Still Fighting Over Health Reform: The Policy & Practice Podcast

It’s been a full year since the Affordable Care Act became law, but in many ways it feels like the debate never stopped. Last week, the Obama administration marked the one-year anniversary of the law’s signing by traveling the country to talk up the benefits of health reform. This week Congress is back from its recess and health reform is once again on the agenda for many committees.

Image via Flickr user Tobyotter by Creative Commons License.

The House Energy and Commerce Committee will look at the impact of the law on jobs and the federal budget. Later in the week, members of the House Appropriations Committee will question Health and Human Services Secretary Kathleen Sebelius on the implementation of the health law.

Check out this week’s edition of the Policy and Practice Podcast to hear what the public thinks about health reform and how the American Medical Association is weighing in on regulations coming out of the law.

Take a listen:

And stay tuned next week to see if lawmakers can reach agreement on a federal budget for the rest of this year and what impact it could have on health reform implementation.

— Mary Ellen Schneider (on Twitter @MaryEllenNY)

The Battle for Berwick, Medicare Woes: The Policy & Practice Podcast

HHS Secretary Kathleen Sebelius defended embattled Medicare Chief Berwick at a House subcommittee hearing. Photo by Alicia Ault.

On Capitol Hill, Health and Human Services Secretary Kathleen Sebelius took a moment to defend Dr. Don Berwick, administrator of the Centers for Medicare and Medicaid Services, as the right man for the job. Dr. Berwick, a recess appointment, faces strong opposition in the Senate, which has yet to call confirmation hearnings for his position.

While the Medicare chief faces a steep obstacle, physicians now face a potentially deep cut in Medicare pay.  Without congressional action, the Sustainable Growth Rate formula will cut payments by nearly 30% in 2012.

For more on Medicare cuts, the Administration, and health reform, take a listen to this week’s Policy & Practice Podcast. Like what you hear? Come back for more, next week.

— Frances Correa

Doctors Question Health Reform: The Policy & Practice Podcast

It’s been nearly a year since the Affordable Care Act become the law of the land, but doctors still have plenty of questions about the impact of the law. Physicians from across the country gathered in Washington, D.C., last week for the American Medical Association’s annual advocacy conference looking for answers.

Image via Flickr user Xurble by Creative Commons License.

But other than a review of the health reform law’s timeline for implementation, they were treated mostly to best guesses by policy experts, who pondered whether the law can stand up to legal challenges and if the Congress will tweak any of its provisions.

For more on those predictions, check out this edition of the Policy & Practice Podcast. You’ll also hear more about the brewing debate on abortion funding and the potential impact of proposed legislation to restrict federal spending on abortion. Take a listen:

And stay tuned next week for the latest on the President’s budget proposal and how it was received on Capitol Hill.

— Mary Ellen Schneider (on Twitter @MaryEllenNY)

Politics, the Law, and Health Reform: The Policy & Practice Podcast

It was only a week ago that a Florida judge tossed out the Affordable Care Act, declaring the mandate to purchase insurance unconstitutional. But since then lawmakers, legal scholars, and pundits have been trying to guess what might ultimately happen with the law. Will the Supreme Court invalidate the whole thing? Will the high court carve out the individual mandate and send lawmakers back to the drawing board on that one piece? Will the court find that Congress acted within its constitutional authority and uphold the ACA?

Image via Flickr user dbking by Creative Commons License.

One thing is for sure, many people are already sick of waiting. Sen. Bill Nelson (D-Fla.) has introduced a resolution calling for an expedited review of the law by the Supreme Court. And Kenneth T. Cuccinelli, II, the attorney general of Virginia, who is leading a legal charge against the ACA, is petitioning to have his case heard sooner rather than later.

“Currently, state governments and private businesses are being forced to expend enormous amounts of resources to prepare to implement a law that, in the end, may be declared unconstitutional,” Mr. Cuccinelli said in a statement. “Regardless of whether you believe the law is constitutional or not, we should all agree that a prompt resolution of this issue is in everyone’s best interest.”

