http://views.washingtonpost.com/healthcarerx/panelists/ 15 Views on America's health care reform debate from our panel of experts at Health Care Rx. en Copyright 2009 Thu, 19 Nov 2009 09:17:13 -0500 http://www.movabletype.org/?v=4.2-en http://blogs.law.harvard.edu/tech/rss With every passing month in America's "jobless recovery," more jobs are lost. Lost jobs in the U.S. quickly morph into uninsured lives. In April 2008, the Kaiser Family Foundation calculated a metric that showed a 1 percent increase in the unemployment rate leads to a 1.1 million person increase in the uninsured and a 1 million person increase in Medicaid enrollment. That was April 2008 -- this is November 2009. State governors, who fund one-half of Medicaid, are hard-pressed to absorb these hundreds of thousands of lives. Then what? The number of the uninsured increases. "I'm insured, so should I care?" ask Harry and Louise. Based on recent surveys on American attitudes about the health-care safety net for people 'other than me,' it appears the European model of social insurance is seen by many American health citizens, still, as socialism, not insurance. The sooner we get uninsured people covered -- http://views.washingtonpost.com/healthcarerx/panelists/2009/11/deadline-sarasohnkahn.html http://views.washingtonpost.com/healthcarerx/panelists/2009/11/deadline-sarasohnkahn.html Economic crisis Thu, 19 Nov 2009 09:17:13 -0500 It's better to take more time rather than rush through a Pandora's box of perverse incentives like the 1,900-page House bill (HR 3962). The quality of the reform is far more important than the date of enactment. At the same time, that doesn't mean it's OK to kick back and relax for another 15 to 20 years. Open the House bill and out flies a menagerie of stinging things: Job-killing employer mandates, payroll taxes and surtaxes. Hazy market rules to be set and re-set by a powerful "Health Choices Commissioner." A public option menacing private markets and amplifying the financial disasters of Medicare and Medicaid. Onerous red-tape and reporting requirements for firms and individuals. Dozens of new government agencies. New incentives for lawsuits. And a staggering price tag, according to the nonpartisan Centers for Medicare and Medicaid Services (CMS) and the Lewin Group (which analyzed an earlier, but similar, version http://views.washingtonpost.com/healthcarerx/panelists/2009/11/deadline-graboyes.html http://views.washingtonpost.com/healthcarerx/panelists/2009/11/deadline-graboyes.html Health Care Reform Wed, 18 Nov 2009 15:21:22 -0500 To paraphrase President Obama, "the U.S. Congress works better when they have deadlines." As practicing physicians, the National Medical Association is very concerned about the tens of thousands of Americans who lose their coverage every day. For their sakes we should be reviewing the final bill now, so that Obama can sign it this year. The deadline is necessary. We hope the Senate Majority Leader will find it feasible. http://views.washingtonpost.com/healthcarerx/panelists/2009/11/deadline-edwards.html http://views.washingtonpost.com/healthcarerx/panelists/2009/11/deadline-edwards.html Health Care Reform Wed, 18 Nov 2009 11:34:20 -0500 Health-care reform is not a fairytale, though it often seems to be an elusive dream. And that dream, in order to be realized, needs good politics as well as good policy. Looking back across the American landscape, great presidents, led by an enduring sense of urgency, dared to birth a nation, end slavery, champion citizen rights, broker a Square Deal, a New Deal and ultimately a Fair Deal. Change agents have fought tirelessly to advance the American domestic agenda, though universal health coverage has never been among the purse. What about now? Time remains of the essence. Meaningful reform and not an artificial cutoff should be the priority. Too often in a rush to be efficient we become less effective. Neither must we deliberately delay or prolong a solution, yet we must build a foundation, upon which progress can begin. Still is the 2009 deadline necessary? Yes, if none other http://views.washingtonpost.com/healthcarerx/panelists/2009/11/deadline-pernell.html http://views.washingtonpost.com/healthcarerx/panelists/2009/11/deadline-pernell.html Health Care Reform Tue, 17 Nov 2009 18:46:11 -0500 Every year, the primary deadline Congress has is September 30th, the cut-off date for passing all federal spending bills. Do they meet it? No. The last time they stuck to it was 1994, in fact. Does it serve to spur progress and keep efforts moving? Absolutely. Let's examine the alternative: no deadline. I can picture the current health-care debate creeping far into 2010, derailing on middling controversies and irrevocably mired in partisan dissent. Clearly, deadlines are necessary. Congress needs them in order to sustain the momentum that keeps big reform efforts like this one from going off the tracks. And while the deadline set by President Obama may not be met, it is doubtful we would have made the amount of progress we have seen to date without it. http://views.washingtonpost.com/healthcarerx/panelists/2009/11/deadline-schmeadline.html http://views.washingtonpost.com/healthcarerx/panelists/2009/11/deadline-schmeadline.html Health Care Reform Tue, 17 Nov 2009 18:24:02 -0500 I know deadlines seem completely arbitrary, but the reality is that deadlines are often necessary to get work done. How many of us wait until April 15 to pay our taxes? Without a deadline, we would