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Center for Health Transformation E-Newsletters

Newt Notes

The most exciting development of the past few weeks is what has been happening up in Massachusetts. The health bill that Governor Romney signed into law this month has tremendous potential to effect major change in the American health system.

We agree entirely with Governor Romney and Massachusetts legislators that our goal should be 100% insurance coverage for all Americans. Individuals without coverage often do not receive quality medical attention on par with those who do have insurance. We also believe strongly that personal responsibility is vital to creating a 21st Century Intelligent Health System. Individuals who can afford to purchase health insurance and simply choose not to place an unnecessary burden on a system that is on the verge of collapse; these free-riders undermine the entire health system by placing the onus of responsibility on taxpayers.

The Romney plan attempts to bring everyone into the system. The individual mandate requires those who earn enough to afford insurance to purchase coverage, and subsidies will be made available to those individuals who cannot afford insurance on their own. We agree strongly with this principle, but the details are crucial when it comes to the structure of this plan. Under the new bill, Massachusetts residents earning more than 300% of the federal poverty level (approximately $30,000 for an individual) will not be eligible for any subsidies. State House officials had originally promised that there would be new plans available at about $200 a month, but industry experts are now predicting that the cheapest plan will likely cost at least $325 a month. This estimate totals about $4000 per year, or about 1/5 of a $30,000 annual take-home income.

While in theory the plan should be affordable if the whole state contributes to the cost, the reality is that Massachusetts has an exhaustive list of health coverage regulations prohibiting insurers from offering more basic, pared-down policies with higher deductibles. (This is yet another reminder that America must establish a cross-state insurance market that gives individuals the freedom to shop for insurance plans in states other than their own.)

In our estimation, Massachusetts residents earning little more than $30,000 a year are in jeopardy of being priced out of the system. In the event that this occurs, Governor Romney will be in grave danger of repeating the mistakes of his predecessor, Mike Dukakis, whose 1988 health plan was hailed as a save-all but eventually collapsed when poorly-devised payment structures created a malaise of unfulfilled promises. We propose that a more realistic approach might be to limit the mandate to those individuals earning upwards of $54,000 per year.

While the Commonwealth’s plan will naturally endure tremendous scrutiny from those who assert that the law will not work as intended, Massachusetts leaders are to be commended for this bipartisan proposal to tackle the enormous challenge of finding real solutions for creating a sustainable health system. I hope that Massachusetts’ initiative to provide affordable, quality health insurance for all continues to ignite even more debate around the subject of how to best address our nation’s uninsured crisis and the critical problems within the health system at large.

On a different note, I am pleased to report that our work on accelerating the Right-to-Know movement continues to build. Leaders in Washington are now demanding that Medicare disclose its data, and CHT is helping to carry the message to the states. During my recent trip to Sioux Falls, South Dakota, our work on accelerating the Right-to-Know movement played a key role. My host in South Dakota was state senator and majority whip Tom Dempster, who is the recognized leader in South Dakota healthcare policy.

Senator Dempster is responsible for passing legislation in 2005 that requires all hospitals in the state to post the prices of their 25 most commonly-performed procedures. The law takes full effect on July 1, 2006, and will be the first of its kind in the country. The Sioux Falls Argus Leader did a poll last year that found 85 percent of South Dakotans supported this law. Senator Dempster said he looks forward to working with CHT to develop transformational ideas relating to Medicaid, health insurance, and their state employee health plan.

Also, last month the Center held a two-day Pandemic Influenza Strategic Simulation with our partner and CHT member, Booz Allen Hamilton. The exercise, hosted by the U.S. Chamber of Commerce at their Washington headquarters, was sponsored by MedImmune and Securitas. We were honored to be joined by 150 leaders of pandemic influenza preparedness planning drawn from federal, state, and international government organizations, as well as by business and health sector leaders.

Thanks both to Booz Allen’s excellent facilitation of the event and the insights shared by all who attended, participants have told us that they regarded the event as a great success. We expect to release a report of strategic simulation’s results and findings by the close of this month. (For more information, please contact Robert Egge, the director of CHT’s Health Preparedness and Homeland Security Project, at 202-375-2001 orregge@gingrichgroup.com.)

Finally, I want to take a moment here to challenge the Congress to put forth genuine effort to fix major faults compromising the quality of our health system. The House absolutely must pass a health IT bill this year. Hurricane season is fast approaching – how many lives will be lost this year to our disconnected, paper-based health system?

Source: http://web.archive.org/web/20060822061158/http:/www.healthtransformation.net/News/E_newsletters/index.cfm?newsletterid=20

In case you haven’t seen it yet, there’s a new Rasmussen poll out and the numbers are pretty striking. A near 20 point advantage for Rubio means he has this all but sewn up barring a major reversal or gaffe. Given that he delivered a nice performance at CPAC, he can expect grassroots and other cash to flow into his coffers so Crist cannot dump a deluge of ads and expect no response. So this brings up the inevitable question: What will Charlie do now?

I hate to agree with Kos, but months ago he said that Rubio would wipe Crist out and that the governor’s only option to win was to run as a Democrat since a three way split would not be enough to stop Rubio from winning. I didn’t see anyone else in the blogosphere, left or right, making this claim last fall, so grudgingly full credit to him. But no, I will not link to his diary showing that statement because I don’t want him to have any more traffic.

The numbers, quite frankly, bear this out to be true. The now famous Miami Herald poll demonstrated that Crist simply does not have enough appeal to win as an independent candidate. His only path to victory, then, is to flip to the Democrat side where Kendrick Meek would not put up much of a fight. Or would he?

