The Obama Budget and the EMBRACE Healthcare Reform Plan

It is very telling, and in that respect so different than the Clinton healthcare initiative, that in his budget Obama has put aside a $634 billion reserve fund for health care reform and left it up to the Congress to come up with a plan. He has outlined a set of guidelines and has left it up to Congress to hash out the details. He has stipulated that the plan should ensure that coverage be universal, affordable, portable and there should be investments in prevention and improved quality of care.

Although there are many proposals out in Congress, EMBRACE  fits these criteria and comes at  a good time, especially since it looks like we will need a compromise.

Gil

A Letter to Our Website

We recently received a note from our web site:

I am a Licensed Practical Nurse . I also believe in Universal Healthcare . It’s a sad shame when a single mom has to work 50 hours a week and the facility where I worked full-time stated My Health Insurance would be free Until I found out I had to pay 250 every to weeks to add my son to the plan BCBS offered . Most insurance companies are taking away health insurance from hard working nurses and making us pay higher copays Why?? They say our job is high risk. Sad shame What next I’ll be having a heart attack dying and go to the emergency room and the hospital will say to bad to bad you don’t have health insurance Think about it we aren’t that far away from taking place Change is needed !!!

Helen P.

The Response:

Hi Helen,

This is why we developed EMBRACE. The sad fact is that many would not even count you in their statistics, since you do have insurance for yourself! The other sad fact is that Universal health coverage means different things to different people. Many plans that are now being proposed for universal coverage aim to expand programs like Medicaid which are significantly inferior to the private insurance you have. They are concerned more with achieving coverage for everyone than giving them access to the best care. EMBRACE will allow you and your son unlimited access to basic health care. There will be no co-pays for these basic services (but may for the optional Tier 2 coverage depending on what you negotiate with the insurance company). Almost all acute hospital admissions (especially heart attacks), will be covered, with no charge to you even if you do not have Tier 2 (private insurance) coverage. In addition, the basic (Tier 1) coverage will never look at your “risk profile” and these coverages (whether Tier 1 or Tier 2) are fully portable from job to job and state to state. These next few weeks are very important, since this is when Congress will be taking up and (hopefully) drafting a healthcare reform proposal to present to the president. Please contact your Representative AND both your Senators and tell them your story and about EMBRACE. To find your Senator click here To find your House Representative click here The basic EMBRACE plan can be found on our web site: www.hpfhr.org/the_plan

Gil

Obama and Healthcare Reform

This is what Obama said about healthcare reform yesterday in his speech:

Now, there will be many different opinions and ideas about how to achieve (healthcare) reform, and that is why I’m bringing together businesses and workers, doctors and health care providers, Democrats and Republicans to begin work on this issue next week.

I suffer no illusions that this will be an easy process. It will be hard. But I also know that nearly a century after Teddy Roosevelt first called for reform, the cost of our health care has weighed down our economy and the conscience of our nation long enough. So let there be no doubt: health care reform cannot wait, it must not wait, and it will not wait another year.

I only hope that there will be more input from doctors and healthcare providers and less from industry… but I am not sure that’s going to happen.

Gil

PNHP is gearing up for the fight and so should we!

One of our members sent me this “email alert” from PNHP, the major group advocating single payer health coverage. It underscores the need for us, a much smaller and yet unrecognized group to consider doing the same for EMBRACE:

February 24, 2009

Dear PNHP Colleagues,

We have some good news, some bad news, and some breaking news!

The good news is that single-payer legislation (H.R. 676) was reintroduced in the 111th Congress on Jan. 26. Supported by 94 representatives in the 110th Congress, the bill is now backed by a new alliance of physicians, nurses, unions and grassroots groups with a base of over 20 million Americans and growing!

The bad news is that Sen. Max Baucus (D-Mont.), chair of the powerful Senate Finance Committee, will not allow consideration of single payer as an option for reform, and Sen. Kennedy (D-Mass.) is, by all indications, poised to promote the flawed Massachusetts health plan at the national level after months of secret meetings with insurance, business, and pharmaceutical company lobbyists.

The breaking news is that PNHP is co-hosting a briefing to refute the Massachusetts model and to promote single payer on Capitol Hill tomorrow (Wednesday, Feb. 25). The congressional forum will be webcast live on our web site at www.pnhp.org starting at 2 p.m. EST, with PNHP founder Dr. David Himmelstein as the first speaker(the forum will be posted for viewing later as well). Last week, PNHP released, with Public Citizen, a report on the Massachusetts plan, along with a letter to Sen. Kennedy signed by 500 physicians and other health professionals in the state, calling on him to return to his earlier support for single payer.

