Tag: Policy

Families USA Health Action 2008: An Alternative Plan – Brian

Jan 28, 2008• 2

A wonderful meeting (Full disclosure: They brought me in to blog my impressions.), The Families USA conference that ended Saturday brought together some impressive Congressional politicians – Nancy Pelosi, Tom Daschle, Ken Salazar, Blanche Lincoln – and true health care experts – Don Berwick, Tony Fauci – with "consumer advocates" from around the country.

I thoroughly enjoyed the people at the conference. They were, for the most part, knowledgeable about health care and committed to driving a better system. (My favorites were a group of California Gray Panthers, all of whom were VERY up on the issues). There were also bright young people relatively early in their careers, and representatives from community health advocacy organizations around the country, all fervently dedicated to a better, more equitable health system.

Families USA Health Action 2008: Berwick on Everything Health Care – Brian

Jan 28, 2008• 1

One of the pleasures of the Families USA Health Action conference was that the speakers represented a nice blend of top politicians and genuine health care experts. Tony Fauci MD, the wonderful head of NIH’s National Institutes for Allergies and Infectious Diseases, who talked about Global Health, was followed by the equally impressive Don Berwick MD, the Founder and leader of the Institute for Healthcare Improvement. I’ve heard Dr. Berwick speak several times and am always delighted by his cogent, comfortable, sensible presentations.

I can think of several people who, if they gave one, deserve a health care Nobel Prize for the positive impact they’ve had on millions of people through their work to change the industry. Dr. Berwick is one. (Others include Jack Wennberg MD, the founder of the Dartmouth Atlas, and David Eddy MD, who leads the Archimedes Project and who coined the term "Evidence-Based Medicine.")

Families USA Health Action 2008: Anthony Fauci on Global Health

Jan 26, 2008• 1

By BRIAN KLEPPER

I first met, heard and came to admire Tony Fauci several months ago at the Aspen Health Forum. Dr. Fauci heads the National Institute of Health’s National Institute of Allergy and Infectious Diseases. In addition to his spectacular medical contributions, he is, equally importantly, a passionate and wonderfully articulate explainer of the importance of infectious disease and global health to common people. Unfortunately, I was called unexpectedly out of the meeting for a call, but here are my notes on his comments. They provide a clear view of the value of his work.

Plagues and epidemics have shaped societies since the beginning of civilization. Gradually, though, and with progress in hygiene and the management of disease, the dangers from infectious diseases to ordinary people have been significantly lessened, though the idea that we’re home free is seductive and illusory. In 1967, Surgeon General William Stewart testified a little prematurely that “the war on infectious disease has been won.”

Families USA: Tom Daschle on Health Care Reform – Brian Klepper

Jan 26, 2008• 36

Former Senator and Majority/Minority Leader Daschle gave the opening address on the 2nd day of the Families USA Health Action conference. Mr. Daschle has a new book coming out in March on America’s health system and our past efforts to fix it.

I was honestly impressed with Mr. Daschle’s grasp of the sweep of health care problems and how they play out. Mostly importantly, he was clearly aware of the deep challenges associated with getting meaningful change, given the industry’s control of Congress and the policy-making process.

POLICY: The Lessons of ’94

Jan 25, 2008• 3

Ezra Klein, who I think is hanging with Brian Klepper at Families USA — where Don Berwick is hopefuly showing the link between system reform and insurance reform Friday— has a nice article out on the The Lessons of ’94. I, being biased and an arrogant git, slightly prefer this take on the matter.

But the basic question is, will things be bad enough to override the coming opposition of the health care industry to going after their goose? Remember that we need three convergent factors to actually get health care reform that means anything. 1) The Democrats to win big enough in November to both take White House in a canter, and a bigger chunk of the Senate. 2) A new spirit of political ruthlessness (perhaps they could hire Karl Rove, who seems to have time on his hands?) and 3) radical increase in middle class and more importantly middle-class voter insecurity about their continuity of insurance coverage. Translation for #3 is a bad mother of a recession that seems to have no end.

I don’t think we get any of the above….but at least one guy who seems to understand markets a little better than I (around $6bn better) thinks that #3 is coming.

Nancy Pelosi’s Health Care Address – Brian Klepper

Jan 24, 2008• 5

The featured highlight address at the opening session of the Families USA conference is by Nancy Pelosi, Congress’ first woman Speaker. In person, Speaker Pelosi clearly comes across as a brilliant and warm woman, a friend of Families USA, and she was introduced as a champion of social justice and equality in the 110th (2007) Congress, passing the first minimum wage increase in a decade and making college more affordable for working families. While I’m not certain this is true, I heard comments beforehand that this speech was slated as a major health care policy statement by the Speaker.

In it, she succinctly laid out several core principle of her view of reform.

"I want to start by talking about something that we all agree on: that everybody in America has a right to quality health care. But what is it that this health care should look like? What are the principles that this approach should have?"

