Marilyn Werber Serafini has been the health care and welfare reporter for National Journal since 1995, and has won awards for articles on these subjects. The most recent was an award from the Association of Health Care Journalists for an article comparing and analyzing the 2008 presidential candidates’ health care proposals. She also won an award from the Casey Journalism Center on Children and Families for an article that scrutinized President Bush's controversial proposal to give states money to encourage marriage and discourage divorce. She has written extensively about Medicare policy, the uninsured and bioterrorism. Serafini has covered Congress since 1985, writing about health care, welfare, trade, tax and budget policy. She served two terms as a member of the executive committee of the congressional periodical galleries. She is a graduate of the University of Maryland and of American University, where she received an M.A. in Journalism and Public Affairs.
Baucus Praises Senate Bill Too many parents struggle to pay for health insurance and also try to save for college, too many employers are forced to drop health coverage because they simply can’t afford the premium... This is the moment to change that. Sen. Max Baucus, chairman of the Senate Finance Committee, released this statement after the Sen. Reid unveiled the Senate Democratic bill: The CBO score we received today illustrates the Senate health reform legislation is a balanced, fiscally-responsible package that will deliver the real reform that American families, businesses and the economy need. The Senate bill is fully… Read more
Does The Senate Bill Move In The Right Direction? Senate Democrats yesterday unveiled their health reform bill, which looked much like the bills already approved by committees of jurisdiction, and which cost $849 billion. The bill is paid for in part through Medicare cuts, according to CongressDaily, including an increase in the Medicare payroll tax for individuals making $200,000 or more, and a tax on high-cost insurance plans. The Medicare payroll tax would bring in $54 billion and the Cadillac tax would raise $149 billion in revenue. Senate Minority Leader Mitch McConnell , R-Ky., called the bill another “trillion dollar experiment,”… Read more
Only Enforcement Can Stop Fraud As long as the system is run by people there will be fraud. Joe Luchok, a communications consultant who has worked on health care issues for organizations including the March of Dimes and the now defunct Health Insurance Association of America, argues that health information technology might offer limited improvement, but that the biggest help would come from increased enforcement. Here’s what he has to say: “Health care fraud will be very difficult to stop. We may be able to control some of it but stopping it is a daunting task. The system is so large… Read more
Look To Biometrics Scott Kimmel, founder of Biometric Technologies, Inc., argues that fraud prevention is all about health information technology, and he offers here an explanation of biometrics as one possible solution. “Perhaps Mickey Mouse is the answer to eliminating health care, Medicare and Medicaid fraud. The Disney theme parks have 45 million visitors who enter their parks every year by placing their finger on a biometric device. The same technology can and should be used to eliminate health care fraud. Blue Cross states that at least 75% of health care fraud is committed by the provider and 18% by… Read more
House Democrats have ruled out an excise tax on high-end insurance plans as a way to pay for health reform, although that is a primary revenue raiser in Senate Finance Committee Chairman Max Baucus’s plan. House Democrats are considering limiting their proposed health care surtax to individuals earning above $500,000 a year, and that leaves about a $100 billion funding shortfall for reform, CongressDaily reported October 8 [[[link the story]]]. To help fill the funding hole, they are considering taxing securities transactions and/or taxing insurance company profits. But insurer profits are “much less than other industries within the… Read more
Senate Finance Committee Ranking Republican Chuck Grassley, R-Iowa, said in a statement today that he didn't want colleagues to focus only on the deficit-neutral piece of CBO's assessment, and not on new taxes. "A celebration of the deficit effects masks who pays the bills. This package includes hundreds of billions of dollars in new taxes and fees. Most Americans with health insurance will see their premiums increase. That's according to CBO and JCT, the non-partisan experts. Premiums would increase as early as 2010, before most of the health reforms, including tax credits to help people pay for health insurance, take… Read more
CBO Director Douglas Elmendorf has released an assessment of Senate Finance Committee Chairman Max Baucus's health care reform plan, and here is Elmendorf's comment on his Director's blog on the CBO web site. Preliminary Analysis of the Senate Finance Committee Chairman’s Mark As Amended CBO and the staff of the Joint Committee on Taxation (JCT) have just issued a preliminary analysis of the Senate Finance Committee Chairman’s mark for the America’s Healthy Future Act of 2009, incorporating the amendments that have been adopted to date by the committee. That analysis reflects the specifications posted on the committee’s Web site on October… Read more
The Congressional Budget Office and Joint Committee on Taxation today released estimates of the health care reform bill that Senate Finance Committee Chairman Max Baucus, D-Mont., unveiled today. The estimates show it would reduce the deficit by $49 billion over ten years and continue to bring it down in the following decade. Here are links to the CBO documents: CBO Analysis Joint Committee On Taxation Analysis… Read more
