Posted: 11/21/09 With no votes to spare, Democratic senators moved health care reform past its first major hurdle Saturday night, with a party-line, 60-to-39 vote to begin consideration of the 2,000-plus page bill that Senate Majority Leader Harry Reid unveiled this week.
The fate of the measure came down to two moderate Democrats -- Blanche Lincoln of Arkansas and Mary Landrieu of Louisiana. Both women had withheld their support for debating the bill until the last hour, but announced in the afternoon that they would vote with Reid -- at least for now.
"My vote today should in no way be construed as an indication of how I might vote as this debate comes to an end," said Senator Landrieu. "After a thorough review, I have decided that there are enough significant reforms and safeguards in this bill to move forward, but more needs to be done."
Senator Lincoln echoed her colleague's skepticism, saying she would vote to move forward with the debate, but stressing that she wants changes to the legislation -- including striking the public option entirely -- before she would consent to vote for it on final passage. "I have concluded that it is more important to begin debate rather than simply dropping the issue and walk away," Lincoln said.
The bill that senators will begin debating after Thanksgiving combines proposals passed by the Senate Finance Committee and the Senate Committee Health, Education, Labor and Pensions Committee (HELP), and is designed to make health insurance more accessible and affordable. The Congressional Budget Office estimates the bill would expand coverage to 94 percent of Americans at a cost of $848 billion over the next 10 years.
In addition to imposing new regulations on insurance companies, the legislation would create health insurance exchanges, which would function as a marketplace of last resort where Americans could choose between private insurance, non-profit cooperative insurance, and a government-run public insurance option. While Democrats differed in their levels of enthusiasm for the bill, Republicans were unanimous in their opposition, describing Reid's proposal as everything from a spending binge to a Ponzi scheme.
Sen. Olympia Snowe of Maine, who voted for the Democrats' bill in the Senate Finance Committee, voted against debating it Saturday night. She objected to many of the the policies in the version of the bill that emerged from the Majority Leader's office, including the public option. Mostly, Snowe was critical of the closed-door, partisan process used by Reid to combine the two committee bills.
Sen. Mike Enzi (R-Wyo.), the top Republican on the Senate HELP Committee and the only accountant in the Senate, warned of the bill's potentially catastrophic effect on the federal budget deficit. "Perhaps the best way to qualify this bill is to say it keeps me up nights," Enzi said, summing it up in one word: "Disaster."
Other Republicans, such as Sen. Orrin Hatch of Utah objected to the bill's abortion provisions, which are weaker than the House-passed bill, as well as the bill's estimated cost of nearly $1 trillion to the taxpayers over the next decade. Missouri Republican Sen. Kit Bond said there were so many objectionable elements to the proposal that his colleagues had a hard time choosing which ones to go after first. "We're like a mosquito in a nudist colony," he said. "We have so many targets to attack in this bill we don't know which one to hit."
Democratic leaders defended their bill, with Reid saying of Sen. Mitch McConnell (R-Ky.), "The facts he is talking about do not exist, except in the minds of people who do not understand this bill." Several Democrats also invoked the late Sen. Ted Kennedy before casting their votes, including Kennedy's close friend Connectucut Sen. Chris Dodd, who said "there is no greater compliment we could give to Ted Kennedy than to pass this bill."
In the minutes before the vote, Sen. Max Baucus, a leader for the Democrats in health care reform, said to his fellow senators, "History is knocking on the door. Let's open it."
Saturday, November 21, 2009
Friday, November 13, 2009
House Bill DOES NOT regulate insurance premiums resulting in big gains for corporations.
From Marcia Angell, MD Harvard University
The Health Care Reform Bill passed by the House enshrines and subsidizes the "takeover" by the investor-owned insurance industry that occurred after the failure of the Clinton reform effort in 1994. To be sure, the bill has a few good provisions (expansion of Medicaid, for example), but they are marginal. It also provides for some regulation of the industry (no denial of coverage because of pre-existing conditions, for example), but since it doesn't regulate premiums, the industry can respond to any regulation that threatens its profits by simply raising its rates. The bill also does very little to curb the perverse incentives that lead doctors to over-treat the well-insured. And quite apart from its content, the bill is so complicated and convoluted that it would take a staggering apparatus to administer it and try to enforce its regulations.
What does the insurance industry get out of it? Tens of millions of new customers, courtesy of the mandate and taxpayer subsidies. And not just any kind of customer, but the youngest, healthiest customers -- those least likely to use their insurance. The bill permits insurers to charge twice as much for older people as for younger ones. So older under-65's will be more likely to go without insurance, even if they have to pay fines. That's OK with the industry, since these would be among their sickest customers. (Shouldn't age be considered a pre-existing condition?)
Insurers also won't have to cover those younger people most likely to get sick, because they will tend to use the public option (which is not an "option" at all, but a program projected to cover only 6 million uninsured Americans). So instead of the public option providing competition for the insurance industry, as originally envisioned, it's been turned into a dumping ground for a small number of people whom private insurers would rather not have to cover anyway.
