Image via WikipediaThey are a good lot and deserve some positive recognition for their progress so far. Politico.com reports that "Junior" Democrats are split regarding the health care reform bill. The four Democrats (in the class of 2006), who favor a government-run public insurance option are Senators Sheldon Whitehouse (D-RI), Sherrod Brown (D-Ohio), Bob Casey (PA), and Independent Bernie Sanders (D-VT). Nine senators wrote a letter praising the bipartisanship efforts of the Senate Finance Committee, and did not take a position on the public option. Senators in favor of a bipartisan solution include Senators Kay Hagan (D-NC), Jeff Merkley (D-Oregon, Mark Warner (D-VA), Amy Klobuchar (D-Minn), Claire McKaskill (D-MO), Jim Webb (D-VA), Michael Bennet (D-Colo), and Mark Begich (D-Alaska). In the same issue (8/5/09) another story describes Democrats as "pitching small ball." To quote:
As if hedging their bets on health reform, Democrats are emphasizing smaller but still significant health-related investments this year, from food safety and community health centers to a greater emphasis on rooting out abuses in Medicare and Medicaid.
It’s a far cry from the more ambitious government-backed insurance option proposed by President Barack Obama and House Democrats. But it does add up to a major expansion of the government’s role in public health — and one that shows a greater willingness to add personnel to regulate and administer programs.
The White House has done well on this big issue, despite lots of media quibbling with the details. Note that, according to (July 6) Congressional Quarterly Politics, "President Obama is on pace to be the most successful Oval Office occupant in more than half a century when measured by his ability to get Congress to vote his way". But that will not deter the big lobbying groups from spending record-breaking amounts to influence the direction of reform, CQ reports (7/21/09). An organization to which we belong, AARP, for example, "spent $5.3 million from April 1 through June 30, an increase of $1.2 million over its first-quarter spending of $4 million, according to . . . lobbying disclosure reports filed Monday with the Senate Office of Public Records."
Monday meant good TV on C-SPAN, as Congress is in recess. The Alliance for Health Reform held a luncheon panel discussion that was the best I have seen in a long time. Their link goes to a rich group of resources, including the speakers' power point presentations along with a good long list of other briefing documents at other websites. A podcast and video of the discussion is provided at the Robert Wood Johnson website, along with an additional summary. Susan Denzer, a well respected journalist gave an excellent briefing. From her I learned more about the details of what Congress has produced than ever before. Nancy Dickey, head of a big medical education institution, talked at length about the shortages of primary care providers. I also got a very good overview of how the Massachusetts health reform effort has gone so far. Deborah Devaux spoke, representing the private insurance provider Blue Cross Blue Shield, as did Sharon Long, of the Urban Institute, who did the research on the Massachusets experience. Both the state government's perspective as well as the private sector's were very well represented. There is much to learn, if you view this as a real pilot project. According to the Foundation, panelists addressed the following questions:
- What provisions exist in the health reform proposals that speak directly to expanding access to health care?
- What types of payment reforms would help? What are the special challenges faced by rural areas? How are these reforms incorporated into Medicare versus the private insurance market?
- Are we educating enough primary care providers to sustain an increase in access?
- If not, how can policy changes attract more to that field? What has Massachusetts’ experience been with primary care capacity after their reform efforts?
- Are things like retail clinics helping to alleviate the shortage?
Congress and the President will get this done this year. Senators Claire McKaskill and Arlen Spector braved the disruptors today in town hall meetings. And President Obama held one in New Hampshire that gathered a huge, friendly, and at times a bit contentious, crowd. He sought out critics' questions.
Give support to Senator Ted Kennedy who lost his sister, Eunice Kennedy Shriver, and to Senator Chris Dodd, who underwent surgery for prostate cancer this morning. His wife, Jackie reports that "it went very well." Best wishes for a quick and successful recovery, Sir.
[Post date - August 11, 2009]
See also Behind the Links, for further info on this subject.
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