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Changing quickly - what we might expect

By JustinC on January 6, 2010 9:07 AM 0 Vote 0 Votes

Kaiser Health did a recap today of several news agencies and their takes on what might change in the short term with the new health care reform bill.

McClatchy examines benefits that "would take effect quickly and should produce a noticeable impact on consumers, according to many independent analysts and Democrats." The House and Senate bills "would bar lifetime limits on coverage, starting six months after the measure is enacted. They also would expand community health centers, where consumers could go for care, and would require health plans to allow young people, up to age 26 in the Senate bill and 27 in the House bill, to stay on their parents' policies. Age requirements now vary by state. Both bills provide immediate aid for the uninsured. The Senate bill includes $5 billion to help finance a temporary program that would provide coverage to uninsured people with pre-existing conditions, effective 90 days after the bill is signed" (Lightman, 1/5)

CNN: "Arguments over the massive overhaul of the health care system -- which congressional Democrats hope to pass by next month -- are expected to keep shaking up the country long after the vote." David Gergen, who worked in the Nixon, Ford, Reagan and Clinton administrations, explains that "unlike other major legislation which has passed with more bipartisan support, health care is going to remain a political football, and people are going to have a sense that it is not fully settled yet for a while" (Keck, 1/5).

Read Kaiser Health's full story here.

Bill negotioations to be televised?

By JustinC on January 5, 2010 7:27 PM 0 Vote 0 Votes

In a letter dated December 30th, and released today, C-SPAN asked to broadcast the health care negotions between the 2 houses.

The head of cable network C-SPAN, which shows government proceedings, wrote a letter to Ms. Pelosi and other congressional leaders saying they should allow cameras at the discussions. That echoed a point Republicans have often made during the health-care debate, charging that Democrats were making too many decisions in private discussions...

In a letter to congressional leaders, C-SPAN Chief Executive Brian Lamb urged both chambers to allow C-SPAN cameras inside the talks, noting that the legislation "will affect the lives of every single American."

Read the full story, and discussion of the negotiations from the Wall Street Journal, here in Democrats Circle the Wagon as Health Talks Restart.

2 Houses almost back from break

By JustinC on January 3, 2010 10:12 AM 0 Vote 0 Votes

As both houses get ready to come back from their breaks, they are getting ready for negotiations where they will take their two bills and merge them into one. The Washington Post has a table comparing the bills in terms of their costs, impacts to various parties, and benefit packages.

There's also an interesting break down of each representative, their vote on the bills, the percentage of uninsured people in their states, and the amount of contributions they've received from the health care industry. Here's the Senate breakdown, and here's the House of Representatives' breakdown.

Merry Christmas or Bah Humbug

By JustinC on December 25, 2009 7:51 PM 0 Vote 0 Votes

On Christmas Eve, the health care reform bill passed by a vote of 60 - 39. Coverage from The Hill is here. Next up - the House and Senate negotiators will work in January to merge the 2 versions of the bill. Coverage from the Wall Street Journal, Senate, House to Haggle Over Differences is here.

The most highly debated issue still pending, is that of abortion. Coverage of the abortion issue from Time is here. The GOP is pushing, and many are discussing, the issue of whether its even legal for the federal government to require people to have health insurance. Chicago Sun Times coverage is here.

The ongoing political effects of the bill and debate are being discussed, in terms of how this will affect party relations and strategy.

Politico's coverage, Parties Risk It All on Health Care Reform is here.

Specifically targeting consumers, Kaiser Health News has published a guide, The House, Senate and You: A New Guide to Health Care Reform, which can be found here.

Filibuster ended - onto final vote

By JustinC on December 23, 2009 2:46 PM 0 Vote 0 Votes

A 60-39 vote has just ended the Republican's filibuster. The filibuster was the last stop for the health care reform bill before it's voted on. Recent procedural decisions - such as starting the debate and ending the filibuster - have required 60 votes, but passing the bill requires a simple majority. The final vote is scheduled for tomorrow, Christmas Eve day, at 7am. It has been 114 years since a vote was held on Christmas Eve.

"Away from Capitol Hill, special deals on Medicaid obtained by some Democrats - notably Ben Nelson of Nebraska, who provided the crucial 60th vote - continued to provoke grumbling. Under the Senate bill the federal government will pay the entire cost of an expansion of Medicaid in Nebraska, unlike other states, which will have to start picking up a portion of the tab themselves after several years."

You can read the coverage from the Associated Press here.

