There may be good science behind a federal task force recommendation that women in their 40s don’t need annual mammograms, but it was bad timing for the Obama administration. Coming in the midst of the heated debate about health care reform, the recommendation became instant fodder for those claiming that the government is going to ration health care and get between patients and their doctors. Health and Human Services Secretary Kathleen Sebelius responded Wednesday that the task force does “not set federal policy and they don’t determine what services are covered by the federal government.” But that’s unlikely to quell concerns.
The public is evenly divided on the proposed health care reforms, with 49 percent opposed and 48 percent supportive, according to a new Washington Post-ABC News poll. The public also doubts that the reform will help control costs, with 56 percent saying that overall health care costs will go up. But 66 percent support requiring all large employers to provide health insurance coverage or face fines, and 53 percent support a public insurance option (72 percent support one limited to those who lack access to coverage).
The public still favors President Obama over Republicans in handling the economy (52 to 37 percent) and health care (50 to 37 percent), though the gaps have narrowed some during the year. And 61 percent of those surveyed think that GOP leaders mainly criticize Obama’s proposals without offering alternatives.
Rep. Lynn Jenkins, R-Topeka, was one of nearly four dozen Republican and Democratic House members who submitted statements into the official record about health care reform that were written, in whole or in part, by lobbyists for a biotechnology company, the New York Times reported. Jenkins and Reps. K. Michael Conaway, R-Texas, and Lee Terry, R-Neb., used nearly identical words in criticizing the health care reform bill, but each also said: “I do believe the sections relating to the creation of a market for biosimilar products is one area of the bill that strikes the appropriate balance in providing lower cost options.” So not only do lobbyists help write bills, they help write what lawmakers say.
UPDATE: Rep. Jerry Moran, R-Kan., also submitted text written by lobbyists.
Kansas’ GOP members of Congress oppose cutting billions of dollars in federal subsidies to privately run Medicare Advantage plans as a way to help pay for health care reform. But Kansas Insurance Commissioner Sandy Praeger says the cuts make sense. “When Congress is looking for savings, this is a very appropriate place to look,” Praeger told the Kansas Health Institute News Service. “I mean, keep in mind, Advantage plans are supposed to be costing less, not more.” Praeger said the private plans currently cost 13 to 14 percent more than traditional Medicare.
Rep. Joseph Cao, R-La., the sole House Republican to vote for the health reform bill, said he has been getting some “pretty nasty responses” from people upset with his vote. “From downright racist remarks just to hate speech, you name it, we have it,” Cao told the New York Times. But he has no regrets about his vote, saying that it was “based on my own conscience that people should have health care.” Cao, who represents a Democratic-leaning district, said that “we have to go beyond partisan politics” and do what is “right for America.”
To hear the GOP members of the Kansas congressional delegation tell it, passage of health reform will end liberty as we know it. Rep. Todd Tiahrt, R-Goddard, is already talking about trying to repeal or defund any bill that makes it into law. Kansas Insurance Commissioner Sandy Praeger (in photo), also a Republican, has concerns about the unlevel playing field a public option could create, but she remains optimistic about reform overall, telling the Topeka Capital-Journal: “If we go with a plan that retains as much flexibility as possible, keeps the states are regulators, allows us to continue to be there for consumers, and we could get a national system in place in terms of no pre-existing condition exclusions and everybody have coverage and meaningful subsidies, I think we’d all be better.”
The Congressional Budget Office concluded this week that the GOP health care reform proposal would end up adding about 6 million people to the ranks of the uninsured. By 2019, 52 million people would be uninsured (up from 46 million today). In comparison, the CBO determined that the Democrats’ bill would leave about 18 million uninsured. The Democrats’ bill also would reduce the deficit more than the Republican plan, the CBO calculated. “The only thing worse than having no health care reform plan is releasing a bad one, getting thrashed by CBO and making the House Democrats look good in comparison,” wrote Ezra Klein of the Washington Post.
Senate Majority Leader Harry Reid, D-Nev., proposes letting Americans in some states have the “public option” while leaving out other Americans who happen in lives in states that choose to opt out. The politically motivated idea offends Washington Post columnist David Broder. “Consider the precedent that would be set if a major piece of social legislation were to be passed with a states’ rights provision,” Broder wrote. “Imagine, for example, if Franklin Roosevelt had signed the first Social Security law with the proviso that any states with Republican governors and legislatures could exempt themselves from its coverage. This might have seemed a minimal concession to conservative opinion. But what would have followed? How long before some states would have demanded an exemption from the wage-and-hour law that established a minimum wage? And what about the clamor in a broad swath of the country when the first civil rights law was passed?”
