Wednesday, September 30, 2009

9/30/09 - Tell Legislators NO on MCARE Fund

9/30/09 - Liability and Health News ALERT
TELL Legislators NO on MCARE Fund

by Donna Baver Rovito, Editor, "Liability and Health News Update"
Author, "Pennsylvania's Disappearing Doctors"

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One PA Senator reports getting 700 phone calls in two days from PA physicians and others upset about the state's plan to use Mcare $$$$$ to balance the state budget! I've opened numerous emails from people confirming that they've been told, while making their own calls, that there are LOTS of people calling.

Rumor has it that the sheer number of calls is making people nervous....

Let's double that today - please make calls if you haven't already, and please, pass this on to others who care about the quality of health care in Pennsylvania.

Here's what's going on right now:

From a PA Medical Society newsletter to members: "The Philadelphia Inquirer had reported that $100 million was set aside in the budget to fund legislator’s pet projects, known as “walking-around-money” or “WAMS.” But WAMS are controversial, so now the $100 million is being used to secure votes for the budget in a different way. News media sources confirm that legislative leaders and the Rendell administration will use $100 million to increase key line items in state budget allocations to appease legislators who would otherwise oppose the budget. Either way, your Mcare insurance premium dollars will balance the budget “deal.”"

If you didn't call last week, PLEASE CALL NOW. It takes less than 10 minutes to make the five or six phone calls we've asked you to make - the numbers follow.

Call your own state representative and senator, too. If you don't know who they are, use the PA Medical Society's Capwiz feature to find out:
Your calls can make the difference. In the next 24 hours, please call all of these conference committee members
Rep. Dwight Evans—(717) 783-1540
Rep. Todd Eachus—(717) 787-2229
Sen. Robert Mellow—(717) 787-6481
Sen. Dominic Pileggi—(717) 787-4712
Sen. Jake Corman—(717) 787-1377
Your message: “I strongly urge you to oppose any proposal that uses Mcare insurance premiums to balance the state budget.” Be sure to tell them where you practice. (Or where you live.)
It takes less than 10 minutes to make the phone calls the numbers are listed above. Call your own state representative and senator, too. If you don't know who they are, use the PA Medical Society's Capwiz feature to find out:

Here's more information that might be helpful:

From the PA Medical Society website:
Video: Mcare Message on the State Budget ProposalOn Sept. 29, 2009, the State Society sent this video to members of the state General Assembly regarding the proposed use of physician premium dollars to help balance the state budget.


from the PA Medical Society website:
Mcare Fund Raid Facts and Misconceptions

((The misconceptions are first - the facts follow, in bold italics.))
The proposed Mcare Fund raid to balance the state budget has rightfully angered Pennsylvania physicians. I hope the information below will clear up any misconceptions you may have about the Fund. This information will help you talk to your legislators about Mcare. Daniel Glunk, MD, President, Pennsylvania Medical Society

The Mcare Fund balance is made up of cigarette tax revenues or Auto CAT Fund surcharges.
Mcare Fund balance resulted from excess premiums paid by physicians, hospitals, nurse midwives, podiatrists, and nursing homes.

The Mcare balance is excess money that is not needed to pay claims. The Mcare Fund says that if claims payouts exceed
annual assessments, the balance can be used to shield providers from premium spikes.

The Mcare Fund balance is available to balance the budget. The Mcare Fund balance is the subject of
ongoing litigation and may be required to be used to lower Mcare assessments.

Physicians have received nearly a billion dollars in Mcare abatements. Although the legislature granted $946 million in abatements between 2003 and 2007, the Rendell administration only transferred $330 million from the Health Care Provider Retention Account to the Mcare Fund to pay for them. To a large extent, physicians paid for their own abatements through inflated Mcare assessments.
Raiding the Mcare Fund balance will have little impact on future assessments charged to physicians and hospitals. The Mcare Fund has an
unfunded liability of $1.66 billion. Every penny taken to balance the budget will have to be recouped from health care providers to retire that shortfall.

Taking money from the Mcare Fund to balance the budget isn’t a "big deal." Physicians and injured patients trust the state to run the Mcare Fund for their benefit. Raiding the Fund is a fundamental breach of faith, and will destroy any remaining belief in the Mcare Fund’s integrity.

Please contact your legislators TODAY, now, while you're thinking about it. We have momentum now - let's not lose it!

THANK YOU for your commitment to quality health care in Pennsylvania!


