Changing News Archive - July, 2009

In August 2005, doctors at Urological Associates, a medical practice on the Iowa-Illinois border, ordered nine CT scans for patients covered by Wellmark Blue Cross and Blue Shield insurance. In September that year, they ordered eight. But then the numbers rose steeply. The urologists ordered 35 scans in October, 41 in November and 55 in December. Within seven months, they were ordering scans at a rate that had climbed more than 700 percent.

The increase came in the months after the urologists bought their own CT scanner, according to documents obtained by The Washington Post. Instead of referring patients to radiologists, the doctors started conducting their own imaging -- and drawing insurance reimbursements for each of those patients.

In focusing on health-care reform this year, President Obama pledged that a revamped system would hold down exploding costs. But none of the players -- Congress, the administration or the array of interests involved in the process -- has offered a clear path to that goal. And efforts to control medical practices that have driven up expenses, including physician "self-referrals," underscore how difficult it is to alter entrenched patterns.

While Americans may complain about the high cost of health care, they're still willing to shell out roughly $34 billion a year out-of-pocket on alternative therapies that aren't covered by insurance, a new study shows.

That's a growth of more than 25% in the past decade, says an in-person survey of 23,000 Americans from the Centers for Disease Control and Prevention and National Institutes of Health.

After more than a week's delay, the House Energy and Commerce Committee said it is continuing consideration of the Tri-Committee healthcare reform bill (H.R. 3200) on Wednesday afternoon after reaching an agreement with the conservative Democrat group, the Blue Dogs, to trim $100 billion from the bill.

An agreement also was reached not to seek a full House vote on the bill prior to the beginning of the summer recess, which begins July 31.

The public health insurance plan proposed under the House healthcare reform bill (H.R. 3200) would have "a substantial price advantage" over private insurance because it would pay providers using current Medicare payment methodology, according to an analysis of the House healthcare reform bill (H.R. 3200) released by The Lewin Group this week.

Key lawmakers on Wednesday moved to cut roughly $100 billion from the cost of health-care reform proposals as they sought to break weeks of gridlock on President Obama's signature legislative initiative before Congress departs for a month-long recess.

The heath-care bill that has been wending its way through the Senate Finance Committee is likely to contain a provision that President Obama opposed during his campaign: a tax on at least some employer-provided insurance plans.

WASHINGTON -- Liberals who see the effort to overhaul health care as a once-in-a-generation opportunity are growing anxious that a final deal -- and a Democratic president they backed -- will negotiate away their top priority: a public plan to compete with private insurers.

Some Democrats are threatening to oppose any bill that excludes this option, and sympathetic outside groups are pressuring wavering lawmakers. Health Care for America Now, a liberal group, and the American Federation of State, County and Municipal Employees spent $800,000 on television ads targeting moderate Democrats, citing their opposition to a public option.

Meanwhile, MoveOn.org announced a series of television ads Monday to run in Washington, D.C., and on national cable networks accusing the Republicans of playing political football with health care. Americans United For Change, another liberal group, announced a radio ad targeting moderate Republican Sen. Olympia Snowe of Maine, a key swing vote.

The many-headed Hydra, with breath poisonous enough to kill, is one of the more gruesome beasts in Greek mythology. In Hercules’s great clash with it, he would cut off one of its heads, only to have two more appear. No matter what he did, he couldn’t keep up.

You can think of Congress’s efforts to pay for health reform as being a little bit like a battle to slay a many-headed Hydra.

Members of Congress have come up with one idea after another to pay for covering the uninsured. But they still haven’t put together legislation that could pass. And that’s in large part because most of those ideas have a basic flaw.

WASHINGTON (Reuters) - Republican and Democratic senators negotiating financial details of healthcare reform have made great progress and are on the verge of a deal, a key Republican senator said on Wednesday.

"We have made great progress. Every day we make some progress," Senator Charles Grassley, one of the three Republicans from Senate Finance Committee involved in the talks to overhaul the healthcare system, told NPR radio.

President Obama on Wednesday will take his plea for health-care reform to audiences in North Carolina and southwest Virginia, armed with a bullet-point-style message that his aides are hoping will be persuasive.

