Newsletter, "What's going On...", July 8, 2010
July 8, 2010
We’re deep into the transition to a professional program for managing our newsletter distribution. Last week, unfortunately, many subscribers didn’t get their copies. We think we have the kinks worked out in the distribution system now. Wish I could simply write, “Will anyone who doesn’t get this newsletter please let me know?” But I’ll follow up again with a note, sent through our old Mail Merge program, to see how we did this week. Our new web site, www.HealthCareForEveryone-Alabama.org, has copies of the current newsletter and will soon have archived copies of older newsletters, should anyone want to see them.
We’ll send this newsletter on a Thursday, and change to Tuesday as our routine distribution day starting next week.
President Obama appointed Dr. Donald Berwick to head the Centers for Medicare and Medicaid Services with a recess appointment this week. Berwick appears to be a man exceptionally well qualified for the position, recommended by many prior CMS heads under Republican administrations, but the Republicans had vowed to stall his appointment and to make as much of a fuss about it as they were able. The recess appointment bypasses that snarl and puts an excellent man to work immediately. A Kaiser Health News background guide to the man:
Ezra Klein found a speech Dr. Berwick gave in Britain to a distinguished audience on the eve of the British National Health Services’ 60th Birthday. He praised the system, but then offered 10 ideas for its reform. This was the first:
“First, put the patient at the center – at the absolute center of your system of care. Put the patient at the center for everything that you do. In its most helpful and authentic form, this rule is bold; it is subversive. It feels very risky to both professionals and managers, especially at first. It is not focus groups or surveys or token representation. It is the active presence of patients, families, and communities in the design, management, assessment, and improvement of care, itself. It means customizing care literally to the level of the individual. It means asking, “How would you like this done?” It means equipping every patient for self-care as much as each wants. It means total transparency – broad daylight. It means that patients have their own medical records, and that restricted visiting hours are eliminated. It means, “Nothing about me without me.” It means that we who offer health care stop acting like hosts to patients and families, and start acting like guests in their lives. For professionals made anxious by this extreme image, let me simply remind you how you probably begin every encounter when you are following your best instincts; you ask, “How can I help you?” and then you fall silent and you listen.”
The whole of the speech is here: (courtesy of Mr. Klein)
Don McCanne’s Quote of the Day this week abstracted an important article by Dr. Theda Skopcol from this month’s Health Affairs:
The Political Challenges That May Undermine Health Reform
By Theda Skocpol
As with all major social legislation, years of decisions and disputes over implementation lie ahead for the Patient Protection and Affordable Care Act. Opponents at the state and national levels may seek the law’s judicial overturn or repeal. However, a far more serious effort to undermine the law will come about through challenges to various administrative arrangements, taxes, and subsidies to fund expansions of coverage. The redistributive aspects of health reform will be especially at risk, as business interests and groups of more-privileged citizens press for lower taxes, looser regulations, and reduced subsidies for low-income people.
(Theda Skocpol is the Victor S. Thomas Professor of Government and Sociology at Harvard and an internationally recognized analyst of comparative and American politics. Skocpol’s books on social revolution and the state are considered fundamental texts and have been translated into several languages.) I recommend the original article in this month’s Health Affairs. http://content.healthaffairs.org/cgi/content/full/29/7/1288
From Herndon’s Health Care Media Summary, Peter Van Vranken: First Health Overhaul Provisions Start To Kick In AP by RICARDO ALONSO-ZALDIVAR - The first stage of President Barack Obama's health care overhaul is expected to provide coverage to about 1 million uninsured Americans by next year, according to government estimates. That's a small share of the uninsured, but in a shaky economy, experts say it's notable. Many others — more than 100 million people — are getting new benefits that improve their existing coverage. The major early coverage benefits include:
§ Allowing young adults to stay on their parents' coverage until they turn 26. In 2011, an estimated 650,000 young people who would otherwise have been uninsured will gain coverage. Another 600,000 will benefit by switching from individually purchased policies to less costly, more comprehensive employer plans. The number with coverage will grow in 2012 and 2013.
§ A health plan for uninsured people with pre-existing health conditions. From 200,000 to 400,000 could benefit in 2011, according to the Congressional Budget Office. The government may limit enrollment if $5 billion allocated through 2013 starts to run out, as projected. Beginning in 2014, insurers will be required to accept all applicants, regardless of medical history.
