Health Care Reform Now

Reform Not Quite Dead Yet?

noreply@blogger.com (KJ Wojciechowski) — Wed, 27 Jan 2010 21:30:00 +0000

Democrats are planning on continuing the fight for reforming the nation's health care system.

When asked on the subject today, House Speaker Nancy Pelosi (D-CA) said "I don't see that as a possibility. We will have something."

Well, that's nice. Something.

I suppose that something is better than nothing, but in the end, if we end up with health care reform lite, which is what many in Congress are urging the administration to pursue, we will have no meaningful reform, only a photo-op for the President and members of Congress to trumpet as "success".

But success it will not be. In fact, a stripped-down version of health care reform legislation will do more harm than good, as it will make more difficult the introduction of the real meaningful reform that is needed, and will be unavoidable, eventually.

Can One New Senator Sink Health Care Reform?

noreply@blogger.com (KJ Wojciechowski) — Sat, 23 Jan 2010 23:03:00 +0000

That is the question that many reform supporters are asking themselves this week, after the surprise election last Tuesday of Republican Scott Brown to a Senate seat in Massachusetts previously held by the late Edward Kennedy.

Senator Kennedy was famously a champion of health care reform, who worked tirelessly towards the goal of improving health care access for all Americans practically until the day that he died.

Now, the fear (and the hope of HCR foes) is that the one additional vote gained by Republicans in the Senate will be enough to stop all further work on reform legislation.

Why would one vote make such a big difference?

Prior to Sen. Brown's election, the Democratic senators who were shepherding the various reform bills through the twists and turns of the law-making process, held a 60 seat "super majority" in the Senate, ensuring enough votes to pass the legislation even if ALL Republican senators voted "Nay" (which they did on a staggeringly regular basis).

Now the Republicans have the power to "filibuster", that is to block the legislation from moving forward.

The Republicans are widely expected to use this power.

Now what?

The Democrats in the Senate have a few options, however, none of them appear to be palatable to the leadership:

• They can try to pass the legislation in the week to two before Sen. Brown is formally seated

• They can ask the House of Representatives to pass the Senate bill, and then "ram" the bill through the Senate through a process called reconciliation, which requires only a 51-seat majority

• They can try to convince Sen. Brown, who professes to be very independent, and comes from a state which already has enacted sweeping health insurance and health care reform legislation, that HCR is for the good of the country and he should support it

But none of these options are likely to work.

Instead, the likely next step is a significant slow-down in the push for reform, and a return to the status-quo, or in other words, nothing has changed, except that many more Americans are now possibly aware for the need for reform, while many more, apparently, are now completely against it for reasons that they themselves probably don't understand very well.

Sen. Lieberman Tries to Kill Meaningful Reform

noreply@blogger.com (KJ Wojciechowski) — Mon, 14 Dec 2009 16:19:00 +0000

"You got to take out the Medicare buy-in. You got to forget about the public option.”

Sen. Joe Lieberman, (I-CT) is adamant on wanting to water down the health care reform bill, to the point that the overall effect of it will represent nothing more than a cosmetic change over the status quo.

As the senator from Connecticut, a state with some of the largest insurance companies headquartered within its borders (and consequently within its tax and voter base), Lieberman is playing fast and loose with the health of all Americans for the benefit of a small number of citizens of its state (and for the benefit of his own reelection efforts, to be sure).

To summarize, Sen. Lieberman is "dead set" against the idea of the public option (in essence, government run and funded health care), as well as the Medicare buy-in provisions of the bill, which would have allowed Americans as young as 55 to buy into the Medicare program, already the largest medical plan in the country.

Obviously, both of these provisions of the overall bill would go a long way towards covering the nearly 50 million Americans who are currently uninsured. Make no mistake: conservatives in Congress have been against any such provisions in the bill from the get-go, and they will fight tooth-and-nail to keep them out of the final framework.

Now, the leadership in the Congress will need to find a Republican vote to bring the total of "YES" votes to 60, the filibuster-proof majority that will be needed to pass the HCR bill with any meanigful reform included.

Odds are that Harry Reid will try to lean on Sen. Olympia Snowe of Maine, a moderate Republican, to help pass the bill.

And the dirty business of democracy goes on.

President Obama on HCR

noreply@blogger.com (KJ Wojciechowski) — Thu, 10 Dec 2009 19:33:00 +0000

President Obama spoke earlier today on the progress that's been made in Congress on the health care reform bill.

Lots of bipartisan work, apparently. Who would have thunk it?

Health Reform Bill Passes First Big Test in the Senate

noreply@blogger.com (KJ Wojciechowski) — Fri, 04 Dec 2009 00:37:00 +0000

Today, the health care reform bill as it is currently being considered in the Senate, passed two major tests on its way through a long and tumultuous approval process.

The first, arguably smaller hurdle, was the inclusion of provisions in the bill, which, if approved in the final draft, will force insurers to pay for certain services for women with no out-of-pocket costs (i.e. free for you); services include things like mammograms and other screening procedures, as well as some reproductive health services. (But not abortion - we're not touching the third rail today).

Sidebar
It's nice that for once a government body made up of mostly old men has decided to do something for women. Let's forget that Viagra is already covered under most typical insurance plans, and just move on.

The money. It's always about the money.

The second, much bigger and meaningful hurdle, was the stripping of US$460 billion from the Medicare program over ten years, to help pay for the reforms proposed in the bill. Sort of a shifting of money from one account to another, both of which are used to pay for essentially the same things.

