Thirty million people without health insurance stand to gain coverage under a deal announced on Saturday by Senate Democrats. To get the 60 votes needed to pass their bill, Democrats scrapped the idea of a government-run public insurance plan, cherished by liberals, and replaced it with a proposal for nationwide health plans, which would be offered by private insurers under contract with the government. The legislation also includes a proposal that would limit insurance coverage of abortion. The provision, which was the last piece of the puzzle to fall into place, was negotiated by the Senate majority leader, Harry Reid, Democrat of Nevada, to win the support of Senator Ben Nelson, Democrat of Nebraska, who is an opponent of abortion. Under the agreement, states could choose to prohibit abortion coverage in the insurance markets, or exchanges, where most health plans would be sold. But if a health plan did cover the procedure, subscribers would have to make two separate monthly premium payments: one for all insurance coverage except abortion and one for abortion coverage.
An company that advises dozens of health insurers nationwide says the real problem with mammograms is radiologists who aren't reading them correctly. In response to a controversy last month, when a federal task force recommended against annual breast cancer screenings for women in their 40s, National Imaging Associates reviewed more than 400,000 mammograms. The issue, according to the task force, is that there are too many "false positives"—findings that women might have cancer, when, in fact, they do not. After an exhaustive review over the past few weeks, a high-ranking official at National Imaging—a unit of Magellan Health Services Inc., of Avon, CT—reached a different conclusion: Poorly performing radiologists are the root of the problem.
Maumee, OH-based St. Luke's Hospital is considering merging with another local hospital group—most notably Mercy or ProMedica Health System—as it continues to be shut out of lucrative insurance contracts, its chief executive says. The independent nonprofit Maumee hospital had an operating loss last year of $8.8 million, an amount based on the business of caring for patients that is expected to be even higher this year. Although it has upward of $70 million in reserves to keep it going, a merger or other arrangement may be necessary unless St. Luke's can negotiate better health insurance contracts with existing or additional insurance providers, said Dan Wakeman, St. Luke's president and chief executive officer.
Under a new law, effective July 1, healthcare facilities will be prohibited from forcing nurses and other healthcare workers to work beyond their scheduled shifts. Nurses and other medical professionals have been lobbying for such legislation for years. The new law is aimed at improving patient safety.
When Senate Democratic leaders agreed this week to remove a public insurance plan from their massive healthcare bill, they did more than quash a liberal dream of expanding the government safety net. They effectively pinned their hopes of guaranteeing coverage to all Americans on a far more conventional prescription: government regulation. The change sprang from a compromise made to placate conservative Democrats wary of a new government program. But shorn of a "public option," the Senate healthcare bill has reverted to a long-established practice of leveraging government power to police the private sector, rather than compete with it. Despite the resistance among Republicans and conservatives to more government regulation, even the insurance industry has agreed to broad new oversight of their business in exchange for the prospect of gaining millions of new customers. The expanded regulation of insurance programs ultimately could ripple through the entire healthcare system, affecting how doctors, hospitals, and other providers care for their patients.
A widening gulf in the health status of blacks and whites in Chicago comes even as disparities between the two races nationally have remained relatively constant, a new study has found. The disparity is particularly jarring in five areas: death from all causes, heart disease mortality, breast cancer mortality, rates of tuberculosis, and the percentage of women who received no prenatal care during the first trimester of pregnancy. Nationally, the racial gap got worse from 1990 to 2005 for six of the 15 health indicators researchers studied. However, in Chicago, disparities worsened for 11 of the 15 indicators, according to research by the Sinai Urban Health Institute, published online Thursday in the American Journal of Public Health.