Healthcare Reform - Medical Justice

Patient’s Bill of Responsibilities: #1 Take Good Care of Yourself

August 15, 2024March 30, 2010 by Jeffrey Segal, MD, JD

It seems people are always talking about (and demanding) Rights. With Rights, though, come Responsibilities. Here are a few thoughts on how patients can be more responsible for their own well-being.

The single most valuable piece of advice, a refrain echoed time and time again by physicians, is taking proper care of one’s body to avoid problems in the first place. This is something that the individual (and family) must practice, but the government can promote. Our current system rewards getting ill while providing little direct incentive to practice wellness. It costs a lot less to address obesity in a child than to perform a coronary bypass operation. It costs less to prevent smoking (or help a smoker quit that addiction,) than to treat lung cancer, emphysema, and heart problems, premature births and infant deaths (amongst the problems caused by first-hand smoke, let along second-hand smoke.)

Even what we eat makes a profound difference. A finding within The China Study

A Place At The Table; Heathcare Reform Decisions Being Made Without Doctors: Dr. D. Berwick New Head of CMS

August 15, 2024March 29, 2010 by Jeffrey Segal, MD, JD

The eminent appointment of Donald Berwick, MD, as head of CMS (Centers for Medicare & Medicaid Services) may seem like a step in the right direction. After all, Dr. Berwick is well known for championing improvements to health care. “At least he’s a doctor,” some might say. But is appointing a doctor really giving physicians a place at the table? Dr. Berwick is also politically capable. Few could argue the reasons for putting him on the list of candidates. But is that reason enough to make the appointment? Is appointing an MD really a place at the table, or is that allowing a doctor to work as a server for the dinner guests?

It stands to reason that Washington is going to appoint someone who is politically astute. It also stands to reason that President Obama would appoint someone capable of delivering fiery rhetoric. In 2004, he unequivocally stated “I’m losing my patience. Not with the people in healthcare, but the system itself. Healthcare professionals are doing so many things so well; they’re putting actual transformation within reach. Now we need to grab it. The clock is a tyrant, and if you spend too much time ‘getting ready,’ you’re going to lose.” In another campaign, he noted “… the attention of the strategic leaders in healthcare has not been focused on the improvement of care. The strategic objectives have focused on more traditional goals such as growth, marketing and capital development. We need leaders to create a new future, not defend the status quo.” In a keynote speech last year, Dr. Berwick was bold enough to state that anyone who claims the U.S. healthcare system is the best in the world is not looking at the facts. Dr. Berwick is clearly a man of passion, unafraid to challenge the system. Sounds like the perfect man to repair a broken system, doesn’t it? Unfortunately, the White House has not asked us that question.

Serious man wearing medical coat and stethoscope

Procedural Issues To Send Reconciliation Back To House For Another Vote

September 17, 2024March 25, 2010 by Jeffrey Segal, MD, JD

A fatigued Harry Reid (D-NV) called for the session to come to a close at 2:45 am, shortly after the discovery of those technicalities. They will return to continue work on the bill at 9:45 today, just 7 hours later. It was not clear who noticed the errors.

It’s Official, Obama Signed the Bill, But We STILL Don’t Know What It Means

August 15, 2024March 23, 2010 by Jeffrey Segal, MD, JD

A short while ago, the wire service put out (and everyone chimed in) that President Obama had signed the Affordable Health Care for America Act (as it is apparently now being called,) into law. Hurray! It’s a great day for America! Now if we could please find out what we just bought into?

The same rehash has been playing over and over again on the media. 16 million more get Medicare. Children won’t be saddled with Pre-Existing Conditions. Most (but not all) Americans will have to have health insurance, and those who are without coverage now because of pre-existing conditions can expect to be able to get insurance via a high-risk pool until more of the bill kicks in, a few years down the line. Could it possibly be more vague? Perhaps. Maybe if they just left it at that it’s “really gonna be good for everybody — you wait and see!”

Medical law concept with gavel and stethoscope on desk

This Is What Change Looks Like – Health Care Reform Act of 2010 Passes the House

September 17, 2024March 22, 2010 by Jeffrey Segal, MD, JD

As most of you know, Medical Justice has been watching the health care reform act’s progress closely. What played out was a bit like a soap opera, full of melodramatic statements. It was very informative, and demonstrated why the Democrats pushed this through procedurally.

Finally, debates were done, and it was time to vote.

The Democrats were slightly divided. Republicans all voted along party lines. By 10:45 pm, EST, the U.S. House of Representatives had enough votes to pass the bill. Two minutes later, the final tally showed 219 Democrats in favor, 34 opposed. The Republican vote was 176 against, with 2 abstaining. The final tally was 219 in favor, 212 against. The House had confirmed the Senate’s Heath Care Reform Act of 2010. This vote makes the Senate’s act law, subject to the President’s signature, which is expected in the first few days of this week.