For more on the most recent court ruling on health reform, check out this week’s Policy & Practice Podcast:

And stay tuned next week for more implementation news and continued political debate over abortion and the health reform law.

— Mary Ellen Schneider (on Twitter @MaryEllenNY)

A Government Official’s View on Pandemic Flu

How well do you think the federal government performed in handling the 2009-2010 pandemic H1N1 influenza outbreak? Here’s the view of the physician who oversaw the effort at the U.S. Department of Health and Human Services (HHS), Dr. Nicole Lurie: “Looking back, I just feel very proud of what we accomplished as a nation.”

HHS Photo of Nicole Lurie, MD by Chris Smith

Dr. Lurie spoke last week at a meeting sponsored by the Infectious Diseases Society of America, in which participants reviewed the response to the pandemic flu in terms of what worked and what didn’t, and brainstormed to devise a list of priorities for future approaches to both pandemic and seasonal influenza.

The IDSA will incorporate those discussions into a revision of its January 2007 document, “Pandemic and Seasonal Influenza Principles for U.S. Action.” Back then, public health officials were concerned about the H5N1 “bird flu” virus as a possible pandemic strain.

“We were planning for a ‘different’ pandemic. But planning let us ‘pivot.’ Prior investments paid off in terms of vaccine manufacturing capacity and a strengthened public health system,” noted Dr. Lurie, who became the HHS Assistant Secretary for Preparedness and Response in June 2009, 2 months after the first case of pandemic H1N1 influenza was detected. Prior to that, she directed public health and preparedness work at the RAND Corporation.

Among the government’s major accomplishments, she noted, were the initial identification and sequencing of the virus, provision of test kits for states and for other countries, and delivery of the vaccine “in record time” to more than 70,000 sites, over 116,000 providers, and 10,000 retail pharmacy stores. As a result of the combined efforts of several different agencies within HHS, more than 80 million people were vaccinated.

“All-hazards public health preparedness paid off . … Unprecedented, cross-government, whole of community response is indeed possible,” Dr. Lurie said.

But, of course, there were gaps and opportunities for improvement. Response time needs to be faster for making vaccine and implementing other medical countermeasures, and for obtaining funding. Indeed, there was a time lag of about 6 months for Congressional budget appropriations to reach the federal, then state and local levels to the actual shot in a person’s arm. “We have to be more nimble about moving money.”

Photo by G C Lee via Flickr Creative Commons

Communication with the public could also be improved. “Addressing public concerns is key. The health care system handled this one well, but would be challenged in a more severe pandemic. You can never communicate enough,” she noted.

HHS is addressing these and other concerns, including building stronger day-to-day systems within those already in place, incorporating surveillance and scientific endeavors along with clinical care. The ultimate goal, as informed by the 2009 H1N1 influenza pandemic: “Ensure that we are prepared for something we have never seen.”

-Miriam E. Tucker (@MiriamETucker on Twitter)

Health Reform in 2011: The Policy & Practice Podcast

The big political story this week is the State of the Union address. A year ago, President Obama stood before Congress and asked lawmakers not to “walk away” from reform when they were so close to passing it. They listened. Now, the Affordable Care Act is the law of the land, but Democrats no longer control the House.

President Obama works on his State of the Union speech with speechwriter Jon Favreau on Jan. 24, 2011. Official White House Photo by Pete Souza.

Despite the role that health reform’s passage may have played in Democratic defeats last year, the President is expected to defend the new law in his speech. Meanwhile, Republicans are showing no signs of letting up on their campaign to convince the public that the law is too expensive. Leaders in the new GOP-controlled House are holding hearings this week to look at the effects of the law on jobs and the economy.

