September 8, 2009

IN THIS ISSUE

In My Opinion: Let Facts, Not Fiction Improve Health Care
'Gang Of Six' Gets Health Reform Bill
House Dems Split On Reform
AMA Health Care Reform Update
St. John Hospital Cord Blood Program Receives National Accreditation
Program: Elimination And Sleep Problems In Young Children
Immunization Webcast Series
Crain's Health Care Leadership Summit

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In My Opinion: Let Facts, Not Fiction Improve Health Care

Obama's reforms can cut costs, cover most of uninsured

DR. HERBERT C. SMITHERMAN JR.
I see the urgency for federal health care reform every day in my urban practice.

Take the case of a 29-year-old woman who was diagnosed with cervical cancer. The cancer was caught early enough to be treated with surgery, but she couldn't afford it. Her company didn't offer insurance along with her low-paying job. She couldn't afford insurance herself and made too much in income to qualify for government assistance.

Our office eventually got her the medical care she needed, but the time she needed to take off to have the surgery and recover caused her to lose her job. Now she can't afford to pay her mounting medical bills.

This story, which I see repeated in many different ways, shows that the United States provides the best medical care in the world, but has the worst way of paying for it. Unless the system is reformed, physicians like myself and other health care providers will continue to see the numbers of such hardship cases rise. The status quo is unsustainable and unaffordable for the health and economic future of this country.

http://www.detnews.com/
article/20090903/OPINION01/909030340/1008/opinion01/Let-facts--not-fiction-improve-health-care

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'Gang Of Six' Gets Health Reform Bill

Baucus Sends $900 Billion Health Care Proposal To 'Gang Of Six'

Sep 08, 2009

Sen. Max Baucus, D-Mont., chairman of the Senate Finance Committee, has sent his "gang of six" colleagues on the Senate Finance Committee a health overhaul proposal that would cost under $900 billion.

The proposal is the "first concrete and comprehensive proposal to come out of the bipartisan talks" in the Senate Finance Committee, Politico reports. It would "levy new fees on insurers and create a network of consumer-owned insurance cooperatives," but it does not include a public insurance option, "a major difference from bills approved by three House committees and the Senate Health, Education, Labor and Pensions committee."

"Another significant variance with the House bills is the absence of a mandate on employers to provide coverage. Instead, the Baucus plan includes a 'free-rider' provision in which employers would contribute to the cost of providing government subsidies for the employees who purchase coverage in a government-organized insurance marketplace known as an exchange, according to the plan circulating among senators. Baucus’ plan also is expected to be less generous in terms of subsidies and coverage than those bills – which, along with the absence of the public option, is sure to rankle more liberal Democrats."

Although the plan "does not include any new taxes on alcohol or sugar," the bipartisan group is "considering a tax on insurance companies that provide expensive coverage plans. And one feature that might help satisfy the more liberal members of the committee is that insurance companies could face a separate new fee to help pay for the plan. It would be determined based on market share, and could raise $6 billion a year starting in 2010, the sources said" (Brown, 9/7).

Related KHN story from 7/30: "Free-Rider" Penalty For Employers Draws Ire From Advocates, Yawns From Business

The New York Times reports that "[t]he plan, circulating among some committee members of both parties, would also offer the option of lower-cost insurance, with protection only against the costs of catastrophic illnesses, to those 25 and younger. In addition, it would provide basic Medicaid coverage to millions of low-income people who are currently ineligible for the program, but the benefits would be less comprehensive than standard Medicaid." In addition to the insurer fee, the Baucus plan would also impose fees of "$4 billion a year on manufacturers of medical devices and $750 million a year on clinical laboratories"

On Tuesday, Baucus will try "to win support from the three Republicans and two other Democrats on his committee with whom he has been deliberating for months. Ultimately, however, he will need a majority of the committee's 23 members, several of whom are resentful at being excluded" (Calmes and Pear, 9/7).

CNN: The proposal is "considered a last-ditch effort to secure Republican votes for a health-care bill as President Obama pushes the issue with a planned speech to a joint session of Congress on Wednesday night. So far, none of the three Republican senators involved in talks with Baucus on the compromise have indicated whether they support the version he is proposing" (Barrett and Bash, 9/7). 