There are a couple of reasons why this a big step: first off, this provision of the bill faces much lobbying opposition, specifically in the form of the They're not taking away MY guaranteed federal benefit money! lobby, which, as you can imagine, is strong on Capitol Hill.

Second, due in part to the to the strenuous lobbying, many Democratic senators had expressed "grave concerns" about the removal of funds from Medicare. It has all the hallmarks of the "health care reform will kill your grandma" meme from a few months ago, and many senators wanted absolutely no part of it.

Let's examine the reality.

Sen. Mitch McConnell (R-KY), (who is fast becoming my favorite prince of darkness in the post Lott-Delay era), said even as late as today: "Medicare is already in trouble. The program needs to be fixed, not raided to create another new government program".

Uhm, yes, Medicare is in trouble, but, and this is a HUGE but, it is in trouble mostly because the health care system as a whole is in trouble; fixing the latter will go a long way towards fixing the former. If we do nothing about the system now, Medicare is hopeless anyway.

Secondly, and perhaps most importantly, the US$460bln will not come out of any existing benefits funds.

I'll let Senators Max Baucus and Chuck Grassley explain:

Sen. Max Baucus, D-MT, and Sen. Chuck Grassley, R-IA

"I’d like to once and for all lay to rest this false claim that the pending bill is going to ‘hurt seniors’ and it is going to hurt providers and it’s going to be this long parade of horribles that the other side likes to mention. It is totally, patently untrue, the claims that they are making.”

And in a separate interview on Thursday he added:

"Our bill does nothing to reduce guaranteed Medicare benefits."

Got that?

Earlier, while speaking to reporters from his home state of Iowa, Sen. Chuck Grassley, a Republican, said that he doesn't think seniors will die sooner because of Medicare cuts in the Senate healthcare bill, rebutting a fellow Republican senator's claim.

To summarize, the plan to scare grandma into being against this particular provision of the larger bill was based on a falsehood, happily propagated by those who stand in the way of reform.

In the end, only two Democrats broke ranks, and this part of the bill passed 58-42 (yes, 42 United States Senators do not want you to have access to affordable health care; it's true).

This is significant, because it shows that when the chips are down, Democrats, like Republicans (always, it seems) can present a unified front in the face special interest opposition, and (at least for today) will not waver in their commitment to the grander project (getting the health care system fixed and saving us all from certain doom).

Today was a good day for our democracy. Now, if we could only do something about that Lieberman guy

Public Option With Optout For States?

noreply@blogger.com (KJ Wojciechowski) — Sat, 24 Oct 2009 21:38:00 +0000

Apparently, the Democrats in congress are willing to compromise in order to get the so-called "public option" passed, i.e. the institution of government-run health care for everyone.

Senate Democrats are leaning toward including a government-run insurance plan in a health-care measure that would let individual states opt out, a proposal House leaders signaled would be acceptable.

The establishment of the so-called public option to compete with private insurers is opposed by Republicans and has split Democrats. To get support from reluctant members of his party, Senate Democratic Leader Harry Reid of Nevada is likely to include the opt-out version in the legislation, said a Democratic aide who requested anonymity.

House Speaker Nancy Pelosi, who backs what she calls a more “robust” form of the public option, was asked yesterday about the Senate proposal at a Washington press conference. “I don’t think there’s much problem with that,” she said.

Does this sounds like Two Americas or what?

While the public option is a great idea, and fundamentally necessary for the success of health care reform, allowing states to opt out will create a situation in which Republican-run states (which are often poorer states, by the way) will deny their citizens the health care that the citizens of Democratic-run states will receive.

In essence, Americans living in places like Mississippi or Florida will get nothing while Americans living in Wisconsin will get their doctor bills paid for.

Does this sound like two Americas or what?

Does an "Obesity Tax" Make Sense?

noreply@blogger.com (KJ Wojciechowski) — Sat, 18 Apr 2009 20:38:00 +0000

This past week, my friend David Pechar wrote an opinion piece about New York State's proposed so-called "Obesity Tax" for Demockracy.com, in which he unequivocally defends Governor Patterson's decisions to back the legislation which would impose a tax on all soft drink purchases in the Empire State.

David writes:

The rise in health care spending for chronic illness is staggering and can be attributed to just a handful of conditions. Although the scientific data varies, one study by Kenneth Thorpe, PhD, Chair of the Department of Health Policy and Management at Emory University and former Deputy Assistant Secretary for Health Policy in the Clinton Administration, found that just five medical conditions accounted for a 31% increase in health care spending in a period spanning from 1987 to 2000. All five of these – heart disease, pulmonary disorders, mental disorders, cancer, and hypertension – are conditions associated with obesity.

This being all well and good, the question remains: are average Americans ready to accept the level on governmental intrusion into their daily lives that such a tax on basic consumption represents?

Head over to Demockracy.com and learn more about this interesting new wrinkle in the all-out war on health care expenditures.

Insurance Companies Propose Ending Practice of Setting Rates Based on Preexisting Conditions

noreply@blogger.com (KJ Wojciechowski) — Wed, 25 Mar 2009 15:16:00 +0000

The Administration's aggressive stance on health care reform has been a worry to the health insurance industry, which fears being marginalized (read: put out of business) by a possible government-run single-payer system.

The industry, not one to stand idly by as billions in revenue become endangered, has been working behind the scenes to ensure that they too, will have a voice in the new, reformed health care system.

