KHN Original Reporting & Commentary
Kaiser Health News staff writer Julie Appleby reports on findings regarding Medicare drug plan costs: "The 10 insurers with the largest numbers of Medicare drug plan customers raised premiums an average of 10 percent this year, an analysis released Friday by consulting firm Avalere Health shows" (Appleby, 3/12).
Read entire story.
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Kaiser Health News' Kate Steadman surveys the blogosphere to see how recent polls on health reform are playing. Her finding: "There's little consensus among bloggers about trends in public opinion toward the health care overhaul bills" (Steadman, 3/11).
Read entire Blog Watch.
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Kaiser Health News provides a different perspective on health policy developments with "Speed The Plow" by Clay Bennett.
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Health Reform
Democrats Thursday looked for a way forward on a health reform bill as colleagues in the House worried about abortion, other provisions and Senate passage of a reconciliation measure.
The New York Times: "Leaving a meeting of the House Democratic Caucus, lawmakers said they had received few details about what would be in the legislation, on which they may be asked to vote in the next week or two." Lawmakers continue to wait for cost estimates from the Congressional Budget Office on President Obama's proposal for a health overhaul. Wednesday, the CBO released cost estimates for the already-passed Senate bill that the House is considering passing. "In addition, lawmakers said, they were not given the text of the latest legislation drafted by House and Senate Democratic leaders and the White House to address widespread concerns about the bill passed by the Senate in December." House Speaker Nancy Pelosi said that the reconciliation bill, which Democrats hope to pass after passage of the Senate bill, would "reduce the Senate's tax on high-cost health insurance plans and increase subsidies to help low-income people buy health insurance." House lawmakers would then send it to the Senate for consideration, where it would need only a simple majority vote to pass (Pear, 3/11).
The Los Angeles Times reports that the timeline has slipped a bit from the March 18 deadline that White House officials set for final passage. Pelosi "said she wanted to give her members 'at least one week' to review the package before they vote on it. 'It may take longer,' she said after House Democrats met behind closed doors for two hours with Nancy-Ann DeParle, head of the White House Office of Health Reform" (Levey and Hook, 3/12).
The Associated Press: House Democrats will meet again Friday. After meeting Democrats Thursday, White House Chief of Staff Rahm Emanuel said, "'We made a lot of decisions. We're getting toward the end.' … Even with initial votes possible next week, few were claiming that Democrats had the votes in hand to prevail — especially in the House, where the roll call is expected to be a cliffhanger." House Democrats are worried that the Senate will not approve the reconciliation bill, which would leave them vulnerable to GOP campaign attacks (Fram, 3/12).
The Washington Post: Democrats are hopeful they can attach legislation that would expand federal aid for college students to health care reform. "Both proposals, stuck in Congress for nearly a year, are gaining new momentum as Democrats contemplate facing voters in November without having delivered on any of Obama's major policy objectives. Key Senate Democrats initially balked at combining the health-reform bill with a measure that overhauls the nation's student-loan program, but on Thursday they had warmed to the idea." Emanuel also supports pairing the two (Murray and Montgomery, 3/12).
The Wall Street Journal: The White House appears to have softened its deadline for passage of the health reform bill. "White House spokesman Robert Gibbs said it wasn't a big deal if President Barack Obama's March 18 target for House action on the bill slipped a bit. … Mr. Obama met Thursday with members of the congressional black and Hispanic caucuses to try to build support." The Hispanic lawmakers are threatening to withhold their votes if illegal immigrants aren't allowed to buy health insurance in the exchanges using their own money, but abortion is most likely the biggest sticking point. "Winning over a bloc of anti-abortion Democrats could be the most significant hurdle to House passage." As many as 12 Democratic votes could be pegged to how the abortion funding issue is handled in the final measure (Adamy, 3/12).
Politico 44 Blog: The Associated Press, according to this Politico blog, reported Friday morning that "President Obama is pushing back his trip to Asia, previously planned for March 18, by three days in order to focus on health care." The news came from a tweet by White House press secretary Robert Gibbs that the president will leave for Indonesia and Australia on Sunday (3/12).
