For those of us in the healthcare policy field in Washington it has become as ritualistic as the changing of the seasons, the anticipation of the Masters Tournament in April or opening day in Major League Baseball – it’s known as “The Doc Fix.” For over a decade now, Congress has gone through the process of staving off reductions in payments to physicians under the Medicare program. Unfortunately, each year it does so, it gets more expensive to fix it permanently. It’s officially known as the sustainable growth rate (SGR) and the only thing sustainable about the growth rate in this instance is the frustration level most Members of Congress feel about having to go through this rite of passage every year or two. So, it is with great expectation and hope among many in Washington that we find ourselves nearing an agreement on a permanent solution to the madness we put ourselves through with too much regularity. (continue reading…)
Medicare Part D, the prescription drug program for America’s seniors, is a unique success story in how a government program can work effectively by harnessing the efficiencies and strengths of our private sector. Reformative in its approach, the program relies on the private sector to negotiate prices, set premiums and compete for customers on a level playing field.
Unfortunately, there are some in Congress who are pushing proposals that will undermine this popular program. With a 90 percent satisfaction rate among beneficiaries and a programmatic budget 40 percent below cost estimates, where is the wisdom in tinkering with it?
The “Super Committee” is tasked with finding $1.2 trillion in savings and one of the ideas is to impose new “rebates” on the manufacturers of the medicines low-income seniors use in the program. The justification requires a short history lesson.
Under the old system, some beneficiaries received their medicines through Medicaid because they were considered low-income first and seniors second. Under Medicaid, companies have to provide a rebate to the program for the volume of medicines used by its beneficiaries. Under the new Part D program, we treat seniors as seniors first and low-income second. The rebates previously siphoned off to the government have actually gone into discounts to the Part D plans making the program stronger and less expensive for beneficiaries. This is one of the many reasons the program is successful and highly popular among beneficiaries. (continue reading…)
Leaders of the Start Over! Coalition, including the National Association of Manufacturers, wrote Sen. Kay Bailey Hutchison (R-TX) to express support for her amendment (S.Amdt.197) to the pending small business bill, S. 493, that would suspend further implementation of the Patient Protection and Affordable Care Act.
From the letter:
As you know, the constitutionality of the Affordable Care Act (ACA) is now the subject of considerable litigation before the Federal courts. To date, the U.S. District Court for the Eastern District of Virginia, ruling in Virginia v. Sebelius, and the U.S. District Court for the Northern District of Florida, ruling in Florida et al v. U.S. Department of Health and Human Services, have ruled the “individual mandate” in the ACA unconstitutional, and the latter went on to rule that the “individual mandate” is not severable from the rest of the ACA thus voiding the entire statute. Three other Federal district courts in the District of Columbia, Michigan and Virginia have upheld the constitutionality of the ACA. It is a virtual certainty that the constitutional issues in controversy in the ACA will ultimately be resolved by the U.S. Supreme Court.
The timing and outcome of the legal process in this matter is speculative at best. What is currently certain, however, is that the Federal government is continuing to implement the ACA at considerable cost to the taxpayers. If the Northern District of Florida court’s decision is upheld, State governments which have proceeded with implementation facing considerable risks if they do not do so, will have needlessly expended considerable sums of their taxpayers’ money. It is no small matter that employers find themselves similarly and expensively caught between a judicial ruling that invalidates the ACA and an Administration in Washington, DC that insists on plowing ahead with implementation as though this matter had never arisen.
Under the present circumstances we believe it is simply prudent to impose a moratorium on further implementation of the ACA until such time as the pending litigation is brought to its conclusion. This is exactly what the Hutchison Amendment would accomplish.
Earlier Shopfloor posts on Start Over!
The most puzzling of all the decisions that went into the legislative maneuvering that gave us the benighted Patient Protection and Affordable Care Act a year ago today was, why no acronym-inviting title? You would have thought if Congress was going to so dramatically expand the federal government’s control of health care and insurance, it would embrace a grandiose, if forced, title that would give us an acronym for the ages.
