QUICK POST: Health Reform Deadline In Doubt July 31, 2009
Posted by Obi Jo in health reform.Tags: affordable health insurance, Congress, health, health care, health care reform, health insurance, health insurance access, health Insurance exclusions, health insurance reform, health plans, health reform, healthcare, Hospitals, House of Representatives, Insurance, insurance access, insurance benefits, Insurance Profits, mandated health coverage, Medicaid, medical care access, Medicare, patient care, patients, personal health mandates, personal health responsibility, physician payment, Physicians, pre existing conditions, President, President of the United States, Senate, underinsured, uninsured
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Senate Majority Leader Harry M. Reid acknowledged Thursday that his chamber is unable to pass health-care reform before its August recess, a move that highlighted internal Democratic divisions on the legislation and is likely to result in significant changes to the shape of the final bill.
The Aug. 7 deadline that President Obama set for House and Senate leaders to move their versions of reform served as a vital tool for congressional leaders in minimizing dissent as the $1 trillion package moved through five committees. But with their hopes of reaching that target date slipping in recent days, a torrent of complaints and concerns began to surface.
The comments by Reid (D-Nev.) confirmed the growing consensus on Capitol Hill that the White House’s fast-track approach has failed, and that a more plodding and contentious process has taken hold. Not only would the Senate not meet Obama’s timeline for passing a bill, but across the Capitol, House Speaker Nancy Pelosi (D-Calif.) was struggling to quell an uprising by conservative Democrats that had brought House action to a near halt.
When Democratic members of the Senate Finance Committee met Thursday morning and raised doubts about the bill coming through their panel. Sen. John F. Kerry (Mass.) questioned new Medicare formulas that could penalize high-cost states such as his. Sen. Bill Nelson (Fla.), who represents millions of elderly constituents, also expressed doubts about Medicare cuts that could add up to $500 billion over 10 years. Sen. John D. Rockefeller IV (W.Va.) lambasted the panel’s tentative decision to support the creation of member-run cooperatives rather than the government insurance plan that he and many other Democrats prefer.
Health Reform Deadline In Doubt Process Could Be Slow And More Contentious – http://www.washingtonpost.com/wp-dyn/content/article/2009/07/23/AR2009072303929.html
QUICK POST: Health bill inches forward in House July 31, 2009
Posted by Obi Jo in health reform.Tags: affordable health insurance, Congress, health, health care, health care reform, health insurance, health insurance access, health Insurance exclusions, health insurance reform, health plans, health reform, healthcare, House of Representatives, Insurance, insurance access, insurance benefits, Insurance Profits, Medicaid, medical care access, Medicare, patients, personal health mandates, personal health responsibility, Physicians, politics, pre existing conditions, President, President of the United States, Senate, underinsured, uninsured
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House Democrats pushed ahead with a compromise health overhaul today over liberals’ complaints, intent on achieving tangible — if modest — success on President Barack Obama’s top domestic priority ahead of a monthlong summer recess.
“We’ve got to pass the bill. Not only do we have to, but we’re going to,” said Rep. Henry Waxman, D-Calif., chairman of the Energy and Commerce Committee, the last of three House committees to act on the sweeping legislation.
In the Senate, which breaks for recess a week later than the House, talks on a bipartisan compromise sputtered with mixed signals emerging from negotiators.
Sen. Charles Grassley, R-Iowa, one of the six lawmakers involved in the talks, said they had made “very good progress” that could lead to a bipartisan bill, “but that’ll never happen if Democrat leaders tell Republicans to take a hike by forcing the committee to move on an all-Democrat bill.”
Pelosi provided House Democrats with talking points to take back to their districts. The headline — “Health Insurance Reform to Hold Insurance Companies Accountable” — showcased Democrats’ stepped-up efforts to cast insurance companies as villains in the debate, as polls show a public increasingly wary of the health care effort.
