22 Democratic Members of Congress join to form Populist Caucus

Representative Bruce Braley (D-Iowa),, announced the formation of the new Populist Caucus. It is aimed at protecting and expanding the middle class. "This is the moment, and the time is right to form the populist caucus because many of us feel that the needs of the middle class are being ignored or not been given the proper attention."

Rep. Peter Welch (D-VT) said that this country has been founded on the proposition that people who want to work hard to get into the middle class can make it, and that those who are in the middle class can work to do better. "We have never seen, since the 1920's, the greatest disparity of wealth that we have had in this country. And it's shocking, it's unconscionable, and it's wrong. And many Americans have a sneaking suspicion that part of the reason is that Congress has lost its way." He said it is time for Congress to start advocating for the middle class, which is what the caucus intends to do.

"As we move forward and debate the policies that will hopefully rebuild this economy and re-build the middle class in this country, we will lean heavily on the lessons that we've learned over the last ten years or so and work again to make this an economy that works for everyone," said Rep. John Yarmuth (D-KY).
In order to strengthen the middle class, the caucus outlined 6 issues that they plan to focus on: creating good jobs and a secure retirement, cutting taxes for the middle class, affordable and quality for healthcare, quality and affordable education, fair trade, and protecting consumers.

In Health Care Reform, We Don't Know What Works, But We know What Doesn't

In Health Care Reform, We Don't Know What Works, But We know What Doesn't

Coffee Brown,MD, University of New Mexico, for Talk Radio News Service


 
 "We just have to try some of these, knowing some of them will fail," Director Douglas W. Elmendorf, Director of the Congressional Budget Office, told Senate Budget Committee Chairman Sen. Kent Conrad (D-ND). Elmendorf reinforced Conrad's statement that healthcare costs will rise from 16 percent of the GDP to 20 percent if nothing is done. One dollar out of five would then go to healthcare in 2020, and the total Medicare-Medicaid burden would rise to 52 Trillion dollars over the next 75 years if nothing were done and if that money existed, according to both Conrad and Elmendorf. This would occur within the lifespans of most of the children who are alive now.
Elmendorf told the Senate Budget Committee, that none of the projections in the CBO's report on the costs of medical reform are certain, that some are much more speculative than others, and that there is simply  no way to know ahead of time which strategies will be most cost effective.
The most promising way to pay for some form of universal healthcare access,Elmendorf said, would be to completely or partially roll back tax credits for employer and personal health insurance premiums. "That saves the government money, but the cost is transferred to individuals," he said.
To achieve universal health coverage, it will be necessary to pool risks and to enforce and subsidize health insurance mandates, he said.
Medical insurance premiums increased by 78 percent during the same period,( 2003-2007) that wages increased 19 percent. So long as medical costs rise faster than wages, more of every dollar will go into medical care.
Chairman Conrad then pointed out that we pay almost twice as much, 8,300 dollars per person per year, as any other nation, yet we rank below 20th on international quality scales. Even within the U.S., he pointed out, the regions that spend the least tend to have the best outcomes. Clearly, he said, higher cost does not equal higher quality. To save healthcare, we need to put less, rather than more money into it, though he accepted that there may be transition costs.

The High Cost of Doing Nothing

Coffee Brown, MD, University of New Mexico, for Talk Radio News Service

For each increase of one percent in the unemployment rate, the number of medically uninsured goes up by approximately 1 million, according to Professor Jeanne Lambrew, Deputy Director of the new White House Office of Health Care Reform. Unemployment and medical debt in turn, increases foreclosures, she stated while addressing the National Health Policy Conference in Washington D.C., speaking at the National Health Policy Conference.
The coming spike in the uninsured will trigger a provision in the recovery act to subsidize 65 percent of cobra payments. When workers lose their jobs, they usually lose their insurance as well. By law, they can continue their former plan for six months by paying the entire premium plus two percent. This is about 80 percent of typical unemployment benefits, rendering it unaffordable for most. It may be wise to offer medicare as a less expensive, longer-lasting alternative, Lambrew said.
She also expressed concern over medical error rates that are higher in America than in peer nations. Health reform is needed to address these problems and the healthcare workforce shortage as well. This in turn will create lasting jobs, and cash flow within communities, she concluded.


Robert Berensen said that there is no longer any significant debate about the need for healthcare reform, now it’s about the form of the healthcare delivery system itself. The effort to reform the system has been gridlocked for 30 years, he said.
Paul Wallace, M.D., spoke for Kaiser Permanente and Glenn Steele, M.D., spoke for the Geisinger Health System. They described private sector innovations aimed at increasing efficiency, such as varying pay structures to improve healthcare benchmarks. The most important of these was getting caregivers to adopt electronic records. This measure speeds flow, reduces redundancy and reduces errors by making sure that the patient’s history is up-to-date at each visit, even when they cannot see their usual provider.
Both physicians emphasized the importance of a patient “care home”, a clinic and staff who know the patient well. This practice, the modern equivalent of the family doctor, is increasingly common as states experiment with ways to reduce costs and increase patient satisfaction. Results reported at several recent conferences have been very positive.

Sen. Max Baucus, D-Mont., at the National Health Policy Conference, said there are several good reasons for healthcare reform right now.
First, he said, the cost of doing nothing has become greater than the cost of doing something. Prices were rising faster than inflation even before the crash, he said. By 2014, half of U.S. households will be spending 45 percent of their total incomes on health insurance premiums.
Second, the current system is failing. Costs are higher and quality markers are lower than for other industrialized nations. Medical errors are killing tens of thousands of us a year, largely due to poor Health IT systems, which are now a major item in the recovery package.
Third, there is an unprecedented degree of bipartisan and even industry support.
Baucus concluded with the statement that the first priority has to be changes that create economic stimulus, and the second needs to be speed, while the momentum is favorable. The problem, he said, is that we also have an economic crisis, two wars, and an oil-dependence crisis competing for the attention of congress and the president.