To that effect, insurers have made three separate proposals for cooperation with the government, the latest of which represents a huge departure from the way in which the industry has historically operated.

Namely, a number of large insurers, among them Wellpoint, UnitedHealth, as well as the BlueCross BlueShield group of companies, have sent a letter to the offices of Senators Max Baucus (D-MT) and Edward Kennedy (D-MA), proposing the scrapping of the current system under which sick patients, or people with preexisting conditions, are charged much higher rates than healthy individuals.

This is potentially a huge development, because individuals with preexisting conditions historically make up a large portion of the percentage of Americans with no health insurance.

The quid pro quo that the industry is asking for, for now, is for the government to pledge not to set-up yet another publicly-run entity to compete with the insurers in seeking to cover those who currently lack coverage.

“We have outlined a path to achieving a health-care system where everyone has access to affordable coverage,” Zirkelbach said in an interview with Bloomberg. “This will accomplish the same goal that a government-run plan is designed to achieve.”

Well, maybe.

What the insurers want

As mentioned above, the insurance companies are looking for a pledge from the government to not create a public plan that would compete with the insurers themselves.

The industry is also seeking a government requirement that all individuals and families be required to purchase health insurance of some kind, whether directly from the private providers, or through some sort of public subsidy program for those who cannot afford to buy coverage on the open market.

In addition, insurers will continue to set rates based on age, geographical location, and family size, just as they do now.

National "Cover the Uninsured Week"

noreply@blogger.com (KJ Wojciechowski) — Tue, 24 Mar 2009 04:19:00 +0000

This week marks the seventh annual Cover the Uninsured Week, a project of the Robert Wood Johnson Foundation, which aims to shine a spotlight on the nearly 50 million Americans who live without government or private health insurance of any kind.

This week, health care industry members, local and national legislators, as well as representatives from organizations as diverse as the U.S. Chamber of Commerce, the AFL-CIO, the AARP, and many others, will hold summits and meetings around the country to discuss issues related to the uninsured, as well as to put forth proposals for solutions to our developing health care crisis.

Of course, this year the Week is all the more poignant given the Obama administration's stated goal of reforming health care and the health insurance industry. An important reform is already in place, with the signing earlier this year of the S-CHIP legislation, which provided insurance to millions of previously uninsured children.

The focus of the organizers is now shifting towards insuring whole families, not just children, as well as young adults who may be foregoing insurance coverage because of financial reasons.

During the 2008 Cover the Uninsured Week, organizers put together over 800 events that offered insurance enrollment to eligible families. The stated goal of this year's Week is to provide even more opportunities for individuals to learn more about insurance options available to them, and to make enrollment simple and inexpensive for those who qualify.

To learn more about Cover the Uninsured Week, and to find out about events taking place in your area, visit

http://www.covertheuninsured.org

National Small Business Association Gets Behind Reform. Sort Of.

noreply@blogger.com (KJ Wojciechowski) — Mon, 23 Mar 2009 15:40:00 +0000

Today, the National Small Business Association launched a website touting it's pro-reform efforts and platform.

This, of course, makes sense, as health care costs have been strangling small businesses in the U.S. for years. Many companies have simply decided to not offer benefits of any kind, while others, straining under the weight of legacy benefits, have shut down rather than continue to pay insurmountable premium bills.

One interesting statement from the site:

Reforming how health care is delivered in the U.S. is critical to the success of small business—something NSBA has been saying for years. In fact, in 2004, and previously in 1993, NSBA poured enormous resources into developing a proposal for broad health care reform. Meeting with small-business owners, benefit managers, insurance providers, Congressional staff, think-tank experts and leaders of small-business organizations throughout the country for more than a year, NSBA arrived at a proposal that will reduce health care costs while improving quality, bring about a fair sharing of health care costs, and focus on the empowerment and responsibility of individual health care consumers.

Basically, the NSBA is saying that they've been behind reform all along. Maybe.

The problem is that politically, the NSBA has historically supported candidates for office who've had an anti-reform agenda once elected. Let's see if this new mantra at the NSBA will lead them to truly support pro-reform efforts, or if this website/initiative is just a smoke-screen.

Could Veterans Be Forced To Pay For Service-Related Care?

noreply@blogger.com (KJ Wojciechowski) — Thu, 19 Mar 2009 15:18:00 +0000

Earlier this week, reports in the Atlanta Journal Constitution and CNN, described an Administration proposal to force veterans to pay for service-related injury care using third-party funding (health insurance, etc.), instead of the VA system.

Wha????

Apparently, the Obama Administration believes that it can save $540 billion by cutting costs at the Veterans Administration, and passing those costs on to third-party care providers.

As ridiculous as this plan sounds (even Jon Stewart made fun of the plan on his show Tuesday night), apparently the executive intends to go forward with exploring the possibility of implementing it, according to Gen. Erik Shinseki, Secretary of the VA.

Here are some problems I see right off the bat:

1. This idea is outrageous. As many veterans organizations have put it, such a plan would violate the "sacred trust" between government and soldier, which assures veterans (as well current active duty personnel and prospective recruits) that any injury they incur while serving will be cared for at 100% government expense.

2. This plan is unworkable. So far, the insurance industry's trade association has released a statement saying only that they take no position on the matter; you better believe that if the idea ever makes it past the embryonic stages, industry lobbyists will work overtime in the halls of Congress to quash it there.

