03 April 2009

The week in health care politics

In Government:
HHS nominee Kathleen Sebelius sailed through her confirmation hearings, aided in part by the fact that the budget debate and votes were occurring contemporaneously.   Promised conservative grillings on her abortion positions and some tax issues never really materialized, though there was one extremely hostile exchange between Senator Abe Simpson John McCain and Governor Sebelius:
McCain's next round of questions played out much the same way: "Do you support a government-run health system," he demanded. Sebelius disputed the premise. McCain asked again. Sebelius asked him to clarify. McCain interrupted a third time. Finally, Sebelius ended the questioning. "If the question is do I support a public insurance option side by side in an insurance exchange with private options," she replied icily. "Then yes. I do."
Although there is a sense of urgency to get this last major nomination approved, in order to move forward with health care reform, it appears that Senate Republicans, unlikely to block her confirmation, will do what they can to delay it as long as possible.

It was nice to see that Sebelius does in fact back the inclusion of a public plan in a health care reform package.  Baucus has been hinting that it may be used as a bargaining chip.   According to a NYT report, Congressional Democrats remain committed to the public plan as a key plank in any reform package, but there are worrisome signs of compromise which could put the public plan on the chopping block:
Congress would authorize a new government-run insurance program, but it would come into existence only if certain conditions were met — if, for example, private insurers failed to rein in health costs by a certain amount after several years.
Harold Pollack at TNR reviews the history of physicians and the AMA in resisting past health care reforms, and notes that attitudes seem to be shifting, as more and more doctors come to embrace reform:
Sure, there will be pushing and shoving within the medical profession before this thing is done. Specialists and primary care doctors have different interests and different perspectives regarding comparative effectiveness research or the degree
to which public or private payers should exercise bargaining power over provider payment. [...] Without discounting these frictions, the medical profession is coming to see what many others have also seen. Our existing, increasingly dysfunctional healthcare system doesn’t just work poorly for patients. It works poorly for doctors and for many others, too.
In the media:
Multiple reports came out this week detailing the failure of the private market in covering patients who do not have employer-sponsored plans but who do have medical problems:

The Miami Herald
:
Insurers shun those taking certain meds:How health insurers secretly blacklist those with certain ailments.
Trying to buy health insurance on your own and have gallstones? You'll automatically be denied coverage. Rheumatoid arthritis? Automatic denial.
The New York Times:
Getting a Health Policy When You’re Already Sick
INSURANCE executives held out hope to the afflicted late last month by announcing their willingness to end a notorious industry practice: charging higher premiums to people with health problems or denying them coverage altogether. [...] For now, consumers with pre-existing medical conditions must continue the struggle to obtain and keep medical coverage.

“It is arguably the biggest minefield out there when it comes to getting and keeping your health insurance,” said Karen Pollitz, project director at the Health Policy Institute at Georgetown University. “Under the current system, the people who need insurance most can’t afford or can’t get coverage.”
Frontline:
Sick Around America
Outside of employer-based health care plans, matters are even worse. Americans seeking insurance in the individual market must submit to "medical underwriting," and if they have a pre-existing condition, they will likely be denied. Kaiser Permanente Chairman and CEO George Halverson says frankly: "I could not get insurance. I've had heart surgery, and so I am completely uninsurable in the private market. So it's important that I keep my job."
Remarkable honesty from an insurance executive.

Lastly, a little light comedy:
Voltaire famously said, "I have never made but one prayer to God, a very short one: 'O Lord make my enemies ridiculous.' And God granted it."    Perhaps Barack Obama uttered the same prayer once, for the conservative opposition to his health care plan is indeed laughable.

First, it was noted that one of the few private organizations spearheading the PR war against reform, "Conservatives for Patients' Rights," is headed by one Rick Scott.  Yeah, the same guy who was ousted by his own Board of Directors at HCA in the biggest health care fraud case ever.   Seriously.

Additionally, the House Republicans took President Obama's bait and released their own budget.  (Twice -- the second time with actual numbers!) Their solution to health care costs -- Privatize Medicare!   No, really.   They want to scrap medicare entirely and replace it with a system of vouchers for seniors to purchase privately administered insurance programs.  There must be a sort of freedom in being so irrelevant to the governing process that allows you to propose the wingnuttiest of schemes, knowing that it will appeal to the few ideologues left in your coalition but have no chance to become law.   Granted, nobody really cared, because the real budget passed easily without any republican involvement.   But it's worth noting that the gap between the Republicans left in Congress and the John Birch society grows smaller and smaller.

6 comments:

  1. Thank you! I always enjoy the variety of topics you wander between, but this was the most useful thing I've ever read. I am a medical student and I know that the current/imminent changes in health care are really, really important. I am also drowning in coursework. This = perfect.

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  2. I think Congress should make all health insurance companies accept the terms the Office of Personnel Management uses to contract for Federal Employee Health Benefits(FEHB)- there is no such thing as a pre-existing condition.
    for info on FEHB go to
    http://www.opm.gov/insure/

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  3. Great article, i really like it. thanks for nice sharing on Health Care.
    www.callcarenet.com

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  4. We are self insured, and my daughter was on Singulair and Flovent. Instant denial for a certain insurance. I felt like I was in the movie Sicko, as I argued with the health insurance, "You know she's not on a vent, she just has asthma when she gets a cold."

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  5. off topic, but, by the way:

    http://nortonbooks.typepad.com/everydaysociology/2009/04/total-institution-and-lifeworld.html

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  6. This is not anything new as insurance companies are private businesses and positively are within their rights to set protocols on which they will cover.

    Good day.

    ----------------
    Health Insurance

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