You know, like the PATRIOT Act, or RICO, or last year’s SPEECH Act (Securing the Protection of our Enduring and Established Constitutional Heritage Act). Give the law a name to remember it by.
No such luck. Democrats and other supporters usually drop the “Patient Protection” part to refer to the law as simply by the anodyne Affordable Care Act. Republicans deride it as Obamacare.
Such a missed opportunity for truth in acronymization. Is it too late? If not …
- The HEALTH Act — Helping Eliminate Affordable, Life-extending Treatments, Hospitalization Act
- The NANNY Act — The Not Affordable, Nope, Not Yet Act
- ABCDE Act — A Bill that Cost Democrats Election Act
Oh well. Some good commentary as the anniversary festivities subside…
- Sen. Ron Johnson (R-WI), a manufacturer, Wall Street Journal, “ObamaCare and Carey’s Heart: My daughter probably wouldn’t have survived in a system where bureaucrats stifle innovation and ration care.”
- Heritage Foundation, The Foundry blog, “Obamacare’s Failed First Year“
- Dr. Jason Fodeman and Dr. David Gratzer, The Washington Times, “Obamacare: One year later –Stripping patients and doctors of authority over care“
- Joe Trauger, National Association of Manufacturers, Shopfloor blog, “Health Care Law at One Year: Little Protection, Not So Affordable”
- Editorial, Washington Examiner, “Obamacare is even worse than critics thought“
NAM President John Engler mentioned the medical device industry in remarks at the Managing Automation Summit in Palm Beach, Fla., yesterday, remarking that it was one of the industries where U.S. industry is an indisputable global leader. And how does Congress treat this center of competitiveness and innovation? By taxing it to pay for an expansion of health care?
Here’s the inevitable response, via The Boston Herald, “Mass. device firms see health law as burden“:
Massachusetts medical-device companies say they’ll cut back on operational costs – and jobs – after a planned 2.3 percent tax on their products is implemented in 2013, according to a new survey.
The Massachusetts Medical Device Industry Council, which held its annual meeting yesterday in Boston, said about 90 percent of the 100 medical-device firms said they would reduce costs due to the new tax tucked into the recently passed health-care reform bill.
The tax – imposed to help pay for the massive health-care industry overhaul and expansion – is “of the greatest concern” to a majority of its members, the survey found.
MassDevice, an online trade publication, also covers the survey, “Survey: Device tax could force job cuts, higher prices.”
From Kaiser Health News, a roundup of the big health care news from last week, “CMS Actuary: Health Reform Will Cover More People, Cost More Than Orginally Projected,” starting with a paragraph from AP:
Economic experts at the Health and Human Services Department concluded in a report issued Thursday that the health care remake will achieve Obama’s aim of expanding health insurance — adding 34 million to the coverage rolls. But the analysis also found that the law falls short of the president’s twin goal of controlling runaway costs, raising projected spending by about 1 percent over 10 years. That increase could get bigger, since Medicare cuts in the law may be unrealistic and unsustainable, the report warned.
In an April 1 blog post at OMB, Office of Management and Budget Director Peter Orszag took strenuous issue with critics of the health care bill who argued it would not “bend the cost curve downward.” Excerpt:
[In] response to some of the recent skepticism, OMB’s staff went back through the document that the Congressional Budget Office released last June entitled “Health Care Reform and the Federal Budget.” In this analysis, CBO discussed the potential effects of health reform on Federal government expenditures, and identified policy options that could increase efficiency in the health care system.
