Barbara --
Although it's Christmas Eve, I wanted to share some exciting news: The Senate just passed a historic health reform bill.
In all the back and forth, it's easy to lose sight of what this incredible breakthrough really means. But consider this: This Christmas, there are millions of Americans without health insurance who risk losing everything if they get sick.
There are mothers and fathers who wonder how they'll provide for their children because an illness has wiped out their savings. There are small business owners who worry that they'll have to lay off a long-time employee because the cost of insurance is rapidly rising.
If we finish the job, all this can change. We will have beaten back the special interests who have for so long perpetuated the status quo. We will have enacted the most important piece of social policy since the Social Security Act in the 1930s, and the most important health reform since Medicare in the 1960s.
In Decembers to come, millions more will have access to affordable coverage. Parents will have the security and stability of knowing their insurance can't be revoked at a moment's notice. And the skyrocketing costs plaguing our small businesses will be brought under control.
When you make calls, write letters, organize, this is the change you're making -- a better life for your family and for men and women in every state.
There is still more to do before I can sign reform into law -- a last round of negotiations and final votes in the Senate and the House -- and I'm counting on your help every step of the way. But for now, I hope that as you celebrate this holiday season, you remember that the work you are doing is making our union more perfect, one step at a time. For that, I am grateful to you.
Merry Christmas and happy holidays,
President Barack Obama
P.S. -- Organizing for America supporters are signing a note of appreciation to all the senators who have worked so hard to make this possible. I hope you'll join them:
http://my.barackobama.com/SenateLetter
Thursday, December 24, 2009
Friday, December 4, 2009
Report: Hospitals barely broke even
New Jersey's ailing hospital industry eked out its smallest profit in a decade last year, according to the latest annual financial state-of-the-state of hospitals report.
The report comes as outgoing Gov. Jon Corzine has targeted hospitals for an unspecified number of cuts to close a $1 billion budget gap. Hospital executives say this report explains why the state should look elsewhere to save money.
"New Jersey has a state full of hospitals teetering on the edge,'' New Jersey Hospital Association president and CEO Betsy Ryan said yesterday, noting there have been six bankruptcies and nine closures in two years.
"Hospitals across the state have already implemented layoffs and reduced services. Further cuts could only cause more harm, at a time when many newly uninsured New Jerseyans are turning to hospitals as their safety net," Ryan said.
The report is based on the combined 2008 financial statements from 95 percent of the 74 acute care hospitals in New Jersey. No hospital is identified by name.
Although the vast majority of New Jersey's hospitals are nonprofit entities, they strive to turn a modest margin so they can invest in new technology, expand services and maintain facilities.
But hospitals barely broke even in 2008, netting an average 0.2 percent profit, the report said. The statewide profit margin was 1.3 percent in 2007.
Sean Hopkins, the association's senior vice president of health economics, said the state and federal governments bear a large share of the blame, given that about half of New Jerseyans get their health care from Medicare, Medicaid and charity care.
Medicare reimburses hospitals 89 cents for every dollar spent on treatment, Medicaid pays 66 cents on the dollar and the state's charity care program provides an average of 42 cents for every dollar spent on uninsured patients, Hopkins said.
Having the government as a customer is at least a guarantee of some payment, said Joel Cantor, director of the Rutgers Center for Health Policy in New Brunswick.
"Health care is not recession-proof. But because Medicare is so important and recession-proof, things are not quite as dire as it is in other industries.''
But Cantor said the report shows that the economy continues to weaken an industry that has historically been an economic powerhouse.
"The forces that were in play are still in play -- tight reimbursement rates, competition with physician-owned ambulatory care centers is drawing a lot of revenue out of hospitals. That leads to continued stress,'' Cantor said. "That, overlaid with the recession, can't help.''
source
The report comes as outgoing Gov. Jon Corzine has targeted hospitals for an unspecified number of cuts to close a $1 billion budget gap. Hospital executives say this report explains why the state should look elsewhere to save money.
"New Jersey has a state full of hospitals teetering on the edge,'' New Jersey Hospital Association president and CEO Betsy Ryan said yesterday, noting there have been six bankruptcies and nine closures in two years.
"Hospitals across the state have already implemented layoffs and reduced services. Further cuts could only cause more harm, at a time when many newly uninsured New Jerseyans are turning to hospitals as their safety net," Ryan said.
The report is based on the combined 2008 financial statements from 95 percent of the 74 acute care hospitals in New Jersey. No hospital is identified by name.
Although the vast majority of New Jersey's hospitals are nonprofit entities, they strive to turn a modest margin so they can invest in new technology, expand services and maintain facilities.
But hospitals barely broke even in 2008, netting an average 0.2 percent profit, the report said. The statewide profit margin was 1.3 percent in 2007.
Sean Hopkins, the association's senior vice president of health economics, said the state and federal governments bear a large share of the blame, given that about half of New Jerseyans get their health care from Medicare, Medicaid and charity care.
Medicare reimburses hospitals 89 cents for every dollar spent on treatment, Medicaid pays 66 cents on the dollar and the state's charity care program provides an average of 42 cents for every dollar spent on uninsured patients, Hopkins said.
