Let’s put to rest, once and for all, the idea--or rather, the notion (it’s not even an idea, just a vague impression, based on hearsay)--that the health reform legislation now under discussion includes no plans for containing health care spending. Continue Reading.
Today, President Obama sent this letter to Congressional leaders,
offering to incorporate more Republican ideas in health care legislation. Don’t panic: Of the four ideas, two are excellent, one was almost certain to happen anyway, and one simply funds pilot projects in the states to explore alternatives to resolving medical malpractice disputes. This provision does not call for capping malpractice awards—the president has made it clear that he opposes caps. Continue Reading.
This afternoon, President Obama spoke with the confidence and determination of a leader who knows that he is right—and that he has won.
He is no longer pleading for bi-partisan co-operation. His final proposal includes all Republican suggestions that reformers find useful. The president realizes that some will not agree with his plan. As he said at the end of the Summit, “That’s why we have elections.” Those who disagree can make their beliefs known at the polls. Continue Reading on the Taking Note Blog.
You might be wondering why I haven’t written about the President’s HealthCare bill. The reason is that I have very little to say. This, I realize, is unusual. But the truth is that the president’s proposal is very similar to the Senate bill—which is not a surprise.
Nevertheless, I am very glad to see the proposal. I was worried that the White House had put reform on the back burner.
Will it pass? As always, I’m trying to be optimistic. But I think that everything depends on whether the White House decides to twist arms.
Continue Reading on the Taking Note Blog.
Do the uninsured die because they don’t have access to medical care—or because more than three-quarter of the uninsured are poor? In part 1 of this post, I explained that we know that poverty is a killer. It destroys mind and body, slowly but surely. In the U.S. the poor die seven years earlier than the rich. And most of the uninsured are poor. Continue Reading.
While others seem ready to declare health care reform dead, Henry. Aaron explains why reformers must stay the course in the most recent issue of the New England Journal of Medicine. They have everything to lose, and nothing to gain if they abdicate their responsibilities now. More importantly the nation will be left with a health care system that fails society while threatening our economy. Continue Reading on the Taking Note blog.
President Barack Obama in his State of the Union address doubled down on his commitment to health care reform, which disappointed conservatives who were hoping he’d run away from that commitment. And he left conservatives fuming about his claim that the health care reform plan in Congress suffered from a lack of clear explanation. How can he say that, the conservatives argue, when recent events like the Massachusetts Senate election show that voters have rejected the whole idea of comprehensive health care reform?
Naomi Freundlich,
The Century Foundation,
2/4/2010
Are we finally ready to close the door on the much-disputed link between the MMR vaccine and autism?
On January 30, Britain’s General Medical Council ruled that Andrew Wakefield, a gastroenterologist, had acted “dishonestly and irresponsibly” in conducting his research that established a link between autism and the MMR vaccine. Continue Reading.
Naomi Freundlich,
The Century Foundation,
2/2/2010
Health reform may be stalled in Congress, but you need only look to the overburdened Medicaid program to find evidence of the continued toll the current economic crisis is taking on Americans’ ability to afford and access medical care.
At the same time that states are experiencing huge budget deficits, more and more of their residents are unemployed; more and more are joining the ranks of the uninsured and clamoring for Medicaid benefits. Continue Reading on the Taking Note blog
According to the headlines, 10 percent of Americans are unemployed. The truth is that closer to 17 percent of the population cannot find full-time work; this number includes workers who have become discouraged and have given up looking for work as well as those who have settled for part-time jobs because they cannot find the full-time employment that they need. Continue Reading.
Naomi Freundlich,
The Century Foundation,
1/14/2010
Recently, a series of anecdotes appeared on the website People’s Pharmacy, posted by readers who suffer from depression. They detail how switching from name brand antidepressants to generics—or in some cases from one generic to another—caused a return in symptoms. Here’s one excerpt: Continue Reading.
The Washington Postreports that union leaders are close to cutting a deal with Democrats on the so-called “Cadillac tax,” the 40% tax on expensive insurance plans that the Senate has proposed to help fund health care reform. According to the Post, unions would be exempted from the tax, for two years following the 2013 effective date, giving them time to negotiate new contracts with employers. For other reports on the negotiations, see Kaiser Health News. Continue Reading.
If you drive from Buffalo, New York to Ontario, Canada, you’re likely to see this message on highway billboards: “Fast-track Your Medical Procedure Here.” The red arrow on the sign points Canadians to Buffalo’s Kaleida Health, a five-hospital health care system located minutes from the U.S.-Canada border. Continue Reading.
In recent polls, more of the public opposes than favors the health care reform bills in Congress. Conservatives would have you believe that the opposition plurality in these polls is a result of public distaste for a big government takeover of our health care system. Not so. In a December CNN poll, a total of 55 percent either favored the Senate health reform bill outright (42 percent) or opposed it at this point because its approach to health care isn’t liberal enough (13 percent). Just 39 percent said they opposed the bill because its approach to health care was too liberal.
“Cadillac Health Care Plans.” Even the phrase suggests gilt-edged insurance for Greedy Geezers at Goldman Sachs . No wonder the Senate wants to slap a tax on insurers and self-insured employers who offer over-the-top policies beginning in 2013.
After all, plans that fetch more than $23,000 for families (or $8,500 for individuals) must encourage over treatment, right? Continue Reading on the Taking Note Blog.
Does anyone remember the original goal of healthcare reform? I could type it in my sleep: “to provide high quality, affordable care for all Americans.”Today, the goal has shrunk; the current Senate compromise aims only to make certain that 30 million uninsured Americans have insurance--which may or may not provide access to the care they need. Continue Reading on the Taking Note Blog.
Does anyone remember the original goal of healthcare reform? I could type it in my sleep: “to provide high quality, affordable care for all Americans.”Today, the goal has shrunk; the current Senate compromise aims only to make certain that 30 million uninsured Americans have insurance--which may or may not provide access to the care they need. Continue Reading on the Taking Note Blog.
“Where is the plan to make health care affordable?”
“I want to see the savings.”
“Show me the money: Lay it out in simple language-- on one page.”
Critics of health care reform legislation have become increasingly adamant on one point: They want to know how reformers are going to rein in the skyrocketing cost of care. Continue Reading.
Naomi Freundlich,
The Century Foundation,
12/11/2009
There is much to be hammered out before a final health reform bill emerges from Congress. Disputes over the public plan, abortion, financing and when reforms will actually take effect continue to delay progress. But on one thing, apparently, there is broad consensus: Nearly everyone supports prevention. In fact, a recent poll found that 71% of Americans favor increased investment in disease prevention and believe it will save money in the long run. Continue Reading on the Taking Note Blog.
Last night, the news broke that the “Gang of Ten” (the Senators who have been trying to break the deadlock between moderates and liberals) had come up with a two-part alternative to the public option. Under their proposal, Americans 55 to 65 could buy in to Medicare if they choose—and if they could afford it. Meanwhile, for Americans under 55, the public option would be replaced with non-profit private insurance plans overseen by The Office of Personnel Management, the group that now administers the Federal Employees’ Plan. Continue Reading.
