Advocacy and policy news for internists
Will New Congress Make Headway on Health Reform?
Tactical questions on timing and scope of action remain
HealthDay News -- With Democratic majorities in the U.S. House and Senate and key health committee leaders poised to take action, the climate for health reform in 2009 -- by many accounts -- is favorable. But given the nation's economic challenges, how it plays out is anybody's guess.
President-elect Barack Obama's transition team must decide what to focus on initially, said Fred Hannett, a consultant specializing in federal health markets with The Capital Alliance in Washington D.C., a company that helps in developing strategic planning. "Are they going to do healthcare reform writ large right out of the box?" he reflected. "Or are they going to include pieces of healthcare reform (in other bills)?"
One possible vehicle is the State Children's Health Insurance Program (SCHIP), which comes up for reauthorization in March. Obama has pledged to expand SCHIP, but even that scenario raises tactical questions.
"Do you want to rack up an early win on a subject that's pretty popular?" asked Ed Howard, executive vice president of the Alliance for Health Reform in Washington, D.C. "Or do you want to use that as an attractive ornament on a much broader bill that might bring along a few people who wouldn't otherwise vote for it?"
Policy experts agree that whatever choices the administration makes will be impacted by the nation's economic decline. When Obama takes office in January, he'll inherit a federal budget deficit projected to reach $1 trillion in the current fiscal year, which began Oct. 1, 2008.
A new analysis by PricewaterhouseCoopers' Health Research Institute concludes that Obama's health reform plan would cost about $75 billion in 2009 and more than $1 trillion over 10 years. Those figures assume full implementation in 2009 and are based on the premise that Obama's plan would operate in a similar fashion as Massachusetts' health reform initiative.
Amid it all, Congressional health leaders are jockeying for a piece of the health reform action. In the Senate, Finance Committee Chairman Max Baucus (D-Mont.) unveiled his own blueprint for health reform on Nov. 13 (see related story). Sen. Edward M. Kennedy's (D-Mass.) staff has reportedly held meetings with health stakeholders for months to seize the opportunity to lead health reform once the new administration takes office.
In the House, Rep. John D. Dingell (D-MI), Chairman of the Energy and Commerce Committee, wrote a letter to Obama outlining key principles for health reform and expressing his desire to work with the president and his administration on moving legislation forward. He and Rep. Henry Waxman (D-Calif.), a longtime health reform advocate, are engaged in battle for committee control, splintering the party along ideological lines.
And therein lies the challenge for the House Speaker Rep. Nancy Pelosi (D- Calif.) who presides over a party with many factions, from the fiscally conservative Blue Dogs, the moderate New Democratic Coalition and Congressional Black Caucus, to the liberal-leaning Progressive Caucus.
"She's had to walk that minefield and constantly reach out and negotiate with each one of those groups for virtually every major piece of legislation, and healthcare reform is going to be no different," The Capital Alliance's Hannett said.
Obama is reportedly considering former South Dakota Senator Tom Daschle as his Secretary of Health and Human Services to help steer the process. The President-elect also brings a seasoned team with him who knows how things get done on the Hill and in the White House, which bodes well for avoiding the Clinton-era gaffs that doomed health reform in the 1990s.
"A lot of them have been through the wars and have the scars to prove it," Howard said, "and I'm sure they're make mistakes, but they won't likely make the same ones."
November 19, 2008
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Leadership Day, ACP's annual two-day advocacy event in Washington, enables members from across the country to bring ACP's issues to U.S. lawmakers. It's a great opportunity for ACP and its members to bring policy priorities to Congress and try to influence the legislative process on behalf of internal medicine. The registration deadline is May 1.
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Fri. Mar. 31, Examining the Rise in Prescription Drug Pricing and Costs (9:30am-10:30, Rm 1).
Sat. Apr. 1, 60 Minutes: Special Report on Hot Issues in Health Policy (9:30am-10:30, Rm 8), Climate Change: The Health Perspective (4:00pm-5:00, Rm 2).
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Thur. Mar. 30: Patients before Paperwork: What Can Be Done to Ease Administrative Burdens on Physicians and Their Patients? (8:15am-9:15, Rm 2), ACP's Dragon's Lair: Breathing Fire into Health Care Transformation (11:15am-12:45, Rm 14), Implementing Revenue-Positive and Time-Saving Adult Immunization in Your Practice (11:15 am-12:45, Rm 1), Hospital Inpatient Coding: Thinking inside the Box (2:15 pm-3:45, Rm 7), Opportunities for Subspecialists: Navigating Alternative Payment Models under MACRA (4:30pm-5:30, Rm 8),
Fri. Mar. 31: There Is No Place like Home: Why Patient-Centered Medical Homes and PCMH Specialty Practices Are Here to Stay (7:00am-8:00, Rm 7), Promise and Peril of Value-Based Payment: What Will You Be Measured On—and Will You Measure Up? (11:15am-12:45, Rm 8), More News You Can Use: Current Best Practice Advice (11:15 am-12:45, Rm 20A), MIPS Reporting: Managing the Health IT Challenges (11:15am-12:45, Rm 7), New Physician/Provider Boot Camp (11:15am-12:45, Rm 2), Outpatient Coding: Do It Right and Get Paid for What You Do (2:15pm-3:45, Rm 1), iPatient/Electronic Health Records (2:15pm-3:45, Rm 7), What May Change Your Practice Tomorrow: Hot Topics in Medical Informatics (4:30pm-5:30, Rm 2),
Sat. Apr. 1: C. Wesley Eisele Lecture: The Good, the Bad, and the Ugly: Physicians in the Digital Age (8:15am-9:15, Rm 7), Team-Based Care: Interprofessional Practice Innovations in Primary Care (11:15am-12:45, Rm 1), Billing and Coding: What You Didn’t Learn in Residency, and Why It Matters (11:15am-12:45, Rm 8), MIPS or APM: Making the Most of Medicare Payment (11:15am-12:45, Rm 7).
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Thur. Mar. 30: Looking Toward 2020: New Care Delivery Models Enabled by Existing and Near Future Technology (11:15am-12:45, Rm 7),
Fri. Mar. 31: Beyond the Hype and into the Real World: Making Mobile Health (mHealth) Matter for Your Practice (8:15am-9:15, Rm. 7), MIPS Reporting: Managing the Health IT Challenges (11:15am-12:45, Rm 7), iPatient/Electronic Health Records (2:15pm-3:45, Rm 7), What May Change Your Practice Tomorrow: Hot Topics in Medical Informatics (4:30pm-5:30, Rm 2),
Sat. Apr. 1: C. Wesley Eisele Lecture: The Good, the Bad, and the Ugly: Physicians in the Digital Age (8:15am-9:15, Rm 7), Blogging and Social Media in Health Care (8:15am-9:15, Rm 2), Telemedicine Use in Providing Quality Care (9:30am-10:30, Rm 7), What Physicians Really Need from EHRs to Be Successful in a Value-Based World (2:15pm-3:45, Rm 7), Wearables, Smartphones, Trackers—Oh My: The New Age of Patient Technologies (4:00pm-5:00, Rm 8).