The Associated Press/USA Today, in a separate story: Democratic leaders are planning to go ahead without the votes of anti-abortion lawmakers. Rep. Bart Stupak, D-Mich., "has been pushing for stricter provisions and says he and a dozen or so abortion opponents would vote against the health care bill if the Senate's version is retained. Leaders will try to peel off some of those lawmakers and make up for any remaining deficit with Democrats who opposed the health care legislation on the first round, when it passed 220-215. 'Many of the pro-life members are going to support passage of the health care bill,' [House Energy and Commerce Committee Chair Henry] Waxman predicted" (3/11).
Roll Call: There are "cracks showing" in the anti-abortion coalition. "Rep. Dale Kildee (D-Mich.), a key ally of Stupak's, said Wednesday night that he is satisfied that the Senate's abortion language effectively prohibits federal funding of abortions and will probably vote for the bill. And Rep. Marcy Kaptur (D-Ohio) said she would not easily vote for a bill that did not include Stupak's more restrictive language banning insurance coverage of abortion but stopped short of issuing an ultimatum" (Dennis and Newmyer, 3/11).
Politico: "House leaders now believe they can't change the abortion language in the Senate bill under the reconciliation process, which is only supposed to be used on budgetary matters. … Democratic leaders were nonetheless gearing up for a pair of committee hearings next week that will start the clock on a final, down-to-the-wire vote, which will require House Democrats to swallow their significant distaste for the Senate bill and to vote on faith that Senate leaders can muster the support to change it" (O'Connor, 3/11).
The Hill: "House Budget Committee Chairman John Spratt (D-S.C.) said he would convene members of his panel ... to prepare for a markup, the final stop for the legislation before it is readied for the floor. The next stop would be the Rules Committee, where Chairwoman Louise Slaughter (D-N.Y.) is mulling an arcane maneuver that would allow House Democrats to avoid actually voting on the Senate-passed bill" (Allen and Young, 3/11).
CNN reports the House Budget Committee is expected to vote Monday on the reconciliation bill (Desjardins, 3/12).
Bloomberg: "Obama is pushing Congress to act before lawmakers leave for a two-week recess on March 26. Pelosi said the vote 'is not something we are going to drag out'" (Litvan and Jensen, 3/12).
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Roll Call: After initially indicating "the Senate-passed health reform bill must be signed into law before Congress acts on companion reconciliation legislation, the Senate Parliamentarian has acknowledged that there are perhaps ways to draft a reconciliation measure that could move first." But, if Democrats choose to pursue this approach, "they likely would have to narrow the scope of the reconciliation bill." The Parliamentarian has noted that moving a broad reconciliation measure without the Senate measure first being signed into law "could create challenging procedural hurdles for Senate Democrats." This week, Senate GOP leadership received word from the Parliamentarian's office that "reconciliation instructions require any reconciliation bill to make changes in law. The parliamentarian's office is standing by this advice, according to Senate aides" (Drucker, 3/12)
The Hill: The Democrats' plan for passing the health overhaul was called into question when the Senate parliamentarian said yesterday that President Obama must first sign into law the Senate-passed health bill before the senators could consider separate legislation that would alter it on behalf of House members" (Bolton, 3/11).
CBS News: "Democrats were planning on bypassing Republican obstruction -- as well as reaching a compromise on the legislation within their own party -- with a multi-step process: The House would pass the health care bill already approved by the Senate. Then, both the House and Senate would pass a 'fix it' bill that would amend the Senate bill. The 'fix it' bill would pass the Senate via a process called reconciliation, which only requires 51 votes." Yesterday's ruling "could foil Democrats' plans to avoid signing into law the 'sweetheart deals' that have tainted the Senate bill" (Condon, 3/11).
Meanwhile, Senate Republicans touted the parliamentarian's ruling Thursday, but House Democrats say it will not affect their plans, since they have different rules from the Senate, CongressDaily reports. "That includes a rule that would declare the Senate bill passed upon passage of the reconciliation package, in effect helping House Democrats avoid an uncomfortable vote on the Senate-passed bill." A Democratic aide "then said the president would sign the Senate-passed bill before the Senate votes on reconciliation. It would appear that could cause a problem with House members who distrust the Senate to actually pass the reconciliation bill, but the aide said the House is good with proceeding that way" (Edney and Friedman, 3/12).