If a similar bill emerges from the Senate and the reconciliation process, and is ultimately passed, what will happen?
First, health costs will continue to skyrocket, even faster than they are now, as taxpayer dollars are pumped into the private sector. The response of payers -- government and employers -- will be to shrink benefits and increase deductibles and co-payments. Yes, more people will have insurance, but it will cover less and less, and be more expensive to use.
But, you say, the Congressional Budget Office has said the House bill will be a little better than budget-neutral over ten years. That may be, although the assumptions are arguable. Note, though, that the CBO is not concerned with total health costs, only with costs to the government. And it is particularly concerned with Medicare, the biggest contributor to federal deficits. The House bill would take money out of Medicare, and divert it to the private sector and, to some extent, to Medicaid. The remaining costs of the legislation would be paid for by taxes on the wealthy. But although the bill might pay for itself, it does nothing to solve the problem of runaway inflation in the system as a whole. It's a shell game in which money is moved from one part of our fragmented system to another.
Here is my program for real reform:
Recommendation #1: Drop the Medicare eligibility age from 65 to 55. This should be an expansion of traditional Medicare, not a new program. Gradually, over several years, drop the age decade by decade, until everyone is covered by Medicare. Costs: Obviously, this would increase Medicare costs, but it would help decrease costs to the health system as a whole, because Medicare is so much more efficient (overhead of about 3% vs. 20% for private insurance). And it's a better program, because it ensures that everyone has access to a uniform package of benefits.
Recommendation #2: Increase Medicare fees for primary care doctors and reduce them for procedure-oriented specialists. Specialists such as cardiologists and gastroenterologists are now excessively rewarded for doing tests and procedures, many of which, in the opinion of experts, are not medically indicated. Not surprisingly, we have too many specialists, and they perform too many tests and procedures. Costs: This would greatly reduce costs to Medicare, and the reform would almost certainly be adopted throughout the wider health system.
Recommendation #3: Medicare should monitor doctors' practice patterns for evidence of excess, and gradually reduce fees of doctors who habitually order significantly more tests and procedures than the average for the specialty. Costs: Again, this would greatly reduce costs, and probably be widely adopted.
Recommendation #4: Provide generous subsidies to medical students entering primary care, with higher subsidies for those who practice in underserved areas of the country for at least two years. Costs: This initial, rather modest investment in ending our shortage of primary care doctors would have long-term benefits, in terms of both costs and quality of care.
Recommendation #5: Repeal the provision of the Medicare drug benefit that prohibits Medicare from negotiating with drug companies for lower prices. (The House bill calls for this.) That prohibition has been a bonanza for the pharmaceutical industry. For negotiations to be meaningful, there must be a list (formulary) of drugs deemed cost-effective. This is how the Veterans Affairs System obtains some of the lowest drug prices of any insurer in the country. Costs: If Medicare paid the same prices as the Veterans Affairs System, its expenditures on brand-name drugs would be a small fraction of what they are now.
Is the House bill better than nothing? I don't think so. It simply throws more money into a dysfunctional and unsustainable system, with only a few improvements at the edges, and it augments the central role of the investor-owned insurance industry. The danger is that as costs continue to rise and coverage becomes less comprehensive, people will conclude that we've tried health reform and it didn't work. But the real problem will be that we didn't really try it. I would rather see us do nothing now, and have a better chance of trying again later and then doing it right.
The Health Care Reform Bill passed by the House enshrines and subsidizes the "takeover" by the investor-owned insurance industry that occurred after the failure of the Clinton reform effort in 1994. To be sure, the bill has a few good provisions (expansion of Medicaid, for example), but they are marginal. It also provides for some regulation of the industry (no denial of coverage because of pre-existing conditions, for example), but since it doesn't regulate premiums, the industry can respond to any regulation that threatens its profits by simply raising its rates. The bill also does very little to curb the perverse incentives that lead doctors to over-treat the well-insured. And quite apart from its content, the bill is so complicated and convoluted that it would take a staggering apparatus to administer it and try to enforce its regulations.
What does the insurance industry get out of it? Tens of millions of new customers, courtesy of the mandate and taxpayer subsidies. And not just any kind of customer, but the youngest, healthiest customers -- those least likely to use their insurance. The bill permits insurers to charge twice as much for older people as for younger ones. So older under-65's will be more likely to go without insurance, even if they have to pay fines. That's OK with the industry, since these would be among their sickest customers. (Shouldn't age be considered a pre-existing condition?)
Insurers also won't have to cover those younger people most likely to get sick, because they will tend to use the public option (which is not an "option" at all, but a program projected to cover only 6 million uninsured Americans). So instead of the public option providing competition for the insurance industry, as originally envisioned, it's been turned into a dumping ground for a small number of people whom private insurers would rather not have to cover anyway.
If a similar bill emerges from the Senate and the reconciliation process, and is ultimately passed, what will happen?
First, health costs will continue to skyrocket, even faster than they are now, as taxpayer dollars are pumped into the private sector. The response of payers -- government and employers -- will be to shrink benefits and increase deductibles and co-payments. Yes, more people will have insurance, but it will cover less and less, and be more expensive to use.