Health care transforms, Gingrich gives thoughts

Newt Gingrich, former Speaker of the House of Representatives, participated in the Center for Health Transformation's Healthcare that Works presentation at the Washington Press Club.
A panel of speakers presented data on the need for robust and universal computerized medicine for safety and cost savings. Gingrich said government could save much more by promoting private sector best practices than by just funding benefits.
Merrill Mathews, PhD, said centralized accounting could combat fraud totaling billions of dollars annually. He said the private sector has much better control of this, and should be the model.
Brandon Savage, MD, of GE Healthcare, said electronic patient records Could be modeled on ATM software which already provides fast access no matter where the user is, while remaining secure. Gingrich added that such records could monitor medical errors, medicine conflicts, allergies, etc.

According to Donald Doak, EBSCO Publishing, 40 thousand to 90 thousand lives a year might be saved . He also said Evidence based (objective, statistically supported best practices) medicines is derived from, and distributed by, networked databases.
Gingrich said that he had tried to encourage electronic medical information reforms under Bush for six years; now they are part of Obama's package.
In a broader concluding statement, Gingrich also proposed tripling NSF funding, based on a "generational investment strategy": the payoff is huge, but delayed. "My biggest mistake as Speaker was not doing that."
Dr. Rita Colwell, former director of the National Science Foundation, endorsed Gingrich's estimate of needed funding.

The entire presentation will be available as a video at www.healthtransformation.net

Democrats plan for America

Topic: Democratic senators lay out plan for America

On Wednesday, January 21, 2009, the first full day of the new administration, Democratic senate leaders laid out their overarching agenda for at least the next two years.
Priorities were:
1. Economic recovery, which, according to Senate Majority Leader Harry Reid means “jobs, jobs, jobs.” Senator Debbie Stabenow, who led the entire presentation, emphasized that each of the proposed programs should produce more recovery in jobs and return on investment than they cost.
Sens. Charles Schumer and Byron Dorgan discussed the economy. Schumer described sewage treatment and fresh water reclamation as examples of neglected infrastructure projects, which could create jobs and sustainability. He stated that Social Security is not in jeopardy, but that Medicare will require adjustments.
Both Senators said that energy programs will be major areas of investment, and Dorgan specifically said that expansion of the power grid was a priority. This would provide for the decentralization of power production and make distribution more robust.
Dorgan also specifically addressed the need to regulate practices, like derivatives, which encourage risk taking by lenders, as well as mortgages with “teaser” rates leading to balloon payments later.
While there was some inevitable finger pointing, the emphasis was on the need for bipartisan commitment.
Sen. Amy Klobuchar said that Obama has promised to personally review and approve proposed economic policies, and to improve transparency by posting financial data, such as expenditures, interest rates and returns on the web
2. Energy: Sen. Harry Reid stressed the need for oil independence, first from the need to import oil, which is a major cause of the imbalance of trade, but ultimately from domestic oil as well. He said this was a security issue as much as an environmental and economic one.
Sens. Amy Klobuchar and Jeff Bingaman answered question on energy policy. Bingaman supports a cap and trade policy for carbon units, with a need to simplify the details, and to cap the level to which fees for allowances can rise as oil prices fluctuate. He noted that even oil produced by American companies is generally imported. He declined to give a timetable for addressing climate change, reminding the press that it is not possible to address every important issue simultaneously. Bingaman did say that Sen. Henry Waxman plans to submit an energy bill by Memorial Day.
Klobuchar said, with confirmation of Ray LaHood as Secretary of Transportation and Commerce, the United States would be in a position to be leaders again at the Copenhagen conference on climate change, the successor to the Kyoto conferences. Referring to cap and trade policy, she said it is important not to ratify historic carbon emissions, but also not to punish companies that have alreadybeen working to bring emissions down.
3. Healthcare: Sens. Ron Wyman and Debbie Stabenow presented. Stabenow said that Obama will immediately lift bans on stem cell research, and that expanded SCHIP coverage, including mental health and dental care, will pass within the next two weeks. She noted that “community mental health” had become, for some, code for reduced federal funding on mental health programs. She confirmed that universal coverage includes mental as well as physical illness. As a strategy to address the critical shortage of nurses, she proposed forgiving student loans upon completion of training.
Stabenow also said that medical information technology is an important investment for better and more efficient health care.
Regarding the economic impact of expanding health coverage, she said Canada remains competitive partly because its businesses do not have to bear the costs of employee health insurance. The big question, Stabenow said, is maintaining choice for patients.
Wyman said that for progressives “the story of universal health care is one of unrequited love.” There have been several occasions in the past when comprehensive reform appeared likely, but powerful interest groups or intervening crises prevented its passage. This time, things look better in that former foes have become allies as industry tries to divest itself of the cost and responsibility of health care. Sen. Tom Daschle, who has devoted much of his career to this issue, will become Secretary of Health and Human Services. Sens. Kennedy, Daschle, Stabenow, and Wyman have worked to make the legislation more transparent and streamlined than last time, Wyman said,and the public is likely to choose the health plan that congress uses.
Sen. Harry Reid told the press this is an aggressive congress with the political tools and capital to get much of the desired legislation passed, noting that they just passed 164 environmental bills, which would have been impossible, just a short time ago.