KHN Original Reporting & Commentary
Kaiser Health News staff writer Jenny Gold writes about legislation to repeal this exemption. "With comprehensive health care legislation foundering in Congress, the House is turning to a narrower piece of legislation that lawmakers hope has widespread, populist appeal: repealing the antitrust exemption for health and medical liability insurers. … But many antitrust experts say that ending the exemption -- by repealing the 1945 McCarran-Ferguson Act -- wouldn't significantly increase competition or reduce premiums" (Kaiser Health News).
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In his latest
Kaiser Health News column, done in partnership with The New Republic, Jonathan Cohn writes: ''[F]or much of the last year, Republicans have been scaring the bejeezus out of seniors by telling them that Democrats were out to destroy Medicare. But the Roadmap makes clear that it's not Democrats who seek massive, disruptive changes to the program. It's the Republicans. If the coming engagement between the Republicans and President Obama help the public to understand that reality, extending the debate might actually be worth it" (2/8).
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Kaiser Health News provides a fresh look at health policy development with "Hitting The Brakes" by Kirk Walters.
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Health Reform
The New York Times reports that the President's inivitation is for a half-day televised summit February 25. It is "a high-profile gambit that will allow Americans to watch as Democrats and Republicans try to break their political impasse." The move is seen as a way for Obama to force Republicans to help govern and to "put more scrutiny on Republican initiatives" on health care. There remains, however, a split among lawmakers – even among Democrats – on what should be in health reform legislation with even House and Senate Democrats differing on several key tenets, including inclusion or exclusion of a tax on high cost insurance policies (Zeleny, 2/7).
The Washington Post: Republican leaders on Sunday welcomed "the outreach" but maintained their position that lawmakers must start over on the health reform effort to win Republican cooperation. Meanwhile, Democratic leaders seem to welcome the step. "'As we continue our work to fix our broken health care system, Senate Democrats will not relent on our commitment to protecting consumers from insurance company abuses, reducing health care costs, saving Medicare and cutting the deficit,' Senate Majority Leader Harry M. Reid (D-Nev.) said in a statement shortly after the interview." House Speaker Nancy Pelosi and Reid are trying to "negotiate fixes to the Senate bill that the Senate could approve under special budget rules to protect the package from a GOP filibuster. Then the House could pass the fixes, along with the Senate bill." Many have called that process too partisan, however (Shear, 2/8).
Politico: "Obama said he wants to 'look at the Republican ideas that are out there. … If we can go, step by step, through a series of these issues and arrive at some agreements, then, procedurally, there's no reason why we can't do it a lot faster the process took last year,' he said. … Speaking to [CBS' Katie] Couric, Obama acknowledged public unhappiness with all the special deals in the legislation. 'What we have to do is just make sure that it is a much more clear and transparent process,' he said. 'I've got to push Congress on that'" (Budoff Brown and Allen, 2/7).
Bloomberg: "Senate Republican Leader Mitch McConnell of Kentucky, responding to Obama's idea, said legislation should start from scratch if Obama wants a measure that can get support from both parties. 'If we are to reach a bipartisan consensus, the White House can start by shelving the current health-spending bill,' McConnell said in an e-mailed statement. 'There are a number of issues with bipartisan support that we can start with when the 2,700-page bill is put on the shelf'" (Anderson Brower, 2/8).
Roll Call quotes a statement from Pelosi: "The House-passed health insurance reform legislation included a number of Republican amendments — added as the bill worked its way through three committees. In the last Congress, we worked with President Bush in a bipartisan way to pass initial economic recovery legislation, a bill to deal with the financial crisis and historic energy legislation that increased our nation's fuel efficiency standards for the first time in more than 30 years. We remain hopeful that the Republican leadership will work in a bipartisan fashion on the great challenges the American people face" (Pierce, 2/7).
The Wall Street Journal: But from others in the Democratic party, "[t]here was immediate skepticism ... that the forum would break the impasse. House Majority Leader Steny Hoyer (D., Md.) said he had reached out to Republicans 'on several occasions' last year to seek their ideas and feedback. 'I was, however, disappointed that these meetings did not result in any serious follow-through to work together in a bipartisan fashion,' he said" (Reddy and Meckler, 2/7).