probably wait even longer. The same is true for health-care reform. Like taxes, it is a painful process. There are potential winners and losers. Politicians are making many difficult decisions as part of reform, and people typically don't like change, especially if they don't think it will benefit them. The strategy is then to delay. Delay can often weaken reform, or when there are competing priorities, delay can shift focus elsewhere. A deadline forces all parties to come together to make a decision. It is true that too early a deadline can result in a bill that isn't ideal. But let's face it...no one bill is going to address all the problems with our http://views.washingtonpost.com/healthcarerx/panelists/2009/11/deadlines-whyte.html http://views.washingtonpost.com/healthcarerx/panelists/2009/11/deadlines-whyte.html Health Care Reform Tue, 17 Nov 2009 15:53:49 -0500 The 2009 deadline for health-care is more a race against the 2010 mid-term elections and the fear of losing more seats in Congress than it is about the right outcome. There are still many issues that remain unresolved as it pertains to merging the two bills that are, essentially, oil and water. Will there may be a public plan? Will there be more taxes and, if so, for whom? These remain two of many critical laments that remain unresolved. The Senate is still awaiting yet more numbers from the Congressional Budget Office on what these options will really cost. The goal of having the president sign a bill before the end of the year seems unrealistic with so many unanswered questions. President Obama has an opportunity to pass landmark legislation on health-care reform, but it is far more important to get it right then simply get it done. http://views.washingtonpost.com/healthcarerx/panelists/2009/11/deadline-potarazu.html http://views.washingtonpost.com/healthcarerx/panelists/2009/11/deadline-potarazu.html Health Care Reform Tue, 17 Nov 2009 08:11:25 -0500 My spirits tend to sag a little bit at this time of the year. I'm pretty sure it's a sunlight/Vitamin D deprivation sort of thing. But the health-care non-reform legislation coming down the pike has me dragging even more than normal compared to the typical Wisconsin November. We've read proposed legislation from the House of Representatives that expands access to care dramatically (with an expanded price tag to boot) while doing nothing to rein in wasteful spending nor drive towards health. In its present state it's just another deferred tax for our children and their children and their children's children to pay. So where's the health-care delivery transformation in the bills being bandied about in Congress? Where's the waste removal effort going to come from? Certainly not from government. And that's why my biggest beef is with the weak employer non-penalties for non-participation. It's a very simple formula, folks. Public http://views.washingtonpost.com/healthcarerx/panelists/2009/11/deadline-zastrow.html http://views.washingtonpost.com/healthcarerx/panelists/2009/11/deadline-zastrow.html Employer health plans Mon, 16 Nov 2009 23:59:07 -0500 I can understand the political reasons why President Obama has set a 2009 deadline for passing health-care legislation. As Congressional sessions head into federal election years, the political difficulties of passing any major legislation increase significantly. It gets harder for proponents and opponents to focus on the merits of the legislation simply because everything they do gets looked at through the lens of election campaigning. That being said, this is a complex piece of legislation with far-reaching implications with many details that can have big negative long-term consequences. It must be done right, and getting it right is more important than getting it done fast. Having worked on complex postal reform legislation that dragged past the 2006 elections into a one-week special session that passed at 2:45 am December 10, I found that, even if it would have been easier for the legislation to have passed in 2005, the final http://views.washingtonpost.com/healthcarerx/panelists/2009/11/deadline-critelli.html http://views.washingtonpost.com/healthcarerx/panelists/2009/11/deadline-critelli.html Health Care Reform Mon, 16 Nov 2009 20:56:22 -0500 No, it is not necessary to pass this confusing, verbose mess of legislation this year. The health-care reform issue has been convoluted to the extreme. We have politicians making decisions based on factors they don't even understand. Millions of us no longer trust their motives and know their representatives don't, quite frankly, know what they're doing. When a matter of this importance becomes a power play, our elected officials are no longer listening to the people. Perhaps that is the reason for the rush to pass this ridiculous 2,000 page bill in the House and who-knows-what in the Senate. "Quickly now, let's do this to prove the politician is quicker than the eye of the average American." Most of us recognize slight of hand when we see it. Yes, we need some changes and some solutions but those decisions should be made by those who have experience in the field http://views.washingtonpost.com/healthcarerx/panelists/2009/11/deadline-wood.html http://views.washingtonpost.com/healthcarerx/panelists/2009/11/deadline-wood.html Leadership Mon, 16 Nov 2009 15:06:05 -0500 The magnitude of the changes in our current health-care system necessary to "get it right" warrants thorough, informed and thoughtful analysis and debate. The