The 24-hour news cycle is notoriously subversive when it comes to allowing the media to sip news nuggets just before a (holiday) weekend. This move allows for two things to occur: the ruminations begin and essentially give the responsible parties time to (1) create negative spin from something superficially positive, or (2) create lemonade from the most spoiled of lemons — all by the time Monday morning rolls around and the damage control has abated.
First, there was news that Whitney Houston, who hasn’t had a major studio LP release in over seven years, “leaked” what appears to be her new single online; then, Senate Democrats on the Finance Cmte. have appeared to revise burdensome cost estimates to bring healthcare reform legislation more in line with Obama’s initial requirements for a self-sufficient “public option”. Most of the initial up-front savings would be the result of employers of over 25 people to cover insurance for employees or pay a penalty fee for not doing so. Also, the government would pay the start-up costs for the public insurance option as a loan to be repaid, as premiums would be set up to essentially fund the public option. Of course, Republicans have much to grouse about Obama’s hunches that much of his trillion dollar spending on this issue will be delayed because of his insistence that greater efficiencies and cost controls as a result of better access would ultimately rein in much of the up-front costs of this Democrat-led revised plan.
BTW, I am totally dying to hear Whitney’s new album on 9/1, the day of its release. As for the revised nature of the healthcare spending bill, I hope that the lemonade isn’t too bitter. | LINK
The concern and outrage controversial Oscar-winning filmmaker Michael Moore created in his anti-corporate healthcare screed Sicko (2007) seems to have spilled over into the land of indie documentary filmmaking. A spate of docs lamenting the state of the healthcare “system” and its effects on everything from mishaps in chronic disease treatment to personal stories of financial ruin at the hands of insurance companies have been released since then — each focusing on troubled niches in healthcare delivery.
Predictably, many of these films have a leftist bent; however, activists on the right have also been preparing similarly themed films — though, focusing on the negative effects government-sponsored care have on patient choice, medical innovation, and, of course, socialized medical care delivery.
While it is welcome that opposing groups find another medium to express and further their agendas with respect to health policy, there may be a darkside: information — no matter how well researched and intentioned for its respective audiences — is power. If that power is misconstrued by the patient as consumer, then sound healthcare policy in the court of public opinion may take that much longer to convince everyone of its merits, regardless of who sits in the White House. | LINK
The country’s largest drug lobby, PhRMA, spent $6.9 million during the first three months of this year on lobbying expenses, an almost 40 percent jump from what it spent on average per quarter last year. The biggest reason for all the new hires? Democrats. The lobby is particularly targeting Sen. Baucus — the leading reform figure and Sen. Kennedy alternative to a more conservative approach to Obama’s proposed healthcare reform package. Recall that PhRMA recently pledged $80M to the healthcare reform effort, with 2/3 going to fund, among other things, a so-called “reform fee”, which will charge pharma companies a fee to cover any difference between the cost of Medicare, Medicaid and biogenerics programs and the $80M spending commitment. Are PhRMA lobbyists trying to pre-empt efforts of some congressional Democrats’ attempts at industry price controls as part of the reform package? | LINK
Today has started off with a double take at the health policy headlines finding their way to my Google Reader. One stood out in particular — a Reuters newsservice blurb entitled Wal-Mart’s Health Scare. Knowing that it really couldn’t get any worse for the healthcare coverage employees of the venerable big-box bad guy, I was compelled to look further. To my surprise I found out that Wal-Mart is backing Obama’s plans to force employers to provide health insurance to workers. Many a retail lobby in Washington have always opposed such moves. (In fact, the nation’s largest retail lobby is said by many media outlets to be “flabbergasted” by the move.)
