HealthLawProf Blog

Public Plan: Cost Containment Rationale

Urban Institute has an article by John Holahan and Linda Blumberg concerning the type of public plan that   should be included in health reform legislation:

This paper makes the argument that a public plan is important to health reform because it will contribute to cost containment, primarily by addressing problems caused by increased concentration in insurance and hospital markets. We describe how the public plan might be structured, how many people might be expected to enroll, and how much money the public plan might save. We discuss the most frequent arguments that are made in opposition to the public plan. We conclude that the private insurance industry would survive at about the same size but be more efficient and more effective in controlling health care spending.. ..

The arguments around the public plan too often ignore what we believe is the central reason for including a public plan as a component of reform: that health insurance markets today, by and large, are simply not competitive. And as such, these markets are not providing the benefits one would expect from competition, including efficient operations and consequent control over health care costs. We believe that the concentration in the insurance and hospital industries that has taken place over the past several years has been a significant contributor to this problem. The role of the government plan is to counter the adverse impacts of market concentration and, in doing so, slow the growth in health care costs....

Food Inc. and New Food Safety Rules

This looks like a great movie, Food, Inc.  It makes me think that now would be a good time to start a      garden ... Here is the Movie's Director, Robert Kenner, on the Daily Show.

In a related matter, the Obama Administration announced new rules for food safety.    National Public Radio reports,  

The Obama administration has announced plans for aggressive rules aimed at making the nation's food supply safer. The moves come in the wake of a series of serious food outbreaks and concern within the food industry that people fear their food. Reaction so far has been positive, both from industry and consumer groups.

Recalls Scare Consumers

At the announcement of the new initiatives Tuesday, Vice President Biden set out to make one thing clear: Food safety is important to this administration.  "You know, my dad used to say if everything is equally important, then nothing is important. There have to be priorities, and this is one of those priorities," he said.   Secretary of Health and Human Services Kathleen Sebelius told food producers and food-safety advocates that enough is enough. "We've seen too many large-scale recalls, everything from spinach to peanut products, pistachios, peppers, mushrooms, alfalfa sprouts and recently even cookie dough."   Five thousand Americans die from contaminated food each year, she said, and tens of millions get sick.

The administration is directing its agencies to design tougher production standards for marketers of poultry, beef, leafy greens, melons and tomatoes. The Food and Drug Administration and the U.S. Department of Agriculture will be designing a national food registry so contaminated food can be traced back to its source, and so consumers can be alerted immediately once a problem is discovered.

Stopping Salmonella

Meanwhile, the FDA announced a special initiative on eggs. Egg producers will have to buy chicks and young hens only from buyers who monitor for the salmonella bacteria. They'll have to have specific safety plans, eliminate rodents and pests, guard against bioterrorism, test regularly for salmonella, and refrigerate eggs during storage and transportation. . . .

Final Stem Cell Guidelines

The Scientific Activist reports on the final stem cell guidelines released by the NIH today and has some interesting commentary:

Today, the NIH has released its final guidelines (pdf).

Not much has changed, so there's not really much to say that I haven't already. The bad news is that the fairly restrictive nature of the rules was maintained (i.e. no federal funds for hESC lines derived from embryos generated specifically for research), but the good news is that the government didn't cave into some fairly outlandish requests (clearly from anti-abortion activists) to insert some loaded language into the rules.

Timing of Health Reform: Delay?

ThinkProgress and RollCall report on Senator Dodds recent discussion about the timing of a health reform bill. David Drucker of RollCall writes:

Senate Democratic leaders’ hopes of approving health care reform before adjourning for the August recess appear all but dead, with the prospect of meeting President Barack Obama’s demand for a bill on his desk by Oct. 15 looking increasingly difficult.

Logistical hurdles in the Senate, while significant, are only part of the problem. A major political battle looms over the key components of health care reform — particularly over the role of the federal government — that could stall Democrats even after they gained a filibuster-proof majority with the addition of Sen.-elect Al Franken (D-Minn.).

Sen. Chris Dodd (D-Conn.), managing the health care bill in the Health, Education, Labor and Pensions Committee, signaled late last week that Democratic leaders do not expect a bill to clear the Senate in the next five weeks. Rather, Dodd indicated, the goal is to complete the tricky merger of the HELP and Finance Committee bills, with the floor fracas over a final bill put off until after Labor Day....

The Finance Committee has yet to put out a mark on its bill, which is still being negotiated. The pending merger of the Finance and HELP bills could be tricky.

Finance Chairman Max Baucus (D-Mont.) is attempting to draft a bill that costs less than $1 trillion, is deficit neutral and can garner significant bipartisan support. The HELP bill has been drafted to satisfy liberal reform goals, including a robust government-run insurance option Republicans will never accept.

HELP announced last week that its legislation would cost approximately $611 billion over 10 years. But that is not a deficit-neutral figure, and the score did not include the cost of expanding Medicare, projected by some to be worth another $400 billion in additional spending.

Meanwhile, political difficulties abound in Obama’s push to overhaul the nation’s $2.3 trillion health care system this year. ...

AIDS Success in Haiti

Americablog's Chris reports on some good news out of Haiti and writes,  

What a great report out of Haiti.

. . . In the early 1980s, when the strange and terrifying disease showed up in the U.S. among migrants who had escaped Haiti's dictatorship, experts thought it could wipe out a third of the country's population.  Instead, Haiti's HIV infection rate stayed in the single digits, then plummeted. . .  .

Much of the credit went to two pioneering nonprofit groups, Boston-based Partners in Health and Port-au-Prince's GHESKIO, widely considered to be the world's oldest AIDS clinic.

"The Haitian AIDS community feels like they're out in front of everyone else on this, and pretty much they are," said Judith Timyan, senior HIV/AIDS adviser for the U.S. Agency for International Development in Haiti. "They really do some of the best work in the world."