VitalSigns... by iMedExchange: JustinC: November 2009 Archives

Behind two doors - same clinic, different care

By JustinC on November 24, 2009 8:45 PM 0 Vote 0 Votes

MSNBC ran an interesting story today about the differences in the treatment of patients paying cash vs. using insurance.

In America, you get what you pay for. Those who pay more get better service. That's the way it is in restaurants, and in health care, too.

But imagine a restaurant with one kitchen, one chef, but two doors and two price lists. That's the model of health care that some doctors are practicing.
In New York City, msnbc.com heard of doctors locating their practices on corners, so they can have one door where they take insurance and another door offering services for patients who pay cash up front for each procedure.

We visited one of these clinics with two doors, to see how it works. The result is a glimpse into a two-tiered system of health care, a system that could be coming.

Two MSNBC reporters got mammograms - one going to the 'cash side', and one to the 'insurance side'. The reporters discuss their treatment, charges, and experiences. Click here to read the full story.

Authenticated Senate Health Care Reform Bill Available Online

By JustinC on November 23, 2009 8:04 AM 0 Vote 0 Votes

A press release from the Government Printing Office announced that the Senate health care reform bill is available on their Federal Digital System.

The U.S. Government Printing Office (GPO) has made available the U.S. Senate's health care reform bill in electronic and printed form. The authentic, electronic version is available on GPO's Federal Digital System (FDsys), named by Government Computer News as one of the Government's best Web sites. GPO authenticated the document by digital signature. This signature assures the public that the document has not been changed or altered. A digital signature, viewed through the GPO Seal of Authenticity, verifies the document's integrity and authenticity.

Link to FDsys: www.fdsys.gov

Direct link to the Senate bill:
http://www.gpo.gov/fdsys/pkg/BILLS-111hr3590AS/pdf/BILLS-111hr3590AS.pdf

Direct link to the House bill:
http://www.gpo.gov/fdsys/pkg/BILLS-111hr3962IH/pdf/BILLS-111hr3962IH.pdf

Time to Wait

By JustinC on November 18, 2009 11:31 AM 0 Vote 0 Votes

Now that the bill has passed in the House, there seems to be a lot of 'waiting'.

The Senate's top Democrat declined Tuesday to say when he would introduce a hotly anticipated health care reform bill.

Senate Majority Leader Harry Reid, D-Nevada, said he was waiting for a cost estimate of the legislation from the nonpartisan Congressional Budget Office.

"We're going to be hearing from CBO very soon," he promised on Capitol Hill. CBO's estimate won't be completed until at least Wednesday, a senior Democratic source said.

Republicans say they'll filibuster. This can be overturned and a debate can be started with 60 senate votes. However there may not be enough votes given that the more conservative democrats and the 2 independents may not be willing to vote to start the debate.

GOP leaders expressed fears Tuesday that the Democrats would try to spring the measure on the Senate with little warning to deny Republicans a chance to adequately review it before starting debate.

Senate Minority Leader Mitch McConnell, R-Kentucky, said he expects a vote to open debate on the measure will come Friday. He pledged that Republicans would continue to strongly oppose a bill that they say will result in tax and premium increases while doing little to rein in spiraling medical costs.

Read the full story here.

MD: What makes you think we're in this for the $$?

By JustinC on November 17, 2009 10:07 AM 0 Vote 0 Votes

In a letter to the editor in this weekend's NY Times, Dr. Jack Arbiser responded to the concern that doctors may order extra/unnecessary tests and procedures to earn more money.

As a physician 15 years after residency, I have never understood the argument that doctors make more money by ordering more lab tests and procedures. I don't get extra money by ordering lab tests -- the laboratory does, and I need to follow the results.

Similarly, with procedures, if I cannot justify the procedure as medically necessary to a patient's insurer, I won't be paid. Additional procedures that are not medically justified would also create increased exposure to malpractice, because the more procedures, the more likely a negative result will occur.

Jack L. Arbiser, M.D., Ph.D.

Don't get in line yet

By JustinC on November 16, 2009 10:00 AM 0 Vote 0 Votes

There's an interesting article on Politico this morning, where they highlight health reform's hidden land mines. The first one they point out is the expectation from many people that they'll be able to shop around and choose the public option if they want it.

The debate has placed disproportionate emphasis on the creation of a government insurance plan, raising the expectation that everyone could ditch their employer-provided coverage and enroll in the public option.