3. Having third-parties pay for service care is likely against the rules of 99.9% of insurance policies. An insurance company could simply treat any injury that produces a claim as "work-related", which would make it a workers' comp issue.

4. The plan is "dead on arrival". This, according to Sen. Patty Murray, D-WA. Of course, anyone in Congress who ever puts the stamp of approval on any such plan, can kiss his or her seat good-bye, as outraged voters would quickly remove such a person from office.

What's REALLY Going On?

Does President Obama really want to hurt military families by forcing them to find a way to pay for care of combat and other service-related injuries?

Of course not!

This fake "proposal", is a ruse, a ploy to get Congressional leaders on board for an 11% increase in VA funding, which the Administration is seeking. While the Bush Administration constantly sought to cut the budget of VA hospitals and rehab centers (ironic, considering that the same Administration created quite a few injured and disabled veterans), President Obama has vowed to dramatically increase the level of care at these institutions.

But President Obama needs Congressional approval for budget increases in the Veteran Administration, and this red-herring plan is a way of showing representatives and senators how dire the situation is, and that they need to act to avert further cuts in care, and possible funding shortfalls.

It's somewhat surprising to see veterans' organizations getting all up-in-arms about the matter, but one could suppose that they must recognize at least the possibility that the plan is a real one, and react accordingly to defend their constituency.

More instructive is the reaction of the insurance industry. If they really believed that they might be on the hook for over half a billion dollars in future annual care expenses, they would be working overtime to stop the plan in its tracks. But they are not, thus telling everyone that they do not deem it to be a realistic proposal.

As with every other question in Washington, follow the money.

Bonus: watch Jon Stewart make fun of this "idea":

The Daily Show With Jon Stewart

M - Th 11p / 10c

That Can't Be Right - Veterans' Health Insurance

comedycentral.com

Daily Show Full Episodes

Important Things w/ Demetri Martin

Political Humor

The Brewing Controversy Over Health Benefit Taxation

noreply@blogger.com (KJ Wojciechowski) — Wed, 18 Mar 2009 19:10:00 +0000

Lost in the AIG bonus kerfuffle this week, is the developing story over the about-face that the Obama Administration appears to be making on the taxation of health benefits to employees.

According to a story in this past Sunday's NY Times, while President Obama will not openly push for such a change in policy, he "will not object if Congress takes up the issue".

A Little History

Health benefits, as offered to employees of companies that offer them, (those companies left that still offer them, that is), are not taxed as part of ordinary income due to a quirk in the law that goes back all the way to WWII.

During wartime, due to wage freezes, companies that wanted to attract or retain good workers could not offer salary raises or bonuses, so instead they begin to offer excellent benefit packages, inadvertently creating today's employer-sponsored health care system. Because industry had many friends in Congress, these benefits were not taxed at the time, and have remained untaxed for over sixty years, resulting in huge tax savings to employees, totaling over 246 billion dollars this past year.

Sen. Max Baucus

Now, many in Congress, among them Sen. Max Baucus (D-MT), who has a very detailed health care reform plan making its rounds through Congress, want to tax these benefits in order to pay for this plan.

The Problem for Obama

The problem for President Obama, and the reason why he must tread lightly on this issue, is twofold, and in both instances, political: first off, he made a specific promise during the presidential campaign not to tax benefits, calling Sen. McCain's plan to do so a "multi-trillion dollar tax increase"; as George Bush Sr. famously found out, voters tend to be rather unforgiving when it comes to campaign promises concerning tax increases.

Secondly, one of President Obama's most loyal (and most powerful) constituencies, the trade unions, are vehemently opposed to the taxing of benefits, because their rank-and-file members receive enormous benefit in the form of huge tax-savings under the current system. Angering the Teamsters and the other unions is probably not something that the Administration wants to do at this time, so any proposal that advocates the taxation of benefits will also have to come with assurances that the added cost to employees will come with substantial savings and or service improvements in other areas, such as lower overall health care costs, and improved access for all.

The Fundamental Problem

Neither of the above problems, however, appears to be insurmountable for Mr. Obama, who appears to be able to wily circumvent all political obstacles that special interests throw at him.

No, I believe that the problem with the taxation of health benefits is a more fundamental one, one that gets overlooked by many who focus strictly on the pros and cons of the numbers in play. Namely, I believe that the problem lies with messing with what works, in other words, making huge changes to the health benefits of those who are happy with their insurance, and do not want anything to upset the balance of care and cost that they currently enjoy.

While this may appear to be an egotistical position to take, it is nonetheless what millions of Americans firmly believe in, and one that can ultimately sink any well-meaning program of reform.

In fact, any health care reform plan, once drafted, absolutely must ensure that any American who is currently enjoying his or her insurance coverage, will be able to continue with the same standard of care, without substantial changes in cost and service levels. Upsetting this balance, which taxing employee health benefits might very well do, could doom any hopes for meaningful reform, as the insurance industry, and the wider health care industry as a whole, is sure to use tactics that will scare voters into not accepting such measures.

Sebelius Accepts Appointment, To Face Opposition From Pro-Life Groups

noreply@blogger.com (KJ Wojciechowski) — Mon, 02 Mar 2009 02:05:00 +0000

As expected, Kansas Governor Kathleen Sebelius has formally accepted the nomination to become the next Secretary of Health and Human Services. The nomination will now proceed to the Senate, where questioning is likely to arise concerning Ms. Sebelius' stance on women's reproductive rights, specifically abortion.

