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10/21/2009
Obama Administration CTO Aneesh Chopra at Health 2.0
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Good Intentions Aren't Enough with Health Care Reform
By SARAH PALIN
Former Alaska Governor Sarah Palin's widely publicized comments on death panels and rationing this August were among the opening shots of an unprecedented national fight over health care reform. At the time, few sober analysts would have predicted that Palin's criticisms would gain traction. Yet, they found a receptive audience among conservative opponents of the Obama administration's health care reform plans, triggering an ugly battle between supporters of reform and right wing opponents.This weekend, Gov. Palin returned to the healthcare debate with another post to her official Facebook page that touches on the talking points you're likely to hear in the months to come from Republican critics of the Obama administration's health care reform efforts. In the spirit of debate we are republishing the post in its entirety. -- John Irvine
Now that the Senate Finance Committee has approved its health care bill, it’s a good time to step back and take a look at the long term consequences should its provisions be enacted into law.
The bill prohibits insurance companies from refusing coverage to people
with pre-existing conditions and from charging sick people higher
premiums. [1] It attempts to offset the costs this will impose on
insurance companies by requiring everyone to purchase coverage, which
in theory would expand the pool of paying policy holders.
However, the maximum fine for those who refuse to purchase health
insurance is $750. [2] Even factoring in government subsidies, the cost
of purchasing a plan is much more than $750. The result: many people,
especially the young and healthy, will simply not buy coverage,
choosing to pay the fine instead. They’ll wait until they’re sick to
buy health insurance, confident in the knowledge that insurance
companies can’t deny them coverage. Such a scenario is a perfect storm
for increasing the cost of health care and creating an unsustainable
mandate program.
Those driving this plan no doubt have good intentions, but good
intentions aren’t enough. There were good intentions behind the drive
to increase home ownership for lower-income Americans, but forcing
financial institutions to give loans to people who couldn’t afford them
had terrible unintended consequences. We all felt those consequences
during the financial collapse last year. Unintended consequences always
result from top-down big government plans like the current health care
proposals, and we can’t afford to ignore that fact again.
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10/19/2009
Why AHIP needs the public option
By Matthew Holt
It’s been a fun week. After years of THCB explaining that neither could AHIP do genuine research nor could its venerable President open her mouth without lying, the rest of the world has caught on. I won’t rehash the blow by blow here—Jonathan Cohn is among many who’s done that already—but essentially AHIP commissioned PWC to include the half of the analysis about the Baucus bill that was favorable to them and leave the rest out. And the fall from grace has been particularly fun to watch. Even the whores from PWC who wrote the report criticizing the bill have been backing away from it. And some astute commentators think that the debacle has helped the likelihood of a more liberal bill’s passage.
Now to be fair (or overly fair as they’d never concede this to the other side), the insurers have a point. They loaded Baucus up with lots of cash and put a former Wellpoint exec in as his chief of staff. They romanced the White House and kept quiet when Pelosi and the rabble criticized them. The deal they thought they’d cut was that they would give up the way they currently make money by underwriting and risk skimming in individual-small group and being overpaid for Medicare Advantage, and in return they’d get 45 million more customers, all forced to buy insurance and subsidized by the government to do so.
But somehow along the way the Democrats, despite lots of tough talk about “bending the curve,” lost the cojones to find even a mere $100 billion a year to redistribute from the probably $1 trillion waste in our $2.5 trillion health care system.
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10/14/2009
Will We Get a Health Care Bill in 2009?
By ROBERT LASZEWSKIIt’s decision time. The Congress will or won’t pass a major health care bill during the next few weeks.
Will we get health care reform in 2009?
Almost
certainly not. As I have been saying for months, if we get a bill it
will be more a trillion dollar entitlement expansion funded by
relatively minor provider cuts and about $500 billion in tax increases.
That is not health care reform.
Will we get that trillion-dollar entitlement expansion health care bill?
That outcome lies in the coming convergence on Capitol Hill of three extraordinarily powerful, and contradictory, forces.
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10/07/2009
Let’s Not Lose Sight of the Goals
By BILL KRAMER
I love Daniel Schorr. I’ve never met him in person, but I love his voice and his insights about politics on NPR’s Weekend Edition. But this morning I was disappointed. After listening to his comments on the Olympics and Iran, I looked forward with anticipation to his thoughts about the Senate Finance Committee’s accomplishments earlier this week on health reform legislation. When asked whether a “real health care bill” is likely to pass later this year, he said, “Well, it begins to look more [likely] . . . that there will be a bill. The question is not whether there will be a bill . . . but what will be left in the bill, because so many things have been taken out.” I could almost hear him sigh. He went on to talk about the fact that the public option is not a part of the Senate Finance bill, although it might be restored in full or part (through a trigger mechanism or health cooperatives) as the bill moves through Congress.