§ Ending lifetime limits on coverage, and restricting annual limits. As many as 20,400 people a year hit lifetime limits. Many more — an estimated 102 million — are in plans that impose such limits and will no longer be able to do so.
§ Requiring insurers to cover children with medical problems. An estimated 51,000 uninsured children are expected to gain coverage. Another 90,000 children who have been excluded for coverage for a particular condition — asthma, for example — will also benefit.
The importance of this post is that Alonso-Zaldivar has usually been pretty critical of the new health care reform law.
Adios to the junkiest of junk health insurance. Most of us don’t know about the junky health insurance that’s around. Oh, we might have guessed from some of the roadside signs offering insurance that’s too good to be true…but that’s just the tip of the iceberg. Read this paragraph from this article….” Another person we met was a woman who had retired early and opened a wine shop. Being responsible she bought health insurance that her broker told her was just as good as the coverage she had had at her corporate employment. It all went fine until she got bit by a rattlesnake while clearing out her new backyard and found out the insurance did not cover the first day of hospitalization, the only day she needed. The hospital billed her $98,000 for that day of care…” And that’s just one example of the kinds of junk insurance the article talks about. Adios, indeed. The new health care reform law will eliminate that kind of slease.
The question arises again: should contraceptives be included in the list of preventive services that the new law mandates be provided free?
The Center on Budget and Policy Priorities notes: Among those who will qualify for Medicaid when the program is expanded nationwide to 133 percent of the poverty line in 2014 are poor and low-income adults who do not have a disability or live with an eligible child, a group that is uninsured at higher rates and has greater health care needs than other uninsured groups. The health reform law allows states to provide newly eligible Medicaid beneficiaries either with the regular Medicaid benefits package or with a less comprehensive package……. (emphasis is mine.)
We’ve heard for a long time that the problem of Medicare payments…the 21% reduction in fees that the current reimbursement formula mandates, the recurrent last-minute rescues that Congress always grants the medical profession at the last moment…would drive doctors to stop taking Medicare patients, and patients to frustration in finding doctors to take care of them. Somehow the facts on the ground haven’t agreed with the prediction of impending catastrophe for Medicare. But are we getting closer to doomsday?
Where have we heard this before? Germany's coalition government on Tuesday agreed to water down the sweeping health care reform plans promised in last year's election. The Wall Street Journal's Andrea Thomas reports from Berlin http://bit.ly/cz238F. From Politico.
The nine word long Republican bill in the Senate that would repeal the new health care reform act has many co-sponsors but only a few of the Senate Republican leadership.
Who else would be interested in planning a Birthday Bash for Medicare when it turns 45 this July? Maybe in the Birmingham area? Montgomery? Tuscaloosa? Mobile? We ought to be able to get some cake, serve it with candles to some elected officials, local TV and newspapers. Let me know if you’re interested.
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Sunday, July 11. Healthcare-NOW! will be hosting it's standing activist conference call at 7pm (CDT). Please use this Dial-in Number: 1-218-862-1300 and Conference Code: 441086.
Thursday, July 22. 8 PM Central. PNHP Conference Call. Call me for the number and the Conference Code.
Friday, July 30. Medicare Birthday Bash, Huntsville Public Library, 12-1. Birthday cake, speakers. Details to follow.
Friday, July 30. Medicare Birthday. Healthcare-NOW is “looking to July 30th this year as a major day of action to protest the cuts and privatization of our hard-won entitlement programs. These cuts are simply, ‘off the table.’ We hope you will consider activating your network on July 30th to demonstrate at your local Congress person's office, your state capitol, a private insurance company, or another target that you think will bring awareness, media attention, and pressure on our elected officials. Healthcare NOW will help to support your efforts with sample press releases, media kits, post cards, petitions, staff support, and email blasts. We need you on the ground to make the noise, and collectively, our work to protect these important programs will build our networks in advocating for what we know can help alleviate so much of the unnecessary suffering in this country: expanded and improved Medicare for All. Please let Healthcare-NOW staff know if you are interested in planning actions for July 30th at firstname.lastname@example.org.”
Monday, August 2, 2010 @ 5:30 PM. North Alabama Healthcare for All Monthly Meeting —Huntsville/Madison County Public Library, 901 Monroe Street (downtown). The meeting is in Room AB, on the first floor. After you enter the library’s front door, turn right towards the auditorium. The July meeting is CANCELLED
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