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The Wall Street Journal reports on a Republican strategies for influencing Democratic health reform votes. "Republicans ... are ramping up their warnings to Democratic lawmakers themselves, saying a 'yes' vote puts their political careers at risk. … 'I believe if they ram the bill through the House like this, they will lose their majority,' (House Minority Whip Eric Cantor) said. ... 'They do this at their peril.'" Republicans have shifted their strategy, which before consisted of pointing at public opinion they said was against the Democrats' health overhaul. In addition, Republicans are telling House Democrats "there is no guarantee the Senate will approve the 'fixes' bill, because reconciliation gives them other ways to block it." The GOP is also attacking the legitimacy of using reconciliation — which requires only a simple majority vote in the Senate to pass legislation (Bendavid, 3/12).
The Hill: Two senior Republicans said Thursday "they will use a grueling parliamentary process to chip away at healthcare reform legislation if Democrats decide to use reconciliation. Senate Republican Conference Chairman Lamar Alexander of Tennessee and ranking Republican Budget Committee member Judd Gregg (N.H.) said they will force votes on virtually every sentence of the healthcare reform bill to overcome Democrats' parliamentary maneuver. … 'There will be a lot of tough votes on this bill — a lot — that our colleagues are going to have to take,' Gregg said'" (Rushing, 3/11).
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The Charlotte (N.C.) Observer: "With the health care debate headed toward a showdown on Capitol Hill, the battle is being joined locally at street rallies, in television ads and through phone banks. Members of Congress, particularly Democratic moderates such as Rep. Bob Etheridge, are facing stepped-up lobbying efforts as President Barack Obama makes a final push for passage of a bill aimed to change the health care system. At the same time, conservative critics are waging a last effort to derail the bill" (Christensen, 3/12).
Fox News: The Chamber of Commerce is expected to spend around $200 million on political campaigns this fall, targeting mainly open seats and "vulnerable Democrats like Sens. Michael Bennett in Colorado and Blanche Lincoln in Arkansas." The Chamber has typically supported Republicans, but its leaders maintained an "uneasy" relationship with the Obama White House last year until breaking over health care and climate change legislation (Rosen, 3/11).
Roll Call: The American Future Fund, a conservative advocacy group, has launched a "$250,000 television ad buy targeting Senate Majority Leader Harry Reid (D-Nev.) over Democrats' procedural maneuvering on the health care bill. The 60-second spot, airing statewide on network and cable television starting Thursday night, comes as Republicans step up their rhetoric opposing Senate Democrats' plans to pass a controversial health care overhaul via reconciliation" (Cadei, 3/11).
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Quality
The Associated Press: "Too much cancer screening, too many heart tests, too many cesarean sections. A spate of recent reports suggest that too many Americans -- maybe even President Barack Obama -- are being overtreated." Defensive medicine and a culture focusing on medical technology have lead to overtesting but "now new evidence and guidelines are recommending a step back and more thorough doctor-patient conversations about risks and benefits."
This week's New England Journal of Medicine included a study suggesting "that too many patients are getting angiograms -- invasive imaging tests for heart disease -- who don't really need them who don't really need them; and specialists convened by the National Institutes of Health said doctors are too often demanding repeat cesarean deliveries for pregnant women after a first C-section." But some doctors and advocacy groups argue that screening "can improve survival chances and that saving even a few lives is worth the cost of routinely testing tens of thousands of people" (Tanner, 3/12).
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Coverage & Access
CNN reports that specialist nurses last year were paid higher average salaries than primary care doctors. "Primary care doctors were offered an average base salary of $173,000 in 2009 compared to an average base salary of $189,000 offered to certified nurse anesthetists, or CRNAs, according to the latest numbers from Merritt Hawkins & Associates, a physician recruiting and consulting firm." While this trend leads some to worry that it will only exacerbate the shortage of primary care doctors, the American Association of Nurse Anesthetists (AANA) continues to say they are being fairly compensated for the work that they do (Kavilanz, 3/11).
USA Today: A bill under consideration in Kentucky would give nurse practitioners more independence and allow them to prescribe certain medications without a signed agreement from a physician and other routine medical tasks. Already in Kentucky, the approximately 3,700 nurse practitioners in the state "are able to practice independently without being supervised by a physician. But in order to prescribe medicine they must obtain a signed agreement from a physician, even though that physician may not work directly with or consult with the nurse."