The Congressional Budget Office said that a draft bill expected to emerge from the Senate Finance Committee would cost under $900 billion over the next decade and ensure healthcare coverage of 95% of Americans.

Committee Chairman Max Baucus (D-Mont.), speaking to reporters outside of his Capitol Hill Office, called the report “good news,” but cautioned that the package omits several key provisions. He did not go into detail, however.

“Nevertheless, the report is encouraging,” he said.

WASHINGTON — A bipartisan group of senators on Monday reported progress toward agreement on a compromise health care overhaul while the House speaker suggested that any House vote on a health plan would be delayed until more was known of the Senate approach.

“We’re on schedule either to do it now or to do it whenever,” said Speaker Nancy Pelosi, who had hoped to win approval in the full House by the end of this week.

With the Obama administration's top domestic priority struggling in Congress, supporters and opponents of the health-care proposals are focusing on the constituency that both sides agree has become pivotal to the debate: the majority of Americans who have health insurance and are generally satisfied with their care.

Although polls have consistently shown that just over half of Americans think the health-care system is in need of reform, a substantial majority say they are satisfied with their own insurance and care. Any hope of change will require their support, according to experts and advocates across the ideological spectrum.

WASHINGTON (Reuters) - Democrats in the U.S. House of Representatives pounced on a congressional budget analysis to bolster their plan for a government-run health insurance option on Monday, as party leaders said they were closer to agreement on healthcare reform.

The report by the nonpartisan Congressional Budget Office said the public option proposed by Democrats would not drive private insurers out of business and most people would still choose to get their medical coverage through employers.

HHS Secretary Kathleen Sebelius congratulated the National Conference of State Legislatures (NCSL) after the conference approved an amendment in favor of health insurance reform. The amendment was approved by a vote of 38-11. According to NCSL rules, amendments must receive 75 percent of the vote in order to pass.

WASHINGTON — The major health care bills moving through Congress would require nearly all Americans to have health insurance. But as lawmakers struggle to achieve the goal of universal coverage, a critical question is whether the plans will be affordable to those who are currently uninsured.

WASHINGTON (Reuters) - Senate Democrats do not have the votes to pass healthcare reform without Republican support, a key Democrat said on Sunday, but White House spokesman Robert Gibbs said he is confident a bill will pass by year's end.

Democrat Kent Conrad, a key player in bipartisan Senate Finance Committee negotiations on healthcare, refused to predict whether the panel will be able to produce a bill before the Senate breaks for a month long recess on August 7.

WASHINGTON -- President Barack Obama's health-care plan is in jeopardy because of serious concerns that costs will spin out of control. As much as anyone, it's White House budget director Peter Orszag's job to save it.

Mr. Orszag is the administration's point man for controlling health-care spending. So when the director of the Congressional Budget Office, which Mr. Orszag used to run, testified eight days ago that none of the health plans pending on Capitol Hill would control long-term spending, Mr. Orszag knew that meant trouble.

WASHINGTON — President Obama showed great fluency in the intricate details of health policy at his news conference on Wednesday night, but experts said some of his points were debatable.

Mr. Obama said doctors, nurses, hospitals, drug companies and AARP had supported efforts to overhaul health care.

While it is true the American Medical Association has endorsed a bill drafted by House Democratic leaders, a half-dozen state medical societies have sharply criticized provisions that would establish a new government-run health insurance plan.

WASHINGTON (Reuters) - President Barack Obama said on Wednesday he realized Americans were skeptical about his healthcare overhaul, but that the country's economic recovery depended on implementing the $1 trillion plan.

Obama, insisting the "stars are aligned" for approval this year despite discord in Congress over the plan, warned inaction would undermine the economy, worsen the deficit and cripple millions of Americans financially.

President Obama's dream of dramatically remaking the nation's health-care system is still a long way from reality. But if lawmakers can reach an accord, one thing is virtually certain: For the first time ever, every American would be required to carry health insurance

The Health IT Policy Committee approved revised recommendations for defining "meaningful use" of electronic health records this past Thursday. But for many providers—especially rural community hospitals and solo or small group practices—the objectives for meaningful use are still out of reach.