But that won't happen, at least not at the start. The reality is that only about 30 million Americans -- 10 percent of the population -- would even be eligible.

"People think they are going to get it -- and they aren't," said Sen. Ron Wyden (D-Ore.), who has pushed for changes to provide consumers with more choices. "That's what they're going to flip out about."

They also call out fines, higher premiums, years of delays until most people see benefits, and age issues. Read the full article here.

The Abortion Issue & Fuzzy Language

By JustinC on November 13, 2009 7:45 AM 0 Vote 0 Votes

The issue of funding and coverage of abortions is the most controversial issue facing the health care bill right now. According to Politico...

...Senate Majority Leader Harry Reid found his health reform efforts seriously complicated Monday by the explosive issue of abortion, as key centrist senators said they wanted to see airtight language in the bill blocking federal funding for the procedure.

Abortion threatened to derail a House health reform bill Saturday, and now it's standing in the way of Reid's attempts to get 60 votes as well, with Sen. Ben Nelson (D-Neb.) saying he wants to see language as restrictive as the House's in the Senate bill.

Full story here.

The Atlantic talked with Representative Stupak about this abortion amendment that's getting so much attention.

Rep. Bart Stupak's (D-MI) abortion amendment, which passed Saturday night just before the House approved its comprehensive health care reform legislation, has set off a firestorm of criticism from pro-choice lawmakers and interest groups, and it's being viewed as a coup for pro-lifers in Congress.

Continue reading The Abortion Issue & Fuzzy Language.

Money Concerns

By JustinC on November 10, 2009 3:25 PM 0 Vote 0 Votes

Today the NY Times discusses the rising concerns from some democrats that this health care reform bill is not going to cut spending.

Mr. Obama has made cost containment a centerpiece of his health reform agenda, and in May he stood up at the White House with industry groups who pledged voluntary efforts to trim the growth of health care spending by 1.5 percent, or $2 trillion, over the next decade.

But health economists say it is impossible to know whether the bills, including one passed by the House on Saturday night, would meet that goal, and many are skeptical that they even come close.

The Hill reported this afternoon that the White House is not happy with the NY Times story.

A senior White House official took on the New York Times on Tuesday over a story the paper ran warning of the fiscal impact of health reform.

Office of Management and Budget (OMB) Director Peter Orszag called out the paper's news story on the White House blog, emphasizing that President Barack Obama is committed to signing a health bill that is deficit-neutral.

"Every two weeks or so, there seems to be a story ringing the alarm bells over the fiscal dimension of health reform," Orszag wrote in his blog post. "As I've said time and again, the President is committed to signing a health reform bill that is deficit neutral in the first decade - and deficit reducing thereafter."

Read the full post here.

Funny Stuff

By JustinC on November 10, 2009 2:49 PM 0 Vote 0 Votes

Politico has a funny compilation of some clips from comedy sketches this week, mostly covering health care reform.

Name-dropping

By JustinC on November 2, 2009 9:33 AM 0 Vote 0 Votes

Politico ran a piece today covering the "who's who" of the health care reform battles. They briefly cover the 10 - 15 people who are most involved up front, as well as behind the scenes.

After months of committee work, Senate Majority Leader Harry Reid of Nevada and Speaker Nancy Pelosi of California are driving the debate on health care reform, but they are each relying on a cast of supporting actors.

If the Democratic leadership expects to pass the most far-reaching legislation in 40 years, it needs an assist from a bona fide deal maker such as Sen. Chuck Schumer and an emerging one such as Sen. Tom Carper. There are also wild cards, progressive loyalists, centrist doubters and 2010 targets who will each shape the health care bill.
Reid, Senate Finance Committee Chairman Max Baucus (D-Mont.) and Sen. Chris Dodd (D-Conn.) have played outsize roles in shaping the legislation to this point, and they are likely to maintain their influence by managing the legislation on the floor later this month. In the House, Pelosi showed she could corral her disparate caucus and position Democrats to pass a bill as early as next week.

Click here to learn about the other key players.

JustinC: November 2009 Archives

Behind two doors - same clinic, different care

Authenticated Senate Health Care Reform Bill Available Online

Time to Wait

MD: What makes you think we're in this for the $$?

Don't get in line yet

The Abortion Issue & Fuzzy Language

Money Concerns

Funny Stuff

Name-dropping

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