Tag: Policy/Politics

QUALITY: Medicare Health Support–Done and more or less dusted

Jan 31, 2008

Recently the targets on Medicare Health Support were changed to make them more financially favorable to the DM companies running the projects. Everyone inside the DM industry has known that MHS has not been doing too well for some time now. But now according to Vince Kuratis’ blog, the preparations to pull the plug are well underway. Here’s Vince’s interpretation of CMS’ decidely low-key announcement of where MHS stands.

MHS is not meeting targets for financial savings. While it is theoretically possible that the MHS program could climb out of the hole financially during the remaining months of the program, we are doubtful that this will happen — so much so that we are scheduling the patient’s (MHS’) funeral even though technically we are not allowed to pronounce the patient dead yet. In the event that hell freezes over and the program revives, we will then schedule Phase II, but don’t hold your breath.

In a new twist on an old saying by Mark Twain: The rumors of MHS’ death have NOT been greatly exaggerated.

POLICY/POLITICS: Health insurance without health care by Claudia Chaufan

Jan 29, 2008• 5

Claudia Chaufan teaches sociology of health and medicine and health policy at UC Santa Cruz,. and is Vice President of California Physicians Alliance, the California Chapter of Physicians for a National Health Program, which argues for a single payer system. What does she think of ArnieCare–which looks like it suffered a fatal blow in a California Senate committee yesterday? You can guess but read on….

Doesn’t everybody agree that the American health care system is broken, that too many are often an illness away from bankruptcy or go without medical care altogether – and up to 18, 000 die each year for that reason? If so, have some of us lost our senses when opposing the “Health Care Security and Cost Reduction Act”, or ABX1 1, according to the New York Times, a “bipartisan blueprint to bring near-universal coverage to the most populous state”? Are we driven by ideology, callously ignoring that this “ambitious” legislation has the potential to expand health coverage to 3.6 million Californians without raising any taxes or creating new ones?

Some would argue that we are. But be warned: when something is too good to be true, it is probably not true. For instance, some of us are concerned with the fantasy numbers of Governor Swcharzenegger and Assembly Speaker Fabian Nunez, proponents of the bill, who, if they at all bothered estimate the costs of the bill, conveniently stopped their estimates by the fourth year. As legislative analyst Elizabeth G. Hill pointed out, assuming that the $250 premium level proposed by the bill is realistic (Hill thinks it is not), revenues will cover the costs of the first year of operation of the program, but by the fifth year annual costs will exceed revenues by $300 million. So in the best case scenario, five years from now we will be facing the same, or worse, problems we do today.

POLICY: Shannon Brownlee is da man!

Jan 29, 2008• 3

It’s been really great getting to know the new voice of the Dartmouth school, Shannon Brownlee. She’s interviewed in her local paper about the concept that the American health care system delivers More money, but less health. Hopefully we’ll have her writing more on THCB soon!

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.

POLITICS: Whisper it quietly…

Jan 27, 2008• 6

But some on the left are begging to realize that health reform, post an assumed 2008 Democratic victory, is still a very, very big assumption. On liberal blog Daily Kos, DemfromCT uses the recent polling data from ~~Bob Blendon’s group at Harvard~~ MollyAnn Brodie’s team at KFF and an editorial from Columbia’s veteran health policy prof Larry Brown in the NEJM to help his colleagues understand why health reform is so hard. Of course you sensible folk already know.

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.

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.

POLITICS: Another Zogby poll that’s wrong (but understandably so)

Jan 22, 2008• 4

Americans have been lying to pollsters for years, and here’s another example

Question: The candidates for president have each proposed changes to the healthcare system in America. Generally speaking, on a scale of 1-5, with 1 being not at all well, and 5 being very well, how well do you understand the details and differences of the various healthcare proposals put forth by the current presidential candidates?

1. Not at all well: 34%2. Not very well: 21%3. Neutral: 25%4. Well: 13%5. Very well: 6%6. Not sure: 1%

So discounting for the bullshit inflation factor of about 75% that means less than 5% of Americans understand all the candidates proposals—and not that many people read Bob L’s blog. And no I don’t count myself in that 5%. I have no idea what Romney’s health care plan is, ditto most of the rest of the Republicans other than Giuliani’s and he’s probably off back to fake homeland security consulting after Tuesday in Florida. And the Democrats can’t really make their minds up either. On the other hand I’m not sure I count the candidates in that 5% either!

The poll is from a website called PresidentialRx from a group at Vanderbilt Univ with a bunch of middle of the road healthcare worthies on board attempting to explain the health care policies of the candidates to the unwashed masses. There’s another one from HealthCentral run by our bud Craig Stoltz which we featured on THCB the other day which has really cool graphics. (And Susan Blumenthal has done yeoman’s work getting all the details down on her HuffPo blog)

But don’t forget kids, chances of anything actually happening in the next Administration that resembles anything much of the actual plans of any candidate as now described? — low