Senators Up at 1am; Vote Passed

By JustinC on December 21, 2009 8:29 AM 0 Vote 0 Votes

Despite a dramatic few weeks, democrats have advanced their healthcare bill with a clean party-line vote of 60-40. The American Hospital Association has endorsed the bill, but the AMA has yet to officially declare their support for this version. Politico reports...

The Democratic Party's decades-long push to remake the U.S. health care system cleared a major hurdle early Monday morning, with the Senate voting to advance a massive $871 billion bill to extend coverage to nearly all Americans and tighten regulations on private insurers...

In the coming negotiations, the House will almost certainly be forced to give up the government-run insurance plan that is part of its bill. The idea failed in the upper chamber after centrists including Connecticut independent Joseph Lieberman drew a line in the sand against it.

The final bill is also likely to embrace a version of the Senate's proposed tax on high-value insurance plans, rather than add a surtax on the wealthy, as the House wanted.

Read Politico's coverage here, and the Wall Street Journal article here.

Christmas + Health Care Reform Humor

By JustinC on December 18, 2009 7:38 PM 0 Vote 0 Votes

From Kaiser Health...

Hurdles for democrats

By JustinC on December 14, 2009 9:37 AM 0 Vote 0 Votes

Over the last few days, Democrats have faced more challenges in getting the health care bill passed. Politico says:

Democrats must work out compromises on long-standing problems like the public option and abortion while dealing with more recent intraparty spats, like whether to allow consumers to buy Food and Drug Administration-approved drugs from other countries, an issue that stalled last week and remains stuck on the Senate floor...

...Most insiders agree that Democrats have until Thursday to work out their differences if they want to pass a bill by Dec. 23. It will take at least five or six days after Democrats move to end debate before they can vote on the bill. Democrats expect to begin the endgame early this week and still sound optimistic that they can get it done.

Also an issue is that Senator Lieberman won't vote for the bill with the Medicare expansion included. The NY Times coverage is here and the Wall Street Journal coverage is here.

What do agriculture and health care have in common?

By Angie on December 11, 2009 8:17 AM 0 Vote 0 Votes

What do farming and medicine have in common? In the latest edition of The New Yorker, Dr. Atul Gawande explores the parallels between agricultural cost control pilots in the early 1900s and the potential to use health care control pilots to control health care costs nearly 100 years later. Just like the agricultural crisis in the early 20^th century, Dr. Gawande that the current health care cost crisis also monopolizes a large percentages of the American economy, had "unmanageably costly sectors," and seems intractably difficult to remedy.

In the absence of a sweeping solution to costs, the current health overhaul legislation pursues a piecemeal approach, cobbling together lots of pilot projects to see what works. Similarly, an agricultural cost crisis in the early 1900s (when more than 40 percent of family income went toward food) eventually produced a medley of U.S. Department of Agriculture-run pilots, spurring Gawande's optimism that the similar "hodgepodge" of proposed pilots in the proposed health care legislation could have similar results. Farmers quickly learned that following the pilot programs offered a solution to their cost problems. For example, Texas farmers who followed a pilot program to improve soil quality and plant yield, quickly earned an additional $700 in the first year of the program and quickly expanded the program to reap similar benefits in future years.

Although Gawande doesn't address this in his article, we have previously reported in this blog that federal health care pilot programs, despite successful results, do not have a good history of being widely adopted.

To read the entire article in The New Yorker, click here and for our previous blog post on health care pilots, click here.

Poll Results Suggest that 2/3rd Don't Understand the Public Option

By Angie on December 9, 2009 11:51 AM 0 Vote 0 Votes

For months, the idea of a public option--a government-run health insurance program--has taken center stage in the debate over health care reform. But a recent poll by 60 Minutes and Vanity Fair finds that two-thirds of respondents said they couldn't explain the concept. The poll asked people whether they could "confidently explain what exactly the public option is to someone who didn't know." Sixty-six percent of respondents said no. The poll prompted Ezra Klein to comment in the Washington Post, "So far as health-care reform goes, the public option is fairly simple, and undeniably prominent. Imagine how many could explain the exchanges, or the mandate, or the benefit package ..."

To see the 60 Minutes/Vanity fair poll results, click here. To read Ezra Klein's post on the poll, click here.

Public Option to be Traded for Expansion of Medicare/Medicaid?

