January 2011 – Page 11 – The Health Care Blog

A Bipartisan Agreement on Health Care Was Possible in 2009

Jan 1, 2011• 6

By ROBERT LASZEWSKI

Readers of this blog have often heard me say that a bipartisan agreement on a health care bill was possible in 2009–driven from the Senate Finance Committee. I have continually made the point that the two sides were much closer than is commonly believed–or partisans are willing to concede.

Every time I post this, the overwhelming reaction is that I am wrong–with one side inevitably blaming the other for a lack of good faith in the discussions.

Bara Vaida had an interview in Friday’s Kaiser Health News with Mark Hayes, who was the lead Republican health staffer on Senate Finance at the time and had a “clear view” of the negotiations.

Here are the key excerpts:

Q: [Vaida] Key Democrats, including Senate Majority Leader Harry Reid, D-Nev., recently said their biggest regret was allowing the Senate Finance Committee leaders, your former boss Sen. Grassley and committee chair Max Baucus, D-Mont., to spend so much time trying to forge a bipartisan compromise on health care. What do you think about that criticism?

A: [Hayes] We really devised much of the health care framework even before the Gang of Six Senate (Finance Committee) leaders started meeting. In the summer of 2008, Sens. Grassley and Baucus held a summit and we were chugging along with planning our roundtables and it is my understanding that the leadership was frustrated with us that we were moving too quickly and they wanted us to slow down. We got agreement on 80 percent of the framework even before the Gang of Six started meeting to take on the remaining 20 percent. People were naturally impatient but the complexity of the job, connecting the dots and making the model work is a huge challenge so those who pushed for it to be done quickly were watching the clock and likely didn’t have a full appreciation for the issues we were attempting to resolve. The idea that the health care law could be done quickly and be done right is like saying you can go to the moon on the first try.

Critical Review of Medical Literature

Jan 1, 2011• 4

By MARYA ZILBERBERG

Today I am launching a series of posts on how to read medical literature critically. The series should provide a solid foundation for this task and dove-tail nicely with some of the more dense themes that occur on this blog. Who should read the series? Everyone. Although the current model of dissemination of medical information relies on a layer of translators (journalists and clinicians), it is my belief that every educated patient must at the very least understand how these interpreters of medical knowledge (should) examine it to arrive at the information imparted to the public.

At the same time, both journalists and clinicians may benefit from this refresher. Finally, my own pet project is to get to a better place with peer reviews — you know how variable the quality of those can be from my previous posts. So, I particularly encourage new peer reviewers for clinical journals to read this series.

First, a conflict of interest statement. What comes first — the chicken or the egg? What comes first — expertise in something or a company hiring you to develop a product?

Well, in my case I would like to think that it was the expertise that came first and that Pfizer asked me to develop this content based on what I know, not on the fact that they funded the effort. At any rate, this is my disclaimer: I developed this presentation about three years ago with (modest) funding from Pfizer, and they had it on a web site intended for physician access. Does this mere fact invalidate what I have to say? I don’t think so, but you be the judge.