Market Reform Key to Health Care Reform?

In today's Boston Herald, Dr. Lawrence A. Hunter, a senior fellow at the Institute for Policy Innovation, critiques health care reform plans that involve market reform.

Hunter criticizes "market-based health plans," such as those proposed by 2008 Presidential candidates Sen. Hillary Clinton, Massachusetts Gov. Mitt Romney, and Sen. Barack Obama, and former Sen. John Edwards.

In both parties, politicians have proposed to "curb," "harness" or "reform" the market to "fix" America’s health care system. However, lawmakers continue to ignore the underlying problem with today’s health care system. Because of government intervention in the marketplace, there’s a vast gap between the demand for health care and its supply.

Hunter discusses troubles he believes are already apparent in Massachusetts' state-based health care reform and compares these to potential reform on the national level. He also goes on to point out specific problems he sees with the candidates' plans.

John Edwards' plan hides this tax hike by forcing businesses to "either cover their employees or help finance their health insurance," and Obama has promised to "require employers to make a meaningful contribution to the health coverage of their employees." Romney’s plan assessed new taxes on those who chose not to buy health insurance and small business owners who wouldn’t play along - proving there is no such thing as voluntary socialism, even when designed by a so-called conservative.

SOURCE: "Market Reform Most Unhealthy: Gov’t Meddling Sickens System" 07/30/07

Chronic Diseases Getting Noticed

The Kansas City Star reported yesterday that chronic diseases are becoming a more prominent topic in discussions on health care reform.

The article quotes the same 75% cost statistic that George Halvorson cites in Health Care Reform Now!:

Long-term chronic ailments such as diabetes, heart disease, obesity and cancer account for 75 percent of U.S. health-care expenditures and seven of 10 deaths. Yet chronic-disease sufferers get only 56 percent of the recommended preventive care they need. And many of their ailments are preventable.

If these patients were treated in a more proactive fashion, experts say, the country could save from $100 billion to $125 billion a year in health-care spending — enough to cover many of the 46 million uninsured.

This approach to health care reform has drawn the support of 2008 Presidential candidates from both the Republican and Democratic parties, including Sen. Barack Obama, Sen. Hillary Clinton, Sen. John Edwards, former Wisconsin Gov. Tommy Thompson, and former Arkansas Gov. Mike Huckabee.

SOURCE: "Curbing Chronic Diseases New Issue in Health-Care Politics" 07/26/07
Photo by Adam Ciesielski courtesy of Stock.Xchng

Medical Records on the Internet

The Wall Street Journal ran an editorial by digital diva Esther Dyson
having to do with health care reform. (Journal articles require
registration to view.)

Dyson begins with this announcement:

In a couple of months, my genome, my answers to a substantial health questionnaire and my medical records (as many of them as I can collect, anyway) will be posted on the Internet for all to see.

Ms. Dyson -- who has a stake in several health-related start-up companies -- is one of 10 pioneers who have agreed to participate in the Personal Genome Project run by Harvard University geneticist, George Church.

Dyson explains that there are privacy concerns about putting this much personal health information online, but she believes the benefits will be worth it.

In his book, Health Care Reform Now!, author George Halvorson makes similar claims to Dyson's about the potential benefits of having health records accessible on the Internet:

We are on the very edge of using the Internet to improve care in a great many ways, both with individual patients and with caregivers.... Caregiver[s] would not need to wait years to attend a seminar to learn [a] new technique.

How do you feel about having your medical information available on the Internet? Do you think it's a bad idea that will lead to abuse of data, or a good idea that will lead to better care?

We'd love to hear your opinion. Comments are open but moderated.

SOURCE: "Full Disclosure" 07/25/07
photo courtesy of FreeImages

Kids Count

Today, The Annie E. Casey Foundation released the 18th annual KIDS COUNT Data Book, a national and state-by-state effort to track the status of children in the United States. KIDS COUNT monitors such issues pertaining to kids as education benchmarks, poverty levels, and health insurance coverage.

The 18th annual Kids Count report compiles information about health, living arrangements, economic status and education to compare the well-being of children state by state. Minnesota, New Hampshire and Connecticut topped the overall rankings; Alabama, Louisiana and Mississippi finished at the bottom.

Newspapers across the country are printing commentary on their state's ranking in the report, including The San Francisco Chronicle.

The Chronicle articles indicates that California lags behind national averages for children's health insurance coverage. The state dropped from a #18 rank last year to #19 this year.

Of the 8.3 million U.S. children without health insurance in 2004, 15 percent were in California. That year, 13 percent of the state's children had no health insurance, slightly higher than the national average of 11 percent.

"We're headed the wrong direction, and it's especially disconcerting on some of the health indicators where California traditionally has seemed to be a leader," said Ted Lempert, president of Children Now, an advocacy group based within the state.

Read the full report here.

