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Newsletter, What's Going On, February 25, 2011

Kaiser Health News: Half the country thinks health care reform has been repealed, or isn't sure.

Kaiser Health Tracking Poll: Americans are still divided about what they want lawmakers to do on health reform. Three in ten say Congress should expand the law, and two in ten vote for the status quo -- leaving the law to be implemented as enacted. On the other hand, four in ten want it repealed -- with half of those hoping to see it replaced with a "Republican-sponsored alternative" and the other half wanting no further action.

Boston Herald: Medicaid chief: Single payer may be better than ‘devil-may-be’ market  A senior Patrick administration health care official said Friday that a single payer system may work more effectively and efficiently than Massachusetts’s existing insurance market, a high-profile endorsement that raised eyebrows at a legislative hearing.  “I like the market, but the more and more I stay in it, the more and more I think that maybe a single payer would be better,” said Terry Dougherty, director of MassHealth – the state-run Medicaid plan that insures nearly 1.3 million Massachusetts residents – when lawmakers asked for his “personal view” on a single payer system.  Ezra Klein

Wonkbook: A federal judge has tossed out an anti-health care reform lawsuit, reports Nedra Pickler: "A federal judge on Tuesday threw out a lawsuit claiming that President Barack Obama's requirement that all Americans have health insurance violates the religious freedom of those who rely on God to protect them. U.S. District Judge Gladys Kessler in Washington dismissed a lawsuit filed by the American Center for Law and Justice, a Christian legal group founded by evangelist Pat Robertson, on behalf of five Americans who can afford health insurance but have chosen for years not to buy it...Kessler is the third Democratic-appointed judge to dismiss a challenge, while two Republican-appointed judges have ruled part or all of the law unconstitutional."

Wonkbook: States are resisting the Obama administration's attempt to move ahead with health care reform implementation, reports Tim Grieve: "The 26 states who came out on the winning end of a federal court decision invalidating the health care reform law say an Obama administration request for clarification is nothing but 'wishful thinking.' The administration has asked U.S. District Judge Roger Vinson to clarify his order invalidating the Affordable Care Act. But in a brief filed Wednesday night, the states say the administration is effectively seeking a stay of Vinson's order - and that it hasn't met the standards for one...The states ask Vinson - who's indicated that he'll rule quickly - to 'make clear' that he 'does not mean to entertain a subsequent stay motion with the attendant further delay.'"

The Arizona Republic: Arizona Aide: Ending Medicaid Would Cripple State If shutting down the state's health-care program for indigents sounds drastic, that's because it's supposed to. While other states have just talked about it, Arizona on Wednesday became the first to take official action toward killing its Medicaid program. Senate Bill 1519, approved by the Senate Appropriations Committee on an 8-5 vote, would end the nearly 30-year-old safety-net program, which now covers more than 1.3 million Arizonans, about half of them children. The state would forego more than $7.5 billion in federal matching funds, and most of the $2 billion in state funding would be redirected to the general fund, with about $1 billion earmarked for the developmentally disabled, behavioral health care and the "medically indigent" (Reinhart, 2/23).  Kaiser Daily Health Policy Report. 

The Arizona Republic: Health-care providers say they're under siege from the Legislature, battling against a raft of proposals to shrink the public system and bring illegal-immigration enforcement into hospital corridors and doctors' offices.  Bills making their way through the legislative process would add fees for people on the state's Medicaid program, withhold federal emergency-care funding from hospitals that treat illegal immigrants and make it a crime if health-care workers fail to report people without proper documentation.

The Hill’s Healthwatch: A bruising battle over who gets to control a key element of Democrats' healthcare reform law has broken out in North Carolina, providing an early glimpse into an issue that's likely to consume many state legislatures over the next two years.  Consumer advocates in the Tar Heel State are accusing the state's biggest insurer, Blue Cross and Blue Shield of North Carolina (BCBSNC), of attempting to control the board that would regulate the exchange. They say legislation supported by the insurer would give Blue Cross a permanent seat at the table and weaken the exchange's consumer protections.

POLITICO Pulse: SENATE CR (CR=Continuing Resolution, the stop-gap measure put in place to guide governmental expenditures until a budget is passed.): NO HEALTH DEFUNDING- Senate Dems are prepping a long-term CR - and it won't be loaded up with the kinds of health care riders the House put into its bill, Democratic aides say. That means no defunding of the health care law, and no defunding of Planned Parenthood either - giving the Senate a "clean" bill it can take into negotiations with the House to fund the government for the rest of the year. The Senate version of the long-term spending bill is expected to include some of the cuts President Barack Obama has proposed, to make it harder for Republicans to claim that Democrats are resisting any spending cuts at all. But by leaving out the health care defunding and Planned Parenthood riders, Senate Democrats would be able to fight all of them more easily when the House and Senate meet to work out a final bill, rather than trying to pick them off one by one on the Senate floor.