Los Angeles Times: "The summit invitation serves two political purposes. For months, the president has endured criticism that he reneged on a promise to televise healthcare negotiations on C-SPAN. By opening up the summit to the cameras, Obama can argue he is making good on that commitment at a crucial point in the process. Also, the summit gives the president a chance to paint Republicans as obstructionists who refuse offers of compromise. If that's how the event is perceived, it could pay off for Democrats in the November midterm elections" (Nicholas, 2/8).
Kaiser Health News provides highlights of the weekend's headlines and highlights of health policy news, including President Obama's speech to the Democratic National Committee and Sunday's week-ahead reports.
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Kaiser Health News: "Proponents say that the legislation would spur competition among insurers and bring down costs for consumers. Reps. Tom Perriello, D-Va., and Betsy Markey, D-Colo., who are sponsoring the bill, said in a press release it would 'end special treatment for the insurance industry that allows them to fix prices, collude with each other, and set their own markets without fear of being investigated.' But many antitrust experts say that ending the exemption -- by repealing the 1945 McCarran-Ferguson Act -- wouldn't significantly increase competition or reduce premiums." The federal government is already "responsible for antitrust enforcement involving mergers and acquisitions" for insurers (Gold, 2/8).
McClatchy: The antitrust bill is part of an effort by House Democratic leaders "to start moving pieces of the [health reform] bill that they think can win approval. They also figured that simply having the debate - televised on C-SPAN and covered by the news media - would get the public re-engaged. 'This is very popular with the public. The market power of insurers has been blamed for increased health insurance premiums,' said Austin Frakt, a Boston University health economist. But rising costs, he said, stem from money passing through insurance companies to health care providers such as doctors and hospitals, and therefore 'passing something focused on insurers like this is not going to do a lot. It's not the reform that's really needed'" (Lightman, 2/7).
NPR: "David Balto, a former policy director at the Federal Trade Commission, now a senior fellow at the liberal Center for American Progress ... says the antitrust exemption has been a 'substantial obstacle' to consumer protection and other enforcement efforts aimed at insurance companies at both the state and federal level. 'In over a third of the states, including all the states with highly concentrated [insurance] markets, there were zero enforcement actions over the past five years,' he says. Backers of the legislation say they hope that more aggressive enforcement of antitrust laws against health insurance companies can reverse the trend toward consolidation - where just one or two or a handful of companies control the entire market. And that more competition can mean lower premiums" (Rovner, 2/8).
Politico: Perriello, one of the bill's co-sponsors, "is a test case, of sorts, to gauge the political fallout of voting for the legislation. His support has emboldened a slew of challengers in his central and southern Virginia district. He won the seat in 2008 from Virgil Goode, a six-term Republican lawmaker, and is now considered one of the more endangered Democrats in Congress. But he also left himself open to voting for a more sweeping package, should Democratic leaders in the House and Senate come to an agreement" (Sherman, 2/5).
Minnesota Public Radio: "The Minnesota Department of Commerce, which regulates insurance here also has some concerns about repealing the exemption. It's conceivable that some of the state's regulation power would shift to the federal government. Deputy Commerce Commissioner Manny Munson-Regala said a shift could mean a loss of money for Minnesota's treasury. 'We, like other states, collect a tax on the premium that companies write,' Munson-Regala said. 'If suddenly the federal government has a role in the regulation of those companies it's not clear to us that they'd allow us to continue collecting that revenue. They might insist on sharing that revenue'" (Stawicki, 2/8).
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The Associated Press reports that aides who helped with President Bill Clinton's health care reform effort are pushing to help President Barack Obama pass his health system overhaul this year.