But, you say, the Congressional Budget Office has said the House bill will be a little better than budget-neutral over ten years. That may be, although the assumptions are arguable. Note, though, that the CBO is not concerned with total health costs, only with costs to the government. And it is particularly concerned with Medicare, the biggest contributor to federal deficits. The House bill would take money out of Medicare, and divert it to the private sector and, to some extent, to Medicaid. The remaining costs of the legislation would be paid for by taxes on the wealthy. But although the bill might pay for itself, it does nothing to solve the problem of runaway inflation in the system as a whole. It's a shell game in which money is moved from one part of our fragmented system to another.
Here is my program for real reform:
Recommendation #1: Drop the Medicare eligibility age from 65 to 55. This should be an expansion of traditional Medicare, not a new program. Gradually, over several years, drop the age decade by decade, until everyone is covered by Medicare. Costs: Obviously, this would increase Medicare costs, but it would help decrease costs to the health system as a whole, because Medicare is so much more efficient (overhead of about 3% vs. 20% for private insurance). And it's a better program, because it ensures that everyone has access to a uniform package of benefits.
Recommendation #2: Increase Medicare fees for primary care doctors and reduce them for procedure-oriented specialists. Specialists such as cardiologists and gastroenterologists are now excessively rewarded for doing tests and procedures, many of which, in the opinion of experts, are not medically indicated. Not surprisingly, we have too many specialists, and they perform too many tests and procedures. Costs: This would greatly reduce costs to Medicare, and the reform would almost certainly be adopted throughout the wider health system.
Recommendation #3: Medicare should monitor doctors' practice patterns for evidence of excess, and gradually reduce fees of doctors who habitually order significantly more tests and procedures than the average for the specialty. Costs: Again, this would greatly reduce costs, and probably be widely adopted.
Recommendation #4: Provide generous subsidies to medical students entering primary care, with higher subsidies for those who practice in underserved areas of the country for at least two years. Costs: This initial, rather modest investment in ending our shortage of primary care doctors would have long-term benefits, in terms of both costs and quality of care.
Recommendation #5: Repeal the provision of the Medicare drug benefit that prohibits Medicare from negotiating with drug companies for lower prices. (The House bill calls for this.) That prohibition has been a bonanza for the pharmaceutical industry. For negotiations to be meaningful, there must be a list (formulary) of drugs deemed cost-effective. This is how the Veterans Affairs System obtains some of the lowest drug prices of any insurer in the country. Costs: If Medicare paid the same prices as the Veterans Affairs System, its expenditures on brand-name drugs would be a small fraction of what they are now.
Is the House bill better than nothing? I don't think so. It simply throws more money into a dysfunctional and unsustainable system, with only a few improvements at the edges, and it augments the central role of the investor-owned insurance industry. The danger is that as costs continue to rise and coverage becomes less comprehensive, people will conclude that we've tried health reform and it didn't work. But the real problem will be that we didn't really try it. I would rather see us do nothing now, and have a better chance of trying again later and then doing it right.
Wednesday, November 11, 2009
Is there really any question that HEALTH CARE REFORM is NECESSARY?
Following is an article published by Associated Press discussing the unethical and immoral behavior of pharmaceutical company Pfizer. The people at Pfizer who conduct bogus research that is then used for marketing their drugs based on the "fudged" results should be criminally prosecuted. As stated in several blog posts, the insurance companies, the pharmaceutical companies, and the medical device companies should all be held accountable for the price fixing, price gauging, and unethical behavior exhibited by these companies executives, researchers, and other employees.
Review: Reporting on Pfizer drug studies fudged
By LINDA A. JOHNSON, Associated Press Writer – 1 min ago
Analysis of a dozen published studies testing possible new uses for a Pfizer
Inc. epilepsy drug found that reporting of the results was often fudged,
indicating the medicine worked better than internal company documents
showed.
According to the report, when a company-funded study's primary finding
wasn't favorable, that result was usually buried and something else positive
was highlighted, without disclosing the switch.
The documents used in the review were obtained by lawyers suing Pfizer for
refunds on prescriptions paid for by insurers and consumers. The lawyers,
who are seeking class action status for the cases, claim Pfizer concealed
evidence the epilepsy drug Neurontin didn't work for those unapproved uses,
including nerve pain, migraines and bipolar disorder.
One of the report's authors is an expert witness for the plaintiffs; another
has received fees from the lawyers.
Pfizer disputes the report's conclusions, saying the company never
"attempted to mislead the medical community about the effectiveness" of the
drug for certain uses.
"We believe the review suffers from significant bias, insufficient data,
poor methodology, and cannot pass the threshold of credible scientific
research," Pfizer said in a statement.
The report, by researchers at the University of California at San Francisco
and the Johns Hopkins Bloomberg School of Public Health, comes two months
after Pfizer was fined a record $2.3 billion — including an unprecedented
$1.2 billion criminal fine — for illegally marketing other blockbuster
drugs.
The report appears in Thursday's New England Journal of Medicine.
