National study names 75 hospitals as ‘best value’

By Anne Zieger

A group of 75 hospitals have been named by research firm Data Advantage as offering the highest quality of care in the U.S.

These 75 facilities came out on the top of the firm’s 2009-2010 Hospital Value Index, which crunches publicly-available data to examine hospital performance. The Index includes stats on hospital quality, affordability, efficiency and patient satisfaction.

To draw their conclusions, researchers looked at CMS and AHRQ data for more than 4,500 facilities, taking into account patient safety indicators, 30-day mortality scores and readmissions. It then chose 75 for its “Superior Quality Merit Award.”

The company notes that hospitals it chose as best in value–the top 25 percent of those identified int he study–improved their quality scores by an average 8.14 percent since March 2009, while those in the remaining 75 percent saw their quality score drop by 1.1 percent during the same period.

To get more data from the study:
- read this Data Advantage press release
- check out its Hospital Value Index site

MANDATES AND AFFORDABILITY ON HEALTHCARE REFORM

New York Times -

Nov. 2: If Congress approves health care reform, virtually all Americans will be required to buy health insurance or pay a penalty. That raises a fundamental question: Will the policies be affordable?

People everywhere are complaining that relentlessly rising costs are making health insurance unaffordable. The situation is especially dire for millions of Americans who are uninsured, self-employed or whose employers do not offer subsidized group coverage.

A survey by the Commonwealth Fund found that 73 percent of the adults who tried to buy insurance on the open market over a three-year period never bought a plan because they could not afford it, could not find a plan that met their needs, or were turned down.

Pending legislation would help some of them by preventing rejections or high charges based on health status and by setting minimum benefit requirements.

But many people who might still find the premiums too high will face an agonizing choice: buy insurance coverage or pay a penalty of hundreds or even thousands of dollars per family if they still decide to forgo insurance.

Successful reform will provide financial support for those who need it and is the only way to finally guarantee coverage for tens of millions of uninsured Americans.

Here is a look at some of the issues behind the affordability debate:

WHY IS A MANDATE NECESSARY? It is important that everyone be required to buy insurance, either from their employers or on new insurance exchanges.

Reliable studies show that people who lack insurance seldom get regular medical care and therefore suffer more severe illness and death than those who are insured. When they do get sick, they often turn to expensive emergency rooms for free care driving up costs for everyone else.

Finally, the health care reforms, which require insurers to accept all applicants, will not work well unless nearly everyone carries health insurance. Unless the pool includes a large number of healthy people, the costs for everyone on the exchange will be too high.

WILL PREMIUMS GO UP OR DOWN? Those forced to buy their own insurance could choose from an array of private plans and possibly a public plan that will be offered on the exchanges. There is sharp debate over whether these plans would be less or more expensive than plans that would be available on the open market.

Insurance industry studies contend that premiums would go up because various fees imposed on health insurers and health care providers to pay for covering the uninsured would inevitably get passed on to consumers.

We believe premiums would come down for several reasons. Companies would no longer need to spend as much money on administrative costs, to screen out people with pre-existing conditions (prohibited by all reform bills). If they wanted to participate on the exchanges (and have access to millions of new customers), the companies would also be forced to compete with other private plans, and possibly a public option, encouraging them to lower premiums and accept lower profits.

A hint of what might happen can be seen in an analysis by the Congressional Budget Office. Under a version of the Senate Finance Committee bill, the average single person would pay a $5,000 premium for a ’silver plan’ sold on the exchanges in 2016 but would pay $6,000 for a plan with less generous coverage if the reform failed.

WILL THERE BE HELP? Right now, only the poorest Americans get help, through the state-federal Medicaid program. The bills in both houses would expand eligibility for Medicaid to cover millions more people, and lower the contributions of the poorest Americans.

For those buying policies on the exchanges, perhaps 30 million people in all, the bills would provide tax-credit subsidies to help low- and middle-income people pay the premiums. People would have to pay specified percentages of their income toward the premium, ranging in the House bill from 1.5 percent for those barely above Medicaid level to 12 percent for those earning four times the poverty level, or $88,000 for a family of four.

