Jonathan Bush, chairman and CEO of Athenahealth, says the problem with U.S. healthcare is that there's "no landscape of choices, or choosers." Many physicians don't even know the actual value of the services they render, he says in this opinion piece by the Wall Street Journal. There really can be "radical improvement" in healthcare, Bush tells the Journal, but only if there are "radical improvers" able to set themselves apart and lead the forward advance.
The Florida Agency for Health Care Administration has approved HCA's certificate of need to build the 85-bed West Jacksonville Medical Center.
"We are very pleased with the state's decision and have been delighted with the reception and support we have received from the Westside community," said Jim Wood, president/CEO of Memorial Hospital, in a media release. "The residents of the Westside are very anxious to improve their access to care in this growing community."
Services at the 85-bed, three-story, acute-care hospital and an adjacent 200,000 -square-foot medical office building will include an emergency department, cardiac cath lab, obstetrical unit, operating rooms, ICU, medical/surgical unit, and extensive diagnostics services, including MRI and CT scan.
The location in western Duval County has yet to be finalized. Construction will cost between $100 million and $130 million and will provide an estimated 250 people with jobs during the two-year building phase. Once completed, HCA estimates that 800 people will be needed to staff the hospital, which will generate approximately $60 million from in local payroll and benefits.
HCA said its private, for-profit status means that Duval County residents will not see their taxes rise to fund the project. HCA expects to pay an additional $1 million in property taxes and $1.7 million in sales tax each year related to West Jacksonville Medical Center.
Comparing the past two weeks of the Senate floor debate to a steeple chase race, Senate Majority Leader Harry Reid (D-NV) said the time is close to vote on the bill.
"It's been a tough race, but it's been worth it," Reid said Monday in a briefing accompanied by several key Democratic senators who have participated in the floor debate.
"We all stand shoulder to shoulder in the belief that healthcare reform is necessary and timely. We're working hand-to-hand with the White House to accomplish that goal," he said. "I am confident that by next week we'll be on the way to fowarding this bill to the president."
The question remains, though: What exactly is in the bill in terms of a public insurance option, Medicare buy-in plan, a not-for-profit private insurance option, or something new? Since last week, Reid has kept the direction and language under wraps—and yesterday was no exception.
The Medicare buy-in plan, though, for individuals age 55-64 without insurance is one idea that appears dead—though Reid did not discuss Medicare expansion specifically.
"We have been careful about not talking about specifics in [Reid's] manager's package for reasons that are very, very obvious," he said. "We don't want to have to make this public and then have to change things—if CBO [the Congressional Budget Office] handles this the right way," he said. He expressed his desire that Democrats—and even a few Republicans—would support the package.
Senators accompanying Reid, such as Finance Committee Chairman Max Baucus (D-MT), were left promoting other aspects of the bill, including "lowering taxes." He said: "It's the biggest tax cut since the 2001 tax cut. On a net basis, this legislation, because of tax credits, lowers taxes for Americans."
So far, the pace of the Senate healthcare reform debate could be best described as glacial—with less than 20 amendments out of nearly 400 being voted on. Discussion, though, appears to be lively off the Senate floor—with various compromises and agreements being forged.
Some of the amendments could appear in the manager's amendment. However, this manager's amendment would not be finalized most likely until after the Senate leadership decides that they have the 60 votes for final passage of the healthcare reform bill in hand.
When the bill is released, pending the review by the CBO, the debate is expected to be quite intense among Republicans who during the floor debate have complained about being left out of the drafting process. At one point on Monday, Senate Minority Leader Mitch McConnell (R-KY) talked about the bill stuck in a conference room nearby "being turned into sausage to get to 60 votes."
Today, the Senate will resume votes on amendments, including the proposal by Sen. Byron Dorgan (D-ND) to permit the importation of prescription drugs from Canada and other countries.
While the Senate's healthcare reform bill has come under scrutiny over the past week about whether it will contain costs, a report from the White House Council of Economic Advisers released Monday suggested that it actually will slow medical spending growth over the next decade.