If you look at the policy options CBO assessed as having the biggest potential for reducing long-term health care cost-growth, you will see that a vast majority of these proposals are, in some form, part of the historic health care reform legislation the President signed into law…
- Rep. John Kline (R-MN), “CMS Analysis Confirms Government Takeover of Health Care Will Increase Costs, Undermine Existing Coverage for Millions”
- Heritage Foundation, “Side Effects: It’s Official- Higher Health Care Costs“
- The Hill, “Government report: Health law could hike prices, make employers drop coverage “
The Washington Post today unveils its new weekly business supplement, Capital Business, inserted in a trial run in home-delivery copies and available online in a digital version. MediaDailyNews.com summarizes:
Headed by editor Dan Beyers, the new business title will offer a mix of enterprise reporting, analysis and commentary, industry trend-watching, and profiles of local entrepreneurs and businesses, with coverage of government contracting, tech, finance, real estate and legal issues. Beyers said: “Capital Business is intended to help the business community navigate the region’s dynamic economy at a time of great change and opportunity.”
Noting the “extraordinary emergence” of the capital-area business scene, Steve Hills, The Washington Post‘s president and general manager, promised: “Every issue should produce a potential lead to a business opportunity or tell our business audience something they didn’t know.”
Good luck. The Post dropped its separate business section a while ago, and it’s good to see coverage coming back in another form.
Today’s lead story does say lots about the local economy, that is, its reliance on government, “The pieces are in place for the next great burst of business across the region“:
The pieces are now in place for the next great burst of business in Washington. There is a new wave of government activism underway, and with it, new opportunities for the private sector: Cutting down on paperwork in the health-care system, developing greener energy supplies, making information more secure, overhauling education. And following the last three booms, Washington has more skilled workers and capacity for businesses to grow than ever — including hundreds of now-seasoned executives who have built companies, and are ready to do it again.
Makes you wonder whether there was a piece in the Post or Star or other Washington newspapers in early 1942, “Boom Time: Local businesses to expand to serve overseas activism.”
In other Washington Post specials, Politico reports, “Health care reform: The book!“:
A few weeks back, publisher PublicAffairs and the Washington Post announced they were teaming up for an “instant” book on the recent passage of health care reform.
“Landmark: The Inside Story of America’s New Health-Care Law and What It Means For Us All” will come out April 26, earlier than expected since “the project has moved exceptionally quickly,” according to PublicAffairs publicity director Jaime Leifer. “[T]his book will be the first book on the new health care law, and will answer our most pressing questions about the legislation’s impact on individuals, small businesses, and the health-care industry.”
NEW YORK — A substantial number of heart doctors — about one in four — say they order medical tests that might not be needed out of fear of getting sued, according to a new study.
Nearly 600 doctors were surveyed for the study to determine how aggressively they treat their patients and whether non-medical issues have influenced their decisions to order invasive heart tests.
Most said they weren’t swayed by such things as financial gain or a patient’s expectations. But about 24 percent of the doctors said they had recommended the test in the previous year because they were worried about malpractice lawsuits.
That would be a good issue to address in federal health care legislation, don’t you think?
Hat tip: Bob McCarty Writes
Hugh Hewitt, the radio talk show host, blogger, law professor and all-around good guy, on Monday interviewed Commissioner Anne Northup of the Consumer Product Safety Commission, and the transcript of the conversation is now up at HughHewitt.com.
Hugh accurately expresses the astonishment and frustration of business people in trying to figure out and respond to the Consumer Product Safety Improvement Act (CPSIA), and Northup, a former Republican member of Congress, confirms that the law is excessive, complicated and disconnected from reality. The discussion of lead content is good, and we appreciate her reaction to efforts now under way in Congress to “fix” the CPSIA.
HH: And the regulatory burden, I know, because many of them are our clients, people don’t know how to interpret this. They write in, they have to hire expensive lawyers to go get exemptions from you. It must be a morass at the building.
AN: Well, and we’re not giving any exemptions. So far, there hasn’t been a vote to give exemptions. And so they’re trapped in figuring out how they’re going to make this. And you know, I think there’s the ATV, the bicycle people, I mean, who sucks on their bicycle handlebars at six years old? And you know, even if you did, you couldn’t swallow enough lead that it would register a change in your blood lead level.
HH: And Congress won’t fix it. I saw Chairman Waxman has proposed an amendment on your blog, and your blog has dissected it. It’s not really that helpful. In fact, it might make things worse.
