A last-minute addition to the Senate healthcare bill that requires small construction companies to offer health coverage or pay a fine touched off a battle with some industry groups demanding its removal. The change, offered by Sen. Jeff Merkley (D-OR), says construction companies should offer coverage if they have five or more employees and a payroll of $250,000 or more, or face fines of up to $750 per employee per year if the employees receive tax credits. The threshold for other types of companies is 50. Construction-related industries say it is unfair to single them out, as the recession has hit them particularly hard. Recent data show that unemployment in construction is 19.4%, nearly twice the national average of 10%.
Companies are alarmed at potentially costly provisions in the Senate healthcare bill, many of which they hope will be scrapped during a final round of negotiations early next year. A scramble to massage the hefty measure, instead of pushing to kill it, reflects the view of many in the business community that a sweeping remake of the healthcare system now appears inevitable. The U.S. Chamber of Commerce is among a few big business groups calling for Congress to scrap the overhaul effort. Business is worried that President Barack Obama's push to extend coverage to millions more Americans will raise the burden on employers. Business groups have widely criticized the 2,074-page Senate bill, which looks set for passage on Christmas Eve. They also have offered a variety of fixes.
The top prosecutors in seven states are probing the constitutionality of a political deal that cut a funding break for Nebraska in order to pass a federal healthcare reform bill, South Carolina's attorney general said. Attorney General Henry McMaster said he and his counterparts in Alabama, Colorado, Michigan, North Dakota, Texas, and Washington state—all Republicans—are jointly taking a look at the deal they've dubbed the "Nebraska compromise." McMaster's move comes at the request of Republican U.S. Sens. Lindsey Graham and Jim DeMint of South Carolina.
Facing last-minute liberal resistance in Congress, the drug industry is bracing for an increase in its share of the cost of the proposed healthcare overhaul beyond the $80 billion over 10 years that it had negotiated with the White House, industry lobbyists said. House lawmakers and Senate liberals were furious to learn in August that to win drug makers' political support, the White House and the Senate Finance Committee had struck the deal to cap industry costs at $80 billion. But the White House and the Senate nonetheless appeared to stick by the agreement, which drug lobbyists called "rock-solid." Now, after narrowly beating back some Senate proposals to extract far more and facing similar demands from House leaders, the drug makers acknowledge that they may have to renegotiate, several drug lobbyists said.
The Ronald Reagan U.C.L.A. Medical Center, one of the nation's most highly regarded academic hospitals, has earned a reputation as a place where doctors will go to virtually any length and expense to try to save a patient's life. Yet that ethos has made the medical center a prime target for critics in the Obama administration and elsewhere who talk about how much money the nation wastes on needless tests and futile procedures. They like to note that U.C.L.A. is perennially near the top of widely cited data, compiled by researchers at Dartmouth, ranking medical centers that spend the most on end-of-life care but seem to have no better results than hospitals spending much less.
The healthcare bill that the Senate is expected to pass on Christmas Eve has protections that ensure Massachusetts' pioneering health insurance overhaul will remain intact, and it also includes $500 million in extra money for the state, Senator John F. Kerry said during a quick visit to Boston between votes on the measure. The legislation also contains an additional $200 million for Massachusetts hospitals that say they have not been adequately reimbursed by the state for treating a large share of the poor. The Senate's bill is largely based on the Massachusetts plan and adopts some of its hallmark provisions, including a requirement that nearly everyone obtain health insurance coverage or pay a tax penalty, and subsidies to help low- and middle-income residents afford coverage. Yet in some respects, the Senate's plan is more expansive than the program in Massachusetts because it will allow many more people with higher incomes to qualify for subsidized health insurance coverage.
The public option is gone. Expansion of Medicare is dead. But an intense fight continues over a crucial issue in the proposed healthcare overhaul: how far Congress should go in emulating the type of insurance marketplace that is at the center of the pioneering Massachusetts insurance program. Called "exchanges" in the federal health bills and modeled on the Massachusetts Health Connector, they would enable people to compare and purchase insurance as easily as they shop for airline tickets at an all-in-one travel Web site. The concept of such comparison shopping is generally backed by insurance firms, but exchanges are also controversial because Democrats in Congress want to use them to impose greater oversight and cost controls on insurance companies, requiring them to provide certain levels of coverage at lower profit margins.
MaineGeneral Medical Center filed a Certificate of Need application with the state for a new regional, inpatient hospital in north Augusta. The hospital has also applied for permission to update its Thayer Campus in Waterville. MaineGeneral currently operates two inpatient facilities, in Augusta and Waterville, and hospital officials say that set up is no longer viable. MaineGeneral Health President and CEO Scott Bullock said consolidating the two inpatient facilities at one hospital in north Augusta will help MaineGeneral attract top doctors, and operate more efficiently, decreasing the total number of beds from 287 to 226. The Thayer Campus would remain a fully-occupied outpatient hospital, with a 24-hour, seven-day emergency department, officials said. The estimated cost of the project is $322 million.
Pandemic influenza vaccine is getting much easier to find, but more than half of American adults say they still don't want it, and one-third of parents say they don't want their children to get it either, according to two surveys. As of this week, 111 million doses of vaccine against the pandemic strain of H1N1 flu have been released to states and cities. Not all of it has been used. There have been no unusual or unexpected vaccine side effects reported. As of Dec. 12, 11 states reported "widespread" flu activity (as measured by office visits, hospitalizations, and other indicators), down from 14 the week before. During the last two weeks of October, in comparison, 48 states reported widespread activity.
The nation's ambulance crews are pushing a virtual medical ID system to rapidly learn a patient's health history during a crisis—and which can immediately text-message loved ones that the person is headed for a hospital. The Web-based registry, invisibleBracelet.org, started in Oklahoma and got a boost this fall when the state's government made the program an optional health benefit for its own employees. Now the Invisible Bracelet attempts to go nationwide as the American Ambulance Association next month begins training its medics, who in turn will urge people in their communities to sign up.
