The abortion language that was added to the Senate's healthcare bill to win the vote of Sen. Ben Nelson (D-NE) has achieved a rare feat: It is drawing contempt from both sides. That could be taken as a sign that senators finally found an elusive compromise on a thorny issue. But serious questions are already being raised about how the new language would work in practice and whether it would even be feasible to implement. The long-standing ban on federal funding for abortion has complicated congressional Democrats' healthcare legislation. Medicaid bars federal funding for abortion, but 17 states and the District of Columbia allow the procedure for female Medicaid enrollees paid out of their own funds. It is harder to reach middle ground in the bill before Congress, which would provide federal subsidies to millions of people to buy private health insurance plans on a new marketplace, or "exchange."
Republicans are slamming the provisions Democrats inserted in their far-reaching healthcare overhaul bill at the last minute to win over individual senators. With Senate action now almost certain by Christmas, a battle to shape perceptions of the legislation is heating up, and Republicans are wasting no time attacking it as sullied by backroom deals. Republicans criticized provisions such as an agreement pushed by Sen. Byron Dorgan (D-ND) to help hospitals in rural states; a deal on Medicaid payments won by Sen. Ben Nelson (D-NE); and help for a Superfund site in Libby, MT, obtained by Sen. Max Baucus (D-MT), among others.
Even as the Senate took a significant step toward passing its version of a sweeping overhaul of the health insurance system before Christmas, Democrats were grappling with deep internal divisions over abortion, the issue that most complicates their drive to merge the Senate and House bills and send final legislation to President Obama. In the House, advocates and opponents of abortion rights and conservative Democrats have made clear that they object, for different reasons, to the Senate's compromise language on abortion. Interest groups on both sides of the spectrum also oppose the abortion provision in the Senate bill, leaving Speaker Nancy Pelosi with a challenge in rounding up the votes she needs in the House. Pelosi's room for maneuvering is limited because any changes to the language in the Senate bill could unravel the deal that provided Democrats with the 60 votes they need to get the legislation through the Senate.
The public's views on healthcare have stayed largely steady this year, despite dramatic swings in the political battle over President Barack Obama's drive to revamp the nation's medical system, a survey says. Overall, 82% say an overhaul of the nation's healthcare system is important for recharging the economy, according to an average of monthly polls conducted since April by the nonpartisan Robert Wood Johnson Foundation. The most recent survey, covering November, found that 77% agree with that connection. Personal concerns have remained fairly constant as well. About one in four people worry they might lose their health coverage in the next year, while almost half say they are concerned they might not be able to afford care for themselves or a relative.
A Ohio state law passed nearly four years ago requires hospitals to provide extensive quality and pricing information to the Ohio Department of Health— and a consumer-friendly Web site with this information goes live Jan. 1. Hospitals already report some of this information, but it's difficult for consumers to compare hospitals. The new site is called Ohio Hospital Compare and will feature more than 100 quality measures, including mortality and infection rates and how often specific medical procedures are performed at a hospital. There is even information about whether a hospital has a hand-washing program for its health workers. On the main page, consumers will be able to pick hospitals to compare on quality measures. The Web site also will link to lists of hospital charges, but they won't be in an easy-to-use format until the end of 2010, said Sara Morman, an Ohio Health Department spokeswoman. At that time, consumers will be able to compare charges, such as for private and semiprivate rooms, the 30 most-common X-rays, and services in emergency, operating and delivery rooms.
The US military has awarded Brigham and Women's Hospital a multimillion-dollar contract to pay for face transplants for veterans who have survived catastrophic war injuries in Iraq and Afghanistan, but are left severely deformed. The Department of Defense is hoping that the Boston doctors will be able to complete face transplants on six to eight patients over the next 18 months, which would nearly double the nine known procedures completed worldwide. In April, the Brigham performed its first face transplant, which was the second done in this country. The $3.4 million award, which also will be used to provide the surgery to civilians, is a signal that face transplantation could be poised to move into mainstream medicine four years after the first such operation, on a French woman, was met with fierce ethical objections. Doctors and military officials said they are unsure how many veterans will qualify, but estimate the number could be as high as 200.
Rhode Island Gov. Don Carcieri has proposed cutting millions of dollars meant to reimburse hospitals for providing healthcare to the poor during a recession that has cost thousands of Rhode Island residents their jobs and employer-provided health insurance. The latest budget proposal from the Republican governor would eliminate $3.7 million in funding to four hospitals—South County, Miriam, Westerly, and Kent Hospital—that have seen an increasing number of patients who have health insurance, but cannot afford to make copayments or pay deductibles of $1,000 or more required under their insurance plans. Carcieri included the cut as part of a package intended to close a $220 million budget deficit for the fiscal year ending in June, a shortfall equivalent to about 7% of what the state expected to take in. With unemployment hovering around 13%, that budget shortfall could grow larger as people lose jobs and cut back on spending, which drives down state tax collections.
Americans could soon be able to see a doctor without getting out of bed, in a modern-day version of the house call that takes place over the Web. OptumHealth, a division of UnitedHealth Group, the nation's largest health insurer, plans to offer NowClinic, a service that connects patients and doctors using video chat, nationwide next year. It is introducing it state by state, starting with Texas, but not without resistance from state medical associations. OptumHealth believes NowClinic will improve healthcare by ameliorating some of the stresses on the system today, like wasted time dealing with appointments and insurance claims, a shortage of primary care physicians, and limited access to care for many patients. But some doctors worry that the quality of care that patients receive will suffer if physicians neglect one of the most basic elements of health care: a physical exam.
In a packed and stuffy boardroom, a procession of speakers vigorously urged the Eden Township Healthcare District's directors to keep San Leandro Hospital open. The crowd overflowed into the lobby of the Hayward Area Recreation and Park District administration building. The hospital is run by Sutter Health, which last summer exercised an option to purchase the hospital from the healthcare district. Sutter, which says the hospital is losing millions every year, plans to turn it over to the Alameda County Medical Center, which wants to close the emergency room and acute care facility and convert the hospital into a rehabilitation facility with an urgent care clinic. In August, when the healthcare district board voted to reject the purchase, Sutter sued the district demanding that it fulfill its contract. An audit is expected to be completed in January, which should clarify the hospital's finances.
For years, the federal government has spent billions to entice senior citizens into private Medicare Advantage plans run by private insurers that offer bonus care for low premiums. Now that nearly a quarter of Medicare patients have enrolled in these health plans, including 350,000 in South Florida, Congress is poised to pass legislation that would yank billions of dollars from them. Many patients resent this turnabout and want to preserve the program, which offers extras, such as vision care and gym memberships. On the other hand, patients who pay for care in other ways say they resent subsidizing those who get gold-plated treatment at bargain rates. The controversy over Medicare Advantage is one of the thorniest issues complicating final passage of landmark legislation to overhaul the nation's healthcare system. Republicans have turned potential cutbacks into a rallying cry against reform.
