HealthLawProf Blog

Editor: Katharine Van Tassel
Akron Univ. School of Law

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Saturday, February 28, 2009

No More DOJ Raids on Medical Marijuana Clubs

The Huffingtonpost reports on Attorney General Eric Holder's announcement that the Justice Department will not target medical marijuana club.  The story provides,   

Attorney General Eric Holder said at a press conference Wednesday that the Justice Department will no longer raid medical marijuana clubs that are established legally under state law. His declaration is a fulfillment of a campaign promise by President Barack Obama, and marks a major shift from the previous administration.

After the inauguration, the Drug Enforcement Administration (DEA) continued to carry out such raids, despite Obama's promise. Holder was asked if those raids represented American policy going forward.

"No," he said. "What the president said during the campaign, you'll be surprised to know, will be consistent with what we'll be doing in law enforcement. He was my boss during the campaign. He is formally and technically and by law my boss now. What he said during the campaign is now American policy." . . .   Holder's declaration is a high point for the movement to legalize medical marijuana, which has been growing for decades despite federal hostility. . . .

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February 28, 2009 | Permalink | Comments (0) | TrackBack (0)

Friday, February 27, 2009

Appointment of Jeffrey Crowley - AIDS Policy Chief

The Boston Globe reports on the appointment of Jeffrey Crowley to be the Obama Administration's AIDS policy chief and provides a background profile: 

President Obama today named the person who will coordinate federal efforts on HIV/AIDS. Jeffrey S. Crowley, MPH, Senior Research Scholar at Georgetown University’s Health Policy Institute, will be director of the Office of National AIDS Policy.

“Jeffrey Crowley brings the experience and expertise that will help our nation address the ongoing HIV/AIDS crisis and help my administration develop policies that will serve Americans with disabilities,” Obama said in a statement. “In both of these key areas, we continue to face serious challenges and we must take bold steps to meet them. I look forward to Jeffrey’s leadership on these critical issues.”

Crowley's biography, provided by the White House, is below: 

Jeffrey S. Crowley, M.P.H., is a Senior Research Scholar at Georgetown University's Health Policy Institute and a Senior Scholar at the O’Neill Institute for National and Global Health Law, Georgetown University Law Center. In these roles, he is recognized and respected for his capacity to integrate public health research with political strategy to achieve policy changes. He has authored numerous reports and policy briefs, and has testified before various Congressional Committees and the Institute of Medicine on several occasions. His primary areas of expertise are Medicaid policy, including Medicaid prescription drug policies; Medicare policy; and consumer education and training. . . .

February 27, 2009 | Permalink | Comments (0) | TrackBack (2)

Conscience Clause Rule To Be Rescinded

The LA Times reports that President Obama's Administration will move to overturn the Bush Administration's conscience clause rule that took effect last month.  The story provides,

Taking another step into the abortion debate, the Obama administration today will move to rescind a controversial rule that allows healthcare workers to deny abortion counseling or other family planning services if doing so would violate their moral beliefs, according to administration officials.

The rollback of the so-called conscience rule comes just two months after the Bush administration announced it late last year in one of its final policy initiatives.   

The new administration's action seems certain to stoke ideological battles between supporters and opponents of abortion rights over the responsibilities of doctors, nurses and other medical workers to their patients.  Seven states, including California, Illinois and Connecticut, and two family-planning groups have filed lawsuits challenging the Bush rule. They argue that it sacrifices the health of patients to the religious beliefs of medical providers.. . .

The move by the Department of Health and Human Services to throw out the conscience rule is being made equally quietly as most of Washington focuses on the president's blockbuster budget plan. 

On Thursday officials stressed that before the administration finalizes the rollback, a standard 30-day comment period seeks input from people across the ideological spectrum. . . .    If after 30 days of comments the administration throws out the Bush rule, it would have to begin a new rule-making process to enact a replacement.

February 27, 2009 | Permalink | Comments (0) | TrackBack (0)

Conscience Clause Rule To Be Rescinded

The LA Times reports that President Obama's Administration will move to overturn the Bush Administration's conscience clause rule that took effect last month.  The story provides,

Taking another step into the abortion debate, the Obama administration today will move to rescind a controversial rule that allows healthcare workers to deny abortion counseling or other family planning services if doing so would violate their moral beliefs, according to administration officials.

The rollback of the so-called conscience rule comes just two months after the Bush administration announced it late last year in one of its final policy initiatives.   

The new administration's action seems certain to stoke ideological battles between supporters and opponents of abortion rights over the responsibilities of doctors, nurses and other medical workers to their patients.  Seven states, including California, Illinois and Connecticut, and two family-planning groups have filed lawsuits challenging the Bush rule. They argue that it sacrifices the health of patients to the religious beliefs of medical providers.. . .

