The following post appeared last week on the Get Better Health Blog:

President-elect Obama and Secretary of HHS designate, Tom Daschle, invited concerned Americans to discuss healthcare reform in community groups across the country. My husband and I hosted one such group at our home in DC yesterday. Although we had been instructed to compile a list of compelling stories about system failures – instead we decided to be rebellious and discuss “what’s right with the healthcare system” and compile a list of best practices to submit to the change.gov website.

The event was attended by a wide range of healthcare stakeholders, including a government relations expert, FDA manager, US Marine, patient advocate, health IT specialist, transportation lobbyist, real estate lobbyist, health technology innovator, Kaiser-trained family physician, medical blogger, and EMR consultant. Here is what they thought was “right” with the healthcare system: (more…)

Two reports recently released by the Congressional Budget Office, Key Issues in Analyzing Major Health Insurance Proposals, and Budget Options, Volume 1: Health Care, have dominated discussions this week.

Jane Zhang of the WSJ reported:

The Congressional Budget Office analyzed 115 options to change health care, some costly and others that would save the government and consumers some money.
…
Among the findings:

- If no changes occur, CBO says health care spending will rise to 25% of GDP by 2025 from 16% last year.

- If the federal government required all employers with more than 50 workers to provide insurance or pay a penalty, federal revenue would increase by $13 billion in four years and $47 billion over nine years.

- Allowing non-federal workers and companies to buy into the Federal Employees Health Benefits Program would cost the federal government about $2 billion over four years and $6.2 billion over nine years.

Ezra Klein explained the importance of these reports and the impact they could have on healthcare reform plans:

How do we decide how much a government program costs? It’s an essential question. Programs need prices, because the government has to produce a budget. But pricing legislation in advance is impossible… But you still need a number. So Washington operates amidst a tacitly agreed-upon imprecision. What the CBO says, goes. “In this town,” says Henry Aaron, a senior economics fellow at the Brookings Institution, “it’s not infrequent to hear people say it doesn’t make any difference what it really costs. It only matters what CBO says it costs.”

The books that the CBO released this week are essentially a guide to the CBO’s scoring process. They tell congressmen, in advance, how the Number will be built. The Wonk Room and The New York Times are focusing on the equations. But they’re not what’s changed. Rather, the difference is that Congress knows what they’ll be in advance. The scoring process will still be a minefield, but now legislators will have a map. There won’t be a situation analogous to 1994, when the White House was shocked by an unwelcome assumption and their legislation was mortally wounded by a staggering price point. Obama and his allies in Congress, along with Orszag’s help, will be able to build a bill able to survive the scoring process. They can, effectively, decide their own Number.

(more…)

A recent Washington Post-ABC News poll found that over three-quarters of Americans think Obama should make major reforms in our health care system, and a majority think he should start working on health care right after taking office.

What do you think? Share your opinions by responding to our poll:

 Loading ...

The holidays are upon us, and we all know what that means for health issues — besides higher sugar and alcohol intake. That’s right, healthcare reform house parties! Check out the message from HHS Secretary nominee Tom Daschle below, and learn more about hosting or attending a healthcare community discussion over the holidays.

Meanwhile, four issues dominating discussions around the web this week are the future of the FDA, the new Nursing Home Compare rating system and web site, physicians and health IT, and of course, healthcare reform issues.

At the Center for Medicine in the Public Interest DrugWonks blog, Peter Pitts shared his recommendations for reforming the Food and Drug Administration:

I was honored when the Obama FDA transition team called and asked for my advice on how the incoming administration could make the agency a more robust and forward-looking regulatory instrument.
…
My suggested areas of focus are

1. A strong, science-based FDA
2. The Reagan/Udall Foundation — a Partnership of Unequals
3. Clarity vs. Ambiguity
4. Information Management
5. Food Safety and Security
6. Risk Communications
7. The Drug Label and the “Safe Use” of Drugs

…
There are, obviously, many, many other important issues … and I look forward to working with the transition team to ensure that the new commissioner can hit the ground running… And kudos to the Obama transition team for reaching out to a wide variety of groups.

