As little as a few days ago, pundits were claiming the Minnesota US senate race as being incumbent’s Norm Coleman to lose. That’s changed, as Democratic challenger and Republican whipping boy Al Franken is steadily closing that gap.

The former Air America talk show host appears to be capitalizing on the shrinkage in polling data by capitalizing on healthcare reform as it applies to a rather vocal majority against the backdrop of the aging Operation Iraqi Freedom campaign: the veteran. According to Franken, reforms in the administrative sector of VA healthcare would lead to savings in those healthcare costs — allowing him to promise

Military veterans should be guaranteed medical care for life, Democratic U.S. Senate candidate Al Franken said Tuesday as part of a package of proposals that also would expand the level of care.

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• CA Supreme Court: Physicians cannot deny care to homosexuals on religious grounds.
• Since the antidiabetic drug exenatide (Byetta) was approved by the FDA, its role in the cause of adverse events resulting in death has largely flown under the radar of the media….until now.
• WP: For teens, access to prescription drugs easier than trying to procure beer.
• Cool study result: Those who survived the extremely deadly influenza pandemic of 1918 are still producing antibodies over 90 years later.
• Ignorance versus inaccessibility — thousands of Kentucky children missing out on available state funded care.

Medicare officials have just announced rate increases in prescription drug premiums for beneficiaries in stand-alone Part D plans.  Starting next year, the average monthly premium will mean $3 more per month for beneficiaries out of pocket.  CMS is quick to buttress news of this increase with the acknowledgement that the popular program continues to function in the financial black.

There are three reasons behind the premium increase, [Kerry Weems, acting administrator of the U.S. Centers for Medicare and Medicaid Services] said.

“First, there is a trend in prescription drug cost growth generally — prices tend to increase because of price increases for existing drugs, the growth in the average number of prescriptions per person, and the introduction of new drugs,” he said.

Second, the 2008 premiums were calculated as part of a demonstration project that has now expired. This project resulted in premiums being 50 cents less in 2008 than had been projected.

“That change is now reflected in the 2009 premium,” Weems said.

Third, drug distributors participating in Part D have found coverage for catastrophic care to be higher than expected. “So they have adjusted their 2009 bids to reflect those higher-than-anticipated costs,” Weems said.

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Mass. Governor Deval Patrick is fine tuning his state’s focus on the safety, accountability, and accessibility of healthcare for its citizens.  Making refinements in shoring primary care numbers and incentives for producing more primary care physicians, enacting limits on the gifts Pharma gives to physicians to prescribe their medicines, and increasing funding for Massachusetts’ system of universal access are at the top of a new law’s multifaceted approach to improving healthcare quality there. | LINK

Think all of the concerns of primary care physicians regarding time management and patient visits aren’t valid? With all of the demands upon a generalist’s time, the last thing that a busy physician wants to be reminded of is the number of patients he or she could be seeing, as opposed to actually seeing daily.

This observation is highlighted by the fact that the rate of insured patients choosing emergency room care is rising. Number one reason? Lack of access to the primary care physician with no other option. With the incentive for medical school grads to enter subspecialties outside of the less lucrative primary care “market”, this situation is sure to get much worse. | LINK

Just how healthy is the healthcare marketplace?  If you ask the insurance companies, business couldn’t be brisker, even if it involves fraudulent activity cloaked within the invisibility of the homeless.  Just ask the CEO of a Los Angeles County hospital.

FBI agents arrested Rudra Sabaratnam, 64, the owner and top executive of a hospital, and Estill Mitts, 64, the operator of a homeless “assessment center” in the city’s Skid Row area.  They enticed homeless people with the promise of payments to act as hospital patients, an indictment alleges. The homeless people are said to have received medical treatment, and the government was billed for the services.  The unnecessary hospital treatments were then billed to Medicare and Medi-Cal in a scheme that began in August 2004 and lasted until about October 2007, the indictment states.

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It’s a familiar refrain, and one Minnesota senator is making it this time; that is, the call for certain reform of the Medicare payment reimbursement system. In an op-ed, the Democratic senator pushes quality over quantity as the sole parameter for the assignment of Medicare dollars. Although the concept is familiar, Sen. Amy Klobuchar argues, the aggressive adoption of quality claims reporting will result in streamlined payments for “standards of care” which can be applied equally in disparate care settings.