Governor Sebelius is pro-choice, something that right-to-life organizations are likely to try and use against her, in a (likely doomed) attempt to block the nomination.

Read more in-depth coverage from the New York Times.

President Obama's Speech On Health Care

noreply@blogger.com (KJ Wojciechowski) — Thu, 26 Feb 2009 20:22:00 +0000

On Tuesday, President Obama spoke for almost an hour on various domestic issues, including the reform of our health care system, and the introduction of universal coverage.

You can watch the part of the speech concerning health care right here, or read the transcript below. I'll publish analysis of the proposed plan tomorrow.

Excerpt of the speech concerning health care reform:

And for that same reason, we must also address the crushing cost of health care.

This is a cost that now causes a bankruptcy in America every 30 seconds. By the end of the year, it could cause 1.5 million Americans to lose their homes. In the last eight years, premiums have grown four times faster than wages. And in each of these years, 1 million more Americans have lost their health insurance.

It is one of the major reasons why small businesses close their doors and corporations ship jobs overseas. And it is one of the largest and fastest-growing parts of our budget.

Given these facts, we can no longer afford to put health care reform on hold. We can't afford to do it.

It's time.

Already, we've done more to advance the cause of health care reform in the last 30 days than we've done in the last decade. When it was days old, this Congress passed a law to provide and protect health insurance for 11 million American children whose parents work full-time.

Our recovery plan will invest in electronic health records and new technology that will reduce errors, bring down costs, ensure privacy, and save lives.

It will launch a new effort to conquer a disease that has touched the life of nearly every American, including me, by seeking a cure for cancer in our time.

And -- and it makes the largest investment ever in preventive care, because that's one of the best ways to keep our people healthy and our costs under control.

This budget builds on these reforms. It includes a historic commitment to comprehensive health care reform, a down payment on the principle that we must have quality, affordable health care for every American. It's a commitment

It's a commitment that's paid for in part by efficiencies in our system that are long overdue, and it's a step we must take if we hope to bring down our deficit in the years to come.

Now, there will be many different opinions and ideas about how to achieve reform. That's why I'm bringing together businesses and workers, doctors and health care providers, Democrats and Republicans to begin work on this issue next week.

I suffer no illusions that this will be an easy process. Once again, it will be hard. But I also know that nearly a century after Teddy Roosevelt first called for reform, the cost of our health care has weighed down our economy and our conscience long enough.

So let there be no doubt: Health care reform cannot wait, it must not wait, and it will not wait another year.

Can We Afford True Reform Right Now?

noreply@blogger.com (KJ Wojciechowski) — Tue, 24 Feb 2009 06:40:00 +0000

All of the obvious signs point to a big day for health care reform today, as President Barack Obama addresses Congress in a joint session in Washington on Tuesday evening.

Most administration "watchers" (and most cable tv networks, newspapers, bloggers, and your know-it-all office mate) already know what the meat of the speech is going to be: bringing health insurance coverage to the 1 in 7 Americans who currently lack it.

Great, right? Our job here is done. Right?

Unfortunately, not so fast.

With the stimulus funded, is there money left for health care???

Stated quite simply, no.

   It isn't necessarily that the money is lacking in Washington to pay for meaningful reform after close to 800 billion was spent on the economic stimulus package just last week. Rather, it is the political will, that's lacking.

   President Obama always needed 100% support from his Democratic brethren if there was going to be any hope of challenging the health care status quo. On top of this, he, and his Administration, would have needed considerable support, tacit if not actual votes, from across the aisle.

   Now, however, most Republicans in Congress are smarting from what they perceive to be a defeat over the stimulus package that (supposedly) went against everything they stand for. Because of this, they are not likely to give the President an inch in their stance on an issue, that, as I've described earlier, borders on holy doctrine for many in the Grand Old Party and their K Street supporters.

   Not only are President Obama and his health care team going up against formidable opponents in the form of Republican Congressmen and Senators, but the Administration may receive a lukewarm response from a smattering of fiscal conservatives in his own party as well. Some of these Democrats voted along party lines for the stimulus, but are privately appalled at the amount of new federal spending that the bill authorizes. These Democrats are not as likely to toe the line so readily again, especially not when it comes to any new programs that involve massive Treasury outlays.

How it might get paid for could piss off your rich uncle

   The "total cost" figure of 65 billion is one that has been floated by the administration in the press for some weeks now. It is a figure that is probably ridiculously low, realistically-speaking.

   But even if one assumes that the (initial? final? total? yearly? what?) cost of revolutionizing the way we Americans pay for health care is going to be only 65 billion dollars, where does President Obama plan on getting this money? Especially after spending 800 billion we already didn't have on the economic stimulus bill and promising to cut the budget by 50% before his first term is up...

Where will this money come from???

   Well, if you want Western European-styled government services, you're going to need Western European-styled taxation. Which is exactly the idea that is being tossed around in the West Wing these days. That's right: tax the rich.

   A repeal of the Bush tax cut on the wealthy was just a matter of time, but now the President and his allies in Congress (i.e. The Congress) have the excuse to get it done: tax the rich, in order to save our health care system, and provide insurance for all. It may sound socialist, and to many, it may sound un-American. It may also be the only option that is left.

   We can only hope that President Obama will present a logical, bipartisan plan on Tuesday, laying the groundwork for meaningful and true reform later in his term. In any case, it is going to be a long year for those of us who hope for meaningful change in the way that we all pay for health care.