Having the government as a customer is at least a guarantee of some payment, said Joel Cantor, director of the Rutgers Center for Health Policy in New Brunswick.
"Health care is not recession-proof. But because Medicare is so important and recession-proof, things are not quite as dire as it is in other industries.''
But Cantor said the report shows that the economy continues to weaken an industry that has historically been an economic powerhouse.
"The forces that were in play are still in play -- tight reimbursement rates, competition with physician-owned ambulatory care centers is drawing a lot of revenue out of hospitals. That leads to continued stress,'' Cantor said. "That, overlaid with the recession, can't help.''
source
Kindred Hospital Modesto to close
MODESTO, Calif.,12/02/2009 — Kindred Hospital Modesto will be closing its doors after the healthcare company that operates it said it couldn't find a buyer.
Kindred Healthcare Inc. announced Wednesday that it would be shutting down the 64-bed facility.
The Kentucky-based provider of long-term healthcare services said last year it was putting the hospital up for sale because it was no longer profitable.
A notice filed with local government officials say the closure will put 127 employees out of work.
Before the facility is closed some time early next year, Kindred will be required to follow a state-approved closure plan for identifying the health needs of patients and moving them to new care facilities.
source
Kindred Healthcare Inc. announced Wednesday that it would be shutting down the 64-bed facility.
The Kentucky-based provider of long-term healthcare services said last year it was putting the hospital up for sale because it was no longer profitable.
A notice filed with local government officials say the closure will put 127 employees out of work.
Before the facility is closed some time early next year, Kindred will be required to follow a state-approved closure plan for identifying the health needs of patients and moving them to new care facilities.
source
Saturday, November 21, 2009
Historic health care bill nears key Senate vote
In a show of unity, Senate Democrats sealed a 60-vote majority needed to advance health care legislation Saturday ahead of an evening showdown with Republicans eager to doom the bill and inflict a punishing defeat on President Barack Obama.
Two final holdouts, Sens. Mary Landrieu of Louisiana and Blanche Lincoln of Arkansas, announced in speeches a few hours apart on the Senate floor they would vote to clear the way for what is expected to be a bruising, full-scale health care debate after Thanksgiving.
At a 10-year cost approaching $1 trillion, the measure is designed to extend coverage to roughly 31 million who lack it, crack down on insurance company practices that deny benefits, and curtail the growth of spending on medical care nationally.
"It is clear to me that doing nothing is not an option," said Landrieu, who noted the legislation includes $100 million to help her state pay the costs of health care for the poor.
Lincoln, who faces a tough re-election next year, said the evening vote will "mark the beginning of consideration of this bill by the U.S. Senate, not the end."
Both stressed they were not committing in advance to vote for the bill that ultimately emerges from next month's debate. Even so, their announcements marked a major victory for Senate Majority Leader Harry Reid, D-Nev., and the White House in a year-end drive to enact the most sweeping changes to the nation's health care system in a half-century or more.
The legislation would require most Americans to carry insurance, and large firms would incur large costs if they did not provide it to their workforce.
Congressional budget analysts put the legislation's cost at $979 billion over a decade and said it would reduce deficits over the same period while extending coverage to 94 percent of the eligible population.
The House approved its version of the bill earlier this month on a near party line vote of 220-215.
In hours of debate before the Saturday evening vote, Republicans attacked the legislation as a government takeover of health care and worse.
"Move over, Bernie Madoff. Tip your hat to a trillion-dollar scam," said Sen. Kit Bond, R-Mo., likening the bill's supporters to the imprisoned investor who fleeced millions.
Sen. Judd Gregg, R-N.H., said Reid had delayed implementation of many of the bill's key provisions and made it look less costly as a result. He put the true price tag at $2.5 trillion over a decade once implemented.
"Senators who support this bill have a lot of explaining to do," said the Republican leader, Sen. Mitch McConnell of Kentucky. "Americans know that a vote to proceed on this bill is a vote for higher premiums, higher taxes and massive cuts to Medicare. That's a pretty hard thing to justify supporting."
That was a rebuttal to Landrieu and other Democrats who described the evening vote as one of procedure instead of substance.
In her remarks, Landrieu said, "I've decided that there are enough significant reforms and safeguards in this bill to move forward, but much more work needs to be done." She also touted the $100 million included in the legislation to help her state cover its costs under Medicaid, the state-federal health care program for the poor.
"I'm proud to have fought for it. And I will continue to," she said.
Reid worked for weeks drafting the legislation, a blend of bills approved earlier by two committees with new provisions designed to straddle the ideological divide among Senate Democrats.
Among the most controversial is a requirement for the government to sell insurance in competition with private industry, unless individual states opt out.
Landrieu, Lincoln and other Democrats have expressed unease about it, and attempts to modify the so-called public option are certain once debate begins in earnest. One possibility would require the federal government stay out of the insurance business unless there was a shortage of competition or affordable coverage offered by private companies.
At its core, the legislation would create insurance exchanges beginning in 2014 where individuals, most of them lower income and uninsured, would shop for coverage. The bill sets aside hundreds of billions of dollars in tax credits to help those earning up to 400 percent of poverty, $88,200 for a family of four.
Additional funds would be available to help small businesses defray the cost of providing coverage to their employees.
