By Susan Page, USA TODAY
WASHINGTON — Now the policymakers who for months have been promising to overhaul the health care system have to start doing it.

HEALTH CARE: By the numbers

This year’s fast-track timetable on health care calls for leaders of key congressional committees to unveil legislation this month, debate it next month and pass it before leaving for the summer recess in August. Final passage would follow in September or October, before next year’s elections start to complicate things.

That, at least, is the plan.

“I’m not blowing smoke — this is coming together,” Senate Finance Chairman Max Baucus, a Montana Democrat and an architect of the legislation being drafted, said in an interview.

“I really think that the stars may be aligned here,” President Obama said in an interview on C-SPAN over the Memorial Day weekend.

Last month, Obama unveiled a commitment from insurance and pharmaceutical companies to curb rising costs. On Capitol Hill the next day, the Senate Finance Committee began talking specifics about how to pay for covering the uninsured. And in interest-group TV ads, even Harry and Louise, the fictional couple who helped sink the Clinton administration plan 15 years ago, have espoused the need for change.

So what could possibly go wrong?

Figuring out how to pay the $1 trillion-plus price tag, for one, not to mention the competing summertime priority of Sonia Sotomayor’s confirmation to the Supreme Court.

The prospects look promising, but the pitfalls that have undermined efforts since the Truman administration to guarantee health care coverage for nearly every American remain. “The stars are truly aligned this year, but the problem is there are many rogue death stars flying in the policy atmosphere as well,” says Robert Reischauer, who headed the Congressional Budget Office during the last big health care debate in 1993-94, which led nowhere.

Whether the federal government should expand its role in providing health care is a divide that liberal Democrats and the insurance industry, on opposite sides, call a deal breaker.

Perhaps the biggest question is whether powerful factions of the health care industry — from insurance companies to pharmaceutical makers to hospitals — will launch the sort of full-scale attack that kept the Clinton administration’s health care makeover from even coming to a vote in Congress. Many of the groups now espouse the need for change, but the difficult decisions on precisely what “reform” will include haven’t been made.

Of course, there also are forces pushing for what is the top legislative priority of a new president and the career-long cause of a veteran Democratic senator, Edward Kennedy of Massachusetts, who is battling a brain tumor.

One of them: The problem keeps getting worse. Health care costs are rising fast as the number of those who lack insurance, pegged by the Census at 46 million in 2007, is swelling. Over the past 12 months, the percentage of people who had health insurance provided by their employer or union fell by more than 3 percentage points, according to a daily national survey sponsored by Gallup and Healthways, a health management company.

The drop from 49.6% in April 2008 to 46.5% in April 2009 reflects a change for more than 6 million Americans.

Over those 12 months, the number of people who said they didn’t have health insurance of any kind rose by nearly 3 million. Blue-collar workers, the self-employed and those in households earning less than $50,000 have been among the hardest hit.

If nothing is done, government and other studies predict the number of uninsured and costs of health care will continue to rise. On the current course, the Congressional Budget Office projects that health care spending, now 16% of the nation’s economy, will more than double to 37% in 2050.

Expanding coverage and controlling costs will require vaulting a series of hurdles.

Here are five big ones.

1. Avoiding detours

The not-a-minute-to-wait timetable for congressional action this summer leaves little room for detours or distractions. While Obama wants the House and Senate to pass a health care bill by their August break, for instance, he also has set that as a deadline for the Senate to confirm Sotomayor to the high court.

The debate over her confirmation not only will consume some time but also could strain the bipartisan comity he hopes to forge on health care. And North Korea’s nuclear test last week underscored how a foreign policy crisis can command instant attention.

Congress rarely acts so quickly on major legislation, but policymakers call the compressed schedule critical if the bill is to pass during Obama’s first term. The Senate health committee is slated to hold its first public session on a bill in two weeks.

“If you don’t have it this year, you won’t have it for four years,” Iowa Sen. Chuck Grassley, the top Republican on the Finance Committee, warned in an interview. He noted that 2010 was a congressional election year and by 2011 the next presidential campaign would be underway, when politicians might be reluctant to cast tough votes.

