Today’s Wall Street Journal has a piece on the op-ed page giving an up front and personal view of “What death by bureaucratic fiat might look like.” It’s an imaginary account of what facing a “death panel” could be if health care reform moves forward.
On the one hand, it’s of course fictional. “Death panels” aren’t part of the policy of reform. The reference of “bureaucratic fiat” is drawn from the idea that if, as a patient, you would like to see a counselor about items like preparing a living will, or what procedures you’d like (or not) during care, you’ll be able to do that. This reform package will cover the cost for such a visit with a physician.
On the other hand, the politics of “death panels” are highly effective. They have mobilized the right – talk radio listeners and Sarah Palin Facebook fans – around a galvanizing issue and image. That the concern is not reflected in the policy doesn’t matter. The politics of “death panels” are effective and today’s WSJ op-ed in a significant sophistication of the political strategy.
The WSJ is not talk radio – it is far more respected among moderates than Rush Limbaugh. That this article is printed there, with all of the authority of the WSJ brand, brings this issue into the mainstream of right-of-center conversation. That the piece is done in a way that stokes personal fear and concern makes the effect even more hard hitting.
Stay tuned.
Archive for August, 2009
Politics trumps policy in the reform debate
Tuesday, August 18th, 2009The History of Healthcare in 60 seconds
Tuesday, August 18th, 2009Ok, maybe it’s more like 270 seconds, but this is an interesting video from the 2007 Health 2.0 conference. It lays out graphically the history of providing health over a couple of millenia. Pretty efficient!
More info on that conference at www.health2con.com.
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Obama’s support for Public Option wavering, Liberal Dems concerned
Monday, August 17th, 2009Liberal Democrats who have championed a Public Option as the cornerstone of healthcare reform are becoming worried about President Obama’s now wavering support for such a plan.
The plan appears to have a limited prospects for success in the Senate, and considerable opposition in the House.
Click here to read the article in The Hill.
Children’s Hospital Master Plan denied by Seattle Examiner
Wednesday, August 12th, 2009On August 11th, the City Clerk filed the City of Seattle Hearing Examiner’s recommendation to deny expansion of Children’s Hospital.
The Examiner claims the Final Environmental Impact Statement inadequately addressed the impact on existing land use plans in the Laurelon Terrace neighborhood where the expansion would take place.
You can download the full report here.
“We are surprised and concerned by the Hearing Examiner’s findings,” said Dr. Thomas Hansen, CEO at Seattle Children’s Hospital in a press release. “With all due respect, we feel the Examiner’s decision is just plain wrong. We are confident that the City Council will recognize the strength of our proposal and approve it.”
“Without this expansion we are compromising access to immediate, quality care for the children in our region who need it most,” added Hansen.
“In the last three weeks we have been near capacity with few beds available and we haven’t even hit flu season yet or the anticipated demands that will come from swine flu,” said Hansen. “This is a serious situation and it puts our region’s children in a vulnerable position.”
The Seattle Children’s Hospital Major Institutions Master Plan Citizens Advisory Committee said this in their February 3rd, 2009 report, “The Final Major Institutions Master Plan for Seattle Children’s Hospital should be adopted by the City of Seattle.”
Children’s CEO Dr. Hansen said, “We plan to immediately appeal the recommendation to the City Council. If we are unable to obtain a favorable decision on our Master Plan in a timely manner we will need to consider other options that would be extremely regrettable, including a gradual relocation of our hospital facilities – including our downtown research campus – to a single site outside the city of Seattle.”
The Washington Health Partnership plan
Tuesday, August 11th, 2009The Washington State Legislature passed the Washington Health Partnership plan (WHPP) on April 21st. On May 18th, the WHPP was partially vetoed, but signed into law, by Governor Chris Gregoire.
The WHPP establishes a working group tasked with reaching goals set forth by the Blue Ribbon Commission on Health Care Costs and Access. Click here to read the final report published in January of 2007.
This includes extending coverage to individuals below 200 percent of the federal poverty level in an Apple Health program for adults.
The Apple Health program for kids has at its core a goal of ensuring health coverage for all children by 2010. It streamlines applications for childrens health coverage so parents are aware of their child’s eligibility, including the 75,000 children in Washington that are currently without coverage.
The bill digest describes the goals of the bill as follows:
“Creates the Washington health partnership plan to attain
the following goals:
(1) By 2012, every resident of this state
shall have access to affordable, comprehensive health care
services;
(2) Services shall be provided through the private health
care sector;
(3) The health reform plan shall maintain and improve
choice of health care providers and high quality health care
services in this state; and
(4) The health reform plan shall include cost-containment
strategies that retain and assure affordable coverage for all
Washingtonians.
