Healthcare Reform - Medical Justice

House Rules Committee Meeting On Friday, But Still No Real Health Care Reform

August 15, 2024March 16, 2010 by Jeffrey Segal, MD, JD

Louise Slaughter (D-NY), the Chair of the House Rules Committee, has announced that the Committee is expecting to convene this Friday regarding the Health Care bill. This is the next step necessary in preparing the bill for the floor of the House of Representatives. Accordingly, the earliest that the House could vote would be on Saturday. But the transparency policy requires a 72 hour period after the bill is put up on the Committee’s website before they vote on it. No matter how one counts it, the House could be voting very soon.

What does this mean? It means that it appears the Democrats are going to proceed. They are going to employ reconciliation, a legitimate tool of state, it would seem. Yet at this late hour, the American people still haven’t a clue what’s actually in the bill. We have been told that it’s not going to include Special Deals, but the claim hardly seems credible.

Special Deals Boost Support for Health Care Reform Reconciliation Bill

August 15, 2024March 16, 2010 by Jeffrey Segal, MD, JD

Every politician makes campaign promises that everyone knows can’t be kept. One is reminded of George W. Bush’s “Read my lips, no new taxes!” (which, of course, did not pan out to be true.) But constants like Death and Taxes aren’t quite the same thing as other platform policies. When President Obama said that he was going to require transparency in government, we believed him, and the nation elected him. Yet the back door deals march on… and they’re alive and well in the Healthcare bill. President Obama has opposed what he calls the “Cornhusker Kickback,” which requires that the Feds pay for Nebraska’s Medicaid expansion, in exchange for the supporting vote of Ben Nelson, (D, Neb). This is hardly the only special deal in the health care “reform” bill, though.

David Axelrod, senior White House adviser, recently reiterated “The president does believe that state-only carve-outs should not be in the bill.” But “the principle that we want to apply is that are these applicable to all states? Even if they do not qualify now, would they qualify under certain sets of circumstances?” Reading between the phrasing, one gets that there may be other boons for individual states, and that the White House won’t consider them to be Special Deals so long as all states COULD qualify for those benefits.

Reconciliation In Motion, Republicans Remain Opposed

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

The House Budget Committee put Reconciliation in motion today, a move to press the combined Health Care Reform bill through with a democratic majority, rather than a 60% concurrence. It remains unclear what, precisely, is in the bill, let alone what the real effects of the bill may be. What President Obama is telling us is that it will NOT affect Medicare/Medicaid and that opponents to the bill are not telling the truth. Of course, the Democrats aren’t telling the full truth either, because some of the aspects of the bill aren’t scheduled to commence for some 9 years. It’s true that the longest journey begins with the first steps, but people should know that they’ll be paying for it via taxes long before they receive any of its benefits.

Obama: Insurance Carriers Reduce Profits, Legislators Put Aside Politics, But No Tort Reform

August 15, 2024March 11, 2010 by Jeffrey Segal, MD, JD

Speaking sternly and intensely yesterday, President Obama said the “time for talk is over.” He was firm in pressing Congress to pass a bill intended to move healthcare reform forward. The President’s Health Secretary, Kathleen Sebelius, was equally firm in suggesting that health care insurance providers reduce their profits to make coverage more affordable for the nation. She went so far as to say that failing to do so will result in skyrocketing premiums; perhaps referring to the way that some California premiums were raised because people who were at less risk declined to renew policies that had become unaffordable.

President Obama addressed a crowd at a high school gathering in St. Charles, MO, putting aside fancy rhetoric to state “Folks in Washington, they like to talk. So Washington is doing right now what Washington does. They’re speculating breathlessly day or night. Every columnist. Every pundit. Every talking head. Is this proposal going to help the Republicans or is this proposal going to help the Democrats?” Even when he’s not trying to be eloquent, the President seems to get at the heart of the matter. It’s more about picking sides now than about passing health care reform legislation. Speaking as though he were outside of the political realm, he added “I don’t know about the politics, but I know that it is the right thing to do and that is why I am fighting so hard to get it done.”

Senate OKs Extensions of Medicare SGR, Medicaid, Unemployment & COBRA — Bill Awaits House Approval

August 15, 2024March 11, 2010 by Jeffrey Segal, MD, JD

The vote was far from unanimous – even though it’s only a temporary stop-gap measure that returned full Medicare payments to physicians. The Senate approved the $138 billion bill with a vote of 62 for, 36 against. What this means is that the 21% cut to Medicare payments is staved off until October 1, 2010. It should be noted that the SGR portion is a mere $7.3 billion of that, and that’s spread out over the next 10 years. The Medicaid, COBRA and Unemployment benefits will be extended until January 1, 2011, while additional financial aid for the states’ Medicaid programs get only a six month extension.