That sounds like a substantial hit at the upper end $10,560 for a family of four before subsidies kick in. But it is comparable to what many workers are currently willing to pay for their group policies.

And just in case the premiums might still look unaffordable to large numbers of people, the Senate Finance Committee’s version has proposed an escape hatch. No one would be required to spend more than 8 percent of their income on health insurance. They would not be insured, but they would not be fined.

WHAT’S AFFORDABLE? No one has a clear answer, and various experts use different approaches to calculating affordability. Some estimate what people would have to pay for such other necessities as housing, food, day care, transportation and taxes, and then see how much is left over that could pay for health insurance. Others look at what people at various income levels are paying for health insurance today, without a requirement.

By either yardstick, Jonathan Gruber, a prominent health economist at the Massachusetts Institute of Technology, believes that all of the pending bills in Congress would make health insurance affordable to the vast majority of Americans and that none of the bills would require anyone to buy insurance they could not afford.

His only concern is that the Senate Finance Committee’s bill might not provide enough protection against high payments required to meet deductibles or co-payments and other out-of-pocket charges.

The Commonwealth Fund, a staunch advocate of health care reform, believes that the House bill meets its affordability standards (5 to 10 percent of income) for premiums required of families earning up to about $75,000 a year, while the Senate Finance panel’s bill falls short at every step of the way.

HOUSE HEALTH BILL TOTALS $1.2 TRILLION

Associated Press -

Nov. 3: Washington – The health care bill headed for a vote in the House this week costs $1.2 trillion or more over a decade, according to numerous Democratic officials and figures contained in an analysis by congressional budget experts, far higher than the $900 billion cited by President Barack Obama as a price tag for his reform plan.

While the Congressional Budget Office has put the cost of expanding coverage in the legislation at roughly $1 trillion, Democrats added billions more on higher spending for public health, a reinsurance program to hold down retiree health costs, payments for preventive services and more.

Many of the additions are designed to improve benefits or ease access to coverage in government programs. The officials who provided overall cost estimates did so on condition of anonymity, saying they were not authorized to discuss them.

House Speaker Nancy Pelosi has referred repeatedly to the bill’s net cost of $894 billion over a decade for coverage. Asked about the higher estimate, Pelosi spokesman Brendan Daly said the measure not only insures 36 million more Americans, it provides critical health insurance reform in a way that is fiscally sound.

“It will not add one dime to the deficit. In fact, the CBO said last week that it will reduce the deficit both in the first 10 years and in the second 10 years,” Daly said.

Democrats have been intent on passing legislation this year to implement Obama’s call for expanded coverage for millions, curbs on industry abuses and provisions to slow the rate of growth of health care costs nationally.

“Now, add it all up, and the plan I’m proposing will cost around $900 billion over 10 years,” the president said in a nationally televised speech in early September.

Whatever the final cost of legislation, the calendar is working increasingly against the White House and Democrats. While a House vote is possible late this week, Senate Majority Leader Harry Reid, D-Nev., may not be able to begin debate on the issue until the week before Thanksgiving. Additionally, the Republican leader, Sen. Mitch McConnell of Kentucky, has hinted at efforts to extend the debate for weeks if not months, a timetable that could extend into 2010.

One casualty of the time crunch and threatened Republican delaying tactics may be formal House-Senate negotiations on a final compromise. An alternative is a less formal hurry-up final negotiation involving the White House and senior Democrats.

Pelosi and her lieutenants worked on last-minute changes in the measure to ease concerns among opponents of abortion and a contentious provision relating to illegal immigrants. Conservative Democrats have expressed concern about the cost of the bill, and an evening closed-door meeting gave the leadership its first chance to hear their response.

The bill includes an option for a government-run health plan. The leadership can afford more than two dozen defections and still be assured of the votes to prevail on the bill, one of the most sweeping measures in recent years.