As More Americans Are Laid-off, More Lose Medical Coverage

noreply@blogger.com (KJ Wojciechowski) — Mon, 23 Feb 2009 04:49:00 +0000

    Whether or not President Obama ultimately decides to nominate Kansas Governor Kathleen Sebelius to head the Department of Health and Human Services, one thing is clear: the new administrations intends to pursue the reform of our health care system with the vigor and energy that the President and his supporters promised the public during the election campaign.

    Those who want to see change happen, may not have to wait much longer: according to press reports, we can expect Mr. Obama to tackle the topic of covering the uninsured in his prime-time address to Congress this coming Tuesday.

    This action couldn't be more timely. With the number of uninsured Americans expected to rise to as much as 57 million at the end of 2009, up from a high of 47 million last year, the Obama administration simply must tackle this issue head-on, lest it derail all hope of economic recovery, both for the country, and for the millions of families facing bankruptcy due to unexpected (and unpaid) medical bills.

    Of course, as with every issue of this magnitude that is discussed openly in the political arena, there is an elephant in the room that no one wants to bring up first.

    This may seem obvious, but it bears repeating: as people lose jobs, they, and very often their entire families, lose health insurance coverage. Sure, there is COBRA, but those who point to COBRA coverage as the savior of the newly-unemployed conveniently ignore one startling fact: the bridge coverage that COBRA provides often costs recipients as much as 90% of the unemployment benefits they are entitled to collect.

    When the Sisyphean choice is housing or health insurance, or even food or health insurance, the more pressing needs almost always win out. Yes, some people manage to get on Medicaid when employer-sponsored group coverage disappears, but the number of those who qualify is small as compared to the total number of Americans who are losing their jobs (tens of thousands every day, it seems).

    Lawmakers will ignore the growing number of uninsured at their peril. With every new family kicked off the traditional, employer-sponsored insurance rolls, the health care system must somehow absorb individuals who still need care, but are no longer able to pay for it. This puts additional strain especially on public hospitals, clinics, and emergency rooms, institutions that can already be described as "always reeling" from budget cuts by state and local governments.

    No one knows for sure if the already-strained-to-the-maximum health care system can absorb ten additional uninsured this year. The fact is, it probably cannot. This is more reason why Congress, even as it licks its wounds from a short but violent stimulus bill fight, must tackle head-on the issue of reforming the way we pay for health care, lest we all pay for inaction tenfold later on.

    ~ Advertisment ~

Governor Kathleen Sebelius of Kansas to get HHS Nod

noreply@blogger.com (KJ Wojciechowski) — Thu, 19 Feb 2009 02:13:00 +0000

As has been rumored for some time, two-time Democratic Governon Kathleen Sebelius of Kansas will be nominated by President Obama to be the next Secretary of Health and Human Services.

According to the New York Times, Governor Sebelius is expected in Washington this week to continue the vetting process, which has gotten even more stringent after the withdrawn nomination of former Senator Tom Daschle over tax issues.

Because of the deeper investigation into each new nominee's finances and business affairs, it is unclear whether the Governor will be formally nominated this week or next, however, an adviser was quoted anonymously as saying that there are no other candidates near the top at the moment.

The impact on reform

As I've mentioned before, Governor Sebelius is an excellent choice for the role of spearheading health care reform efforts, because of her years of experience in working with industry while she was the Kansas Commissioner of Insurance, and also because of her extremely effective bipartisan efforts at reform while she served as Governor.

I believe that bipartisanship will be first and foremost on the Administration's mind as it attempts to push through some form of universal coverage past a recalcitrant Congress, entrenched industry interests, and overall ideological opposition to reform that borders on the religious in some parts of the political spectrum.

Having had a relatively tough time passing the financial stimulus bill, Mr. Obama and his Administration could be facing a possibly even more formidable set of opponents as they try to overhaul the decades-old way that Americans pay for health care.

Governor Sebelius' experience in the health care arena, coupled with her bipartisan reputation, will be instrumental in moving any bill through the congressional committees that will invariably try to kill anything that resembles real change.

Two Governors Are the Top Candidates to Head HHS

noreply@blogger.com (KJ Wojciechowski) — Tue, 10 Feb 2009 22:00:00 +0000

Would a Former Health Care Slasher Governor Make a Good Choice to Lead the Reform Effort?

After the resignation of Tom Daschle from consideration to head the Department of Health and Human Services, there has been a bit of a stampede by new candidates for the post.

Chief among these, are the candidacies of Tennessee Governor Phil Bredesen, and Kathleen Sebelius, the Governor of Kansas and a rising star in the Democratic party.

While the recent trend of choosing "executive" Governors for cabinet posts would continue regardless of which of the candidates is picked, the differences between the two can be stark.

Ms. Sebelius, a former Kansas Insurance Commissioner before becoming governor, was once named one of the "100 Most Powerful People in Health Care" by Modern Healthcare magazine; she was instrumental in preventing private take over of the state's Blue Cross/Blue Shield program by out-of-state private interests, as well as in some other initiatives, including increased prescription coverage for seniors, and an innovative program which allows Kansans to purchase less-costly prescriptions from Canada and Europe.

She has also been lauded for initiatives that crossed ideological lines in trying to lower health care costs across the whole spectrum of service.