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QUICK POST: How Health Insurance Co-Op Might Work July 30, 2009
Posted by Obi Jo in health insurance, health insurance reform.Tags: affordable health insurance, co-op, Congress, health, health care, health care reform, health insurance, health insurance access, health insurance co-op, health Insurance exclusions, health insurance reform, health plans, health reform, healthcare, Insurance, insurance access, insurance benefits, mandated health coverage, medical care access, patients, personal health mandates, personal health responsibility, Physicians, pre existing conditions, President, President of the United States, Senate, underinsured, uninsured
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This approach is one possible option which would maintain a market based system in relation to private coverage, but allow essentially collective bargaining based on volume of potential subscribers. We continue to think that an individual mandate is the way to go with mandatory acceptance by insurers and a minimum defined base of benefits . . . obi jo
More than 12 million people could ultimately buy insurance under a co-op-styled structure, which would make it the nation’s third-largest provider of health insurance and give it enough clout to drive down costs of other private payers, according to one of its architects, Sen. Kent Conrad (D-N.D.).
Under such a structure, groups could bond together to build a critical mass of people, who would then collectively bargain with insurance companies for lower premiums and more benefits. Conrad said the proposal would give states wide berth to join together, as well.
The measure would require an upfront federal investment of $6 billion, which would be part of a financial reserve. An interim board would also be appointed by HHS and would be charged with setting policy and actuarial values.
Conrad detailed the plan before going into a negotiating session with a small, bipartisan group of Senate Finance Committee members. The committee is strongly leaning toward adopting co-ops instead of a public health plan, which Republicans have railed against. Conrad said that to be actuarially sound, a co-op would need at least 25,000 people to join, but would need considerably more, roughly 500,000, to have strong negotiating powers. More than 40 million people are expected to gain coverage under a reformed health system, he said.
Lawmaker outlines structure of co-op system – http://www.modernhealthcare.com/article/20090728/REG/307289944/-1
QUICK POST: CBO new estimate for health reform: $900 Billion July 30, 2009
Posted by Obi Jo in health reform.Tags: affordable health insurance, CBO, Congress, cost, health, health care, health care reform, health insurance, health insurance access, health Insurance exclusions, health insurance reform, health plans, health reform, healthcare, House of Representatives, Insurance, insurance access, mandated health coverage, Medicaid, medical care access, Medicare, personal health mandates, personal health responsibility, Physicians, President, President of the United States, Senate, underinsured, uninsured
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Well, they at least got the number under $1 trillion, but not by much . . . obi jo
The Congressional Budget Office said that a draft bill expected to emerge from the Senate Finance Committee would cost under $900 billion over the next decade and ensure healthcare coverage of 95% of Americans. Committee Chairman Max Baucus (D-Mont.), speaking to reporters outside of his Capitol Hill Office, called the report “good news,” but cautioned that the package omits several key provisions. He did not go into detail, however. “Nevertheless, the report is encouraging,” he said.
In a report sent to committee members Tuesday night, the CBO said that the current package would reduce the federal deficit in its 10th year by several billions of dollars. The package would also increase employer-sponsored coverage, shielding against “crowd out,” where workers would drop their current health plan in favor of an alternative, Baucus said. Republicans have expressed concern all along that provisions like a government-backed health plan would siphon away individuals from employer-sponsored plans. “This development will help us as we continue our discussions,” Baucus said.
CBO prices draft legislation at under $900 billion – http://www.modernhealthcare.com
QUICK POST: Deal with ‘Blue Dogs’ sets up health care vote July 30, 2009
Posted by Obi Jo in health reform.Tags: affordable health insurance, benefits, Blue Dogs, Congress, costs, doctors, enrollees, health, health care reform, health insurance, health insurance access, health Insurance exclusions, health insurance reform, health plans, health reform, Hospitals, House, House of Representatives, Insurance, insurance access, insurance benefits, medical care access, Medicare, Medicare Advantage, patient care, patients, payments, personal health mandates, personal health responsibility, Physicians, pre existing conditions, President, President of the United States, providers, Senate, underinsured, uninsured
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After weeks of turmoil, House Democrats reached a shaky peace with the party’s rebellious rank-and-file conservatives today and cleared the way for a vote in September on sweeping health care legislation.
