Health Reform

As criticism mounts against HMOs and the number of uninsured continues to rise, a group of Maryland leaders called yesterday for sweeping health reform in the state.The new group, called the Maryland Citizens' Health Initiative, released poll results revealing strong dissatisfaction with health maintenance organizations and a belief that the uninsured need health coverage."Our present health care system is an embarrassment," declared Dr. Alfred Sommer, dean of the Johns Hopkins School of Public Health.

WASHINGTON -- After years of failed efforts to reform health care insurance, the House soundly approved last night a bill to preserve coverage for people who become seriously ill or change or lose jobs.The 267-151 vote by the Republican-led House represented the most progress Congress has made on the issue in decades."This is a giant step toward health security for all working Americans," said Rep. Nancy L. Johnson, a Connecticut Republican who is among the leading advocates in her party for expanding the availability of health care.

A crowd of nearly 700 health care providers, state lawmakers and experts jammed into a Baltimore hotel meeting room yesterday to work on the state's biggest health issue: how to cut costs and expand coverage by changing how nearly half a million Medicaid patients get their health care.The conference at the Omni Inner Harbor Hotel was a preview of all of the sticky issues state officials will face as they try to move Medicaid patients into managed care plans -- which coordinate care and restrict which doctors patients can see.Sponsored by the state Department of Health and Mental Hygiene, University of Maryland Baltimore County and the Milbank Memorial Fund, the conference kicked off a series of 10 public hearings state health officials will hold around Maryland beginning next week.

For Hillary Rodham Clinton to describe herself as having been both "naive and dumb" in the way she handled the administration's failed health care reform plan is startling because such adjectives can hardly describe the most influential and possibly the smartest First Lady in the nation's history. As a result, one has to ask if she really means it and, more important, if it signals a change in the role she seeks to project to the country.After the issue that was supposed to define her husband's presidency crashed last fall -- a forerunner to the devastating Democratic defeat in the November elections -- Mrs. Clinton took on some of the blame.

WASHINGTON -- The combination of Republican power politics and attacks by lobbyists appears close to having sapped Congress of the political will to enact health care reform legislation this year.Republican congressional leaders and most GOP members have concluded that they would not be punished by voters for blocking the Clinton effort -- and might even be rewarded for it in the fall elections."The policy is not to try to make this bill better," said Rep. Fred Grandy, an Iowa Republican who is bowing to a request from party leaders to withhold amendments designed to improve a Clinton-like bill being debated in the House Ways and Means Committee.

The nation's governors have sent Senate Republicans and Democrats on the House Ways and Means Committee a useful reminder about health care reform realities. As officials who have to deal with the consequences not only of what they do but what Congress does to them, their message is, "Please, no more unfunded federal mandates."Senate minority leader Bob Dole is the most immediate target of gubernatorial criticism. His alternative to the Clinton health plan currently calls for a cap on federal spending for Medicaid, with added costs in this mushrooming program to be dumped on the states.

Senate moderates pushing health care reform that puts the emphasis on individuals, not employers, in purchasing insurance may be on to something. The fact is that in the end it will always be individuals -- not employers, not the government -- who have to pay the doctor (and the hospital and the pharmacist and the insurance peddler).When you have an "employer mandate," as Bill and Hillary Clinton propose, the cost is ostensibly covered by the boss. But employees inevitably feel the impact in the form of smallerpaychecks.

WASHINGTON -- When two moderate senators recently became the first Democrats to publicly reject the Clinton health care reform plan in favor of a less ambitious Republican alternative, the Democratic chairman of the Senate Finance Committee was delighted.In fact, Chairman Daniel Patrick Moynihan, the brainy and blunt New Yorker who has been struggling to build a consensus around the Clinton bill, had encouraged Sen. David L. Boren of Oklahoma to join Sen. Bob Kerrey of Nebraska in their defection.

BOSTON -- The polarizing politics of health care reform, featuring back-to-back addresses by President Clinton and Senate Minority Leader Bob Dole, will dominate the annual summer meeting of the National Governors' Association, which begins here today.The association's leaders urged Congress yesterday not to miss the opportunity to enact national health care reform this year -- even though the governors themselves disagree over how far that reform should go."It would be a tragedy for the American people if Congress doesn't pass the health care bill this year," said Democratic Gov. Howard Dean of Vermont, a doctor and the association's vice chairman.

YOU cannot watch a State of the Union address without a scorecard. Here is a handy-dandy sheet of favorite plays and intricate defenses to paste in your hat as the president and Congress put on their annual pre-game pageant.1. Watch for the keyword theme setter. Presidents say "The State of the Union is . . ." and then add "good" or "sound," or as one did in an unprecedented fit of candor, "not good." If Bill Clinton says something like "getting better," keep your eye out for:2. The climbing-economy credit grab.