Requires the department of social and health services to
submit a request to the federal department of health and human
services to expand and revise the medical assistance program
as codified in Title XIX of the federal social security act.”
All of the substantive portions of the bill were passed. Only a section requiring quarterly meetings of an advisory board was vetoed by Governor Gregoire.
The bill went into effect on July 26, 2009.
Read the WHPP here.
Nations’ eyes look to Senate Finance Committee for healthcare reform bill
Monday, August 10th, 2009At present, the fate of healthcare reform appears to be in the hands of Senator Max Baucus (D-MT) and the Senate Finance Committee.
Senators appear to be closer to coming out with a new version of a health reform package. Read more on this from The Washington Post.
Many representatives in Washington, D.C. recognize that simply adding 45 million people to Medicare without changing delivery systems and realigning incentives will just bankrupt the system faster.
Some are beginning to recognize successes in capitated Medicare Advantage plans, but there is a lot of push back from hospitals on that point. The House bill all but guts Medicare Advantage.
There is also discussion about leveling Medicare reimbursement rates nationally, which currently vary state by state and tend to reward states with higher costs and worse outcomes. Again though, there is push back from the states with inefficient care that get more money. There aren’t many representatives out there who would be willing to vote for a proposal that reduces funds their state would receive.
Read more about this development here.
Press Release: Rep. Inslee working to improve Medicare reimbursement rates in Washington
Sunday, August 9th, 2009MEDIA RELEASE
Monday, July 27, 2009
CONTACT
Torie Brazitis
202-225-6311
202-225-0434
Inslee strikes deal for Washington state health care
WASHINGTON, DC – On Thursday, in a six-hour meeting with House leadership, U.S. Rep. Jay Inslee (D-Wash.) forged a deal to better reimburse Washington state physicians and hospitals for the high-quality, low-cost medical care found in Washington state. For years, a complicated state-by-state payment formula and a fee-for-service reimbursement system deprived Washington doctors and hospitals of proper payment for quality, cost-conscious care.
“For years we have worked to untie the Gordian knot that kept Washington on the low end of the reimbursement system,” said Inslee, a member of the powerful House Energy and Commerce Committee. “On Thursday, we cut it. Norm Dicks and I worked together to create a provision to incentivize Washington state’s legendary efficiency in the rest of the country.
“For too long, Washingtonians pioneered high-quality, low-cost care while other places continued with out-dated, wasteful systems,” he continued. “These new steps forward could now save the country billions in the long term by rewarding value, rather than volume, in health care delivery. The agreement will correct the staggering regional disparities in Medicare reimbursement rates, which will mean millions in additional reimbursement for doctors and hospitals in our state.
“This deal is huge victory for Washington, as it could correct the fundamental inequalities in the Medicare which result in underfunded health care in low-cost states like Washington.”
Thanks to the work of Inslee and U.S. Rep. Norm Dicks (D-Wash) over the past two weeks, an agreement was reached that two Institutes of Medicine studies in the health care reform bill will now be completed and implemented simultaneously over the next two years. One study will examine how to create a value index to guide Medicare reimbursement rates instead of the current “fee for service” system. The recommendations will automatically go into effect unless Congress objects within sixty days.
The other study will examine geographical disparities in reimbursement rates. The Institute’s recommendations to fix those disparities will then go into effect automatically.
The goal was to finish all studies and changes before the public option goes into effect in 2013 so the recommendations would be incorporated into it. Originally, the studies would be completed over the next three years, leaving inequalities in place as the public option came into effect.
The studies will critically examine inputs, such as cost of living, and the inclusion of a value index in Medicare reimbursement rates. This deal would provide real cost containment in the bill and would begin to incentivize the quality, not the quantity, of medical care across the United States.
Additional issues remain for Washington state, including resolving concerns over the phase-out of Medicare Advantage.
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Snohomish County Health Indicators
Friday, August 7th, 2009According to a new report on health indicators in Snohomish County, adult obesity has increased from 22% to 28% in the last 3-4 years. Obesity is a large and growing medical problem in Washington State. It is considered a risk factor for virtually every major health and disease indicator in the report, including cancer, diabetes, cardiovascular disease, and asthma.
•Obesity due to sedentary behavior and excessive calorie intake is now the second leading cause of preventable death, resulting in 649 deaths each year in Pierce County.
•In the United States, there are around 24 million youth that are overweight or at risk of being overweight.
See the report here.