Bipartisan Senate negotiators reported progress, too, on a bill to extend coverage to 95 percent of all Americans without raising federal deficits. “We’re on the edge. We’re almost there,” said Sen. Charles Grassley of Iowa, the senior Republican involved in the secretive Senate talks.
The House changes, which drew immediate opposition from liberals in the chamber, would reduce the federal subsidies designed to help lower-income families afford insurance, exempt additional businesses from a requirement to offer insurance to their workers and change the terms of a government insurance option.
More problematic from the Democrats’ point of view is a tentative agreement to omit a provision in which the government would sell insurance in competition with private industry. In its place, the group is expected to recommend non-profit cooperatives that could operate at the state, regional or even national level.
Nor is any bipartisan recommendation likely to include a requirement for large businesses to offer insurance to their workers. Instead, they would have a choice between offering coverage or paying a portion of any government subsidy that noninsured employees would receive.
Like the House bill, the bipartisan proposal under discussion would expand eligibility for Medicaid to 133 percent of the federal poverty level.
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QUICK POST: Health Care Reform and You July 27, 2009
Posted by Obi Jo in health insurance, health reform.Tags: underinsured, health insurance, pre existing conditions, health, health insurance reform, Congress, Medicare, President, uninsured, Medicaid, AHA, AMA, ACS, Senate, individual mandate, House, AAFP, illness, lapse in coverage, drop in coverage, insurance reform, mandatory health coverage
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The health care reform bills moving through Congress look as though they would do a good job of providing coverage for millions of uninsured Americans. But what would they do for the far greater number of people who already have insurance? As President Obama noted in his news conference last week, many of them are wondering: “What’s in this for me? How does my family stand to benefit from health insurance reform?”
Many crucial decisions on coverage and financing have yet to be made, but the general direction of the legislation is clear enough to make some educated guesses about the likely winners and losers.
As part of health reform, all insurance companies would be more tightly regulated. For Americans who are never quite certain that their policies will come through for them when needed, that is very good news.
The House bill, for example, would require that all new policies sold on or off the exchanges must offer yet-to-be-determined “essential benefits.” It would prohibit those policies from excluding or charging higher rates to people with pre-existing conditions and would bar the companies from rescinding policies after people come down with a serious illness. It would also prohibit insurers from setting annual or lifetime limits on what a policy would pay. All this would kick in immediately for all new policies. These rules would start in 2013 for policies purchased on the exchange, and, after a grace period, would apply to employer-provided plans as well.
Health Care Reform and You – http://www.nytimes.com/2009/07/26/opinion/26sun1.html?pagewanted=2&em
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QUICK POST: Reach of Subsidies Is Critical Issue for Health Plan July 27, 2009
Posted by Obi Jo in health insurance, health reform.Tags: bipartisan, Congress, costs, families, health, health care, health care reform, health insurance, health insurance reform, health legislation, health reform, House, Medicaid, Medicare, President, Senate, subsidies, subsidies for health insurance, underinsured, uninsured
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The major health care bills moving through Congress would require nearly all Americans to have health insurance. But as lawmakers struggle to achieve the goal of universal coverage, a critical question is whether the plans will be affordable to those who are currently uninsured.
All the bills offer some kind of assistance to lower-income people who do not get health benefits through the workplace. The bills would provide premium subsidies to millions of people and would establish limits on consumers’ out-of-pocket costs. But lawmakers and consumer groups say insurance could still be out of reach for many families with modest incomes who receive small subsidies or none at all.
“We have to make sure that the health plans are affordable to average Americans, and to low-wage workers who are not eligible for Medicaid, because they would confront a penalty if they do not have health insurance,” said Senator Olympia J. Snowe of Maine, a Republican who is leading efforts to forge a bipartisan bill.
