by R.J. Matson, originally uploaded by the Health Advocate.

This week’s featured satire is by R.J. Matson. How is your health insurance? These days, many Americans find themselves underinsured. The waters of unemployment and pre-existing conditions can be difficult to navigate. I think this also highlights the need for rigorous protection of health information as the prevalence of genetic testing continues to increase. Leave a comment and tell me what you think.

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Melody Barnes, Director of Domestic Policy during the White House Forum on Health Reform (photo by Pete Souza)

ARRA and You (Part I).  The “fierce urgency of now” is the concept that President Barack Obama used to explain why he would run for president. Yet it can also be used to characterize his motivation and subsequent actions in the push to reform health care.

With the new legislation, American Recovery and Reinvestment Act of 2009 coverage for millions was protected or extended.

1. Health insurance coverage for 7 million Americans was extended via insurance premium assistance for COBRA benefits.
2. Families are no longer in jeopardy of loosing current benefits from Medicaid and CHIP due to $15 billion in Federal Medical Assistance Percentage funding allocated to states.

Without pause, the President continues to move forward his agenda for reform. The release of a budget blueprint, proposes a $634 billion reserve fund to extend coverage to some of the 47 million Americans who are currently uninsured. “This is the first step towards getting health care reform done this year,” White House domestic policy adviser Melody C. Barnes told allies on one conference call. “We can’t underestimate the importance of rallying around this budget. It serves as a footprint for something bigger.” In contrast, others express doubts about the prospects for overhauling health care. For example, Sen. Mike Enzi, the senior Republican on the Senate Health, Education, Labor and Pensions Committee stated, “It needs to be done up front and quickly. I’m not so sure that we haven’t already lost that, with so many other things coming in and weighing us down.” As was the case in bringing a stimulus package into law, it appears the President will remain undaunted and continue to seize the opportunities created by environment, his political capitol, his strategic leadership and timing to accomplish the essential goals of his health agenda:

1. providing affordable, comprehensive and portable health coverage for every American;
2. modernizing the U.S. health care system to contain spiraling health care costs and improve the quality of patient care; and
3. promoting prevention and strengthening public health, to prevent disease and protect against natural and man-made disasters.

As he so aptly noted in his address to a joint session of the Congress,

“[Health-care costs are] one of the major reasons why small businesses close their doors and corporations ship jobs overseas…This is a cost that now causes a bankruptcy in America every 30 seconds. By the end of the year, it could cause 1.5 million Americans to lose their homes. ….Given these facts, we can no longer afford to put health-care reform on hold.”

So it is no surprise that on the following Thursday, March 5 the administration convened the White House Health Reform Summit. The event sought to convene the varied stakeholders in the health care reform debate and ultimately, get buy-in. The President stated, “I want to be very clear, at the outset, that while everybody has a right to take part in this discussion, nobody has the right to take it over and dominate.” Participants included leaders from the (American Medical Association) AMA and other medical specialty societies; trade groups for drug makers, insurance companies and hospitals; CEOs of companies including Pfizer and General Mills; advocacy groups such as the American Heart Association and American Diabetes Association; and unions such as SEIU and the Teamsters.

Lawmakers also met on Thursday as they have been given the task of working out the details and writing the actual legislation around several key principles set forth by the President:

• maintaining choice of insurance and doctors,
• ensuring affordable coverage,
• protecting Americans’ financial health,
• investing in prevention and wellness,
• improving patient safety and quality of care.

If you missed the live coverage on CSPAN, you can find a summary and important document links at the White House blog and continue to follow the entire process of health care reform at the newly launched HealthReform.gov. Opponents to the progress of health care reform will have take notice of “the fierce urgency of now” momentum and perhaps much more are already on the President’s side. Regional White House Forums on Health Reform are currently under way to expand upon what was gained at the White House forum.

Sources:

Obama Has Big Challenges In Overhauling Health Care {Obama Has Big Challenges In Overhauling Health Care (2009, February 21) [Electronic Version]. The Washington Post} and Obama Proposes $634 Billion Fund For Health Care {Connolly, C. (2009, February 26) Obama Proposes $634 Billion Fund for Health Care [Electronic Version]. The Washington Post, A01} and Brown, CB. Obama wants Congress to Weigh In (2009, March 6) Politico, p. 3 (Volume 3: Number 24)

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Health and the 44th Presidential Administration (Part III). In three nearly back-to-back announcements, President Obama is working prodigiously to fill his leadership roster for health care. Of course, the most newsworthy was his selection of Kansas Governor Kathleen Sebelius as Secretary-designate of the Department of Health and Human Services (HHS). The White House Office of Health Reform, however will be lead by Nancy Ann DeParle who headed up the Center for Medicare & Medicaid Services during the Clinton administration. The administration may deem DeParle, a Beltway-insider, as having a greater amount of political clout to handle what is sure to be high-stakes negotiation within the White House Office of Health Reform. Both women have a depth of experience in health care financing and health insurance, a stakeholder group incidentally with a powerful voice in previous rounds of the health reform debate.