Dr. Sidney Wolfe, head of health research at consumer group Public Citizen,
called it the first comprehensive look "at studies in which a company and
people working for it so maliciously manipulated the data to make a drug
look more effective than it actually was."
"In every instance, the published article made the drug look better than it
would have," said Wolfe, a member of the Food and Drug Administration's drug
safety advisory committee. "This results in harm."
Review: Reporting on Pfizer drug studies fudged
By LINDA A. JOHNSON, Associated Press Writer – 1 min ago
Analysis of a dozen published studies testing possible new uses for a Pfizer
Inc. epilepsy drug found that reporting of the results was often fudged,
indicating the medicine worked better than internal company documents
showed.
According to the report, when a company-funded study's primary finding
wasn't favorable, that result was usually buried and something else positive
was highlighted, without disclosing the switch.
The documents used in the review were obtained by lawyers suing Pfizer for
refunds on prescriptions paid for by insurers and consumers. The lawyers,
who are seeking class action status for the cases, claim Pfizer concealed
evidence the epilepsy drug Neurontin didn't work for those unapproved uses,
including nerve pain, migraines and bipolar disorder.
One of the report's authors is an expert witness for the plaintiffs; another
has received fees from the lawyers.
Pfizer disputes the report's conclusions, saying the company never
"attempted to mislead the medical community about the effectiveness" of the
drug for certain uses.
"We believe the review suffers from significant bias, insufficient data,
poor methodology, and cannot pass the threshold of credible scientific
research," Pfizer said in a statement.
The report, by researchers at the University of California at San Francisco
and the Johns Hopkins Bloomberg School of Public Health, comes two months
after Pfizer was fined a record $2.3 billion — including an unprecedented
$1.2 billion criminal fine — for illegally marketing other blockbuster
drugs.
The report appears in Thursday's New England Journal of Medicine.
Dr. Sidney Wolfe, head of health research at consumer group Public Citizen,
called it the first comprehensive look "at studies in which a company and
people working for it so maliciously manipulated the data to make a drug
look more effective than it actually was."
"In every instance, the published article made the drug look better than it
would have," said Wolfe, a member of the Food and Drug Administration's drug
safety advisory committee. "This results in harm."
Saturday, November 7, 2009
HALF WAY THERE TO HEALTH CARE NOW!
House Narrowly Passes Historic Health Care Bill
Posted: 11/7/09Filed Under:House, Democrats, Republicans, Abortion, Health Care, The Capitolist, Congress, Deficit 1233 Comments + Join the discussion »TEXT SIZE:AAAPRINT SHARE The U.S. House of Representatives narrowly passed a massive overhaul of the American health care system Saturday night by a vote of 220 to 215. One Republican, Rep. Joseph Cao of Louisiana, crossed the aisle, while 39 Democrats joined the Republicans in opposing the measure.
House Speaker Nancy Pelosi called passage of the bill "an historic moment for our nation and for America's families," while Republicans warned that the bill will raise taxes, increase insurance premiums and make cuts to Medicare. An enormous round of applause broke out throughout the House chamber when the crucial 218th vote was cast to ensure the bill's passage.
The $1.3 trillion-dollar bill would require individuals to buy health insurance, and would also require medium and large businesses to provide it to their employees. Consumers would be able to buy their insurance on an exchange, which would include a public insurance option for people who do not have access to insurance through their jobs. Low- and middle-income families would receive government subsidies to purchase insurance, which would be be paid for through tax increases on individuals making more than $500,000 per year, as well as fees on medical providers. Finally, the bill would prohibit insurance companies from dropping or denying coverage based on pre-existing conditions or cost of care.
The day of the vote was punctuated by high drama, as the House gaveled into a rare weekend session with no indication of whether the Speaker had all 218 votes necessary to pass the bill. But a last- minute addition to the bill to appease pro-life Democrats, as well as a high-profile visit from President Obama to press Democratic members to vote for the measure, provided just enough momentum to pass it through the House with two votes to spare.
House Majority Leader Steny Hoyer began the debate by saying, "This is not a new idea, but it is an idea whose time has come." Hoyer said that the bill under consideration was not perfect, but was the result of "careful scrutiny, hard work, citizen input, and is the right response to this time of economic insecurity in which we find ourselves."
Pelosi added that the bill would also reduce drug costs for seniors, prevent insurance companies from charging women more than men for the same coverage, and would allow young adults to stay on their parents' insurance until their 27th birthdays. She also promised that the bill would add "not one dime to the deficit."
Republicans countered that the bill will in fact explode the deficit and give the federal government an out-sized and improper role in Americans' health care decisions. Rep. Joe Barton (R-Tx.) said, "I just don't think it's right that in the guise of helping Americans, we're telling Americans what they have to do."
Rep. Marsha Blackburn (R-Tenn.) said that the federal government is not capable of running many of the programs it is already responsible for, and should not be trusted with more responsibilities for Americans' health care: "We have talked to mothers who say, 'You can't even get the H1-N1 vaccine out there and you think you're going to handle the health care for my children?' " Manufacturers have not been able to supply enough of the vaccine because of the difficulty of producing it.
