News In Healthcare

Yes­ter­day, Pres­i­dent Bush cel­e­brated Cinco de Mayo in the White House Rose Gar­den with sev­eral famous and influ­en­tial Mexican-Americans.  The Pres­i­dent took the oppor­tu­nity to touch upon our need for immi­gra­tion reform.   He had spo­ken sev­eral times this week on our need for com­pre­hen­sive immi­gra­tion reform.   Since many peo­ple spec­u­late that the unin­sured cri­sis in Amer­ica is largely due to our exist­ing immi­gra­tion poli­cies, this is a topic that health­care providers should fol­low closely — despite the fact that the reform pack­age does not specif­i­cally address health­care.  The reform pack­age has five main goals:

1.  Secur­ing the Border

2.  Cre­at­ing a Tem­po­rary Worker Program

3.   Hold­ing Employ­ers Account­able for the Work­ers They Hire

4.  Resolv­ing the Sta­tus of the Mil­lions of Ille­gal Immi­grants Already in the Country

5.  Find­ing New Ways to Help New­com­ers Assim­i­late Into Our Society

Ear­lier this year, Sen­a­tor Ben­nett (R-Utah) intro­duced the Healthy Amer­i­cans Act (S. 334) which would pro­vide for health care cov­er­age for all Amer­i­cans by remov­ing employ­ers from the equa­tion.  As explained in the Desert News, peo­ple would be required to have insur­ance and it would no longer be tied to a person’s employ­ment.  Instead, the employ­ers would pay the indi­vid­u­als more so they could get cov­er­age on their own.   This bill hasn’t moved much since being intro­duced in Jan­u­ary, how­ever, sup­port­ers to the notion have recently been speak­ing out.  The inter­est­ing piece to note is that this uni­ver­sal health care cov­er­age was intro­duced by a Repub­li­can.  In response to this obser­va­tion, Ben­nett stated that his bill is not per­fect but that the time has come to get some res­o­lu­tion to this issue.

That’s the mes­sage being deliv­ered by Sen­a­tors Norm Cole­man (R-Minn) and Carl Levin (D-Mich).  This week, the two Sen­a­tors are expected to intro­duce leg­is­la­tion which would require Medicare to with­old pay­ments to physi­cians who owe fed­eral taxes.  The arti­cle on TwinCities.com explains that the bill would also autho­rize the recov­ery of non­tax debt, such as unpaid stu­dent loans and child support.

A group that sup­ports fund­ing for in-home care, ADAPT, was gath­ered out­side the U.S. Capi­tol yes­ter­day to show sup­port for S. 799 and H.R. 1621 — two bills which would give peo­ple a choice of ser­vices which would allow them to be cared for in their home rather than in a nurs­ing home.  Accord­ing to the ADAPT orga­nizer, the group was chant­ing “Com­mu­nity Choice Act now.”  While this seems peace­ful enough, the U.S. Capi­tol police appar­ently didn’t think so.  They arrested 74 of the pro­tes­tors, all in wheel­chairs, and charged them with unlaw­ful assembly.

Rep­re­sen­ta­tive Pete Stark, Chair­man of the House Ways and Means Health Sub­com­mit­tee, announed that a hear­ing will be held on May 5, 2007 to dis­cuss finan­cial assis­tance pro­grams for low-income Medicare ben­e­fi­cia­ries.    The focus of the dis­cus­sion will be on the cur­rent state of the Part D Low Income Sub­sidy, the Medicare Sav­ings Pro­grams, and oppor­tu­ni­ties to increase enroll­ment and expand eli­gi­bil­ity in these programs.

Ear­lier this week Pres­i­dent Bush was pre­sented with leg­is­la­tion to amend the Pub­lic Health Ser­vices Act and add require­ments regard­ing trauma care.   H.R. 727 , also known as the Trauma Care Sys­tems Plan­ning and Devel­op­ment Act of 2007, will among other things (1) Autho­rize the Sec­re­tary to make grants to improve access to and enhance the devel­op­ment of trauma care ser­vices, (2) Pro­hibits the Sec­re­tary from mak­ing trauma care grants to states unless the state’s emer­gency med­ical ser­vices plan coor­di­nates plan­ning for trauma sys­tems with state dis­as­ter emer­gency plan­ning and bioter­ror­ism hos­pi­tal pre­pared­ness plan­ning, and (3) Allows a study to be done on the state of trauma care and trauma research. 

Can it be?  Sen­a­tor Edward M. Kennedy and Rep­re­sen­ta­tive John Din­gell intro­duced leg­is­la­tion on April 25 that is aimed at extend­ing Medicare to all Amer­i­cans, from birth to the end of life.  Under the pro­posed plan, any­one with a social secu­rity num­ber is eli­gi­ble to par­tic­i­pate in the plan unless they choose one of the pri­vate options.  The plan will be financed by a com­bi­na­tion of pay­roll taxes and gen­eral rev­enues that will sub­sti­tute for pri­vate pay­ments.  This will be one to watch!

Can you believe that it has been 4 years since the pri­vacy pro­vi­sions of the Health Insur­ance Porta­bil­ity and Account­abil­ity Act went into effect?  Believe it.  In order to cel­e­brate the 4 year mile­stone, the Depart­ment of Health and Human Ser­vices launched a new web­site to pro­vide con­sumers and health­care providers with infor­ma­tion on the pri­vacy regulations.

Despite EMTALA hav­ing been around for quite a few years, CMS issued a guid­ance to hos­pi­tals recently explain­ing what their respon­si­bil­i­ties are in regards to pro­vid­ing emer­gency ser­vices.  The Mem­o­ran­dum issued on April 26, 2007, pro­vides that all hos­pi­tals are required to appraise med­ical emer­gen­cies, issue ini­tial treat­ment and refer­ral, regard­less whether the hos­pi­tal has an emer­gency depart­ment.  In addi­tion, hos­pi­tals may not rely on 9–1-1 ser­vices as a sub­sti­tute for the ini­tial triage of the med­ical condition.

Well we are one step closer to the answer of NO.  Yes­ter­day, H.R. 493 was sent to the Sen­ate after being passed by the House of Rep­re­sen­ta­tives with a 420–3 vote.  The bill, called The Genetic Infor­ma­tion Nondis­crim­i­na­tion Act, would bar employ­ers and insur­ers from deny­ing a job or health cov­er­age to some­one whom DNA tests show to be genet­i­cally pre­dis­posed to a dis­ease.  Accord­ing to Rep. Judy Big­gert (R-IL), the bill spon­sor, this leg­is­la­tion will lower health insur­ance costs, advance med­ical research, and help peo­ple live longer.  We will have to see if the Sen­ate agrees.