The Hill: "A source close to the talks described the proposal as a broad outline for Gang of Six members to consider as they enter their final week of talks before a Sept. 15 deadline that Baucus said he will enforce. A Democratic lobbyist working on healthcare said the marker was intended to spur GOP negotiators to strike a deal before the deadline passed" (Bolton, 9/7).

The Washington Post: "Baucus is urging three Republican colleagues to sign off on the $900 billion health-care reform package they have helped to negotiate over the past two months, in order to add a bipartisan proposal to the mix before President Obama's speech to Congress on Wednesday" (Murray, 9/7).

Kaiser Health News: "Baucus has told members that the proposal is not a final product and that more elements may be added. If members want to suggest changes to the bill that would increase its costs, however, they must also include financing offsets so the overall cost would not increase. But members in both parties may see the Finance proposal as too large and propose possible cuts" (Carey and Pianin, 9/7).

Bloomberg: "Baucus suggested Sept. 4 that he's prepared to move forward, even without Republicans. 'I am committed to getting health-care reform done -- done soon and done right,' he said after conferring with other senators" (Litvan and Gaouette, 9/8).

This information was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery. © Henry J. Kaiser Family Foundation. All rights reserved.

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House Dems Split On Reform

House Democrats Split On Health Reform Options

Sep 08, 2009

After the August recess, House Democrats are facing an uncertain future on health legislation.

"They are in almost the exact position they were in when they left the Capitol in late July," The Washington Post reports. "Conservatives are still leery of supporting a government-funded, or public, insurance option. Freshman lawmakers from suburban districts remain fearful of increasing taxes for their wealthy constituents to pay for the new measure and await alternatives from moderate Senate Democrats. And progressives, who are demanding the most far-reaching reform since the Great Depression, are still threatening to bring down the legislation if it does not contain a robust version of the public option."

The Post conducted interviews "with a cross section of about 15 House Democrats and half a dozen aides" and found that "there is still overwhelming support for some overhaul of the health-care system. But the caucus remains deeply divided over the details of the more than 1,000-page measure and now faces a public that is more skeptical than when House committees began drafting the plan two months ago."

"House Democrats are still expected to take the first step on the legislation, assuming that the frenzy of early August -- with the continual image on cable news of Democrats at town hall meetings with angry voters opposed to the proposal -- has not solidified opposition within their own ranks." Meanwhile, "House Republicans, who held hundreds of their own town hall meetings that drew more than 100,000 voters, according to preliminary estimates, viewed the break as a galvanizing moment for opposition to the Democratic legislation" (Kane, Pershing and Bacon Jr., 9/8).

The Hill reports that "[a]t least 23 House Democrats already have told constituents or hometown media that they oppose the massive healthcare overhaul touted by President Barack Obama. If Republicans offer the blanket opposition they've promised, Speaker Nancy Pelosi (D-Calif.) can afford to lose only 38 members of her 256-member caucus and still pass the bill." Many centrist Democrats "don’t like the public option, or don't want to vote on such a controversial plan when it's unlikely to become law." While it is possible that the House bill won't include the public option, it "won't make life easier for Pelosi. At least 60 liberal Democrats have pledged to vote against a healthcare bill with no public option, which they view as watered-down reform" (Soraghan and Gleeson, 9/8).

Roll Call:  "Amid fresh signs that the White House is preparing to back a scaled-down health care overhaul that would only include a public insurance option as a fallback plan, several House liberals told Roll Call that they could support such a bill depending on how it was structured. The 'trigger' approach has been considered a deal-killer by liberals on and off Capitol Hill, and the willingness of some Congressional Progressive Caucus members to entertain it reflects a recognition that a bruising August recess has imperiled prospects for reform and redrawn expectations for what is possible." Roll Call adds that "(l)iberals stressed that the shift does not amount to an abandonment of their commitment to a 'robust' public insurance option. They said they would only support a trigger if that approach guaranteed the same access, quality and affordability" (Newmyer and Dennis, 9/8).

In a second story, The Hill reports that "President Barack Obama's relationship with Speaker Nancy Pelosi, strained by differences over healthcare, will be tested by their talks on Tuesday in advance of his Wednesday night speech to a joint session of Congress." In a statement released last Thursday, Pelosi said that "a bill without a strong public option will not pass the House." If Obama "doesn't echo Pelosi, it would be the first major policy dispute between the leaders of the Democratic Party" (Allen, 9/8).

