Coverage

Rhode Island has been a leader in developing health information technology, and Sen. Sheldon Whitehouse (D-RI) has some interesting ideas on how to get the rest of the country moving in the same direction. We invited the senator to guest blog on his proposal to create a new national entity with the know-how and the authority to get the job done.

By U.S. Senator Sheldon Whitehouse

Our health care system is in serious trouble.

Americans face embarrassingly low life expectancy rates, embarrassingly high obesity and infant mortality rates, and suffer as many as 100,000 deaths every year because of unnecessary and avoidable medical errors, all while our country spends 16% of our GDP on health care - more than any other industrialized country and double the EU's average. The annual cost of the system exceeds $2 trillion and is expected soon to double. More American families are bankrupted by health care costs than any other cause. There is more health care than steel in Ford cars, and more health care than coffee beans in Starbucks coffee. What is going wrong?

We often find ourselves wishing politicians would skip the rhetorical cover-ups and just give us the naked truth on health reform. Jim Slattery, a Democratic candidate for the U.S. Senate from Kansas, seems to have taken such musings literally in his latest campaign ad:

Hat tip to New America's Liz Wu.

Two polls on health care out this week. Two pols on health care (briefly) last night. First the numbers.

Jane Sarasohn-Kahn at Health Populi takes a look at the latest Kaiser Family Foundation Health Tracking Poll. Not surprisingly the economy remains the top issue on voters' minds. Fifty-six percent of those surveyed listed it as their top concern and as Jane notes, the survey was in the field from September 8 to 13—before the financial crisis came to a head. But as the economic crisis worsens, concerns over health care continue to rise. Health care moved past gas prices into third place with 21 percent of those surveyed listing it as their top issue. Iraq remains No. 2, with 25 percent of respondents listing it as their top issue.

Looking at how respondents' political identification influences their views on health care, the poll finds some interesting results. Health care has remained stable as a top concern for Democrats (25 percent list it as their top issue), dropped for Republicans (11 percent), and risen in by eight points since April for independents (26 percent).

Last year, the Washington Post profiled ten area residents and asked them to rate their own experiences with various forms of health insurance. The average grade: just over a B minus. A year later, the Post checked in with some of those profiled to see how things had changed. The resulting updates, as well as the original profiles, provide a striking survey of the state of health insurance in America.

Here are some of common themes that stood out to us from the series:

Diners in San Francisco are finding something new on the menu of local eateries—health care—as some restaurants are charging customers a bit extra so restaurant employees can access health care services. At least three of those potential diners—Ninth Circuit Judges Goodwin, Reinhardt and Fletcher—decided that a law that forces restaurants (and other employers) to help pay for employee health care is perfectly legal. Many supporters of the San Francisco law are eating up this news—at least until the U.S. Supreme Court induces indigestion (if the high court decides to consider the inevitable appeal).

Baseball playoffs haven't even started, but they're already celebrating in Boston. Yesterday, Massachusetts Governor Deval Patrick announced an agreement with CMS to provide a new three-year Medicaid waiver to support the state's health reform program.

The renewed waiver grants the state $21.2 billion in total spending authority ($10.6 billion in federal funding) over the next three years—an increase of $4.3 billion over the initial $16.9 billion 2006 waiver. Since Massachusetts passed its landmark legislation, 439,000 of the states estimated 650,000 uninsured have gained coverage—191,000 through private insurance, 176,000 through the state-subsidized Commonwealth Care and 72,000 through Medicaid. Massachusetts alone accounted for more than 28 percent of the 1.3-million decrease in uninsured seen in the latest census numbers.

While the Senate debates the bailout today, Karim and Children's Defense Fund offers their own proposal:

NPR continued its focus on the presidential health plans with a pair of well-reported pieces by Julie Rovner on Morning Edition this week.

Yesterday, Rovner examined McCain's focus on high risk pools which he claims could be used to provide coverage for the medically uninsurable—individuals who because of a pre-existing health condition would be denied coverage on the individual market. Georgetown's Karen Pollitz noted that while the some of the theory behind high risk pools may be sound, their implementation has been problematic and expensive. More than thirty states have high risk pools, but they provide coverage to only about 300,000 people—a fraction of the 46 million American's without health insurance.

Today, Rovner examined Obama's plan asking how much would his plan really cost. AEI's Joe Antos expressed skepticism that Obama's plan could deliver enough savings soon enough, especially given the cost of proposal. Health policy analyst Jeff Goldsmith argued both candidates were being pragmatically vague at this point in the campaign because so many parties have a stake in our $2.2 trillion health care system.

If home shopping networks sold health care safety net coverage, they'd probably be telling you to "act now because supplies are limited." State legislatures are especially receptive to this pitch during an economic downturn. Many are struggling to handle growing Medicaid programs during a period of shrinking tax revenue.

We've written about this vicious cycle before, and a new report from the Kaiser Family Foundation provides more insight into why we cannot afford to ignore our struggling health care system any longer, especially in times of economic turmoil. Quick highlights showing the link between health care and the economy:

What would you do with $700 billion? (Aside from buying the fabric ($2.10 a yard) needed to make 3.6 billion golden parachutes.)

Here at the New Health Dialogue, we like to talk about how a quality health care system will actually save us money. But while watching the ups and downs of the Wall Stree bailout plan all week, we couldn't resist indulging in a little health care spending fantasy. So we asked our director Len Nichols how he might spend $700 billion.