Health Care America Now started running a new ad in an “attempt to influence the political commuity to help push the president-elect’s vision of health care reform once he takes office,” as Sam Stein reported for the Huffington Post:

Health Care for America Now is out with a new advertisement Tuesday morning that makes clear that Obama will be held to the health care reform promises he made while on the campaign trail.

The spot, airing in Washington D.C., uses an October speech by Obama on health care as a way to set the ground rules for his forthcoming administration.

Here is the new Health Care for America Now ad:

Speaking of health care reform, in a major development this week, America’s Health Insurance Plans and Blue Cross Blue Shield Association each announced that they would support a reform plan that requires insurers to provide coverage for anyone who applies, regardless of health status, as long as the plan also requires everyone to have health insurance.

On The Plank, Jonathan Cohn commented on the significance of this news for the health care reform movement:

If anything, this announcement is the latest sign that health care reform has serious political momentum heading into 2009. The insurance industry wouldn’t be taking this position if its representatives didn’t believe that the odds of universal health care passing are pretty good — and that they are better off trying to shape the plan from the inside than fight it, unsuccessfully, from the outside.
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Of course, they could change their minds… Still, every day that the insurance industry is saying charitable things about reform is a day it’s not using its resources to knock it down. And that has to help the overall effort.

At his Health Care Policy and Marketplace Review blog, Robert Laszewski expressed a less optimistic reaction to the news:

The industry’s proposal glosses over the real issue — figuring out how to make health insurance affordable so that a mandate that everyone buy coverage is practical and enforceable.
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To enforce an individual mandate to buy health insurance any successful reform program would likely have to cover the 75% of premiums most employer-programs cover in order to make insurance reasonably affordable for most of the middle-class.

So, the health insurance industry is saying that if we cover everyone — and therefore eliminate their underwriting risk — they’d be happy to take 45 million new customers at retail. How magnanimous!

On his The American Prospect blog, Ezra Klein offered his take on this news:

In return for a mandate in which every American must purchase health care coverage, they will stop refusing to sell insurance to those with preexisting conditions. Some deal. They’re basically saying that if we legislate that every American must purchase insurance coverage, they will sell insurance coverage, at some price, to every American. Their “concession” here is something called “guaranteed issue,” and it’s an important step, but not a sufficient one… That said, this discussion is an important step forward.

… the basic foundation here — individual mandate, guaranteed issue, some form of community rating — is the likeliest foundation for a deal, and
the political system knows that full well: That’s the Baucus plan, the Wyden plan, the Clinton, plan, the Edwards plan, and probably will be the Obama plan. The insurers are recognizing that, and trying to pull the terms in their favor, dangling an easy deal where they endorse passage but have more control over the rate structure… This is the beginning of the fight, not the end of it.

(See also: Ezra’s conversation with Robert Zirkelbach of America’s Health Insurance Plans.)

The Disease Management Care Blog analyzed the implications of this news for disease management:

Innovative approaches to reducing the impact of risk in community rated plans will appear more attractive. Since insurers will no long be able to ‘duck’ risk with experience rating, they’ll find approaches like disease management to be an important option in managing their book of business.

On the Healthcare Efficiency blog, Dr. Robert Burney wrote about the National Priorities Partnership, an initiative sponsored by the National Quality Forum that was introduced Monday at the Newseum in Washington, DC. The six National Priorities, Burney explained, are:

1. Engage patients and families in managing their health and making decisions about their care.
2. Improve the health of the population. (“Here, the emphasis is on prevention.”)
3. Improve the safety and reliability of America’s healthcare system.
4. Well coordinated care across organizations, settings, and levels of care.
5. Appropriate care for life-limiting illness.
6. Eliminate overuse while ensuring appropriate care.

On NPP, Burney wrote:

Overall, an ambitious undertaking tho some of the goals are uncertain. A lot of their proposals are motherhood issues — it’s hard to say they aren’t worthwhile. However, for many people today, the biggest problem with U.S. healthcare is that it costs too much… Some of their initiatives may eventually reduce the need for care in the population, and this will reduce the amount spent. But the cost of individual healthcare services will remain high. Unreasonably high.

(Learn more about the National Priorities Partnership on the NPP website.)