While President Obama has acknowledged that single payer is the best option for reform, and while he opposed a mandate requiring all individuals to purchase private insurance during his campaign, it would appear he is poised to embrace the piecemeal, incrementalist approach that keeps the private insurance industry in place. He may outline more details about his stance tonight when he appears on television to address the nation about the budget. As John Nichols blogged for The Nation, single payer national health insurance would be a huge help to the automakers and the economy as a whole.

In this environment, PNHPers across the country are challenging the “inside the beltway” mentality that believes only incremental reform that retains (or “bails out”) the insurance industry is possible. Dr. John Benziger, Dr. John Geyman, Dr. Laura Boylanand PNHP President Dr. Oliver Feinare among the many PNHPers who are writing and publishing op-eds and letters-to-the-editor in support of single payer. Several PNHPers have garnered endorsements from their city councils, most recently in Seattle. And PNHPers from coast to coast responded to the call to host house parties and send messages in support of single payer to Obama over the holidays.

What you can do:

1. Urge your member of Congress to co-sponsor H.R. 676 (in the House) or encourage hearings on single payer (in the Senate). There are useful lobbying materials at www.pnhp.org/change, and PNHP staff can help you set up an appointment: contact Danielle Alexander at danielle@pnhp.org. There will be a national call-in day for H.R. 676 on April 15 (but you don’t have to wait until then!). Plan to visit with your member of Congress during the April 6-17 Easter recess when lawmakers will be at work in their home districts. You may also write them online.
   
2. Submit an op-ed or letter to the editor. Feel free to use any PNHP materials as starting points – especially Dr. Don McCanne’s single payer “quote of the day.”
   
3. Speak out in support of single payer. PNHP has slide sets available for this purpose to members at www.pnhp.org/slideshow. The password is “fein.”
   
4. Encourage grassroots groups to join the new national single payer alliance, The Leadership Conference for Guaranteed Health Care. Requests may be sent to staffer Katie Robbins at healthcarenow08@gmail.com.
   

For many years, PNHP has been inspired by a quote from Dr. Martin Luther King Jr.: “Of all the forms of inequality, injustice in health care is the most shocking and most inhuman.” Lately we have found a new quote from Dr. King that seems very fitting for the newest phase of our struggle: “Although social change cannot come overnight, we must always work as though it were a possibility in the morning.”

In many ways their fight is our fight, since in many ways EMBRACE is a single payer plan that acknowledges that private coverage will grow in any system; either outside the system as in most single payer plans or within the system as in our plan.

As with PNHP, I think we should be writing op-eds and presenting talks about EMBRACE as a politically viable compromise for all of us who believe in evidence based universal health care. I will try to get our slide presentation up on the website, but until then if anyone wants a set please email a request to: gl@hpfhr.org.

Gil

Comparison of Health Care Plans

As our EMBRACE plan has been accepted for publication (we will give details in the next week or two), it is important to understand how many other plans there are out there already. I came across a good website comparing health plans that is worth looking at.

From a spreadsheet on the site, I count 18 “INTEREST-GROUP PLANS”, and 5 “OTHER PLANS” mostly by politicos (excluding the Bush plan but including the Obama plan). Many of these plans have been out for a long time (including the PNHP (HR676) single payer proposal.

EMBRACE, even after its publication will be coming in late to the discussion, but I hope may offer a good alternative/compromise to what is out there.

Gil

The Negotiations are Beginning

In follow-up to the prior post, there is an interesting (and troubling) article in the NY Times today entitled “Health Care Industry in Talks to Shape Policy” .

It seems that the insurance industry is having “secret talks” with Kennedy’s committee. The problem I have with this is, where are the healthcare professionals in this? Why are we getting left out again?

Gil

Update in Health Care Policy and Health Care Reform

With the elections over and the economy suffering one of its worse period since the Great Depression, it is easy to believe that efforts to change health care will fall by the wayside, as it has so often in the past. Indeed, with the withdrawal of former Senator Tom Daschle, arguably the personification of health care reform, from consideration for Secretary of Health and Human Services, it seemed that reform took a major hit even before it could start.

But it appears that the Obama administration and the 111^th Congress were already quite committed to getting some meaningful reform through. This was evident with the passage and signing of the often vetoed SCHIP bill in late January followed by several important provisions in the $787 billion economic stimulus bill signed by the president on February 17^th.  

The final bill provides $87 billion of federal money to the states for Medicaid allowing them to continue to fund the program, and prevent people from losing coverage at a time when the need will probably keep growing. For those workers who lose coverage when they lose their jobs, the bill offers financial help with interim coverage.

Under the 1986 Cobra law, workers can temporarily keep group health benefits, but the cost is often prohibitive because they must pay the entire premium, including the employer’s share. Under the stimulus bill, the federal government would offer premium subsidies, paying 65 percent of the cost for up to nine months.