Sen. Max Baucus, D-Mont., chairman of the Senate Finance Committee, today unveiled his health care reform plan that the Senate Finance Committee will begin considering next week. Here are the details, as released from his office. “The America’s Healthly Future Act” Providing Quality Coverage to All Americans Americans who like their health insurance and want to keep it can do so. For the millions of Americans who don’t have or can’t afford employer-provided coverage, or who are being denied coverage due to a pre-existing condition, the Chairman’s Mark reforms the individual and small-group markets, making coverage affordable and accessible. … Read more
Rep. Charles Boustany, R-La., Delivers Republican Health Care Address following President Obama's speech to Congress tonight “Good evening. I’m Dr. Charles Boustany, and I’m proud to serve the people of Louisiana’s Seventh Congressional District. I’m also a heart surgeon with more than 20 years of experience, during which I saw first-hand the need for lowering health care costs. “Republicans are pleased that President Obama came to the Capitol tonight. We agree much needs to be done to lower the cost of health care for all Americans. On that goal, Republicans are ready – and we’ve been ready – to work… Read more
Remarks of President Barack Obama – As Prepared for Delivery Address to a Joint Session of Congress on Health Care Wednesday, September 9th, 2009 Madame Speaker, Vice President Biden, Members of Congress, and the American people: When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression. We were losing an average of 700,000 jobs per month. Credit was frozen. And our financial system was on the verge of collapse. As any American who is still looking for work or a way to pay their bills will tell you, we are by… Read more
From Nancy Brown, CEO of the American Heart Association We hope the President can break through the rhetoric and return the debate to a discussion of the fundamental issues and challenges in health care that almost everyone agrees must be addressed. The debate must shift back to the urgent needs of individuals – the uninsured, the underinsured, heart disease and stroke patients and others with chronic disease who do not have access to affordable, quality care. Their stories are getting lost in the rhetoric. Each day, more families are losing their homes because of crushing medical debt. We cannot forget… Read more
Comment about Ted Kennedy from former HHS Secretary Louis W. Sullivan: “We mourn the loss of Senator Edward Kennedy – a national champion on health issues who supported Morehouse School of Medicine (MSM) and its mission. I first met Senator Kennedy in 1975, through then-U.S. Congressman Andrew Young. As a member of the Senate Health Committee, Senator Kennedy supported critical funding efforts for the school’s early development; in the late 70’s, a $5 million construction grant for our first building and in 1982, a $15 million Title III education grant. These two grants and other support through the years from Senator… Read more
E. Neil Trautwein, vice president of the Employee Benefits Policy Counsel, National Retail Federation, had this to say about Ted Kennedy: "Like many Americans, I was saddened this morning to hear of Senator Edward Kennedy’s death. Sen. Kennedy (D-MA) – Ted or Teddy Kennedy to many or most – was a true giant of the U.S. Senate. I will miss him. Kennedy’s own words – essentially that we live on past our years in the future we create for others – sum up his life best. There is an excellent retrospective on Kennedy in today’s New York Times if you… Read more
Week before last, during the cars for clunkers votes in the Senate, Sen. Tom Harkin was going around the Senate floor showing other senators the book “Why Our Health Matters” by Dr. Andrew Weil, urging them all to read it. … Read more
Here is the exchange between Elmendorf and Rep. Conrad during a hearing: Conrad: Do you see a successful effort being mounted to bend the long-term cost curve? Elmendorf: No… on the contrary, the legislation significantly expands [costs]. Conrad: It’s being bent the wrong way? Elmendorf: The curve is being raised. House Republican Leader John Boehner, R-Ohio, jumped on the exchange, claiming that the "CBO confirmation that Dems' government takeover will increase cost of Americans' heatlh care." He said: "Americans are concerned about the rising costs of health care, but instead of alleviating those fears, the Democrats government takeover will drive health care costs… Read more
Updated at 11:20 a.m. on July 2. Democratic leaders of the Senate HELP Committee today proposed a new employer responsibility provision for the panel's health care reform plan. Employers with more than 25 workers would have to pay $750 annually for each uncovered employee. Here are the details released this morning. SHARED RESPONSIBILITY OF EMPLOYERS A core value in the HELP Committee’s Affordable Health Choices Act is the principle of “shared responsibility.” To solve the nation’s health care coverage and cost crises, everyone must be part of the solution – government, individuals, medical providers, insurance companies, pharmaceutical companies, and employers. Most… Read more
Gary Lauer, CEO of e-HEALTH, argues that some supervision is essential to implementation of major health reform. Here's what he has to say: I’m glad Senator Daschle is addressing the issue of management here, because there’s a consensus among many that enrolling millions of uninsured Americans in health coverage will be as simple as building a government exchange. As the CEO of the largest online health insurance technology company in the country, I can assure you it won’t be that simple. As Senator Daschle notes, it would be disappointing – unacceptable, I would add – to reform… Read more
