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Newsletter, What's Going On, March 29, 2011

Sent to the Editor of the Birmingham News:

PAINFUL DECISIONS.  WHOSE PAIN?

County commissioners, local legislators will be making 'painful decisions' Wednesday.  They won't be the people feeling the pain.  

They'll meet to plan to remove earmarks from the county's 1-cent sales tax, earmarks first put in place to protect tax receipts from politics.  Those funds make up a third of the health department budget, half of Cooper Green's budget.  

Health Department clinics will close, and we'll all see more people in the emergency rooms of all of our hospitals.  Cooper Green Mercy Hospital will have to struggle just to stay open and many of its present patients will need care elsewhere.  Some will find it.  Some won't, though we'll never know about it.  When poor people die because they can't find care, it doesn't make headlines.

Maybe we'll have an epidemic of food-borne illness from under-inspected restaurants.  A run of infectious disease from under-inspected swimming pools.  A few more cases of appalling care discovered as a result of fewer boarding home inspections.  Or a little more syphilis or gonorrhea.  Or tuberculosis.  And God help us if we have a public health emergency.

So commissioners and legislators will be making painful decisions.  Decisions involving their least possible personal political pain.  I don't envy them.

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SO WHAT CAN YOU DO ABOUT IT?  Folks in Jefferson County should call or email their legislators today.  Folks outside the county should contact their legislators, too, because removing earmarks will require a bill to pass both the Alabama House and Senate. 

This is the roster of House members.

This is the roster of Senate members.

Click on a member’s name and you’ll get to his email address.

Let us know what you’ve done when you’re done, so we can keep score.

And please keep in mind that your donations can let us become even more effective.

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Unearmarking in Jefferson County will also reduce funding  for pre-natal care for low-income women.  Nebraska unfunded pre-natal care this spring.  Five babies have died so far as a result.  The Wonk Room.

The Wall Street Journal:  European countries are facing health care costs that are rising much faster than their economies as a whole.   As one might expect, there’s a good deal of variability in the ways they’re dealing with the problem.

Wonkbook: Medicare premium hikes have wiped out Social Security's latest cost-of-living increase. 

Wonkbook: Republicans will include a Medicaid overhaul in their budget, report Corey Boles and Janet Hook: "House Republicans are preparing to propose a major shake-up of the Medicaid health-care program for the poor, a first step in their drive to overhaul federal entitlements, according to a member of the House Budget Committee. Rep. Mick Mulvaney (R., S.C.) told constituents at a town hall meeting in Lancaster on Thursday that the committee soon would unveil a budget resolution for fiscal 2012 that recommends revamping Medicaid to allow states more latitude in spending federal money. 'We're getting ready to offer people the first real, substantive discussion on a major entitlement--Medicaid--in my lifetime,' the congressman said. Rep. Paul Ryan (R., Wis.), the budget committee chairman, is expected to release his budget proposal by the first week in April."  Ezra Klein discusses the political considerations that put Medicaid at risk of serious funding reductions while Medicare and Social Security are safe. 

Kaiser Health News: Study Finds Raising Medicare Age Would Shift Costs Kaiser Health News staff writer Mary Agnes Carey reports: "Raising Medicare's eligibility age by two years would save the federal government $7.6 billion but those costs -- and more -- would shift to others, according to a report out today" (Carey, 3/29).

The Wall Street Journal: Government Shutdown Grows Likelier Talks between congressional leaders and the White House on a deal to fund the government for the rest of the year appear to have slowed, with Democrats and Republicans loudly bickering over the fate of their negotiations. ... The coming days represent a crucial stage in the negotiations if both sides are to avert a government shutdown. Last week, Vice President Joe Biden played a role in keeping the talks on track after a session broke up in acrimony. But he has been trying to keep a low profile, said one Democrat familiar with the negotiations, out of concern that Republicans would rather not be seen as making a deal with the White House. ... Another stumbling block: conservative-backed amendments contained in the House bill that would cut off funding for the health-care law and other administration priorities (Lee and Hook, 3/29).