US Senate panel rejects public healthcare option
Tue Sep 29, 2009 3:51pm EDT

WASHINGTON, Sept 29 (Reuters) - The U.S. Senate Finance Committee on Tuesday rejected including a government-run "public" insurance option, which is backed by President
Barack Obama, in its sweeping healthcare reform bill.

The panel voted 15-8 against a government-run insurance plan in the first of what is expected to be several battles in Congress over the public option, one of the most contentious issues in the raging U.S. debate over healthcare reform.
Obama has made reforming the $2.5 trillion U.S. healthcare system his top domestic priority.

Five Democrats joined all the panel Republicans in opposing inclusion of the government-run option in the bill. The issue is expected to be raised again in the full Senate and the House of Representatives.

The Senate Finance plan by Democratic Chairman Max Baucus is the only healthcare bill pending in Congress that does not have a public insurance plan, which Obama and other backers say would boost competition for insurers.

Republican critics said the public option would devastate the private insurance industry and ultimately lead to a government takeover of the sector.

Democratic Senator John Rockefeller, who offered an amendment to insert a public option, said the approach would give the public more choices and force the insurance industry to compete.

"Who comes first, the insurance companies or the American people?" he asked.
Senator Charles Grassley, the senior Republican on the panel, said the public option would represent a first step toward what he said was the eventual goal of Democrats -- a complete government-run health insurance system.

"A government-run plan will ultimately drive private insurers out of business," Grassley said. "If you support government bureaucrats, not doctors, making decisions, you should support this amendment."
(Writing by John Whitesides; Editing by David Storey)


Public option fate in Obama's hands
CARRIE BUDOFF BROWN 9/29/09 8:44 PM EDT Read more:

The Senate Finance Committee spent more than five hours debating the public health insurance option Tuesday before voting down two Democratic amendments to add it to the bill.

But the one person who will effectively decide its fate wasn’t even in the room.
Barack Obama got an early look at the depth of the Democratic divide on the government insurance option Tuesday — with Democratic Sen. Kent Conrad saying it would bankrupt North Dakota’s hospitals and Sen. John Rockefeller (D-W.Va.) saying it’s the only way to rein in ravenous, profit-hungry private insurers.

Not long from now, Obama’s going to have to referee the whole thing.

A bloc of three moderate Democrats joined with Republicans to
defeat the two public option amendments Tuesday, setting up the Finance Committee bill as the only version advancing in Congress that lacks the government plan.

squabbling Democrats are looking to the president to be the final arbiter of whether they include the public option in the version of the bill that goes to the Senate floor — and later, whether it will emerge in compromise legislation from a House-Senate conference.

In the Senate, Obama will work closely with Majority Leader Harry Reid (D-Nev.), who speaks with White House chief of staff Rahm Emanuel several times a day. But the final decision rests almost entirely on the president’s shoulders.

“Expect the president and his staff to be key participants in the tough decisions we have to make, on such issues as the level of subsidies and the public plan versus the co-ops,” said a senior Democratic Senate aide. “The only way we are going to get this done is with active involvement of the president.”

Public-option supporters are fine with that. They say they’ll take their chance with Obama at the helm because he’s declined every public opportunity to remove the government option from the table.

Sen. Maria Cantwell (D-Wash.), who voted for both public option amendments, said she wants the White House to make its position clear, if it expects the bill to drive down the cost of private insurance.

“They should weigh in,” Cantwell said Tuesday.

Rep. Anthony Weiner (D-N.Y.) even describes Obama as the Democrats’ “cleanup hitter” who will mediate the dispute — noting approvingly that Obama has always said he wants the public option.

Of course, other more moderate Democrats could point to a variety of statements where Obama is cool to the idea of government-run health care — including saying during his speech to Congress that it’s just one option for driving down costs and ratcheting up competition, but not the only one.

Going forward, Obama will have several chances to inject his views into the process, but he already faces one big decision — does he want a bill that can garner 60 votes in the Senate, or can he live with a bill that Democrats have to force through using a procedural maneuver that requires only 51 votes?

As long as the Democratic leadership and the White House want a bill that can win 60 votes, the public option isn’t likely to survive.

Democrats are expected to go for that threshold as they merge competing bills from the Finance Committee and the Health, Education, Labor and Pensions Committee. So in terms of the most immediate decision, Obama and Reid are not expected to push for a bill with the public option, according to Senate sources.