Republicans put the cost of the bill at nearly $1.3 trillion. “Our goal is to make it as difficult as possible for” Democrats to pass it, House Republican leader John Boehner, R-Ohio, said at a news conference. “We believe it is the wrong prescription.”

One day after announcing Republicans would have an alternative measure, Boehner offered few details. He said it would omit one of the central provisions in Democratic bills — a ban on the insurance industry’s practice of denying coverage on the basis of pre-existing medical conditions. Instead, he said the Republicans would encourage creation of insurance pools for high-risk individuals and take other steps to ease their access to coverage.

Boehner also said Republicans would propose limits on medical malpractice lawsuits in what he said was an attempt to reduce the cost of coverage.

Primary-care physicians leave AAFP over Coca-Cola partnership

By Anne Zieger

It seems that the American Academy of Family Physicians is getting flack for its agreement with The Coca-Cola Co., under which the group is tasked with educating consumers on how Coke products fit into a healthy lifestyle.

Under the terms of the deal, the AAFP will receive a grant to develop consumer content related to Coca-Cola drinks and sweeteners. The content will appear on the association’s health and wellness site, FamilyDoctor.org.

This didn’t sit well with some of the AAFP’s members, however. A group of physicians affiliated with San Francisco-based Contra Costa Health Services have quit the AAFP over the partnership, which was announced last month. This includes Contra Costa Health director Dr. William Walker, who has been a member of the association for 25 years. He argues that Coke products promote obesity by introducing extra sugar into children’s diets.

“I am appalled and ashamed of the partnership,” Walker said in a press release. “How can any organization that claims to promote public health join forces with a company that promotes products that sicken our children?”

Walker is encouraging other doctors to resign from the AAFP, hoping that if the group gets enough negative feedback, it will extricate itself from its relationship with the beverage giant.

To learn more about the controversy:
- read this Atlanta Business Journal piece
- read this AAFP press release
- read Dr. Walker’s press release

This Week in Health Care Reform

Anthem Blue Cross 10-30-09

This week, lawmakers fine-tuned their reform proposals and, once again, the public option became the central issue of the health care reform debate.

Senate and House Negotiations

Senate Majority Leader Announces Senate Bill that Includes Public Option: On Monday, Senate Majority Leader Harry Reid (D-NV) announced that the health care reform package from the Senate is expected to include a public option with an opt-out provision should a state choose to not participate in the government plan. While liberal Democrats cheered the inclusion of the government-run plan, some moderates – including Sens. Joe Lieberman (I-CT), Blanche Lincoln (D-AR), Evan Bayh (D-IN) and Mary Landrieu (D-LA) – all voiced concerns.

Sen. Lieberman said that he would vote to block the passage of the Senate health care reform bill in Sen. Reid’s proposed form. In addition, Sen. Olympia Snowe (R-ME), the only Republican to vote in favor of any health care reform legislation to date, stated that she is “deeply disappointed” with the inclusion of the public option.

This backlash comes as a blow to Sen. Reid and calls into question whether he has the 60 votes needed for final passage of the bill without an anticipated Republican filibuster. Sen. Reid has delivered a variety of proposals to the Congressional Budget Office (CBO) for cost estimates as he works to finalize the legislation.

Pelosi Unveils House Health Reform Bill: On Thursday, following weeks of negotiations to merge three bills passed by House committees last summer, House Speaker Nancy Pelosi (D-CA) unveiled the House’s 1,990-page health care reform legislation.

The merged legislation includes a version of the public option, favored by moderate Democrats, that uses reimbursement rates negotiated with private insurers rather than the option favored by liberal Democrats that pegs rates to Medicare. The bill also includes:

• Mandates for individuals and employers to purchase coverage (with some exemptions)
• Subsidies to help lower-income individuals purchase insurance
• An expansion of Medicaid eligibility to include individuals and families with incomes of up to 150% of the federal poverty level
• Taxes on the wealthy of 5.4% for individuals who earn more than $500,000 and for couples who earn more than $1 million
• Significant insurance market reforms
• Fees collected from the medical device industry totaling $20 billion

The House bill does not include the “Cadillac Tax,” a controversial tax on high-end insurance plans. And, House Democrats indicated that party leaders have yet to resolve long-standing disagreements regarding coverage for abortion and illegal immigrants.

