March 1st, 2010

March 1: Health Care Reform News

By Kelley Luckstein

TOP STORIES

The Cost of Doing Nothing on Health Care

The New York Times

March 1, 2010

 

People think if we do nothing, we will have what we have now,” said Karen Davis, the president of the Commonwealth Fund. “In fact, what we will have is a substantial deterioration in what we have.”

 

Obama Faces Friction Among House Democrats Over Health Plan

The Bloomberg Report

March 1, 2010

 

President Obama, taking charge of health care legislation, is facing resistance from lawmakers in his own Democratic Party over the prospect of pushing the bill through Congress.

 

HHS, OMB to Form Federal Health IT Task Force to Coordinate Intra-Agency Efforts

Department of Health and Human Services Offices of Management and Budget

February 28, 2010

 

The heads of six federal agencies have been asked to designate a senior official for a proposed new intra-agency health information technology task force that would be led by National Coordinator for Health Information Technology David Blumenthal.

 

 

INSURANCE

What Do We Need Health Insurers For Anyway?

The Los Angeles Times

February 28, 2010

 

The only way insurers can remain profitable at all is by selling healthy people on policies that don't offer much coverage at all, while squeezing older, less healthy people remorselessly so they either pay for most of their care out of pocket or get priced out of the insurance market completely.

 

 

TRANSPARENCY/SAFETY

Rising Threat of Infections Unfazed by Antibiotics

The New York Times

March 1, 2010

 

The Acinetobacter baumannii germ is one of a category of bacteria that by some estimates are already killing tens of thousands of hospital patients each year emerging as an even larger threat than MRSA.

 

 

STATE NEWS

Minnesota-Based Park Nicollet Health Services Opens a Window on Doctor Payments

The Star Tribune

March 1, 2010

 

Park Nicollet Health Services began posting the payments its practitioners receive from industry; the health care system is believed to be the second institution of its kind in the country to do so.

 

Battle Over How to Curb Rising Health Care Costs in Connecticut

The Hartford Courant

March 1, 2010

 

Connecticut had the fifth most expensive group health insurance premiums in 2008 and has seen accelerating increases since, placing the state squarely in the national debate about out-of-control premium hikes.

 

Hoosiers and Health Savings Accounts

The Wall Street Journal

March 1, 2010

 

A new Indiana experiment is reducing costs for the state and its employees.

 

 

MEDICARE/MEDICAID

CMS Delays Physician Pay Cut in Hopes That Congress Will Resolve Issue

Healthleaders Media

March 1, 2010

 

Lacking congressional action, the federal government has essentially halted a 21.2% Medicare pay cut for physicians that was to go into effect today.

 

Medicare Doctor Shortage Endangers Seniors’ Access to Care

The National Center for Public Policy Research

February 29, 2010

Chronically low Medicare reimbursement rates to physicians and hospitals are forcing doctors to limit the number of Medicare patients they see or opt out of the program altogether with devastating results to seniors’ health care options.

 

REFORM EFFORTS

Pelosi Says She’ll Get Votes Needed for Health Care Bill

The New York Times

February 28, 2010

 

Speaker Nancy Pelosi says she is confident she will be able to get the votes needed to pass sweeping health care legislation in the House, even if it threatens the political careers of some members of her party.

Additional Coverage                                                                                                                                                                                                           Democrats Will Have Votes for Health Bill - The Washington Post                                                                                                                                         Democrats Push Ahead With Health Care - The Wall Street Journal                                                                                                                                                  Pelosi Confident on Health Vote - The Wall Street Journal

Conrad:  Reconciliation Can’t Be Used for Comprehensive Reform

Politico

February 28, 2010

 

The only possible role for reconciliation would be to make modest changes in the major package.

 

Hoyer:  House Will Go First on Health Bill

The Hill

February 28, 2010

 

House Majority Leader Steny Hoyer (D-Md.) said the House must pass the Senate bill before fixes to both bills can be approved.

 

Lamar Alexander:  Health Care Bill A ‘Political Kamikaze Mission’

The Huffington Post

February 28, 2010

 

Sen. Lamar Alexander (R-Tenn.) said on Sunday that if Democrats push health care through under the majority only process known as reconciliation, it will be a "political kamikaze mission."