Meanwhile, it has been an especially challenging month for "one Ohioan who has been tangling with a conservative, New Jersey-sized district that turned Democratic only after scandal felled a six-term Republican," The Associated Press reports. Second-term congressman Zach Space, D-Ohio, is "one of 52 fiscally conservative 'Blue Dog' Democrats" and has been "struggling to convince his district of his moderate work on health care." But "[t]he 2010 election season is rapidly approaching, and Republicans — who sent Republican National Committee Chairman Michael Steele to campaign against Space in his district on Thursday — smell vulnerability" (Majors, 9/7).

This information was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery. © Henry J. Kaiser Family Foundation. All rights reserved.

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Health Care Reform Update

HHS highlights health reform's benefits for seniors and Medicare

A new report issued by Department of Health and Human Services (HHS) Secretary Kathleen Sebelius highlights the benefits that health reform legislation would have for seniors and the Medicare program. The report points out that pending legislation would preserve seniors' access to care by erasing a 21 percent cut in 2010 Medicare physician payments that is required by the sustainable growth rate (SGR) formula. And reform would significantly extend the solvency of the Medicare Trust Fund by eliminating overpayments to Medicare managed care plans.

In addition, the report notes that a typical couple on Medicare spends $90 a year in higher Part B premiums to subsidize overpayment to Medicare Advantage plans, and health reform would address these out-of-pocket costs. Seniors also would pay less for prescription drugs as health reform would provide for a 50 percent discount on drug prices in the Medicare coverage gap, also known as the "doughnut hole." "The status quo is unsustainable and unacceptable for seniors," Sebelius said. "Health insurance reform will ensure our seniors have the quality, affordable coverage they deserve." View the impact in your state of including a repeal of the SGR formula in health reform legislation.

Commercial lays out the facts about health system reform

A new television commercial by Americans for Stable Quality Care (ASQC) began airing last weekend in select states. The commercial spells out the facts in a clear and straightforward fashion about what reform would provide, such as caps on out-of-pocket expenses, no annual or lifetime limit on coverage, and coverage of preventive care. ASQC is an independent coalition supported by physicians, including the AMA, hospitals, workers and others who agree that America's health care system does not work for everyone and is in need of reform. While the AMA might not agree with ASQC's supporters on all health system reform proposals, we all believe that our nation's health system is in need of reform.

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St. John Hospital Cord Blood Program Receives National Accreditation

Every time a baby is born at St. John Hospital and Medical Center, it has the potential to treat and possibly give life to someone with a life-threatening illness.

That’s because each birth mother has the opportunity to donate her baby’s cord blood to StemCyte, Inc., one of only eight accredited cord blood donation banks nationwide by the Foundation for the Accreditation of Cellular Therapy. StemCyte, and its collection sites across the country, including SJH&MC had to pass a rigorous testing process to receive the accreditation.

“We’ve been collecting cord blood at SJH&MC for four years, and have partnered with StemCyte for a little more than a year,” said Brian Mason, M.D., SJH&MC maternal fetal medicine specialist. “Having the accreditation validates that all our hard work helping those who need stem cell transplants has been recognized.”

SJH&MC nurses counsel birth mothers on cord blood donation. Blood in the umbilical cord has a rich concentration of stem cells, which have the potential to differentiate themselves into a number of different cell types. Stem cells can be used to replace diseased cells in other people, those with leukemia, sickle cell anemia, anemia, solid tumors, and others; nearly 100 diseases in all.

SJH&MC is unique in providing the largest number of stem cell units for transplantation in southeast Michigan. Other hospitals give mothers the option of private cord blood donation, where parents pay a fee to initiate the process and yearly storage fees. The blood is available in case that family ever needs it. With a public cord blood bank, stem cells are available to anyone in the world or possibly to the family who donated.

Once the cord blood arrives at StemCyte, the staff enters the HLA data (information used to determine a suitable match) on the National Marrow Donor Program (NMDP) website. Transplant physicians worldwide access the site to find matches.