The question of how to make insurance affordable to all Americans is just one of the difficult issues facing Congress as it debates what is President Obama’s top domestic priority. The House speaker, Nancy Pelosi, despite resistance from conservative Democrats, vowed on Sunday that a health care overhaul would pass. “When I take this bill to the floor, it will win,” Ms. Pelosi said on CNN.
Under the legislation, insurers generally must accept all applicants and could not deny coverage because of a person’s medical history.
But Senator Ron Wyden, Democrat of Oregon, acknowledged that “there are some questions” about whether insurance would be affordable. “People who are making $50,000 or $60,000 a year and are spending $13,000 on health insurance may not get much of a subsidy,” said Mr. Wyden, a member of the Finance Committee. “Those people will ask, ‘How am I going to make this work for me and my family?’
Reach of Subsidies Is Critical Issue for Health Plan – http://www.nytimes.com/2009/07/27/health/policy/27health.html?_r=1&hp
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QUICK POST: Democratic senators: Some Republican votes needed to reach President Barack Obama’s goal for health care bill July 27, 2009
Posted by Obi Jo in health insurance, health reform.Tags: AAFP, ACS, AHA, AMA, Congress, Democrats, denial of benefits, health, health care, health care bill, health care reform, health reform, insurance access, Medicaid, Medicare, Obama, patients, POTUS, President, Republicans, Senate, underinsured, uninsured
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Democratic senators: Some Republican votes needed to reach
President Barack Obama’s push to overhaul health care needs Republican votes, lawmakers from both parties say.
Democratic and GOP officials acknowledged Sunday that Obama’s ambitious plan would not pass without the aid of a doubtful GOP, whose members are almost united against the White House effort.
“Look, there are not the votes for Democrats to do this just on our side of the aisle,” said Sen. Kent Conrad, D-N.D., the chairman of the budget committee.
Rep. Jim Cooper, a Tennessee Democrat and a member of the fiscally conservative “Blue Dogs,” said he doubts the Democratic-controlled House could pass a proposal as it’s drafted now.
“We have a long way to go,” Cooper said.
House Speaker Nancy Pelosi, however, insisted she has the votes to move forward with the plan despite concerns among fiscally conservative fellow Democrats.
“When I take this bill to the floor, it will win. We will move forward, it will happen,” said Pelosi, D-Calif.
Not so fast, Republicans said. Sensing a public uneasiness over the pace and price tag of the overhaul, Republicans said the longer the delay, the more the public understands the stakes of a policy that has vexed lawmakers for decades.
“We could have a plan in a few weeks if the goal is not a government takeover,” said Sen. Jim DeMint, R-S.C. “We’ve never seen the government operate a plan of any kind effectively and at the budgets we talked about.”
Democrats countered that their plans — and there are many iterations on Capitol Hill, as committees in the House and Senate work on versions — would expand coverage without adding to the deficit. Even so, they are likely to leave for an August recess without a vote.