From KSGovernor.com

In an effort to rein in skyrocketing health care costs, Governor Sebelius organized a Cost Containment Commission of business leaders, health care providers, private insurers, and patient advocates. The Commission has recommended ways to increase modern health care technology such as a transition to electronic medical records, which would reduce the cost of copying forms, as well as promote consistency in care and reduce the burdensome administrative costs that currently eat up more than thirty cents of every health care dollar.

The Slasher

Governor Bredesen, on the other hand, a former managed care executive, is reviled in many reform-minded circles for his slashing of the Tennessee Medicaid program, known as TennCare, in 2005.

At the time, the state had the highest percentage of any state's population on its Medicaid rolls. The costs, spiraling out of control, were seriously hampering the state government's ability to provide other basic services.

After some tough fights in the legislature, Gov. Bredesen cut 170,000 Tennesseans from the rolls, and reduced the benefits for countless others.

These may sound like draconian measures, more likely to be attributed to a conservative governor (and in fact, many conservatives love his candidacy for HHS), but this should not disqualify him from consideration by reform-minded progressives, seeing as he was able to bring a bloated monster of a health care system under control in his state, when inaction would have been fatal to the it.

Gov. Sebelius appeals to many for her ability to work within the system, bringing insurers, doctors, and even drug companies and hospitals together to figure out solutions. She's an excellent candidate. But I have feeling that Bredesen would not be the disaster at HHS that MoveOn and the like claim he would be. Some times, you need decisive action, even if that action is painful.

Democratic Senators Vow to Continue Fight for Reform

noreply@blogger.com (KJ Wojciechowski) — Fri, 06 Feb 2009 20:32:00 +0000

Some good news out on Thursday following the withdrawal of Tom Daschle's nomination for Secretary of HHS and administration point man on health care reform.

Two leading Democratic Senators, Ted Kennedy and Max Baucus (who has his own plan for health care reform he introduced last fall), wrote a letter to President Obama reaffirming their continued support for reform.

It's good to know that some people on the Hill intend to keep the pressure on. The SCHIP bill signing was a good first step, but we need more, much more!

Here's the full text of the letter:

Dear Sir:

We were saddened to hear about Senator Daschle's decision to withdraw from the nomination process. While we continue to believe that Senator Daschle is highly qualified to hold the position of Secretary of Health and Human Services, we respect his decision and wish him all the best in his future endeavors.

We are writing to affirm our continuing commitment to enacting comprehensive health care reform this year, and to express our confidence that you will swiftly choose an exceptionally qualified and dedicated alternate nominee for Secretary of Health and Human Services to assist in our efforts. As you have emphasized, we must act now. The ranks of the uninsured grow larger each day. The cost of health care to families, businesses and government are crippling and, although we spend more on health care than any other country, the quality of care provided by America's health care system is often uneven compared to other industrialized nations.

We have a moral duty to ensure that every American can get quality health care. We must act to contain the growth of health care costs to ensure our economic stability; to help American businesses deal with the health care challenge; and to make sure that we are getting our money's worth. Incremental efforts will no longer suffice and we cannot afford to wait any longer. With your continued leadership and commitment, we remain certain that our goal of enacting comprehensive health care reform can be accomplished this year.

Respectfully yours,

Senator Max Baucus
Chairman
Senate Finance Committee

Senator Edward M. Kennedy
Chairman
Senate HELP Committee

President Obama Signs SCHIP Legislation Giving Insurance to More Children

noreply@blogger.com (KJ Wojciechowski) — Thu, 05 Feb 2009 16:36:00 +0000

The measure, which passed Congress on a 290-135 vote, guarantees medical insurance through the States Children's Health Insurance Program.

The program will be expanded by the addition of up to 4 million kids, up from the current 7 million who participate.

President Obama called the signing "a down payment on my commitment to cover every single American".

Republican members of Congress, who in the past have blocked the CHIP program (a watered down version had passed in the previous Congress, but was vetoed by President Bush), expressed reservations, but didn't have the votes to beat the measure this time around.

This is a small victory for the new administration in what is likely to be a protracted battle over health care reform.

Some additional details from the the Associated Press.:

The CHIP program

_ Continues coverage through 2013 for 7 million lower income children.

_ Expands coverage for another 4.1 million uninsured children.

_ Makes 2.4 million children eligible for the program who otherwise might have access to private insurance.

_ Provides an additional $32.8 billion through Sept. 30, 2013, by increasing federal excise taxes on tobacco products. The tax on cigarettes will go up 62 cents to $1.01 a pack.

_ Provides $100 million in grants for states, local governments, schools and others to enroll more eligible children.

_ Requires states to offer a dental benefit.

_ Allows states to offer SCHIP dental coverage to children whose private medical insurance does not cover dentist visits.

_ Allows states to extend SCHIP and Medicaid to newly arrived legal immigrant children and pregnant women.

_ Allows states to use Social Security numbers to verify an applicant's citizenship, making it easier to prove eligibility and enroll in the program.

Daschle Withdraws

noreply@blogger.com (KJ Wojciechowski) — Tue, 03 Feb 2009 19:04:00 +0000

Daschle withdraws.

Damn it all to heck!

Daschle was an eminently qualified candidate. This is a major blow to our hopes for reform, AND to the Obama administration's plans for change.

The GOP is playing hardball.

Bill in Congress To Help Unemployed Pay for Health Insurance

noreply@blogger.com (KJ Wojciechowski) — Tue, 27 Jan 2009 16:01:00 +0000

The economic stimulus bill currently making its way through Congress contains provisions designed to help the recently unemployed pay for health insurance coverage while out of work.