Abortion remains a sticking point in health care reform legislation. The House version of the bill would allow people to use federal subsidies to buy private insurance that covers abortion, but only if the federal funds don’t go toward paying for an abortion. In other words, the insurance companies would have to use money from other sources, such as private employer insurance premiums, to pay for the coverage. But some House Democrats, led by Rep. Bart Stupak of Michigan, want a complete ban, and may have enough votes to derail the bill.
Sen. Pat Roberts, R-Kan., responded to those who’ve criticized his role in health care reform as partisan and unproductive. “This is not my first rodeo. I know how things can be achieved in the minority,” he wrote in a letter, noting his work on behalf of helping the contaminated town of Treece, securing funding for the national biolab at Kansas State University and keeping terror detainees out of Fort Leavenworth. “But this time, the deck was stacked very firmly against the minority voice. . . . Efforts to negotiate a better health care reform bill had already collapsed when the Obama administration set a rushed and arbitrary deadline for signing a reform bill into law. Despite the fact that compromise negotiations were under way with colleagues who I deeply respect, including the chairs and ranking members of the two committees, it was made clear there were going to be no compromises. Even now, Majority Leader Harry Reid and a select few are merging the two Senate versions of the bill behind closed doors, contrary to the president’s promise that the creation of the bill would be on C-SPAN for all to see.” Roberts concluded: “Rest assured, as the debate — which I expect to get even more heated — continues, you will hear my voice loud and clear. I’ll stand up for what’s right. I’ll offer and support alternative measures that I think make better sense and I’ll continue urging Kansans to share their concerns with me. I am saddled up and ready to ride.”
A public health insurance plan appeared dead two weeks ago, but both House and Senate Democratic leaders announced this week that their reform bills would include the option. The comeback may be fueled by opinion polls showing that a majority of the public wants a public option. Fifty-seven percent of Americans favor a public insurance option, according to a Washington Post-ABC News poll. Support among doctors is even higher — 63 percent favor giving patients a choice that would include both public and private insurance, according to a survey released last month. Overall, however, the public is still divided on the health care reform bills in Congress, with 45 percent favoring the broad outlines of the proposals and 48 percent opposed.
State Rep. Brenda Landwehr, R-Wichita, and other GOP legislators have jumped on a national bandwagon aimed at opting out of national health reform state by state. “We were created to have state sovereignty,” Landwehr said. “We were not set up to have the federal government tell the states who, what, when, where and how.” But their Health Care Freedom Amendment requires two-thirds support in the Legislature and majority approval at the polls, which can be hard to come by in Kansas. And if the constitutional amendment prevailed and Kansans were protected from federal health insurance mandates, would they find it any easier to get and keep insurance and access affordable health care?
As a member of the two U.S. Senate committees tasked with crafting health reform bills, Sen. Pat Roberts, R-Kan., has played the critic more than the architect, objecting noisily on cost and other grounds. That’s probably why he hasn’t been a go-to guy for reform champion and former Kansas Gov. Kathleen Sebelius, the Democrat now leading President Obama’s Department of Health and Human Services. “Even though we know each other very well, she knows how I feel about how health reform, so she’s trying to go where she can get votes,” Roberts told the Kansas Health Institute News Service. “I would welcome — if she had the time — at least an hour discussion to go over these facts (about health reform) with the secretary. I can’t imagine if she were still in her previous role that she wouldn’t be jumping up and down about all this.” Perhaps, but Gov. Mark Parkinson has strongly advocated reform.
In a recent NBC/Wall Street Journal poll, concern about the economy was paramount across gender lines. But “46 percent of women rank health care as one of their top two concerns, versus 34 percent of men who think that — a 12-point difference,” noted MSNBC’s First Read blog. “On the other hand, a combined 39 percent of men rank the deficit and spending as a top two concern, versus 29 percent of women who do — a 10-point difference.”
Experience teaches that many residents of Sedgwick County either don’t know or don’t care that the county bans fireworks in unincorporated areas and that a lawbreaker risks a $1,000 fine. (A similar situation exists in Wichita, where banned 6 feet-plus fireworks are everywhere every Fourth.) But is the proper official response to illegal behavior to make it legal? Lifting the ban and letting state law prevail — one option that county commissioners are considering — would ease the enforcement burden on county fire officials. But would it serve public safety? And given the risk of fire and injury, residents’ free exercise of an expanded right to shoot fireworks wouldn’t come free to taxpayers.
It’s not on the table in Congress right now, but columnist Ross Douthat supports the government providing universal catastrophic health insurance while maintaining a free-market system for non-catastrophic care. Doing so, he wrote, “would marry a central conservative insight — that we’ll never control spending so long as Americans are insulated from the true price of their medical care — to the admirable liberal premise that nobody should go bankrupt paying for lifesaving treatment.”