AN: It really isn’t helpful. It’s really meant to solve the political problem he has from the ATV people. They obviously are very organized. It’s very serious for them. They have children’s, smaller ones that are safer for children, and they’ve had to take them off the market. But you know, I mean, it has all these hoops you have to jump through. You have to prove that you can’t make it officially, you can’t make it, that it’s not practical, that there’s no substitute material, you have to say how you’re going to get into compliance over the next few years, you have to prove…here’s what’s funny. I think the third qualification is you have to prove that it doesn’t harm the health or safety of a child. Well Hugh, if it doesn’t harm the health or safety of a child, why are we even regulating it? What else do we have to prove?
The conversation occurred at a meeting of the Sporting Goods Manufacturers Association. Hewitt also addresses a topic we’ve broached before: If Congress can’t get the CPSIA right, how can it expect to restructure the entire U.S. health care and insurance system?
An editorial in The Washington Times today notes President Obama’s prominent pledges of being open to adopt Republican-supported plans for medical liability reform in the health care bill. From “Trial lawyers love Obamacare“:
Those pledges – which Mr. Obama made twice in major public forums – were worthless. The final version of Obamacare, as signed into law, is a dream come true for big-money plaintiffs’ lawyers.
That was the message in a letter the president of the American Association for Justice wrote to his membership and posted on the group’s Web site. The misnamed AAJ – which was formerly and more accurately called the Association of Trial Lawyers of America – is the house organ for the national plaintiffs’ bar and a major source of campaign cash for congressional Democrats.
Reporting on reformers’ efforts to protect doctors and hospitals from predatory lawsuits, AAJ President Anthony Tarricone wrote, “I am very pleased to report that the health care bill is clear of any [such] provisions. … While there is a provision for demonstration projects, it provides an absolute opt-out clause for plaintiffs at any time.”
Tarricone’s tone is boastful and his claims dishonest. From his e-mail message, posted at the AAJ website.
Whether reading the newspaper or watching C-SPAN, all of you saw the constant assault against trial lawyers and injured patients. Many opponents of these health care bills had no substantive solutions of their own, and in turn, levied attacks on our clients. It was distressing, but at the same time, it was our call-to-action.
Who attacked injured patients? Who levied attacks on the AAJ’s clients? No one we ever saw. The charge is just big lie buncombe. As for “no substantive solutions of their own,” we direct you to the National Association of Manufacturers’ health care principles, which highlights substantive solutions to the failures of U.S. health care, it should go without saying, do not attack injured patients. Separately, Republican members of Congress proposed detailed alternatives to the President’s plan, including medical liability reform.
We do not yet find the final statutory language on the state demonstration projects, but the Kaiser Family Foundation has summarized the provision:
Medical malpractice * Award five-year demonstration grants to states to develop, implement, and evaluate alternatives to current tort litigations. Preference will be given to states that have developed alternatives in consultation with relevant stakeholders and that have proposals that are likely to enhance patient safety by reducing medical errors and adverse events and are likely to improve access to liability insurance. (Funding appropriated for five years beginning in fiscal year 2011)
What’s missing? Any provisions addressing cost control. And for that, the trial lawyers are celebrating.
- Wall Street Journal, “New Law Deals Setback to Malpractice Foes”
- Wall Street Journal Law Blog, “On Tort Reform and the Health-Care Bill: Where’d We End Up?”
- Point of Law, “Now that health care bill is law, trial lawyers free to boast“
- Legal NewsLine, “Trial lawyers’ group claims victory”
A note about media coverage: The Point of Law post was written by this blogger, and Legal NewsLine is a web publication backed by the U.S. Chamber of Commerce. The Washington Times piece is an editorial.
So the only major media outlet to cover as news the trial lawyers’ boasting about blocking health care reform is The Wall Street Journal. A salute to the WSJ, but where are the other reporters who are usually so quick to decry the role of special interests and lobbyists in the health care debate?