Brown and Romney dance around Mass reform

 In a Globe op-ed this morning, Scott Brown said he supports repeal of some parts of the health reform bill – mandates and medical device fees among them. He wants to give states the right to opt out and supports the following measures, which he says will effectively control raging healthcare costs:

We should replace the worst parts of this legislation with solutions that would actually lower costs and improve the quality of care — such as allowing individuals to purchase insurance across state lines, measures that will prevent waste, fraud and abuse, support for increased prevention and wellness programs, and reforms to limit costly litigation and defensive medicine.

I am working on legislation that would allow states to opt out of this federal health care bill because states need flexibility, not a federal government takeover of health care. Instead, individual states should have the flexibility to solve the health care problems in a way that is best for their specific state, similar to the approach we took in Massachusetts that has resulted in a state-specific plan that covers 98 percent of our citizens without raising taxes.

Another national Republican who helped create the Mass plan, Mitt Romney, was also trying to come up with a way to explain his change of heart and back again. Also from the Globe.

AMES, Iowa — Mitt Romney offered an enthusiastic defense last night of the comprehensive health care law he helped create four years ago in Massachusetts, even as he pointed to crucial distinctions between it and a similar national program enacted last week by Democrats.

“Overall, ours is a model that works,’’ Romney said in response to a question after a speech at Iowa State University. “We solved our problem at the state level. Like it or not, it was a state solution. Why is it that President Obama is stepping in and saying ‘one size fits all’ ’’?

Joan Vennochi opines for The Globe.

Both comments come just two weeks after a long list of witnesses said rising costs will destroy the Mass Plan.

More on Brown and health reform

Many letters to the Globe on Scott Brown, from this one:

I AM a Democrat who is profoundly grateful to Scott Brown for his key role in the passage of the health care bill. Without the galvanizing wakeup call his Massachusetts upset provided to the Obama administration and the Democrats in Congress, the bill was unlikely to pass. His campaigning to be Senator “41’’ (as well as an insurer’s recent 39 percent insurance rate increase in California) are perfect examples of the law of unintended consequences. Thank you, Senator Brown.

To this one:

Many polls show that the majority of Americans are opposed to the health care reform bill, and that more than 60 percent of Americans are dissatisfied with the job performance of the Senate and the House.

Yet the will of the people was ignored in order to force through a major agenda item of the party in power

 

Boston’s Berwick to run Medicare

AP is reporting that Obama will nominate Massachusetts pediatrician Donald Berwick – head of the  Institute for Healthcare Improvement Cambridge–to oversee Medicare and Medicaid.

The timing of the nomination is important because Berwick, if confirmed by the Senate, would take over an agency that has not had a permanent chief executive since Mark McClellan stepped down in the fall of 2006.

The Centers for Medicare and Medicaid Services runs the government health care programs for seniors and the poor, providing benefits to an estimated 100 million people — about 1 in 3 Americans.

Here’s a Q&A from Kaiser Health News.

Q: With health overhaul legislation moving forward, how are you feeling about major changes coming to our health system?

A: It’s a pretty exciting time. It’s time to commit to justice and that means universal coverage. We have got to go there. It’s embarrassing that we have not gone there. So that is job No. 1. But to do that simply by funding existing systems is a formula for a spiral we can’t endure. We have to restructure care and the system.

Can we do that from Capitol Hill and the White House? No. We can encourage it, we can support it, we can set some goals out at a price we can afford. But eventually this is going to devolve back to communities…only they can execute the changes and care structures that we really need. It could be an exciting time as we watch the mobilization of change at the level which change has to happen.

