Tuesday, December 2, 2008
The LA Times has a write-up today about the Bush administrations proposed conscience rule and its breadth. David Savage explains,
The outgoing Bush administration is planning to announce a broad new "right of conscience" rule permitting medical facilities, doctors, nurses, pharmacists and other healthcare workers to refuse to participate in any procedure they find morally objectionable, including abortion and possibly even artificial insemination and birth control.
For more than 30 years, federal law has dictated that doctors and nurses may refuse to perform abortions. The new rule would go further by making clear that healthcare workers also may refuse to provide information or advice to patients who might want an abortion. It also seeks to cover more employees. For example, in addition to a surgeon and a nurse in an operating room, the rule would extend to "an employee whose task it is to clean the instruments," the draft rule said.
The "conscience" rule could set the stage for an abortion controversy in the early months of Barack Obama's administration. During the campaign, President-elect Obama sought to find a middle ground on the issue. He said there is a "moral dimension to abortion" that cannot be ignored, but he also promised to protect the rights of women who seek abortion. While the rule could eventually be overturned by the new administration, the process might open a wound that could take months of wrangling to close again.
Health and Human Services Department officials said the rule would apply to "any entity" that receives federal funds. It estimated 584,000 entities could be covered, including 4,800 hospitals, 234,000 doctor's offices and 58,000 pharmacies. . . .
Monday, December 1, 2008
Bob Laszewski and Richard Eskow, two health policy thinkers who I respect very much, have come to opposite conclusions on the Baucus plan. Eskow says that the plan shows the glimmers of an emergent consensus on health reform. Lazewski says that the plans is so vague on key elements like subsidy levels and the definition of "affordability" that is shows how little consensus there is. . . .
One of the Baucus plan's embedded assumptions is that Congress should not define too much. In this, it's taking a page from the successful passage of the Massachusetts reforms, which offloaded a series of thorny questions -- including the definition of "affordability" and the specific premium subsidies -- on the Connector Authority. And sure enough, Baucus's plan has a variant of the Connector Authority in the Independent Health Coverage Council (more on that here and here).
National Public Radio had a great overview of how the Massachusetts plan was working yesterday evening. The story focused mainly on the significant shortages of primary care physicians as individuals who previously could not afford to go to the doctor are now going for care and flooding the system with new patients.
DemFromCt, who writes for the Daily Kos blog, provides an update from FamiliesUSA on children's health care now that we are officially in a recession. DemFromCt highlights various news, mostly bad, from the FamiliesUSA study,
The non-partisan FamiliesUSA sums it up with this November 2008 study:
8.6 Million Children Are Uninsured
- One in nine American children (11.1 percent) is uninsured.
- The five states with the largest number of uninsured children are Texas, California, Florida, New York, and Georgia. Together, the uninsured children in these five states account for nearly half of all uninsured children in the country (48.3 percent).
- The five states with the highest rates of uninsured children are Texas, Florida, New Mexico, Arizona, and Nevada. More than 15 percent of children in each of these states are uninsured, compared to a national median of 9.2 percent.
Medicaid and the State Children’s Health Insurance Program (CHIP) Are Picking up the Slack
- Between 2006 and 2007, the number of uninsured children declined by 521,000.
- The number of children covered by private health coverage declined by 65,000.
- The number of children covered in Medicaid and CHIP increased by 954,000.
FamiliesUSA also found the majority of uninsured children come from working families with two-parent households, so another myth goes out the window. This isn't class warfare, this is everyone.
Remember, this is just the beginning. Covering kids through Medicaid and SCHIP will temporarily help kids (but not adults), and mask what's really happening as people lose insurance and can't get it back (that takes at least two years after a recession). When states start to hurt, eligibility will be cut back and/or new enrollment will be limited at the state level. . . .