Tuesday, February 3, 2009

Dodd Announces Second Town Hall Meeting on Health Care

Senator Chris Dodd, a senior member of the Senate Committee on Health, Education, Labor and Pensions (HELP) who has been asked by Chairman Kennedy to serve as his chief deputy for health reform, is hosting a series of town hall meetings across Connecticut on the issue.
The second stop on the "Prescriptions for Change" tour will take place:
Saturday, February 7, 2009
Doors Open at 2:30pm
Western Connecticut State University
Westside Campus Center Ballroom
43 Lake Avenue Extension, Danbury, CT
Links to video from the first meeting in East Hartford can be found here, here, and here. (Thanks to CCAGOnline and CTLocalPolitics.net for their video.)

Monday, February 2, 2009

Turn into the skid!!

Or ... more precisely ... align your wheels with the direction you intend to travel.

The Congress will likely take another step forward this week when the Senate passes their version of an economic stimulus package. There will be a few big differences with the House version passed last week that can be worked out in conference. The President said that health insurance for the unemployed must be in the final package. The House accomplished this goal by opening the Medicaid program to the unemployed with 100% reimbursement to the states for both direct care AND new administrative costs (like outreach). The Senate isn't there, yet. Additionally, there will be a 65% up-front credit for those who can take advantage of their former employer's COBRA plan. The "take-up" rate for COBRA, however, has long remained in the single digits (+/- 9%) because it's just too expensive.

For the traditional Medicaid programs, the Federal "match" will increase by a minimum 4.9% -- that translates, generally, to 54.9 cents back to CT for every dollar spent. (For more information on those aspects of the plan, see Ellen Andrews' 1/29 post here.)

The States will be the vehicle for getting this part of the stimulus pushed out to the people. But, there's a problem. States aren't created equally. States don't all have the same ability or will to execute the new plan. Some may actually pass up the money for fear that once the economic crisis passes the states will be responsible for a whole new population with rights to access to Medicaid (see Robert Pear's NYTimes piece here).

Paul Krugman did a great job laying out concerns about the states based on economic theories, but it may be more basic -- capacity.

Connecticut, for example, has shown a talent of late for turning good ideas and programs into embarrassing, expensive wrecks. The Medicaid program is underfunded; reimbursements to providers are too low to attract them into the system; and, the networks of providers who serve the existing populations of HUSKY A, HUSKY B and Charter Oak are unstable and dangerously inadequate now, so adding more lives to this system is almost not an option.

If our wheels are aligned in the direction we're headed, I don't see meaningful healthcare on the horizon. Rather, I see a 100 year-old oak tree in our immediate future. Brace yourself.

Sunday, February 1, 2009

"Government is the enemy until you need a friend." -- Sen. William Cohen, (R) Maine, 1996

Columnist E. J. Dionne spoke at the Families USA, Health Action 2009 conference in Washington this week. He confirmed this feeling in America that, perhaps, government isn't the enemy after all. Perhaps Ronald Reagan was wrong? Or, at least partly so.

Dionne's rapid-fire presentation swung from references to Leuchtenburg's 1963 tome "Franklin D. Roosevelt And The New Deal," to the musings of former South Carolina Senator Fritz Hollings (D). Hollings, it's said, was amused by a WW II veteran who, despite life-long assistance from the VA, Social Security, Medicare, the GI Bill, and the Farm Bureau, wanted assurances that the Senator would keep government off his back .

The room was primed for Dionne's presentation, and they met his observations with enthusiastic applause. Folks clearly felt vindicated by the results of November's election. Reality, however, followed close behind.

Throughout the 3-day meeting, excitement about the new possibilities for our country was tempered by concerns about the battle to come. More precisely, folks worried aloud about the resolve of our "friends" on Capitol Hill and the White House to ensure universal access to affordable and meaningful health coverage.

My 2 "take-aways":

  • It will be impossible to correct our economic crisis without reforming healthcare, and impossible to reform healthcare without correcting our economic crisis.

  • While we'll need to be pragmatic in our effort to reform healthcare, pragmatism must be grounded in our moral commitments.