Senate debate on the aggregate bill produced from the work of senate committees is now underway. Democrats are pushing to get the job done by years end, mostly in a political move to achieve a goal set by the President. Centrists and Republicans feel the debate will likely go on well into the new year. The key is to get it right, not necessarily to meet a politically set artificial target. That debate is underway is good. There are things in the Senate bill that are worthwhile. Many other items are pork or special interest legislative additions that can be removed or dealt with item by item at a later date. The CBO report that indicated that premiums would likely rise for self-employed policy holders was not good news. The Senate needs to realize that many persons do not have employer based coverage and rely on individual policies for their health care coverage. The reason that these policies cost more is that health insurers are allowed to rate individuals differently than large groups. One of our proposals from day one is to legislate that health insurers must set rates based on the totality of subscribers, regardless of where those subscribers come from (group plans, employer plans, individual plans, etc.). This would stabilize premiums across the board for all subscribers and force insurers to truly compete for all business, not just cherry pick select large clients or industries.
Additionally, without meaningful tort reform, a so called “comprehensive” health reform bill is far from comprehensive. There must be an end to the continued threat of frivolous legal action every time a patient or family is unsatisfied, has a bad outcome or is simply irritated with their doctor or hospital. Failure to cure, bad outcome, morbidity and mortality are part of life and medicine, day in and day out. True negligence is malpractice. There must be processes put in place to properly screen cases and to discipline attorneys who make a living off of this sort of activity (the term “ambulance chaser” did not arise in a vacuum).
Proposals to expand residency opportunities to train more physicians are laudable. However, if they are not accompanied by expansion of opportunities to train more Americans in medical school, this proposal will simply add to the expansion of foreign born physicians training in the United States. A nation of over 300 million needs doctors who are its own citizens first. Many bright, talented American men and women are denied the opportunity to attend medical school, while our residency programs routinely accept foreign graduates for training since there are not enough American graduates to fill all the spots. This is a ridiculous situation. The Senate should address expansion of medical school slots for American citizens as part of any real health reform.
We continue to hope that the process of debate and amendment will take proposals that are clearly flawed in the both the House and Senate, and render them more useful to the vast majority of Americans. Republicans need to remember that some do need help. Democrats need to remember that helping those in need should not harm the rest of the nation. . . obi jo and jomaxx
The Democrats’ first amendment, offered by Senator Barbara A. Mikulski of Maryland, would require insurers to cover more screenings and preventive care for women, with no co-payments. “Women often forgo those critical preventive screenings because they simply cannot afford it, or their insurance company won’t pay for it unless it is mandated by state law,” Ms. Mikulski said.
The first Republican proposal, offered by Senator John McCain of Arizona, would strip the bill of more than $450 billion of proposed savings in Medicare. The savings would curb the growth of Medicare payments to hospitals, nursing homes, health maintenance organizations and other providers of care. The cuts are not attainable,” Mr. McCain said. “And if they were, it would mean a direct curtailment and reduction in the benefits we have promised to senior citizens.”
As for the fate of the so called public option, Ms. Landrieu and Mr. Lieberman reiterated their opposition to the proposed government-run health insurance plan. “The Democratic caucus is very clear that a compromise on that is going to have to happen before the bill can leave the floor,” Ms. Landrieu said. Mr. Lieberman was more blunt. “The public option is an unnatural and dangerous appendage to health care reform,” he said.
Senators Pitch to Women and Elderly on Health Bill – http://www.nytimes.com/2009/12/02/health/policy/02health.html?_r=1&ref=health
Democrats face near unanimous Republican opposition to the health care measure — and deep divisions within their own ranks. While majority Democrats will need 60 votes to pass a bill, some in the party say they will jump ship from the bill without tighter restrictions on abortion coverage. Others say they will go unless a government plan to compete with private insurance companies gets tossed out. Such concessions would enrage liberals, the party’s heart and soul. There is no clear course for Reid to steer legislation through Congress to the president’s desk.
Democrats Try to Hold Together as Health Care Debate Begins in Senate – http://www.foxnews.com/politics/2009/11/30/battle-begins-senate-opens-health-care-debate/
Senators prepared to cast their first votes Wednesday on health-care reform, but even as partisan divisions hardened and contentious amendments stacked up, Democrats increasingly expressed optimism that they would succeed in passing a bill before Christmas. The initial amendments offered illustrated the legislation’s vast scope and lingering vulnerabilities. The first, co-sponsored by Sens. Barbara A. Mikulski(D-Md.) and Olympia J. Snowe (R-Maine), would increase preventative health care for women at a 10-year cost of $940 million. One aim of the measure is to blunt concerns raised last month when an independent commission recommended that women undergo mammograms less frequently.The second amendment, authored by Sen. John McCain (R-Ariz.), would strip out the bill’s primary revenue source, nearly $500 billion in Medicare cost savings. Although AARP and other seniors groups have said otherwise, Republicans are attacking the cuts as a threat that could eventually shorten lives. Other flashpoints expected to reach the floor in the form of amendments would target provisions in the bill related to abortion and illegal immigrants. Majority Leader Harry M. Reid (D-Nev.) said debate could continue through the weekend.
Senators express hope for a health reform bill- Deep divides remain, but Democrats say everyone’s talking – http://www.washingtonpost.com/wp-dyn/content/article/2009/12/01/AR2009120104127.html?nav=hcmodule
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Isn’t it the AMA that restricts the number of slots American Medical schools can offer? isn’t that part of their strategy?
Yes, in part. The AMA along with Congress and others have great input. However, it is FUNDING from Congress that determines the overall number of medical schools and medical students that are available. There are good reasons related to practice proficiency, needed experience and case loads that effect numbers. However, there is no question that the numbers are too low at present resulting in the need to have foreign medical graduates fill vacant residency slots. This cannot change overnight but does need to be addressed.