Larry McNeely, health care advocate for the U.S. Public Interest Research Group, argues for a bill in Congress that moves toward the same goals as does Sen. Daschle's federal health board. Here's what McNeely has to say: "Former Senator Tom Daschle's remarks on health care note the "massive inefficiencies, a loss in quality, and higher costs." In a strong response, John Goodman of the National Center for Policy Analysis, a champion of free-market solutions to health care, says that the "[The incentives] are very, very perverse." "While the two gentlemen might not agree on the solution, I suspect… Read more
Tim Trysla, executive director of the Access to Medical Imaging Coalition, urges Congress to be careful not to harm patients when considering cost-saving measures. Here's what he has to say: "When considering health reform legislation, lawmakers should take great pains to avoid creating short-term measures intended to cut health care costs that will prove detrimental to patients in the long-term. Lawmakers should also keep the needs of rural Americans in mind. "Unfortunately, recent proposals have already violated this common sense advice. For example, the Obama Administration recently proposed to base Medicare and Medicaid reimbursements on the assumption that physicians operate imaging equipment… Read more
Sen. Baucus and Sen. Grassley today released a series of policy options for health care reform, and included options for changing the tax exclusion for employer-provided health insurance. These options are viewed as viable money savers to pay for health care reform. Here are their options, from a committee statement this morning. Are any of them politically viable, and what is the best and the worst way to do this? "The policy options explore five changes to make the exclusion more equitable and efficient. These options include capping the exclusion based on the value of health insurance policy or the… Read more
President Obama yesterday responded to industry groups who said they would voluntarily undertake efforts to lower costs with excitement, but promised it would not affect his health care reform efforts moving forward. Indeed, he said the two efforts were compatible. Here is what George Condon of CongressDaily wrote yesterday: In the past, some of these groups have pledged to reduce healthcare costs but saw that as a tactic to avert any kind of reform. But he contended it is different this time. "What they're doing is complementary to and is going to be completely compatible with a strong, aggressive effort… Read more
Here is a copy of the full letter that health care industry groups sent today to President Obama, promising to work together voluntarily to lower costs by 1.5 percentage points annually over the next decade. How big a deal is this voluntary commitment. Will it, or should it, change the way that Washington proceeds this year? Dear Mr. President: We believe that all Americans should have access to affordable, high quality health care services. Thus, we applaud your strong commitment to reforming our nation’s health care system. The times demand and the nation expects that we, as health care leaders,… Read more
Don Levit, an independent insurance agent in Sugar Land, Texas, agrees with John Goodman's assessment of the IOU nature of the trust fund. Here's what he has to say: John Goodman is absolutely correct. These are not his opinions. His comments can be verified by the GAO and The Treasury Department. The trust funds hold no cash. When the funds are depleted, what that means is that the numbers get to zero. His comment about Treasury IOUs creating an asset and liability are spot on. I was led to believe that only God can create something out of nothing!… Read more
Ilyse Schuman, Managing Director of the Medical Imaging & Technology Alliance has this to say about comparative effectiveness: A national comparative effectiveness organization that is grounded in science has the potential to be beneficial to ensuring patient access to optimized health care which includes appropriate access to medical imaging technology. The question posed today, “What treatments should be among the first to be compared?” belies a sensitivity regarding comparative effectiveness research: Because diagnostics are different than therapies or treatments, they must be evaluated using different criteria than used to evaluate therapeutic treatments. The medical imaging community… Read more
John Arensmeyer, founder and CEO of Small Business Majority, a national nonprofit advocacy organization run by small business owners, says that mandates are not his greatest concern. Here’s what he has to say: “The primary issue for small businesses is the cost of healthcare, not mandates. Indeed, the focus on mandates in isolation obscures the most important need for small businesses – comprehensive reform of the healthcare system to ensure affordable care for all, including small business owners and their employees. Our scientific research of small business owners shows that they are bottom-line oriented. They want a… Read more
Former Health and Human Services Sec. Mike Leavitt last Tuesday told National Journal that he advised the nation’s governors at their Washington meeting last week to look to Argentina as an example of how increased spending during a recession could be hazardous. Click “read more” to watch video of Leavitt’s remarks, and look for the entire discussion and video highlights Friday.… Read more
President Obama, in his address to Congress last night, said that health reform should no longer be on hold, and that he will begin discussions next week with interest groups, and both Democrats and Republicans. How far can he get without an HHS secretary, and how should he balance his efforts with the efforts already underway in Congress?… Read more
Now that Tom Daschle is out of the running for health care czar... Regardless of who President Obama nominates next to be his Secretary of Health and Human Services, does it make sense to split that position from the head of his newly-created White House office of health care reform? Daschle was going to service in both capacities, and some expressed concern about whether one person could oversee heatlh care reform and at the same time effectively run one of the largest federal departments.… Read more