Today marks a culmination, of sorts, by the retail giant to come to some brand of compromise with regard to its employees’ healthcare. Within the past couple of years, after much haggling with labor in the latter’s efforts to unionize Wal-Mart employees, the retailer joined forces with the SEIU (the nation’s largest union) to call for affordable healthcare for all Americans by 2012. What seemed like an olive branch at the time now appears to be part of a concerted strategy by the retailer to not only cover itself on the issue of employer coverage mandates, but also possibly shield itself from more burdensome future coverage requirements by private third party insurers and the relatively low-wage workers it employs at the hands of any pending reform package Congress ultimately passes. Big news, indeed, and a lot of head-scratching on this one, to be sure. | LINK
Online daily Minnpost has a pretty decent “scorecard” outlining current Minnesota U.S. delegations’ plans for healthcare reform. Seeing as how, until today, Amy Klobuchar was our only seated U.S. senator, I’ll give Al Franken some time to formulate his ideas for reform (although I do recall personally asking him for his ideas at a local fundraiser last October — but that’s another story for another time).
Predicatably she and some of our congressional delegations fall into certain sides in the ideological debate. Briefly: (1) Klobuchar wants to reward prevention over procedure; (2) Republican Rep. John Kline likes things just as they are; (3) Republican Rep. Erik Paulsen favors reform a la Sen. John McCain; (4) Democrat Rep. Betty McCollum (surprise!) hasn’t fully embraced a single payer system whereas (5) Rep. Keith Ellison (the most liberal of our Dem representatives) is only one of the few in the House who has fully endorsed such a plan; and (6) Rep. Tim Walz (also a Dem) is the most pragmatic in the bunch — trying to find ways to optimize the healthcare delivery marketplace that make public funding enrich competition without completely ceding to a default public option.
Finally, Reps. Oberstar and Peterson (more conservative House Dems) really haven’t had time to think about alternatives to a public plan (which doesn’t mean they’re entirely against one, apparently). Let’s see, did I leave anyone out? Nope, don’t think so. | LINK
A short profile of Illinois’ Medicaid reimbursement schedules for primary care physicians’ services illustrates what many of them already know: that the road to riches as a physician isn’t going to come from keeping these patients healthy and out of the hospital.
Though payments can vary depending on the service provided, it’s not uncommon for a physician to be paid $25 to $75 for a Medicaid patient’s routine visit. That can be 20 percent to 30 percent less than what the Medicare health insurance for the elderly pays and less than half the $100 to $125 or more a private insurer would pay for the same service.
Lawmakers have to be more proactive with ways to compensate primary care. Instead of telling physicians who specialize in the care of the “whole person” what they already know, how about nipping the hemorrhaging numbers of U.S. trained family physicians and internists in the bud and coming up with financial incentives to get interest into primary care again? | LINK
Always go with the “human element” as an age-old, time-tested way of pulling at your emotional heartstrings to … sell a product. In this case, the “product” is President Obama’s healthcare reform package. A liberal advocacy group is going out to collect stories, sans all the messy details, from real people as they struggle with the ongoing access to quality, affordable healthcare. The group is apparently sanctioned by Obama.
Yesterday, the group recruited thousands of its volunteer members to gather in farmers’ markets, rehab clinics, parks, and libraries nationwide as part of a National Health Care Day of Service. It was a do-gooder occasion with a blunt, short-term political objective: calling attention to the administration’s “work to reform America’s healthcare system,’’ as Michelle Obama put it in an e-mail to supporters.
It’s a little difficult to know if this effort will have any impact on pending legislation to, at best, offer some sort of (likely dilute) public healthcare financed option for Obama, hard luck story or not. | LINK
I’ve waited until today (after what seems like an interminable barrage of media coverage about him) to post about Michael Jackson’s death. As a physician, who just happens to be a huge MJ fan, I have always wondered what this moment would be like — obviously not in a morbidly curious sense, but in an academically curious one.
Thinking about the enormous toll living in the public eye, constantly, from the moment his father exploited his talents at such a young age, has had on his rather delicate frame; the numerous plastic surgeries which tell us more about his inner soul then he would orally; and the addiction to painkillers for more than, apparently, just pain — I wonder if death at this age was more serendipitous than precipitous.