“If we don’t get it done this year, we’re not going to get it done,” Obama said Thursday in a conference call aimed at rallying his supporters on the issue.

2. Defining roles

There is considerable agreement that the best path to universal coverage is for the government to require Americans to buy health insurance, just as drivers have to buy car insurance. A sliding scale of subsidies would help those who would have trouble affording premiums.

The biggest ideological debate is whether the insurance options Americans could consider should include a public, government-run plan that would compete with those offered by private insurance companies.

Include a public plan or there’s no deal, some liberal Democrats say. “The public option is a compromise by many Democrats who would like to have a single-payer system,” says Rep. Henry Waxman, chairman of one of three House committees with jurisdiction over the health care legislation. The California Democrat says the House bill will include a public option, arguing it would create a “healthy tension” to keep costs down and protect consumers’ interests.

Kennedy said last week that his proposal also would include a public option, though Baucus has been trying to find some middle ground. On Saturday, the two senators issued a joint statement promising their committees would have “similar and complementary legislation.”

The quandary: Include a public plan and there’s no deal, some Republicans and industry leaders say. They say a government plan’s reach would enable it to crush private competitors, creating a back-door path to a government-run health care system like those in Canada and Britain.

“Any activity in which I participate in which the referee and the player are the same person and I’m on the opposing team, I’m going to lose,” says Rep. Tom Price, R-Ga., chairman of the Republican Study Committee.

Both sides are floating compromises. Karen Ignagni, who heads the leading association of health insurance companies, suggests federal regulation of insurance markets nationwide, replacing a patchwork of state regulations and addressing some of the concerns of those who back a public option.

Meanwhile, Sen. Charles Schumer, D-N.Y., proposes that any government-run plan be required to comply with all the rules that apply to private ones, including a requirement that it be self-sustaining and establish a reserve fund. That would be an effort to level the playing field.

3. Paying the price

It won’t be cheap.

Kenneth Thorpe, a health care analyst in the Clinton administration and now a professor at Emory University, estimates the cost of expanded coverage at $1.3 trillion to $1.8 trillion over 10 years. Under congressional rules, the legislation can’t increase the deficit. That means other spending has to be cut or taxes raised to offset its costs within 11 years.

Peter Orszag, Obama’s budget director, has estimated that up to $700 billion over 10 years could be saved by making the health care system work better — eliminating duplicative treatments, changing the ground rules for how doctors and hospitals are reimbursed and moving to more electronic record-keeping. While past promises of savings often have proved elusive, Orszag, Baucus and others say they are possible and an essential first step.

One problem is that the task of implementing new policies and systems would require significant spending at the beginning with savings projected only down the road. Advocates have been working for months with the CBO, which calculates how much a proposal costs.

When it comes to raising money, all the options being floated are controversial, from taxing soft drinks to imposing a national sales tax. Senators from both parties balked when Obama proposed limiting the amount Americans could claim for charitable and other tax deductions as a way to boost revenue and help pay for health care reform.

Baucus has suggested curbing the tax break companies get for providing health insurance to their workers, a step that would increase taxes for those who have the most expensive plans.

However, Rep. Charles Rangel, D-N.Y., chairman of the tax-writing House Ways and Means Committee, said last month there was “no way” he’d support that. He and other critics worry that taxing health benefits would discourage employers from providing coverage. He didn’t suggest another way to raise the money.

Finding the money is particularly tricky at a time the recession has reduced tax revenues and the budget deficit is projected to soar to an unprecedented $1.8 trillion this year.

“It’s a game of dominoes,” says Ron Pollack, executive director of Families USA, which has been pushing for expanded coverage since the Clinton effort. “If you don’t get the financing, you don’t get the mandate. If you don’t get the mandate, you don’t get the subsidies. And if you don’t get the subsidies, you don’t get health insurance reform.”