The move by the Department of Health and Human Services to throw out the conscience rule is being made equally quietly as most of Washington focuses on the president's blockbuster budget plan. 

On Thursday officials stressed that before the administration finalizes the rollback, a standard 30-day comment period seeks input from people across the ideological spectrum. . . .    If after 30 days of comments the administration throws out the Bush rule, it would have to begin a new rule-making process to enact a replacement.

February 27, 2009 | Permalink | Comments (0) | TrackBack (1)

Thursday, February 26, 2009

How Would Health Reform Help You?

Ezra Klein points to a new Kaiser Family Foundation article by Drew Altman showing that people who currently have insurance believe that health reform would also help them as well as helping the uninsured.  He writes,

The salient fact about health insurance in the United States is not that 15 percent don't have it. It's that 85 percent do. . . .  "Look," one of the President's senior health advisers said to me earlier this week, "95 percent of the people who voted for Obama had health insurance. We need to think about what we're doing for them."

That's why the first three health care principles in Obama's budget speak to the concerns of the insured: Choice, affordability, security. But In his latest column at the Kaiser Family Foundation, Drew Altman suggests a metric we should we be watching to see if they're successful. Polls, he notes, generally ask whether you think health reform will make your family better off. Kaiser recently ran one such survey and the results were moderately encouraging . . . [59% said that nation would be better off with health reform and 38% said that they would be better off]

Altman notes that these numbers are better than anything Clinton enjoyed. . . .

February 26, 2009 | Permalink | Comments (0) | TrackBack (0)

President Obama's Health Care Budget - $634 Billion

The Washington Post provides an overview of President Obama's health care budget and states,

President Obama is proposing to begin a vast expansion of the U.S. health-care system by creating a $634 billion reserve fund over the next decade, launching an overhaul that most experts project will ultimately cost at least $1 trillion. The "reserve fund" in the budget proposal being released today is Obama's attempt to demonstrate how the country could extend health insurance to millions more Americans and at the same time begin to control escalating medical bills that threaten the solvency of families, businesses and the government.

Obama aims to make a "very substantial down payment" toward universal coverage by trimming tax breaks for the wealthy and squeezing payments to insurers, hospitals, doctors and drug manufacturers, a senior administration official said yesterday. 

Embedded in the budget figures are key policy changes that the administration argues would improve the quality of care and bring much-needed efficiency to a health system that costs $2.3 trillion a year.

By first identifying a large pot of money to underwrite health-care reform -- before laying out a proposal on who would be covered or how -- Obama hopes to draw Congress to the bargaining table to tackle the details of a comprehensive plan. The strategy is largely intended to avoid the mistakes of the Clinton administration, which crafted an extensive proposal in secret for many months before delivering the finished product to lawmakers, who quickly rejected it.

"We aim to get to universal coverage," administration budget aide Keith Fontenot told health-care activists last night. Obama is "open to any ideas people want to put forward. He wants to work openly with the Congress in a very inclusive process." . . .

About half the money for the new fund would come by capping itemized tax deductions for Americans in the top income bracket. The proposal, which administration officials characterize as a "shared-responsibility issue," would reduce the value of tax deductions for families earning more than $250,000 by about 20 percent, according to administration documents.

Nearly one-third of the money would be generated by eliminating subsidies that the government pays insurers that sell Medicare managed-care plans. Instead, the Medicare Advantage plans would be put under a competitive bidding process, for a savings of $175 billion over the next decade. . . .


 

February 26, 2009 | Permalink | Comments (0) | TrackBack (2)

Wednesday, February 25, 2009

President Obama's Health Care Reform 2009

Last night, President Obama mentioned that health reform was a top priority and could not longer wait.  He stated that he expects reform by next year.  CNN.Com provides an overview of President Obama's health care ideas set forth last night and an initial reaction from Ron Pollack of Families USA:   

President Obama pledged Tuesday night to cure Americans from what he called "the crushing cost of health costs," saying the country could not afford to put health-care reform on hold.  "This is a cost that now causes a bankruptcy in America every 30 seconds. By the end of the year, it could cause 1.5 million Americans to lose their homes," Obama said in his speech to a joint session of Congress.  Obama pointed to the increasing number of uninsured and rapidly rising health-care premiums, which he said was one reason small business closed their doors and corporations moved overseas.

Obama's prescription for health-care reform included making "the largest investment ever" in preventive care, rooting out Medicare fraud and investing in electronic health records and new technology in an effort to reduce errors, bring down costs, ensure privacy and save lives.  "I suffer no illusions that this will be an easy process," the president said, adding that he was scheduling a gathering next week of "businesses and workers, doctors and health-care providers, Democrats and Republicans."  "The cost of health care has weighed down our economy and our conscience long enough. So let there be no doubt, health-care reform cannot wait, it must not wait and it will not wait another year," Obama said to a standing ovation.