Those who oppose reform have been using the recent CBO report to claim that, under the Senate bill, many Americans will pay more for health care.
That’s not what CBO said. A careful reading of the report suggests that even people in the individual market will wind up paying less because under reform, insurance is likely to cover more of their health care costs. Continue Reading on the Taking Note Blog.
A blizzard of health care polling is being produced as we get closer and closer to final resolution of the issue in Congress. Much of this polling tends to be duplicative and doesn’t really tell us anything new. But here are some findings that actually expand our understanding of the public’s views in this area
Naomi Freundlich,
The Century Foundation,
11/30/2009
If an expensive, name-brand cholesterol drug costs four times more than a generic but provides no clear clinical benefit, why do insurers—both public and private—continue to pay for it? The answer, in the case of Vytorin, a combination of two drugs designed to lower LDL or bad cholesterol, is that the influence of big Pharma in maintaining the status quo—even when unsupported by evidence—remains a formidable barrier. Continue Reading on the Taking Note Blog.
What if in 2012, unemployment remains relatively high, the recession continues, and voters blame President Obama, voting him and his Congressional supporters out of office?
Consider how that would affect health care reform. If the House bill prevails on the timing of reform, the Exchanges will open in 2013, subsidies will be available, private insurers will be regulated, and the Public Plan will be available to tens of millions of Americans. Conservatives elected in November of 2012 would have only two months to try figure out how to derail the roll-out scheduled for January 1, 2013. Continue Reading on the Taking Note Blog.
Naomi Freundlich,
The Century Foundation,
11/18/2009
The new recommendation from the U.S. Preventative Services Task Force that women under 50 should not undergo routine mammography is generating a lot of controversy—it is a direct challenge to the strong message women have been receiving for two decades that they should have yearly screening starting at age 40. The task force also recommends that women age 50-74 have a mammogram every two years (rather than yearly) and finds that there is little benefit in screening women over 74 at all. Continue Reading on the Taking Note blog.
These days, many progressives are expressing deep disappointment with the health reform legislation now moving through Congress. Some suggest that legislators made deals with lobbyists and let them write the bills. Others complain that both the subsidies and the penalties are too low. Still others don’t like the fact that states can “opt out” of the public insurance option, and decide not to offer Medicare E. Finally, many ask: “Why can’t everyone sign on for the public plan in 2013? Why do we have to wait until 2013? Why can’t they roll out universal coverage next year?” Continue Reading on the Taking Note Blog.
Last week, I argued that the insurance industry had declared war on President Obama’s plans for healthcare reform because industry leaders sensed—or knew—that support for a federal public insurance option was building. A week earlier, I told an audience at a San Francisco screening of Money-Driven Medicine that I thought the odds were at least 60/40 in favor of a national public plan. They were surprised that I was so optimistic, and this was a very liberal audience in San Francisco. Continue Reading on the Taking Note Blog.
We are into the endgame on health care with the passage (finally) of a health care reform bill by the Senate Finance Committee. Conservatives are hoping the public will rise up against a successful conclusion of this process, spurred by conservatives’ unrelenting attacks on any and all health care efforts. But the public is unlikely to do so. In fact, they say, by 61-29, that they will be disappointed if health care reform isn’t passed by the end of this year.
They are running scared. And why are they so scared? Because they know that the public sector option is still alive. And here I’m not talking about the possibility that some states will offer public plans: Most state plans would be too puny to challenge the strongmen of the health care industry. I’m talking about a federal public plan--Medicare E (Medicare for everyone) a public option for patients under 65, run by the federal government. The scent of real competition is what has insurers on the run. Continue Reading on the Taking Note Blog.
Naomi Freundlich,
The Century Foundation,
10/19/2009
Mandatory vaccination programs are seldom without controversy. Since the early 1900’s when public health workers went door-to-door inoculating people against smallpox and authorities blocked unvaccinated children from attending school, these widespread campaigns have been met with court challenges and public opposition. The underlying issue has always been that mandates threaten medical liberty—the freedom for individuals to choose which medical interventions they want and which they don’t want. But when it comes to vaccines and infectious disease, in the eyes of the law, protecting public health often trumps individual choice. Continue Reading on the Taking Note Blog.
The Mayo Clinic now has two family medicine clinics in Arizona. Beginning January 1, primary physicians at one of those clinics will no longer see Medicare patients unless they are able and willing to pay an annual $250 administrative fee, plus $175 to $400 per visit . They will also have to agree to“an appropriate number of visits each year, including physicals. Continue Reading on the Taking Note Blog.
When I reported on the waste in Medicare Advantage plans not long ago, HealthBeat reader Don Grunt pointed out that not all MA plans are alike. He wrote: “I'm a Medicare Advantage product manager in Oregon where 45% of beneficiaries sign up for MA plans (highest in the country) because we offer good plans and the competitive market keeps us honest. So I don't work in Miami or any of the wild west of MA plans.” Continue Reading on the Taking Note Blog.
Over at TNR, special correspondent Thomas B. Edsall raises provocative questions about the coalition of wealthy and poor that elected Obama. Will they stand together? Below, excerpts from his post, and my comments:
“The health care debate has exposed the ideological tension in Barack Obama’s political coalition between moderates and liberals. But it has also offered hints of how another, less obvious divide built into the Democratic majority could wreak havoc on the administration during the years to come. Continue Reading on the Taking Note Blog.
Naomi Freundlich,
The Century Foundation,
10/1/2009
Earlier this year when President Obama told the graduates of Notre Dame that the country needed to find “common ground” on abortion, it’s likely he envisioned national reconciliation on an issue that has fiercely divided the country for decades. But when it comes to health care reform, Democrats are hoping to find “common ground” through balky legislation that would extend the reach of the current ban on federal funding for abortion to include all plans that participate in health insurance exchanges. Continue Reading on the Taking Note Blog.
Naomi Freundlich,
The Century Foundation,
9/28/2009
If nonprofit hospitals spend far less money on providing charity care for the poor and uninsured than the value of their federal, state and local tax exemptions, do they deserve those exemptions? What about if they turn away indigent patients or hound them with aggressive collection practices? In May, the Senate Finance Committee chairman Max Baucus, and ranking Republican Charles Grassley seemed to agree that nonprofit hospitals have to start acting more like nonprofits or they could risk losing their benefits. Continue Reading on the Taking Note Blog.
“It’s like whack-a-mole,” a Dartmouth researcher commented in a recent e-mail. He was referring to that fact that, as Congress moves closer to the day when it will reconcile House and Senate versions of health-care reform legislation, critics seem to be popping up everywhere to question more than two decades of Dartmouth University research that exposes the waste in our health care system. Dartmouth’s researchers can barely keep up. No sooner have they responded to one op-ed than another mole appears, attempting to undermine the credibility of the research. Continue Reading on the Taking Note Blog.
