Health Care Reform on the Back Burner

By John Ballard

No great words of wisdom from me.
But I do have a few links of interest. You want speculation? check out a few comments threads. You know what they say about opinions and assholes... everyone's got one. 

?Timothy Jost at Health Affairs blog has the most clearly written summary of where matters stand at the moment. He sums up near the start why health care as a commodity generates a lot more paper than health care as a right. 

...It is possible to write very short health reform bills only if you create a public insurance system. The Canada Health Act is 13 pages long, including the French translation (although there is more law implementing the bill at the provincial level). The current English National Health Services Act is 272 pages long. But if you want to build a health care system based on private rather than public insurance, things get much more complicated.

The summary that follows is easy to grasp but hard to swallow.

?The Kaiser Family Foundation has updated their interactive tool comparing various details of reform.
The House and Senate bills can be compared topically or printed out on a fairly easy to follow 24-page pdf file.
I was pleased to learn that the CLASS Act somehow got included in both bills. It hasn't got much attention but is as important to long-term care needs as collision insurance for new drivers.

It's interesting to see how many times the exact language of both bills is identical. Together they represent thousands of hours of work on the part of thousands of staff and resource people on all sides of the debate. I cannot imagine that all that effort, much of which is time-sensitive and interconnected by Washington Mouseprint, will be tossed aside. 

?For profit businesses (I refuse to call them "providers" because they are more concerned on taking than providing anything) are already salivating as they survey the sorry state of hospitals and related health care businesses. Our already overworked system groans under the financial weight of the recession, just as homeowners and other businesses find it harder to meet expenses. 

No health reform could mean more mergers

The top three publicly traded hospital chains--Community Health Systems Inc. in Franklin, Tenn., Health Management Associates Inc. (HMA) in Naples, Fla., and LifePoint Hospitals Inc. in Brentwood, Tenn.--may become more aggressive in acquiring financially precarious medical centers weakened by the recession and unable to project an increase in patient volume without the rush of newly insured patients that health reform would bring in, reports Bloomberg.

With roughly one-third of community hospitals posting operating losses in 2008, the going price for many medical centers has plunged by as much as half in the past three years, giving well-funded for-profit chains such as HMA "increased opportunities," says Senior Vice President Robert Farnham.

Nasty details and several links at the source for those who enjoy reading about bottom-feeders. To me this is something like business pornography. These predators are not far removed from pimps. After all I have read over the last year and a half, I have come to the conclusion that all health care providers should be not-for-profit and all health care insurance companies organized along the old "mutual" arrangements. Perhaps under those arrangements health care professionals would be properly compensated instead of having to share prescious premium dollars with executive and sales types. Don't get me started...

?Someone is finally waking up a few Democrats. Note the mergers and acquisitions item above...

Antitrust legislation for health insurers now the big reform issue...

In an attempt to get some sort of a win out of the seemingly lost health reform situation, House Democrats now are looking to reverse antitrust legislation for insurance companies. Those steps, however, appear to be the only ones being taken in what once was considered to be the most important issue facing America, the Wall Street Journal reports.

By repealing antitrust laws for health insurers, the hope is to reduce insurance prices in areas where one insurer gets the bulk of patients' business. Overall though, Democrats appear to be backing off of the notion of health reform, as a whole.

"Don't pin me down as to days or number of weeks," Senate Majority Leader Harry Reid (D-Nev.) said in regards to getting reform passed, who added that the plan is to get something done this year.

Several groups--including the AARP and the AMA--want the health reform efforts to continue. They feel that the more the issue gets pushed to the back burner, the more it ultimately will be forgotten completely.

Some Democrats believe that reconciliation--in which the House would have to pass the version of the reform bill passed by the Senate on Dec. 24 with a few "modifications"--is the best chance for something to get done.

I came across the same news at Emptywheel so there may be something to it.

?000?

That's all I have tonight. If I had to recommend one link from above it is the Kaiser Family Foundation comparison file. I sprang for the time, ink and paper to print it out, a horizontal booklet 24 pages long. Not bad when you recall how much it took to get there. Anyone who wants to bitch about thousands of pages being too much to read simply hasn't been paying attention. That's like complaining that your doctor spent too many years in med school or had too many years of experience. Solid gold ignorance on sparkling display. With the Kaiser Cliff Notes there is no excuse.