It seems odd that these deadlines would be staggered, though they all appear in the same bill. Perhaps this will allow the legislators to revisit each area more diligently as separate entities. But what is really needed is a comprehensive overall game plan. In light of that need, this move by the Senate is a patchy band-aid at best.

Those who voted against the extension object that the bill adds an additional $10 billion to the federal deficit each of the next 10 years, for a total of $100 billion. They’re also quick to stand up against it because it isn’t paid for. While there is a need for fiscal responsibility, one could easily argue that no budget plan is guaranteed, and that the country and the economy are more likely to prosper when certain needs are met.

This is just the Senate’s version of a solution. The House has also passed a bill. They could either

Health Justice Instead of Tort Reforms? Best Practice Should Provide Exemption

August 15, 2024March 8, 2010 by Jeffrey Segal, MD, JD

For the past couple years, our country has done a lot of talking about health care reform. Much of that centered on providing universal access to health care services. After that comes ways to reduce costs; pivotal to providing health care for everyone. Missing are serious discussions about Defensive Medicine and Tort Reform. It’s as though these items are off the table, presumably because reforming these elements would cut into the legislature’s fellow attorneys’ profits. Thin excuses are provided; such as statements claiming that unfettered civil suits are necessary to ensure that a patient is not violated — even when proposed reforms would not affect patients’ right to direct compensation for actual costs incurred. We at Medical Justice aren’t looking for immunity from civil recourse. We’re simply after reasonable limits, to eliminate the temptation to sue in hopes of receiving a jackpot award. When 3/4 of all medical malpractice suits are found to be baseless, it’s only right that doctors be relieved of the drains on time, energy and finances that defending against such frivolous cases require. But perhaps we’ve been using the wrong term. Rather than calling it Tort Reform, perhaps we should start asking for Health Justice.

Podcast on Defensive Medicine

August 15, 2024March 1, 2010 by Jeffrey Segal, MD, JD

Great podcast from MDWhistleblower on defensive medicine [audio:http://www.interactmd.com/sites/default/files/Defensive%20Medicine%20and%20Gallup%20Poll.mp3] click to play :: Defensive Medicine

Drug Makers Playing the Numbers Game

August 15, 2024February 16, 2010 by Jeffrey Segal, MD, JD

With healthcare reform legislation pending, and the government indicating that they’ll be shaving money off the prices they’ll pay for all things Healthcare, it shouldn’t really have been much of a surprise to see drug manufacturers raising the prices. After all, if they raise them now, they won’t be amongst those to suffer or have to tighten their belts to help make healthcare affordable. The tactic makes one mindful of “Value Added” pricing on cars. They add a few thousand to the sticker price (based on some dubious excuse) and then give you a couple thousand dollars off — so you “save” and they still got more than sticker price for the car. Nothing new there.

But we’re not talking about a new car. We’re talking about the drugs that alleviate suffering and save lives. While everyone else is looking for ways to cut the fat and lower costs, they’re making certain that lower profits don’t happen in their back yards. How close is the analogy? Washington hopes new regulations will reduce the cost of drugs by about $8 billion. They’re adding $10 billion. So look! Net increase of $2 billion for the drug manufacturers. So much for the savings our legislators have spent all that time and effort wrangling into place.

Taking Health Care Reform In Hand

August 15, 2024February 13, 2010 by Jeffrey Segal, MD, JD

As the solidarity of Congress continues to deteriorate, it becomes increasingly apparent that there will be no meaningful Health Care Reform coming forth in the near future. That being the case, what are We The People going to do about it? Bemoan our fates, email our representatives, tighten the belt? Probably all of the above. And when we’ve vented frustration that way, the task will still be there before us, to take Health Care Reform into our own hands.

Though this post is most likely going to be read by physicians, it’s important to realize that we are all responsible for taking hold of the situation. Physician, patient, R.N., P.A., LPN, DC, dentist, midwife, professional and layman alike, we must all take steps to reduce the costs. This includes doctors fighting back, of course. It also includes patients being painfully honest about who is actually responsible for less than desirable outcomes.

Podcast on Tort Reform

August 15, 2024February 9, 2010 by Jeffrey Segal, MD, JD

The blog MDWhistleblower posted two very nice podcasts regarding tort reform. The second is a commentary regarding the IL Supreme Court’s recent decision to rescind med-mal caps.

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