The measure also provides more than $19 billion to digitize medical records and link up doctors and hospitals with information technology. It includes new safeguards to protect the privacy of medical records, generally forbidding health care providers to sell individually identifiable health information without permission from the patient.

Finally, there is $1.1 billion provided for the federal government to compare the effectiveness of different treatments for the same illness. The bill creates a council of up to 15 federal employees to coordinate the research and to advise President Obama and Congress on how to spend the money. The program responds to a growing concern that doctors have little or no solid evidence of the value of many treatments. Supporters of the research hope it will eventually save money by discouraging the use of costly, ineffective treatments.

It is the reaction to this last provision that probably gives us a good idea of the rancor we should expect in the coming debate for further health care reform. The New York Times summarized the debate:

“Consumer groups, labor unions, large employers and pharmacy benefit managers supported the new initiative, saying it would fill gaps in the evidence available to doctors and patients.

“The new research will eventually save money and lives,” said Representative Pete Stark, Democrat of California.

The United States spends more than $2 trillion a year on health care, but “we have little information about which treatments work best for which patients,” said Mr. Stark, who is the chairman of the Ways and Means Subcommittee on Health.

In the absence of information on what works, Mr. Stark said, patients are put at risk, and billions of dollars are spent each year on ineffective or unnecessary treatments.

Steven D. Findlay, a health policy analyst at Consumers Union, said the action by Congress was “a terrific step on the road to improving the quality of care and making it more efficient.”

 

“As Congress translated the idea into legislation, it became a lightning rod for pharmaceutical and medical-device lobbyists, who fear the findings will be used by insurers or the government to deny coverage for more expensive treatments and, thus, to ration care.

In addition, Republican lawmakers and conservative commentators complained that the legislation would allow the federal government to intrude in a person’s health care by enforcing clinical guidelines and treatment protocols.

Critics say the legislation could put the government in the middle of the doctor-patient relationship.

Bureaucrats “will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost-effective,” Betsy McCaughey, a former lieutenant governor of New York, wrote on Bloomberg.com. Rush Limbaugh broadcast the charges to millions who listen to his radio talk show.”

 

It is clear from these debates that we are in for a major fight when the Administration’s full health care reform bill is introduced. It is likely though, now that Daschle is out, that there may be a delay in introducing legislation until all the Administration’s players are in place and ready to push it through. However, it seems that there is very strong interest in the Administration and the Congress for healthcare reform and it is very likely to be introduced within the year.

Gil

Here we go: the opening shots in the health care debates.

So Obama signed the stimulus plan today, with quite a lot of funding for health care. That should be a good thing right? Well, not if you read the papers or listen to the radio.

First the NY Times had a piece on the FRONT PAGE entitled “U.S. to Compare Medical Treatments” , that discussed one provision of the plan that makes $1.1 billion available for studies that test relative effectiveness of therapies (medications, devices and/or surgeries). The Times explains that the program responds to a growing concern that doctors have little or no solid evidence of the value of many treatments and that supporters of the research hope it will eventually save money by discouraging the use of costly, ineffective treatments (sounds a little like EMBRACE doesn’t it?). So how can that be bad?

Well it seems that “public health experts” such as Betsy McCaughey (a former lieutenant governor of New York) and Rush Limbaugh are quoted as saying that bureaucrats “will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost-effective.”

As Congress translated the idea into legislation, it became a lightning rod for pharmaceutical and medical-device lobbyists, who fear the findings will be used by insurers or the government to deny coverage for more expensive treatments and, thus, to ration care.

In addition, Republican lawmakers and conservative commentators complained that the legislation would allow the federal government to intrude in a person’s health care by enforcing clinical guidelines and treatment protocols.

These points are clearly aimed to stoke fear in the general public for instruments that are not only useful, but are essential in developing any meaningful and effective reform.

In truth I think that this is more than just criticism of this particular provision, I believe this is a practice round for when the administration rolls out their health care reform proposal.

This is just a prelude of what’s to come! The pharmaceutical and insurance industries are getting ready to fight any plan tooth and nail.  

So, here we go…

Gil

Daschle Withdraws His Nomination

So now that Tom Daschle withdrew his nomination what does it mean for meaningful healthcare reform??? I have to admit that it looks bad for anything to happen in the near future. Daschle washealthcare reform. I think Obama pretty much had his whole game plan with him. Daschle had some good ideas, he had already started to engage the public and most importantly, he could grease meaningful legislation through congress. I think it may take a while to find a replacement…

On the other hand it does give us a little more time to get EMBRACE out. We have word that EMBRACE will be published on-line within the month. We will keep you informed.