  Here’s a 2004 profile of Berwick from the Globe:

At this point, mild-mannered, soft-spoken, self-effacing 57-year-old Don Berwick can best be described as a revolutionary. A lot of people say the current health care system is broken, but by that they mean the manner of financing it. Berwick gets irritated when health care leaders complain about a lack of resources. There’s too much money in the system already, he says. His critique takes aim at the medical profession’s exalted view of itself. He’s convinced that the fundamentals of the current system — the same fundamentals Boston used to build its reputation as the world’s medical leader — are so screwed up that it is no longer possible for the medical profession to provide reliable, high-quality care, no matter how many innovations its renowned doctors roll out, no matter how many awards they rack up. “They want to cure cancer,” Berwick says. “Well, how about curing health care?”

His conclusion: To save the health care system, it first needs to be blown up.

 This from IHI:

We aim to improve the lives of patients, the health of communities, and the joy of the health care workforce by focusing on an ambitious set of goals adapted from the Institute of Medicine’s six improvement aims for the health care system: Safety, Effectiveness, Patient-Centeredness, Timeliness, Efficiency, and Equity. We call this the “No Needless List”:

 No needless deaths
 No needless pain or suffering
 No helplessness in those served or serving
 No unwanted waiting
 No waste
 No one left outIHI works with health professionals throughout the world to accelerate the measurable and continual progress of health care systems toward these bold objectives, leading to breakthrough improvements that are truly meaningful in the lives of patients.

Rachel Maddow v. Scott Brown and friends

4/1 update: Globe letter-writers defend Maddow, chide staff editorialists. Dan Kennedy, writing in The Guardian, says she would be a good candidate.

Note that on Thursday,  the Senate voted down Brown’s proposed amendment that would have removed a tax on medical device makers from the reform bill.

Now, Maddow isn’t running for Senate. She made that very clear in a clip on her show last night and a full-page ad in today’s Globe.  But, Maddow — who has been very pro-health reform –is unhappy that Brown is noting her rumored candidacy in a fund-raising letter.

In the ad,  she says he never contacted her to confirm her rumoured campaign. She also says Brown fits in with conservatives who “invent scary fake threats to run against — things like made-up death panels in health reform…”

Apparently some Herald readers do find Maddow scary. The story generated  these anti-gay sentiments from Herald readers. The Globe monitors comments. Looks like they were busy.

“Why is this young boy named Rachel? Is he a sissy or something? Makes ya sick!”

  

After 2 minutes watching her opine and blather nonsense I feel like I need to take a shower…ewwwwwwww!

 

What a shame the Dyke wont run against Scott. Wouldnt that have been fun seeing her run on the MSNBC platform of fruits and nuts. 

 

The Wonkette website inadvertently sent some reader to this long list of unkind rants by confusing the Globe and the Herald in their story. (!!!) 

 The comments at Wonketter were much more friendly.

 

Herald: Scott Brown victory delivered health reform

Herald front page w/Ted Fitzgerald photo

And, oh, are those Tea Partiers angry. From today’s Boston Herald:

Republican folk hero Sen. Scott Brown is being taunted by triumphant Democrats – and slammed by irked conservatives – after the historic health-care bill he was elected to kill was signed into law by President Obama yesterday…

“If it wasn’t for the Tea Party movement, Scott Brown wouldn’t have gotten that seat. We expect to see a true conservative in there.”

In fact, Democrats now say Brown’s election as the so-called “41st vote” to block Obama’s health-care overhaul inspired them to seek procedural means to bypass GOP efforts to derail the bill.

“Scott Brown’s election actually delivered health-care reform, because we didn’t need the 60 votes to make it happen. He delivered a significant victory in that,” ( Massachusetts Democratic Party chairman John) Walsh said.

Brown’s senior adviser, Eric Fehrnstrom, countered that the senator has been a stalwart voice against the Democratic initiative.

“Sen. Brown has made it clear, every way he knows how, that he is opposed to Obamacare and the higher taxes and increased spending it entails,” Fehrnstrom said.

Brown declined to comment.

Health reform: How’s it playing in Mass?

A run down on some of the local reaction to the passage of the health reform bill.

WBUR reports that is won’t change much for consumers here.

The Globe predicts a “blistering repeal campaign.”

The Herald quotes “stratagists” from the Scott Brown camp saying health reform will sink the Democrats in November. And, they are going to help.