The insurance industry would come under significant new regulation under the bill, which would first ease and then ban the practice of denying coverage on the basis of pre-existing medical conditions. Beginning in 2014, there would be no limits on lifetime coverage. Effective immediately, children could remain on their parents' insurance policies until age 26, three years longer than under current law, another attempt to cut into the ranks of the uninsured.
Individuals would be required to purchase coverage or pay a fine, unless affordable coverage was not available. Larger employers would not be required to provide coverage, but would face penalties if they did not and any of their workers received federal subsidies to buy individual coverage.
To finance the expanded coverage, Reid proposed higher taxes as well as cuts totaling hundreds of billions of dollars in projected Medicare payments. Hardest hit would be the private insurance Medicare plans, although providers such as home health agencies would also receive significantly less in future years than now estimated.
The bill raises payroll taxes on incomes over $200,000 for individuals and $250,000 for couples. Reid eased the impact of an earlier proposal to tax high-value insurance plans, which has emerged as one of the principal methods for restraining the growth in health costs.
The bill includes tax increases on insurance companies, medical device makers, patients electing to undergo cosmetic surgery and drugmakers.
source
Two final holdouts, Sens. Mary Landrieu of Louisiana and Blanche Lincoln of Arkansas, announced in speeches a few hours apart on the Senate floor they would vote to clear the way for what is expected to be a bruising, full-scale health care debate after Thanksgiving.
At a 10-year cost approaching $1 trillion, the measure is designed to extend coverage to roughly 31 million who lack it, crack down on insurance company practices that deny benefits, and curtail the growth of spending on medical care nationally.
"It is clear to me that doing nothing is not an option," said Landrieu, who noted the legislation includes $100 million to help her state pay the costs of health care for the poor.
Lincoln, who faces a tough re-election next year, said the evening vote will "mark the beginning of consideration of this bill by the U.S. Senate, not the end."
Both stressed they were not committing in advance to vote for the bill that ultimately emerges from next month's debate. Even so, their announcements marked a major victory for Senate Majority Leader Harry Reid, D-Nev., and the White House in a year-end drive to enact the most sweeping changes to the nation's health care system in a half-century or more.
The legislation would require most Americans to carry insurance, and large firms would incur large costs if they did not provide it to their workforce.
Congressional budget analysts put the legislation's cost at $979 billion over a decade and said it would reduce deficits over the same period while extending coverage to 94 percent of the eligible population.
The House approved its version of the bill earlier this month on a near party line vote of 220-215.
In hours of debate before the Saturday evening vote, Republicans attacked the legislation as a government takeover of health care and worse.
"Move over, Bernie Madoff. Tip your hat to a trillion-dollar scam," said Sen. Kit Bond, R-Mo., likening the bill's supporters to the imprisoned investor who fleeced millions.
Sen. Judd Gregg, R-N.H., said Reid had delayed implementation of many of the bill's key provisions and made it look less costly as a result. He put the true price tag at $2.5 trillion over a decade once implemented.
"Senators who support this bill have a lot of explaining to do," said the Republican leader, Sen. Mitch McConnell of Kentucky. "Americans know that a vote to proceed on this bill is a vote for higher premiums, higher taxes and massive cuts to Medicare. That's a pretty hard thing to justify supporting."
That was a rebuttal to Landrieu and other Democrats who described the evening vote as one of procedure instead of substance.
In her remarks, Landrieu said, "I've decided that there are enough significant reforms and safeguards in this bill to move forward, but much more work needs to be done." She also touted the $100 million included in the legislation to help her state cover its costs under Medicaid, the state-federal health care program for the poor.
"I'm proud to have fought for it. And I will continue to," she said.
Reid worked for weeks drafting the legislation, a blend of bills approved earlier by two committees with new provisions designed to straddle the ideological divide among Senate Democrats.
Among the most controversial is a requirement for the government to sell insurance in competition with private industry, unless individual states opt out.
Landrieu, Lincoln and other Democrats have expressed unease about it, and attempts to modify the so-called public option are certain once debate begins in earnest. One possibility would require the federal government stay out of the insurance business unless there was a shortage of competition or affordable coverage offered by private companies.
At its core, the legislation would create insurance exchanges beginning in 2014 where individuals, most of them lower income and uninsured, would shop for coverage. The bill sets aside hundreds of billions of dollars in tax credits to help those earning up to 400 percent of poverty, $88,200 for a family of four.
Additional funds would be available to help small businesses defray the cost of providing coverage to their employees.
The insurance industry would come under significant new regulation under the bill, which would first ease and then ban the practice of denying coverage on the basis of pre-existing medical conditions. Beginning in 2014, there would be no limits on lifetime coverage. Effective immediately, children could remain on their parents' insurance policies until age 26, three years longer than under current law, another attempt to cut into the ranks of the uninsured.
Individuals would be required to purchase coverage or pay a fine, unless affordable coverage was not available. Larger employers would not be required to provide coverage, but would face penalties if they did not and any of their workers received federal subsidies to buy individual coverage.
To finance the expanded coverage, Reid proposed higher taxes as well as cuts totaling hundreds of billions of dollars in projected Medicare payments. Hardest hit would be the private insurance Medicare plans, although providers such as home health agencies would also receive significantly less in future years than now estimated.