SOURCE: "State's Ranking for Child Well-Being Drops" 07/25/07
USDA photo courtesy of GeekPhilosopher.com

Engelberg Center for Health Care Reform Launches

Earlier today, The Brookings Institution announced the creation of the Engelberg Center for Health Care Reform.

The newly named director, Dr. Mark B. McClellan, is a former commissioner of the Food and Drug Administration and administrator of the Centers for Medicare and Medicaid Services.

The Engelberg Center's agenda will focus on four key priorities for long-term change: improving the quality of medical care, increasing access to affordable coverage, encouraging development of more personalized medicines, and reducing costs for public and private programs.

Alfred B. Engelberg, one of two Brookings trustees who gave generous donations for the creation of the Center, says of McClellan:

"[His] proven ability to create and implement important health care reforms, combined with Brookings's long history of thoughtful impact on public policy has the potential to make a real difference in the steps that are taken to fix our broken health care system," said Mr. Engelberg.

More information about the Engelberg Center can be found at the Brookings Institution website.

SOURCE: "PR Newswire"

Wisconsin's Universal Health Care Plan - Pros and Cons

The Wisconsin Senate recently attached a proposal to their budget bill that would create a $15 billion tax increase to fund universal health care within the state.

The proposal is being met with both criticism and praise. The Green Bay Press-Gazette ran two guest columns yesterday -- one in favor of the plan, and one against.

Joe Leean, a former state senator and chair of the planning committee for the new health care plan, writes in his guest column:

It is the largest tax increase in state history. Because the funding for the plan is assessed on payroll, it is collected as a tax. But the naysayers are neglecting to point out that the approximate $15 billion collected for this plan eliminates more than $15 billion currently paid by businesses and consumers in insurance premiums.

Bill G. Smith, state director of the National Federation of Independent Business/Wisconsin, writes in his article:

Now, we understand that when public policy decisions are made, there are compromises. However, this is a proposal seeking to fund health care with a new payroll tax on businesses regardless of their ability to pay, regardless of their profitability and regardless of employer and employee choice.

According to Leean, "Leaders of the Republican-controlled Assembly have stated there is no way this package will pass their house."

SOURCE: "Stop Trashing State Health-Care Plan and Take a Look At It" 07/22/07
SOURCE: "Health Plan Bad Medicine for State's Economy" 07/22/07
Wisconsin capitol photo courtesy of Steve Todey via Stock.Xchng

Smokers to Pay for Uninsured Children

Despite a threat from President Bush to veto the bill, the Senate Finance Committee has approved a 5-year, $35 billion expansion to the State Children's Health Insurance Program (SCHIP).

As many as 9 million U.S. children lack health coverage, a statistic many see as the most urgent sign of the need for reform in the U.S. healthcare system.

The expansion would be financed by a 61-cent increase in federal cigarette taxes, as well as taxes on other tobacco products.

That proposed solution is receiving strong support:

"A higher cigarette tax is a win-win solution," said William Corr, executive director of the Campaign for Tobacco-Free Kids. "It is a health win that will reduce tobacco use and save lives and a financial win that will raise much-needed revenue."

...and equally strong criticicsm:

It would also place two government goals -- reducing smoking and paying for children's healthcare -- at odds, [says Michael Cannon, director of health policy studies at the Cato Institute]. "It puts the government in a bind. On the one hand it wants to achieve good by discouraging people from smoking but on the other hand it will be relying on (tobacco taxes) for revenues."

SOURCE #1: "Analysis: Panel OK's Children's Insurance" 07/20/07
SOURCE #2: "Analysis: Burning Smokers to Help Kids" 07/20/07

NPAF Rallies Against Pre-Existing Condition Limitations

On June 22, two bills were introduced in the U.S. House of Representatives that could change the way pre-existing conditions are considered by medical insurers. The legislation was proposed by the National Patient Advocate Foundation (NPAF), a non-profit organization working toward increased health care access for patients since 1996.

The bills, "The Pre-existing Condition Exclusion Patient Protection Act" (H.R. 2833), introduced by Representative Joe Courtney (D-CT), and The Children's Health Protection Act" (H.R. 2842), introduced by Representative Allyson Schwartz (D-PA), were crafted in response to an increasing outcry from Americans who continue to suffer from health care access problems, especially those with chronic disease conditions.

The proposed legislation would affect almost 94 million Americans who suffer from at least one chronic condition "by changing how and when insurance providers may deny coverage," said Nancy Davenport-Ennis, President and CEO of NPAF.

For example, NPAF believes that the maximum pre-existing condition limitation period should be 3 months. Currently, the limitation period can extend as long as 12 months. NPAF also believes that children should not be subject to any pre-existing condition limitation periods whatsoever.

"We still have much work to do for patients in America, but patients everywhere should celebrate this progressive and patient-friendly legislation," said Davenport-Ennis.

Both bills can be viewed in full at the Library of Congress website.


SOURCE: PR Newswire 07/19/07 and NPAF website

Sicko: Documentary or Propaganda?