This bill is estimated to cost just under $900 billion over the next 10 years. However, the legislation does not address Medicare physician payments and instead moves this portion of the proposal to a separate bill, which is anticipated to increase the U.S. budget deficit by more than $200 billion over 10 years.

Senate and House Propose Lower Medical Device Industry Fees: In the bill originally passed by the Senate Finance Committee, fees collected from the medical device industry would have totaled $40 billion over 10 years. Lawmakers from both the Senate and the House are proposing lower fees. In the emerging Senate legislation, Sen. Reid is expected to adjust the fees to between $15 and $20 billion over 10 years. By comparison, the House version includes a tax that would be imposed at the point of sale, thereby spreading its impact across manufacturers, wholesalers and distributors, and would yield $20 billion between 2013 and 2019.

Additional Activities

U.S. Business Group Opposes Public Option: On Wednesday, The Business Roundtable, comprised of chief executives at Verizon Communications, JPMorgan, General Electric, Wal-Mart and other companies, said the federal government is inefficient and would underpay providers while driving up costs for employers and their workers.

Public Opinion

American Opinion on Public Option Remains Steady: The October Kaiser Family Foundation poll found that 55% of Americans believe that it is now more important than ever to take on health care reform, while 41% say the country cannot afford it, results that are unchanged from the previous month. Other findings include:

• Americans’ support for taxing the wealthy to pay for reform decreased slightly in October, while support for taxing insurance companies increased.
• Americans still worry about the potential impact of the reforms on measures such as wait times, cost and choice of providers.
• Most Americans believe that health care reform will deliver changes immediately. About half of Americans believe that if Democrats pass health care reform legislation, help for the uninsured and consumer protections in the insurance market will begin within a year. In actuality, however, most of the reform provisions will take years to kick in.

 

Looking Ahead

Sen. Reid awaits CBO financial estimates to finalize the Senate bill before bringing it to the Senate floor. The House bill will be submitted to the full House for debate as early as next week.

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New York AG Cuomo announces historic nationwide reform of consumer reimbursement system for out-of-network healthcare charges

SYRACUSE, N.Y. (October 27, 2009) – Attorney General Cuomo today announced historic nationwide reform of the consumer reimbursement system for out-of-network health care charges. A new not-for-profit company, FAIR Health, Inc., and an upstate research network headquartered at Syracuse University will develop a new independent database for consumer reimbursement and a new website where for the first time consumers can compare prices before they choose their doctors.

Read more here:

This Week in Health Care Reform

Anthem Blue Cross 10-23-09

This week legislators from both the House and Senate continued to negotiate their respective final proposals for an overhaul of the health care system.

Industry Activities

Study Shows Premiums Will Increase: This week, our parent company released an analysis that sheds further light on the impact of the Senate Finance Committee’s proposed health care reform legislation on premiums. The findings show increases in premiums due to new fees placed on drug manufacturers, medical device makers and the insurance industry, among others.

AHIP Provides More Context to Premiums Study: Karen Ignagni, president and chief executive of American’s Health Insurance Plans (AHIP), provided more context to the recent report from PricewaterhouseCoopers that showed the Senate Finance Committee bill will unintentionally increase the cost of health care coverage. Ignagni stated in an Op-Ed in Tuesday’s Washington Post , “[AHIP] continues to strongly support reform. In fact, last year we proposed new insurance market rules and consumer protections to achieve universal coverage, remove restrictions on pre-existing conditions and end the practice of basing premiums on health status or gender. We firmly believe that all the cost concerns the report.