 

 

HEALTH INFORMATION TECHNOLOGY

Health Info Management Leaders Push to Elevate the Health Care CIO

Healthleaders Media

March 1, 2010

 

Despite the fact that CIOs and other health care technology leaders have the expertise to help their organizations prepare for change, CIOs still aren't getting the recognition they deserve or the accompanying seat at the c-suite table.

 

 

MISCELLANEOUS

HLC/Update Health Reform

Healthcare Leadership Council - Complete Text

February 28, 2010

For all of the ideas exchanged at yesterday’s White House health reform summit, the bottom line was stated by President Obama at the end of the six and a half hour session.

“If we can’t [come to a bipartisan agreement], I think we’ve got to go ahead and make some decisions,” the President said, clearly giving his blessing for congressional Democrats to go it alone in passing a comprehensive health reform bill.

After over a year of debate, hearings, summits, town hall meetings, and public protests, health reform has now boiled down to a strict numbers game.  The question that remains to be answered over the next few weeks is whether Democrats can summon sufficient votes from their own ranks in both the House and Senate to enact legislation.  This is not a question that can remain unanswered for long, given lawmakers’ desire to get the controversial health reform issue off the stage before election season heats up.

In this memo, I want to examine the legislation on the table, specifically the President’s proposal released this week, the possible scenario for congressional action, and opportunities for HLC members to communicate your policy positions and innovative successes to key audiences.

The President’s Proposal and the Summit Meeting

This week began with President Obama, for the first time in this process, entering his own proposal into the mix.  It was not so much a new offering as much as it was the Senate-passed bill with modifications intended to gain support in the House.

Let’s back up a second.  With both houses of Congress having passed health reform legislation before Christmas, the easiest way to finalize a bill and send it to the President is for the House to simply pass the Senate’s measure.  The House, however, finds the Senate bill unacceptable, largely because of its tax on “Cadillac” health plans, its smaller levels of health insurance subsidies and less Medicaid expansion, and the special deals that were negotiated to win Senate passage.

The President’s proposal contains the modifications that the House would ostensibly approve in a separate vote after passing the Senate bill.  Then, the Senate would also pass the same modifications package.  However, assuming unanimous opposition by the 41 Republicans, the Senate would have to do so using the budget reconciliation process, which requires only 50 Senators for passage.

The President’s proposal does not alleviate our concerns with the pending health reform legislation.  Specific issues include:

·           The extraordinary level of Medicaid expansion, bringing 15 million more Americans into the program, which raises serious health access issues given Medicaid’s very low payment rates.

·           The relatively weak individual mandate, which will cause instability in the insurance market once plans are required to insure all comers.  There are legitimate concerns that many uninsured consumers will choose to pay a fine and remain without coverage until they become sick and need it.

·            The heavy reliance on fees imposed upon various health sectors to finance health reform, which can only lead to increased costs to consumers.

·           The lack of progress on delivery and payment reform, with too great an emphasis placed on demonstration projects, which would take years to develop and may not result in any actual policy changes.

On that latter point, it’s particularly disappointing that the President and congressional leaders are once again emphasizing insurance reform as opposed to health reform.  Using recently-announced premium increases as a springboard, political leaders are focusing all of their rhetorical firepower on insurance companies instead of discussing reforms to bring about high-quality, cost-effective care, which should be the heart of health reform.  (In fact, the President’s proposal includes the creation of a new federal commission that would have the power to reject health insurance rate increases.)

It’s unclear whether yesterday’s White House health reform summit changed any minds or moved public opinion on the subject.  Both Democrats and Republicans went into the meeting with clear game plans and both sides stuck to their strategies.  The President and congressional Democrats emphasized at every opportunity how many Republican ideas they have incorporated into their reform legislation.  Republicans capitalized on recent public opinion polls showing majorities of Americans wanting Congress to tear up the current bills and start over, and Republicans repeatedly called upon their Democratic colleagues to do just that.

In the end, President Obama said he would give Congress six weeks to try to reach a bipartisan compromise (none showed any signs of emerging yesterday) before moving forward.  A more cynical observer would say that the entire purpose of the summit was to show the American people a sincere effort at bipartisanship in order to ease the path for a Democrats-only reconciliation vote.