4. Writing the rules

Passing a bill is likely to be easier in the Democrat-controlled House than the Senate. Senate rules enable Republicans to threaten a filibuster and force supporters to round up 60 votes to move forward.

That would leave Democrats with no wiggle room. Since Pennsylvania Sen. Arlen Specter switched from the GOP, Democrats count 59 senators. Al Franken would become the 60th if he wins the pending court case over Minnesota’s Senate contest.

Just in case, Democrats have put in place rules that would allow parts of the proposal to be included in a process called reconciliation — a procedure that can’t be filibustered and requires a simple majority to pass.

That prospect enrages some Republicans, who argue such an important issue shouldn’t be enacted on a shortcut that limits debate, though Democrats note a GOP majority used reconciliation to pass the Bush tax cuts in 2001.

The issue sounds arcane, but Republicans warn that if Democrats use reconciliation, nearly every GOP senator would vote against the plan. “This is too big for political gamesmanship,” says Utah Sen. Orrin Hatch, a member of the Senate health committee. “The partisan part of me says, ‘Oh, I hope they do that; they’ll have to live with every stinking problem that comes up’ ” in a system passed without significant GOP support.

5. Testing the coalition

Making specific policy choices will test the coalition that has been built around the general idea of revamping health care.

Fifteen years ago, vociferous objections from insurance companies, drug manufacturers, business owners and others helped defeat the Clinton plan, epitomized by the “Harry and Louise” ads sponsored by the Health Insurance Association of America that warned of the perils of change.

So Obama called it a “watershed event” last month when he was joined at the White House by lobbyists representing many of those groups as they promised to curb the growth in costs over the next decade and said change was essential. An odd-couple’s group including the National Federation of Independent Business, the American Hospital Association and Families USA have sponsored the new “Harry and Louise” ad that showed the same actors, older now, discussing the need to fix health care.

Many in the industry have concluded that some sort of bill is likely to pass, and they want to be part of the discussion to protect their interests. Chip Kahn, president of the Federation of American Hospitals now and a mastermind of the original Harry and Louise ads, says the leaders of trade associations and other groups reason, “Something’s going to happen here and they’ve got to be involved.”

The pharmaceutical industry is most concerned about avoiding government price controls on drugs, the insurance industry about competition from a public Medicare-style plan.

The question: Will the groups splinter when the most difficult trade-offs are decided?

Those trade-offs could be disquieting consumers, too. An effort to squeeze out savings by eliminating duplicative tests could make it harder for some patients to be reimbursed for a test they want. Capping the deductibility of insurance premiums would raise the tax bill for those with the priciest plans.

The debate last time demonstrated how quickly public support can evaporate if concerns are pressed about government “rationing” of health care, or limits on patients’ ability to choose their own doctors and hospitals. In January 1994, the Clinton reform plan was supported by 56%-38% in the USA TODAY/Gallup Poll. After six months of debate, that majority support had turned around to majority opposition, with 55%-40% opposed.

“There are lots of moving parts here, and everything is on the table,” Baucus says. “One challenge is education, getting people up to speed, and the other is keeping everybody together, talking together, working together. Now the rubber is going to start meeting the road. We’re going to have to start making choices.”

Health care by the numbers

U.S. expenditures on health care each year $2.3 trillion
Estimated expenditures in 2017 $4.3 trillion
 
Number of uninsured 46 million
 
Number of underinsured  25 million
 
percentage of Americans who couldn’t pay for medicines or health care their family needed in the past 12 months 18%
 
Bankruptcies in which medical debt is a factor One of two
 
Increase in individuals’ premium costs in the last 10 years 117%
 
Health expenditures per capita in USA $6,714
 
Health expenditures per capita in Canada $3,678
 
Health expenditures per capita in United Kingdom $2,760
 
Modern-day presidents who launched major, unsuccessful efforts to cover the uninsured 3

By Andy Sullivan

WASHINGTON (Reuters) - Countless workers in the United States are trapped in jobs they would like to leave because they cannot get health insurance elsewhere, calcifying innovation and mobility in the world’s largest economy.