President Barack Obama’s goal for health care bill – http://www.nola.com/news/index.ssf/2009/07/democratic_senators_some_repub.html
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QUICK POST: Hospital Savings: Salaries for Doctors, Not Fees July 27, 2009
Posted by Obi Jo in health insurance.Tags: underinsured, health insurance, health reform, health, health care reform, Medicare, President, uninsured, Medicaid, Hospitals, AHA, AMA, ACS, health care, doctors, POTUS, health costs, House, fees, salary, salaried doctors, fee for service, surgeons, congress. senate, White House, health care costs
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There is a cadre of reformers that believe if only doctors where on salary then all would be well with health care economics. Heath costs would be curtailed and our economy would be robust and without the drag of excessive health care costs. Yet, what they all seem to miss is that many of the doctors who work in these systems (Mayo, Cleveland, etc.) earn good salaries, but are the beneficiaries of tax payer largess. How? By the extensive federal funding of medical eduction which allows these staff members to have fellows and residents take call, stay in the hospital, be the first responders for most medical and surgical emergencies. These medical education based ‘indentured servants’ provide innumerable benefits for the doctors in these systems. These perks allow these physicians to have a much more lavish and comfortable lifestyle than most physician in private practice. Still, if the benefits are so great, then why are not the vast majority of physicians clamoring to work for or to create systems of the type hyped in this article. Why? Because most physicians are ardently devoted to personal freedom and the ability to interact with patients in a way that is personal and unique to them. They do not wish to be part of a cookie cutter, clinic system that treats all patients the same, usually as clinic numbers, and treats doctors as technologic commodities. It is also true that many of these clinics are referral clinics, treating unique and complex cases and not doing much of the day to day health care that so many in both primary and speciality care do. Forcing doctors on to salary would be among the most counter productive measures we could ever take in attempting to achieve real health reform. Allowing doctors freedom to choose their style of practice has long been the key to the overall high quality of medicine practiced in the United States and can be an asset as we work toward Real Health Reform . . . obi jo and jomaxx
Changing those policies is crucial to the success of health care reform, economists say — something Mr. Obama said that he would do. “Our proposals would change incentives so that doctors and nurses finally are free to give patients the best care, not just the most expensive care,” the president said Thursday in Ohio.
Doctors in the United States are usually paid fees for each service they provide. The more procedures and tests they order, the more money they pocket. There is widespread agreement among health policy analysts that many of these procedures are unnecessary, raising costs in ways that often do nothing to improve patient health.
By contrast, Bassett — like the Cleveland Clinic and a small number of other health systems in this country — pays salaries to all of its doctors. No matter how many tests or procedures are performed, they take home the same amount of money. Medical costs at Bassett are lower than those at 90 percent of the hospitals in New York, while the quality of care ranks among the top 10 percent in the nation, surveys show.
Hospital Savings: Salaries for Doctors, Not Fees – http://www.nytimes.com/2009/07/25/health/policy/25doctors.html?ref=health
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QUICK POST: Partisan or Not, a Tough Course on Health Care July 27, 2009
Posted by Obi Jo in health insurance.Tags: AHA, AMA, Congress, Democrats, doctors, health, health care, health insurance, health insurance reform, health reform, Hospitals, House, House of Representatives, Obama, partisan, partisanship, patients, POTUS, President, Republicans, Senate, underinsured, uninsured
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Sadly, health reform has become a political exercise on all sides, but most particularly on the Democratic side. We have offered real solutions for REAL HEALTH REFORM but the Congress, apparently with the President’s blessing, has continued headlong with many components of health reform that are costly, unnecessary, expensive, and unproven in any fashion. We need Real Health Reform that is based on American principles and values, not much of what is being offered by this Administration or the Democratic congress . . . obi jo
The decision by Senate Democratic leaders last week to devote more time to winning Republican support for a health care overhaul has allowed President Obama to keep alive the possibility of bipartisanship on one of the most contentious issues on his agenda.
But Mr. Obama is under growing pressure to choose between wooing a small band of Republicans or struggling to rally his party to use its big majorities in Congress to get the job done. The bipartisanship exhibited in the passage of two other ambitious domestic programs that offer one historical backdrop for this debate — Social Security in 1935 and Medicare and Medicaid 30 years later — seems increasingly improbable in today’s Washington.
Should Mr. Obama abandon efforts to reach out to Republicans, he risks damaging his appeal among independent voters, who have a history of being put off by overt partisanship.
In addition, the go-it-alone course could cost Mr. Obama and, more important, Congressional Democrats political cover should the health care plan prove ineffective, unpopular or excessively costly before the 2010 or 2012 elections.
Partisan or Not, a Tough Course on Health Care – http://www.nytimes.com/2009/07/26/us/politics/26partisan.html?ref=health
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