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.
In the great healthcare debate of 2009, President Obama has cast himself as a cold-eyed pragmatist, willing to compromise in exchange for votes. Now ideology—an uprising on the Democratic left—is smacking the pragmatic president in the face. Stung by the intense White House effort to court the votes of moderate holdouts like Senator Joseph I. Lieberman, independent of Connecticut, and Senator Ben Nelson, Democrat of Nebraska, liberals are signaling that they have compromised enough. Grassroots groups are balking, liberal commentators are becoming more critical of the president, some unions are threatening to withhold support, and Howard Dean, the former Democratic Party chief, is urging the Senate to kill its health bill. The White House scrambled Thursday to tamp down the revolt, which has been simmering for weeks, but boiled over when the Senate Democratic leadership, bowing to Lieberman, scrapped language allowing people as young as 55 to buy into Medicare.
The White House and Senate Democratic leaders seem willing to give Senator Ben Nelson, Democrat of Nebraska, just about anything he wants to win his support of major healthcare legislation. Anything, that is, but the item at the top of Nelson's wish-list: air-tight restrictions on insurance coverage for abortions. The bid to win Nelson's support has become a race against the clock. The Senate majority leader, Harry Reid of Nevada, has developed plans for a series of votes beginning at 1 a.m. Monday and round-the-clock Senate sessions intended to meet his deadline of completing the healthcare bill before Christmas. But Reid is still at least one vote short of the 60 he needs to move the bill ahead, and as much as anyone, Nelson appears to hold the legislation's fate in his hands.
When Christopher Barton took over as chief of emergency medicine at San Francisco General Hospital this year, he became responsible for balance sheets, income statements, and a sprawling staff—all with no formal business training under his belt. The emergency room's patient load had also begun to swell—up nearly 20% in the past year, according to Dr. Barton, adding to his management headaches. So Dr. Barton decided to get some business school training, a move many physicians are making to cope with the ever-changing pace and paperwork of modern day healthcare. Nurses, private practice managers, and hospital administrators are also seeking guidance on how to analyze the slew of data now accessible to them, with the hope of improving the quality of care and lowering costs. Schools are responding with business management programs geared toward the medical community.
The Illinois Supreme Court Thursday did not rule as expected on whether the state's four-year-old medical malpractice reform survives. The next batch of Supreme Court opinions is expected in mid-January, the court spokesman said. The much-anticipated ruling, which could directly impact the constitutionality of damage caps for doctors and hospitals, is being watched closely by the healthcare industry and employers who see caps on damages as a way to tame rising healthcare costs. Should the high court uphold the law, it could provide momentum in Washington for federal malpractice reform.