Daunted by health-care costs, a would-be technology entrepreneur in Texas decides not to start her own business. A communications expert in Washington decides not to strike out on his own. And a freelance magazine editor in Brooklyn decides to take a less satisfying corporate job.

“I would rather be freelancing, no question,” said Jessica Tolliver, a former editor who now works in public relations. “I got my work done in less time, because once I finished what I had to do, the time was my own.”

Economists call this phenomenon “job lock,” and studies suggest that it keeps between 20 percent and 50 percent of workers from leaving their current jobs.

Because health insurance is tied to employment in the United States, workers who leave their jobs can see health bills skyrocket if they strike out on their own or take a position with a company that offers fewer benefits. Workers who would like to retire early stay on, unable to qualify for the government’s Medicare program until they turn 65.

And those who have existing health problems may not be able to get coverage at all.

Job lock is difficult to measure because many employees don’t like to advertise their unhappiness. But economists and small-business advocates say it takes an enormous toll on productivity.

SLOWING INNOVATION

“We can definitely say that it’s slowing down the rate of innovation,” said Tim Kane, an economist with the Kauffman Foundation which promoted entrepreneurship.

For Mike, a Washington-based communications professional who did not want to use his last name, health costs may force him to pass up the chance to be his own boss at a time when he could easily pick up several major clients.

With two children at home, Mike said he was reluctant to abandon the generous benefits he gets at the trade group where he currently works. Self-employment would probably mean spending more for fewer benefits.

“I don’t want a bad event to knock me and my family out of the box,” he said. “It’s a real hurdle.”

As head of the National Federation of Independent Businesses, Todd Stottlemeyer frequently encountered would-be entrepreneurs who let their ideas go stale and their products languish on the workbench because they did not want to shoulder their own health care costs.

When he asked audiences if health insurance has affected their employment decisions, often half the hands in the room would go up.

“There are lots of factors that go into why somebody starts a business or doesn’t start a business: Do I have a good idea, do I have capital, do I have risk tolerance?,” said Stottlemeyer, now an executive at a hospital chain. “Being able to get health insurance … should not be one of those determinant factors.”  Continued…

By Matthew Holt

Anyone who’s been following along on THCB will realize that there’s a huge divide about whether the HITECH act should pay for and dictate a specified, certified type of EMR product use OR pay for data and outcomes and not specify how providers get there. The “cats” support certification and EMR mandating (more or less). The “dogs” think that existing EMRs are often counterproductive and that a mix of other data sources, processes, and patient outreach technologies will get us where we need to in terms of improving outcomes much quicker. And now there’s an extra $20 billion in the mix, just to add some fun.

Rather than write more about that at HIMSS this week I got detailed interviews on film with leading “cats”, Glen Tullman, CEO of Allscripts, and Mark Leavitt, Chair of CCHIT. And then a response from the always highly caffinated dog-lover Jonathan Bush, CEO of AthenaHealth. And no, they don’t agree with each other…..although there is some common ground.

If you’re at all interested in how Health IT & EMRs will play out, these three are must-sees. (I’d view them in the order I took them).

To watch the video click here: The Health Care Blog

Way to go Chicago area hospitals! 

The following was taken from EMR Specialists Blog: February 24,2009 

“Electronic medical records are the wave of the future, and Chicago area hospitals are already on board.

Hospitals with more advanced record-keeping technology have fewer complications, lower mortality rates, and lower costs, according to a study released last week by Johns Hopkins University. The study looked at more than 40 hospitals with digital record systems and more than 160,000 patients in a six-month period.

“It’s the right thing to do and we’re going to see a lot of studies like this in the next 5-10 years that attempt to measure the benefits of electronic medical records,” said Dr. Mike Kelleher, chief medical information oficer at Children’s Memorial Hospital.

