Mass players throw down in the D.C. health reform rumble
Ted Kennedy has a pair of healthcare fights in front of him, but he’s mailing it in for one of them.
Connecticut Sen. Chris Dodd told The Associated Press the ailing Kennedy, who’s battling a malignant glioma, won’t be able to make next week’s working sessions on the emerging health reform bill.
Instead, Kennedy submitted his own version.
The 615-page bill released Wednesday includes a surprise provision for long-term care:
“Kennedy’s long-term care plan is designed to help disabled people pay for support services that would allow them to remain in their own homes and avoid moving into nursing homes. People would enroll in the program during their working years and begin paying premiums. To collect benefits, a person would have had to pay premiums for at least five years.”
At the same time, Kennedy’s bill – and the other emerging versions – don’t really address a main point of contention: Should the plan offer consumers a government-run, public health insurance option along with a menu of private insurance options? The private insurance industry fears the plan will be unfair competition and conservatives plan to fight it. Consumer advocates say it is a must.
The Senate committee working on their draft of the bill left the private insurance option out as “a gesture to Republicans who oppose it,” Dodd told the AP. Instead, Democrats will work toward a compromise, he said. The emerging House bill is also leaves the question open. There’s more in the Wall Street Journal.
Sen. Jay Rockefeller of West Virginia, a long-time health reform advocate, may end up being the man to push the public plan:
“Private insurance companies want to have their cake and eat it too. They want healthcare reform to earn them maximum profits if they start covering millions of uninsured Americans. But they are not willing to abide by the fair rules, oversight and cost containment that Americans deserve. Shared responsibility – that includes insurers – is the only answer and a public plan is the only real solution.”
For an excellent roundup of the debate over public-private options, check out the Alliance for Health Reform, “Public Plan Option: Fair Competition or a Recipe for Crowd-Out?.” (OK, it’s Rockefeller’s group and he’s made his position known. But, you’ll get both points of view.)
Tune in next week when the issue of taxing health benefits should bubble up for debate.
What’s good for Boston hospitals is good for America?
Sen. John Kerry had a rather defensive response to the issues stirred up by Harvard doc Atul Gawande’s June 1 article in The New Yorker.
Apparently, Kerry and the rest of the world were uninformed about the problem of practice pattern variations until they read the story. Gawande’s thorough piece has gotten a lot of ink and airtime. The New York Times reported this week that the story made such a big impression on President Barack Obama that he called a meeting to discuss it and it “became required reading in the White House, with Mr. Obama even citing it at a meeting last week with two dozen Democratic senators.”
Now they know what healthcare policy wonks have been pondering for, um, 20 years. Much of the work has been done at Dartmouth College, which gets a shout-out in Gawande’s story.
But the Times story also notes that Kerry thinks the Dartmouth Atlas is too crude an instrument to build policy on. Then he went on to defend the high cost of care in places like Boston:
“‘There are many reasons spending could vary: Higher costs of living, sicker people or more teaching hospitals. … States like Massachusetts are concentrated centers of medical innovation where cutting-edge treatments are tested and some of the nation’s finest doctors are trained,’ Mr. Kerry added. ‘This work might cost a little more, but it benefits the entire country.'”
Sounds straight out of a teaching hospital press release. Someone get the Senator that New Yorker story or, even better, a Dartmouth Atlas.
The same Dr. Gawande made his point a bit differently in a commencement address to Harvard School of Public Health grads. (Read the transcript or watch the video.)
He talks about a trip home to India and a stint at rural clinic, where residents now benefit from basic care for once-fatal infectious diseases – but not much more.
Gawande tells a heartbreaking story of a frightened 31-year-old women who lifted her sari to reveal a huge cancerous tumor in her breast:
“We’ve had a century of extraordinary scientific discovery about human health. But we have found ourselves with yawning gaps in our ability to provide it to people here and around the globe. We have trouble managing its complexity, its costs and its implications for everything from how countries should structure their health systems, to how we, as individuals, should manage the end of our own lives.”
There’s more by Tinker Ready over at Boston Health News.