Rep. Phil Gingrey (R-Ga.) warned, "I have no doubt that although the American people may forget what was said here, they will never forget what was done here and who did it to them."
A crucial barrier to the bill was eliminated when the House passed an amendment by Rep. Bart Stupak (D-Mich.), a pro-life Democrat, by a vote of 240 to 192. Stupak's measure would prevent insurance companies from participating in the new government exchange if they also cover abortion. It would also require women enrolled in the exchange to purchase supplemental abortion insurance with private funds if they want to be covered for the service in the future.
Speaking on the House floor Saturday, Stupak called the existing House bill a "direct assault" on existing limits to federal funding for abortion, but pro-choice Democrats lined up in staunch opposition to his effort. Rep. Jan Schakowsky (D-Ill.) called Stupak's amendment "an insult to millions of American women," while Rep. Diana DeGette (D-Colo.) said, "To say that this amendment is a wolf in sheep's clothing would be the understatement of a lifetime. If enacted this will be the greatest restriction on a woman's right to choose in our careers."
Although Pelosi initially resisted the Stupak amendment, the congressman had garnered commitments from more than 40 fellow pro-life Democrats to derail the entire health reform effort without stricter apportion language in the bill. Despite Stupak's victory Saturday, opponents of his measure vowed to strip it from the final bill in the conference committee.
Before voting on final passage, the House defeated the Republicans' significantly smaller alternative health care reform proposal by a vote of 176 to 258, with one Republican, Rep. Tim Johnson, voting against it. The Congressional Budget Office estimated the measure would have cost $61 billion over ten years. It would have expanded high-risk insurance pools and would have revised and expanded the use of health savings accounts, but would not have changed insurance companies' policies of refusing coverage for pre-existing conditions.
Now that the House has passed its version of health care reform, all eyes will be on the Senate, where moderate Democrats have already balked at the Senate bill's cost and scope.
Because the Senate measure already differs significantly from the House bill on everything from the nature of the public option (the Senate lets states opt-out), to income taxes increases (only the House has them), yet another hurdle awaits in the conference committee, where the House and Senate versions will be combined before a final vote in both chambers.
In a statement late Saturday, President Barack Obama thanked the House for its work in passing health care reform and said he is "confident" the Senate will follow suit, adding, "I look forward to signing comprehensive health insurance reform into law by the end of the year."
Posted: 11/7/09Filed Under:House, Democrats, Republicans, Abortion, Health Care, The Capitolist, Congress, Deficit 1233 Comments + Join the discussion »TEXT SIZE:AAAPRINT SHARE The U.S. House of Representatives narrowly passed a massive overhaul of the American health care system Saturday night by a vote of 220 to 215. One Republican, Rep. Joseph Cao of Louisiana, crossed the aisle, while 39 Democrats joined the Republicans in opposing the measure.
House Speaker Nancy Pelosi called passage of the bill "an historic moment for our nation and for America's families," while Republicans warned that the bill will raise taxes, increase insurance premiums and make cuts to Medicare. An enormous round of applause broke out throughout the House chamber when the crucial 218th vote was cast to ensure the bill's passage.
The $1.3 trillion-dollar bill would require individuals to buy health insurance, and would also require medium and large businesses to provide it to their employees. Consumers would be able to buy their insurance on an exchange, which would include a public insurance option for people who do not have access to insurance through their jobs. Low- and middle-income families would receive government subsidies to purchase insurance, which would be be paid for through tax increases on individuals making more than $500,000 per year, as well as fees on medical providers. Finally, the bill would prohibit insurance companies from dropping or denying coverage based on pre-existing conditions or cost of care.
The day of the vote was punctuated by high drama, as the House gaveled into a rare weekend session with no indication of whether the Speaker had all 218 votes necessary to pass the bill. But a last- minute addition to the bill to appease pro-life Democrats, as well as a high-profile visit from President Obama to press Democratic members to vote for the measure, provided just enough momentum to pass it through the House with two votes to spare.
House Majority Leader Steny Hoyer began the debate by saying, "This is not a new idea, but it is an idea whose time has come." Hoyer said that the bill under consideration was not perfect, but was the result of "careful scrutiny, hard work, citizen input, and is the right response to this time of economic insecurity in which we find ourselves."
Pelosi added that the bill would also reduce drug costs for seniors, prevent insurance companies from charging women more than men for the same coverage, and would allow young adults to stay on their parents' insurance until their 27th birthdays. She also promised that the bill would add "not one dime to the deficit."
Republicans countered that the bill will in fact explode the deficit and give the federal government an out-sized and improper role in Americans' health care decisions. Rep. Joe Barton (R-Tx.) said, "I just don't think it's right that in the guise of helping Americans, we're telling Americans what they have to do."
Rep. Marsha Blackburn (R-Tenn.) said that the federal government is not capable of running many of the programs it is already responsible for, and should not be trusted with more responsibilities for Americans' health care: "We have talked to mothers who say, 'You can't even get the H1-N1 vaccine out there and you think you're going to handle the health care for my children?' " Manufacturers have not been able to supply enough of the vaccine because of the difficulty of producing it.