The bill raises payroll taxes on incomes over $200,000 for individuals and $250,000 for couples. Reid eased the impact of an earlier proposal to tax high-value insurance plans, which has emerged as one of the principal methods for restraining the growth in health costs.
The bill includes tax increases on insurance companies, medical device makers, patients electing to undergo cosmetic surgery and drugmakers.
source
Monday, November 16, 2009
Uninsured Twice as Likely to Die in ER
New Study on Patients with Traumatic Injuries Surprises Doctors and Health Experts who Believed ER Care was Equitable
Uninsured patients with traumatic injuries, such as car crashes, falls and gunshot wounds, were almost twice as likely to die in the hospital as similarly injured patients with health insurance, according to a troubling new study.
The findings by Harvard University researchers surprised doctors and health experts who have believed emergency room care was equitable.
"This is another drop in a sea of evidence that the uninsured fare much worse in their health in the United States," said senior author Dr. Atul Gawande, a Harvard surgeon and medical journalist.
The study, appearing in the November issue of Archives of Surgery, comes as Congress is debating the expansion of health insurance coverage to millions more Americans. It could add fodder to that debate.
The United States is the only developed nation that does not have a comprehensive national health care plan for all its citizens, leaving about 50 million of America's roughly 300 million people uninsured. President Barack Obama, who took office in January, campaigned on a promise of offering affordable health care to all Americans.
The researchers couldn't pin down the reasons behind the differences they found. The uninsured might experience more delays being transferred from hospital to hospital. Or they might get different care. Or they could have more trouble communicating with doctors.
The hospitals that treat them also could have fewer resources.
"Those hospitals tend to be financially strapped, not have the same level of staffing, not have the same level of surgeons and testing and equipment," Gawande said. "That also is likely a major contributor."
Gawande favors health care reform and has frequently written about the inequities of the current system.
The researchers took into account the severity of the injuries and the patients' race, gender and age. After those adjustments, they still found the uninsured were 80 percent more likely to die than those with insurance — even low-income patients insured by the government's Medicaid program.
"I'm really surprised," said Dr. Eric Lavonas of the American College of Emergency Physicians and a doctor at Denver Health Medical Center. "It's well known that people without health insurance don't get the same quality of health care in this country, but I would have thought that this group of patients would be the least vulnerable."
Some private hospitals are more likely to transfer an uninsured patient than an insured patient, said Lavonas, who wasn't involved in the new research.
"Sometimes we get patients transferred and we suspect they're being transferred because of payment issues," he said. "The transferring physician says, 'We're not able to handle this."'
Federal law requires hospital ERs to treat all patients who are medically unstable. But hospitals can transfer patients, or send them away, once they're stabilized. A transfer could worsen a patient's condition by delaying treatment.
The researchers analyzed data on nearly 690,000 U.S. patients from 2002 through 2006. Burn patients were not included, nor were people who were treated and released, or dead on arrival.
In the study, the overall death rate was 4.7 percent, so most emergency room patients survived their injuries. The commercially insured patients had a death rate of 3.3 percent. The uninsured patients' death rate was 5.7 percent. Those rates were before the adjustments for other risk factors.
The findings are based on an analysis of data from the National Trauma Data Bank, which includes more than 900 U.S. hospitals.
"We have to take the findings very seriously," said lead author Dr. Heather Rosen, a surgery resident at Los Angeles County Hospital, who found similar results when she analyzed children's trauma data for an earlier study. "This affects every person, of every age, of every race."
source
Uninsured patients with traumatic injuries, such as car crashes, falls and gunshot wounds, were almost twice as likely to die in the hospital as similarly injured patients with health insurance, according to a troubling new study.
The findings by Harvard University researchers surprised doctors and health experts who have believed emergency room care was equitable.
"This is another drop in a sea of evidence that the uninsured fare much worse in their health in the United States," said senior author Dr. Atul Gawande, a Harvard surgeon and medical journalist.
The study, appearing in the November issue of Archives of Surgery, comes as Congress is debating the expansion of health insurance coverage to millions more Americans. It could add fodder to that debate.
The United States is the only developed nation that does not have a comprehensive national health care plan for all its citizens, leaving about 50 million of America's roughly 300 million people uninsured. President Barack Obama, who took office in January, campaigned on a promise of offering affordable health care to all Americans.
The researchers couldn't pin down the reasons behind the differences they found. The uninsured might experience more delays being transferred from hospital to hospital. Or they might get different care. Or they could have more trouble communicating with doctors.
The hospitals that treat them also could have fewer resources.
"Those hospitals tend to be financially strapped, not have the same level of staffing, not have the same level of surgeons and testing and equipment," Gawande said. "That also is likely a major contributor."
Gawande favors health care reform and has frequently written about the inequities of the current system.
The researchers took into account the severity of the injuries and the patients' race, gender and age. After those adjustments, they still found the uninsured were 80 percent more likely to die than those with insurance — even low-income patients insured by the government's Medicaid program.
