Thursday, March 25, 2010

Fallout From Healthcare Reform

The new healthcare reform legislation is generating many news stories about reaction to it which is good for someone like me who is always looking for the next hot topic in healthcare to discuss. There are a number of new developments that I would like to react to.

First of these is a report from the Washington Post that Senate Republicans found two minor violations of reconciliation rules in the House bill that will force it to be revised and re-voted on. They are already living up to their pledge to stop the bill before it starts. House Speaker Nancy Pelosi says the revisions are benign and will not alter the bill substantially. She expects no problem getting the House to again pass the amended bill. We will see. A new House vote is expected this evening.

Also Senate Republicans have been offering all kinds of amendments to the Senate bill originally passed. Most of these are intended to be difficult for Democrats to reject. If even one of them is passed, it means the Senate bill must go back to the House. So far Senate Democrats have rejected 29 such amendments. This is why a political solution to our complex healthcare situation is not the answer.

Another development from the new bill is the discovery that children with pre-existing conditions can still be denied new insurance policies. How did they let that one get through? HHS Secretary Kathleen Sebelius plans to issue new regulations to further define the intent of the new bill and close this gaping hole. It should be noted that in the meantime, children who are currently be denied insurance for this reason can seek coverage through the states' high risk insurance pools being set up.

Finally, representatives of physician-owned hospitals have weighed in strongly opposing the new bill since it puts a ban on new hospitals with this arrangement. It is interesting that they are claiming this will severely compromise rural- and inner-city patients access to care. I can't think of any physician-owned hospitals dealing with either of these populations. Perhaps we should write an amendment to the bill inviting physician-owned hospitals to open in the inner-city areas and treat the currently indigent population. After all they will now have insurance.

I am sure we will continue to see many interesting developments with passage of the reform bill. Remember the Chinese curse, "May you live in interesting times".

More on this later.

Mark Brodeur

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