Naomi Freundlich,
The Century Foundation,
9/15/2009
Jack Coulehan is a physician and senior fellow at the Center for Medical Humanities, Compassionate Care, and Bioethics at Stony Brook University in Stony Brook, NY. He describes himself as “not only an experienced physician, but also an advocate—in fact, a teacher—of standard-of-care practice.” But he was no match for the vagaries of the hospital emergency room. In the most recent issue of Health Affairs, Coulehan writes about hearing tales from friends about being “caught in a web of excessive and unnecessary medical testing” when they went to their doctors for seemingly routine problems. Although sympathetic, he couldn't really relate.
Continue Reading on the Taking Note Blog.
Naomi Freundlich,
The Century Foundation,
9/14/2009
The U.S. Census Department announced last week that in 2008, 46.3 million Americans did not have health insurance, a “not significant” increase from the 45.7 million uninsured the year before. But dig a little deeper into the survey—and understand its limitations—and you’ll find that the 2009 Current Population Survey (CPS) actually provides a compelling snapshot of the country in recession. Besides the new data on the uninsured, the survey also includes information on household income (down 3.6% between 2007 and 2008) and the poverty rate (13.2%, up from 12.5% in 2007). Continue Reading on the Taking Note Blog.
Last week I argued that clarity was conservatives’ greatest enemy on health care. Their plans to derail health care reform depend on spreading confusion about what is in the reform bills before Congress, since the basic components of reform are so popular. Indeed, from their standpoint, the more confusion the better.
A story in yesterday’s New York Times begins: “For years, health policy experts have said health care spending is much higher in New York City and Boston because doctors and hospitals there provide more services, practicing medicine in a more intensive way. But new government data show that Medicare costs per patient in those cities are slightly below the national average when the numbers are adjusted for the cost of living and other factors.” Continue Reading on the Taking Note Blog.
Last night, President Obama gave an excellent speech. He was clear; he was passionate. I did not expect him to draw a line in the sand regarding the public insurance option. That would only have given his opponents a clear target. The decision about the public option will be made at the very end of this process when the House and Senate bills are reconciled. There were no real surprises in the president’s speech. What stood out was the reaction to what he said: “You lie!” Continue Reading on the Taking Note Blog.
The Congressional Budget Office (CBO) has warned that progressive proposals for reforming health care will add to the deficit that looms over our economy. But when you stop to think about it, just how likely is it that CBO can accurately predict the cost of health care reform—and the savings that it will generate-- over a ten year period? Virtually any economic predictions that attempt to go out ten years are, at best, guesstimates. Only a very foolish investor would attempt to project a single company’s earnings out over ten years: how can one “score” the effect of very complicated legislation on a $2.6 trillion industry? Continue Reading on the Taking Note Blog.
Healthcare –and healthcare reform—is complicated, in part because so much of what we think we know about American medicine turns out to be untrue. For instance, one would assume that more expensive care would be better. But the Dartmouth research has taught us that isn’t the case. Most people also assume that for-profit insurers are making a fat profit; after all, look at how high insurance premiums are! Continue Reading on the Taking Note Blog.
In the last month, the public’s view of Congress’ health care reform efforts has certainly darkened. But it’s striking how little change there has been in the public’s view of the basic elements of health care reform as articulated by President Barack Obama and progressives. These essentials of health care reform remain not just popular, but very popular. Consider these data from the just-released August edition of the Kaiser Health Care Tracking poll.
I still recall Ted Kennedy’s speech at the 1980 Democratic convention. It remains the finest, most inspiring political oration that I have ever heard. This is in part because Kennedy was speaking from a position of defeat. He had just lost the Democratic nomination to Jimmy Carter. And yet this was a full-hearted, rousing speech delivered by a man who realized that in the battle ahead, the issues at stake were far, far more important than his own loss. Intuitively, he knew that the country had reached a turning point. Continue Reading.
Beverly Goldberg,
The Century Foundation,
8/25/2009
With the H1N1 virus, which is usually referred to as swine flu, expected to hit hard just as the new school year begins and the announcement of delays until October at best in the availability of the vaccine now in development against the disease, a great deal more attention must be paid to the child care dilemma that all too many working American parents face. The efforts going forward to contain the spread of the disease, in addition to the development of the vaccine and plans by many school districts to provide it when it becomes available, include increased attention to hand-washing, making children aware of the dangers of sharing drinks and food, and emphasizing the need to cover the mouth when coughing or sneezing—and keeping those infected with the virus away from others. Continue Reading on the Taking Note Blog.
Naomi Freundlich,
The Century Foundation,
8/24/2009
The pharmaceutical industry has been settling into its “good guy” role in recent days; first committing to $80 billion in cost savings over ten years to help defray the cost of health reform and then forking over $150 million to finance an ad campaign championing the administration’s plan. (Of course there was that slight fall from grace when it looked as if, in exchange, PhRMA had secured guarantees that Medicare would not be able to negotiate drug prices…click here for Maggie’s take on that.) Continue Reading on the Taking Note Blog.
Richard C. Leone,
The Century Foundation,
8/20/2009
Word is seeping out that there is likely to be a compromise on the so-called “public option” component of the reform package. There a lot of ways to analyze why that is happening in the health care debate. But it really should be no real surprise that the winning side is more ready to compromise than are the losers.Losing campaigns tend to radicalize (right or left) candidates and their key staff members. During the end game, often abandoned by fair weather friends and “the smart money,” they fall back on the true believers who sometimes turn out in huge numbers at rallies that seem to give the lie to polls showing almost certain losses ahead. Continue Reading on the Taking Note Blog.
I doubt it. Progressives are in the middle of a long negotiation with conservatives that will end in conference committee late this fall, where politicians will merge the Senate and House versions of the bills, hammering out the differences. We know that the House bill contains a strong public sector plan. It seems likely that the Senate plan will offer, at best, a weak public sector alternative. What will happen then? Continue Reading on the Taking Note Blog.
In “Getting Better Value From Medicare” I have written about how Medicare reform could pave the way for health care reform.
The current House Bill would do just that. It includes many excellent suggestions for containing Medicare spending in ways that would lift the quality of care. Continue Reading.
That was the headline on a memo prepared by the staff of the House Education and Labor Committee and released by House Speaker Nancy Pelosi’s office last week. The amount of misinformation circulating out there about the House bill is growing. Continue Reading on the Taking Note Blog.
Include the tab for expanding Medicaid, and the proposal for health care reform that the Senate Health, Education, Labor, and Pensions (HELP) Committee approved last week will probably cost $1.6 trillion, report the Urban Institute’s Linda J. Blumberg and John J. Holahan in a brief titled: “Beyond the $1.6 trillion sticker shock.”Continue Reading on the Taking Note Blog.
On Wednesday, the the Senate Health, Education, Labor, and Pensions (HELP) Committee passed its reform bill on a party-line vote, thirteen to ten. Tuesday, the three House committees writing health care legislation released the final text of their bill. Meanwhile, the Senate Finance Committee remains bogged down as Committee Chairman Senator Max Baucus vainly struggles to engineer a “bi-partisan bill.” Continue Reading on the Taking Note Blog.