"I'm really surprised," said Dr. Eric Lavonas of the American College of Emergency Physicians and a doctor at Denver Health Medical Center. "It's well known that people without health insurance don't get the same quality of health care in this country, but I would have thought that this group of patients would be the least vulnerable."
Some private hospitals are more likely to transfer an uninsured patient than an insured patient, said Lavonas, who wasn't involved in the new research.
"Sometimes we get patients transferred and we suspect they're being transferred because of payment issues," he said. "The transferring physician says, 'We're not able to handle this."'
Federal law requires hospital ERs to treat all patients who are medically unstable. But hospitals can transfer patients, or send them away, once they're stabilized. A transfer could worsen a patient's condition by delaying treatment.
The researchers analyzed data on nearly 690,000 U.S. patients from 2002 through 2006. Burn patients were not included, nor were people who were treated and released, or dead on arrival.
In the study, the overall death rate was 4.7 percent, so most emergency room patients survived their injuries. The commercially insured patients had a death rate of 3.3 percent. The uninsured patients' death rate was 5.7 percent. Those rates were before the adjustments for other risk factors.
The findings are based on an analysis of data from the National Trauma Data Bank, which includes more than 900 U.S. hospitals.
"We have to take the findings very seriously," said lead author Dr. Heather Rosen, a surgery resident at Los Angeles County Hospital, who found similar results when she analyzed children's trauma data for an earlier study. "This affects every person, of every age, of every race."
source
Tuesday, November 10, 2009
Over 2,200 veterans died in 2008 due to lack of health insurance
A research team at Harvard Medical School estimates 2,266 U.S. military veterans under the age of 65 died last year because they lacked health insurance and thus had reduced access to care. That figure is more than 14 times the number of deaths (155) suffered by U.S. troops in Afghanistan in 2008, and more than twice as many as have died (911 as of Oct. 31) since the war began in 2001.
The researchers, who released their analysis today [Tuesday], pointedly say the health reform legislation pending in the House and Senate will not significantly affect this grim picture.
The Harvard group analyzed data from the U.S. Census Bureau’s March 2009 Current Population Survey, which surveyed Americans about their insurance coverage and veteran status, and found that 1,461,615 veterans between the ages of 18 and 64 were uninsured in 2008. Veterans were only classified as uninsured if they neither had health insurance nor received ongoing care at Veterans Health Administration (VA) hospitals or clinics.
Using their recently published findings in the American Journal of Public Health that show being uninsured raises an individual’s odds of dying by 40 percent (causing 44,798 deaths in the United States annually among those aged 17 to 64), they arrived at their estimate of 2,266 preventable deaths of non-elderly veterans in 2008. (See table.)
“Like other uninsured Americans, most uninsured vets are working people - too poor to afford private coverage but not poor enough to qualify for Medicaid or means-tested VA care,” said Dr. Steffie Woolhandler, a professor at Harvard Medical School who testified before Congress about uninsured veterans in 2007 and carried out the analysis released today [Tuesday]. “As a result, veterans go without the care they need every day in the U.S., and thousands die each year. It’s a disgrace.”
Dr. David Himmelstein, the co-author of the analysis and associate professor of medicine at Harvard, commented, “On this Veterans Day we should not only honor the nearly 500 soldiers who have died this year in Iraq and Afghanistan, but also the more than 2,200 veterans who were killed by our broken health insurance system. That’s six preventable deaths a day.”
He continued: “These unnecessary deaths will continue under the legislation now before the House and Senate. Those bills would do virtually nothing for the uninsured until 2013, and leave at least 17 million uninsured over the long run. We need a solution that works for all veterans - and for all Americans - single-payer national health insurance.”
While many Americans believe that all veterans can get care from the VA, even combat veterans may not be able to obtain VA care, Woolhandler said. As a rule, VA facilities provide care for any veteran who is disabled by a condition connected to his or her military service and care for specific medical conditions acquired during military service.
Woolhandler said veterans who pass a means test are eligible for care in VA facilities, but have lower priority status (Priority 5 or 7, depending upon income level). Veterans with higher incomes are classified in the lowest priority group and are not eligible for VA enrollment.
source
The researchers, who released their analysis today [Tuesday], pointedly say the health reform legislation pending in the House and Senate will not significantly affect this grim picture.
The Harvard group analyzed data from the U.S. Census Bureau’s March 2009 Current Population Survey, which surveyed Americans about their insurance coverage and veteran status, and found that 1,461,615 veterans between the ages of 18 and 64 were uninsured in 2008. Veterans were only classified as uninsured if they neither had health insurance nor received ongoing care at Veterans Health Administration (VA) hospitals or clinics.
Using their recently published findings in the American Journal of Public Health that show being uninsured raises an individual’s odds of dying by 40 percent (causing 44,798 deaths in the United States annually among those aged 17 to 64), they arrived at their estimate of 2,266 preventable deaths of non-elderly veterans in 2008. (See table.)
“Like other uninsured Americans, most uninsured vets are working people - too poor to afford private coverage but not poor enough to qualify for Medicaid or means-tested VA care,” said Dr. Steffie Woolhandler, a professor at Harvard Medical School who testified before Congress about uninsured veterans in 2007 and carried out the analysis released today [Tuesday]. “As a result, veterans go without the care they need every day in the U.S., and thousands die each year. It’s a disgrace.”
