This post first appeared as a column at Kaiser Health NewsIs The Individual Mandate Really A Lynchpin In The New Health Law?If the Supreme Court does rule the individual mandate unconstitutional will it really bring down the whole law?I don't see it.First, the individual mandate isn't even close to what it has been made to be -- a provision that would protect the integrity of the health insurance
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Back to the Future—Biggest Health Plans Reported to be Building Their Own Political Coalition
I had a real sense of déjà vu this morning reading Bara Vaida’s story in Kaiser Health News:Five of the nation's largest health insurance companies are taking a key step toward building their own inside-the-Beltway coalition to influence implementation of the new health law and congressional efforts to change it. The companies – Aetna, Cigna, Humana, UnitedHealthcare and Wellpoint – are shopping
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What Would Happen If You Were To Pass a Big Health Care Bill Without Bipartisan Support?
During the recent health care debate I heard many people on both sides of the debate worry out loud about passing a heath care bill that did not enjoy broad support.I guess this question is no longer a theoretical one.December will be a big month when it comes to seeing some of the fallout accruing from the very partisan passage of the Patient Protection and Affordable Care Act.First, the White
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"Care and Cost"
Good friends David Kibbe and Brian Klepper have finally started their own blog--aimed at becoming a forum for many contributors to the health care debate.I suggest you add, "Care and Cost"––"Health Care Conversations About Hard Choices and Emerging Solutions" to your bookmarks.
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"Don't Litigate, Innovate." How To Implement A Fully Funded Alternative To The New Health Care Overhaul -- And It's Already In The Law
This post of mine first appeared at Kaiser Health News last week.What if a Republican governor and a Republican legislature had the ability to implement their version of health insurance reform and the federal government would have to pay for it? It's a great idea. And I'm thrilled to say that a bi-partisan bill has already been introduced in the Senate by Ron Wyden, D-Ore., and Scott Brown,
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Will it Be the Bond Market That Finally Forces Serious Health Care Financing Change?
When will the Congress and the White House finally make the hard decisions in order come to grips with the federal deficit problem?When will we finally deal with real health care reform and get the entitlements, and with them the private health care cost issue, under control?My focus on trying to answer those questions has always centered on what's going on in the health insurance market: When
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The 300 Page MLR Rules—About as Valuable as Taking Your Shoes Off at the Airport
This whole medical loss ratio (MLR) provision in the new health care law is a fool’s errand. When it comes to controlling health care costs it is about as productive as taking your shoes off at the airport is valuable at improving air travel security.Without a doubt, the new health care law does far too little toward making health care costs affordable. And, marginal health insurance carriers
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Health Care—Tell Us the Truth Before You Tell Us Why You Are Right
This is post of mine that appeared last week at Kaiser Health News.Just after the election, I saw an exchange between CNN’s Anderson Cooper and the head of the Tea Party House Republican caucus, Michele Bachmann. Cooper tried to pin Bachmann down on just exactly what “specific spending cuts” she would make to get federal spending under control. When he suggested that Medicare was going to need
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Shame on AARP For Their Response to the Deficit Commission Co-Chairs' Report
The Co-Chairs of the President’s Deficit Reduction Commission are out with their preliminary recommendations.They’ve done a great job—they’ve offended about everyone!But we have a nearly impossible but unsustainable challenge in front of us if we are ever going to crawl out of this deep hole.It is not so much what is on their list as what this list tells us about just how fundamental the changes
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Health Care and the 2010 Mid-Term Elections--the Only Thing Now Certain is the Uncertainty
@font-face { font-family: "Cambria"; }p.MsoNormal, li.MsoNormal, div.MsoNormal { margin: 0in 0in 0.0001pt; font-size: 12pt; font-family: "Times New Roman"; }div.Section1 { page: Section1; } The election has given us a Republican House and a still Democratic controlled Senate. But, instead of Democrats having the 60 Senators they had when health care was passed in December, they will have a
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Passing the Democratic Health Care Bill is Not the “Right Thing To Do”
Any big health care bill will be full of compromises—political or otherwise. But this bill doesn’t even come close to deserving to be called “health care reform.”As the Democrats make their final push to pass their health care bill many of them, and most notably the President, are arguing that it should be passed because it is the “right thing to do whatever the polls say.”Their argument is
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The Issue Has Become Arrogance Not Health Care
Away from Washington people I talk to are just amazed at what the Democrats are in the process of doing on health care.What I think the Democratic leadership is missing is that this is no longer about passing a health care bill in the minds of lots of these voters—a majority of voters from what the polls say.To these people, this is about Democratic arrogance. What the polls don't measure is the
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Why Rush Vendor Certification of EHR Technologies?