federal legislature is the worst place for that to happen. There are other priorities such as unemployment, the need for banking oversight and wars, to name just a few, that interfere with the "informed and thoughtful" part. By rushing the delivery of a bill by the end of 2009, the Democrats and President Obama will be able to produce an accomplishment, and there will be several very good things in that bill. If a bill is delayed, it will continue to distract from the other very important priorities. The delay will be evidence of the lack of leadership by Sen. Harry Reid (D-Nev.) and the lack of support for Obama. The very significant problems with our current health-care system will continue. I am in favor of http://views.washingtonpost.com/healthcarerx/panelists/2009/11/deadline-leckman.html http://views.washingtonpost.com/healthcarerx/panelists/2009/11/deadline-leckman.html Health Care Reform Mon, 16 Nov 2009 13:48:31 -0500 Last Friday night, Rep. Bart Stupak put forward a final compromise to House Speaker Nancy Pelosi that would have prohibited abortion coverage in the public plan but would have allowed an annual vote on the abortion ban for the private plans. Pro-choice Democrats rejected this, and the stronger version of the Michigan Democrat's proposal then passed. What happens now? Democratic supporters of abortion rights need to accept that their House majority depends on a large cadre of antiabortion colleagues. They can denounce that reality or they can learn to live with it. There is also a challenge for abortion's foes, above all the Catholic bishops who have a long history of supporting universal coverage but devoted most of their recent energy to the abortion battle. How much muscle will the bishops put behind the broader effort to pass health-care reform? Their credibility as advocates for social justice hangs in the http://views.washingtonpost.com/healthcarerx/panelists/2009/11/abortion-dionne.html http://views.washingtonpost.com/healthcarerx/panelists/2009/11/abortion-dionne.html Abortion Fri, 13 Nov 2009 11:53:45 -0500 I am pro-life. It is a huge issue with me. I hold all life sacred and consider the moment of conception as the creation of human life. I am also an advocate for universal health care for Americans similar to what is offered in other developed western nations. There is no evidence that indicates there is an increase in abortion rates in these nations in comparison to the United States. Tying abortion to health care in America however, will only hinder progress on reform. A law restricting abortion in the House health-care bill prevents the abortion debate from side-tracking efforts to pass much needed reform including a public option for millions of Americans. In fact, without abortion restrictions, the health-care bill could prove to be a back door opportunity for pro-choice proponents to use taxpayer money to fund abortions. With the issue taken out of reform by law, the focus http://views.washingtonpost.com/healthcarerx/panelists/2009/11/abortion-kups.html http://views.washingtonpost.com/healthcarerx/panelists/2009/11/abortion-kups.html Abortion Wed, 11 Nov 2009 23:04:36 -0500 Rep. Bart Stupak's amendment did not make abortion illegal. And it did not block the federal government from subsidizing abortion. All it did was block it from subsidizing abortion for poorer women. Stupak's amendment stated that the public option cannot provide abortion coverage, and that no insurer participating on the exchange can provide abortion coverage to anyone receiving subsidies. But as Rep. Jim Cooper points out in this interview, the biggest federal subsidy for private insurance coverage is untouched by Stupak's amendment. It's the $250 billion the government spends each year making employer-sponsored health-care insurance tax-free. That money, however, subsidizes the insurance of 157 million Americans, many of them quite affluent. Imagine if Stupak had attempted to expand his amendment to their coverage. It would, after all, have been the same principle: Federal policy should not subsidize insurance that offers abortion coverage. But it would have failed in an instant. http://views.washingtonpost.com/healthcarerx/panelists/2009/11/abortion-klein.html http://views.washingtonpost.com/healthcarerx/panelists/2009/11/abortion-klein.html Abortion Wed, 11 Nov 2009 13:35:35 -0500 Opponents of the various Democratic health-reform proposals spend a lot of time talking about how people should be free to purchase whatever kind of insurance they want. Except, it turns out, if those people are women. Going into Saturday's debate on the House health-care bill, the measure included provisions designed to maintain the status quo against federal funding for most abortions. It took steps to ensure that federal subsidies to purchase insurance wouldn't be used to pay for abortion coverage. It required that every exchange include one plan that did not cover abortions, so that no one would be forced to subscribe to a plan that violated anti-abortion beliefs. That wasn't enough for the anti-abortion crowd, including the Catholic bishops. So House Speaker Nancy Pelosi (D-Calif.) was backed into a corner, facing the loss of anti-abortion Democrats unless she acceded to an amendment offered by Rep. Bart Stupak (D-Mich.) that http://views.washingtonpost.com/healthcarerx/panelists/2009/11/abortion-marcus.html http://views.washingtonpost.com/healthcarerx/panelists/2009/11/abortion-marcus.html Abortion Wed, 11 Nov 2009 12:22:35 -0500