One encouraging element of the health care reform bill released today by three House committees is that it would finance expanded eligibility for Medicaid entirely with federal money. Since its inception in 1965, Medicaid’s financing has been shared jointly between the feds and state governments. That arrangement has much to do with Medicaid’s huge shortcomings: wide state-to-state variations in eligibility rules and benefit levels, chronic under-funding, and limited medical options for beneficiaries. Because the program primarily covers individuals with low incomes, along with nursing home residents, it has never benefited from broad political support. Continuing Reading on the Taking Note Blog.
Some observers have suggested that if we tax the gold-plated insurance that some employers offer to their employees, insurance that encourages over-utilization of health care would begin to disappear. To avoid the tax, employees would settle for more basic, less expensive plans. Others propose giving consumers a larger menu of plans to choose from, so that they have an opportunity to pick more modest plans that don’t cover so many unnecessary treatments. Continue Reading.
When the White House announced that President Obama had named Dr. Francis Collins to head the NIH, many applauded the choice. “But praise for Dr. Collins was not universal or entirely enthusiastic,” declared The New York Times. “Dr. Georges C. Benjamin, executive director of the American Public Health Association, called Dr. Collins’s selection a ‘reasonable choice.’ Others privately expressed unease.” Continue Reading.
Naomi Freundlich,
The Century Foundation,
7/9/2009
Here we go again. Do you remember that fine spring morning when President Obama stood in front of the graduation crowd at Notre Dame and spoke of finding “common ground” between foes and supporters of reproductive choice. Abortion politics have reared up again, this time threatening to derail health reform legislation as we eke ever closer to the finish line. Continue Reading.
I’m now part of a Washington Post panel responding to a health-care reform question each week. Click here to find the panel.
This week’s question: “Is the Individual Mandate Necessary?”
You’ll find my reply here. Let me add that while I think we need an individual mandate, I am concerned that the House version of health care reform lets insurers charge older customers twice as much as younger customers. At this point, the Senate Finance Committee also allows insurers to discriminate by age. Continue Reading.
Today’s headlines tell us that last night the nation’s hospitals agreed to contribute $155 billion over 10 years toward the cost of insuring the 47 million Americans without health coverage. According to the Washington Post “the agreement that three hospital associations reached with White House officials and leaders of the Senate Finance Committee is the latest in a series of side deals that aim to reduce the cost of revamping the nation's health-care system and to neutralize influential industries that have historically opposed such reforms." Continue Reading.
Naomi Freundlich,
The Century Foundation,
7/6/2009
There’s powerful storytelling going on over at Obama’s grassroots website, Organizing for America, and clearly the goal is to use gripping narrative to get Americans to stop thinking about health care reform and start feeling the need for change. The newest addition to this site is called “Health Care Stories for America” and it includes a neat, interactive map of the U.S. that is constantly updating with new stories of health care woe from real people across the country. Continue Reading.
One would think that insurers would want to do their own comparative effectiveness research to find out whether cutting edge drugs, devices and procedures really provide greater benefits. Continue Reading.
Some observers have begun to suggest that it really doesn’t matter who pays for health care. What matters is how we pay, and what we pay for. Dr. Atul Gawande made this point in the brilliant piece that the NewYorker published at the beginning of this month. “Activists and policymakers spend an inordinate amount of time arguing about whether the solution to high medical costs is to have government or private insurance companies write the checks . . . ” Continue Reading.
President Barack Obama is stepping forward to take ownership of healthcare reform. In his speech to the American Medical Association, he pulled no punches, emphasizing that while we spend far more than other developed countries, the “quality of our care is often lower.” In effect the president was telling the AMA: “The U.S. does not have the best healthcare in the world.” Continue reading on the Taking Note Blog.
I cannot recall an occasion when I have praised New York Times’ columnist David Brooks. And I’m not quite ready to start today.
But I would draw your attention to yesterday’s column. In some ways Brooks understands Obama’s strategy for passing health care reform better than many more liberal pundits. Continue to blog here.
Naomi Freundlich,
The Century Foundation,
6/17/2009
Growing up in suburban New Jersey, my father was a hematologist; most of his patients suffered from leukemia. In the 1960’s and early 70s, there were few effective treatment options for many of them and my father spent a lot of time running to the hospital in the middle of the night to provide blood transfusions for those who were in crisis; offering support and personal attention to each of them. Continue to blog here.
Naomi Freundlich,
The Century Foundation,
6/16/2009
In President Obama’s speech to the American Medical Association today he stood strong on all the elements of health care reform that he’s championed since the election. And in front of a tepid audience that has yet to drink the Obama Kool-Aid, the President sought to divide and conquer the larger population of physicians—reaching out to those who reject the long-term fear tactics that raise the twin specters of “socialized medicine” and “rationed care.” Continue to blog here.
The battle is underway over President Barack Obama’s ambitious plans to reform our health care system. And conservatives are thinking of every way they can to stall and eviscerate such reform.
This morning, Dr. Atul Gawande spoke to student graduating from the University of Chicago’s Pritzker School of Medicine, calling on them to join in the “battle for the soul of medicine.” Unlike many who say “we must do something,” he offered some very specific examples of how doctors can “resist the tendency to see patients as a revenue stream.” Continue to blog here.
Amy Walter, editor-in-chief of The Hotline, is an excellent polllster. The numbers below show that the strongest supporters of healthcare reform tend to be Democrats who earn less than $100,000 and are under 65. This has been true from the beginning of the current debate on reform, though overall the number of people who support an overhaul grows. Continue to blog here.
Tuesday’s New York Times tries to tell a story at the very center of what is shaping up as a stormy debate over just how much waste there is in our healthcare system. But while striving to be even-handed, the Times quotes both informed and uninformed sources—sometimes taking informed sources out of context—and in the process, makes hash of the facts. Continue Reading on the Taking Note Blog.
Naomi Freundlich,
The Century Foundation,
6/2/2009
With a single bullet, the killing of Dr. George Tiller, an abortion provider in Wichita, Kansas, made the process of finding “common ground” in the abortion debate much more difficult. As much as President Obama has been talking up conciliation, the rhetoric and ideology espoused by some abortion foes makes it almost impossible to work toward a national reconciliation on abortion and freedom of choice. Continue Reading on the Taking Note Blog.
Dick Morris, the former political adviser to President Clinton who is now a ubiquitous gadfly commentator, denounced the White House for not being truthful about what health care reform will mean in a recent column posted on The Hill. Morris’ piece, titled “The Death of American Healthcare” seems worthy of analysis because he does such an able job of packing so much misinformation into a relatively small space:
Continue Reading.
McAllen, Texas likes to think of itself as the Square Dance Capital of the World. McAllen doesn’t like to think of itself as the home of the most over-priced health care in the U.S. Continue Reading.
President Obama has been strong and calm and reassuring. Most voters like him and trust him. But he still must play the risky hand he was dealt, and in the end his success will be measured by his accomplishments, not his image. One central achievement will make or break his legacy: health care reform. Like FDR and LBJ, Obama is trying to use active government to improve the lives of average people. President Clinton, after his health care fiasco, was content to run a thrifty but sound fiscal policy and to trust his legacy to the peace and prosperity the country enjoyed when he was president. Continue Reading on the Taking Note Blog.