The aides "are adamant that the Democrats can't afford another health care disaster. But they're divided on whether scaling down Obama's plan would be an acceptable solution. … 'If Bill Clinton couldn't get it done, and Barack Obama can't do it, no Democrat will ever try again,' said economist Len Nichols, health policy director at the New America Foundation. A Clinton White House health budget aide, Nichols has been operating as an unofficial adviser to lawmakers and administration officials wrestling with details of the current legislation. ... The mere mention of settling for less is causing consternation among former Clinton aides. Obama's health care plan — denounced as a government power grab by critics — is already scaled back from the ambition of the Clinton years." Some of the plans scaled back this time by Democrats include the amount any employer – even small ones – are required to contribute to their employees' health insurance. The Clinton plan would have required even small business employers to provide insurance coverage, Obama's plan does not (Alonso-Zaldivar, 2/8).
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Los Angeles Times: "Only months ago, supporters of the soda tax saw it as an idea whose hour was near. The sheer magnitude of the medical cost of obesity added urgency to the issue ... But opponents questioned any link between sugary drinks and obesity, and expressed concern about a slippery slope of taxes on other products. Proponents, meanwhile, thought a tax that drove down consumption while raising money for health care seemed like a natural with Democrats controlling Congress." But, the Obama White House has now rejected the idea, a congressional committee that once embraced it has refused to bring it to the table, and some interest groups -- having received support from the soft drink industry -- oppose it, even as they campaign against obesity (Hamburger and Geiger, 2/8).
Meanwhile, tanning salon representatives continue to fight another proposed tax in the Senate's health bill - a 10 percent surcharge on tanning bed use - arguing that it "is an example of political wrangling at its worst,"
The (New Jersey) Star-Ledger reports. "The tan tax replaces the earlier 'Botax' — a proposed 5 percent tax on elective cosmetic surgery procedures — and is expected to raise $2.7 billion over 10 years to help subsidize health care coverage for millions of uninsured Americans. ... In December, the American Academy of Dermatology Association -- after much lobbying help from plastic surgeons, dermatologists and the cosmeceutical industry -- persuaded Senate Democratic leaders to swap out the Botax for the tan tax, citing health risks associated with cosmetic tanning" (Kwoh, 2/7).
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Capitol Hill Watch
Lawmakers may include a number of Medicare "fixes" in the jobs bill, now that the health overhaul bill has stalled, The Hill reports. They would include restoring Medicare provisions that expired Jan. 1 or are set to expire later this year. "Nursing homes and rehabilitation therapy providers, along with patient groups, are pushing legislation to undo a hard-dollar cap on Medicare coverage of physical, speech and occupational therapy. Hospitals are seeking to restore special payments to large rural and small urban hospitals. Physicians also are pursuing the reinstatement of bonuses to rural doctors. Doctors are also clamoring for action to prevent a 21 percent cut in their Medicare payments that looms March 1." Senate Finance Committee Chairman Max Baucus, D-Mont., is preparing an "extenders" package to deal with the issues, and the House Ways and Means Committee is drafting its own extender (Young, 2/7).
The physician's change may be possible because of an exception to Congress's new "pay-as-you-go" rules, McKnight's reports. The exception allows "Congress to delay a pay cut for [Medicare] physicians for a number of years without necessarily taking money away from other areas of spending." The pay-go rules, meant to help Congress balance the federal budget, require new spending to be accounted for with savings elsewhere (2/8).
An extension of federal subsidies to help laid-off workers pay for COBRA health benefits could find its way into the jobs bill, too, Business Insurance reports. The COBRA extension was in the president's budget, released last week. And, Baucus and Senate Majority Leader Harry Reid, D-Nev., "and several other top Senate Democrats last week distributed a description of a soon-to-be-introduced jobs bill that would include extending the COBRA subsidy, but provided no specific details. One proposal under discussion, sources said, would extend the subsidy another three months so employees laid off in March, April and May would be eligible. ... The availability of the subsidy has sent COBRA opt-in rates soaring. In a survey of 200 large employers, Hewitt found that the percentage of laid-off employees opting for COBRA more than doubled to 39% from March 1, 2009, when the subsidy generally first became available, through Nov. 30, 2009" (Geisel, 2/8)
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Coverage & Access
The Wall Street Journal reports that insurers are bringing their insurance plans in compliance with new rules and laws that make mental health and substance abuse insurance coverage available to millions of Americans.