(more…)

It’s official: President-elect Obama announced in Chicago last week he will be nominating former Senator Tom Daschle for Secretary of Health and Human Services — and as director of the White House Office of Health Reform. The President-elect also announced his pick of Center for American Progress Senior Fellow Jeanne Lambrew as Daschle’s deputy director. (Official announcements from the transition team: the press release with the President-elect’s prepared remarks, and the blog post, with photos from the event.)

At the National Journal Lost In Transition blog, Mary Gilbert explained:

Daschle, in his new dual role, will be responsible not only for crafting a health care plan but also for implementing it. Calling him “one of America’s foremost health care experts,” Obama claimed that Daschle’s knowledge of health care policy and extensive legislative experience make him uniquely suited to steer an effective reform package through Congress. As “the original no-drama guy,” Obama said, Daschle is also someone who can be trusted to use the HHS Department to implement the new policy on the ground.
…
Pressed by a reporter on how he plans to pay for an overhaul of the health care system, Obama spoke about first cutting costs and then finding ways to make the system pay for itself over the long run, though he was short on specifics. He stressed, however, that fixing health care must be “intimately woven” into his team’s overall economic recovery plan. “We can’t put this off because we’re in an emergency,” he said. “This is part of the emergency.”

From Sarah Rubenstein on the WSJ Health Blog:

For his part, Daschle, who will also head up a new White House office dedicated to health reform, emphasized that this won’t happen behind close doors. (See our post from earlier today.) “We’re going to bring the American people into this conversation and make health-care reform an open and inclusive process that goes from the grassroots up.”

(more…)

The Obama-Biden Transition Team website has been generating a great deal of discussion for its innovative approaches and potential effects (or lack thereof) on key aspects of federal government policymaking. The recent Join the Discussion: Healthcare feature on the Change.gov blog stimulated a 3,701-comment-conversation about important health care issues.

But wait! There’s more!

The video response from former Senator (and head of the Obama healthcare transition team, at least until his HHS nomination is announced) Tom Daschle and Laura Arnonson (Obama healthcare policy team member) regarding the healthcare discussion generated over 4,400 comments since Tuesday afternoon — and counting!

Open, extensive conversations about healthcare issues and policy ideas are obviously very near and dear to our heart here at Disruptive Women. But what impact, if any, do you think the Change.gov approach will have on healthcare reform? What are your reactions to Daschle and Aronson’s video response to the blog comment discussion?

Here’s the video from Daschle and Aronson:

Over on his Washington Monthly Political Animal blog, Steve Benen noted the historical significance of the Change.gov blog, even though “the idea of setting up a website and accepting public comments doesn’t sound especially revolutionary” at first glance:

Historically, government-related sites have avoided public comments. The medium was about one-way communication, not two. To this extent, we’re already seeing the beginnings of a significant shift. George W. Bush ran an operation that stifled dissent and kept opposing viewpoints as far away from policy makers as possible.

On the ZDNet Healthcare blog, Dana Blankenhorn considered how the President-Elect’s effort “to drive the health care debate, from the bottom up” might affect the health care reform process, especially considering “how policy debates typically play out”:

Interest groups lay down markers, then go into small meetings and hash something out, which goes to Congress in order to die. The question is whether the Internet will be allowed to break through this.
…
The question is whether ordinary citizens who are not inclined to support the new Administration will participate, or whether they will rely on top-down organizations to oppose it.

On Covering Health, Ed Silverman reacted to the blog discussion and video response from Daschle and Arnonson, which, he explained, reviewed “a couple of key issues and the overall response to their effort”:

To be candid, there wasn’t much said that we don’t already know. Daschle, at various turns, says things such as, “We need to really put the emphasis on prevention” and later, “We need to contain costs.” To be fair, the willingness to engage the public in this way is worth noting. After all, when was the last time that HHS Secretary Mike Leavitt deliberately spoke to Americans by way of YouTube? Send us a clip if you have one. Meanwhile, Daschle promises more online discussions are forthcoming. (more…)

Please note: This week’s roundup is abbreviated due to the holiday.