Did you know that when there is "no hope of recovery" there are still things for the patient to hope for? Did you know that a "living will" is not a legal document in New York State or Massachusetts? Did you know that environmentalists have created nature preserves where you can be buried?
"What we are doing is basically land conservation," says Dr. Billy Campbell, who has created a preserve along Ramsey Creek in South Carolina. "By setting aside woods for natural burials, we protect it from development. At the same time, I think we put death in its rightful place, as part of the cycle of life.Continue Reading on the Taking Note Blog.
Naomi Freundlich,
The Century Foundation,
5/22/2009
No surprise, these days more and more doctors are searching online for medical information. What is surprising, however, is that in a recent study, nearly 50% of physicians indicated that they use Wikipedia—the open-access encyclopedia that allows anyone to edit articles—as their source for medical information.Continue Reading.
As more and more employers back out of the health benefit business, more and more individual consumers are shopping for health insurance these days. Yet sales have remained relatively flat. The McKinsey Quarterly reports in its most recent issue. “What,” McKinsey asks, “is preventing health insurers from effectively addressing pent-up demand?” Continue Reading on the Taking Note Blog.
You’ve seen the headlines: “Health Care Industry Offers to Rein in Spending”; “Stakeholders to Obama: We’re Ready to Cut Costs.” What does this mean? I think it means that the industry—and in particular the insurance industry—is afraid, very afraid that the healthcare reform train is going to leave the station without them. They’re desperate to have “a seat at the table.” Continue Reading on the Taking Note Blog.
Blog-bioethics reports that drug giant Merck has gone into the publishing business, creating a fake “peer-reviewed” medical journal to tout its products. (Hat-tip to reader and son Michael Klotz for calling my attention to this story yesterday—an unexpected Mother’s Day gift). Continue Reading.
Naomi Freundlich,
The Century Foundation,
5/7/2009
Fifteen years ago, insurers were trying to put a brake on healthcare costs by “managing care”—which often meant saying “no” to patients. Too often, insurers denied coverage for care that patients needed. Then came the backlash against managed care, and insurers relented. They began to say “yes” to more treatments, and passed the cost along to customers in the form of higher premiums, co-pays and deductibles. Continue Reading.
While in medical school, students are supposed to know the answers. They spend hours cramming, memorizing arcane language and hard-to-remember numbers so that if the question appears on a test—or worse still, if a resident decides to quiz them during rounds—they can answer it. Continue Reading.
Rahm Emanuel has warned that when gauging President Obama “Republicans and others have made a mistake: He has an open hand, but it's a very firm handshake." Continue Reading.
This week, the Senate Finance Committee hosted the first of three roundtable discussions on health care reform. This session honed in on reimbursement and delivery reform; future roundtables will focus on expanding health coverage to all Americans (May 5) and financing health care reform (May 14). "Medicare is the big driver here,” declared Finance Chair Max Baucus (D-MT), and “How to scale it up” will be one of the key questions, he said, but “Medicare will be a big part of that solution.”Continue Reading.
Naomi Freundlich,
The Century Foundation,
4/22/2009
I still remember the sound of her voice on the phone: scared, frustrated and looking for answers. That summer I was working as a patient representative at a New York City hospital when I got a call from a middle-aged woman who had undergone a routine mammogram two weeks earlier. She still hadn’t received the results. When the woman called the imaging center, she was told that the radiologist had not yet provided his report because he wanted to see films from her last mammogram in order to make a comparison. Continue Reading on the Taking Note Blog.
Many Americans assume that once they finally become eligible for Medicare, their worries about skyrocketing health care bills will be over. Unfortunately, that just isn’t the case. According to Fidelity Investments a 65-year-old couple retiring this year should assume they will need approximately $240,000 to cover medical expenses in retirement--- even though they have Medicare insurance coverage. Continue to blog here.
Robert Wood Johnson Foundation’s Commission to Build a Healthier America has just released a new report: Beyond Health Care. At a time when all eyes are trained on the debate over providing access to medical care for all Americans, the report looks beyond health care, to the health of the population. As it turns out our health—public health—has less to do with health insurance than one might think.
The Century Foundation,
The Century Foundation,
4/2/2009
This week, Ted Kennedy is back on Capitol Hill, and health care reformers are moved and relieved to see him, stalwartly carrying on, despite his illness. Ever since he collapsed at President Obama’s inaugural luncheon, Kennedy has not been able to spearhead the fight on healthcare reform in Congress as he might have wished, buttonholing colleagues in the halls of Congress on a daily basis. Instead Senate Finance Chairman Max Baucus has become the Democrat’s point-man on reform. And some liberal reformers fear that Baucus may be too quick to compromise with Republicans. Continue to blog here.
In Senator Edward Kennedy’s absence, Senate Finance Committee Chairman Max Baucus has emerged as the Senate’s point man on healthcare reform—“prompting concern among some liberal senators,” according to The Hill. Why are they concerned? Because they “remember Baucus’s history of cutting deals with Republicans.” Continue Reading.
Over at Health Care Pollicy and Marketplace Review Bob Laszewski explains why the insurance industry has made a second concession to health care reform. In November, the industry said it was willing to cover everyone. Now, it has decided that it is willing to move toward charging everyone in a given community the same premium, regardless of pre-existing conditions. Continue to blog here.
The correlation between education, poverty and health is so tight that I sometimes think we need to address the three simultaneously. Often this just isn’t feasible. But there are places in our society where the three problems come together in a way that invites a battle on all three fronts. Consider, for example, our nation’s poorest public schools. Continue Reading.
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Nursing Homes, like deteriorating public schools, crumbling bridges and other pieces of our society’s essential infrastructure have been neglected for a long time. Now, HeatlhBeat reader Gregory Pawelski reports that this year, Congress is finally give nursing homes the attention they badly need. Continue to blog here.
Many Republicans in Congress are dead-set against including public sector health insurance--some call it “Medicare for All”-- as a choice under National Health Reform. The resistance is so strong that this could be the deal-breaker that prevents President Obama from gathering the Senate votes he needs to pass his plan for universal coverage this year. Nevertheless, if we want to provide sustainable, affordable, safe and effective healthcare for all, many say that the public sector option is essential. At the recent Healthcare Summit, President Obama put it this way: “The thinking on the public option has been that it gives consumers more choices and it helps keep the private sector honest, because there's some competition out there.”
Continue Reading.
Conservatives often argue that it just isn’t fair to force private health insurers to compete against a government plan because . . . Well, to be perfectly candid, they know that most for-profit insurers would lose. They don’t put it that way, of course. They argue that the government plan would enjoy “unfair advantages.” It wouldn’t’ have to pay profits to shareholders, for instance, and it wouldn’t have to pay seven-figure salaries to its secretaries. It also wouldn’t have lay out hundreds of millions to advertise –or to lobby Congress. Continue Reading.