"The law, called the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, ensures that employees receive the same level of mental-health benefits as they do for medical and surgical care. It bans a plan from using deductibles for the treatment of mental-health disorders or substance abuse that are different from ones for medical and surgical care. And there can no longer be limits on treatment if no limits on medical and surgical care are in place as well." Analysts say the additional cost to insurers will likely be 1.5 percent annually, and employers seem to be keeping the benefit though the law doesn't require them to (Mincer, 2/7).
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Health Care Marketplace
News outlets report on how the fate of the health care overhaul might affect health industry mergers and biotech firms.
BusinessWeek: "With Congress' sweeping overhaul of the health system stalled, industry will seek its own answers to a push by government and the private sector to rein in costs, said Curtis Lane, senior managing director at MTS Health Partners, a New York-based equity fund." An aging population will further increase health spending, and "[o]ne solution will be increased consolidation, with companies led by WellPoint Inc., the biggest U.S. insurer by enrollment, and Community Health Systems Inc., the largest publicly traded hospital chain, scooping up rivals unable to 'spread rising costs across fewer customers,' said Paul Keckley, of the Deloitte Center for Health Solutions" (Nussbaum and Tirrell, 2/8).
Star-Ledger/NJ.com reports that while some biotech firms, including a start-up called Soligenix, are thriving, many others in the industry are struggling. "The nation's economic downturn has dried up many of the usual sources of money the smallest drugmakers depend on to pay for their work. ... Now, the industry is banking on a little-known provision of the Senate's health care reform bill to help ease - at least, temporarily - its inability to raise money from the usual sources, namely venture capitalists and the financial markets. The provision, known as the Therapeutic Tax Credit, is intended to help companies with 250 or fewer employees pay the salaries of their scientists, continue their research and even hire workers to help the companies push out new medicines."
"Sen. Robert Menendez (D-N.J.), who pushed to include the amendment as part of health care reform, has said the provision also could be added to the Senate jobs bill" (Todd, 2/7).
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A Texas court case reveals gaps in physician oversight,
The New York Times reports. "It was beyond [Anne Mitchell's] conception that she would be indicted and threatened with 10 years in prison for doing what she knew a nurse must: inform state regulators that a doctor at her rural hospital was practicing bad medicine." Mitchell was first jailed in June and will stand trial this week for "misuse of official information, a third-degree felony in Texas," after reporting a physician for using unorthodox procedures – some of which went awry – and practicing in an operating room where he did not have privileges. Mitchell says reporting the alleged transgressions was her responsibility as a nurse administrator. After the complaints were filed, the physician in question, Rolando G. Arafiles Jr., contacted the local sheriff, a friend and former patient, setting in motion the events that have led to Mitchell's unusual prosecution (Sack, 2/6).
Health News Florida: "Dr. Carlos Contreras has been in a federal prison since he pleaded guilty to health fraud in September 2008. But a state consumer web site still lists him in West Palm Beach with a 'clear and active' medical license -- and he's far from alone. It's the policy of Florida's Department of Health not to post public information about arrests and convictions until a professional licensing board takes final action, no matter how long that takes. ... The web site, which is supposed to inform the public about health professionals in the state, runs months and years behind real life" (Gentry, 2/5).
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Medicare
Reuters: "Medicare's move in 2005 to pay doctors to do bladder cancer surgery in their offices rather than in hospitals dramatically raised the number of procedures and overall health costs, U.S. researchers said on Monday. ... The findings reflect the complexity of cutting health costs in the United States, showing how in some cases Medicare -- the insurance program for the elderly and disabled -- gives doctors incentives to provide too much care, they said."
"Bladder cancer is the most expensive of all cancers to treat, with an average cost from diagnosis to death ranging from $96,000 to $187,000, according to [Dr. Micah Hemani, a bladder cancer expert] and colleagues. In theory, the Centers for Medicare and Medicaid Services decision in 2005 to pay doctors extra to do the procedure in their offices would cost less than doing it in a hospital, he said. Instead, the number of outpatient bladder cancer procedures in Hemani's group practice doubled after the Medicare pay hike and costs to Medicare rose 50 percent overall." The study appeared in the journal Cancer (Steenhuysen, 2/8).