The Office of National AIDS Policy is set to be led by Jeffrey S. Crowley. With a background in public health, Crowley will bring the appropriate knowledge for managing the health of populations and the dynamics of epidemics in leading the effort to set an appropriate national policy. He will also serve as a member of the Domestic Policy Council. The President stated the following:

“In [AIDS and disability policy], we continue to face serious challenges and we must take bold steps to meet them. I look forward to Jeffrey’s leadership on these critical issues.”

Mary Wakefield has been appointed Administrator of the Health Resources and Services Administration (HRSA). President Obama made the following comments regarding her appointment:

“As a nurse, a Ph.D., and a leading rural health care advocate, Mary Wakefield brings expertise that will be instrumental in expanding and improving services for those who are currently uninsured or underserved. Under her leadership we will be able to expand and improve the care provided at the Community Health Centers which serve millions of uninsured Americans and address severe provider shortages across the country.”

For even more insight into this health braintrust, check out what’s on the bookshelf (a widget to the right) featuring books and articles with references and contributions from these political appointees. Several leaders are now in place and not a moment too soon. With the American Recovery and Reinvestment Act of 2009 now signed into law and the more recent unveiling of the budget proposal for 2010, there is plenty of (health care) work to be done.

Sources:

Sebelius at HHS at the White House Blog and Administrator of HRSA Announced and Obama Names Head of AIDS Policy Office and Obama Picks Kansas Governor Sebelius as Health Secretary – washingtonpost.com.

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44 to increase portions of health insurance and cover more currently uninsured children

Last week, by a margin of 66 to 32 votes (including 9 Republicans), the Senate approved expansion and reauthorization of SCHIP and today, President Obama signed that bill into law. This legislation was resurrected and revised after two vetos by former President Bush and began making its way through the Congress once again scarcely a week before the Inauguration. The critical health insurance program administered by the states, expands medical coverage to some 4 million children nation-wide whose parents do not qualify for Medicaid. This is estimated to bring the total number of children enrolled in the program to 11 million. Many of these families are newly unemployed or part of the legions of working poor in this country. With the passage of this law, we can count this as the first victory in the Obama plan to reform health care in this country.

Watch: Video of the signing ceremony at the White House

Sources:

Obama Views Children’s Health Bill as Step One at washingtonpost.com

Senate Approves Children’s Health Bill at NYTimes.com

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by Vic Harville Little Rock, Arkansas

Today’s House vote to expand SCHIP brings Americans one step closer to universal access to health insurance. With a vote of 289 to 139, the House passed a bill to expand the capacity of State Children’s Health Insurance Plans (SCHIP) from 6 to nearly 11 million enrollees. Earlier versions of this legislation were vetoed twice by President Bush but President-Elect Obama stated, “In this moment of crisis, ensuring that every child in America has access to affordable health care is not just good economic policy, but a moral obligation we hold as parents and citizens.”

Specifically, the current crisis in unemployment has left an increasing number of families in the difficult position of making too much to qualify for Medicaid but too little to pay the extremely expensive premiums for health insurance offered through COBRA once an employee has lost his or her job. Combine this fact with the trend for health insurance policies toward providing less comprehensive coverage for greater and greater premiums. The result is millions of children who have fallen through the cracks in a fragmented system. This program, originally created with the Balanced Budget Act of 1997 has sought to remedy the problem of uninsured children since it’s inception. Passage of this new legislation will go further towards accomplishing that goal, as well as accomplishing one of the three key pillars of the proposed Obama-Biden administration’s health care plan—universal access to care.

Sources:

Long Stalled by GOP, Expansion of Children’s Health Insurance Program Is Approved In House

Department of Labor http://www.dol.gov/dol/topic/health-plans/cobra.htm

Kaiser Family Foundation http://www.kaiseredu.org/topics_im.asp?id=704&imID=1&parentID=65