March 19, 2010
2:44 pm
Previously in this space, I’ve mentioned the flaws in using expansion of the Medicaid program – a key provision in pending health reform legislation – as a prominent tool for reducing the uninsured rolls. Many physicians don’t see Medicaid patients because of the program’s low reimbursement rates. Thus, moving 15 million more Americans into Medicaid can only exacerbate healthcare access problems.
But there’s another issue with Medicaid expansion, and it’s brought to the fore by Tennessee Governor Phil Bredesen (D). In a letter to Senator Bob Corker (R-TN) and Congressman Bart Gordon (D-TN), Governor Bredesen points out the havoc that Medicaid expansion will raise with the state’s financial future.
He wrote:
“In this environment, for the Congress to also send along a mandatory bill for three quarters of a billion dollars for the health reform they’ve designed is very difficult. These are hard dollars – we can’t borrow them – and make the management of our finances post-recession even more daunting than it already is.”
It’s critical that health reform be sustainable for the long term. Encumbering fiscally-challenged state governments with more long-term financial obligations doesn’t meet that goal. A better idea is to focus on providing assistance to help families and individuals better afford private coverage, and take steps to bring all Americans into the system in order to keep costs affordable.
Governor Bredesen makes an important point that Capitol Hill should be hearing.
March 18, 2010
8:41 am
The Robert Wood Johnson Foundation deserves the nation’s thanks for so diligently spotlighting the difficulties faced by Americans without health insurance and reminding us how imperative it is to address this challenge. Cover the Uninsured Week has long served as an opportunity to engage citizens and communities throughout the country in this vitally important effort.
In the years since Cover the Uninsured Week began, we have learned a great deal about how to make progress toward achieving a fully insured America. We’ve found that public education and energetic outreach can make a tremendous difference. When the private and public sectors work to provide illumination on the importance of health coverage and information on how to acquire it, it’s possibly to significantly reduce the uninsured rolls.
We also know that the right public policies can make a difference. Eight of every 10 uninsured Americans lives in a wage-earning households, and half of that group receives an offer of insurance from an employer. One of the most important objectives health reform can achieve is to help bridge the gap to help working Americans afford that private health insurance coverage.
The Healthcare Leadership Council is proud to be a long-time supporter of Cover the Uninsured Week, and we salute the Robert Wood Johnson Foundation for the commitment they bring to this important issue.
March 17, 2010
12:17 pm
We all know that the American Medical Association has endorsed the health reform legislation currently awaiting votes in the U.S. House of Representatives. It’s worth noting, though, a survey of physicians that has been published in the New England Journal of Medicine.
The survey, conducted by The Medicus Firm, found that there is a great deal of pessimism in the physician community about what this health reform legislation will mean for their practices. It even raises questions about the supply of doctors who will be around to treat the millions of Americans who would be added to the Medicaid rolls if this bill becomes law.
Among the noteworthy findings:
• 46.3 percent of primary care physicians feel health reform will either force them out of medicine or make them want to leave medicine.
• The number of physicians who would not recommend medicine as a career jumps from 36% to 63% when the passage of health reform is factored in.
• 62.7 percent believe health reform is needed, but that it should be implemented in a more targeted, gradual way instead of a sweeping overhaul.
• Should the so-called public option arise again as an issue, one of every four doctors said they would seek to retire early if a public option were implemented with another 21 percent saying they would leave medicine even if not near retirement age.
Chatter in Washington is so immersed right now in the legislative mechanics of how health reform may or may not gain passage that we’re devoting little attention to the ins and outs of how it might be implemented. This new survey deserves policymakers’ attention.
March 12, 2010
2:29 pm
There’s an important op-ed piece in today’s Washington Post, written by two prominent Democratic pollsters, Pat Caddell and Doug Schoen, who did polling for Presidents Jimmy Carter and Bill Clinton, respectively. On a day when the White House is making the case that public opinion is shifting in the direction of its health reform proposal – and allies like Paul Krugman of the New York Times are echoing that message – Caddell and Schoen argue that the battle for hearts and minds has already been lost.
They wrote:
“…a solid majority of Americans opposes the massive health-reform plan. Four-fifths of those who oppose the plan strongly oppose it, according to Rasmussen polling this week, while only half of those who support the plan do so strongly. Many more Americans believe the legislation will worsen their health care, cost them more personally and add significantly to the national deficit.”
Caddell and Schoen make the point that it’s still possible to salvage health reform this year, but only if Congress will put the current bills on the shelf and bring together new, centrist legislation merging Democratic and Republican proposals. Read more
March 09, 2010
1:37 pm
In order to boost public support for its health reform push, the White House added a new wrinkle to the Senate-passed reform bill it has, by and large, embraced. The White House proposes to create a new federal agency with the power to review, regulate and, if it so wishes, block health insurance rate increases.
It’s not difficult to see the political strategy involved here. With health insurance premium increases in the news as of late, the health reform debate has been cast as a heroes-versus-villains morality play. A new federal rate commission will save vulnerable Americans from the health insurance industry and its, as one Administration spokesman termed them, “wildly excessive rate increases.”
But, as veteran health policy journalist Robert Pear writes in today’s New York Times, there are serious flaws with this populist initiative.
For one, health insurance premiums are already regulated by the states. As Sean Dilweg, Wisconsin’s insurance commissioner, said, “The federal proposal would be a huge pre-emption of decisions that states have made over their history.”
It’s important to note here the difference between what states actually do and the new federal responsibilities being proposed. When states analyze proposed insurance rate increases, they look at the entire picture. What are overall healthcare costs? How much of an increase can consumers reasonably absorb? What is essential to keep health insurers solvent? Read more
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