New America on Health Policy

Year after year, Republicans try to pass legislation that would limit medical malpractice awards. Fix the tort system, they argue, and we fix rising health-care costs. And year after year, Democrats resist placing arbitrary caps on awards to people who may have suffered from an egregious medical error. The fight plays out like a predictable old Western -- good guys versus bad guys. Depending on your politics, the villain is either the greedy doctor or the greedy trial lawyer.

Health… more

Last week, the debate over the Democratic health reform effort took a brief and unexpected philosophical turn. Bart Stupak, a pro-labor Catholic Democrat representing Michigan's 1st congressional district, managed to pass the Stupak amendment as part of the House health bill. Sensing that an insurrection among anti-abortion Democrats threatened to derail the legislation, Speaker of the House Nancy Pelosi, who ardently opposes restrictions on abortion, allowed Stupak to offer the amendment, and it passed by a wide margin thanks to Republican votes.

The Medicare payment reforms in both the House and the Senate bills will help to slow the growth of costs by rewarding value over volume, as will the proposed Medicare commission and the tax on insurers who offer high-cost health plans, which are in the Senate Finance Committee bill. And both House and Senate legislation also include “innovation centers” which will allow us to test different payment models and health care processes.

Even with these steps, the reform bills could be strengthened. Specifically:

There is widespread agreement that if federal health care reform passes, making it work will depend in great part on getting a handle on spiraling medical costs that already consume nearly one of every five dollars spent in the United States.

American presidents have tried seven times to bring us into the community of nations that provide health care to all citizens. Seven times the effort failed. More accurately, it was blocked. In the 1940s, the anti-reform movement was led by doctors, through the American Medical Association. In the 1990s, it was led by the insurance and small-business lobbies.

Drive too fast along Red Lion Road, beside Philadelphia's Northeast Airport, and you will miss the low-rise cement building where the biotech company MedImmune has been quietly pumping out swine flu vaccine at about a million doses a week. Through the summer and fall, workers wearing protective gear that covered them from head to toe brewed up batches of live, genetically modified flu virus. Robots then injected tiny doses of virus-laden fluid into glass vials, which were mounted into nasal spritzers, labeled, and readied for shipment at the… more

The health care drama in the U.S. Senate is cresting. After months of hearings--and decades of dithering--it is time to see if the United States is going to remain the only advanced industrial nation in the world that does not provide universal health care.

Health-care cooperatives have gotten a bad rap. But if properly designed, they could offer quite a lot to both the left and the right, as well as to anyone interested in expanding health-care coverage and reducing costs.

Bill O'Reilly supports a public option in the health care debate, given that it will provide cheaper insurance to those who can't afford it and isn't intended to replace insurance providers as the status quo for the majority; Tommy Thompson, W.'s secretary for Health and Human Services and a former four-term governor of Wisconsin, has praised the Senate's proposed reforms.

The man who would be known as Patient No. 1 emerged from routine open-heart surgery at Columbia University Medical Center in stable condition. Then he began to bleed uncontrollably. Surgeons rushed him back to the operating room to reopen his chest, but by the time they could stop the hemorrhaging, Patient No. 1 was barely breathing and in a coma.

On Aug. 15, 2000, shortly before he was discharged on his way to a nursing home, a physician wrote a… more

Throughout the healthcare debate, President Obama has not always appeared very "presidential". He hasn't engaged in LBJ-like arm twisting or FDR-like brinksmanship, or exerted the strong leadership that the office of the presidency has been known to possess. Other than his brilliant healthcare speech in early September, Obama has mostly seemed content to lay low while the Senate thrashes out the details.

Bobby Jindal, the 38-year-old Indian-American governor of Louisiana, and a rising star in Republican circles, did a brave thing on Monday morning: He took to the op-ed page of The Washington Post to urge his fellow GOPers to "join the battle of ideas" on health care. That is, Republicans should put forward their own health care plan. And to get that process rolling, he put forth ten ideas of his own.

In the first part of this two-part piece, I noted that the hot issue-within-an-issue for Washington health care wonks is "bending the curve" on health care costs--that is, reducing future increases.

Even Barack Obama is talking the "bend" talk. In an interview with The Washington Post in July, the president used the "b-word" no less than 11 times. In this particular passage, he said that he wants to "bend" the cost curve, not only for government expenditures, but also for private-sector expenditures: 

During last year's Republican presidential primary season, candidate Rudy Giuliani succinctly captured what millions of Americans think about health care abroad. "These countries that say they provide universal coverage -- they pay a price for it, you know," Giuliani told his audience. "They do it by rationing care, by long waiting lines, and by limiting, or I should say eliminating a patient's choice."

With official unemployment in the US hovering around 10 per cent, and actual levels much higher when the underemployed and discouraged are counted, the most urgent priority is job creation. But efforts to get America working again must be informed by the striking fact that most employment growth in the past decade has been concentrated in three sectors: healthcare, education and government, mostly state and local public services.

Following President Barack Obama's speech on healthcare last week, several pundits said it was a performance worthy of Harry "Give 'em Hell" Truman. After his election, he was likened to Presidents Abraham Lincoln and Franklin Roosevelt. But for the coming battle over healthcare reform, Mr Obama needs to step into the shoes of President Lyndon Baines Johnson. Especially when it comes to lining up votes from recalcitrant members of his own party, LBJ's brawling, southern style of trench politics is… more

Now and then a moment occurs that clarifies the nature of American politics like a flash of lightning over a prairie landscape. Such a moment occurred on Sept. 9 during President Obama's televised address to a joint session of Congress about healthcare. As the president explained that illegal immigrants would not be eligible for benefits under the plan he supported, Joe Wilson, a conservative Republican member of Congress from South Carolina, shocked the chamber and the television audience by shouting, "You lie!"

As the nation girds itself for an epic battle over health care reform, all eyes will be on the U.S. Senate. That chamber, whose members often refer to themselves as the world's most deliberative body, more accurately can be described as the least representative body outside Britain's House of Lords, where "minority rule" strangles reform on a regular basis.

After defeating President Clinton's health reform effort in 1993, Republicans achieved a stunning victory that ended 40 years of Democratic control of Congress. And so it's easy to see why most congressional Republicans are convinced that there is no advantage in working constructively with President Obama now.

The last ten minutes of Barack Obama's health care speech, invoking the legacy of Ted Kennedy and emphasizing concern for others as an essential part of "the American character," were powerful and affecting. Eschewing the professorial tone he has too often struck when discussing health care in recent months, Obama spoke instead about "large heartedness" and the "terror and helplessness" any parent would feel to have a sick child go without treatment because of money. He also said "the danger of too much government is matched by… more