Over the week-end, when I heard that President Obama had selected Margaret Hamburg as FDA commissioner and Joshua Sharfstein as deputy commissioner, I began Googling “Sharfstein.” I already had read about Hamburg and I knew the former New York City health commissioner has earned very high marks. Continue reading.
We know that
health, education and poverty are linked. This is why, at one time,
the U.S had a Secretary of Health, Education and Welfare. Restoring
that cabinet post might go a long way toward inspiring discussion
about how to approach all three simultaneously. By viewing them as
separate problems, we “see” only one part of the
elephant. With that in mind, I have decided that, from time to time,
HealthBeat should look at ideas for educational reform.
Some of President Obama’s critics have expressed disappointment with his plans for healthcare reform. Why is the president raising taxes to sink more money into an already bloated healthcare system? Why isn’t he doing more to cut wasteful healthcare spending? Continue reading.
Over at Centered Politics.com Jim Jaffe once again has written a provocative piece about health care reform. I don’t agree with him on every point. But I am persuaded by his opening premise: the main lesson we need to learn from the 90s involves managed care, not the Clinton effort, which “was a one-off effort with unique problems.” Continue to blog here.
Inevitably, the debate over healthcare reform will inspire some to try to broadcast misinformation, sowing seeds of doubt, false hope or fear in the public mind. I will try my best to rebut some of the more flagrant attempts, on both sides of the issue. In the past, I have complained that progressive single-payer advocates sometimes exaggerate just how much could be saved if we eliminated private insurers’ administrative costs from the nation’s healthcare bill here (For an excellent, even-handed analysis of administrative costs for private sector insurers compared to public sector insurers, see this Urban Institute report). Continue Reading.
Regular readers may recall a blog where I questioned CNN chief medical correspondent Sanjay Gupta’s qualifications as a potential surgeon general. I had planned to write a part two to that blog, but as Gupta’s name began to disappear from the press, I decided I would be beating a dead horse. I suspected that either the administration was having second thoughts about the nomination, or that Gupta himself was concerned that his ties to drug-makers might lead to embarrassing questions during confirmation hearings.
Today, Politico reported on a conservative initiative to block healthcare reform: “Firing some of the first shots in the coming showdown over health care, a conservative group led by the former owner of the Hospital Corporation of America is beginning a multimillion-dollar campaign Tuesday in opposition to government-run coverage.Continue to blog here.
Over at Managed Care Matters, Joe Paduda posted this letter from a “very good friend.” Does every patient in London get such good care? Probably not. But I have heard similar stores—and the UK does not have the best care abroad. (The NHS is still under-funded, though each year they’re putting more money into it.) France, Germany, Sweden, Denmark any Switzerland all boast better care.
Continue to blog here.
President Obama’s budget demonstrates how difficult it will be to build a sustainable, effective, and safe health care program for all Americans. His ten-year $634-billion plan for funding health care reform depends on “asking the wealthy to pitch in a bit more” (budget director Peter Orszag’s happy phrase), wringing some of the waste out of Medicare and Medicaid (cuts that are needed, but that will not be popular ); and strong-arming drug makers to raise discounts on Medicare drugs from 15 percent to 21 percent. About half of the money will come from changes in government programs, half from tax increases. Continue Reading on the Taking Note Blog.
During a recent appearance on MSNBC’s Hardball, former Gov. Howard Dean (D-VT) said that a public insurance option is essential to any health reform effort (Thanks to Igor Volsky for pointing this out on The Wonk Room, and Hat-tip to Dr. SteveB on Daily Kos.) Continue to blog here.
Last week the Commonwealth Fund published a proposal for a “High-Performance Health Care System” that is ambitious, and admirably honest. Unlike many health care pundits, the lead author, Cathy Schoen, understands our Byzantine health care system from the inside out. Continue to blog here.
In a private conversation with bloggers at the Families USA healthcare conference last week, Princeton healthcare economist Uwe Reinhardt recalled a conversation, when he asked health care economist Victor Fuchs, “When will we ever have universal health insurance in the U.S.?” Continue Reading on the Taking Note Blog.
Howard Dean? Kansas Gov. Kathleen Sebelius? Former NIH director Harold Varmus (now at Memorial Sloan-Kettering Cancer Center)? Dr. Atul Gawande? Former Oregon Governor John Kitzhaber? John Podesta, founder and president of the Center for American Progress, formerly chief of staff to President Bill Clinton? These are a few of the names being floated in the mainstream press and the blogosphere as possible replacements for Tom Daschle as Secretary of Health and Human Services and/or healthcare czar.Continue Reading on the Health Beat Blog.
According to a new working paper by the National Bureau of Economic Research (NBER), as the nation’s hospitals battle for paying customers, they are engaged in a fierce “amenities race.”. What is troubling about the report is that it reveals that many patients seem to care more about rooms with views and pleasant service than just how many patients survive their hospital stays. Continue to blog here.
Many Americans assume that all European health care systems are essentially the same: single-payer, government run systems that were created, from scratch, by wise and benevolent reformers. Continue to blog here.
As you no doubt have heard, the healthcare blogosphere has been seriously divided on President Obama's nomination of CNN chief medical correspondent Dr. Sanja Gupta as our next surgeon general.Continue to blog here
When President Obama said “The time has come to put away childish things,” I couldn’t help but recall healthcare reformer Don Berwick, sounding discouraged last winter, as he said “Maybe this country just isn’t mature enough for health care reform.”Continue reading.
When Tom Daschle testified on the Hill earlier this month he reassured many by saying that as Health and Human Services Secretary, he would be working for healthcare reform “guided by evidence and effectiveness, not by ideology.”Daschle, like Laszlewski, was suggesting that reform could and should be bi-partisan. But as I suggested in part 1 of this post, Daschle is only half-right. Medical evidence should guide our decisions about what to cover; but when it comes to questions of whom to cover—and how much coverage they should receive-- we are going to have to wrestle with “ideology."Continue reading.
Maggie recently wrote about a MedPAC decision aimed at stopping for-profit hospices from purposefully keeping patients under their care for extended periods of time in order bill Medicare for more days of service. Medicare’s concern that the hospices might be bilking the system raises a larger question: should we be worried that so many of today’s hospices are for-profit? Continue reading.
Over at Healthcare Policy and Marketplace Reform, Bob Laszewski reports that “the extension and expansion of the State Children's Health Insurance Program (SCHIP) has now passed the full House and the Senate Finance Committee and is on its way to the full Senate where it will undoubtedly also pass and then be reconciled with the similar House bill.Continue reading.
Like so many other federal agencies, the National Institutes of Health (NIH) has struggled under the Bush Administration, and today, it needs to be revitalized. Not long ago, I wrote about what we can expect for the FDA when president-elect Obama comes to office; now I’d like to turn the NIH. But to understand the agency’s future, one needs to recognize its recent past. Continue reading.