The Incidental Economist: “I’ve been asked several times and in several ways how and why health reform will play out differently across the states. In part, this has already been addressed by me and Aaron Carroll on this blog (see also my latest Kaiser Health News column with Kevin Outterson).  One thing I’ve not yet highlighted (or not fully) is the role of leadership. It’s plausible that the way state-level public figures talk about health reform will affect how populations in different states respond, particularly to the mandate. Is there any research that suggests a link between leadership and response to public programs? Yes, there is! I did some, with Steve Pizer and wrote a summary on this blog. The work was about the relationship between enrollment in Medicare prescription drug plans (PDPs) and the popularity of the administration promoting the program (President Bush).”   The blog post continues….

The incidental Economist: “I just finished reading Pricing the Priceless: A Health Care Conundrum, by Joe Newhouse. It’s not an easy read, but it is loaded with value. The final paragraph makes a crucial point:  [A]ll [health care financing] arrangements that can be implemented have important drawbacks. Although variation in ideology plays a role in the payment methods that different countries use, the wide variation in institutional arrangements around the world as well as the ongoing efforts at attempting to reform and improve those arrangements in almost every country are consistent with that conundrum.  A close corollary is that any proposal to reform any health system is imperfect. Each comes with obvious or hidden deficiencies, threatened by potential market or government failures.

I can’t tell you how many emails and comments on this blog I’ve read (or posts elsewhere) that suggest all will be solved by a single-payer system, or more consumer-directed health plans, or by driving the profit motive out of the health system, or any number of other very simple ideas. I guarantee, not one of them will solve all our problems. Nor will the ACA.  The blog post continues.........

HHS (The Department of Health and Human Services) went live with a new Facebook page Tuesday dedicated to telling young adults and parents about how to stay insured. The Facebook page:

The AMA News published a brief factual description of the Vermont health plan without adding the organization’s approval or disapproval.  The Vermont Times-Argus published an on-line, unscientific opinion poll Wednesday.  Supporters of Gov. Shumlin’s  proposal outnumbered opponents as of mid-day yesterday, though earlier results were less favorable to single-payer advocates. 

Dr. Pippa Abston has a superb piece discussing where priorities deserve to be put in funding that affects children.  Really a must-read.

Dr. Hsiao and his team presented a preliminary report to the Vermont legislature in January, recommending a single-payer health care system.  After a two-week period for commentary and a two-week re-writing period, this was their final report. (.pdf)

House Bill 3510, the Affordable Health Care for All Oregon bill, was introduced this week.

SB 810, California’s single payer bill, was reintroduced this week.

Health Reform GPS: A glossary of terms used in the Affordable Care Act.

Ezra Klein: The average bill for surgery in Birmingham, Alabama, in 1953 was $99.  That was when I was in medical school.  Jwr. 

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Wednesday, March 2, 2011. Please join NAHA (North Alabama Healthcare for All), for a fun lunch with no agenda, just some good discussion. 

Location in March to be determined.  .  Wednesday before each monthly meeting.

Sunday, March 6, 2011  7PM CDT. Healthcare-NOW monthly activist phone call. Please use this Dial-in Number 1-218-862-1300 and Conference Code 441086. To mute and unmute the line, please hit *4.

Monday, March 7, 2011  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.  Rob Kilpatrick will lead a discussion of the basics of what a single payer health care system is. 

Thursday, March 10, 7:00 PM.  Health Care for Everyone-Alabama meeting, Community Meeting Room, Emmet O’Neal Library, 50 Oak Street, Mountain Brook.  We’ll combine a drop-in health care study group, this month starting with the ‘Individual Mandate’; talk about recent goings on in health care reform and plans for what to do next.  All invited. 

Thursday, March 17, 2011.  @5:30 PM.  Third Thursday happy hour (social gathering), at The Scene, restaurant and lounge, upstairs at Monaco, 370 The Bridge Street, Huntsville.  Rob Kilpatrick would appreciate knowing you’re coming.  rob2020@mac.com

Thursday, March 24, 2011. 8 PM. CST  PNHP Leader/Activist Conference Call.  Call me for the number and access code. 

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