Most of Chicago’s top medical institutions including Northwestern Memorial Hospital, NorthShore University HealthSystem–Evanston Hospital, Glenbrook Hospital, Highland Park Hospital, Skokie Hospital, and 75 doctor’s offices–, University of Illinois Medical Center at Chicago, Rush University Medical Center and Children’s Memorial Hospital have either already made the leap to digital records, or are in the process.

Former President George W. Bush laid out the goal of having electronic records nationwide by 2014, a goal that was quickly adopted by President Barack Obama.

Wired In

The study findings are no surprise to Chicago-area hospitals, well versed in digital technology.
“What we did was transformational–it changed the way we do things and the way we think,” says Mark Neaman, president and chief executive officer of NorthShore University HealthSystem.

“Patients can even have a Blackberry conversation with their physician or order a prescription online,” Neaman said.
NorthShore University HealthSystem, one of the pioneers in digital records, went completely digital in 2004.

Digital records can even prevent mistakes from being made.

“We have seen measurable improvements in the quality of our outcomes, reduced medication errors and become generally more efficient,” Neaman said.

The complete transition at NortthShore $took 15 months from launch to finish in April of 2004 and cost an estimated $42 million, according to Neaman.

“We applied the big bang theory,” Neaman said. “We wanted to have everything up and running quickly.”

Almost all Chicago-area hospitals have some digital record keeping system in place or are in the process of implementing one.

Security, however, becomes a major concern with personal information in digital form.

With electronic records, it is much easier to track who has accessed a file—an important security feature—but making sure the right people have access can be time consuming.
“It’s a big concern,” Kelleher said. “You have to make sure that the people you give access to are properly vetted.”
“Before electronic medical records, files were continually being misplaced,” said Dr. David S. Channin, radiologist at Northwestern Memorial Hospital and chief of imaging informatics at Northwestern University Medical School. “We relied on loose pieces of paper with illegible writing, and human memory.”

Northwestern Memorial has used electronic records for more than a decade now for nearly all of their services.

More Benefits
The benefits of digital records aid in many different aspects of patient care.

One key benefit is allowing doctors to find information on patients more easily.

While it may take physicians or nurses more time to enter information into the system, the ability to find it and search for it with ease is invaluable according to Kelleher.
Patients and doctors can also have their information readily available at the touch of a keyboard without having to dig through extensive files.
Digital Divide
Despite the many advantages there are still countless hospitals that are falling behind with this technology.
After years of recording information manually, some doctors are hesitant to change to a new electronic system.
“The older physicians are more likely to be unwilling or uncertain about using the computer system,” said Kelleher.
“The catch is that there are tradeoffs between quality and efficiency and independent tradeoffs within each one,” says Dr. Channin.
There is also a steep cost of investment as far as equipment and training.
NorthShore University HealthSystem invested an estimated $42 million in the new technology, $5 million of which went to training staff, according to Neaman.

They are foreseeing an estimated return of 17 million dollars per year in savings related to the new system, but the return is very long-term and small in comparison.”

Originally Published by Vanessa Handand and Chris Kelly, Northwestern University.

By Aliza Marcus

Feb. 23 (Bloomberg) – With the economic stimulus package signed, President Barack Obama this week will outline how he plans to provide affordable medical coverage for all Americans, an administration official said.

Obama tomorrow will tell a joint meeting of the House and Senate that revamping the U.S. health system is a priority, according to the official, who spoke on condition of anonymity. The president will outline how he plans to pay for it when he submits his budget to Congress on Feb. 26, the official said in a telephone interview yesterday.

The president’s readiness to move the week after he signed a $787 billion stimulus measure shows how important health care is to economic growth, said Senator Ron Wyden, an Oregon Democrat. It also is a sign Obama hasn’t been sidetracked by the delay in naming a Health and Human Services secretary, said Len Nichols, a former Clinton administration official.

Obama’s budget “will help set the table for health reform,” said Wyden, a member of the Senate Finance Committee, which oversees U.S. government health programs.