Senate and House Negotiations

Public Option Continues to Shape Debate:White House officials appeared on NBC’s “Meet the Press,” ABC’s “This Week,” CNN’s “State of the Union” and CBS’s “Face the Nation” this past weekend to set the parameters for this week’s negotiations around health care reform, particularly regarding a public option. The officials, including Chief of Staff Rahm Emanuel and senior White House advisers Valerie Jarrett and David Axelrod, indicated that President Barack Obama continues to prefer a public option but will not demand its inclusion in the final legislation.

Senate Majority Leader Harry Reid (D-NV) continues to face mounting pressure from liberal lawmakers to revive a proposed government-run option. As Sen. Reid works to craft the legislation, reports indicate he is “more likely” to include a version of the public option that requires the government to negotiate rates with providers, as private insurers do, and not just tie them to Medicare reimbursement rates as a way to create fair competition in the marketplace.

On the House side, Speaker of the House Nancy Pelosi (D-CA) continues to voice strong support for the public option, declaring in a news conference last week, “our House bill will have a public option.”

Senate Finance Committee Courts AMA: Lawmakers on Wednesday voted to block a $247 billion measure proposed by Sen. Debbie Stabenow (D-MI). The measure is aimed at eliminating scheduled Medicare reimbursement cuts for doctors and enacting a permanent, predictable system for future rate increases. Lawmakers criticized the bill for adding to the budget deficit. Sen. Reid brought the measure to the floor in an attempt to court American Medical Association (AMA) support for the Senate health care reform legislation. AMA President Dr. James Rohack countered that reform legislation must also address significant medical liability reform to gain AMA support.

CBO Provides Estimates For House Versions: House Speaker Pelosi announced Tuesday that recent Congressional Budget Office (CBO) estimates showed that a health care overhaul by House Democrats would reduce the U.S. budget deficit over 10 years and cost less than $900 billion, a goal outlined by President Obama. Speaker Pelosi had asked the CBO to provide cost estimates on three competing House versions for executing the public option – one based on reimbursement rates paid to health care providers under Medicare and two that would rely on reimbursement rates negotiated with the providers.

Medicare Office of the Actuary Points to Cost Increase Under House Legislation: The Medicare Office of the Actuary released a report on Wednesday showing that total national health care spending would increase by an additional 2.1% from 2010-2019 under the bill drafted by House Democratic leaders. The increase would be due primarily to newly insured people seeking medical care. The report found that health care would account for 21.3% of the U.S. economy in 2019, slightly more than an estimated share of 20.8% of the economy if no bill passes.

Additional Activities

Insurance Industry Antitrust Exemption Under Scrutiny: Top Senate Democrats Harry Reid, Patrick Leahy (D-VT) and Chuck Schumer (D-NY) announced Wednesday that they are inclined to incorporate an amendment into the health care reform legislation to strip the health insurance industry of its exemption from federal antitrust laws. Also on Wednesday, the House Judiciary Committee voted 20-9 to end the industry exemption that dates back to 1945. If enacted, the measure would increase federal regulation over the insurance industry.

White House Pushes to Influence Negotiations: As the final health care reform bills are taking shape in the House and the Senate, White House officials have stepped up their efforts to influence the negotiating process. On Tuesday, President Obama spoke from New York City by video to hundreds of small gatherings sponsored by Organizing for America, a spin-off of his 2008 presidential campaign. Top White House aides will attend strategy sessions for the Common Purpose Project, a coalition headed by President Obama’s former campaign officials. In addition, Chief of Staff Emanuel and other aides are at the table when Sen. Reid and Speaker Pelosi meet with their respective committees to negotiate and draft legislation.

Republicans and Democrats Back Medical Device Industry: Countering Democrats on the Senate Finance Committee who view medical device manufacturers as contributing to increasing health care costs, Democrats and Republicans from Minnesota, Indiana, New Jersey and other states have banded together to defend the industry in their home states. Last week, the Senate Finance Committee approved a $40 billion fee on device makers over the next 10 years. In reaction, 14 Democratic senators sent a letter to Sen. Reid, urging them to “moderate” the fees which will “threaten the existence of some manufacturers” and result in “significant job reductions.” Five Republican governors also objected to the fees.