The Kentucky Medical Association is fighting the legislation, sharing the view of the American Medical Association, "which issued a report last fall critical of the training that nurse practitioners receive." Supporters of the bill say increased independence for nurse practitioners will help make up for the primary care doctor shortage, and Kentucky's bill would follow a national trend along those lines. According to the American Nurses Association: "Twelve states, including Alaska, New Mexico, Montana, Wisconsin and Wyoming, and the District of Columbia allow nurse practitioners to prescribe independently, including controlled substances … In 29 states, laws require physician collaboration for prescribing controlled substances" (Yetter/Halladay, 3/12).
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NPR: Some evangelical Christian groups in America are driving down health care costs in their own way, by helping each other pay medical bills instead of paying premiums. "James Lansberry, the vice president of Samaritan Ministries, says the concept is simple. First there's a $170 annual fee to cover Samaritan's administrative costs. His nonprofit group then compiles members' health care bills and tells its 14,000 households where to send their monthly checks." But there are restrictions, as well: "Religion is a large part of Samaritan's business model. Members need a pastor's signature just to join. And there are restrictions. If a member contracts a sexually transmitted disease outside of marriage, Samaritan members won't pay the associated health care costs." Benefits are also capped at $100,000 and members can vote to raise monthly contributions. There is also no guarantee that someone's bills will be covered. Groups like Samaritan are watching health reform for inclusion of an individual mandate to carry insurance, which would render their service effectively useless (Brady, 3/12).
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Health Care Marketplace
"The sour economy is producing a bumper crop of cash-strapped consumers, business owners and shady agents who're fueling a wave of insurance fraud that's keeping regulators and law enforcement officials busy from coast to coast," McClatchy reports. "Whether it's worthless health plans peddled by fax, staged auto accidents, arson or slip-and-fall accidents at the local mall, insurance fraud of all kinds is booming in the recession and consumers are paying the price in higher premiums. … A recent survey of 37 state insurance-fraud bureaus by the Coalition Against Insurance Fraud found that the recession 'appears to have had a significant impact on the incidence of fraud' last year. On average, the bureaus reported increases in case referrals and new investigations in all 15 categories of fraud the survey covers" (Pugh, 3/11).
Meanwhile, in other news, U.S. News and World Report reports on short-term health insurance plans, "which are offered by many major carriers," and "typically afford coverage for six months to a year, though some are available on a monthly basis. They are generally intended to insure against the unpredictable—accident, injury, or illness—and are heavily marketed as ways for healthy people in life transitions to 'bridge the gap' between jobs, say, and prevent lapses in coverage." But while the plans tend to be cheaper, benefits are usually limited, and they "generally are very strict about pre-existing conditions and don't tend to cover conditions that became manifested during a certain period prior to the plan's start date." In addition, short-term plans are usually not renewable, so "[a]ny health problem that arose and was covered during the last short-term policy will now likely be considered a pre-existing condition and probably won't be covered—if the person is even accepted" (Lyon, 3/11).
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Health Information Technology
Utah's health department will use $6.3 million in federal dollars to build a "computer pipeline" that will allow doctors and hospitals to share patient information,
The Salt Lake Tribune reports. The pipeline is paid for by the federal economic stimulus package, and the state will contract with the nonprofit Utah Health Information Network to build it. With the pipeline, "doctors could ... retrieve data from another provider about a patient's medical history, allergies or prescriptions. ... Participating clinics would pay a yearly subscription fee. And no one would have access to a patient's medical record unless the patient authorized it." But, some are skecptical. "Among deterrents to 'wiring' medical records are privacy concerns, high up-front costs and the lack of uniform ways of collecting and sharing patient information" (Stewart, 3/11).
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Health Policy Research
Urban Institute: The Cost Of Uncompensated Care With And Without Health Reform – This report analyzes various health bills. "The cost of uncompensated care will fall from $62.1 billion in 2009 to $46.6 billion in 2019 under the Senate bill, and to $36.5 billion in 2019 with the House bill. Without reform, the cost of uncompensated care will increase to between $107 and $141 billion in 2019, depending on growth in the economy and health care costs. ... Without health reform, the number of uninsured and the amount of uncompensated care will grow substantially. This will translate into increased pressure on state and local government to finance the growing cost of the uninsured" (Holahan and Garrett, 3/9).