One American in seven lacks health insurance, according to the Census Bureau. For those with coverage, the price rose an average of 5 percent last year, the Henry J. Kaiser Family Foundation in Menlo Park, California, reported in September. Obama said during his campaign that covering everyone might cost at least $65 billion a year.

By proposing how to pay for health changes in his budget plan, Obama is showing that he is committed to providing the necessary money, said Nichols, now head of the health policy center at the New America Foundation in Washington, in a telephone interview.

‘Can’t be Put Off’

“This is a president who knows that fixing health care can’t be put off any longer,” Wyden said in a telephone interview.

Obama’s first HHS nominee, former Senator Thomas A. Daschle, pulled out amid questions about his taxes, and no one else has been named. Kansas Governor Kathleen Sebelius is a leading contender for the job, an administration official, who spoke on condition of anonymity, said last week.

Obama campaigned on a promise to expand government health programs and give people subsidies to help them afford coverage. He also proposed creating a public plan to compete with private health insurers and taking steps, such as putting more health records in digital form, to help reduce costs.

The president may look to reduce payments to private Medicare Advantage plans to help pay for health-care changes, the administration official who spoke yesterday said.

$15 Billion in Cuts

Obama said during his campaign that he wanted to cut $15 billion in government payments to the plans, which private insurers such as UnitedHealth Group Inc., of Minnetonka, Minnesota, offer to seniors in place of the government’s Medicare insurance program for the elderly.

David Sloane, a lobbyist with AARP, the advocacy group for older people, said determining how to pay to get everyone covered is critical.

“Given all other spending priorities and economic peril, there’s a lot of uncertainty whether they can find savings elsewhere to offset this,” Sloane said in a telephone interview on Feb. 19.

Obama’s plans were boosted in the stimulus package, which he signed Feb. 17. The measure allocates $20 billion to encourage adoption of computerized records and gives $1 billion to research the comparative effectiveness of medical treatments. Both may save money later on, according to the Congressional Budget Office, an arm of Congress.

Bush’s Footsteps

President George W. Bush successfully used his budget to push a new health program. He devoted two sentences in his fiscal year 2002 budget proposal to create a program to subsidize prescription drug coverage for people in Medicare, the U.S. health insurance plan for the elderly and disabled. Congress approved it in 2003.

Obama’s plan isn’t expected to reach the level of detail that then-President Bill Clinton had in his 1,300-plus page health plan that he presented to Congress in 1993.

This is a good thing, said Sara Rosenbaum, who worked on Clinton’s failed health-care plan. Clinton tried to dictate to Congress.

“The point is to get the ball rolling and that’s where the president is needed,” said Rosenbaum, chair of the health policy department at George Washington University in Washington, said in a telephone interview on Feb. 19. “People don’t want to act until they have broad outline.”

Senator Edward M. Kennedy, chairman of the Health, Education, Labor, and Pensions Committee, and Senator Max Baucus, chairman of the Finance Committee, have been working on legislation to overhaul the health system

by Vanessa Handand Chris Kelly
Feb 03, 2009

Related Links

Headlines for the Week of January 28-February 4, 2009:

Here are links to the current news in life, legal and healthcare.  If you find stories that you think should be included please email me at epeterson@mediconnect.net, or leave a comment on the blog. If you would like to receive this as an RSS Feed, click on the “subscribe link” at the top of this page.

Thanks.