Rep. Phil Gingrey (R-Ga.) warned, "I have no doubt that although the American people may forget what was said here, they will never forget what was done here and who did it to them."
A crucial barrier to the bill was eliminated when the House passed an amendment by Rep. Bart Stupak (D-Mich.), a pro-life Democrat, by a vote of 240 to 192. Stupak's measure would prevent insurance companies from participating in the new government exchange if they also cover abortion. It would also require women enrolled in the exchange to purchase supplemental abortion insurance with private funds if they want to be covered for the service in the future.
Speaking on the House floor Saturday, Stupak called the existing House bill a "direct assault" on existing limits to federal funding for abortion, but pro-choice Democrats lined up in staunch opposition to his effort. Rep. Jan Schakowsky (D-Ill.) called Stupak's amendment "an insult to millions of American women," while Rep. Diana DeGette (D-Colo.) said, "To say that this amendment is a wolf in sheep's clothing would be the understatement of a lifetime. If enacted this will be the greatest restriction on a woman's right to choose in our careers."
Although Pelosi initially resisted the Stupak amendment, the congressman had garnered commitments from more than 40 fellow pro-life Democrats to derail the entire health reform effort without stricter apportion language in the bill. Despite Stupak's victory Saturday, opponents of his measure vowed to strip it from the final bill in the conference committee.
Before voting on final passage, the House defeated the Republicans' significantly smaller alternative health care reform proposal by a vote of 176 to 258, with one Republican, Rep. Tim Johnson, voting against it. The Congressional Budget Office estimated the measure would have cost $61 billion over ten years. It would have expanded high-risk insurance pools and would have revised and expanded the use of health savings accounts, but would not have changed insurance companies' policies of refusing coverage for pre-existing conditions.
Now that the House has passed its version of health care reform, all eyes will be on the Senate, where moderate Democrats have already balked at the Senate bill's cost and scope.
Because the Senate measure already differs significantly from the House bill on everything from the nature of the public option (the Senate lets states opt-out), to income taxes increases (only the House has them), yet another hurdle awaits in the conference committee, where the House and Senate versions will be combined before a final vote in both chambers.
In a statement late Saturday, President Barack Obama thanked the House for its work in passing health care reform and said he is "confident" the Senate will follow suit, adding, "I look forward to signing comprehensive health insurance reform into law by the end of the year."
Maybe LAST CHANCE for YOU to Make a Difference: Call your Congressperson NOW
Health Care NOW to be voted on in the House of Representatives. It is TIME to FIX our broken health care system. Let your Congressperson know how you feel. Call today.
WASHINGTON (Nov. 7) - President Barack Obama is traveling to Capitol Hill on Saturday to try to close the sale on his signature health care overhaul, facing a make-or-break vote in the House certain to be seen as a test of his presidency.
Obama scheduled a late-morning visit with House Democrats convening a rare Saturday session on legislation to remake the U.S. health care system, extending coverage to tens of millions now uninsured and banning insurance company practices such as denial of coverage based on pre-existing medical problems.
Late Friday, House Democrats cleared an abortion-related impasse blocking a vote and officials expressed optimism they had finally lined up the support needed to pass Obama's signature issue.
Under the arrangement, Democratic Reps. Bart Stupak of Michigan, Brad Ellsworth of Indiana and other abortion opponents were promised an opportunity to insert tougher restrictions into the legislation during debate on the House floor.
The leadership's hope is that no matter how that vote turns out, Democrats on both sides of the abortion divide will then unite to give the health care bill a majority over unanimous Republican opposition.
"We wish to maintain current law, which says no public funding for abortion," Stupak said. "We are not writing a new federal abortion policy."
Ellsworth added, "From day one, my goal has been to ensure federal tax dollars are not used to pay for abortions and to provide Americans with pro-life options on the exchange. And I am proud to be part of an effort to help make this goal a reality."
With Democrats' command of the necessary votes looking tenuous in the final hours, Obama threw the weight of his administration behind the effort to round up support. He and top administration officials worked the phones to pressure wavering lawmakers.
Rep. Jason Altmire, D-Pa., said he heard Friday from Obama, White House Chief of Staff Rahm Emanuel, Health and Human Services Secretary Kathleen Sebelius and Education Secretary Arne Duncan.
Their message: "This is a historic moment. You don't want to end up with nothing," said Altmire, who remained undecided.
Democratic leaders hoped to hold the vote Saturday evening, but Majority Leader Steny Hoyer said it could slip.
Democrats hold 258 seats in the House and can afford 40 defections and still wind up with 218, a majority if all lawmakers vote. But all 177 Republicans were expected to vote "no," and Democratic leaders faced a series of complications trying to seal the needed votes for their complex and controversial legislation that would affect one-sixth of the economy and touch the lives of countless Americans.
In the GOP's weekly radio address, Mississippi Gov. Haley Barbour said Democrats should scrap their ambitious legislation and concentrate on modest health care changes that could find bipartisan support.