Dr. David Himmelstein, the co-author of the analysis and associate professor of medicine at Harvard, commented, “On this Veterans Day we should not only honor the nearly 500 soldiers who have died this year in Iraq and Afghanistan, but also the more than 2,200 veterans who were killed by our broken health insurance system. That’s six preventable deaths a day.”
He continued: “These unnecessary deaths will continue under the legislation now before the House and Senate. Those bills would do virtually nothing for the uninsured until 2013, and leave at least 17 million uninsured over the long run. We need a solution that works for all veterans - and for all Americans - single-payer national health insurance.”
While many Americans believe that all veterans can get care from the VA, even combat veterans may not be able to obtain VA care, Woolhandler said. As a rule, VA facilities provide care for any veteran who is disabled by a condition connected to his or her military service and care for specific medical conditions acquired during military service.
Woolhandler said veterans who pass a means test are eligible for care in VA facilities, but have lower priority status (Priority 5 or 7, depending upon income level). Veterans with higher incomes are classified in the lowest priority group and are not eligible for VA enrollment.
source
Sunday, November 8, 2009
Sweeping Health Care Plan Passes House
November 8, 2009
By CARL HULSE and ROBERT PEAR
WASHINGTON — Handing President Obama a hard-fought victory, the House narrowly approved a sweeping overhaul of the nation’s health care system on Saturday night, advancing legislation that Democrats said could stand as their defining social policy achievement.
After a daylong clash with Republicans over what has been a Democratic goal for decades, lawmakers voted 220 to 215 to approve a plan that would cost $1.1 trillion over 10 years. Democrats said the legislation would provide overdue relief to Americans struggling to buy or hold on to health insurance.
“This is our moment to revolutionize health care in this country,” said Representative George Miller, Democrat of California and one of the chief architects of the bill.
Democrats were forced to make major concessions on insurance coverage for abortions to attract the final votes to secure passage, a wrenching compromise for the numerous abortion-rights advocates in their ranks.
Many of them hope to make changes to the amendment during negotiations with the Senate, which will now become the main battleground in the health care fight as Democrats there ready their own bill for what is likely to be extensive floor debate.
Democrats say the House measure — paid for through new fees and taxes, along with cuts in Medicare — would extend coverage to 36 million people now without insurance while creating a government health insurance program. It would end insurance company practices like not covering pre-existing conditions or dropping people when they become ill.
Republicans condemned the vote and said they would oppose the measure as it proceeds on its legislative route. “This government takeover has got a long way to go before it gets to the president’s desk, and I’ll continue to fight it tooth and nail at every turn,” said Representative Kevin Brady, Republican of Texas. “Health care is too important to get it wrong.”
On the House floor, Democrats exchanged high-fives and cheered wildly — and Republicans sat quietly — when the tally display showed the 218th and decisive vote, after the leadership spent countless hours in recent days wringing commitments out of House members.
“We did what we promised the American people we would do,” said Representative Steny H. Hoyer, Democrat of Maryland and the majority leader, who also warned, “Much work remains.”
The successful vote came on a day when Mr. Obama traveled to Capitol Hill to make a personal appeal for lawmakers to “answer the call of history” and support the bill.
Only one Republican, Representative Anh Cao of Louisiana, voted for the bill, and 39 Democrats opposed it. The House also defeated the Republicans’ more modest plan, whose authors said it was a more common-sense and fiscally responsible approach.
The Democrats who balked at the measure represent mainly conservative swing districts, signaling that those who could be vulnerable in next year’s midterm elections viewed voting for the measure as politically risky.
“Today’s may be a tough vote, but it was in 1935 when we passed Social Security,” Representative John Dingell, Democrat of Michigan and the dean of the House, said as the debate drew to a close late Saturday.
Some Democrats said they voted for the legislation so they could seek improvements in it. “This bill will get better in the Senate,” said Representative Jim Cooper, a Tennessee Democrat who has been outspoken in his criticism of some provisions of the bill but decided to support it. “If we kill it here, it won’t have a chance to get better.”
After the vote, Mr. Obama issued a statement praising the House and calling on the Senate to follow suit. “I am absolutely confident it will,” he said, “and I look forward to signing comprehensive health insurance reform into law by the end of the year.”
Senator Harry Reid of Nevada, the majority leader, said he would bring a bill to the floor as soon as possible.
The vote came on the third anniversary of the 2006 Democratic takeover of the House, and the passage moves the bill well beyond the health care overhaul attempted by President Bill Clinton in 1993.
Lawmakers credited Mr. Obama with converting a final few holdouts during his appearance at a closed-door meeting with Democrats just hours before the vote. Democratic officials said that Mr. Obama’s conversation Saturday with Representative Michael H. Michaud, Democrat of Maine, was crucial in winning one final vote.
Many Democrats also credited Speaker Nancy Pelosi for pulling off a victory that proved tougher than many had predicted. “She really threaded the needle on this one,” said Representative Jim McGovern, Democrat of Massachusetts.