There has been a great deal of buzz over President-Elect Obama’s choice of Melody Barnes for Director of the White House Domestic Policy Council, as ThinkProgress reported Monday. (You can also check out the official Obama-Biden Transition Team blog post.) Before taking an advisory role on Obama’s transition team and campaign, Barnes held the position of Executive Vice President for Policy at the Center for American Progress. Also, from 1995 to 2003, Barnes served as chief counsel to Senator Ted Kennedy. Many have suggested that Barnes’ primary focus in the new Administration will be on health care policy, given her record on health care issues and the President-Elect’s stated domestic agenda priorities. Noting Barnes’ record at CAP, Ezra Klein wrote:

Barnes has been one of the chief architects of CAP’s domestic policy program, and in that, she’s created a formidable and decidedly impressive organization.

At The Field, Al Giordano commented on Barnes’ record as an “unabashed progressive,” and on what her role in the Obama Administration will include:

Barnes will coordinate the mega-board of the Cabinet secretaries of Health and Human Services, Justice, Labor, Education, Housing and Urban Development, Commerce, Energy, Treasury, Agriculture, Transportation, Interior and Veterans Affairs. Basically, she’ll be domestic policy czar.
…
1993. Want to get an idea of how progressive she is? Read this: In January of 2007, prior to President Bush’s state of the union address, Barnes wrote this essay for the Washington Post, What a Progressive President Might Say…

(Read Barnes’ essay here.)

(more…)

Today is Public Health Thank You Day, honoring legislators, researchers, government agency employees, and other professionals who focus on community-wide health. Take a look at profiles of public health heroes, and spread the word!

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:

(more…)

Senator Max Baucus (D-MT) issued a “Call to Action” on health care reform this week, unveiling what he calls a “blueprint” for ensuring all Americans have “quality, affordable health care.” (Here’s the official press release and executive summary from Sen. Baucus’s office.)

Sen. Baucus’s proposal has drawn both praise and criticism, but more importantly, it has stimulated a great deal of substantive discussion about our health care system, the need for reform, and potential solutions.

On her blog, Health Beat, Maggie Mahar called the white paper “shockingly honest”:

In his clear-eyed summary of the problems in our health care system — and his candid description of the obstacles — Baucus makes it clear that overhauling the system, and providing healthcare for all will probably require more than one piece of legislation. As he puts it, “The solution will demand time and attention to make sure that we get it right.”

Wall Street Journal health blogger Jacob Goldstein pointed out similarities and differences between the Baucus and Obama health plans:

[The Baucus plan] has a lot in common with Barack Obama’s plan, and at least one major difference: It would require everyone to buy health insurance… Obama says all children should be required to have health insurance, but has not supported a mandate for adults.

Both the Obama and Baucus plans would offer government-backed plans to more citizens, and would bar insurers from denying coverage for people with pre-existing conditions.

Over on his New York Times blog, Paul Krugman hailed Sen. Baucus’s move as “big news” signaling a “reasonable chance” for universal health care to be enacted in 2009:

One of the key questions about the new Democratic majority was whether Congress would try to play it safe, backing down on big ideas about reform, especially on health care…

But now Max Baucus — Max Baucus! — is leading the charge on a health care plan that, at least at first read, is more like Hillary Clinton’s than Barack Obama’s; that is, it looks like an attempt at full universality.

On Daily Kos, in agreement with Krugman, mcjoan commented:

That this is coming from cautious, conservative, DLCish Max Baucus does indeed mean, as Krugman says, that it’s looking much more likely that we have universal health care enacted in the next year. (more…)

View full post

Last Monday, Stephanie Mensh wrote about her experience with medical homes. Dr. Pamela Mitchell, President of the American Academy of Nursing, has provided Disruptive Women with another perspective.