AMA Supports Health Care Reform Bill, Throws Tort Reform Under The Bus

August 15, 2024March 21, 2010 by Jeffrey Segal, MD, JD

The House Health Care Reform bill of 2010 is almost a reality. Some have suggested that the entire bill be tossed out. Others are saying that it should be held off until our representatives have had sufficient time to read and analyze them. Yet another faction thinks that it’s not what anyone really wants, but it’s a good start, so they should vote for it and get that hurdle over with. Those who were opposed are jumping on the bandwagon for the sake of the 31,000,000 uninsured (who won’t actually get benefits for years.) Then there’s the AMA.

Dr. J. James Rohack, president of the American Medical Association, claims “qualified support” for the bill, because he believes the bill will be “extending health coverage to the vast majority of the uninsured.” Supposedly it it was further stated that doctors are deeply disappointed that the bill doesn’t repeal the method by which Medicare payments are calculated. Though Congress informally agrees to address the issue, physicians’ Medicare payments are repeatedly threatened by significant cuts, which Congress keeps putting short-term bandages on. Surprisingly enough, some Democrats (such as Peter DeFazio,) have said that they won’t support the bill unless it increases Medicare payments to states that provide high-quality care at low costs. It would seem the AMA wasn’t as interested in protecting the interests of their members as is Mr DeFazio.

Pelosi: Just Vote For It And Then You Can Find Out What It Says

August 15, 2024March 20, 2010 by Jeffrey Segal, MD, JD

It is the eve of historic change. With every new piece of news that hits the wire, it becomes clearer that Speaker Pelosi will have the votes necessary to pass the Heath Care Reform Act of 2010. Fantastic! A new day, a new era for America! But, uhm… what is it that we’re celebrating? What is it that they’re passing on our behalf? 2309 pages, and the representatives are still struggling to read PARTS of it… yet the Speaker of the House tells people to vote for it? When has there ever been a Congress so willing to vote in the blind?

Medical Justice is by and for healthcare professionals. Of course, we want people to have health insurance. We want them to have health care available to them, health care they can afford. After all, we’re here to alleviate suffering. But, come on, people, at least know WHAT it is you’re voting for!

In comments to a blog about the subject, a cardiologist admitted that while it may not be the best thing for him, it’s the best thing for his children, grandchildren, friends, and acquaintances, so he’s in favor of it. Noble… but he doesn’t know what’s in those 2309 pages either. And that’s not the end of it either.

Some of the votes are “secured” by agreements to change the bill AFTER it is voted on and before it is presented to President Obama for signature. What sort of things are we talking about?

Then there’s the quote from a trial attorney,

2309 Pages in 72 Hours = 32 Pages An Hour — If They Don’t Think Or Sleep

August 15, 2024March 19, 2010 by Jeffrey Segal, MD, JD

The Reconciliation Act of 2010 sits before us now, a 2309 page .pdf file chocked full of Therefors and Wherebys and a whole slew of legalese; one piece referencing another. Even if you have a law degree, there’s no way you’ll know what it all means and how (or IF) it all works together. In short, even legislators are going to have to take each others’ word for it. But that all assumes that any of them will have or will take the time to read it.

72 hours of “transparency” means over 32 pages per hour — if they don’t sleep, eat, shower, cross-reference the spaghetti-code, or think about what any of it means or how it all supposedly fits together. The reality is that there is barely time to read it all, never mind the hope of catching mistakes or misunderstandings. There is certainly no time to analyze it, to ponder, to decide… and yet the House is expecting to vote?

38 States Poised to Sue Federal Government Over Mandatory Health Care Insurance Requirement

September 17, 2024March 18, 2010 by Jeffrey Segal, MD, JD

But even if it passes in the next few days and the President signs it, the battle is still far from over.

Kucinich and Kildee Switch Votes on Health Care Reform bill, Deeming Arises

August 15, 2024March 17, 2010 by Jeffrey Segal, MD, JD

This morning, Dennis Kucinich, (D-OH) am outspoken opponent to the current health care reform bill, switched his vote to a Yes. Even as he announced his conversion, he made no bones about his feelings on the matter, saying “I have doubts about the bill. … This is not the bill I wanted to support. However, after careful discussions with President Obama, Speaker Pelosi, my wife Elizabeth and close friends, I’ve decided to cast a vote in favor of the legislation.” Kucinich went on to explain that he changed his position because he realized that it was better to pass a bill that can be changed than to pass nothing at all. President Obama’s reaction was anticlimactic; he simply said that it was good that Kucinich did so.

Representative Dale E. Kildee (D-MI) had also been opposed to the bill, but his objection was that he didn’t want to vote for government-funded abortions. Earlier today, he said the abortion restrictions were sufficient to win his vote, though. He expressed that he felt the sanctity of life for the 31,000,000 Americans without health insurance was a pretty strong motivation to vote in favor of it.

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