable Care Act. And the bill heading to the White House would indeed kill vital parts of the law, such as its health insurance subsidies, its expansion of Medicaid to low-income adults and the mandates that most Americans get health coverage and that large employers provide it to workers.

The next thing that will happen is the repeal bill will speed its way to Obama's desk, where he will promptly veto it and carry on with whatever else he was doing.

Self-congratulatory press conferences won't change the fact that Republicans haven't actually repealed anything and are nowhere near proposing their long-awaited "replacement" plan, despite new pledges from House Speaker Paul Ryan (R-Wis.) and other leaders.In the meantime, millions of Americans will continue enrolling in health insurance on the law's exchange marketplaces, and millions more will keep using the health plans and Medicaid benefits they already have.

Republicans took over the House in 2011 and the Senate in 2014. GOP leaders in both chambers spent months last year hashing out this repeal bill and negotiating with the Senate parliamentarian about what they could put in it. They passed it three times (first in the House, then in the Senate, and now in the House again). But all they'll have to show for it is a stack of paper with the president's veto on it.

Repeal diehards told their supporters they could force Obama to cave on the Affordable Care Act, which they attempted to do when they shut down the government and threatened to withhold a debt limit increase and default on the country's debts. But Obama was never going to sign a bill that eliminated his signature domestic policy achievement -- especially one so tied to his presidency that it's been unofficially named after him.

And although finally sending a repeal bill all the way to the White House may look like a victory in the War on Obamacare, it's a hollow one at best. Conservative voters won't be satisfied with just a veto, and everyone is still waiting for Republicans to propose a replacement, not simply kick people off the health insurance rolls and increase the ranks of the uninsured by 24 million over 10 years.
That's why repeal alone isn't politically tenable. For evidence, look to Kentucky Gov. Matt Bevin (R), a tea party favorite who accused Sen. Mitch McConnell (R-Ky.), the Senate GOP leader, of being insufficiently anti-Obamacare during an unsuccessful 2014 primary election challenge.

Bevin campaigned for governor last year on a pledge to rescind the state's Medicaid expansion and kill off its health insurance exchange, Kynect. He still says Kynect is done for, but his position on Medicaid expansion shifted as election day approached, and last week Bevin announced he would negotiate with federal authorities on changes to the Medicaid expansion instead.

Likewise, Arkansas Gov. Asa Hutchinson (R) took office last year and ignored cries from conservatives to undo the expansion. Instead, he has merely proposed requesting federal permission to modify it.

Even in Congress, a handful of Senate Republicans nearly got cold feet about the repeal bill in November, and GOP Sens. Susan Collins (Maine) and Mark Kirk (Ill.) ultimately voted against it.

The exchange between Fox News anchor Bill Hemmer and House Budget Committee Chairman Tom Price (R-Ga.) on Tuesday, which can be seen below, is revealing. Even on the precipice of what they want to be seen as a win on Obamacare, the congressional GOP leadership has no answer to the question of what comes next.
Hemmer tried repeatedly to get Price to explain what Republicans want to achieve on health care, and when they will have their official plan ready. He failed, as this portion of the interview demonstrates:

*Hemmer:* I'm going to bounce back to you yet again on the idea of what you replace Obamacare with. And that really is the linchpin for this entire debate. What will Republicans do? What will they fashion in terms of a bill that replaces Obamacare? What does it look like?

*Price:* This is why I'm so excited about the new leadership of Speaker Ryan. What he has done is charging the committees in the House of Representatives that work on health care to come forward with a positive solution, a common-sense solution, a patient-centered solution, that puts patients and families and doctors in charge of health care, and not the federal government.

And we'll do that over a period of a number of months. This isn't going to be top-down, like Obamacare was. This is going to be a bottom-up, organic process that brings together over a hundred pieces of legislation that are currently in the House of Representatives that deal with health care, and comes forward with those positive solutions that recognize the principles.

Price's comments mainly consisted of a hodgepodge of talking points that Republicans have been using since 2009, when the Affordable Care Act debate began, without saying much about what they actually want to do.

And having more than a hundred pieces of health care legislation (one of which Price himself has been pushing fruitlessly since 2009) is a sign of how far the GOP is from consensus, not an indication of how close the party is to a post-Obamacare health care reform platform. These bills also wouldn't "replace" the Affordable Care Act in any meaningful way, because they don't even attempt to cover the uninsured or to enact consumer protections like a guarantee of coverage to people with pre-existing conditions.

And then there's the process Price describes, in which GOP lawmakers put their noses to the grindstone and come up with a plan they can pass.

That should sound familiar, because Republicans leaders have said it before. In 2015. In 2014. In 2013. In 2012. In 2011. And in 2010, as soon as Obamacare became law.

But the presidential election is one reason why this year may be different. If a Democrat is elected president, the stalemate continues. But if a Republican winds up in the White House instead, this repeal vote could portend some real internal strife for the GOP.

Republicans would no longer be able to blame Senate Democrats or Obama for their failure to coalesce around a health care plan. With control of Congress and the White House in their hands, the onus fully would be on GOP lawmakers to work with their new president to live up to their promises of a better health care system and to take ownership of the reality that whatever they propose will create winners and losers, just as Obamacare did. 

That grand bargain has, so far, eluded them. And if the past six years -- plus the decades that preceded them -- are any indication, it will continue to.

*Also on HuffPost:*

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