What actually did cause his death? If you believe media accounts, you probably should do so with a wary eye. Not only were TV and print media awash throughout two 24-hour news cycles with continuous wall-to-wall coverage, but the effect of the news of his death on the sheer weight of Internet traffic is well documented. Naturally, all of the information, particularly from the latter source, is probably not the most reliable. However, if one is to believe widely reported accounts of frank cardiac arrest, it does seen fairly plausible that any of the factors listed above could have contributed in some fashion. We won’t know for weeks what the results of the toxicology post mortems will be; and with the Jackson family desperately searching for answers and coping the best way they can (for themselves and the trusting legions of fans faithful worldwide), a definitive cause of death may take some time to reach.
At least we’ll always have his music to console us, teach us, ponder, and enjoy for the rest of our lives.
The public discussion on the seemingly never-ending saga of the morality of healthcare reform in this country has won the hearts and minds of those (non-politicians) on both sides of the ideological aisle. The general tenor of those discussions has focused on access to medical care by the some 46 million Americans who need it the most — the uninsured. But who really comprises this group? It certainly is heterogeneous to a degree. One could also argue that the heterogeneity in this critical group is characterized by many factors, of which the most common focus — race — is only a small part.
Should it be a larger part? So much so that race is a prime criterion essential to any long term solution on health care reform? This op-ed seems to say so. At a time in the debate when the president of the United States, a man of color, is focusing on changing the economics of healthcare to ensure its delivery, should the tenor of the discussion be altered to include race as a factor in reforming not only access but care inequity?
Wednesday § June 24, 2009
Although issues such as these can (and usually do) happen daily to doctors across the range of specialties and subspecialties, one really has to wonder how much of their frustrations directed to patients and their idiosyncrasies are a symptom of a much larger problem within the realm of primary care.
In a more recent article in the same journal, published in February of this year, 449 internists and family practitioners surveyed said major difficulties arose when patients appeared to be dissatisfied with their care or when patients had unrealistic expectations. [..] But, beyond personality differences, many doctors run into patients with bad habits, which makes diagnosing and treating them seem maddening.
LINK
Wednesday § June 24, 2009
A recent survey on the public “pulse” of President Obama’s signature policy point echoes sentiment that could be a thorn in many a Republican’s side as the he takes to the airwaves tonight to act as spokesperson for the debate on healthcare overhaul. The University of Minnesota announced today results of a survey [PDF], taken in May, on the public’s level of discomfort with the current system of healthcare financing and access to it. Keep in mind, these results are based upon data taken well before the current level of national discourse on this topic.
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Wednesday § June 24, 2009
Another day, another story of Medicare fraud. Perhaps the Obama administration should focus on preventing the misuse of this government-backed insurer rather than trying to create another from scratch.
Federal agents have dismantled a Miami-based ring they said schemed to defraud Medicare of $100 million by filing false claims for obsolete HIV therapy across five states — although two of the suspects who posed as clinic owners have fled to Cuba.
Obsolete HIV therapies. Perhaps the problem isn’t entirely with Medicare. After all, what private insurers won’t recognize bogus therapies when paying out claims? | LINK
Media followers of any political flavor know that, in the effort for the media to stake their claim on the news of the day, a buzzword has to be created. Within the scope of legislative debate on healthcare reform, that buzzword is “public option”, the so-called modicum of increased government-influenced guaranteed care access[] (and private insurer competitor) for the un- and underinsured. At the start of another weekly news cycle on Capitol Hill, the issue is only getting more incendiary … so much so that newly annointed HHS Secretary Kathleen Sebelius has taken to the airwaves to discuss its necessity.
What makes debate around this topic so unique is that it appears to have overtaken the entire healthcare policy discussion these days — as if the entire universe of healthcare delivery hinges on its complete agreement by its opposing factions. If only it were that easy. Perhaps more discussion is needed to address the apparent unraveling of any semblance of bipartisan cooperation as we begin the dog days of summer. | LINK
