Battle over Bush’s proposed HHS midnight regulation
Yesterday, Senator Hillary Clinton (D-NY) and Senator Patty Murray (D-WA) introduced legislation (The Protecting Patients and Health Care Act ) that would block the Bush administration’s intended midnight regulations to protect health care providers from discrimination for refusing to provide reproductive and other care on the basis of religious or moral grounds. Bush’s proposed rule would prohibit recipients of federal funds from discriminating against such health care workers and requiring their employees to assist in the provision of certain health service programs that they object to because of their “religious beliefs or moral convictions.”
Senator Clinton describes the “ill-conceived” midnight regulation as “a serious threat to patients’ access to information and care” and warns of the “slippery slope” that such a rule would create, endangering patients’ access to contraception and other vital care or information.
For more, see the New York Times coverage of the Bush legislation and Senator Clinton’s guest post at RH Reality Check.
Health Care as Stimulus — analysis from the Center for Economic and Policy Research
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Health Care as Stimulus: The Best Way to Spend Big Bucks
By Dean Baker
The Great Depression was an economic catastrophe that subjected much of the country to poverty and insecurity for more than a decade. But this catastrophe provided the political backdrop for enormous political change, including the national minimum wage, the 40-hour work week, full legalization of labor unions, and Social Security.
The current economic crisis provides the same sort of opportunity. We are likely to see a higher minimum wage. It is possible that an Obama administration will bring the United States in line with the rest of the world by guaranteeing workers some amount of paid sick leave and/or vacation days. It is also possible that it will act to protect workers’ right to organize by pushing through the Employee Free Choice Act.
But the really big follow-on to Social Security, national health care insurance, is an item that should sit at the very top of President Obama’s agenda. The reason is that we need to pass a stimulus package right away, and health care should be a very big part of this package.
The need for large-scale stimulus is recognized by economists across the political spectrum. The housing sector has collapsed and will not be revived soon. The bubble in commercial real estate is also now collapsing, placing a further drag on the economy. Most importantly, consumer spending is crashing in response to the loss of more than $5 trillion in housing bubble wealth in addition to the loss of a comparable amount of wealth in the stock market. The drop in annual consumption spending is likely to be in the range of $300 billion to $400 billion.
A boost from the government is the only plausible way to replace this collapse in spending. Most economists place the size of the necessary boost in the range of $300 billion to $450 billion annually. Paul Krugman has argued that $600 billion is a more appropriate target. Given the recent rise in the dollar, which will kill export growth, this higher figure is almost certainly a better target.
The problem is that it is not easy for the government to find ways to usefully spend this much money. There are obvious ways in which the government can get money to help alleviate the impact of the downturn and increase spending such as extending unemployment insurance benefits and increasing food stamps. But additional spending in these areas will not likely exceed $30 billion.
It can probably spend another $60 billion a year on infrastructure projects, perhaps $50 billion aiding hard-hit state and local governments, and maybe $40 billion on green investment projects. This sums to $180 billion, a figure well short of even the $300-$450 billion stimulus range.
This is where health care comes in. Health care is a $2.4 trillion sector. It can reasonably be expanded by 5-10 percent in a relatively short period of time, which would imply an additional $120 billion to $240 billion in annual spending. The jobs created in this sector would provide a substantial boost to the economy.
More importantly, we could substantially extend coverage through a stimulus package, getting much closer to the goal of universal health care system. The quickest way to get there would be with a tax credit for employers who cover currently uninsured workers. Employers who already cover their workers can get a credit for increasing the generosity of their coverage. Generous credits should be sufficient to extent coverage to most uncovered workers.
At the same time, the government could open up the Medicare system, allowing all employers and individuals to buy into a Medicare-type plan that would compete with private insurers. This step, together with rules that limit abuses by private insurers, would be important in setting up a system that allows for cost containment over the long-run.
After two years the credits could be phased down to the earnings-based subsidies advocated by President Obama during his campaign. In the longer-term, steps could also be taken to fill the gaps to ensure that people still left behind get covered.
The downturn has given President Obama the opportunity to quickly accomplish one of the most important goals he set himself during the campaign. One of the biggest problems in getting to universal coverage was finding the money to extend care before reforms could actually rein in costs.
The recession brought on by the collapse of the housing bubble has created a situation in which the main priority for the moment is spending money, not saving it. There is no better way for us to spend large amounts right now then getting our health care system in order. President Obama should seize this extraordinary opportunity.
— This article was published on November 17, 2008 by The Guardian Unlimited.
Dean Baker is the co-director of the Center for Economic and Policy Research (CEPR). He is the author of The Conservative Nanny State: How the Wealthy Use the Government to Stay Rich and Get Richer. He also has a blog on the American Prospect, “Beat the Press“, where he discusses the media’s coverage of economic issues.
The Center for Economic and Policy Research is an independent, nonpartisan think tank that was established to promote democratic debate on the most important economic and social issues that affect people’s lives. CEPR’s Advisory Board of Economists includes Nobel Laureate economists Robert Solow and Joseph Stiglitz; Richard Freeman, Professor of Economics at Harvard University; and Eileen Appelbaum, Professor and Director of the Center for Women and Work at Rutgers University.
Center for Economic and Policy Research, 1611 Connecticut Ave, NW, Suite 400, Washington, DC 20009
Phone: (202) 293-5380, Fax: (202) 588-1356, Home: www.cepr.net
Comparing universal health care systems in ten countries
The Insure the Uninsured Project has released a report comparing universal health care systems in ten different countries. The report explores the solidarity underlying systems that are committed to the notion of health care as a human right, as well as examines the competing interests that these states must reconcile in dealing with the rising cost of health care.