The president also said Americans would see a cure for cancer "in our time." Obama's mother, Ann Dunham, died of ovarian and uterine cancer at 52. . . .

During his speech, Obama touted changes in the health-care system already passed in his month-old administration as part of The American Recovery and Reinvestment Act. "Already, we have done more to advance the cause of health-care reform in the last 30 days than we have in the last decade," he said. "When it was days old, this Congress passed a law to provide and protect health insurance for 11 million American children whose parents work full-time." 

Signed into law on February 17, The American Recovery and Reinvestment Act also includes $87 billion to bolster state Medicaid programs and offers a 65 percent subsidy for nine months to help the unemployed pay for their COBRA coverage.  COBRA allows the unemployed to pick up the payments and continue the health insurance coverage they had with their former employer. The subsidy would help an estimated seven million Americans, according to a congressional estimate.

The president's health-care message was applauded by Ron Pollack, executive director of Families USA, a national organization for health care consumers.  "President Obama is absolutely correct that the nation's economy and the federal budget deficit cannot be fixed without meaningful health-care reform," Pollack said in a statement.

February 25, 2009 | Permalink | Comments (0) | TrackBack (2)

Individual Mandates . . .

Ezra Klein provides a window into what the White House currently contemplates about reforming our health care system.  He writes,

I've now been able to confirm with multiple senior administration sources that the health care proposal in Obama's budget will have a mandate. Sort of.

Here's how it will work, according to the officials I've spoken to. The budget's health care section is not a detailed plan. Rather, it offers financing -- though not all -- and principles meant to guide the plan that Congress will author. The details will be decided by Congress in consultation with the administration.

One of those details is "universal" health care coverage. 

That word is important: The Obama campaign's health care plan was not a universal health care plan. It was close to it. It subsidized coverage for millions of Americans and strengthened the employer-based system. The goal, as Obama described it, was to make coverage "affordable" and "available" to all Americans.

But it did not make coverage universal. Affordability can be achieved through subsidies. But without a mandate for individuals to purchase coverage or for the government to give it to them, there was no mechanism for universal coverage. It could get close, but estimates were that around 15 million Americans would remain uninsured. As Jon Cohn wrote at the time, "without a mandate, a substantial portion of Americans [will] remain uninsured."

The budget -- and I was cautioned that the wording "is changing hourly" -- will direct Congress to "aim for universality." That is a bolder goal than simple affordability, which can be achieved, at least in theory, through subsidies. Universality means everyone has coverage, not just the ability to access it. And that requires a mechanism to ensure that they seek it.

Administration officials have been very clear on what the inclusion of "universality" is meant to communicate to Congress. As one senior member of the health team said to me, "[The plan] will cover everybody. And I don't see how you cover everybody without an individual mandate." That language almost precisely echoes what Senate Finance Chairman Max Baucus said in an interview last summer. "I don’t see how you can get meaningful universal coverage without a mandate," he told me. Last fall, he included an individual mandate in the first draft of his health care plan. . . .

February 25, 2009 | Permalink | Comments (0) | TrackBack (2)

Tuesday, February 24, 2009

Health Care Cost - Tops List of Fiscal Woes

The Washington Post reports on President Obama's fiscal responsibility summer and notes that he will make health care reform one of his top priorities.  Lori Montgomery and Amy Goldstein write,

President Obama will make reforming the U.S. health-care system his top fiscal priority this year, administration officials said yesterday, contending that reining in skyrocketing medical costs is critical to saving the nation from bankruptcy.

At a summit on "fiscal responsibility" convened by the White House, top administration officials said they also are committed to stabilizing the Social Security system and to revising a tax code that generates too little money to cover the cost of government. . . .

The White House budget director, Peter Orszag, delivered a forceful argument for keeping Washington's focus, for now, on slowing "the growth rate in health-care costs," calling it "the single most important thing we can do to improve the long-term fiscal health of our nation."  "Let me be very clear: Health-care reform is entitlement reform. The path of fiscal responsibility must run directly through health care," Orszag said.

Although the $787 billion stimulus package approved by Congress this month, along with bailouts for the nation's financial system, has bloated this year's budget deficit, administration officials and many outside experts contend that the rising costs of Medicare and Medicaid, the federal health programs for the elderly and the poor, present a far greater threat to the nation's long-term financial stability.

Most of the spending on the stimulus package will run out after a few years; the $700 billion the Treasury Department is investing in banks and other financial institutions promises to pay some returns to taxpayers. But health-care costs for the retiring baby-boom generation are inexorably rising.