Maggie Mahar,
Niko Karvounis,
The Century Foundation,
1/13/2009
2007 marked the first time in 50 years that less than 20% of Americans smoked. This is the good news. The bad news is that, just as the battle against smoking has entered what may be its most critical, final phase, support for that battle has waned among policymakers—even though the problem is far from solved. Continue to blog here.
Today, the Kaiser Network reported that on Friday, the Medicare Payment Advisory Commission (MedPac) approved a set of recommendations that would revise the current Medicare payment system, which was implemented in 1983, for hospice care providers serving terminally ill patients. CQ HealthBeat reports that these recommendations will be included in a report to be issued in March to Congress and to take effect in 2013. Continue to blog here.
During the holidays, I received the letter below from Dr. Peter Eisenberg, Medical Director at California Cancer Care, an oncology practice in Northern California. A member of The Century Foundation’s Working Group on Medicare Reform. Eisenberg is a very experienced, and successful oncologist, who has served on the board of the American Society of Clinical Oncology and the Association of Northern California Oncologists. Continue to blog here.
Imagine appointments with your primary care doctor that last 30 minutes—or longer. What if you could e-mail her when you need a prescription refill? If you have a two-minute question, she encourages you to call; she or a nurse practitioner will come to the phone. If they’re busy, they’ll return your call within a few hours. Continue to blog here.
By now you’ve probably heard the calls for speedy action on health care reform during the Obama Administration’s first hundred days. Some prominent observers even say that the President-elect should get the ball rolling during “his first days in office” The possibility of imminent health care reform is certainly exciting, but a word of caution: just because some of us might be ready for health care reform doesn’t mean that the media is ready to cover it properly. Continue to blog here.
According to the American Bar Association’s Commission on Legal Problems of the Elderly, the notion that everyone should have a living will is a “myth.” Continue to blog here.
Niko Karvounis,
The Century Foundation,
12/31/2008
No matter how you slice it, health care is complicated—which means that the media has a vital role to play in helping the public navigate the ins and outs of the issue. Unfortunately, more often than not, reporters, commentators, and pundits don’t serve as trustworthy guides when it comes to health care. In fact, 2008 saw the media once again regurgitating myths that obscure the facts surrounding health care in the United States. Here are some of the most egregious offenders. Continue Reading on the Taking Note Blog.
Wishful thinking leads many well-meaning reformers to imagine that we can accomplish universal coverage in a single stroke. Writing in the December 31 edition of the New Republic, political scientist Jacob Hacker suggests that by declaring “healthcare for all” we can achieve universal coverage and , simultaneously, kick-start the economy. How do we do it? Continue Reading.
Niko Karvounis,
The Century Foundation,
12/30/2008
Earlier this month newspapers reported that Columbo—that is, actor Peter Falk—has Alzheimer’s Disease. Usually, when news breaks that a celebrity is suffering from a serious medical condition, there’s a flurry of coverage discussing the nature of the disease. Hopefully, the pattern will hold in Falk’s sad case—because Alzheimer’s is both a terrifying disease and a greater public health issue than most of us realize. Continue to blog here.
This is from the Wall Street Journal’s Washington Wire: “Ezekiel J. Emanuel, a prominent bioethicist at the National Institutes of Health–and the brother of incoming White House Chief of Staff Rahm Emanuel–will serve as a senior counselor at the White House Office of Management and Budget on health policy, two Democratic officials said Thursday. Continue Reading.
Niko Karvounis,
The Century Foundation,
12/17/2008
“Companies are concerned about how their balance sheets are going to look after two down quarters last year, the events of Sept. 11 and the big increases we've been seeing in health care costs,” the U.S. Chamber of Commerce’s Kate Sullivan told the New York Times in 2002. Reading the tea leaves, Sullivan pointed out that “employers are looking at any way they can to shave off some of those costs”—and that one of their biggest targets were company-sponsored health benefits for retired employees. Continue Reading on the Taking Note Blog.
When President-elect Obama outlined his economic stimulus package earlier this month, he emphasized the need to invest in the healthcare system’s infrastructure by pushing for electronic health records (EHR), nationwide: “We will make sure that every doctor’s office and hospital in this country is using cutting edge technology and electronic medical records so that we can cut red tape, prevent medical mistakes, and help save billions of dollars each year.” Continue Reading.
The Dallas Morning News has done a wonderful series on end-of-life care. Thanks to
Annie for pointing it out. Here are excerpts from part one, written by Lee Hancock, describing an encounter at a Baylor University Medical School ICU unit between Ms. Patel, a palliative care team nurse, and Dr. Edward Taylor, a 36-year-old trauma surgeon. Continue to blog here.
Niko Karvounis,
The Century Foundation,
12/12/2008
The Wall Street Journal has some of the best health care reporting of any major newspaper, yet its editorial page is often filled with shrill, misleading nonsense—particularly when it comes to health care. Continue to blog here.
Recently, a somewhat starry-eyed op-ed in the New York Times suggested that a $100 billion annual investment in universal healthcare is just the medicine that our economy needs. The goal, declared Jonathan Gruber, a professor of economics at the Massachusetts Institute of Technology: “covering every American.” Continue reading on the blog.
Maggie Mahar,
Niko Karvounis,
The Century Foundation,
12/5/2008
Last week the New York Times published a story about one of the biggest medical trials ever organized by the federal government, a study that showed that the newest, most expensive drugs used to treat high blood pressure (a.k.a. hypertension) work no better than inexpensive diuretics—water pills that flush excess fluid and salt from the body. Moreover, the research revealed that the pricier drugs increase the risk of heart failure and stroke. Continue Reading on the Taking Note Blog.
Yesterday Reutersreported that, in comments at a Financial Times conference in London, a top executive at Roche Pharmaceuticals condemned direct-to-consumer advertising as a disaster. “Direct-to-consumer promotion [of drugs] was the single worst decision for the industry," said William Burns, Roche’s head of pharmaceuticals, to conference attendees. "When industry says we're spending all the money on R&D but actually it's spending it on TV advertising to preserve margins, it doesn't get much credibility,” he continued. Continue Reading on the Taking Note Blog.
Assume that you are a 40-year-old man. What do you think the chances are that you will die of a heart attack or stroke in the next 10 years? (Please forgive the morbidity of the question; there is a purpose to this pop-quiz.) The answer: just 4 out of 10,000 according to Drs. Steve Woloshin and Lisa Schwartz, authors of Know Your Chances. Indeed, the chance that you will die in an accident before reaching your 50th birthday are 50 percent higher: 6 out of 10,000. Continue to blog here.
I recently attended a conference where bloggers and print journalists talked about the pros and cons of their respective professions. I noted that as a blogger, I am never censored. As a print journalist I was told, on more than one occasion; “Maggie, you can’t say that!” (even though I had evidence to back up my facts.) Usually, the editor was concerned that I would “scare the readers” or upset the publisher (and advertisers). Continue to blog here.
Forces calling for Healthcare Reform Now are gaining momentum. I share their sense of urgency—assuming that they are talking about the “reforms” needed to create an effective, affordable, patient-centered health care system. But if they simply mean “universal coverage,” I have to disagree. Continue to blog here.