Health Affairs: A Partisan Divide On The Uninsured – Based on a "random-digit-dial telephone survey" including over 1,000 adults, conducted June 17–20 2009 the authors found "the majority of survey respondents (56 percent)… perceived that the uninsured are able to get necessary medical care," however, less than 31 percent believed their care was as good as that received by an insured person. "Senior citizens are less aware than others of the problems faced by the uninsured. Even among those Americans who perceive that the uninsured have poor access to care, Republicans are significantly less likely than Democrats to support reform. Thus, our findings indicate that even if political obstacles are overcome and health reform is enacted, future political support for ongoing financing to cover the uninsured could be uncertain," the authors write (Oakman et al., 3/11).
Kaiser Family Foundation: Comparison Of Expenditures In Nongroup And Employer-Sponsored Insurance: 2004-2007 – Based on pooled data from the Medical Expenditures Panel Survey Household Component 2004-2007, this brief reports, "The average and median annual amounts paid by private health insurance are higher for ESI [employer-sponsored insurance] enrollees than for nongroup enrollees for most age groups," however "nongroup insurance is less likely than employer-sponsored health insurance to pay for health care expenditures that people have, leaving nongroup enrollees to pay for a relatively high share of their health care expenditures out-of-pocket." The brief also finds "nongroup enrollees are more likely than ESI enrollees to classify their health status as excellent."
"These findings raise some important considerations for policy makers evaluating different options for covering the uninsured. … Policymakers should be careful not to assume that they could insure many of the currently uninsured at the premium levels now observed in the nongroup market" (March 2010).
Mathematica Policy Research: Quality's New Frontier: Reducing Hospitalizations And Improving Transitions In Long-Term Care – This brief "identifies ways to measure and reduce potentially avoidable hospitalizations and improve the quality of long-term care for people in nursing homes and other home- and community-based service settings." The authors write: "We also need to explore how to adapt effective interventions from other settings to the long-term care field, scale up the most promising practices, and change underlying financial incentives" (Lipson and Simon, March 2010).
Robert Wood Johnson Foundation: Improving Patient Flow And Reducing Emergency Department (ED) Crowding – This issue brief tracks the progress of the Urgent Matters Learning Network II (LN II) initiative, "a collaborative of six participating hospitals nationwide that are working together over an 18-month period to identify, develop and implement strategies to improve patient flow and reduce [Emergency Department] crowding." Some of the focus is on getting patients' pain managed more quickly (Feb. 2010).
Annals of Family Medicine: Physician Office vs Retail Clinic: Patient Preferences In Care Seeking For Minor Illnesses – This study examines how cost of care and appointment wait time influence a consumer's willingness to seek care at retail clinics or physician's office. "Willingness-to-pay estimates suggest that, all else being equal, a cost savings of $31.42 would be required for the respondents to seek care from a nurse practitioner at a retail clinic. Similarly, a cost savings of $82.12 would be required for them to choose to wait 1 day or more. Overall, a savings of $167.77 would be required for the respondents not to seek medical care for their symptoms (ie, they would seek care if the cost is less than $167.77). ... Primary care physician practices, especially in competitive markets, are therefore likely to derive greater competitive advantage by addressing patient convenience features (such as same-day scheduling, walk-in hours, and extended hours) than by reducing fees" (Ahmed and Fincham, March/April 2010).
Commonwealth Fund: The Massachusetts Child Psychiatry Access Project: Supporting Mental Health Treatment In Primary Care – This case study examines a program in Massachusetts aimed at increasing primary care providers' access to child psychiatrists and mental health specialists. As of July 2009, the Massachusetts Child Psychiatry Access Project (MCPAP) had enrolled 365 primary care practices "believed to cover at least 95 percent of the approximately 1.5 million children in the Commonwealth. .... MCPAP's success in supporting primary care providers may be a model that is adaptable beyond children’s mental health" and "may also offer a model for leveraging other scarce specialty resources," author of the case study writes (Holt, March 2010).