Left unchecked, they will quickly push the annual budget deficit to unsustainable levels, and expand the debt owed to foreign governments and other private investors to 300 percent of the nation's gross domestic product by mid-century, Robert Greenstein, executive director of the Center on Budget and Policy Priorities, said at yesterday's summit.

"The recent economic recovery package is not driving the problem," Greenstein said. "The increases projected in federal spending in coming decades as a share of the economy are due entirely to the projected growth in Medicare, Medicaid and Social Security -- which in turn is driven by rising health-care costs and the aging of the population." . . . 

February 24, 2009 | Permalink | Comments (0) | TrackBack (0)

IT and Health Care

Health Affairs Blog will be running stories on the importance of information technology for the health care industry in its upcoming March/April issue.  Chris Fleming writes,

There is widespread agreement that greater investment in information technology (IT) is critical to reforming U.S. health care. The use of such technologies as electronic health record systems, personal health records, e-prescribing, and computerized physician order entry holds the potential for vastly improving care at a reasonable cost. The recently enacted economic stimulus legislation included just over $19 billion for health information technology, so major public and private investments in the sector now lie ahead.

At this crucial moment, Health Affairs devotes its forthcoming March-April 2009 issue to health IT—its transformative promise, but also the challenges to its adoption and the substantial dangers it could pose if that adoption is not done right. . . . .

February 24, 2009 | Permalink | Comments (0) | TrackBack (0)

Monday, February 23, 2009

Fresh Air Asks Questions About Fertility Clinics

Based on the recent birth of octoplets, Fresh Air will present a program today on fertility clinics.  The discussion includes remarks by author Liza Mundy.  The program overview provides,

Washington Post staff writer Liza Mundy discusses how multiple births are affecting parents, their babies and society. Mundy is the author of Everything Conceivable: How Assisted Reproduction Is Changing Our World.

February 23, 2009 | Permalink | Comments (0) | TrackBack (0)

Stimulus Bill Health Care Spending

The LATimes has an interesting piece on who benefits and who does not benefit from the spending available in the new stimulus bill.  Noam Levey writes,

John Peeler, an unemployed computer technician in South Carolina, may soon get health insurance for his wife and three children. Four months after being laid off, he is one of the lucky jobless Americans who could receive thousands of dollars in government subsidies from the new stimulus plan.  Susan McKowen, a 62-year-old breast cancer survivor from Illinois, is not so fortunate. Though she too lost her job in the current economic crisis, she won't be getting help with health insurance under the new law. . . .

But in the scramble to pass a bill, lawmakers made changes that left out millions of middle-class Americans who have lost their jobs and are struggling to fill a prescription or pay for a visit to the doctor.  That reflected a frenzied process in which sometimes arbitrary decisions were made to speed agreements and satisfy a dizzying array of political interest groups working to influence the massive bill.  During last-minute negotiating, provisions were cut that would have opened the government-run Medicaid insurance program to the unemployed, a move opposed by more conservative lawmakers.  Another provision to allow older jobless workers like McKowen to keep their employer-based coverage until they qualified for Medicare was eliminated amid opposition from business groups.

Even the rules governing which workers were eligible for aid were picked on the fly, officials acknowledged. Sensitive to businesses' concerns, senior Democrats decided to give health insurance subsidies only to workers who lost their jobs after September, even though the recession began nearly a year earlier.

That means Peeler, who was laid off in November, is eligible for assistance; McKowen, laid off 13 months ago when the recession was starting, is not . . . .

Peeler, 39, looked at getting COBRA coverage when he was laid off in November from an apartment management firm. But he quickly calculated he couldn't afford the premium -- more than $1,300 a month.   He said his unemployment check of $326 a week barely covered the mortgage and the groceries. And his wife, who had been looking for a job since the beginning of last year, couldn't find full-time work.

Continue reading

February 23, 2009 | Permalink | Comments (0) | TrackBack (4)

Sunday, February 22, 2009

Oscar Night - Any Doctor Movies?

The Wall Street Journal's Health Blog provides an interesting list of their favorite movie doctors.   For example,

Doctor Yuri Zhivago, Doctor Zhivago
ZHIVAGO: You lay life on a table and cut out all the tumors of injustice. Marvelous.

Hawkeye Pierce, M*A*S*H
BLAKE: Headquarters … says you stole a jeep.
HAWKEYE: No sir, no. I didn’t steal it. No, it’s right outside.

I think I have probably enjoyed the movies with a focus on the patient rather than the doctor but that is probably just me.

February 22, 2009 | Permalink | Comments (0) | TrackBack (2)