Let’s step back for a minute. (This is what I usually rely on Schorr to do for us.) Where were we a year ago? Although advocates of health reform were encouraged that the health care crisis was getting a lot of attention in the Presidential election campaign, the outlook was not rosy. Obama and McCain were neck and neck, and McCain’s reform proposal was so weak as to be laughable. The pundits and pollsters were predicting that the Democrats would get about 56 seats in the Senate – not enough to overcome a filibuster. And there was serious concern that even if Obama were elected, health reform would be crowded out by other major crises – the threat of a serious economic depression, the banking collapse, Iraq/Afghanistan/Iran, energy and global climate change, and who knows what else. In October 2008, the likelihood of serious comprehensive health reform was probably about 25%.
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10/06/2009
Health Care Outlook Not Improving
By ROBERT LASZEWSKI
Sen. Max Baucus (D-Mon) released his much-anticipated healthcare proposal Wednesday morning.
The next big test for a health care bill in 2009 (notice that I did not call it health care reform) will come in Senate Finance.
The
final vote in that committee will tell us a lot about whether the
Democrats have any chance for 60 votes in the full Senate. So far, it
does not look good.
I have the greatest respect for Senators
Baucus and Grassley and their good faith efforts to find a bipartisan
health care solution. But I also think their efforts were fatally
flawed from the beginning.
I think the problem is that Baucus
and Grassley were trying to bridge the wide chasm between liberal and
conservative ideas. Finding the fine balance necessary has created an
unwieldy compromise—no one is happy. Most striking, the compromise
reached between cost and premium subsidies has yielded an $880 billion
bill that requires middle class people to buy health insurance they will in no way will be able to afford. On top of that, the policies have big deductibles and out-of-pocket costs.
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09/14/2009
The Speech: Could this have been
what he planned all along?
By BOB WACHTER
A conventional look at The Speech:
Obama over-learned the lessons of Hillary-care; he gave Congress too long a leash; he lost control of the message; the wacko’s attacked with a barrage of Socialist/Nazi/Plug-Pulling-on-Grandma-isms; not only was health reform on the ropes but the entire Obama Presidency was in danger of imploding (taking the Dems down with him in the mid-terms); Obama had his back against the wall, a make-or-break moment. Then last night, the President gave a great speech that staked out a thoughtful middle ground; Joe Wilson went rogue, horrifying nearly everyone; this led to real sympathy for Obama and the Dems and a shift in the political landscape. In the end, a mild version of health reform – with nearly-universal coverage, some regulatory protections against the most heinous insurance practices, fee hikes to pay for it all, and a little movement toward improving quality and efficiency – passes.
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10,000 US physicians have something to say and we're not wasting time.
By DANIEL PALESTRANT, MD
Today, as Congress returns to session, all 100 Senators will be listening to physicians on SERMO when they deliver the “US Physician’s Appeal” on Capitol Hill. Wasting no time, my physician colleagues and I, armed with the over 10,000 signatures will deliver the Appeal directly to lawmakers, requesting them to include us in national health reform strategy.
We are pledging our commitment to true healthcare reform focused on the real sources of spiraling, bureaucratic costs and by doing this on day one of Congress’ return, we are telling them that true healthcare reform will only succeed IF:
- Tort and malpractice laws are reformed;
- Billing is streamlined and pricing made transparent, ending systemic support of the AMA owned billing codes (CPT Codes);
- The insurance industry is reformed; and
- Payment systems are simplified so they align with the growing need for preventive medicine.
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No Alternative: An Analysis of the GOP Plan
By HARRIS MEYER
Congressional Republicans have been blasting away all summer at the Democrats’ health reform legislation. But they might face heavy blowback if more Americans took a close look at two ambitious health reform bills sponsored by GOP lawmakers.
While the GOP plans include some worthy ideas, they have fatal policy flaws at their heart, largely related to insurance risk selection. Plus, they’re vulnerable to many of the same big-government political attacks leveled against the Democratic proposals. That may be the reason Republican lawmakers aren’t talking up their plans at the stormy health care town hall meetings they’re hosting across the country.
The two bills – the Patients’ Choice Act (PCA), sponsored by Oklahoma Sen. Tom Coburn and several House Republicans, and the Health Care Freedom Act of 2009 (HCFA), sponsored by South Carolina Sen. Jim DeMint – have a fair amount in common, though DeMint’s bill is the more conservative and deregulatory of the two.
More surprisingly, each bill shares some features with the Democratic proposals – including health insurance exchanges, subsidies for the uninsured to buy coverage, insurance market reforms, accountable health organizations, and a national rulemaking commission. The sad part of the nasty, mendacious political debate this summer is how little Republicans and Democrats have focused on those big areas of agreement.
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