Public Opinion

Polls Suggest Remaining Divide: A CNN/Opinion Research Corporation survey released Wednesday showed that 53% of Americans say it would be better for the country if Congress passed a reform bill, with 44% feeling that things would be better if the current health care system was left in place with no changes.

In addition, a USA Today/Gallup poll this week showed that Americans are increasingly worried about the cost and quality of medical care that could result from the health care reform. The poll showed 49% of Americans believe that costs will increase under the measure, up from 42% last month.

Looking Ahead

Sen. Reid may introduce a combined Senate bill for health care reform this week. If this happens, Senate floor debates are expected next week.

Register now with the Health Action Network and join others in our industry who want their opinion heard by lawmakers.

WHAT’S BEHIND RISING HEALTH COSTS? LOTS!

The Philadelphia Enquirer -

Oct. 5: Lots of us think we know why American health-care costs are rising faster than a speeding bullet, or at least faster than our GDP, incomes, and inflation. It’s because we’re such profligate users of medical care. We run to the doctor at the first sign of a sniffle and demand heroic treatment until our final days.

We may cringe at the bills, but we’re all after pain-free immortality. Plus, we’ve built the best health-care system in the world. Industry experts see a much more complicated picture. Americans actually see doctors and stay in the hospital less than residents of other industrialized countries, they say. Our costs are high for a constellation of reasons involving relatively uncontrolled prices, insurance that masks real costs from consumers, heavy use of technology, wide variations in care, and excessive administrative costs.

Making a dent in this problem, as Washington is discovering, is a tough, disruptive job that not only would change the way people get care, but also threaten the livelihood of powerful vested interests.

“Your cost is my income,” Tom Getzen, a health economist at Temple University, pointed out. “Real cuts, the kind of cuts that count, are also the kind that hurt.” Health-care experts are divided on the best approach, with some saying a more rational use of resources could curtail spending and others saying the only effective solution is price control.

Reining in expenses

Uwe Reinhardt, a health economist at Princeton University who falls into the latter group, sees little in the health-care packages under discussion that would rein in expenses. “For bending the cost curve, there’s really nothing in there but a few little hopes and a few little prayers,” Reinhardt said.

Our cost curve is a thing to behold. While health spending has grown faster than GDP by half a percentage point a year in other rich democracies, it has averaged an extra 2 percent in the United States, said Jacob Hacker, an expert on the politics of health policy at Yale University.

Health spending now $2.2 trillion accounts for 16.2 percent of GDP. We spend an average of $7,421 per person, even with millions uninsured. Other countries average far less and cover almost everybody. Generally, experts said, care here is not markedly more effective.

Economists say that health-care spending tends to rise with income everywhere. Even taking that into account, though, the United States spends about $2,000 per person per year more than expected based on income, Reinhardt said.

End of life

Much as we might like to blame some of that on excessive spending in the last year of life, economists say that’s not a major cost driver. Joseph White, an expert on international health care at Case Western Reserve University, said the proportion of Medicare spending in the last year of life has been consistent for decades.

“Do we spend a lot of money at the end of life? Yes,” he said. “Do we spend a lot of money on people who are really sick? Yes. That’s the whole point.

That’s why you have insurance.”

Insurance itself has driven spending, some experts said, not only by making it possible for customers to get more care while insulating them from the cost, but by making it safer for companies to risk developing expensive new machines and for hospitals to buy them. But, other countries have more insurance than we do.

Overuse of technology

That leaves the big culprits, resource use and prices. We do use more technology, which researchers define broadly to include medicine, devices, and techniques. Over the years, new technology has improved care. But, American doctors and patients too often assume that “more is always better,” said Elliott Fisher, director of the Center for Health Policy Research at Dartmouth.

