March 30: Health Care Reform News
Will Health Care Law Actually Reduce Health Costs?
In the next decade, health spending may rise to 6.1%. The figures are projected to reach $4.5 trillion, i.e. almost 20% of the economy. Karen Ignagni, president of America Health Insurance Plans believes that ‘the cost crisis needs to be addressed as underlying health care costs are exploding’… keep costs down.
Programs like the Mayo Clinic,promote physician and hospital services under one roof. They also pay for efficient prevention and management of illnesses. This means that the patient will no longer have to pay for each visit or medical test.
Times Newsline, 3/29/10
Additional MC healthcare reform mentions: Guardian, HealthTechnica
Top stories
Insurance Industry Agrees to Fix Kids Coverage Gap
AP/Google News
March 30, 2010
In a letter to Health and Human Services Secretary Kathleen Sebelius, the industry's top lobbyist said insurers will accept new regulations to dispel uncertainty over a much-publicized guarantee that children with medical problems can get coverage starting this year. Read Sebelius’ letter urging the insurance industry to guarantee coverage here. Read the industry’s response here.
CMS Nominee Berwick on Empowering Patients and Improving Quality
Health Affairs blog
March 29, 2010
Don Berwick, President Obama’s reported nominee to lead the Centers for Medicare and Medicaid Services, has been a leading voice for improving clinical quality and empowering patients, themes he has discussed in the pages of Health Affairs. This blog entry summarizes some of his past writings.
Distinguished Scholar to get Chance to Put Theory into Practice as Medicare Chief
The Los Angeles Times
March 30, 2010
Profile of Donald Berwick, President Obama's likely pick to run CMS.
Companies Push to Repeal Provision of Health Law
The New York Times
March 30, 2010
An association representing 300 large corporations urged President Obama and Congress on Monday to repeal a provision of the health care overhaul that prompted AT&T, Caterpillar and other companies to announce substantial charges for the current quarter. Related: Prudential to Take $100M Health Care Charge in 1Q, AP
Insurance
Health Premiums Could Rise 17 Pct for Young Adults
The Washington Post
March 30, 2010
Under the health care overhaul, young adults who buy their own insurance will carry a heavier burden of the medical costs of older Americans - a shift expected to raise insurance premiums for young people when the plan takes full effect.
Insurance Premiums Outrun Reform
The Indianapolis Star
March 30, 2010
Employer-sponsored plans could see double-digit increases.
Mental Health Experts Applaud Focus on Parity
The New York Times
March 30, 2010
Even without the new health care law, mental health advocates were getting ready to celebrate parity — a law requiring benefits for substance abuse and mental illnesses to be on par with benefits for medical illnesses.
Transparency/Safety
Law May Do Little to Help Curb Unnecessary Care
The New York Times
March 30, 2010
The health care law takes a stab at tamping down unnecessary tests and treatment, but it will not change the chronic overuse of care, experts say.
New Type of Ultrasound Might Substitute for Some Biopsies
The Washington Post
March 30, 2010
A new ultrasound technique called elastography can distinguish between malignant and benign tissue without the risk, and expense, of using a needle or scalpel.
State news
Hospital Strikes Loom in Pennsylvania, Minnesota, Massachusetts
Fierce Healthcare
March 29, 2010
Nurses and other unionized healthcare workers in at least three states are considering walking off the job if contract negotiations with hospitals don't address their concerns. Those concerns are wide-ranging, but pension benefits figure heavily in most disputes.
The Boston Globe
March 30, 2010
The New York private equity firm that struck a deal to buy Caritas Christi Health Care could build the chain of six Catholic community hospitals into a competitive lower-cost provider of medical services in Massachusetts. Cerberus Capital Management plans to invest $830 million to acquire Caritas Christi and turn the charity into a for-profit venture. The hospitals could emerge as an attractive lower-cost alternative to Boston's big teaching hospitals as healthcare reform moves forward soon in Massachusetts and later across the country.
Medicare/Medicaid
Doctors Get Reprieve From 21% Medicare Payment Cut
BusinessWeek
March 29, 2010
Doctors slated to have their Medicare reimbursements cut 21 percent on April 1 got a reprieve from the Centers for Medicare and Medicaid Services, which is delaying lowered payments until after Congress reconvenes.
Reform efforts
Health care experts on what the heath care overhaul will mean for Americans, sick and well alike. Those weighing in include Elizabeth A. McGlynn (associate director of health programs, RAND Corporation); Brian D. Smedley (vice president and director, Health Policy Institute at the Joint Center for Political and Economic Studies); Michael D. Tanner (senior fellow, Cato Institute); Henry J. Aaron (senior fellow, Brookings Institution); Gail Wilensky (administrator, Health Care Financing Administration, 1990-92); Timothy Stoltzfus Jost (professor, Washington and Lee University School of Law); Yvette Roubideaux, M.D.; (director, Indian Health Service); William H. Dow (associate professor, University of California, Berkeley); Karen Davenport (director of health policy, Center for American Progress); Karen Davis (president, Commonwealth Fund); and Jacob S. Hacker (professor political science, Yale University).
Sebelius Announces Health Reform Q&A Sessions
Department of Health and Human Services
March 31, 2010
The Department of Health and Human Services will be holding live, online Q&A sessions to answer consumers’ questions about the new health care reform law. The first will be held at 7 p.m. on Wednesday, March 31. Sebelius had indicated this will be the first in a series of weekly webcasts and discussions.