Dr. B. Dale Magee, a practicing physician and president of the Massachusetts Medical Society, published a critique of Michael Moore's new documentary "Sicko" in The Winchester Star today.

Mr. Moore has grabbed our attention with the right subject at the right time, but the film comes across as more propaganda than documentary. He shows us a world of mostly villains and victims, and he portrays everything American as bad and everything foreign as good.

Magee analyzes a few key points in "Sicko," and raises some fact-based arguments against them.

SOURCE: "Just How 'Sicko' Are We?" 07/18/07

EMRs meet the iPhone

Life Record, a company that developed "the world's first web enabled medical record software based on the Intersystems Cache database" in 1998, is now hyping its compatability with the newly released Apple iPhone.

As always you can access your Life Record EMR on your Mac, Windows, or Tablet PC, but what if you are in a restaurant and do not have your laptop with you? What if you are on the golf course and you're miles away from your laptop? Have no fear, pull out your iPhone, log in to your Life Record with EMRAnywhere technology and you are not only viewing your patient records, you can add, edit, make changes, issue prescriptions, and review images from the palm of your hand in a mobile beauty that has never before been realized.

In addition to web-based Electronic Medical Records software, Life Record sells a variety of other programs to medical practitioners.

SOURCE: Med Gadget

Massachusetts Governor Won't Use State Model for U.S.

On July 1 of this year, a universal health care plan for all state residents went into effect in Massachusetts. The plan was pushed through by governor -- and 2008 Presidential candidate -- Mitt Romney.

With an article in yesterday's Miami Herald, writer Steven Thomma ponders why Romney has not been talking about the Massachusetts model, or health care in general, in his campaign.

Aides say the Massachusetts plan wouldn't work nationally, and Romney has no plans to propose a nationwide version.

Romney spokesperson Kevin Madden says that the omission of the Massachusetts health care plan from TV ads is not intentional, and that Romney is discussing reform with voters in town hall meetings. According to Thomma, however, Romney doesn't want to apply the Massachusetts model to the country.

SOURCE: "Healthcare Success Proves Tricky for Romney" 07/15/07
Stock photo courtesy of GeekPhilosopher.com

State-Run vs. National

Today on the TPM Cafe blog, health care specialist Maggie Mahar argues against state-by-state health care reform.

The fight for national healthcare reform will be fierce. To stand up to the powerful national interests that oppose reform, reformers will need muscle. This is just one reason why the battle must take place at the national level. Incrementalism -- one state at a time -- is no answer.

Mahar cites other reasons, such as the U.S. having more clout than individual states in dealing with pharmaceutical and insurance companies, wealthier states helping the poorer states, and the low ratings that state-run Medicaid programs receive.

She also brings up the possibility that problems within state-run health care plans will reflect negatively on potential nationwide programs, and give opponents to national health care reform the ammunition to shoot the ideas down.

SOURCE: "Why We Can't Reform Healthcare One State At A Time" 07/13/07
Photo by Chance Agrella, courtesy of Free Range.

Economic Impact of California Reform

UC Berkeley News shares results of a report by university researchers about the economic impact of the two major statewide health care reform plans under consideration in California.

Their study concludes that neither plan will mean job losses in California, and it forecasts that most firms will experience little or no net change in business operating costs after a short adjustment period. Increased operating costs related to increased health care provisions are likely to be absorbed through increased productivity, modest price hikes for consumers and delayed wage increases for workers earning more than minimum wage, the report says.

The article summarizes findings in the report, "Health Coverage Proposals in California: Impact on Businesses." The report was authored by researchers at the University of California at Berkeley's Center for Labor Research and Education, and it analyzes Gov. Arnold Schwarzenegger's health care reform proposal and Assembly Bill 8 (AB 8).

The story also includes a link to the full report.

SOURCE: "Study Predicts Positive Net Economic Impacts of Key Health Reform Plans" 07/11/07

Socialist vs. Universal

John M. Schwarz, director of United Health System, published a glossary of health-care reform recently in The Star Tribune.

It's time for health-reform dialogue to move beyond ideological rhetoric[...] Commentators from all walks, including the media, are guilty of misrepresenting what single-payer and universal coverage are.

Among other things, the article offers clarification of socialized health care vs. universal health care. The word 'socialism' is "most-abused label in health-reform dialogue," according to Schwarz.

SOURCE: "A Glossary of Health-Care Reform" 07/02/07

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Welcome to the Health Care Reform Now book blog. This blog is a companion to the new book, Health Care Reform Now: A Prescription for Change, by George C. Halvorson, Chairman and Chief Executive Officer of Kaiser Foundation Health Plan, Inc. and Kaiser Foundation Hospitals, and aggregates the latest health care news on the Web. Because the book calls for widespread systems reform in health care and universal coverage for all citizens, we wanted to provide a place for those interested in the topic to read the latest updates and to talk with each other about them.

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