Making Medicare a purchaser of quality, rather than just an indiscriminant government guarantor of entitled healthcare to certain patient populations is a step in that direction, according to Klobuchar. The problem is — this is known already. The initial fixes must reach beyond establishing vague quality parameters to stimulate change among those on the frontlines of healthcare quality — the physicians. Adoption by this critical segment of healthcare delivery in this country will be hard to achieve without discrete, concrete goals. Unfortunately, for the providers on the front lines of healthcare (primary care), getting paid is the immediate quality concern. | LINK

In an effort to assuage the increasing antipathy of medical lobbyists and physicians against the recent GOP-led campaign to enforce Medicare reimbursement cuts to healthcare providers, Republican leaders recently held a private meeting with top healthcare thought leaders to mend a relationship which has increasingly favored Democrats as of late.  The last time Republicans seemed as though they were in the good graces of the medical leadership community was in 2003, when George W. Bush held his own against those in the medical provider cohort who were being bruised by unfair tort practices nationwide.  That was also the year in which bold GOP initiatives were easily passed and yielded, among other things, a complete overhaul in how the government, Pharma, and patients later obtained prescription medications — under Medicare Part D. 

However, recent spikes in the number of uninsured and a general sense of healthcare management malaise on the part of legislators on both sides of the ideological divide have made a tenuous relationship even more fragile.  Can the Republicans make it up to physicians this time?

In the run-up to the 2006 midterm elections, doctors and the groups that represent them gave 62 percent of their combined $52.4 million war chest to Republicans, compared with 37 percent to Democrats, according to the Center for Responsive Politics. That breakdown mirrors previous cycles since Bush entered the White House.  But since 2006, doctors and related groups have given Democrats 53 percent of their combined $53 million in campaign contributions, according to the watchdog group.  The switch is even more stark for the AMA.  In the run-up to the 2006 election, the AMA’s political action committee gave Republicans 70 percent of its campaign cash, according to the Center for Responsive Politics. In 2004, the AMA’s PAC contributed 80 percent of its total donations to Republican lawmakers and candidates.  Since 2006, that PAC has directed 53 percent of its contributions to Democrats.

If the current state of re-election possibilities continues to wane for the GOP, don’t bet on it. | LINK

• Colorado veterans oppose VA hospital plan to partner with an existing private non-profit.
• Wisconsin Medicaid fraud unit exposes tactics of neuroleptic drug maker.
• Holy menu, Batman!  NYC restaurants can be fined for not showing calorie counts on their offerings.
• House committee will investigate healthcare plan rescissions nationwide.

A congressional committee will investigate health insurers’ practice of canceling coverage when policyholders get sick, its chairman said Thursday.
The problem first came to light in California, but witnesses testifying before the House Oversight and Government Reform Committee suggested that it was more widespread. The problem affects the individual insurance market, in which 14 million Americans, including nearly 3 million Californians, purchase medical benefits on their own. In light of proposals to expand the individual market, the committee’s chairman, Rep. Henry A. Waxman (D-Beverly Hills), said the individual market demanded more scrutiny, especially of cancellation practices.

• McCain criticizes Obama for voting against so-called “partial birth” abortion ban.

Could this really be true?

Access to health care in the United States continues to elude more and more Americans, a new survey shows. […] “Despite the best efforts of millions of talented and dedicated health-care professionals, this latest scorecard demonstrates that we are losing ground,” Karen Davis, president of the Commonwealth Fund, said during a Wednesday teleconference.

Of course it is.  Silly of me to even ask. | LINK | LINK 2

Special interest groups of various political ideologies are holding nothing back in their quest to shift the prime focus on the ‘08 election back to healthcare. In recent weeks, the tenor of both the Obama and McCain campaigns has taken to talk on reforming Big Oil with special emphasis on Iraq. Groups such as the newly formed left-tilting Health Care for America Now and the venerable AARP are spending a combined $60 million to get the word out about the one entity that seems to be driving healthcare in this country — the insurance companies. | LINK

This has all the makings of a classic sports brawl.

Two powerful health trade groups will begin airing dueling ads this week in their fight over Medicare, hoping to influence Congress as lawmakers face pressure to reverse scheduled cuts in doctor fees.

America’s Health Insurance Plans, a trade group of private insurers, is siding with Senate Republicans and the White House in their standoff with Democrats over a measure that would halt the cuts by trimming payments to private insurers.  [..]  On the other side, the American Medical Association said Tuesday it was airing new television and radio ads in six states through the week that targets a group of senators who blocked action on the proposed legislation. The bill passed the House but stalled in the Senate last week amid a veto threat by President Bush.

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If George W Bush had an explanation for this, it would probably contain the phrase, “activist judges”. Citing procedural improprieties in forming the Medicaid rules, a federal judge blocked a Bush administration regulation slashing $5 billion in Medicaid funds over 5 years for California public hospitals. The ruling actually came down last Friday (23), just two days before a moratorium on blocking the Medicaid cuts set by Congress was to expire. The losses imposed by such cuts in the state’s Medicaid program would be substantial, affecting acute care reimbursements statewide. The loss may be short-lived, however, as the ruling affects implementation of the rules, not the Bush admin’s substance of the original regulation. | LINK