Statistics show that health insurance coverage is the single biggest non-housing expense for individuals and families who find themselves in between job. Many people join the ranks of the uninsured, rather than pay for expensive COBRA coverage, or private health insurance. (In fact only 8% of those eligible actually pay for existing coverage under the COBRA plan).

The current bill, if approved by both the House and the Senate, would pay 65% of the premium of former workers who lost or will lose their jobs between Septempber 1st 2008, and December 31st, 2009.

For the unemployed, another option is temporary health insurance, which provides coverage for hospitalization at a fraction of the cost of a traditional health plan. However, these types of policies generally last only 6 months.

A Lesson in Health From an American Hero

noreply@blogger.com (KJ Wojciechowski) — Sat, 24 Jan 2009 19:47:00 +0000

I flew across the country yesterday, and had the pleasure and honor of flying with real, true American hero, Lt. Colonel Lee Archer of the 322nd Air Expeditionary Group, also known as the Tuskegee Airmen.

Mr. Archer was returning from the Presidential Inauguration at which he and many of his comrades had been guests of honor.

I have to say, that despite a knee injury, which visibly hobbled him, Mr. Archer was probably the spryest 89-year old man I have ever seen. It’s hard to explain, but he just had that “alive” look in his eyes, that kids playing ball on summer afternoons have. He looked like he was ready to live another 89 years.

I talked with his daughter-in-law for a bit, and together with a flight attendant, we talked about the subject of aging, and aging well. The F/A told us that her grandfather had recently passed, at the ripe age of 108. One hundred and eight!!!

What was his (and Mr. Archer’s) secret to such happy longevity?

Don’t drink, don’t smoke, and only eat food "out of your own hand" she quoted him as saying. Meaning, live a healthy life, and your body will reward you with a long and happy life.

The “don’t smoke” part is obvious (don’t smoke, and if you do, find a way to quit!), but the “don’t drink” part is a little tougher for most of us. Come on, who doesn’t enjoy a beer or three occasionally?

The thing that intrigued me the most about her grandfather’s statement was the “eat food out of your own hand” bit. Meaning, only eat what you yourself prepare – don’t eat out too much.

If you know what goes into your body, you can control what your body is burning for fuel. This is probably the most important, and the most often overlooked part of wellness. Fresh, unprocessed food is what our bodies evolved to “run on”, and keeping your diet as close to that primitive ideal will insure that our bodies run optimally. Like a well-tuned, taken-care-of engine of a car that runs for 20 years, our bodies, if taken care of well, will also run well for many, many years.

I for one am going to prepare all my own food today, even as I drink a glass or two of wine with dinner. But no cigarettes!

What Obama Means for Health Care Reform

noreply@blogger.com (KJ Wojciechowski) — Wed, 21 Jan 2009 17:20:00 +0000

Like millions (billions?) of people around the world, I watched President Barack Obama's inauguration speech yesterday, in awe of the hope and optimism that he engendered with a few simple words.

In his great speech, the President mentioned health care only twice, and then only in passing:

Our health care is too costly;

and

We will restore science to its rightful place, and wield technology's wonders to raise health care's quality and lower its cost.

These two statements alone might not be enough to make one hopeful that great change in health care is coming, but taken together with the President's stated goal of overhauling the way that our nation pays its doctor bills, they show that the Administration considers the matter to be of utmost importance.

Now, whether or not soon-to-be Secretary of Health and Human Services Tom Daschle will be able to push through the President's health care agenda in Congress remains to be seen. Certainly, the Democratic Party having control of both houses creates a perfect storm of opportunity to finally get something done in the reform arena, but as we saw in the 90's (with Hillary Clinton's ill-fated attempt at health care overhaul), sometimes all the good intentions and political will are not enough to overcome the entrenched special interest in Washington. (That would be the pharma, hospital, and most importantly, insurance lobbies).

Will we see the change that we're promised? That remains to be seen. But we can at the very least be hopeful, which is a nice change from the previous fifteen years.

UnitedHealth Group Settles Suit with NY State

noreply@blogger.com (KJ Wojciechowski) — Tue, 13 Jan 2009 19:09:00 +0000

In February of 2008, the New York State Attorney General, Andrew Cuomo, made a big splash by announcing that his office would investigate, and very possibly sue major health insurance carriers in the state over what were alleged to have been fraudulent billing practices.

“We believe there was an industrywide scheme perpetuated by some of the nation’s largest health insurers to deceive and defraud consumers,” Mr. Cuomo said at the time.

Well, lo and behold, one of the suits was settled today, by none other than UnitedHealth Group, the state's biggest insurer.

As part of the settlement with the state, the insurer admitted to no wrongdoing, however, it agreed to pay the state $50 million, which will ostensibly be used to set up a non-for profit independent billing company.

At the heart of the lawsuit were the billing practices of UnitedHealth and its competitors, who were accused of forcing patients to pay more for out-of-network care than the established market rates dictated.

How did these companies pull this off? UnitedHealth Group created a subsidiary, Ingenix Inc. which dictated the fees (co-payments, co-insurance, and such), that patients paid. But since Ingenix was in essence a part of UnitedHealth, there was an inherent conflict of interest, a conflict which, as the NY Attorney General proved, amounted to at least a $50 million fraud.

Score one for the good guys.

More on this story from MSNBC.