Kaiser Family Foundation/Center for Children and Families at the Georgetown University Health Policy Institute: CHIP TIPS: Children's Oral Health Benefits - In addition to expanding dental coverage for children, the new requirement under the Children’s Health Insurance Program Reauthorization Act (CHIPRA) that all CHIP programs cover comprehensive dental benefits "calls for improved access to information on dental providers and covered dental benefits for Medicaid and CHIP enrollees; Allows federally-qualified community health centers (FQHC) to contract with private practice dental providers to provide oral health services; Compels states to report on certain oral health services; and Includes dental care among the initial core set of child health quality measures to be developed by the Health and Human Services (HHS) Secretary, and requires the Secretary to provide information on efforts to improve dental care in reports to Congress on the quality of children’s health care under Medicaid and CHIP," according to the brief (March 2010).
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Medicaid
The Boston Globe: "President Obama's demand to delete 'special deals' in the health care package would eliminate $500 million in extra Medicaid cash for Massachusetts, but Bay State lawmakers say they are confident the state would recoup that and probably more once negotiations are complete. Obama, facing an electorate angry over side deals in the massive package, has told congressional leaders to remove them to make the proposal more salable to the public. One of those deals is a Senate provision to reimburse Massachusetts and Vermont for having already expanded Medicaid coverage to a broader base of low-income people. But Senator John F. Kerry, a key Obama ally in the health care talks, said the White House has given him personal assurances that Massachusetts will not suffer in the final package" (Milligan, 3/12).
The Associated Press: "The South Dakota Legislature's plans to cut state spending next year were thrown into question Thursday when lawmakers learned the state might get an extra $36 million in federal aid. ... Legislative leaders said they want to find out whether Congress gives final approval by the end of March to a measure that would provide states with extra federal money for Medicaid, the state-federal program that pays the medical expenses of poor people. ... The delay in finishing work on the state budget will give South Dakota officials time to find out if the expected extra federal aid can be used to patch holes in the state budget, said Senate Appropriations Chair Jean Hunhoff, R-Yankton" (Brokaw, 3/11).
The Arizona Republic: "State lawmakers delivered on Gov. Jan Brewer's promise to end the days of 'expanded government,' passing a budget Thursday that eliminates programs and cuts $1.1 billion in spending. On largely party-line votes, the Republican-controlled Legislature approved an $8.9 billion spending plan that ends a health-care program for 47,000 low- income children, removes 310,000 adults from state health coverage and cuts the funds that were one of the last best hopes for the state parks system to stay afloat. The cuts are needed, Republicans said, to bring state spending in line with its sagging revenue. Arizona faced a $2.6 billion deficit for fiscal 2011" (Pitzl, 3/12)
The [South Carolina] State: "The S.C. House will not have to tighten the belt on state spending quite so much when legislators begin debating the budget next week. Congress is poised to approve $200 million more in state aid, which would reverse some proposed cuts in the $5.1 billion budget plan. And state revenues - which have been in free fall for two years - are stabilizing. Wednesday, the U.S. Senate approved a six-month extension for stimulus-related state health care money. House lawmakers said Thursday they plan to use the roughly $200 million to restore cuts that could have eliminated services for 26,000 of the state's disabled, cut access to state-funded health care for children in low-income families and restricted the number of prescription drugs for Medicaid patients" (O'Connor, 3/12).
The Columbia Missourian: "Facing the largest revenue decline in Missouri history, Gov. Jay Nixon cut an additional $126 million from the current budget Thursday. Revenue collections for fiscal year 2010 have declined 12.7 percent as of March 1, according to the Office of Administration. More than $850 million in cuts have been made to the fiscal year 2010 budget since it was passed in May. According to Budget Director Linda Luebbering, almost 60 percent of the $126 million will come from savings in Medicaid ... because of an increase in match rates" (Essig, 3/11).
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State Watch
Texas Tribune: Since 2004 Texas has run a disease management program they believed would improve care for Medicaid patients and save the state money. "The company said it would use persistent phone calls, a 24-hour hotline, and house visits if necessary to persuade Medicaid patients to take better care of themselves, saving the state an estimated $14 million a year in hospitalizations and other costs."
Texas went ahead with their program even though similar programs in many other states were not proven successful. "Those that improved care didn't always save money; those that saved money didn’t always improve care. A 2004 study by the Congressional Budget Office fired a warning shot: It found 'insufficient evidence to conclude that disease management programs can generally reduce overall health spending.'"