Nancy Brown, CEO of the American Heart Association, is enthusiastic about childhood obesity provisions in SCHIP legislation, as well as expansions for kids and pregnant women. Here's what she has to say: "Expanded access to quality health care for children and provisions that address childhood obesity are among the strengths of the SCHIP legislation. We’re pleased that the House and Senate bills would expand access to affordable health care for an additional four million children. This is extremely important for children from low-income families who are born with heart-defects – the No. 1 birth defect in the United States. The legislation helps strengthen… Read more
Nancy Brown, CEO of the American Heart Association, advocates a "significant federal investment" in HIT. Here's what she has to say: "We should not hesitate in making a strong and sustained investment in health information technology (HIT), particularly clinical decision support. HIT is a building block for health reform and a significant federal investment is needed to stimulate provider adoption of HIT and fully achieve the promise of HIT to prevent medical errors, improve quality of care, reduce health disparities and stimulate a sluggish economy. In the scheme of things, it’s a small price to pay for a maximum return… Read more
Last week, a key Senate Democrat, Sen. Barbara Mikulski, D-Md., expressed concern about moving too quickly on health information technology. Here's what CongressDaily reported Jan. 15: Lawmakers working to spur the adoption of electronic medical records should not rush the process, a key Senate Democrat said today. As she chaired a Senate Health, Education, Labor and Pensions Committee hearing on health IT, Sen. Barbara Mikulski, D-Md., said that she will work with colleagues and President-elect Obama to craft a sound bill but cautioned against moving too quickly. "I've seen where we've ... thrown a lot of money at stuff, and… Read more
Did yesterday’s news from HHS solve our high health care cost problem? So we’re talking this week about what needs to be done quickly on health care this year, and much of the early action will be geared to high health care costs. But yesterday, HHS’s Centers for Medicare and Medicaid Services reported that health care spending growth in 2007 slowed to its lowest rate since 1998. Spending grew 6.1 percent in 2007 (It grew 6.7 percent the previous year). The reason? Well, most health care services grew at about the same rate as or faster than the… Read more
Here's what Jason Rosenbaum, deputy director of online campaigns for Health Care for America Now, a national grassroots campaign advocating quality, affordable health care for all, has to say about public health programs: Mr. Gelfand raises good questions that deserved to be answered. Indeed, some of the answers are already apparent. (1) Medicare is indeed in dire financial straights, because it operates outside the normal logic of insurance. In an insurance system, risk is spread over a large pool of people. In a good insurance system, those who are less at risk still pay into the system, in effect… Read more
House Ways and Means Committee Chairman Charles Rangel, D-N.Y., indicated his strong support for a "strong public health insurance program" in an op ed in Roll Call Monday. Here is what he said: "As we undertake health reform next year, we must remember that a strong public health insurance program is a central component of a healthy and workable public-private partnership. A public program would serve as a safeguard available to everyone, protected from the whims of the marketplace, and we must ensure their future for generations to come. "Unfortunately, some of my colleagues like to scapegoat public programs because it is… Read more
The Medical Banking Project is going to be collaborating with the Mayo Clinic Health Policy Center for a panel discussion about the idea of a Federal Health Board at the 2009 medical Banking Institute. A news release with details can be viewed at: http://www.mbproject.org/mbtv/archive05/pr_11-2008_7mbi.html .… Read more
In a National Journal panel held during the Democratic National Convention this summer, Tom Daschle, who is likely to head the Department of Health and Human Services next year, talked about his ideas for health care reform. Here is a video clip from that panel.… Read more
This is what John Castellani, President of Business Roundtable, had to say on the subject: For the business community, the stakes for an affordable, sustainable health care system could not be higher. We have high costs that inhibit job creation, damage our nation’s competitiveness and impose a major strain on American household incomes. Most Americans’ health benefits are tied to their jobs – so people worry that they won’t be able to afford coverage for their families if they get laid off, move to a new job or try to start their own business. There are three areas we need to… Read more
The Consumer group Consumer Watchdog in a news release today called the insurance industry’s support of a mandate for individuals to buy insurance “self-serving.” According to the group: “The proposal amounts only to a customer delivery system for the fragmented, wasteful private insurance market. It will not solve America's health care problems and will only encourage the industry to charge higher premiums and demand more taxpayer subsidies while providing less health care. "Insurance companies expect praise because they are 'willing' to sell their policies at whatever price they want to people who are forced to buy? That's like GM agreeing… Read more
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