Sen. Olympia Snowe (R-Maine) would not support the public option, which means Sen. Ben Nelson (D-Neb.) is also a “no” vote since he told constituents that he could not go with a Democrat-only bill. Sen. Blanche Lincoln (D-Ark.) voted against both public option amendments in the Finance Committee.

But once the bill makes it to the conference committee, the calculus could change. This is where Vice President Joe Biden has said the White House plans to really exert its voice. Half the committee will be from the House, which is expected to pass a bill with a public option. And Republicans, as the minority party, play a diminished role.

A third option is asking the 60 Democratic senators to vote to break a filibuster before allowing them to vote as they wish on final adoption, which requires only 51 votes. Sen. Tom Harkin (D-Iowa) told “The Bill Press Show” on Tuesday that a simple majority of Democrats support the public option.

“This was the toughest terrain for us,” said Sen. Chuck Schumer (D-N.Y.) of the Finance Committee. “It gets easier on the Senate floor, and it gets easier still in conference.”

While progressive senators work to win 60 votes for a public option, a new alternative is beginning to emerge on the Finance Committee.

Cantwell said she will offer an amendment to give states the power to negotiate down the price of insurance. If insurance companies agree to cover a chunk of the uninsured, states would help pay for the coverage. The states negotiate with insurers to set the cost and coverage of the program. The rates wouldn’t be tied to Medicare or Medicaid but set at the state level, she said.

“It’s a way to get a foothold. If you can cover 75 percent of people that way, then it’s definitely a public plan for the big chunk of the uninsured,” Cantwell said of the idea, which is modeled after her state’s “basic health plan.”

In the Finance Committee, eight Democrats supported an amendment from Rockefeller that would have created a Medicare-like program for all Americans. Five Democrats voted against it: Conrad, Lincoln, Chairman Max Baucus of Montana, Tom Carper of Delaware and Bill Nelson of Florida.

The division was less apparent on a more moderate approach offered by Schumer, which would set higher reimbursement rates for providers. His amendment failed 13-10, as Baucus, Conrad and Lincoln voted with Republicans.

“My first job is to get this job across the finish line,” Baucus said. “I fear if this provision is in this bill as it goes out of this committee, it will jeopardize real meaningful health reform.”

Conrad said Rockefeller’s amendment will tie the public option to Medicare rates for two years. If that happens, Conrad said, “every major hospital in my state goes broke.” That’s because Medicare reimburses his state’s providers well below the cost of care, and they make up the difference with higher payments from the insured and private payers, he said.

Despite the loss, Schumer said he was more optimistic about the chances of enacting a public plan.

“It was given up for dead a few weeks ago, but what we find is every time we debate it, whether back home or here at the Senate Finance Committee, we pick up more support,” Schumer said. “I am more optimistic now than I was six hours ago. Every day I am more optimistic that we can get something done.”

Schumer's amendment picked up support from Nelson and Carper, who had previously been noncommittal on the public option. Schumer said Carper still had concerns, but “voted with us as a message that we can get this done.”

The two switched votes indicate that moderates are more willing to negotiate than their public pronouncements have suggested. As jockeying gives way to voting, Schumer and other public plan proponents are expected to tweak the proposals to attract moderates, and to move the bill closer to 60 votes. If Democrats show movement towards the public option, the White House could be less inclined to go with one of the weaker compromises, such as Snowe's trigger plan or Conrad's nonprofit insurance cooperatives.

In a statement, Carper said Schumer's proposal was "not perfect," but he supported it because "I believe it -- or something similar to it -- could help drive down insurance costs for consumers in a way that doesn't unfairly disadvantage insurance companies."

Carper said he would work on a compromise as the bill moves to the floor.

The debate laid bare the philosophical divides over government. Sen. Chuck Grassley (R-Iowa) captured the dichotomy between Democrats and Republicans on the level of trust in government: “The government is not a fair competitor — it is a predator.”
Echoing the warnings used for decades against increased government involvement in health care, Republicans uniformly presented the public option as a federal takeover that would leave bureaucrats in charge of medical decisions.

“Gimme a break,” said Sen. Orrin Hatch (R-Utah), dismissing the argument that the public option won’t lead to an entirely government-run health care system. “If we pass a single-payer program or something that gets us there ... we’ll never be able to change it. And I can tell you right now it will be a disaster.”


((It frustrates me when I hear people who support the health care plans now being debated accuse those who oppose them of "being the party of NO" or not having their own solutions. Several legislators have proposed alternative plans - here's some information about some of them.))