The bar needs to push providers, while ensuring that a reasonable number of leading-edge organizations can achieve it by 2011, says John Haughom, MD, senior vice president of clinical quality and patient safety at PeaceHealth, a Bellevue, WA-based seven-hospital system with a 500-member medical group. Haughom is no stranger to HIT. Roughly 14 years ago, PeaceHealth implemented a community health record that shares patient information with providers throughout the region—including its competitors. The community health record has roughly 2 million patient records in its database and more than 20,000 clinical users—only a portion of whom are PeaceHealth employees

WASHINGTON (Reuters) - Some of the ideas proposed for U.S. healthcare reform could cost patients thousands of dollars a year out of their own pockets, and premiums could end up being too high, according to two reports.

One analysis for the American Cancer Society's Cancer Action Network showed a plan now offered to federal employees, including members of Congress, sometimes costs patients $7,000 a year in out-of-pocket expenses -- many of which a seriously ill patient would have no way of avoiding.

As liberal protesters marched outside,  Sen. Max Baucus sat down inside a San Francisco mansion for a dinner of chicken cordon bleu and a discussion of landmark health-care legislation under consideration by his Senate Finance Committee.

At the table on May 26 were about 20 donors willing to fork over $10,000 or more to the Democratic Senatorial Campaign Committee, including executives of major insurance companies, hospitals and other health-care firms.

WASHINGTON — As President Obama began a new push to overhaul the health system, Democratic Congressional leaders, bowing to unease among lawmakers and governors in their own party on Monday, suggested scaling back a plan to tax top earners to pay for the sweeping legislation and signaled a retreat from their ambitious timetable.

House and Senate leaders had been pressing for floor votes in each chamber before lawmakers depart for the August summer recess. But Congressional aides said it was increasingly clear that the Senate would not be ready to vote on its bill before its recess begins on Aug. 8, and that House Democrats seemed unwilling to vote to raise taxes without knowing where the Senate stood.

Emboldened by divided Democrats and polls that show rising public anxiety about President Obama's handling of health care and the economy, Republicans on Monday launched an aggressive effort to link the two, comparing the health-care bills moving through Congress to what they labeled as a failed economic stimulus bill.

And the news Monday that the Obama administration would delay release of a congressionally mandated report on the nation's economic conditions only stoked the rhetoric, spawning GOP speculation that the White House is trying to avoid bad news amid the health-care debate.

WASHINGTON – Major business groups are launching a series of new advertising campaigns aimed at shaping Congress' health overhaul.

The U.S. Chamber of Commerce, which represents three million employers, plans to introduce a sharply worded multimedia advertising campaign in the next several days pushing back against the key planks of Democrats' health overhaul proposals. The group plans to run television and print advertisements in the Washington area and about a half dozen states with lawmakers who hold key votes in the debate, including Maine, Arkansas, Louisiana and Nebraska.

The ads will take aim at Democrats' proposals to create a public health insurance plan and raise taxes on the wealthy. The campaign also will emphasize the significance of existing employer-provided health insurance plans, which currently cover about 170 million Americans.

Six months into his presidency, Barack Obama may have no greater test of his ability to translate personal popularity into a successful legislative agenda than the upcoming two weeks.

With skepticism about the president's health-care reform effort mounting on Capitol Hill -- even within his own party -- the White House has launched a new phase of its strategy designed to dramatically increase public pressure on Congress: all Obama, all the time.

WASHINGTON -- The White House and congressional leaders are facing new resistance on Capitol Hill to rapid movement on health-care legislation amid concerns about the cost, the political price for raising taxes -- and even an emerging dispute about whether abortions should be covered.

Congress's chief budget analyst delivered a devastating assessment yesterday of the health-care proposals drafted by congressional Democrats, fueling an insurrection among fiscal conservatives in the House and pushing negotiators in the Senate to redouble efforts to draw up a new plan that more effectively restrains federal spending.

WASHINGTON — The House Ways and Means Committee approved legislation early Friday to overhaul the health care system and expand insurance coverage after a marathon session in which Democrats easily turned back Republican efforts to amend the bill.

In a 13-10 vote along party lines, the Senate Health, Education, Labor and Pensions Committee on Wednesday became the first committee to approve a marked up healthcare reform bill. The bill, called the "Affordable Health Choices Act," is expected to be merged with the Senate Finance Committee's bill, which is not completed.