We are far more likely than people in other countries to get MRIs and CT scans, Cesarean sections and knee replacements, Mark Pearson, head of the health division of the Organization for Economic Cooperation and Development, told the Senate Special Committee on Aging last week.

We also have big regional variations in resource use without corresponding variations in quality, Fisher said. “Most of the differences across regions are about how much time people spend in the hospital for similar illnesses and how many physicians are involved in their care,” he said.

Making everybody’s care like that in the most cost-effective regions would cut overall costs 20 percent to 30 percent, he said. But, you cannot just cut spending 20 percent in high-cost areas like Philadelphia without causing “chaos,” he added.

Accountability

He thinks the key is making hospitals and doctors more accountable for spending. Other experts said the main reason we pay so much for health care is that we have done a lousy job of controlling expenses compared with other countries.

“Our prices are higher for everything,” said Jonathan Oberlander, a University of North Carolina expert on social medicine and health policy.

Oberlander and White argued in the New England Journal of Medicine last month for a system where all public and private insurers pay the same rates to doctors and hospitals.

“What I would say is that if countries want to control health-care spending, then they should have spending controls,” Oberlander said. In other countries, someone pays attention to overall cost, White said. Either there’s a single payer, or payers band together to set rates. Here, everything is fragmented.

Given all the hoopla about the more minor changes proposed so far, the policy experts think there is little chance that Americans will jump on the rate-setting bandwagon soon.

“It will happen, but not right away,” Reinhardt said. “You have to get the American people a whole lot more desperate. The American people have to suffer.”

This Week in Health Care Reform

Anthem Blue Cross – Sept. 25,2009

This week’s health care reform debate focused on the long-awaited health care reform legislation proposed by Finance Committee Chairman Sen. Max Baucus (D-MT).

Senate Negotiations

Introduced last week, Sen. Baucus’s Finance Committee bill has faced criticisms from both sides of the aisle, resulting in 564 proposed amendments to the legislation. On Tuesday, to address some of the concerns outlined in those amendments, Sen. Baucus suggested changes to the bill that would further increase regulation of insurance companies, expand consumer protections and increase subsidies to help people buy insurance. In an effort to appease Republicans, he also exempted consumer items of $100 or less – items ranging from Q-tips to contact lenses – from a proposed tax on medical device manufacturers. As the week progressed, clear partisan battle lines emerged as Senate Democrats and Republicans debated controversial proposals, such as changes to Medicare .

As the Finance Committee continues the mark-up process and votes on amendments, Sen. Baucus will attempt to keep the 13 Finance Committee Democrats on board. He will have to achieve this without moving so far left politically that he loses the support of key Republicans, including Sen. Olympia Snowe (R-ME), the only Republican of the 10 who sit on the Finance Committee seen as likely to vote for the bill.

Outside of the committee, Sen. Snowe has become a pivotal figure in bipartisan negotiations for reform as Democrats seek the 60 votes in the Senate required to pass the legislation. Other reports suggest that the Finance Committee bill also has the backing of Sen. Blanche Lincoln (D-AR), another key swing senator.

Public Plan

President Obama Conducts Media Blitz: On Sunday, President Obama advocated for health care form legislation in back-to-back broadcasts of taped interviews on five morning news shows (ABC’s “This Week,” NBC’s “Meet the Press,” CBS’s “Face the Nation,” CNN’s “State of the Union” and Spanish-language Univision’s “Al Punto”). While admitting to being “humbled” by the challenge of reform, he called for a more civil tone in the debate.

Going into the Sunday interviews, a Siegel+Gale poll showed that, following President Obama’s televised address to a joint session of Congress earlier this month, only 36.9% of Americans said they understood the President’s reform plan. Of those who actually watched the President’s address to Congress, 57.9% claimed to understand his platform.

Democrats Woo Seniors: White House officials and Democrats have focused on convincing skeptical seniors to support the administration’s reform legislation. On Wednesday, Vice President Joe Biden visited a retirement community in Maryland to deliver the Democratic health care reform message and to reassure seniors that they will not see cuts in their Medicare coverage.