After ducking the nation's health care crisis for many years, Congress finally stands on the verge of passing comprehensive health reform. Each of several bills on the table would build on our existing public-private system to bring us much closer to making comprehensive, high-quality health care available to all Americans. Maryland is the wealthiest state in the nation. Yet almost one in five residents is uninsured or underinsured, and many more are just one medical bill from bankruptcy or foreclosure.

Harris offers wrong fix for health system Dr. Andy Harris has made a misdiagnosis of the underlying problem in U.S. health care, and his suggestions for treatment are off ("Reform, not overreach," Oct. 6). He's shared a misconception that competition among insurers would bring down the cost of health care insurance. That was the original concept before the industry went to a for-profit model. Since that time, the annual cost of care for individuals and families has risen steadily. The 2009 Kaiser Family Foundation's annual survey of health benefits notes that despite these hard economic times and the focus on health insurance costs, the average annual premiums for employer-sponsored health insurance are $4,824 for single coverage and $13,375 for family coverage - a 5 percent increase from last year alone.

Deneice Valentine was a wife, mother and college-educated professional with a family income in six figures. But for a year and a half in the late 1990s, she slept in a small park across the street from Morgan State University. Valentine was diagnosed with major depression and a stress disorder but lost her mental health insurance after her divorce. She eventually lost her Baltimore home, custody of her children and the ability to care for herself. Stories like hers are the reason that mental health advocates have joined the immense lobbying effort in Washington on health care reform.

Sin taxes may not prevent sinning, but they do slow it down. That's the beauty of vice; whatever drives people to smoke and drink alcohol is mercifully price-sensitive. But it's not just economists and clergy who can rejoice in the power of basic economics to improve our lives. Doctors see the advantages as well. High cigarette taxes have done wonders for keeping kids away from smoking, and that's saved lives. Might a sin tax prove just as helpful in the fight against the nation's epidemic of childhood obesity?

WASHINGTON - -When Barack Obama steps inside a University of Maryland arena today, he will be making his latest appeal in what is quickly becoming the most extensive presidential selling job in years. Since his nationally televised speech on health care to Congress last week, Obama has rallied supporters at election-style events in Minnesota, Ohio and Pennsylvania. On Sunday, he will hit no fewer than five TV talk programs and, for good measure, will appear on David Letterman's late-night show on Monday.

Plan wouldn't fund abortion After a month of right-wing activists employing every scare tactic imaginable at congressional town hall meetings on health reform, columnist Kathleen Parker falsely claimed that health care reform would lead to federally funded abortions ("Abortion issue could thwart Obama's health reform goals," Sept. 9). The truth is that advocates for women's health care, including Planned Parenthood, are focused on achieving affordable, quality health care for all and ensuring that women's broad health needs are met through reform.

Tavon Stokes, 22, is seldom sick and keeps in shape by running and walking. He figures he has no need to see a doctor. So even though the full-time sales clerk from Baltimore could get health insurance from his employer, RadioShack, Stokes figures he can find far better ways to spend his cash. Health problems "aren't coming up yet, so it's not much of a priority," he said. In the debate over health care reform, Stokes and his peers are known as "invincibles," strong and healthy young adults who have no experience with wallet-crippling illness and feel they have no need for coverage.

Watching the news during the past week became a daily exercise in rubbernecking at the train wreck that was town hall democracy. At a certain point, it beame impossible to determine, and maybe immaterial, who came to meetings congressmen and senators held to discuss health care reform out of genuine concern and who came as part of an orchestrated show of force by one side or the other. Supporters and opponents of the Democratic reform plans said they felt insulted and misunderstood by the other side, and it was clear that little real debate or dialogue was going on. That's what happened Monday night when Sen. Benjamin L. Cardin held a town hall meeting at Towson University.

It's theoretically possible that some of the ordinary citizens who showed up at Monday night's town hall meeting about health care reform with Sen. Benjamin L. Cardin might actually think that the proposals under consideration include government-ordered euthanasia of the elderly. It's hard to believe that they have not seen any of the many concrete debunkings of this myth, and even harder to believe that they would imagine their fellow citizens who represent them in Congress and work in the federal government would be capable of such a thing.

There's a tantalizing rumor running through the Internet that the Democrats in Congress are conspiring to exempt themselves from the health care reform bills now being debated in Washington. It's caught life in talk boards and blogs among the substantial number of people who are terrified that the government is secretly trying to completely take over health care and deny necessary treatment to millions. The fact that it's not true doesn't seem to have made much of a dent in the hysteria, which is increasing in its fervor this month as representatives and senators fan across the country to talk about health care with citizens in town hall meetings, web chats and conference calls.