More than 500 amendments were considered, and of those, about 160 Republican amendments were accepted, said Sen. Chris Dodd (D CT), who chaired the committee in the absence of Sen. Edward Kennedy (D MA), who is recovering from a brain tumor. "Although it wasn't a bipartisan vote, it was a bipartisan effort that produced this bill."

Few topics can get physicians worked up like generational differences in practice styles. I've heard Baby Boomer physicians complain about being forced to take call during holidays because the younger physicians in the practice refused to, and I've listened to Generation X doctors lament the lack of work-life balance and the poor communication skills in their older colleagues.

America's Best Hospitals, an annual ranking of the country's elite medical centers, is a tool for patients who need medical sophistication most facilities cannot offer. Unlike other rankings and ratings that grade hospitals on how well they execute routine procedures like outpatient hernia repair or manage common conditions like low-grade heart failure, the U.S. News approach looks at how well a hospital handles complex and demanding situations--replacing an 85-year-old man's heart valve, diagnosing and treating a spinal tumor, and dealing with inflammatory bowel disease, to name three examples.

The Congressional Budget Office on Tuesday said that the House's version of a health reform bill would cost $1.04 trillion over a 10-year period, but cautioned that its analysis is preliminary and did not take into account a plan to raise taxes or savings from Medicare and Medicaid.
 

WASHINGTON -- House Democrats on Tuesday unveiled sweeping health-care legislation that would hit all but the smallest businesses with a penalty equal to 8% of payroll if they fail to provide health insurance to workers.

The House bill, which also would impose new taxes on the wealthy estimated to bring in more than $544 billion over a decade, came as lawmakers in the Senate raced against a self-imposed deadline of this week to introduce a bill in time for action this summer.

House Democrats announced a plan yesterday that would force the richest 2 million U.S. taxpayers to shoulder much of the cost of an expansion of the nation's health-care system, by imposing a surtax of as much as 5.4 percent on income above $350,000 a year.

Regina M. Benjamin, an Alabama family physician who served for almost two decades as one of the few doctors in a shrimping village along the Gulf Coast, was nominated as U.S. surgeon general yesterday by President Obama.

Flanked by the president and Health and Human Services Secretary Kathleen Sebelius at a Rose Garden ceremony, Benjamin, 52, promised to act as "America's doctor" if appointed.

House Democrats have introduced a 1,018-page bill that would make scores of Medicare and Medicaid provider payment changes, create a public health insurance option, expand Medicaid eligibility, require individuals to hold some level of health coverage and levy fees against businesses that don't offer insurance.

House Energy and Commerce Committee Chairman Henry Waxman (D-Calif.), one of the lead authors of the bill, called it “landmark legislation.” “This is a defining moment for our country,” he said. At the outset, the legislation includes a public health plan that would compete with private payers in an open “exchange,” and accounts for federal subsidies to help transition individuals into it. The legislation would also prevent health plans from denying coverage to people with pre-existing conditions.

President Barack Obama nominated Regina Benjamin as U.S. surgeon general. Benjamin is a rural Alabama family physician who made headlines with her fierce determination to rebuild her nonprofit medical clinic in the wake of Hurricane Katrina.

She also is a leader in the call to improve health disparities, pushed by the need in her own fishing community of Bayou La Batre, Ala., and its diverse patient mix—where immigrants from Vietnam, Cambodia and Laos make up a growing part of the population.

WASHINGTON — In the struggle to overhaul the nation’s health care system, 16 physicians have ended up in ringside seats — as members of the House and Senate.

But they have taken different lessons from their experiences in medicine, and they do not agree on what a bill should look like.

President Obama's overhaul of the nation's health-care systems is unlikely to be completed by the White House's August deadline, lawmakers said Sunday.

Democrats and Republicans alike said the administration's sweeping health-care reform proposals are moving forward on Capitol Hill, but they cautioned against rushing into a spending plan that could cost trillions of dollars over the next decade.

This morning marked another major milestone for health reform, as Vice President Biden, HHS Secretary Kathleen Sebelius and representatives of the hospital industry came together to announce a major investment from hospitals in the effort.