Crist appeals to the center, I guess, but Florida is a closed primary state. Meek is a liberal from south Florida who would crush Crist in the black vote and probably pick up a substantial segment of the Hispanic vote as well along with the liberal activist vote. That leaves Crist with a tough road to hoe quite honestly. It’s tough to win any Democratic primary by appealing to the right flank, though if anyone can do it in Florida it’s Charlie Crist.

So what will Chameleon Charlie do now? Your guess is as good as mine. The guy is a political survivor and has a very quiet mean streak. But it has to be evident to him that he will not win the Republican senate primary in August. I don’t think he can politically survive a flip to the Democratic side as he would be seen as a total opportunist and he doesn’t have the coalition to run and win as an independent.

I think Crist will wait until the next non-Rasmussen poll comes out on this and then weigh his options. And the most likely scenario for him to survive for another day is for him to drop out of the senate race and jump back into the governor’s race where he’d handily beat Bill McCollum in the primary and spank Alex Sink. Just watch it happen by the end of March.

At least according toRasmussenFor those of you who are too lazy to click the link, he’s up 47-43 on Feingold. I know that the good folks over there have been fairly generous to our side this cycle, mostly because of the likely voter models they have in place. They’ve been spot on so far, but the electorate can always change between now and election day.

For what it’s worth, I’m not really a Tommy Thompson fan. He’s a squish on a number of issues, but he did do a good job as governor of the Dairy State years ago and instituted a model for welfare reform that was copied by the GOP Congress and President Clinton in the mid 90s. Thompson has also been a big time advocate for school choice and instituted a pretty decent program in Milwaukee to help low income families send their kids to whatever school, public or private, that they felt is best. That would be a nice direct contrast to Obama’s tearing apart of a similar program in DC.

So yes, Thompson is not a rock-ribbed conservative and no, Wisconsin is not Massachusetts where we really do need to settle for candidates on the center-right. But even in this cycle I don’t think Feingold is vulnerable unless we bring in a big name. Even if Rasmussen is off by a few points, the bottom line is that Thompson starts out on even footing with Feingold and has history in the state. I doubt very much being HHS Secretary under Bush will drag him down. What say you RedStaters… draft Thompson?!

The arrogance of our president is just stunning.

Marion Berry apparently ripped Barack Obama apart in the latest edition of the Arkansas Democrat-Gazette. Read the whole thing, it’s truly mesmerizing and tells you all you need to know about our commander in chief. History started anew with his presidency, except for the recession which is, of course, Bush’s fault. Same goes for the war and the environment. But when it comes to the institution of the presidency, toss everything out because Barack Obama is here. Now he’s extending this doctrine to the rest of the political world; he’s here so everything will be different.

But as we all know in our truly reality based-community, everything that’s old is new again and the pendulum will inevitably swing. And it’s swinging high and hard right at the throat of the Democratic party. Apparently, however, our president doesn’t see it that way. While Berry expressed concern that the rank and file were being exposed to too many controversial votes, Obama told them that his Messianic visage would solve everything.

“I’ve been doing that with this White House, and they just don’t seem to give it any credibility at all,” Berry said. “They just kept telling us how good it was going to be. The president himself, when that was brought up in one group, said, ‘Well, the big difference here and in ’94 was you’ve got me.’ We’re going to see how much difference that makes now.”

Berry, is of course, absolutely right when he says that the country and his party will soon see how much of a difference Obama’s rapidly weaking clout and public image will provide. But frankly, he’s not optimistic:

‘I began to preach last January that we had already seen this movie and we didn’t want to see it again because we know how it comes out… I just began to have flashbacks to 1993 and ’94. No one that was here in ’94, or at the day after the election felt like. It certainly wasn’t a good feeling.”

No it’s not a good feeling indeed for the Democrat rank and file that have been forced to swallow tough votes time and again while getting nothing in return. And that should make our side feel quite inspired indeed.

A quick check of a paper I worked for awhile ago yielded this very, VERY interesting nugget…

Bill Nelson predicts ‘public option’ will not pass the U.S. Senate

A government-run public option is not likely to be included in the final health care reform bill, said U.S. Sen. Bill Nelson, D-Florida, at a meeting of business officials Tuesday.

Nelson addressed the Chamber of Southwest Florida at Edison State College on a myriad of political issues – the recession, health care reform and off-shore drilling – and said that even though he is a Democrat he’s not supporting the public option recently passed by the House of Representatives.

“At the end of the day, a public plan is not going to pass the Senate,” he said. “That is why the Senate version will basically be close to what is the final result that will ultimately go to the president for his signature.

Amazingly enough, Nelson now appears to hold the position that the public option is an unnecessarily divisive part of the entire “reform” package that won’t actually help many people and can only now serve as a weapon to torpedo the entire bill.

“You can’t get 60 votes for a public plan. If you had a public plan, the maximum a public plan would cover is no more than 2 percent of all American citizens and yet the way it has dominated the debate you would think that is the only thing that is important,” he said.

Well duh, at least for now. The public plan would cost its customers more than private plans, but of course the big problem with it is that it opens a pathway to complete government control of health care. So what does it mean that a fairly liberal senator is now saying all of this publicly? That Reid is likely to jettison the public plan at some point to get Lieberman, Snowe and possibly Collins on board to counter a possible defection of Sanders and Burris. I doubt the last two would support a filibuster with the GOP over a final bill without a public option, so the GOP needs to be wary of this tactic. Getting rid of the public option doesn’t make this bill better. In fact, then it just moves from a gateway to government-run health care to a massive gift to the health insurance industry courtesy of individual and business mandates and that’s a gift that said industry sure as hell doesn’t deserve.