"The House Democrats' health care bill should be withdrawn and reworked," he said.
Tuesday's elections — in which Democrats lost two governors' races — sent a message that voters care about jobs, not growing the size of government, Barbour said.
The final hurdle for the Democrats was a controversy over federal funding for abortion, which simmered into Friday night with tensions running high as party leaders shuttled between meetings of anti-abortion and abortion rights lawmakers.
Federal law currently prohibits the use of federal funds to pay for abortions except in the case of rape, incest of situations in which the life of the mother is in danger. That left unresolved whether individuals would be permitted to use their own funds to buy insurance coverage for the procedure in the federally backed insurance exchange envisioned under the legislation.
Democrats have little room for error, with the prospect of the 2010 midterms looming large and a some of their own moderates already declaring their opposition.
The 10-year, $1.2 trillion House bill would create a new federally supervised insurance marketplace where the uninsured could purchase coverage.
Consumers would have the option of picking a government-run plan, the most hotly contested item in the legislation.
Associated Press writers David Espo and Ricardo Alonso-Zaldivar contributed to this report.
WASHINGTON (Nov. 7) - President Barack Obama is traveling to Capitol Hill on Saturday to try to close the sale on his signature health care overhaul, facing a make-or-break vote in the House certain to be seen as a test of his presidency.
Obama scheduled a late-morning visit with House Democrats convening a rare Saturday session on legislation to remake the U.S. health care system, extending coverage to tens of millions now uninsured and banning insurance company practices such as denial of coverage based on pre-existing medical problems.
Late Friday, House Democrats cleared an abortion-related impasse blocking a vote and officials expressed optimism they had finally lined up the support needed to pass Obama's signature issue.
Under the arrangement, Democratic Reps. Bart Stupak of Michigan, Brad Ellsworth of Indiana and other abortion opponents were promised an opportunity to insert tougher restrictions into the legislation during debate on the House floor.
The leadership's hope is that no matter how that vote turns out, Democrats on both sides of the abortion divide will then unite to give the health care bill a majority over unanimous Republican opposition.
"We wish to maintain current law, which says no public funding for abortion," Stupak said. "We are not writing a new federal abortion policy."
Ellsworth added, "From day one, my goal has been to ensure federal tax dollars are not used to pay for abortions and to provide Americans with pro-life options on the exchange. And I am proud to be part of an effort to help make this goal a reality."
With Democrats' command of the necessary votes looking tenuous in the final hours, Obama threw the weight of his administration behind the effort to round up support. He and top administration officials worked the phones to pressure wavering lawmakers.
Rep. Jason Altmire, D-Pa., said he heard Friday from Obama, White House Chief of Staff Rahm Emanuel, Health and Human Services Secretary Kathleen Sebelius and Education Secretary Arne Duncan.
Their message: "This is a historic moment. You don't want to end up with nothing," said Altmire, who remained undecided.
Democratic leaders hoped to hold the vote Saturday evening, but Majority Leader Steny Hoyer said it could slip.
Democrats hold 258 seats in the House and can afford 40 defections and still wind up with 218, a majority if all lawmakers vote. But all 177 Republicans were expected to vote "no," and Democratic leaders faced a series of complications trying to seal the needed votes for their complex and controversial legislation that would affect one-sixth of the economy and touch the lives of countless Americans.
In the GOP's weekly radio address, Mississippi Gov. Haley Barbour said Democrats should scrap their ambitious legislation and concentrate on modest health care changes that could find bipartisan support.
"The House Democrats' health care bill should be withdrawn and reworked," he said.
Tuesday's elections — in which Democrats lost two governors' races — sent a message that voters care about jobs, not growing the size of government, Barbour said.
The final hurdle for the Democrats was a controversy over federal funding for abortion, which simmered into Friday night with tensions running high as party leaders shuttled between meetings of anti-abortion and abortion rights lawmakers.
Federal law currently prohibits the use of federal funds to pay for abortions except in the case of rape, incest of situations in which the life of the mother is in danger. That left unresolved whether individuals would be permitted to use their own funds to buy insurance coverage for the procedure in the federally backed insurance exchange envisioned under the legislation.
Democrats have little room for error, with the prospect of the 2010 midterms looming large and a some of their own moderates already declaring their opposition.
The 10-year, $1.2 trillion House bill would create a new federally supervised insurance marketplace where the uninsured could purchase coverage.
Consumers would have the option of picking a government-run plan, the most hotly contested item in the legislation.
Associated Press writers David Espo and Ricardo Alonso-Zaldivar contributed to this report.
Tuesday, November 3, 2009
Cancer Treatment and Health Care Reform
From Barbara O’Brien
One argument you may hear against health care reform concerns cancer survival rates. The United States has higher cancer survivor rates than countries with national health care systems, we’re told. Doesn’t this mean we should keep what we’ve got and not change it?
Certainly cancer survival rates are a critical issue for people suffering from the deadly lung cancer mesothelioma. So let’s look at this claim and see if there is any substance to it.