Why Rush Vendor Certification of EHR Technologies?by DAVID C. KIBBE and BRIAN KLEPPERA surprise move by ONC/HHS indicates the wheels may be falling off health IT reform at about the same rate they've fallen off Democrats' broader health reforms.David Blumenthal and his staff have unveiled two separate plans to test and certify EHR technology products and services. We don't think this is a good
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"What a Disaster Looks Like"
In case you missed Peggy Noonan's column in the WSJ yesterday, let me suggest it is worth your time.I think she hit the nail on the head:It is now exactly a year since President Obama unveiled his health care push and his decision to devote his inaugural year to it—his branding year, his first, vivid year.What a disaster it has been.At best it was a waste of history's time, a struggle that will
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After the Failure of Reform
After the Failure of ReformbyBrian Klepper and David C. KibbeThe stalemate in the bi-partisan health care summit was cast the moment it was announced. Republicans demanded that the reform process start anew, and Mr. Obama insisted on the Senate bill as the framework going forward. The President may now offer a more modest reform bill that can demonstrate some progress on the health care crisis,
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Post-Summit Health Reform: What a Mess
Everyone agrees our health care system is unsustainable and too often unfair. At the White House health care summit, that was the only common ground between Democrats and Republicans.Many Americans are either left-brain liberals or right-brain conservatives, with the remainder somewhere in the middle. These left- and right-brain types look at the same facts but come to different conclusions—no
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The White House Health Care Summit--Democrats: 0 Republicans: 0 -- The Republicans Win
There is politics and there is policy.On the policy front what we saw today was the same exchange of the old talking points we have watched for a longtime. No progress was made toward any kind of health care bill. That is no surprise--this was never going to be the place to fashion any kind of compromise.At the end the President asked the Republicans if it was worth it to spend another month or
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Live Blogging During the Health Care Summit
I am blogging live with a number of others at the NewsHour site.
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Obama to Uneasy Democrats: Please Walk the Plank for Me But If It Doesn't Work Out Here's Plan B
The President and the Democratic leadership have been pushing hard on the idea that the Democrats should ram their unpopular health care bill through by using reconciliation--no matter how many Democrats in swing districts lose their jobs over it this November.But Laura Meckler had an important story in the Wall Street Journal yesterday that is bound to give many of the nervous moderate Democrats
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The President’s Health Care Plan—Not a Game Changer
It is hard to see how the health care plan the President released this morning changes anything.There is nothing new in it save a health insurance rate regulatory board that is an awkward political proposal at best. What powers would it really have and how would it operate in conjunction with the states already charged with insurance company oversight are just two of the first questions it does
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Wellpoint and Their “39%” Rate Increase
Wellpoint is getting killed in the press over a “39%” rate increase for their individual health insurance block in California.HHS Secretary Sebelius has pointed to the Wellpoint individual rate increases demanding an explanation. The President even brought it up in his interview on Sunday. At a time Democrats are fond of calling insurance executives “villains” this story just adds more fuel to
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The Health Care Summit—Who’s Gonna Win the Photo-Op?