A critical turning point was the decision by Ms. Pelosi late Friday night to allow anti-abortion Democrats to try to tighten restrictions on coverage for the procedure under any insurance plan that receives federal money. That concession eased a threat by some Democrats to abandon the bill, but also left Democrats who support abortion rights facing a choice between backing a provision they bitterly opposed or scuttling the bill. The new abortion controls were added to the measure on a vote of 240 to 194.
Mr. Obama made his rare weekend appearance on Capitol Hill as part of an all-out effort to rally Democrats to support the biggest health care legislation since the creation of Medicare for the elderly four decades ago.
During the private meeting with Democrats in the Cannon Caucus Room, the president acknowledged the political difficulty of supporting major legislation in the face of unanimous Republican opposition and tough criticism from conservatives.
But, those present said, he urged them on, saying, “When I sign this in the Rose Garden, each and every one of you will be able to look back and say, ‘This was my finest moment in politics.’ ”
Republicans said the measure was too costly and would end up burdening the nation for decades to come. Some Democrats expressed the same view in explaining their opposition.
“This bill is a wrecking ball to the entire economy,” said Representative Jack Kingston, Republican of Georgia. “We need targeted specific reforms to help people who have fallen through the health care cracks.”
But Democrats said that Republicans were intent on protecting the status quo in health care and that the new Democratic approach would vastly improve the ability of Americans to gain affordable health insurance.
“Now is the chance to fix our health care system and improve the lives of millions of Americans,” Representative Louise M. Slaughter, Democrat of New York and chairwoman of the Rules Committee, said as she opened the daylong proceedings.
The wall of Republican opposition gave Democrats little room to maneuver, and they worked to corral as many party members as they could. But the preliminary approval to clear the way for the debate came on a 242-to-192 vote, suggesting that Democrats had a victory within reach.
The House vote was a significant step in the long-sought Democratic goal of enacting broad changes in the way health care is delivered in the nation. But the Senate has yet to bring its own emerging measure to the floor for debate, and the two chambers will still need to negotiate and approve a final bill in the weeks ahead.
The struggle House Democrats had in lining up the minimum number of votes for the measure was a clear indication of how difficult it would be to get final legislation to the president’s desk.
The House legislation, running almost 2,000 pages, would require most Americans to obtain health insurance or face penalties — an approach Republicans compared to government oppression.
Most employers would have to provide coverage or pay a tax penalty of up to 8 percent of their payroll. The bill would significantly expand Medicaid and would offer subsidies to help moderate-income people buy insurance from private companies or from a government insurance plan. It would also set up a national insurance exchange where people could shop for coverage.
Republicans forced a House vote on their much more modest plan that would expand coverage to just three million of the uninsured. But its authors said it would bring down the costs of private insurance premiums, which they argued was the chief concern of most Americans.
“More taxes, more spending and more government is not the plan for reform the people support,” said Representative Virginia Foxx, Republican of North Carolina and one of the conservatives who relentlessly criticized the Democrats’ plan.
But Democrats said their proposal was long overdue, would relieve the mounting anxiety of Americans struggling to get and retain health insurance, and would ultimately improve the economy by bringing spiraling health care costs under control.
“Our plan is not perfect, but it is a good start toward providing affordable health care to all Americans,” said Representative Peter A. DeFazio of Oregon.
David M. Herszenhorn contributed reporting.
source
By CARL HULSE and ROBERT PEAR
WASHINGTON — Handing President Obama a hard-fought victory, the House narrowly approved a sweeping overhaul of the nation’s health care system on Saturday night, advancing legislation that Democrats said could stand as their defining social policy achievement.
After a daylong clash with Republicans over what has been a Democratic goal for decades, lawmakers voted 220 to 215 to approve a plan that would cost $1.1 trillion over 10 years. Democrats said the legislation would provide overdue relief to Americans struggling to buy or hold on to health insurance.
“This is our moment to revolutionize health care in this country,” said Representative George Miller, Democrat of California and one of the chief architects of the bill.
Democrats were forced to make major concessions on insurance coverage for abortions to attract the final votes to secure passage, a wrenching compromise for the numerous abortion-rights advocates in their ranks.
Many of them hope to make changes to the amendment during negotiations with the Senate, which will now become the main battleground in the health care fight as Democrats there ready their own bill for what is likely to be extensive floor debate.
Democrats say the House measure — paid for through new fees and taxes, along with cuts in Medicare — would extend coverage to 36 million people now without insurance while creating a government health insurance program. It would end insurance company practices like not covering pre-existing conditions or dropping people when they become ill.
Republicans condemned the vote and said they would oppose the measure as it proceeds on its legislative route. “This government takeover has got a long way to go before it gets to the president’s desk, and I’ll continue to fight it tooth and nail at every turn,” said Representative Kevin Brady, Republican of Texas. “Health care is too important to get it wrong.”
On the House floor, Democrats exchanged high-fives and cheered wildly — and Republicans sat quietly — when the tally display showed the 218th and decisive vote, after the leadership spent countless hours in recent days wringing commitments out of House members.
“We did what we promised the American people we would do,” said Representative Steny H. Hoyer, Democrat of Maryland and the majority leader, who also warned, “Much work remains.”
The successful vote came on a day when Mr. Obama traveled to Capitol Hill to make a personal appeal for lawmakers to “answer the call of history” and support the bill.