The Families USA Health Action 2008 Conference – Brian Klepper

Jan 24, 2008

Along with other familiar voices like Maggie Mahar and Ezra Klein, I’m in DC today writing from the Families USA Health Action 2008 conference. Families USA is a progessive (liberal) consumer advocacy organization dedicated to universal coverage, driven by mobilizing the nation’s passionate citizen advocates. I am here at their invitation, but I should note, as an objective observer, not necessarily a cheerleader for the approaches advocated here. My perspective will undoubtedly be colored by my own experiences and realizations working on the dynamics of reform.

The idea that citizen involvement can drive meaningful change was a core theme of the conference’s opening speaker, Senator Blanche Lambert Lincoln, the senior senator from Arkansas. She serves on the Senate Finance Committee, which has oversight of Medicare, Medicaid, SCHIP, and other health care programs. She was a champion of the SCHIP reauthorization bill, and advocated for small employer health care purchasing pools.

POLICY: Why you shouldnt be interviewed over the phone…

Jan 17, 2008• 1

Apparently in an interview I had with journalist Thomas Day from Medill reports news service which showed up in this article I said:

If you look at California and Blue Cross-Blue Shield, their biggest provider, they came out against the Schwarzenegger bill because it essentially said the same thing [as Democratic proposals],” said Matthew Holt, a San Francisco-based health-care advocate.

What I hope I meant to say was this:

If you look at California ~~and~~ Blue Cross~~-Blue Shield~~, ~~their~~ the biggest ~~provider~~, insurer in the small group market ~~they~~ came out against the Schwarzenegger bill because it essentially said the same thing [as Democratic proposals], such as limiting underwriting in the individual market and limiting the amount of money insurers could make” said Matthew Holt, a San Francisco-based health-care ~~advocate~~.blogger/consultant/wise-ass

There’s that’s better!

WSJ Editorial on Liver Transplants Cherry-Picks the Numbers

Jan 16, 2008• 12

By MAGGIE MAHAR

Dr. Scott Gottlieb, a resident fellow at the conservative American Enterprise Institute, published an op-ed in the Wall Street Journal last week that returned to the much-exploited story of Nataline Sarkisyan, the 17-year-old Californian who died before receiving a liver transplant. Gottlieb used the story to make the argument that “the U.S. has the best health care in the world.”

Gottlieb is squaring off against John Edwards, who has been suggesting that if Nataline had lived in a European country she might have lived. Edwards blames CIGNA, her for-profit insurer, for refusing to cover the procedure. Dr. Gottlieb, who is a former FDA official, responds with a double-barreled argument: “Americans are more likely than Europeans to get an organ transplant, and more likely to survive it too.” He sounds confident, and at first glance, his argument seems persuasive.

But a closer look reveals that Gottlieb makes his case by carefully culling the numbers that fit his argument, while omitting those that don’t. Unfortunately, too many people involved in the healthcare debate play fast and loose with the facts. Everyone interested in reform should be on the look-out for those who don’t cite solid evidence for their assertions. If they don’t give you their source, it may be because they don’t want you to look it up—and because they realize that they are cherry-picking the numbers.

Before engaging Gottlieb’s argument, I should acknowledge that, as I have said in an earlier post, I think Edwards has picked a bad case to make his argument for healthcare reform. I am not at all certain that the transplant would have helped this particular patient. And while Edwards puts all of the blame on CIGNA, Nataline’s insurer, I am bothered by the fact that the hospital asked for a $75,000 down payment on the surgery and then refused to go forward without it. As one physician/blogger from the very same hospital where Nataline was treated asked: “Why didn’t the hospital simply perform the surgery and defer payment from the family or CIGNA [Nataline’s insurer] until later? If it was such a great idea, why didn’t they exhibit the outrage and strength of conviction to go ahead regardless of CIGNA’s assessment?”Continue reading…

POLICY: Can You Really Mandate People To Buy Health Insurance? by Robert Laszewski

Jan 10, 2008• 13

Robertlaszewski This evening THCB welcomes our newest contributor. Robert Laszweski has been a fixture in Washington health policy circles for the better part of three decades. He currently serves as the president of Health Policy and Strategy Associates of Alexandria, Virginia. Before forming HPSA in 1992, Robert served as the COO, Group Markets, for the Liberty Mutual Insurance Company. You can read more of his thoughtful analysis of healthcare industry trends at The Health Policy and Marketplace Blog. Can you really mandate people to buy health insurance? That’s not so much a policy question as a practical question and it is what Hillary Clinton seems to be saying
is the big difference between her health care reform plan and the health reform plan of Barack Obama. That’s why a news story this week out of Massachusetts caught my eye.

It seems that the Mass Department of Revenue is in the process of drafting new regulations to up the penalty for people who do not buy health insurance. If they are approved, the maximum penalty for those who do not buy health insurance would jump from $219 per year to a maximum of $912 in 2008. The penalty is estimated to be half the per person cost of the lowest priced health plan available.

Penalties would vary by age and the time a person was without health insurance.
A 26 year-old would have a penalty of $672 per year and those over 26
would pay $912. So, a family of two adults over 26 would pay about
$1,800 in penalties if they didn’t buy health insurance (a reader has correctly pointed out children are not covered by the mandate).