As for Brown himself,  The Globe reports that our new senator didn’t seem quite sure how to react.

Rachel Maddow had Barney Frank on to talk about reform – and about protesters calling him a “fag.” Frank looked profoundly exhausted.

Mass Health Care for All has a video response from regular folk.

Harvard docs Steffie Woolhandler and David Himmelstein  signed on to a statement from the Physicians for a National Health Plan. The group fought hard for a single-payer approach.

As much as we would like to join the celebration of the House’s passage of the health bill last night, in good conscience we cannot. We take no comfort in seeing aspirin dispensed for the treatment of cancer.

Instead of eliminating the root of the problem – the profit-driven, private health insurance industry – this costly new legislation will enrich and further entrench these firms. The bill would require millions of Americans to buy private insurers’ defective products, and turn over to them vast amounts of public money.

And, from the “ladyliberty1045” of the Mass Tea Party Patriots:

Sad day for American with thisRadical HCR being passed. But, WE THE PEOPLE, will not forget come this Nov. Let’s stand strong and VOTE THEM OUT in Nov. We the People will have the last word!!

Mass. takes health reform another step forward

 Update via WBUR’s Commonhealth : David Morales, Commissioner, Division of Health Care Finance and Policy, explains what happens now that the state cost control hearings have wrapped up.

 All eyes are on DC in terms of health reform and the uninsured. But, this week’s state sponsored hearings in Massachusetts aimed at the core problem with the U.S. healthcare system — costs

 But, it can be tough to get good play for story that quotes a bunch of industry types and wonks. So, BHN leads you to the Globe’s fine coverage.

 Faced with an A.G. report that shows charges at Partner’s hospitals literally off the charts,  the Harvard-charged hospital giant finally cried uncle, Liz Kowalczyk reported yesterday.  

 A top executive from Partners HealthCare, the large hospital and physician network that has been blamed by some for helping to push up health care costs, said today that the organization realizes it’s too costly and is working to become less expensive.

 The head of Partners rival BIDMC, Paul Levy, also had his say at the hearings.

 State regulators should more closely oversee hospital costs, including setting prices, limiting new programs that make money for hospitals but drive up overall costs, and even sitting in on contract negotiations with insurers. 

Here’s an editorial.

BHN Report: Massachusetts health costs hearings

The Commonwealth is getting serious about health care costs. Increases are unrelenting and over the top.

In Massachusetts, health costs are rising at three times the rate of wages, according to testimony below. Rising prices are eating away at company profits, family savings, worker’s wages and public health programs.  

Studies, bills, hearings. Will we get action?

See the Globe’s reporting on the ongoing hearings on health costs and the push toward global payments. Instead of paying per procedure, global payments cover costs per patient. The idea is to encourage quality instead of overtreatment.

The testimony continues on Thursday and Friday. The state is streaming the hearings live and posting copies of speaker statements.

BHN caught the end of Monday’s testimony, which came from Harvard Professor Nancy Turnbull and a panel of consumer groups. Below find some unedited audio from the panel, which was called “Consumer Experiences with Health Care Cost Trends.”

Nancy Turnbull, Senior Lecturer on Health Policy and Associate Dean for Educational Programs, Harvard School of Public Health.

“In Massachusetts, health insurance premiums are increasing faster than income, which is creating a crisais of affordaility for individual and families.”

• Audio
• Written testimony

Cheri Andes, Lead Organizer, Greater Boston Interfaith Organization

“GBIO believes that this trend of out-of-control health care costs is a moral issue as well as an economic one.”

•  Audio
• Written testimony

Robert Restuccia, Executive Director, Community Catalyst, Inc.

• Audio
• Written testimony

Matt Selig, Executive Director, Health Law Advocates

“In our work with individual clients we find that consumers still consistently face the burden of out-of-pocket health care costs aside from premiums, deductibles and copayments.”