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State Watch
Virginian-Pilot: Area hospitals are preparing "for a round of Medicaid spending cuts that executives say could be the worst in decades and lead to more cutbacks in their organizations. Rising health care costs and a surge in the number of Medicaid patients have increased the state's obligation to the government health insurance program for the poor and disabled by $777.7 million over two years. The state also must find $1.2 billion to replace stimulus money that the federal government provided last year to help Virginia cope with rising health care demands and declining state revenue. That funding stops at the end of this year." Former Gov. Timothy M. Kaine recommended in his budget proposal that Medicaid payment rates for hospitals be frozen. The General Assembly is trying to set a budget that deals with that as well as absorb a $1.9 billion shortfall in state revenues (Jeter, 2/8).
In a separate article, the Virginian-Pilot reports that Medicaid funding for the disabled is also being cut: "Not only is there no additional funding for the Medicaid waiver program that helps families keep disabled or elderly relatives at home instead of at institutions, but there's a one-year freeze on the existing waivers. That means even if someone already in the program dies, drops out or moves out of state, the money for that slot can't be used for someone on the waiting list" (Simpson, 2/8).
The Tennessean reports on state cuts to mental health care: "Tennessee's mental health agency, already struggling from last year's budget cuts, is facing a double whammy in 2010 -- deeper cuts to its own budget coupled with reductions in TennCare insurance for many of its patients. Advocates for the mentally ill say more reductions in services may endanger lives. ... Since July 2008, [The National Alliance on Mental Illness of Tennessee] has shed nearly a quarter of its staff -- 672 positions -- and more than 247 beds at its state hospital. ... Now, the Department of Mental Health and Developmental Disabilities is facing $9.4 million in additional cuts. For many patients, the newly proposed TennCare health plan cuts will compound the challenge by restricting doctor visits and laboratory tests" (Sanchez, 2/8).
In a separate story, the Tennessean reports on a possible hospital tax to help raise funds for TennCare, the state's Medicaid program: "Representatives for the hospital industry have suggested bringing back the hospital tax, which expired in 1994 when TennCare was created, to reduce or stave off cuts in state funding proposed by Gov. Phil Bredesen. Those cuts would save the state $380 million, according to one analysis. But they would cost Tennessee two to three times as much in federal aid, amplifying the effect on hospitals and other health-care providers far beyond the state's savings. ... Hospitals estimate that they would lose $526 million in state and federal funding this budget year and next if lawmakers approve the $28 billion spending plan that Bredesen presented to the legislature last week" (Sisk, 2/7).
The Nashua Telegraph reports on cuts to mental health care in New Hampshire: "Six years of incremental budget cuts have left the state's mental health centers on the brink of financial catastrophe, according to mental health experts. They worry that more cuts will push them over the edge. ... It's a position in which all of the state's community mental health centers find themselves to one extent or another, according to a new study released by the Endowment for Health. ... The report closely analyzed a six-year financial history of the centers and discovered that while the mental health system isn't in dire straits, it has no cushion to cover significant losses in revenue. All 10 of the mental health centers are independent nonprofits that contract with the state Department of Health and Human Services on an annual basis. But too much of the centers' revenue, an average of 75 percent of the combined $150 million in 2009, comes from state Medicaid and Medicare reimbursements and a federal match of those funds. The centers lack the ability to shift revenue from other sources to cover cuts in government reimbursements because there aren't many other revenue sources, according to the study" (Cote, 2/7).
Fond du Lac Reporter, on Medicaid cuts in Wisconsin: "Rural hospitals around Fond du Lac say a proposed assessment will help them avoid cutting services or raising prices. Ripon Medical Center and Waupun Memorial Hospital are two of the 59 critical-access hospitals across the state dealing with cuts in Medicaid payments. In an effort to slash costs, the state reduced its Medicaid reimbursements by 10 percent, leaving hospitals to pick up heftier bills for caring for low-income patients. ... The Wisconsin Hospital Association and Rural Wisconsin Hospital Cooperative are drafting a legislative bill that would help restore federal dollars to rural hospitals. Under a special assessment, each hospital would contribute 1.6 percent of its revenue to the Medicaid program. As a result, the federal government would provide matching funds to make up for the cuts" (Stanek, 2/8).