Another important meeting this week was the Wall Stree Journal-sponsored conference attended by about 100 CEOs who worked together to develop issue priorities for our next President. On The Health Care Blog, Brian Klepper reviewed this meeting:

This meeting brought together the nation’s industry power players. Several Senators and Congressional representatives participated, as well as Rahm Emanuel, the President-elect’s new Chief of Staff, and others who advise Mr. Obama.
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The health care group — co-chaired by Angela Braly of Wellpoint Inc., Dr. Denis Cortese of the Mayo Clinic, Jeffrey Kindler from Pfizer Inc., and Dr. Daniel Vasella from Novartis AG — identified Obesity as the nation’s top health priority. Dr. Vasella said that that two-thirds of Americans older than 20 are obese, “and their children are becoming obese now.”

The health care group’s second priority was Tort Reform. Third was Defining and Measuring Value. Fourth was Payment Reform that would move toward paying-for-value. Fifth was Building the Health Care Workforce, with an emphasis on primary care, nursing and other allied health professionals… Interestingly, the Health Care Focus Group had not identified Universal Health Coverage as a priority, but the General Session participants added it.

A Physicians’ Foundation survey released this week found that nearly half of primary-care doctors would stop practicing medicine if they thought they could. The UC San Diego
href=”http://blog.ucsd.edu/bml/2008/11/20/survey-frustrated-dissatisfied-mds/”>Biomedical Library Blog reviewed the report:

With the projected shortage of physicians (24,000 by 2020), this might just compound that problem and severely effect access to care.
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The frustration and dissatisfaction seems to stem from the business side of health care, specifically dealing with “insurance company red tape” and keeps them from the most satisfying aspect
of their job, patient relationships. The survey from the Physicians Foundation found that nearly 60% of primary care physicians would not recommend the medical profession as a career choice.

DemConWatch commented on President-Elect Obama’s choice of former Senator Tom Daschle for Secretary of Health and Human Services:

Daschle brings a wealth of experience that will be helpful in steering an important department within the administration.
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What’s more: he will be a highly valuable ally in any healthcare reform debates that require a lot of negotiation with both houses of Congress. Having a seasoned, former Senator working to pass legislation in the Democratically controlled House and Senate was among the missing links to the Clinton plan proposed back in 1994.

The Wall Street Journal Health Blog considered

Daschle’s book on health care to get a “sense of where he’d like to take things”:

His basic idea: Create a board modeled on the Federal Reserve to “offer a public framework within which a private health-care system can operate more effectively and efficiently — insulated from political pressure yet accountable to elected officials and the American people.”

Daschle was also one of the Senators most committed to the failed Clinton health reform plan of the early ’90s — and the book spends a chapter unpacking the lessons of that failure.

Jon Popham commented at TakePart on the report released this week about the cost of diabetes in the US:

Diabetes costs the United States $218 Billion annually according to a new study released today. The astronomical, bailout scale, figure includes medical care costs, insulin, amputations, hospitalization, and indirect costs like lost productivity, disability payments and early retirement. The costs to the American economy amount to an astounding 10% of all health care costs in the country.

What makes these already frightening numbers even scarier is that the total number of people suffering from diabetes in the United States has nearly doubled in the past decade, from 5 in 1000 ten years ago to 9 in 1000 today, and continues to grow.

Over at The Pump Handle blog, Liz Borkowski analyzed an issue raised by the Boston Globe earlier this week: “the vastly different fees that different Massachusetts hospitals charge to insurance companies.” Here are some of Borkowski’s comments:

We certainly ought to be outraged about the state of healthcare in this country, and premium escalations and the imbalance between favored and less-favored hospitals are serious concerns. Before we go placing too much blame on the favored hospitals, though, it’s important to recognize the environment in which hospitals are operating.

Hospitals’ major problem is that they don’t get paid for all of the care they provide. The ones that survive are the ones that successfully cost-shift — that is, charge some payers more to cover shortfalls from others.
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The more financially strapped hospitals will probably respond by cutting services, or they may shut down altogether. This is a serious problem, but … These are the kinds of actions we see in a market-based health system.
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Steep premium increases and struggling hospitals will continue to be problems until we fix our healthcare system. Looking at the worsening imbalances between favored and less-favored hospitals is valuable, but we should consider it in the context of the economic forces at work. Hospitals may deserve a little bit of outrage, but our broken system deserves more.

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