Health Care

And I thought yesterday was crazy. Brian Beutler has sources telling him that Senate Majority Leader Harry Reid is close to rounding up 60 votes for an "opt-out" public option, but that the White House is trying to slam on the brakes. The main reason? Republican Senator Olympia Snowe, whose support the White House covets, is against the idea and prefers some sort of trigger. One source tells Beutler:  They're skeptical of opt out and are generally deferential to the Snowe strategy that involves the trigger...

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AHIP Gets Punk'd!

Slipping their way past the tight security at the Capitol Hilton, liberal activists from a group called “Billionaires for Wealthcare” interrupted AHIP pollster Bill McInturff as he took the stage for the closing speech of the insurance lobby’s conference this morning. About five activists who had infiltrated the conference, wearing business suits and pearls, burst out into a rendition of “Tomorrow” from the musical Annie. “Just give me a pu-blic option! We can sniff out waste just like a dauschaund—costs come down!” they sang to the insurer-friendly audience. “The option, the option!

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Thursday was as crazy a day as I've seen in Washington. The flurry of legislative activity over the public insurance option--and the flurry of media coverage it generated--made it difficult to keep up and, at times, to separate truth from rumor or hyperbole. But over the course of the day, one thing became increasingly clear. At least for the moment, the debate isn't over whether to include a public option. It's over what kind. Brian Beutler and Carrie Budoff Brown have the essentials on the Senate situation.

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“Are they going to try to storm the building?” a man in a dark business suit asked a colleague inside the Capitol Hilton ballroom, during a break in the America's Health Insurance Plans (AHIP) conference this afternoon. “Or are we not going to let that happen?” Directly outside the Hilton's well-guarded doors, about a hundred protesters had gathered to denounce the rapacious insurance executives they believed to be inside the Hilton.

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Speaking beneath the twinkling crystal chandeliers of the Capitol Hilton ballroom this morning, America’s Health Insurance Plans (AHIP) president Karen Ignagni declared that the insurance industry is still on board with the Democratic health care reform effort, pushing back against the presumption that the two sides have declared war. “Our community was one of the first to position ourselves very actively to a massive overhaul of the insurance market,” Ignagni told the audience members, who were attending the organization’s conference on state insurance issues.

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Trigger Unhappy

Jacob S. Hacker is the Stanley B. Resor Professor of Political Science at Yale University. An expert on the politics of U.S. health and social policy, he is author, coauthor, or editor of numerous books and articles, both scholarly and popular, including The Great Risk Shift: The New Economic Insecurity and the Decline of the American Dream (2006; paperback, January 2008) and Health At Risk: America’s Ailing Health System and How to Heal It (2008). As closed-door discussions continue in the Senate, the idea of triggering the public health insurance option is once again on the table.

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How Pharma Won

Time's Karen Tumulty and Michael Scherer have a thoroughly enlightening, and thoroughly depressing, article in the new Time about how the drug industry got its way in health care reform. The industry spends more than $600,000 a day in lobbying, they note. And, from the looks of things, it's money well spent. The focus of the article is the debate over "exclusivity" for biological drugs--that is, the period during which the maker of a drug can manufacture and sell it without threat of generic competition.

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Doctors, who didn't win repeal of Sustainable Growth Rate formula in Medicare (Jay Newton-Small, Time) The insurance industry, which has turned out to be its own worst enemy (Paul Waldman, The American Prospect) The Washington media, which has all too predictably failed to tell an accurate story about the politics of the public option (Timothy Noah, Slate) Oh, and if you're going to read one thing today, check out Austin Frakt's post about low-income people with chronic health conditions or disabilities. Why does this matter?

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Show some CLASS

Harold Pollack is a professor at the University of Chicago School of Social Service Administration and Special Correspondent for The Treatment. Imagine that you walk outside your home one rainy morning to get your morning paper. You slip and fall on your slippery front steps, breaking your back and suffering irreparable spinal cord damage. Even if you have perfect medical insurance, you would quickly discover that you would need a lot of help. You might need a home health care aid. You might need ramps and equipment for your house, a handicap-accessible van.

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This is the second installment of our new feature: Curbside Consult. For the uninitiated, curbside consults are a venerable medical tradition, whereby a doctor seeks informal advice from an experienced colleague in treating a patient with a complex condition. In covering or understanding complex health and social policies, we need sometimes help too. Today’s interview is with Katherine Swartz, PhD. She is Professor of Health Economics and Policy at the Harvard School of Public Health.

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