Six years after Congress added a prescription drug benefit to Medicare, Democrats in the House and Senate are poised to make a change that would get rid of a gap that forces millions of elderly patients with especially high expenses for medicine to pay for much of it on their own, the Washington Post reports. The closing of the unusual gap in Medicare drug coverage would "forever end this indefensible injustice for American's seniors," Senate Majority Leader Harry M. Reid (D-NV) said in announcing that the Senate would join the House in supporting the change.
Major health insurers, which decided to support key aspects of President Barack Obama's healthcare overhaul, are now picking through the Senate's version of the legislation and finding cause for concern, the Wall Street Journal reports. Big insurers are still hoping to influence some language in the legislation before Congress sends it to the president, but the initiative is poised to change their industry more than any other sector of the U.S. healthcare system, the Journal reports.
In 1994, healthcare spending in Dallas and Sacramento was about the same. Since then, Dallas has become one of the highest-spending cities in the country. In Sacramento, medical inflation has cooled down, and the city now spends well below the national average. Healthcare workers in Sacramento say they bent the cost curve through integration. They cut duplication and waste by bringing doctors, hospitals, nurses, and other caregivers together so patient care could be coordinated, the Dallas Morning News reports.
As Democrats tout the American Medical Association's endorsement of their healthcare overhaul, critics are pointing to their sidestepping of a monopoly that sends millions into the trade group's coffers each year. The AMA holds the exclusive rights to the medical billing codes that doctors are required to use when they submit bills to insurance plans. It is a monopoly that critics say gets in the way of making healthcare less expensive and potentially more effective, the Chicago Tribune reports.
The Mayo Clinic, often cited by the Obama administration as a model for high-quality, cost-effective healthcare, generally supports key provisions of the legislation approved by the Senate, but one Mayo official called for more aggressive steps to change how care in the U.S. is paid for. "The concerns are whether the legislation will be strong enough to change the incentives in the system today, which are mostly around paying for volume" and not for "value" of care, Jeffrey Korsmo, executive director of health policy center at the Mayo Clinic, told the Wall Street Journal.
If you listen to hospital lobbyists in Washington, the industry teeters on the brink of financial ruin, depending on how healthcare reform plays out. But the rhetoric does not match the balance sheets of some of Chicago's largest hospital operators. Many are spending unprecedented amounts on new buildings and seeing some of their best improvements in cash since the dot-com boom of a decade ago. Critics say large hospital operators that are amassing cash are doing so at the expense of patients, charging higher prices when that money could be used to lower costs or subsidize hospitals in a hole. The hospitals maintain they need to have ample cash to invest in the latest medical technology, attract top medical care providers, and maintain a reserve to cushion themselves from rocky economic conditions.