Guest post by Pamela H. Mitchell, RN, PhD, FAHA, FAAN

There is much talk these days in health professional, health payer, and even legislative circles about the “medical home.” This is a term coined in 1967 by the American Academy of Pediatrics. The medical home was originally meant as a single place for a child’s medical record and was particularly salient for children with special care needs. It later expanded to denote the one place that families with children with special care needs might obtain coordinated, continuous, family-centered and culturally effective care.¹ The concept of a medical home has additional roots in recognized needs for care coordination for people with chronic illness in managed care, case management, disease management and comprehensive discharge planning for complex or chronic illnesses. Most recently, a coalition of the American Association of Family Practice, American College of Physicians, American Academy of Pediatrics, and American Osteopathic Association developed and disseminated “Joint Principles of the Patient-Centered Medical Home.” This document defines the Patient-Centered Medical Home (PC-MH) as “an approach to providing comprehensive primary care for children, youth and adults. The PC-MH is a health care setting that facilitates partnerships between individual patients, and their personal physicians and, when appropriate, the patient’s family.”¹ At its best, this new movement promises quality, coordinated care for people, rather than their diseases. Further, it recognizes that care coordination and management is a complex skill that deserves payment in our current payment system. However, because of the consistent emphasis on physicians as the home “owner” and leading partner, it connotes care centered in a particular practice profession rather than care for the person or family who comes “home.”

(more…)

Guest post from Donna Barnes

Chronic disease prevention presents an obvious opportunity for health care reform. The platforms of both Senators McCain and Obama note the potential savings—in dollars and lives—that can result from preventing chronic illnesses. However, by focusing exclusively on chronic disease, we miss an opportunity for prevention of a common cause of death that takes as many lives as Alzheimer’s disease and causes ripples throughout American families and communities.

What I am talking about here is violent death—among others, homicide, suicide, child abuse, and domestic violence that takes lives. Recognizing the growing damage from violent death and recognizing that it can be prevented—just like countless medical conditions—is critical.

(more…)

Guest post from Alexandra Carmichael

Open source has emerged as a powerful set of principles for solving complex problems in fields as diverse as education and physical security. With roughly 60 million Americans suffering from a chronic health condition, traditional research progressing slowly, and personalized medicine on the horizon, the time is right to apply open source to health research. Advances in technology enabling cheap, massive data collection combined with the emerging phenomena of self quantification and crowdsourcing make this plan feasible today. We can all work together to cure disease, and here’s how. (more…)

Guest Post by Fran Drescher

A doctor tells his patient, “I have good news and bad news. The good news is you have 48 hours to live.” The woman says, “If that’s the good news, then what’s the bad news?” The doctor answers, “I was supposed to tell you yesterday.”

Too many women are being told that they have cancer today, when they should have been told yesterday.
It took me two years and eight doctors to get a proper diagnosis of uterine cancer. As a result of my experience, I wrote the New York Times bestseller, Cancer Schmancer. I realized that what happened to me had happened to millions of women. It was then that I realized the book was not the end, but rather the beginning of a journey to improve women’s healthcare and raise consciousness of wellness and prevention issues globally. Toward this end, I founded the Cancer Schmancer Movement and Foundation, and made advocacy for Stage 1 diagnosis of cancer my life’s mission.

Cancer Schmancer is a policy-driven women’s health movement that will alert Capitol Hill that the collective female voice is louder and more powerful than that of the richest corporate lobbyist. Through education, prevention, and policy change, we will revolutionize the way Americans think about cancer. The mission of Cancer Schmancer is to ensure that all women with cancer get diagnosed in Stage 1, when cancer is most curable. We want women to understand the early warning whispers of the cancers that could affect them, and the available tests that could save their lives. We encourage them to become better partners with their physicians, and to transform from patients into medical consumers. We all know that early detection equals survival. But what’s being done by patients, the government, and the medical community to ensure early detection? We need to take the right steps forward to ensure that all cancers get diagnosed in Stage 1. (more…)