What Happens Next?

Right now, virtually all observers say the House doesn’t have the votes to pass the Senate health reform bill.  The bill initially passed the House by a 220-215 vote.  Since that time, one Democratic “yes” vote has retired and another, Congressman John Murtha, passed away.  Another “yes” vote – Neil Abercrombie of Hawaii – resigned today to run for governor of that state.  Also, the only Republican to vote for the bill – Joseph Cao of Louisiana – said he will switch his vote to “no” the next time around.

Further complicating matters, the leader of the pro-life House Democrats, Bart Stupak of Michigan, has said he can’t support the watered-down abortion language in the Senate bill.  He plans to vote against the bill and indicates he will take along somewhere in the neighborhood of a dozen pro-life Democrats who initially voted “yes.”  That means House Speaker Pelosi has to convince several of her Democratic colleagues – increasingly uneasy as campaign season approaches – to switch their initial “no” votes and support legislation that is far from wildly popular.

The Senate has its own interesting dynamic.  With Vice President Biden breaking any ties, it only requires 50 Senate Democrats to pass legislation through the budget reconciliation process.  However, reconciliation allows Senators to offer an unlimited number of amendments.  Republicans have indicated they will force votes on hundreds of amendments, including some on hot-button issues like closing Guantanamo Bay and trials in U.S. civilian courts for terrorism suspects.  The rhetoric at yesterday’s summit tells us that reconciliation could be an ugly, drawn out, inflammatory spectacle.

Some have suggested that, if comprehensive health reform can’t gain sufficient support, Democratic leaders will move toward a “skinny” bill that expands Medicaid and takes other smaller steps, such as allowing young people to stay on their parents’ insurance policy until age 26.  That’s possible, and White House chief of staff Rahm Emanuel indicated as much when he met with HLC members over a year ago, but that approach carries its own problems.  Starting over with new legislation will lengthen a process that many lawmakers feel has gone on too long already.

The upshot here for HLC members is that we need to continue to reach out to moderate Democrats, in both the Senate and House, with our views.  We can expect the leadership in both parties to be freely using both carrots and sticks to strong-arm the votes they need.  Given, however, the volatility of this year’s election season and the shaky public standing of health reform in polling, I believe members of Congress will continue to be very receptive to our viewpoints.  We have already held 15 in-district meetings with lawmakers in February, including meetings with key moderates such as Congressman Brad Ellsworth (D-IN), often spotlighted as the possible successor to retiring Senator Evan Bayh (D-IN).

Using Our New Media Tools

 

We are gaining consistently larger followings for HLC’s blog (www.prognosisblog.com) and our Twitter feeds (@hlcmembers and @healthinfocus).  Statistics are telling us that a high number of health policy insiders, Capitol Hill staff, and media are reading our blog, which focuses on current health issues, every day.  Meanwhile, our Twitter feed, which is used primarily to link to new innovations on your websites and positive news stories about HLC member companies and organizations, is reaching thousands of policy influencers.

We want you to feel free to make use of these tools.  We would like to feature your op-eds and your health policy speeches on the Prognosis blog.  Also, please keep us updated about your new service initiatives, policy announcements, or exciting product innovations, so we can drive audiences to them through Twitter.

In an upcoming blog post, we’re going to spotlight what HLC members have been doing to help address the crisis in Haiti.  If you have an initiative you would like mentioned, please contact Michael Freeman at mfreeman@hlc.org or 202-452-8700.

HLC Innovations Expo

We have a date for our annual Capitol Hill Innovations Expo.  It will take place on September 28, 2010 in the Cannon House Office Building.  At last year’s event, we attracted more than 50 members of Congress and hundreds of influential congressional staffers to review the innovative products and programs of HLC members.  There is room for approximately 17 display booths in the Cannon Caucus Room and we fill them on a first-come, first-serve basis, so please reserve your spot early.  A registration form is attached to this email.

Finally, a calendar reminder – our next HLC membership meeting is Wednesday, June 23, 2010 in Washington, DC.  Our June meeting traditionally features meetings with key members of Congress to discuss our priority issues.  I look forward to seeing you then and please contact me anytime with your thoughts on the continuing development of health reform legislation.

Tags: health care reform, Health Policy, Health Policy

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