A 2009 report states: "no conclusive evidence that [disease management] reduces overall costs and only limited evidence that it can improve quality of care for some conditions." But others say programs provide more value to patients, and "the health care reform Congress is considering will likely include more incentives for employers who provide the service." The Texas state legislature is still deciding whether or not to continue the disease management program (Ramshaw 3/12).
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"Gov. Brian Schweitzer [D-Mont.] said Thursday that he is seeking federal permission to import cheaper drugs from Canada for use in state insurance programs,"
The Associated Press/The New York Times reports. "Schweitzer said he thinks the move could chop 40 percent off the $100 million the state spends each year on prescription drugs for Medicaid, the children's health insurance program, state employees, and inmates at the prison. …The governor said he envisions the state setting up a deal with a Canadian wholesaler that could mail the drugs to local pharmacies on insurance plans paid for by the state. In the case of the prison, the governor said he expects the state would order those directly" (3/11).
In New York, "[a] settlement of up to $657.5 million has been reached in the cases of thousands of rescue and cleanup workers at ground zero who sued the city over damage to their health, according to city officials and lawyers for the plaintiffs,"
The New York Times reports. "They said that the settlement would compensate about 10,000 plaintiffs according to the severity of their illnesses and the level of their exposure to contaminants at the World Trade Center site. … The settlement, which took two years to negotiate, raises the prospect of an end to years of complex and politically charged litigation that has pitted angry victims against city officials, who questioned the validity of some claims and argued that the city should be immune from liability" (Navarro, 3/11).
Meanwhile, "[a]nother set of health care reform bills that will keep Utah moving down its own health care reform path regardless of what Congress does this spring [was] approved this session,"
Deseret News reports. The central piece of legislation "adds more girders to support the basic free-market, consumer-oriented restructuring of the state's health care system now in the third year of a decade-long process." It also "adds transparency so consumers can track positive and negative outcomes of procedures, expands and refines the pilot Web-based health care exchange and adds a caveat for health care insurance carriers to ensure they develop plans that will allow significant portions of Utah's 300,000 uninsured to be able to buy into a plan" (Thalman, 3/11).
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Editorials and Opinions
Health Reform Myths The New York Times
Health reform is back from the dead. ... But reform still has to run a gantlet of misinformation and outright lies. So let me address three big myths about the proposed reform, myths that are believed by many people who consider themselves well-informed, but who have actually fallen for deceptive spin (Paul Krugman, 3/11).
If Democrats Ignore Health-Care Polls, Midterms Will Be Costly The Washington Post
Bluntly put, this is the political reality: First, the battle for public opinion has been lost. Comprehensive health care has been lost. If it fails, as appears possible, Democrats will face the brunt of the electorate's reaction. If it passes, however, Democrats will face a far greater calamitous reaction at the polls. Wishing, praying or pretending will not change these outcomes (Patrick H. Caddell and Douglas E. Schoen, 3/12).
Government Or Private: Somebody's Going To Come Between You And Your Doctor The Seattle Times
Why has the idea of letting the government do what private insurers do to save taxpayers money become such a hysterical hot button? Because the medical industry can more easily bully politicians than they can insurance companies. They do this through campaign contributions and ads directed at an unsophisticated public (Froma Harrod, 3/11).
Does U.S. Have Free-Market Healthcare? Hardly The Christian Science Monitor
The American healthcare system does not represent a free market any more than the British one does, or the Cuban one for that matter. Firstly, out of every dollar spent on healthcare in the USA, 50 cents is spent by the government – The US government spends more on Medicare, Medicaid and SCHIP than is spent on defence by The Pentagon (Nikhil Arora, 3/11).
Why Health Reform Is Bad Politics The Wall Street Journal
Another week, another episode of health-care drama, another round of headlines proving the end is not yet nigh. The polls are dismal, the Democratic caucus is in disarray, it is spring of 2010. Yet the ObamaCare dozer grinds on, and on, and on (Kimberley A. Strassel, 3/12).
Cost Control's The Key The Los Angeles Times
Lawmakers may very well find themselves having to do more in the future to restrain healthcare costs. But that task will be significantly easier if they pass a comprehensive bill now (3/12).
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