New Law Deals Setback to Malpractice Foes (subscription required; full text below)
Wall Street Journal
March 29, 2010
Some advocates of a tort overhaul said the new healthcare bill signed by President Obama failed to address their chief concern: that outsize jury verdicts have driven up the cost of malpractice insurance
Poll: Public Almost Evenly Divided on Health Care Law
USA Today
March 29, 2010
A USA TODAY/Gallup Poll shows an uphill selling job ahead for President Obama and congressional Democrats to convince most Americans that the health care overhaul passed last week will help them and their families.
In the poll, 50% call passage of the bill "a bad thing" and 47% say it was "a good thing." That's at odds with the findings of a one-day USA Today poll taken a week ago -- a day after the U.S. House approved the legislation -- in which a 49%-40% plurality called the bill "a good thing."
Miscellaneous
Politics Makes Strange Bedfellows in Fight Against Nonprofit Hospitals
The Hill
March 30, 2010
Sen. Chuck Grassley (R-Iowa) and Rep. Bobby Rush (D-Ill.) have formed an unusual alliance to ensure that tax-exempt hospitals treat patients without insurance.
Federal Judge Rules Against Patents On Human Genes
NPR
March 30, 2010
A decision against Myriad Genetics, holder of patents on gene tests for breast and ovarian cancer, could challenge the validity of thousands of patents on human genes.
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New Law Deals Setback to Malpractice Foes
Wall Street Journal
March 29, 2010
The health-care legislation has dealt another blow to a movement seeking to limit the amount doctors have to pay in medical-malpractice suits.
As a result, tort-overhaul advocates, who battle the well-organized lobby of plaintiffs' lawyers, are struggling to find ways to fight back.
On Tuesday, President Barack Obama signed the health-care bill in law. Some advocates of a tort overhaul—critics of how the nation's courts compensate the injured—said the bill failed to address their chief concern, that outsize jury verdicts have driven up the cost of malpractice insurance. Such verdicts have also caused doctors to practice "defensive medicine" in which they order unnecessary and pricey tests or procedures, according to tort-overhaul advocates.
The setback comes after two recent and similar court decisions. In February, the Illinois Supreme Court struck down the state's cap on medical-malpractice damages, saying it conflicted with the state's constitution. Earlier this week, the Georgia Supreme Court quashed a law that had limited pain-and-suffering awards in malpractice cases to $350,000.
Referring to the plaintiffs' lawyers lobby, a spokesman for the American Tort Reform Association, said: "These days, they're in the cat-bird seat. They're going to use these rulings to 'rah-rah' their supporters and build momentum." The association has a broad membership including nonprofits, corporations and trade groups.
During some of the earlier health discussions on Capitol Hill, a malpractice overhaul did receive some support from prominent Democrats, including Sen. John Kerry (D. Mass.) and former Sen. Bill Bradley, but petered out, critics say, after the plaintiffs' lawyers lobby applied pressure to Senate Democrats.
Anthony Tarricone, the president of the American Association for Justice, a leading lobbying group for the plaintiffs' bar, said: "Our position throughout the health-care debate was no secret: The rights of injured patients could not be used as bargaining chips. Health care is about patients, and when 98,000 people die every year from preventable medical errors, we worked to make sure their voices were heard loud and clear."
Some changes did make it into the final version, but critics say they are toothless. The law allocates $50 million to states looking to reduce costs associated with malpractice by setting up alternative ways of trying cases or trying to improve patient safety. But the law also provides an exemption, allowing plaintiffs to back out of any alternatives to state court, and instead to file claims in state court.
"I don't know anybody who thinks this is actual medical-liability reform, or finds this meaningful at all," said Lisa Rickard, president of the U.S. Chamber of Commerce's Institute for Legal Reform. "You're going to get watered-down demonstration projects designed to let plaintiffs' lawyers opt out at any time."
Backers of a tort overhaul have long pushed for sweeping changes to the way malpractice cases are handled.
Over the years, they have won damage caps in many states, including Texas, Florida and California. Still, citing ballooning costs of malpractice premiums for doctors, they have urged more change, such as setting up a separate court system for medical-malpractice cases.
But the recent Illinois and Georgia rulings—both of which dealt with limits on "non-economic damages," or damages for pain and suffering, disability and disfigurement—have troubled advocates.
In the Georgia case, a jury awarded $1.15 million in pain-and-suffering damages to a woman who suffered injuries during a facelift, and to her husband. On appeal, the state's Supreme Court rejected the argument that the damages cap should apply, ruling that it violated the state constitution's right to a jury trial.
In the Illinois case, lawyers for a girl born with brain damage sued for malpractice and challenged a law capping non-economic damages at $500,000 for doctors and $1 million for hospitals. The Illinois Supreme Court overturned the law, ruling it gave to the legislature a role traditionally reserved for the courts—the ability to reduce a verdict award—and thus violated the state's separation-of-powers doctrine.
"It's hard to comment on [the decision] because it's such a strange theory—that the legislature can't set limits on damages," said Theodore Olson, the well-known appellate lawyer for the doctor in Illinois.
Because the cases deal predominantly with state law, the defense lawyers see little point in appealing to the U.S. Supreme Court. So for now, tort-reform advocates in both states are relying on politics. Illinois Sen. Dave Luechtefeld last month introduced an amendment to the state constitution to allow for damage caps.
In both states, efforts are afoot to elect new justices in November. "We're evaluating all of their records," said Al Adomite, the vice president of the Illinois Justice League. "We want the public to get an immediate opportunity to let the justices know how they feel."
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