Kansas legislators just lost one reason not to legalize medicinal use of marijuana, something former Kansas Attorney General Robert Stephan has endorsed. It made no sense for Kansas to join the 14 states with patient pot laws as long as the Bush administration was prosecuting cases related to prescription marijuana. But on Monday the Obama Justice Department formally directed federal prosecutors to refocus their efforts. “It will not be a priority to use federal resources to prosecute patients with serious illnesses or their caregivers who are complying with state laws on medical marijuana,” said Attorney General Eric Holder, adding, however, that “we will not tolerate drug traffickers who hide behind claims of compliance with state law to mask activities that are clearly illegal.”
Judging from the Kansas Republicans’ votes and statements on health reform this year in Congress, you’d think most of their constituents would be pro-status quo. But a new survey from the Docking Institute of Public Affairs at Fort Hays State University found that 56 percent of Kansas adults think the government has the responsibility to ensure that all Americans have health care coverage and that 88 percent think the Kansas health care system needs change — major change, according to 58 percent.
Though Kansas dropped from 18th to 23rd in a national ranking of health system performance, it improved dramatically in its percentage of children who received needed mental health care, the Kansas Health Institute News Service reported. The Commonwealth Fund ranked Kansas in eighth place in the mental health care measure, up from 28th in 2007. But the report noted that more than 1 in 4 Kansas children who needed mental health care didn’t get it — so there is still room for improvement.
As for Kansas’ overall drop in the rankings, Jason Eberhart-Phillips, health director at the Kansas Department of Health and Environment, likened it to changing “seats in a rowboat that’s still running in last place” — referring to the World Health Organization’s ranking of the U.S. health system as 37th in the world.
As the Senate Finance Committee prepared to vote on its health reform bill this afternoon, Sen. Pat Roberts, R-Kan., got in touch with his Dodge City roots oratorically: “I am terribly concerned that we are riding hell for leather into a health care box canyon, full of spending quicksand, cactus tax hikes, policy briar patches, complete with CMS (Centers for Medicare & Medicaid Services) regulatory scorpions, rattlesnakes and bad news bears — something like riding your pickup over a whole tangle of barbed wire. And getting out of this, Mr. Chairman, and back on solid ground to make Medicare solvent is going to be a mighty rough and long ride.”
Are the official pleas to get an H1N1 vaccine coming into conflict with a high distrust of government, at least in Kansas? In the latest SurveyUSA poll, sponsored by KWCH, Channel 12, 60 percent of those surveyed said they would not be getting the vaccine, with 33 percent of those folks saying they don’t believe the vaccine is safe.
On the safety question: Andrew Pekosz, an associate professor of molecular microbiology and immunology at Johns Hopkins University’s Bloomberg School of Public Health in Baltimore, told the Washington Post that all the data indicates the H1N1 vaccine is “just as safe as the regular seasonal flu” vaccine, adding that “this was expected, since the 2009 H1N1 vaccine is made in exactly the same way as the seasonal flu vaccine.”
Health care reform received a significant boost Wednesday with the release of a Congressional Budget Office analysis concluding that the Senate Finance Committee bill actually would reduce the federal deficit by $81 billion over the next 10 years. It also was aided by former Sen. Bob Dole, who called for passage of health care reform (though he opposes the public option). Dole also said that Senate Minority Leader Mitch McConnell, R-Ky., told him not to say that he supported reform, and Dole said that the public was the loser when Congress couldn’t agree on reform when President Clinton proposed it (and he took partial blame for that failure).
Columnist Thomas Frank noted the “curious reversal” by Republicans who argue that private insurance companies wouldn’t be able to compete with a “predatory” public option insurance plan that covers all comers, including those private companies won’t insure. Thomas wrote: “Just think of the conservative caricatures that must be inverted for this argument to work: All those soft liberal bureaucrats? Ferocious man-eaters. The welfare state? Law of the jungle. And the actuarial-minded hardliners of the insurance biz, the ones who deny your claim or cancel your policy? A gentle but endangered species that needs our nurturing, sort of like panda bears.”
Rather than leave health care reform to Democrats, “conservatives should seize the mantle of reform and lead,” Louisiana Gov. Bobby Jindal wrote. He offered 10 ideas to increase the affordability and quality of health care (nearly all of which have been around for some time). The proposals include voluntary purchasing pools, lawsuit reform, increased transparency and payment reform, electronic medical records, tax-free health savings accounts, rewarding healthy lifestyle choices and requiring coverage of pre-existing conditions. “The public is interested in solutions that will improve America’s health-care system, not dismantle it,” Jindal wrote. “Republicans can lead on this.”
For years, Democrats wrongly portrayed GOP proposals to curb the growth of Medicare as attempts to kick medicine out of Granny’s hand. Now the roles have reversed, and Republicans are falsely accusing Democrats of cutting Medicare benefits as part of the health care reform proposals. Some may cheer this role reversal as “turnabout is fair play.” But it shows how both parties are willing to scare seniors in order to score political points. No wonder it is so difficult to reform entitlement programs.