Chances of a match increase with the number of cord blood unit donations available. Currently, SJH&MC has collected nearly 5,000 cord blood units since beginning this project. As one of the largest collection sites in the U.S., SJH&MC continues to make stem cells available to those who need them including a large number of minority patients. Across public blood banks worldwide, very few have donations from African Americans. HLA matches usually coincide with race, which increases the importance for people of all ethnicities to donate.

Catholics can rally behind the program because these cells are not embryonic, they cannot be cloned, and are not ending a life. It is simply using a waste product for a valuable purpose.

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Program: Elimination And Sleep Problems In Young Children

Click here to Register

Elimination and Sleep Problems in Young Children:
Early Identification and Management
with Barbara T. Felt, MD Developmental-Behavioral Pediatrician University of Michigan Health System

Thursday, September 17, 2009
FOR YOUR CONVENIENCE - A CHOICE OF TWO TIMES!
3:00 PM - 5:00 PM or 6:00 PM - 8:00 PM
Center for Excellence
13111 Allen Rd.

Southgate, MI 48195

Continuing Medical Education units & Social Work CECs awarded

For registration and questions, please contact Laura Sheldon at (734) 785-7705, ext. 7271.

This seminar is for pediatricians, family physicians, child & family therapists, educators and infant mental health workers.

After the training, participants will be able to:
• Discuss the normal development progression of toileting
in children

• Describe the prevalence of constipation and enuresis problems in young children

• Name potential medical problems underlying persistent diurnal enuresis in young children

• Explain the presentation of functional constipation and soiling in young children and how this is usually evaluated

• Compare and contrast the evidence for medication and behavioral management of constipation problems in children

• Distinguish the medical and behavioral aspects of normal sleep in infants and young children

• List common sleep problems in infants and young children and identify points of intervention

Sponsored by Wayne State University in Partnership with Detroit- Wayne County Community Mental Health Agency, the Virtual Center of Excellence and Wayne County Community College District.

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Immunization Webcast Series

Click here to Register

Most Tuesdays in September

1:00 - 2:00 p.m.

The MSMS Foundation is partnering with the MDCH to present an immunization webcast. This four-part webcast series will provide CME over the Internet. Using a telephone and broadband Internet hook-up, you will be able to see, hear, and ask questions in real time as you sit at your desk; eliminating travel and time off. The sessions are designed to present physicians and other health care professionals with updates, tools, and guidance on vaccines for all ages. Who Should Participate: Physicians, nurses, physician assistants, and all other health care professionals

Easy registration: Online: www.msms.org/eo  Telephone: MSMS Registrar (517) 336-5785

Topics:

Adolescent Immunizations - September 8, 2009
Karen Mitchell, MD, Director, Providence Family Medicine Residency

Immunizations for Infants & Young Children - September 15, 2009
Charles Barone, MD, Henry Ford Medical Group, and Michigan Chapter of the American Academy of Pediatrics

Adult Immunizations - September 22, 2009
Diana Torres-Burgos, MD, MPH, Medical Director, Washtenaw County Public Health

Influenza Update: Seasonal and H1N1 Flu - September 29, 2009
Eden V. Wells, MD, MPH, Medical Epidemiologist, Michigan Department of Community Health Bureau of Epidemiology

4 AMA PRA Category 1 Credit(s)™ (1 per session)

The Michigan State Medical Society (MSMS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The MSMS designates this

educational activity for a maximum of 4 AMA

PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity. Nurses: The ACCME is approved by the Board of Nursing as an acceptable provider of continuing education for license renewal or relicensure.

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Crain's Health Care Leadership Summit

Thursday, Oct. 15, 2009

Hospital trustees, physicians, researchers, administrators and business leaders will gather Oct. 15 to tackle health-care issues and opportunities in Southeast Michigan. Some of the region's top names in health care will participate in a unique on-stage discussion. Breakouts will cover such topics as reducing cost and medical errors, electronic medical records, federal stimulus dollars, patient-centered homes, health care as an economic driver and new ideas for handling uninsured people. A luncheon program will honor Crain's "Health Care Heroes."

Date: Thursday, Oct. 15

Time: 8 a.m. - 5 p.m.

Tickets: $50 Luncheon ONLY

$149 Full Day Conference (Includes 1 yr. subscription to Crain's Detroit Business

$140 each for groups of 5 or more (for group tickets call 313.446.1652)

Location: Rock Financial Showplace, 46100 Grand River, Novi, MI. 48374

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