Anchorage Daily News: "As part of an effort to shave earmarks from the federal spending plan, President Obama has proposed cutting $10 million from a Denali Commission program that pays to purchase health equipment and build village clinics and elder housing in rural communities. ... Trying to delete the money has become a routine part of the federal budget-making process. Presidents Bush and Obama have proposed cutting the program each of the past three years, only to see Congress re-inject the money. ... The Denali Commission has steadily lost funding in recent years. The annual budget has fallen from about $141 million in 2006 to $61 million in 2010, according to the commission. ... The president proposes pulling all funding for the commission's health care construction budget, which has parceled out $191 million over the past 10 years and has paid at least partial construction costs for 95 clinics across the state, according to the commission" (Hopkins, 2/7).
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News outlets across the country report on state health policy developments.
The Los Angeles Times: "At a time when nearly 7 million Californians are uninsured, state regulators are trying to rein in discount health and dental plans that officials say frequently overstate benefits, offer little if any savings and promise access to doctors who aren't part of the system. Some of the discounters fraudulently market themselves as insurance, while preying on the poor, the elderly and others who urgently need care, officials say. ... Plan executives bristle at such criticism. They say a few bad apples have tarnished an industry that offers reliable -- and relatively inexpensive -- services. Consumers, however, have lodged complaints against more than 150 unlicensed discount health and dental plans over the last four years, prompting the California Department of Managed Health Care to seek new licensing regulations" (Helfand, 2/8).
WZZM, an ABC station in Michigan: "Health care experts say Michigan's expected nursing shortage may not be as bad as once thought. The state was bracing for deficit of nearly 18,000 nurses by the end of the decade. For years the medical community warned how the growing nursing shortage could jeopardize the industry and people's ability to get quality care. ... [Shawn Ulreich, the chair of The West Michigan Nursing Advisory Council] says the medical community has spent a lot of time and money attracting quality candidates to the field to reduce the chances of reaching a critical shortage" (2/7).
Lexington Herald Leader: Kentucky "has never had enough doctors. It is behind in primary care, specialty care and care for patients who live in rural areas. About 2,200 more physicians are needed in the state to meet the national standard of 267.9 doctors for every 100,000 people. Kentucky has about 213.5 active physicians for every 100,000 people. ... Now, a battle is brewing over how to give Kentuckians more medical attention in the future as the state's residents, already beset by a host of health maladies, grow older and sicker, and more people seek care. In one corner: medical schools, which are both adding new slots for more students and stepping up their efforts to train physicians to work in traditionally underserved rural areas. In the other: nurse practitioners, who are pushing for an increased role in serving patients" (Truman, 2/7).
Standard Speaker (of Hazleton, Penn.) reports on loss of nursing homes in Pennsylvania: "Carbon County appears to be joining Luzerne and Lackawanna counties in looking to get out of the nursing home business. In each case, the county nursing home has been viewed as a financial burden to a tightening budget. ... Michael J. Wilt, executive director of the Pennsylvania Association of County Affiliated Homes ... said selling the county nursing home amounts to a one-time budget boost, and wonders whether the short-term gain is worth it. ... Fifty counties in Pennsylvania once operated nursing homes, but the number is down to 31, according to Wilt" (Ragan, 2/7).
The Salt Lake Tribune reports: "Victims of medical malpractice could see the amount of damages they could receive cut in half under a bill that is likely to pit the state's physicians against the lawyers who represent injured patients. SB145, sponsored by Sen. Stuart Adams, R-Layton, would impose a hard limit of $250,000 available to malpractice victims as a result of pain and suffering. The current limit in Utah is $480,000. ... In October, the nonpartisan Congressional Budget Office wrote in a letter to Sen. Orrin Hatch, R-Utah, that a $250,000 cap on pain-and-suffering awards and instituting other tort reforms could reduce overall medical costs by 0.5 percent" (Gehrke, 2/7).