Additional Activities

First Lady Enters Health Care Debate: Working to galvanize women around health care reform, First Lady Michelle Obama jumped into the debate last week at a meeting of the newly formed White House Council on Women and Girls. Michelle Obama urged women to mobilize behind the President’s plan. Meeting attendees included members of the Business and Professional Women, the YWCA, the Women’s Chamber of Commerce and the National Council of Negro Women.

President Obama Speeds Up Tort Reform: Last Thursday, President Obama sought to ease tensions this week among physicians whose concerns over malpractice costs and Medicare reimbursement were modestly addressed in the Finance Committee bill. The President moved to accelerate a $25 million grant program aimed at addressing medical malpractice lawsuits.

Looking Ahead

Sen. Baucus plans to steer his health care reform bill through the Finance Committee by the end of the week. Once the Finance Committee votes and approves the bill, Senate leaders will then combine it with another bill approved by the Health, Education, Labor and Pensions Committee in July.

A similar process is also occurring in the House with bills passed by three committees: Energy and Commerce; Education and Labor, and Ways and Means. House Speaker Nancy Pelosi (D-CA) has indicated that she hopes to have a single, final version of the House bill by the end of next week.

White House Budget Director Peter Orszag anticipates completion of health care legislation by mid-November. He also believes that the final version will be largely based on the Senate Finance Committee bill.

Did you miss our “Building a Sustainable Health Care System” webinar?

If you didn’t have the opportunity to participate in our webinar event, “Building a Sustainable Health Care System,” last week’s presentation to employers and other clients is now available. Visit the Health Action Network to download a copy of the presentation or to listen to the event recording.

Register now with the Health Action Network and join others in our industry who want their opinion heard by lawmakers.

This Week in Health Care Reform

Anthem Blue Cross – Aug. 21,2009

The survival of the so-called “public option” as the cornerstone of health care reform took center stage this week, as Democrats debated the importance of its inclusion in the final bill. Media reports on Thursday suggested that lawmakers are considering dividing the bill into manageable parts instead of pushing ahead with a large, comprehensive health reform package.

Health Reform Activities

Conflicting Opinions on the Importance of a Public Option: White House Press Secretary Robert Gibbs went on defense this week, following remarks on Sunday from Health and Human Services Secretary Kathleen Sebelius that a public option was “not essential” to reform. In response, a group of House Democrats sent a sharply worded letter to Sec. Sebelius in which they called the removal of a public option a “grave error.” White House officials have since been working to calm a swell of criticism from Democrats, with Sec. Gibbs insisting that the Administration had not taken the public option off the table.

Cooperatives Touted as Public Plan Alternative: In response to what initially appeared to be a concession from White House officials on the public option, key senators are taking another look at Sen. Kent Conrad’s (D-ND) proposal for member-owned, nonprofit cooperatives. GOP leaders, however, have expressed concern over the option. Sen. Jon Kyl (R-AZ) voiced his suspicions of the plan, referring to the co-op proposal as “a Trojan horse.”

Democrats Focus on Insurance Reforms: President Obama stepped up attacks on the insurance industry in his recent town hall meetings and on his weekly radio address. He promised reforms preventing insurers from capping coverage or charging “outrageous” fees. President Obama also indicated that people currently with health insurance coverage would be among the biggest beneficiaries of his reform legislation.

Opinion Polls

Poll Shows Slim Majority Still Favors Health Care Reform: The margin between those who support health care reform and those against it has narrowed in recent months, as concerns about reform measures mount. An August Kaiser Family Foundation poll reports that 53 percent of the public believe that tackling health reform is more important than ever, compared to 42 percent who say the country cannot afford to take on health care reform right now.

Looking Ahead

White House officials and key lawmakers continue to negotiate a bipartisan bill over August recess, in an attempt to prepare a final bill for passage this fall.

Lawmakers are slated to return to Washington on September 8.

Register now with the Health Action Network and join others in our industry who want their opinion heard by lawmakers.