Getting Democrats and Republicans to constructively engage on health care is the best way to make progress.To date, the Democrats have blown health care reform once again by being too arrogant in thinking they could just ram their version through.The Republicans have no health care proposal. Their “black book” list of ideas they handed the President in Baltimore is a collection of second and
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A Way Out of the Health Care Wilderness?
I just came across an interview that I will suggest we all may have missed and perhaps charts the way out of this health care reform wilderness we now seem to be in.It was on February 2nd and was between the Washington Post’s Ezra Klein and rising Republican House star Paul Ryan (WI).Ezra asked Ryan about the bipartisan Wyden-Bennett bill as a place for both sides to find common ground. It’s a
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“Plan B” Has Begun
With word that the House is likely to take up the repeal of the health insurance industry anti-trust exemption it is now clear the Democratic leadership has begun Plan B.It is also clear that this is much more a part of a political Kabuki dance then any substantive effort at even piecemeal health care reform.The House probably has the votes to pass the repeal. The Senate does not. I doubt that
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Friday in Baltimore--The Way to Actually Accomplish Something
Intentionally or unintentionally, my sense is that the White House came out of Baltimore thinking they are now on to something, and I hope the Republicans took the same lesson away.Constructive good faith political engagement in Washington actually works.It is just incredible that House Minority Leader John Boehner has had not direct contact with the White House for about a year. A pox on both
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The State of the Union--The President Came to a Fork in the Road and He Took It
As Yogi Berra said, "When you come to a fork in the road, take it."The President came to a fork in the road tonight on health care reform. Would he do what many liberals have demanded--push harder to pass the Democratic health care bills? Or, do as many moderate Dems and some Republicans have called for--work to get a smaller but bipartisan health care bill?Listening to his speech he seems to be
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Plan B—There Isn’t One—But There Could Be
As the State of the Union approaches Democrats are considering their health care policy options. There are lots of reports about “Plan B”—pushing through the Senate bill with a parallel corrections bill that could be passed in the Senate using reconciliation rules.That’s as dead as the original House and Senate health care bills. Moderate Democrats have no stomach for such a legislative stunt in
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A Smaller Bipartisan Health Bill? What It Could Look Like
In the wake of the Massachusetts vote, Democrats are scrambling to find a way out of the health care political mess they are in.Right now they are in a daze standing by waiting to see if any of the "trial balloons" they have launched gain any traction. So far, ideas to ram though the now toxic Senate bill in the House in one parliamentary form or another are falling flat.Last night, the President
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Stick a Fork in It! The Democratic Effort to Pass a Health Bill is Dead
Tuesday’s Republican victory in Massachusetts means the current Democratic health care bills will not be on the President’s desk in 2010.Forget the crazy talk of ramming something through—including just having the House pass the pending Senate bill.I’ve talked to lots of people in the past few months that didn’t like the Democratic effort but conceded that the Dems won the 2008 election on a
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The Silver Lining in the Massachusetts Vote
The Silver Liningby Brian Klepper and David C. KibbeMassachusetts voters' stunning rejection of Democrat Martha Coakley, in favor of a not-very-impressive Scott Brown, should be exactly the splash of cold water that the Democratic party - and Congress as a whole - needed. The defeat can be understood in two ways: one large and one fairly small.First, the large one. This will probably send reform
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The Union “Cadillac” Tax Sweetheart Deal
Just when you thought you couldn’t be more cynical about the health care bill.As I have said before, there wasn’t a lot of hope the same administration that ignored the rule of law in granting unions priority over Chrysler bondholders was going to offend them on the “Cadillac” tax.We’ve seen the “Louisiana purchase” giving Senator Landrieu hundreds of millions for her vote, only to be upstaged by
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A Great Summary of Where We Are
Good friend Brian Klepper has an excellent round-up of recent blog reactions to the health care bill's progress in a "Special Edition of Health Wonk Review."It is posted on The Health Care Blog.It is really worth your time.
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