First, it’s important to understand that “cancer survival rate” doesn’t mean the rate of people who are cured of a cancer. The cancer survival rate is the percentage of people who survive a certain type of cancer for a specific amount of time, usually five years after diagnosis.
For example, according to the Mayo Clinic, the survivor rate of prostate cancer in the United States is 98 percent. This means that 98 percent of men diagnosed with prostate cancer are still alive five years later. However, this statistic does not tell us whether the men who have survived for five years still have cancer or what number of them may die from it eventually.
Misunderstanding of the term “survivor rate” sometimes is exploited to make misleading claims. For example, in 2007 a pharmaceutical company promoting a drug used to treat colon cancer released statistics showing superior survival rates for its drug over other treatments. Some journalists who used this data in their reporting assumed it meant that the people who survived were cured of cancer, and they wrote that the drug “saved lives.” The drug did extend the lives of of patients, on average by a few months. However, the mortality rate for people who used this drug — meaning the rate of patients who died of the disease — was not improved.
But bloggers and editorial writers who oppose health care reform seized these stories about “saving lives,” noting that this wondrous drug was available in the United States for at least a year before it was in use in Great Britain. Further, Britain has lower cancer survival rates than the U.S. This proved, they said, the superiority of U.S. health care over “socialist” countries.
This is one way propagandists use data to argue that health care in the United States is superior to countries with government-funded health care systems. They selectively compare the most favorable data from the United States with data from the nations least successful at treating cancer. A favorite “comparison” country is Great Britain, whose underfunded National Health Service is struggling.
It is true that the United States compares very well in the area of cancer survival rates, but other countries with national health care systems have similar results.
For example, in 2008 the British medical journal Lancet Oncology published a widely hailed study comparing cancer survival rates in 31 countries. Called the CONCORD study, the researchers found that United States has the highest survival rates for breast and prostate cancer. However, Japan has the highest survival for colon and rectal cancers in men, and France has the highest survival for colon and rectal cancers in women. Canada and Australia also ranked relatively high for most cancers. The differences in the survival data for these “best” countries is very small, and is possibly caused by discrepancies in reporting of data and not the treatment result itself.
And it should be noted that Japan, France, Canada and Australia all have government-funded national health care systems. So, there is no reason to assume that changing the way health care is funded in the U.S. would reduce the quality of cancer care.
—
One argument you may hear against health care reform concerns cancer survival rates. The United States has higher cancer survivor rates than countries with national health care systems, we’re told. Doesn’t this mean we should keep what we’ve got and not change it?
Certainly cancer survival rates are a critical issue for people suffering from the deadly lung cancer mesothelioma. So let’s look at this claim and see if there is any substance to it.
First, it’s important to understand that “cancer survival rate” doesn’t mean the rate of people who are cured of a cancer. The cancer survival rate is the percentage of people who survive a certain type of cancer for a specific amount of time, usually five years after diagnosis.
For example, according to the Mayo Clinic, the survivor rate of prostate cancer in the United States is 98 percent. This means that 98 percent of men diagnosed with prostate cancer are still alive five years later. However, this statistic does not tell us whether the men who have survived for five years still have cancer or what number of them may die from it eventually.
Misunderstanding of the term “survivor rate” sometimes is exploited to make misleading claims. For example, in 2007 a pharmaceutical company promoting a drug used to treat colon cancer released statistics showing superior survival rates for its drug over other treatments. Some journalists who used this data in their reporting assumed it meant that the people who survived were cured of cancer, and they wrote that the drug “saved lives.” The drug did extend the lives of of patients, on average by a few months. However, the mortality rate for people who used this drug — meaning the rate of patients who died of the disease — was not improved.
But bloggers and editorial writers who oppose health care reform seized these stories about “saving lives,” noting that this wondrous drug was available in the United States for at least a year before it was in use in Great Britain. Further, Britain has lower cancer survival rates than the U.S. This proved, they said, the superiority of U.S. health care over “socialist” countries.
This is one way propagandists use data to argue that health care in the United States is superior to countries with government-funded health care systems. They selectively compare the most favorable data from the United States with data from the nations least successful at treating cancer. A favorite “comparison” country is Great Britain, whose underfunded National Health Service is struggling.
It is true that the United States compares very well in the area of cancer survival rates, but other countries with national health care systems have similar results.
For example, in 2008 the British medical journal Lancet Oncology published a widely hailed study comparing cancer survival rates in 31 countries. Called the CONCORD study, the researchers found that United States has the highest survival rates for breast and prostate cancer. However, Japan has the highest survival for colon and rectal cancers in men, and France has the highest survival for colon and rectal cancers in women. Canada and Australia also ranked relatively high for most cancers. The differences in the survival data for these “best” countries is very small, and is possibly caused by discrepancies in reporting of data and not the treatment result itself.
And it should be noted that Japan, France, Canada and Australia all have government-funded national health care systems. So, there is no reason to assume that changing the way health care is funded in the U.S. would reduce the quality of cancer care.
—
Subscribe to:
Comments (Atom)