Taken together, the combination of Medicare- and Medicaid-related provisions in the Senate bill are estimated to "reduce the annual growth rate of federal spending on both programs" by 1% in the upcoming decade and "by an even greater amount in the subsequent decade," the report said. Overall, these savings "would increase national savings and improve the long run performance of the U.S. economy."
To explain some of the differences in findings, the report said that Congressional Budget Office (CBO) projections in the past have "sometimes understated the savings from delivery system reforms and revised payment policies, such as those included in the Senate bill."
For example, actual savings following the Balanced Budget Act of 1997, which changed the way skilled nursing facilities and home health services were reimbursed under Medicare, were 50% greater in 1998 and 113% greater in 1999 than CBO originally forecast. Also, spending on the Medicare Part D prescription drug benefit following the Medicare Modernization Act of 2003 was "about 40% less than CBO forecast."
In addition, the CBO's analysis is "generally limited to the federal budget, and does not attempt to account for savings in the healthcare system more broadly from policies implemented through reform," it stated.
However, recent research published in the New England Journal of Medicine suggests that bundled payments for chronic diseases and elective surgeries could reduce healthcare spending by as much as 5.4% from 2010 to 2019, the report noted. Even if such savings applied to only half of spending in the healthcare sector, the result could be more than $900 billion of savings over the decade.
The council's findings likely will be compared to the report issued on Thursday by the Centers for Medicare and Medicaid Services' chief actuary who noted that national health expenditures under the bill could increase by $234 billion between 2010 and 2019.
Senate Democratic leaders appeared poised to abandon efforts to create a government-run insurance safety net in their push for healthcare reform, as they attempted to close ranks around a bill they hoped would win the backing of all 60 members of their caucus, the Washington Post reports. Party leaders conceded that a key portion of the compromise they crafted to replace the public option—a proposal allowing people as young as 55 to buy into Medicare—did not have sufficient support from Democratic moderates to overcome a likely Republican filibuster, reports the Post.
The day after Sen. Joseph I. Lieberman (I-CT) threatened on national television to join the Republicans in blocking the healthcare bill, Democratic senators emerged from a 90-minute closed-door session and suggested that they were on the verge of bowing to Lieberman's main demands: that they scrap a plan to let people buy into Medicare beginning at age 55, and to put an end to a fallback version of a new government-run health insurance plan. Lieberman said he believed that the Medicare expansion was off the table, though he did not get any guarantee, reports the New York Times.
Sen. Ron Wyden (D, OR) is proposing amendments to the Senate healthcare bill that would give people who are eligible for coverage through their employer the option of buying cheaper coverage from the new insurance exchanges and keeping the difference. The legislation without the amendments opens up the exchanges only to small businesses and to people who don't have insurance through an employer. There are virtually no provisions in the Senate or House health bills that directly reward consumers for choosing cost-efficient care or lowering their medical costs through healthy behavior, the Wall Street Journal reports.
The Rehabilitation Institute of Chicago has purchased a vacant lot about a block south of the existing facility for an undisclosed sum. RIC executives said they have outgrown their existing 165-bed facility, which has only 40 private rooms. Also, certain services are located outside of the main hospital building, making it inconvenient for some patients and RIC staff, officials said. "This will be the site of a new facility," Chief Executive Joanne Smith, MD, told the Chicago Tribune.
Widespread overuse of CT scans and variations in radiation doses caused by different machines are subjecting patients to high radiation doses that will ultimately lead to tens of thousands of new cancer cases and deaths, researchers reported. The two new studies published in the Archives of Internal Medicine are the first to quantify the extent of exposure and the related risks, the Los Angeles Times reports. Each year that current scanners are used, researchers reported, 14,500 deaths could result.
Mayo Clinic Florida and St. Andrew's Lighthouse sare partnering to build an $8.8 million extended-stay facility to house cancer and organ transplant patients and their families. The Gabriel House of Care, a 30-bedroom hospitality house, will be built on a 4.5-acre lakeside site on Mayo Clinic's campus in Jacksonville. It will be leased to and managed by St. Andrew's Lighthouse, a Jacksonville not-for-profit. Mayo Clinic is raising $13.5 million for the project, some of which will fund future operations and expansion.