By Angie on December 9, 2009 7:30 AM 0 Vote 0 Votes

Debate on Senate health care reform bill continue this week, with the on again off again public option the subject of intense behind the scene negotiations. Politico reports that a potential deal took shape on Monday that would put the public option on the chopping block in exchange for big expansions of Medicare and Medicaid. The public option may still survive, but in a much weaker form:

[N]egotiators [are] still struggling to craft a compromise that could satisfy moderates worried about the too-heavy hand of government -- and liberals who would be giving up on their cherished goal of a federal health insurance safety net.

After five days of intensive talks among five moderates and five liberals, the outlines of a compromise aimed at appeasing both ends of the Democratic political spectrum were emerging: a plan designed to expand insurance coverage without creating a new government-run program.

Continue reading Public Option to be Traded for Expansion of Medicare/Medicaid?.

Senate Rejects Amendments to Further Restrict Abortions in Health Care Reform Bill

By Angie on December 8, 2009 3:55 PM 0 Vote 0 Votes

The Senate has rejected an amendment proposed by Senators Ben Nelson (D-Nebraska) and Orrin Hatch (R-Utah) that would have placed greater restrictions on funding for abortions in the Senate health reform bill. From MSNBC:

By a vote of 54-45, the Senate sidetracked an amendment by Democratic Sen. Ben Nelson of Nebraska and Republican Sen. Orrin Hatch of Utah that would ban any insurance plan getting taxpayer dollars from offering abortion coverage. The restrictions mirrored provisions in the House-passed health care bill. The Senate bill currently allows insurance plans to cover abortions, but requires that they can only be paid for with private money. The legislation calls for insurance plans that would receive federal subsidies in a new insurance marketplace to strictly separate public funds from private dollars that would be used to pay for abortion.

Last month the House approved abortion restriction similar to those in the Senate amendment in order to help secure passage of the bill. The failure of this amendment to pass the Senate may sidetrack the entire bill. Seven Democrats supported Senator Nelson's amendment and it is uncertain if they will vote for the bill without it.

Read the full story here and read coverage from The New York Times here.

Doctors Divided on Senate Health Care Reform Bill but Agree That it Needs Surgery

By Angie on December 8, 2009 11:45 AM 0 Vote 0 Votes

Friday's Wall Street Journal health blog notes major physician organizations are divided on the Senate health care reform bill. As reported earlier on this blog, the AMA sent a letter to Senate Majority Leader Harry Reid (D-Nevada) saying that it supported some but not all of the bill's provisions and that it would reserve judgment until the bill's final version is settled on.

Among other things, the group likes that the bill makes insurance more accessible, eliminates copayments for certain preventive health services and increases research on which treatments are most effective. AMA succeeded in keeping out of the bill some provisions that irked doctors. A Senate Finance Committee proposal to penalize doctors who administer the greatest quantities of test and treatments, designed to penalize over-users, didn't make it into the Senate bill.

But lots of other provisions that worry doctors did. AMA is against the bill's call to give more power to an independent commission that could cut Medicare spending. It's opposed to Medicare payment changes that take money from specialists' payments and increases pay for primary care doctors. It's also against reworking the Medicare payment system to reward doctors for producing better health outcomes, which is says can't be measured scientifically....

Continue reading Doctors Divided on Senate Health Care Reform Bill but Agree That it Needs Surgery.

Most Americans Support Public Option

By Angie on December 8, 2009 8:49 AM 0 Vote 0 Votes

MSNBC is reporting the results of a new poll, showing that 59% of Americans are in favor of some kind of public option, but the poll also revealed serious doubts about Congress' ability to control costs or improve quality of care. Highlights from the poll include the following:

· Believe in public option: 59.9 percent yes, 40.1 percent no.

· 86 percent of Democrats support the public option versus 57 percent of Independents and 33 percent of Republicans.

· Quality of healthcare will be better 12 months from now: 35 percent strongly disagree. 11.6 percent strongly agree. 29.9 percent put themselves in the middle.

· Believe the amount of money spent on healthcare will be less 12 months from now: 52 percent strongly disagree, 13 percent strongly agree.

· 23 percent believe it will be easier for people to receive the care they need a year from now.

Read the full story here.

Abortion amendment filed

By JustinC on December 7, 2009 1:55 PM 0 Vote 0 Votes

Politico reports that Senators Nelson and Hatch just filed their amendment on federal funding for abortion. The amendment would prevent federal funds for being used for abortion. Politico has a brief summary, as well as the full text of the amendment. It's noted that many expect this amendment to fail. It will be debated tomorrow.