When President-elect Barack Obama takes office, he will be preoccupied with a broad range of enormous and complex challenges, including a downward spiraling economy and two wars. But some problems that might seem lower on the priority list also present relatively manageable opportunities to make meaningful progress in ways that would greatly benefit the country. One such target for saving money and improving lives is dealing with tobacco—the nation’s number one cause of preventable death and one of its greatest contributors to high health care expenditures. Continue Reading on the Taking Note Blog.
Below, a story and a poem from Pulse, a very special online magazine that uses stories and poems from patients and health care professionals to talk honestly about giving and receiving care. Continue to blog here.
Niko Karvounis,
The Century Foundation,
11/23/2008
In my previous post, I discussed how the realities of primary care—the “hamster wheel” of 15-minute visits with sometimes-difficult patients suffering from complex, chronic conditions—can burn out idealistic primary care physicians (PCPs). Increasingly, disillusioned PCPs are leaving the field. A recent survey from the Physicians’ Foundation reports that one-half of PCPs would leave medicine if they thought they could do so. Continue to blog here.
Niko Karvounis,
The Century Foundation,
11/20/2008
In a recent post, Health Beat described the policy strategies that must be employed in order to address the primary care crisis in the United States. This post focuses on the human side of the primary care crunch by highlighting the personal experiences of doctors. Moving from the policy to the personal adds an all-important qualitative element to our understanding of just why American primary care is in such dire straits. Continue Reading on the Taking Note Blog.
Niko Karvounis,
Maggie Mahar,
The Century Foundation,
11/17/2008
Last week Senator Max Baucus (D-MT) offered a “Call to Arms” for health care reform by way of a 98 page policy document. Because Baucus’ document was a sweeping, comprehensive look at America's health care problems, media coverage tended to focus on its grand principles rather than specific policy details. But when it comes to health care policy, it's all about the details, among which Baucus includes the following sticking point: a proposal to increase payments to primary care providers at the expense of compensation for specialists. Continue Reading on the Taking Note Blog.
The film opens with a fetching red-head puffing away on a treadmill. She’s perspiring, but she’s smiling gamely into the camera. “It’s not an average work-out, but I wasn’t an average weight,” she explains. “I have to do above and beyond what any of you guys would have to do. I have to try twice as hard, sometimes three times as hard—just to maintain this level of…chubbiness.”
Today, Senate Finance Chairman Max Baucus issued a “Call to Action” for Health Care Reform. And it is shockingly honest. The bombshell in the plan is that it would require every American to purchase health insurance. There would be sliding subsidies for everyone under the Federal poverty level ($70,400 for a family of 3), but there would be no exemptions. Continue to blog here.
Here we go again. If you haven’t yet heard the news from the American Heart Association meeting that was held in New Orleans yesterday, here is Bloomberg’s report on a medical breakthrough that, some say, will “change the way we practice medicine.” Continue to blog here.
What is the biggest threat to the U.S. economy? According to Congressional Budget Office Director Peter Orszag, it is not credit famine, the long-term price of energy, competition from China, the loss of jobs overseas, or even a surfeit of Chrysler SUVs. It is, Orszag declared in October, “the nation’s looming fiscal gap — which is driven primarily by rising health care costs.” Continue Reading on the Taking Note Blog.
Beverly Goldberg,
The Century Foundation,
10/28/2008
Ever since the enactment of Medicare Part D, which pays private insurers to offer senior citizens plans to help cover the costs of their prescription drugs, bitter complaints about the program have been the norm. Most of the complaints have focused on the "doughnut hole," the coverage gap that occurs when someone spends more than the year's covered amount—$2,510 in 2008—on his or her medications. When that cap is reached, because an individual is on multiple medications or extremely expensive ones or both, the costs of medications must be paid for out—of—pocket until the person spends up to a level that is significantly higher than the covered amount—an additional $3,216 in 2008. At that point, the plan again begins to cover needed drugs under a catastrophic coverage provision. Continue Reading Here.
The conventional wisdom about skyrocketing healthcare costs tends to blame someone: patients who demand too much care; doctors who practice defensive medicine because they fear being sued; aging boomers, and finally, everyone’s favorite, “the insurance companies.” Continue on the Taking Note Blog.
After working at the Mayo Clinic in Rochester, Minnesota for nine years, Dr. Marc Patterson decided to change his life. In 2001, he moved to New York City to take a job as chief of pediatric neurology at New York-Presbyterian Hospital (NYPH).
This year, Patterson returned to the Big House on the Prairie. "Sometimes I miss New York,” he acknowledges, “but working in a system that actually functions is worth it." Continue Reading on the Taking Note Blog.
In theory, Medicaid ensures that low-income families receive health care. But in practice, the program leaves much to be desired—and serves as a painful illustration that the existence of an insurance program isn’t enough to ensure access to necessary care.
The Robert Wood Johnson Foundation’s Commission to Build a Healthier America has just released a report that reveals the degree to which a child’s health is determined by the hand he draws when he is born.
I have to admit I often have found the language of healthcare “rights” off-putting. Yet the idea of healthcare as a “right” is usually pitted against the idea of healthcare as a “privilege.” Given that choice, I’ll circle “right” every time.
In “Getting More Value from Medicare,” The Century Foundation, fellow and HealthBeat Blog editor Maggie Mahar (www.healthbeatblog.org) points out that past proposals for containing Medicare’s costs, such as putting a cap on physicians’ fees or requiring beneficiaries to pay more for their care, have not worked. She calls for a fundamental set of reforms that would not only save money but also improve the quality of care that beneficiaries receive. Download the Agenda here.
Always a trailblazer, The Mayo Clinic’s Medical School has had a generous scholarship program for the past 20 years that enables about 60 percent of its students to attend school tuition-free. The 50 students who started at Mayo last summer each received $25,000 to use towards tuition of $29,200. Students also are eligible to receive an additional $2,000 to $5,000 a year based on need, said David Dahlen, director of student financial aid at Mayo, based in Rochester, Minn. Continue Reading on the Taking Note Blog.
The Health Beat by Maggie Mahar Blog The Century Foundation fellow, Maggie Mahar discusses today's most pressing health care policy issues in The Health Beat by Maggie Mahar blog. Click here to view.
Getting More Value from Medicare In “Getting More Value from Medicare,” The Century Foundation, fellow and HealthBeat Blog editor Maggie Mahar points out that past proposals for containing Medicare’s costs, such as putting a cap on physicians’ fees or requiring beneficiaries to pay more for their care, have not worked.
Money-Driven Medicine View, Money-Driven Medicine: The Real Reason Health Care Costs So Much (Harper/Collins 2006), a book by The Century Foundation's Health Fellow, Maggie Mahar.
The Century Foundation fellow, Maggie Mahar discusses today's most pressing health care policy issues in The Health Beat by Maggie Mahar blog. Click 
View, Money-Driven Medicine: The Real Reason Health Care Costs So Much (Harper/Collins 2006), a book by The Century Foundation's Health Fellow, Maggie Mahar.