"It’s time to start over on a common-sense, bipartisan plan focused on lowering the cost of health care while improving quality. That’s what I heard over the past several months in talking to thousands of my constituents. Replacing your family’s current health care with government-run health care is not the answer. We can do better, with a targeted approach that tackles the biggest problems." – Rep. Charles Boustany, Jr. , MD, September 9, 2009

The American people have spoken. They oppose government-run health care. Republicans are on the side of the American people.

What Americans want are common-sense, responsible solutions that address the rising cost of health care and other major problems. In the
Republican address following President Obama's speech to a Joint Session of Congress on Wednesday, September 9, 2009, Dr. Charles Boustany (R-LA) outlined a series of such solutions:

"We do need medical liability reform, and it needs to be real reform. We need to establish tough liability reform standards, encourage speedy resolution of claims, and deter junk lawsuits that drive up the cost of care."

"Let's also talk about letting families and businesses buy insurance across state lines. I and many other Republicans believe that will provide real choice and competition to lower the cost of health insurance."

"All individuals should have access to coverage, regardless of preexisting conditions."

"Individuals, small businesses and other groups should be able to join together to get health insurance at lower prices, the same way large businesses and labor unions do."

"We can provide assistance to those who still cannot access a doctor."

"[I]nsurers should be able to offer incentives for wellness care and prevention – something particularly important to me. I operated on too many people who could have avoided surgery if they’d simply made healthier choices earlier in life."

For more information about these and some of the other common-sense health care reforms proposed by Republicans, please visit these links:
House GOP Health Care Solutions Group Plan (Unveiled June 17, 2009)

Empowering Patients First Act (Republican Study Group Health Care Reform Bill, unveiled July 30, 2009)

Improving Health Care for All Americans Act (Shadegg Health Care Reform Bill, introduced July 14, 2009)

Patients’ Choice Act (Ryan-Nunes Health Care Reform Bill, introduced May 20, 2009)

Medical Rights & Reform Act (Kirk-Dent Health Care Reform Bill, introduced June 16, 2009)

Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act (Gingrey medical liability reform bill, introduced June 6, 2009)

Small Business Health Fairness Act of 2009 (Johnson small business health plans bill, introduced May 21, 2009)

31 Common-Sense Changes Republicans Offered to Improve Democrats’ Health Care Bill (GOP Leader Alert, July 28, 2009)

House Republican Leaders’ Letter to President Obama [PDF] Outlining Areas for Common Ground on Health Care Reform (May 13, 2009)

Democrats have proposed the establishment of a public-option government-run health plan. Some of the consequences of this government take over of health care include higher costs, lower quality and fewer choices.Government Control: Government programs constitute nearly half of all health care spending, and further increasing government's clout may well limit patient care as a way to contain costs. The federal government already imposes price controls on doctors, hospitals and pharmaceutical companies. Controls on patient procedures are likely to follow.

Spending and Tax Increases: Democrats proposed more than $850 billion in tax increases on small businesses and middle class families to pay for their health care reform plan. Health spending will jump from 16.6% to 17.6% of GDP this year alone.

House Democrats are calling for an additional $1.6 trillion in new health spending - on top of the more than $150 billion in health spending in the "stimulus" bill.

Massive, Forced Dislocation of Currently Insured Individuals:Analysis by actuaries at the independent Lewin Group found that nearly 114 million individuals could involuntarily lose their private coverage due to a government-run plan, and be forced into the public plan. Reduced Revenue for Providers: Other analysis by the Lewin Group found that a government-run plan reimbursing at Medicare rates would cause hospitals' total revenue to drop by nearly 5% ($36.5 billion), and physicians' total revenue to decline by nearly 7% ($36.4 billion). Poorer Coverage and Access: CBO Director Doug Elmendorf recently testified that traditional Medicare provides a benefit package 15% lower than the standard employer-sponsored plan which is one reason why more than four in five Medicare beneficiaries rely on supplemental health coverage. In Medicaid, low provider participation rates often lead to long waits for care, such that low-income Americans would prefer private insurance coverage to Medicaid by a more than two-to-one margin. Fraud: Reports by the Government Accountability Office and other watchdog groups have highlighted persistent problems with fraud in government-run Medicare - estimating tens of billions per year, at taxpayer expense.

For more information about the Democrats' government-run plan, please visit these links:

Democrats’ Government Takeover Will Raise Medicare Premiums By 20%
A “Trigger” for Destroying Americans’ Health Coverage

Reading Guide - Democrat Health "Reform"



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