For more on Republican push back against the law, medical liability reform, and the latest implementation news, check out this week’s Policy & Practice Podcast:

— Mary Ellen Schneider (on Twitter @MaryEllenNY)

House to Vote on Health Reform Repeal: The Policy & Practice Podcast

Later today the U.S. House of Representatives will vote on whether to repeal the controversial health reform law. The outcome isn’t in suspense. The measure will pass the GOP-controlled House, but won’t see the light of day in the Senate.

But the certainty of the outcome hasn’t stopped both sides from reigniting the health reform debate. Since health reform is now the law of the land, Democrats are saying that Republicans want to take away popular benefits like free preventive care and bans on discrimination based on pre-existing conditions. And Republicans are hitting the budget issue hard, saying that repeal is the only way to keep the health reform law from sinking the economy.

House Speaker John Boehner argued against the passage of the health reform bill back in 2009 when the GOP was in the minority. Image via Flickr user House GOP Leader by Creative Commons License.

Check out next week’s Policy & Practice Podcast for all the details on the debate and what will happen after today’s vote. But if you can’t wait that long to get your health policy fix, listen to today’s podcast for more on lawsuits challenging the health reform law, how the Medicare Payment Advisory Commission plans to stay relevant, and how many physicians plan to take advantage of new government incentives for the adoption of electronic health records.

Take a listen:

— Mary Ellen Schneider (on Twitter @MaryEllenNY)

Health Reform Debate on Hold: The Policy & Practice Podcast

The President, the First Lady, and the White House staff observe a moment of silence on Monday morning. White House photo by Pete Souza.

This week in Washington, D.C., was supposed to be all about health care reform, with Republicans calling for a complete repeal of the new law and Democrats mounting a vigorous defense of their signature legislative achievement of 2010. But all of that was set aside over the weekend when Rep. Gabrielle Giffords (D.,- Ariz.) and 19 others were shot outside of a supermarket in Tucson, Ariz.

Now, members of Congress are reflecting on the violence and the need for civility, and legislative business is on hold for the week. It’s unclear when the House will vote on the proposed repeal of health reform and whether the debate will have a different tone in the wake of this shooting.

Listen to this week’s Policy & Practice Podcast for the latest health reform developments, including value-based purchasing for hospitals and trends in health spending.

— Mary Ellen Schneider (on Twitter @MaryEllenNY)

Funding More Primary Care: The Policy & Practice Podcast

The Obama Administration made good on its promise last week to help fund more primary care, as it released some $320 million in grants designed to train more doctors, nurses, dentists, and mental health providers.  This is especially important as health reform comes on line and more people have access to health care.

Photo via Seattle Municipal Archives flickr stream

But even as HHS Secretary Kathleen Sebelius announced this boost, a Kaiser Family Foundation study showed that some states have begun cutting their Medicaid payments to physicians.  The move is a response to the recession and states’ inability to meet budget demands.

Take two minutes out of your day to hear our synopsis:

– Alicia Ault (on Twitter @aliciaault)

Feds Hand Out Cash: The Policy & Practice Podcast

Image via Flickr user AComment by Creative Commons License.

Seniors got some and so did the states. Some doctors may be getting theirs soon. That’s federal dollars of course.

Members of the House of Representatives interrupted their August recess to come back to Washington for 1 day last week to vote on an aid package for states, $16 billion of which was increased funds for Medicaid. Many seniors also are getting checks from the federal government, though their share is quite a bit smaller. Medicare beneficiaries who have fallen into the Part D prescription drug doughnut hole will be getting a $250 rebate check from the government. The checks are part of the Affordable Care Act and are the first step in eventually closing the doughnut hole altogether. And physicians could qualify for some federal incentive payments next year, if they successfully implement electronic health records and meet government standards for their use.

Hear about all this and more in this week’s Policy & Practice Podcast.

Take a listen and share your thoughts:

Get your fill of the podcast now because the Policy & Practice team is taking a little break. We will return with more health reform news on Sept. 7.

– Mary Ellen Schneider (on Twitter @MaryEllenNY)