02/04/09 USAToday.com: House Set to Pass Kids Health Bill
02/04/09 USAToday.com: Obama Catastrophe Coming If Congress Does Not Act
02/04/09 Newsinferno.com: Gardasil: More Adverse Reactions and Scandals
02/04/09 Newsinferno.com: Xigris Lin ked to Increased Risk of Deaths, FDA Announces Safety Review
02/03/09 Reuters.com: Doctors: Under the Drug Industry’s Influence?
02/03/09 USAToday.com: Trial Opens in Florida Widow’s Tobacco Lawsuit
02/03/09 Reuters.com: Obama hit by Withdrawal of Health nominee Daschle
02/03/09 Newsinferno.com: Chinese Drywall debacle Sparks Lawsuits
02/03/09 Newsinferno.com: Peanut Salmonella Company’s Texas Plant Had No License
02/03/09 Newsinferno.com: Diet Supplement Maker Gets Jail for Selling Illegal RX Drug
02/02/09 Newsinferno.com: Carbon Monoxide Poisoning Incident Sickens 15 in Philadelphia
01/28/09 USAToday.com:  More Americans having out patient surgery
01/27/09 Newsinferno.com: FDA to Take Closer Look at Plavix
01/27/09 Newsinferno.com: KV Pharmaceutical to Recall Most of its Drugs
01/27/09 Newsinferno.com: Peanut Butter Pulled From Starbucks
01/27/09 Insurancenewsnet.com: Most Carriers and Brokers are Still Confident about Future of Voluntary Market According to Eastbridge’s Year-End 2008 Survey
01/27/09 CNN.com: Zimbabwe Cholera death toll nears 3000

By CALVIN WOODWARD –

WASHINGTON (AP) — It will get vastly cheaper for most people to keep health insurance after losing a job if the government’s stimulus plan becomes law. Some nickel and dime cuts in health coverage for the poor will be reversed, too. Geek jobs in medicine will grow.

The billions to be poured into health care from the economic stimulus package will do little if anything about the chronic conditions behind the nation’s stubbornly large ranks of uninsured.

Instead the plan is a temporary lifeline, hasty measures for nearly desperate times.

Jobs aren’t the central point of the package sought by President Barack Obama, passed by the House and steered to the Senate.

The point is to cushion the blow from losing one.

For those who qualify, relief would be substantial.

Under a dramatic, temporary expansion of COBRA, the law that lets the unemployed keep health insurance from their old job for up to 18 months if they pay for it in full, costs would drop by about two-thirds for a year.

Moreover, people who lose a job they’ve had for 10 years could stay on COBRA at their expense all the way to age 65, when Medicare takes over, if they don’t get another job with insurance first. People 55 and over could do the same without meeting the 10-year requirement.

It’s so expensive for people to extend that insurance now that many don’t do it. It can quickly eat up a majority of unemployment benefits.

That’s just one of the steps to maintain health access in the worst economic conditions Americans have lived through in generations. And that’s the key — maintenance more than advancement.

People who lose jobs at businesses that employ fewer than 20 people don’t qualify for COBRA. For them, the government would bring many more jobless people under Medicaid’s wing. The feds would pay for this, plus give states much more money to run cost-shared part of the program.

In return, states taking the extra money would have to back down on some of the cuts they’ve made to the program recently.

Altogether it’s a pricey lifeline: $40 billion to subsidize health insurance for the unemployed and more than twice that to support Medicaid.

Budget hawks, whose voices are practically lost in the wind these days, wonder whether the relief really will be temporary. They know it’s politically tough for the government to take something back once people get a taste of it.

Witness the expiring tax cuts that former President George W. Bush won from Congress. Obama promised to continue most of those cuts while raising taxes back up on the rich. But with the recession so deep, it’s less likely he’ll seek to raise those tax rates after all.

The recovery plan also sets aside $20 billion for medical record-keeping, a sum likely to grow jobs in information technology.

Four in five doctors still rely on old-fashioned paper files. Digital records are bound to cut administrative costs and improve care by making it easy to share patient information. But conversion is a huge task, for which Obama wants to spend $50 billion over five years.

The economic recovery plan isn’t the only game in town when it comes to health care, although it’s the most expensive. The Senate has voted to extend government-sponsored health insurance to about 4 million of the estimated 9 million uninsured children. The House acts on that next.

This article is from the website appscout.com 

We at MediConnect, think this cutting edge technology, and others like it- are the wave of the future. 

Leave a comment and let us know what you think.

The day where you can access your own medical records—or transfer them to a health professional—right from your cell phone is fast approaching. Recently, the U.S military signed a deal with AllOne Mobile, a health information management application by AllOne Health, to link Wounded Warriors recuperating at home with their case managers and unit support staff, according to TMCNet.