Only one Republican, Representative Anh Cao of Louisiana, voted for the bill, and 39 Democrats opposed it. The House also defeated the Republicans’ more modest plan, whose authors said it was a more common-sense and fiscally responsible approach.
The Democrats who balked at the measure represent mainly conservative swing districts, signaling that those who could be vulnerable in next year’s midterm elections viewed voting for the measure as politically risky.
“Today’s may be a tough vote, but it was in 1935 when we passed Social Security,” Representative John Dingell, Democrat of Michigan and the dean of the House, said as the debate drew to a close late Saturday.
Some Democrats said they voted for the legislation so they could seek improvements in it. “This bill will get better in the Senate,” said Representative Jim Cooper, a Tennessee Democrat who has been outspoken in his criticism of some provisions of the bill but decided to support it. “If we kill it here, it won’t have a chance to get better.”
After the vote, Mr. Obama issued a statement praising the House and calling on the Senate to follow suit. “I am absolutely confident it will,” he said, “and I look forward to signing comprehensive health insurance reform into law by the end of the year.”
Senator Harry Reid of Nevada, the majority leader, said he would bring a bill to the floor as soon as possible.
The vote came on the third anniversary of the 2006 Democratic takeover of the House, and the passage moves the bill well beyond the health care overhaul attempted by President Bill Clinton in 1993.
Lawmakers credited Mr. Obama with converting a final few holdouts during his appearance at a closed-door meeting with Democrats just hours before the vote. Democratic officials said that Mr. Obama’s conversation Saturday with Representative Michael H. Michaud, Democrat of Maine, was crucial in winning one final vote.
Many Democrats also credited Speaker Nancy Pelosi for pulling off a victory that proved tougher than many had predicted. “She really threaded the needle on this one,” said Representative Jim McGovern, Democrat of Massachusetts.
A critical turning point was the decision by Ms. Pelosi late Friday night to allow anti-abortion Democrats to try to tighten restrictions on coverage for the procedure under any insurance plan that receives federal money. That concession eased a threat by some Democrats to abandon the bill, but also left Democrats who support abortion rights facing a choice between backing a provision they bitterly opposed or scuttling the bill. The new abortion controls were added to the measure on a vote of 240 to 194.
Mr. Obama made his rare weekend appearance on Capitol Hill as part of an all-out effort to rally Democrats to support the biggest health care legislation since the creation of Medicare for the elderly four decades ago.
During the private meeting with Democrats in the Cannon Caucus Room, the president acknowledged the political difficulty of supporting major legislation in the face of unanimous Republican opposition and tough criticism from conservatives.
But, those present said, he urged them on, saying, “When I sign this in the Rose Garden, each and every one of you will be able to look back and say, ‘This was my finest moment in politics.’ ”
Republicans said the measure was too costly and would end up burdening the nation for decades to come. Some Democrats expressed the same view in explaining their opposition.
“This bill is a wrecking ball to the entire economy,” said Representative Jack Kingston, Republican of Georgia. “We need targeted specific reforms to help people who have fallen through the health care cracks.”
But Democrats said that Republicans were intent on protecting the status quo in health care and that the new Democratic approach would vastly improve the ability of Americans to gain affordable health insurance.
“Now is the chance to fix our health care system and improve the lives of millions of Americans,” Representative Louise M. Slaughter, Democrat of New York and chairwoman of the Rules Committee, said as she opened the daylong proceedings.
The wall of Republican opposition gave Democrats little room to maneuver, and they worked to corral as many party members as they could. But the preliminary approval to clear the way for the debate came on a 242-to-192 vote, suggesting that Democrats had a victory within reach.
The House vote was a significant step in the long-sought Democratic goal of enacting broad changes in the way health care is delivered in the nation. But the Senate has yet to bring its own emerging measure to the floor for debate, and the two chambers will still need to negotiate and approve a final bill in the weeks ahead.
The struggle House Democrats had in lining up the minimum number of votes for the measure was a clear indication of how difficult it would be to get final legislation to the president’s desk.
The House legislation, running almost 2,000 pages, would require most Americans to obtain health insurance or face penalties — an approach Republicans compared to government oppression.
Most employers would have to provide coverage or pay a tax penalty of up to 8 percent of their payroll. The bill would significantly expand Medicaid and would offer subsidies to help moderate-income people buy insurance from private companies or from a government insurance plan. It would also set up a national insurance exchange where people could shop for coverage.
Republicans forced a House vote on their much more modest plan that would expand coverage to just three million of the uninsured. But its authors said it would bring down the costs of private insurance premiums, which they argued was the chief concern of most Americans.
“More taxes, more spending and more government is not the plan for reform the people support,” said Representative Virginia Foxx, Republican of North Carolina and one of the conservatives who relentlessly criticized the Democrats’ plan.
But Democrats said their proposal was long overdue, would relieve the mounting anxiety of Americans struggling to get and retain health insurance, and would ultimately improve the economy by bringing spiraling health care costs under control.
“Our plan is not perfect, but it is a good start toward providing affordable health care to all Americans,” said Representative Peter A. DeFazio of Oregon.
David M. Herszenhorn contributed reporting.
source
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