Kaiser Health News: Administration Delaying Some Rules For Appealing Health Insurance Denials  The Obama administration is delaying until next January its enforcement of some new rules designed to protect patients who appeal insurers' decisions to deny or reduce health care benefits. 

In the meantime, the Labor Department said in a posting on its website that it will revise the requirements to deal with objections raised by insurers. These rules were mandated by the health care law, and federal officials had earlier said they would start enforcing them in July. 

The delays were defended by the administration and the insurance industry but worry consumer advocates. 

Among the rules now on hold are: 

--A reduction in the amount of time an insurance company is allowed to review a denial of coverage in urgent cases, from no more than 72 hours to 24 hours.  

--A requirement that insurers provide information about the denial and how to appeal in appropriate language for non-English speaking beneficiaries. 

--A requirement that insurers must provide consumers with specific details, which would include diagnostic codes used by doctors, hospitals and insurers, about what treatment isn’t covered and why.  Health Care for All-Colorado.

HealthAffairs Blog: Medicare’s Embedded Ethics: The Challenge of Cost Control in an Aging Society. The challenge of reining in the rising costs of the Medicare Program is particularly thorny because it confronts a recalcitrant societal tension between the necessity for cost control and the value of open-ended technology use for life extension in the later years.  more

CommonHealth: FactCheck.org Offers Reality Check on Claims About MA Health Reform

POLITIO Pulse: THE $93,000 QUESTION - If anything is too expensive for Medicare, it just might be a prostate cancer therapy that costs $93,000 and gives men, on average, an extra four months to live. The decision is due March 30, when CMS must decide whether Medicare will pay for Provenge, a cancer therapy. If CMS decides not to cover it, the agency could open itself up to the "government rationing" charges again (because Don Berwick was really missing those). And if the agency decides to cover it, the Obama administration will lose a lot of its talking points about controlling health care spending.

POLITIO Pulse: The Republican alternatives to the health care law suggested so far - ranging from limiting malpractice lawsuits to allowing insurers to sell across state lines - would save less than $5 billion a year, according to a Bloomberg analysis.

Tuscon Citizen: Arizona Gov. Jan Brewer will attempt to restore transplant coverage to Medicaid.  POLITICO Pulse.

Mother Jones: The tea party has a new plan to attack health care reform. While some conservative activists are still fighting to get the law defunded and eventually repealed, others are organizing behind a radical, states'-rights proposal that would go beyond merely derailing health reform. Egged on by tea partiers, at least a dozen states are now contemplating legislation that supporters believe would allow them to seize control of and administer virtually all federal health care programs operating in their states and exempt them from the requirements of the health care law. That includes Medicare, the government health care program for the elderly on which a sizable number of tea partiers rely. The vehicle for this reform end run is called the health care compact, an interstate compact not very different in theory from the ones states use to create regional transit authorities, for instance. Recently, the nation's largest tea party group, the Tea Party Patriots, has thrown its weight behind the concept, seeing it as another way of downsizing the federal government.  Peter Van Vranken

WCAX: Article on the medical student rally in support of the Vermont single-payer legislation.  And at Favstocks.

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Wednesday, March 30, 2011. Please join NAHA (North Alabama Healthcare for All), for a fun lunch with no agenda, just some good discussion.
 Jamos Café, 413 Jordan Lane NW, Huntsville, AL..  Wednesday before each monthly meeting.

Friday, April 1 (evening)-Sunday, April 3, 2011.  Global Health & Humanitarian Summit.  Emory University Main Campus, Atlanta.   PNHP members from Georgia and Alabama will be there, as will Dr. Garrett Adams, President of PNHP.  For more details: http://www.imvc.org/

Sunday, April 3, 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, April 4, 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.

Thursday, April 21, 2011.  @5:30 PM.  Third Thursday happy hour (social gathering), at the Preve lounge, upstairs at Monaco, 370 The Bridge Street (6782 Old Madison Pike), Huntsville.  Rob Kilpatrick would appreciate knowing you’re coming.  rob2020@mac.com

Thursday, April 28, 2011. 8 PM. CST   PNHP Leader/Activist Conference Call.  Call me for the number and access code. 


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