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Editorials and Opinions
Back To The Drawing Board Los Angeles Times
Democrats may not attract any GOP support for comprehensive healthcare reform by stepping up efforts to limit the growth in healthcare costs. But they will make the benefits of the measure clearer to a skeptical public (2/8).
Five Ideas For Getting Health Care Reform Back On Track USA Today
The only reasons for delay are short-term and political. It's expedient to punt. But Democrats are delusional if they think they'll inoculate themselves against attacks this fall by backtracking. No one wins by trying and failing. Nor, in the long run, does anyone win by simply stonewalling in the midst of crisis, as the Republicans have done. The problem still has to be solved (2/8).
Yes, Let's Talk About Those Republican Ideas Kaiser Health News
The idea that Republicans haven't had a chance to present their ideas on health care reform is a bit mind-boggling. Five separate congressional committees had hearings; each chamber had floor debates. That's hundreds of hours the GOP had to talk about health care, all of it in public view and televised on C-SPAN. And that’s not even including all of the unofficial channels at the Republicans' disposal. Generally speaking, the party of Rush Limbaugh and Fox Television doesn’t struggle to get across its message (Jonathan Cohn, 2/8).
The Full Cost Of Medical Fraud The Miami Herald
[M]ake no mistake: People who abuse the system by charging for bogus medical services, billing for unnecessary or inappropriate procedures or devices -- or even inventing patients and billable maladies -- are killers (Pascal J. Goldschmidt and Kenneth W. Goodman, 2/8).
Single-Payer Is The Only Answer To Health Reform Toledo Blade
I care for low-income patients in an inner-city Toledo clinic. My work there convinces me that our country never will have high-quality, accessible, affordable health care as long as private insurers make the rules. The best policy solution would be a single-payer system, such as an improved and expanded 'Medicare for All' (Johnathon Ross, 2/7).
On Health Care: 'Finish The Kitchen' The Washington Post
Democrats can finish the kitchen. Or they can face the wrath of voters who will wonder why the contractors they sent to Washington left all the wires hanging and the plumbing disconnected and useless (E.J. Dionne Jr., 2/8).
Health Care Reform -- A Plan In Search Of A Strategy Los Angeles Times
If Obama, Reid and Pelosi want to pass a bill this year, they can start by agreeing on a list of changes to reassure worried voters that their voices have been heard. Reid and Pelosi will have to persuade their fractious Democratic caucuses to walk in step, which is no small task. They'll need more help from Obama to do that. And Obama will need to appeal directly to the public to rebuild support for reform (Doyle McManus, 2/7).
Reform Can Be Simple, Or It Can Work St. Louis Post-Dispatch
The U.S. health care system isn't simple; it's mind-numbingly complex. So are the problems that beset it. ... The simple solution is to require everyone to get coverage. That means helping the many American families who don't earn enough to buy a health insurance on their own. What are you left with when it's done? A bill like those that have already passed in the House and the Senate (2/8).
Let's Get Rational About Health Care 'Rationing' The Baltimore Sun
As we embark on a path leading to universal health insurance, as we must, we also must begin to discuss the constraints that must be applied on the care to be provided. We must 'ration' health care and provide basic care to all that balances costs and benefits -- not only to the individual but also to society. Rationing end-of-life care and elective procedures might be a place to begin, but we also need a public debate on prioritizing that care. Let the debate begin (John M. Freeman, 2/8).
Put Health Costs On A Diet The Boston Globe
Paying for health care on a fee-for-service basis is an engine for inflation. Last year, a state reform commission came up with a better proposal: pay doctors and hospitals a fixed annual amount for treating each patient's particular condition, with quality safeguards. But for such a 'global' system to hold down costs, that annual amount has to go on a diet, with each year's increase ratcheted downward. Only in this way will patients and the doctors supervising their treatment have incentives to provide high-quality care in cost-efficient settings (2/8).
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