• Audio
• Written testimony

Deborah Banda, Massachusetts State Director, AARP

Written testimony

Finally, the March Madness review of the Health Wonk Review is up. I live with a couple of Tar Heel fans. So, with the the boys’ team out,  our motto here is — Go Big Red!  The Yankee half of the family has Cornell links.

Privacy, profiteering and other perils of computerized health records

BHN finally caught up on the ongoing series on health information technology, or HIT, running on The Huffington Post. Some of this ground has been covered elsewhere – privacy, issues with patient access and conflict of interest for former senator and quasi-lobbyist Tom Daschle.

Still, take note of the recent report on the digital divide. And when the Huff Po team started following the money, they produced a solid piece on the feeding frenzy for federal stimulus money.

The competition among companies has spawned a wealth of sales gimmicks. One firm offers a “cash-for-clunkers”-inspired deal that gives doctors $3,000 in rebates if they junk their current system for a new model.  Another has announced interest-free loans to doctors that won’t come due until their stimulus checks arrive. Even Wal-Mart has begun selling a “turnkey” digital health records system through Sam’s Club.

A super group of major tech firms has banded together and hit the road with what they call a “stimulus tour” to boost sales. So far, the tour, which includes officials from Microsoft, Dell and Allscripts-Misys Healthcare Solutions, has played in more than 30 cities. It stops at local convention centers and hotels, where it holds seminars for doctors. Those who attend receive a “customized stimulus analysis of how much money your practice could earn in federal incentives.”

The marketing blitz comes amid a simmering debate over how closely government should keep watch over the young, but fast-galloping industry. Officials expect electronic health records to transform the practice of medicine by greatly improving the quality of care and sharply cutting costs

Yet federal officials don’t require the same degree of testing, safety inspections or marketing oversight for electronic records systems as for many types of medical devices. While tech firms believe strict regulation of the industry would stifle innovation, critics want to clamp down.

Critics got their wish in the form of that defender of government oversight, Republican Chuck Grassley.

Sen. Charles E. Grassley (R-Iowa), ranking member of the Senate Finance Committee, has asked 31 hospitals and health systems across the country in a  Jan. 19 letter to advise him of any problems with their computer systems and any “issues or concerns that have been raised by your health care providers” over the past two years.

“Hospitals are on the front lines and their perspective will be very valuable in this effort, so I look forward to hearing what they have to say about expanded use of health care information technology,” Grassley said Wednesday in a statement.

Mass General and the Brigham got the letter, according to the story.  Oddly, Tufts also got the letter but Beth Israel – which has a very active HIT program – did not.

Keep an eye on the site for more. It seems some of the key players didn’t want to talk to the Huff Po team. BHN would like to see a few more comments from the Office of the National Coordinator, the federal agency running the operation.

Also, since this work is a product of the Huff Po Investigative FUND, we’re hoping that means that –unlike many other contributors to the liberal-leaning web site — these folks got paid for their work.

Finally, for more on how this is playing out here in Massachusetts,  check out this radio piece on wiring health care in Newburyport, Mass. by BHN senior writer Tinker Ready.

Scott Brown speaks as health reformers rally

Just to be clear, Brown didn’t speak at the rally — he spoke to a group of insurance execs across town.

Since protests are often seen as staged events, they don’t get much news coverage. Take the reports on yesterday’s protest in Washington DC at a meeting of health insurers, compiled here by Kaiser Health News.  Former Vermont Gov. Howard Dean spoke to the crowd and health reformers here were supposed to take a busload down

 These days, protesters can cover themselves. The Health Care for America Now has a report and lots of pictures.  

Also in DC, Scott Brown has spoken on health care. According to a story in the Globe, our new senator supports the idea of letting the states decide how to expand health coverage. He was speaking to a meeting of health underwriters. 

Senator Scott Brown railed yesterday against President Obama and congressional Democrats for continuing their quest to pass a comprehensive health care bill, saying the majority party in Washington has failed to heed the lessons of his own surprise victory in January.