See the full report here.
Uninsured woman denied full-body scan after biopsy detects cancer
Mary Gannon, a 54-year-old temp worker in a doctor’s office, discovered a lump in her groin one day that was removed after it was determined to be cancerous. Her surgeon recommended a full-body PET scan to detect the presence of lumps anywhere else on her body and to determine the stage of the cancer.
“That day, after she learned the biopsy results, Mary called the Excela Health-Mountain View Diagnostic Testing Center to schedule a PET scan…The information was crucial to planning her care.
The woman who answered the phone, Mary said, told her she wouldn’t schedule the $3,000 PET scan unless Mary had insurance. The woman told Mary to apply for medical assistance from the state…”
“…Driving to work from the mobile home became a 75-minute grind at rush hour. So Mary left the job where she worked for 11 years as a medical assistant – with insurance – and took the temp job near her new home.
For the first time in 20 years, she wouldn’t have health insurance, but she figured, “I’m not going to get sick.”
In June, Mary heard from the county assistance office, which handled her medical-assistance application.
Denied.
Mary had no understanding of why she was denied. She continued to work, wait and fret.
“It’s scary, not knowing what stage it’s in,” Mary said on July 18, referring to any cancer. Angered by the delay, Mary said, “It’s like I just sit and wait to see what’s going to happen next.””
The Philadelphia Inquirer ran this article today, as part of its series “Falling Through: Casualties of the Health Insurance Crisis,” chronicling the barriers this woman has faced to accessing the care she required to save her life without health insurance.
Racial barriers faced by medical providers
We have called attention to the unjust and dangerous inequities in care provided to minority patients in the past, and will continue to do so, but an article by Dr. Pauline Chen in yesterday’s New York Times sheds some light on the barriers faced by those on the other side of the health care equation – our doctors.
Chen discusses preconceptions based on race that physicians of color face among colleagues and in doctor-patient interactions. Some recount experiences in which patients assume they are transports, or nurses pass them over assuming the younger white medical student or resident is in charge. While such assumptions – as conscious or subconscious as they may be – must be confronted within the profession and by the individuals who make them, perhaps even more significant is one study’s finding of a higher rate of error reported by white patients treated by minority doctors than those treated by whites.
The Healing Fields
Many uninsured and underinsured Americans head over once a year to Wise County, Va, early in the morning to line up with hopes of receiving medical care at the three day Remote Area Medical Volunteer Corps clinic, where hundreds of doctors, dentists and volunteers come over to offer their services for free. For some Americans, including children, this is the one time in the entire year they actually go to the doctors because of the lack of proper health care at their local communities or the high costs for medical care. The longest lines are for dental or vision care. At times, the clinic must turn down patients due to high demand. These videos are proof that we are in desperate need for a better health care system in America.
To watch the videos, please visit:
http://www.washingtonpost.com/wp-srv/nation/interactives/healingfields/
Obama and Health Policy
With the new elected President, there is new hope in finally getting a health care system that will suit all Americans’ needs. John Iglehart discusses in his article what Obama will do once he steps into the White House.
For the full article, please visit: http://healthaffairs.org/blog/2008/11/07/obama-and-health-policy-campaign-successes-and-governing-plans/#more-462
Baby, You’re Home: The Growing Popularity of Home Births
More women are starting to prefer to give birth in the familiarity and intimacy of their homes, accompanied by a midwife, rather than giving birth in a hospital- even in New York City. The number of deliveries performed midwives has been as high as ten per month and the sales of birthing pools has doubled since last year. One of the reasons for the new interest in home births is Ricki Lake’s film, The Business of Being Born. In the film, Lake shows the many advantages of having home birth, such as the woman’s feeling of comfort from being in her own home. In addition, many soon-to-be-mothers prefer home births because of the control they have over the process of their own childbirth and the constant contact with their newborn, unlike in a hospital. Also, number of caesarean sections has increased by fifty percent since 1996. But who knew home births could be so popular in New York City, where the apartments are usually tiny and the walls thin? To hear more about the growing popularity of home births in New York City, go to: http://www.nytimes.com/2008/11/13/garden/13birth.html?_r=1&pagewanted=2&em&oref=slogin
Choices in Childbirth Statement Encourages Options and Evidence in Maternity Care
In recent news, Our Bodies Ourselves is asking for safer and fairer choices for women in the process of childbirth that would meet all their various needs by presenting a proposal. One of the points they bring up is more safe childbirth alternatives. In the link below is the OBOS article, including a more in depth description of their proposal. Also, maternity care providers, public health professionals and childbirth advocates who supports OBOS’ beliefs are encouraged to sign their online form (which can be found in the link below).
For the complete article, please visit:
http://www.ourbodiesourblog.org/
Also, for those who are more interested in maternity care, please check out Childbirth Connection’s report, Evidence-Based Maternity Care: What It Is and What It Can Achieve. Childbirth Connection points out the many obstacles in achieving proper maternity care as well as several suggestions in ways to improve.
Senator Takes Initiative on Health Care
Now after the 2008 Election is settled, the focus has returned to health care and the need for health care for all, aside from the economical troubles our country is currently facing. Senator Max Baucus is spearheading the issue of health care this past Wednesday by presenting a blueprint guaranteeing all Americans health insurance. Many other Democrats are also getting a head start on establishing proper health care system before elected President Obama moves into the White House by contributing their thoughts and plans. For more information on Senator Baucus and other Democrats’ ideas, please visit http://www.nytimes.com/2008/11/12/washington/12health.html?ref=health
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