The linkup provides secure, two-day communication, and lets injured service members reach case managers and other military personnel who will monitor soldiers through personalized encrypted messages provided by AllOne, according to the report. Over time, AllOne Health aims to give regular employees and employers more control of their health records, along with access to tools and services for navigating health insurance plans. Currently they’re working with Microsoft on the company’s HealthVault service, among other projects.

By James Thalman

Deseret News

Published: Tuesday, Jan. 27, 2009 12:17 a.m. MST

Ready or not, one day soon there will be another pandemic. Like it or not, health-care system reform is really going to happen this time. Believe it or not, the one person who is gaining a new appreciation for President George W. Bush is President Barack Obama.

Those were among several assertions made to the Deseret News editorial board Monday by Michael O. Leavitt, former Utah governor, former head of the Environmental Protection Agency and, most recently, former U.S. Secretary of Health and Human Services.

Asked to assess the legacy of Bush, Leavitt said being critical is not his place as a Cabinet member nor is it his desire as a friend. The only things that can be said for certain is that it’s too soon to say.

During a recent visit to the Oval Office, Leavitt recalled, Bush pointed to the portrait of George Washington and said if historians are still arguing the legacy of the first president, arguing over the legacy of the 43rd is a given.

Leavitt, who said he fully shares in the nationwide hope for the new president, said he believes Iraq and Afghanistan “have a very good chance of ending up with functioning democratic governments. Those are very important world-changing results.”

Seeing the presidency up close also gave Leavitt a new perspective on how the country views the position — “as both an object for the manifestation of our hopes and our fears.” The Bush administration didn’t do things perfectly, “but no administration does.” He said circumstances, such as Hurricane Katrina, never allowed the president an opportunity to rally around optimism.

“There was never a time when we all set aside our divisions and moved forward,” he said.

Leavitt also got an up-close perspective of the world outside Washington, from seven weeks overseeing emergency medical services for Katrina victims, to visits to China to establish FDA standards for food and products manufactured there, to the efforts of the administration to contain the AIDS epidemic in Africa. The latter, he said, is one of Bush’s mostly unsung and significant achievements in improving the public health.

The position also gave him a new vantage point on health care, particularly the need for reforming it.

He envisions a time when patients can look up the cost, outcome and quality of medications, procedures and doctors from a home computer.

He also has a clear idea of what health-care reform is and likes to describe it by what it is not: the 47 million Americans who don’t have medical insurance. He calls that “an administrative problem that gets all the attention but one we can fix.”

One thing that must change is spending 16.5 percent of the gross national product on health care, “which rewards based on procedures, successful or not, and for treating sickness rather than keeping people well.”

The system is a network of independent “silos” that is very specialized and very expensive, but not very good compared to countries that spend a fraction of their national product on medicine.

“The solution isn’t to continue to keep doing what we did in the past,” he said. “The role of government needs to be worked out. Is it to own the system or organize the system?”

Leavitt said he foresees three possible outcomes for making comprehensive changes: incremental steps with expansions of health-care insurance for children and by expanding Medicare for seniors, the Big Bang change with details to be worked out later, the Big Bang carefully done.

“Health care is a big part of the stimulus — $100 billion — and a lot of it is for improving health care information technology, which is wonderful,” he said. “The big question is if this will be a pay-as-you-go effort. If they stick to a pay/go principle, the changes are more likely to be incremental.”

Health care is absolutely going to be changed, he said, noting that issue is finally ripe in the public’s mind, a factor that destined previous efforts to little more than nice tries.

He is also sure that a pandemic is a certainty, noting the three in the 20th century and the 10 the past 300 years. He pointed to his efforts to make the public aware of the avian flu threat, which he said were bolstered substantially by being mentioned on “The Tonight Show With Jay Leno” three nights running in 2002. He said there have been improvements in public health and in scientific preparedness, and the U.S. vaccine industry has been retooled under his watch.