Monday, March 20, 2006
Least shocking headline of the year!
Lobbyists Foresee Business As Usual
Post-Abramoff Rules Expected to Be Merely a Nuisance
Washington Post, March 19, 2006; Page A01
Post-Abramoff Rules Expected to Be Merely a Nuisance
Washington Post, March 19, 2006; Page A01
Feeling safer now? Me neither.
Last week Health and Human Services Secretary Michael Leavitt announced that Americans should prepare for bird flu by stashing canned tuna and powdered milk under their beds (What? No chicken soup?) . "When you go to the store and buy three cans of tuna fish," said Secretary Leavitt, "buy a fourth and put it under the bed. When you go to the store to buy some milk, pick up a box of powdered milk. Put it under the bed." Sure. Right next to the duct tape and plastic sheeting we'll use in case of a bioterrrorist attack. If this is what passes for public health policy, we're all in deep trouble.
Friday, March 17, 2006
Good news! Unqualified crony resigns
Stewart Simonson, the Bush administration's "point man for just about every health emergency that may hit our shores, ranging from anthrax attacks to an avian flu pandemic," has resigned. It's about time: Simonson had "no background in medicine, public health, or bioterrorism preparedness."
Here's the scoop on Stew, as I presented it here back in October:
...Simonson graduated from the University of Wisconsin law school in 1994 and served as legal counsel to Tommy Thompson while he was governor of Wisconsin from 1995 to 1999. Simonson then followed Thompson to Washington when the governor was appointed as head of HHS. Simonson’s bio at HHS states that "from 2001-2003, he was the HHS Deputy General Counsel and provided legal advice and counsel to the Secretary on public health preparedness matters. Prior to joining HHS, Simonson served as corporate secretary and counsel for the National Railroad Passenger Corporation (AMTRAK)."Congressman Henry Waxman has recently pointed to Simonson as an example where Bush has "repeatedly appointed inexperienced individuals with political connections to important government posts, including positions with key responsibilities for public health and safety.
"In addition to being very close to Thompson, Simonson has given generously to the Bush political machine. The website, Political Money Line’s contribution database shows that he contributed $3,000 to various Bush-Cheney committees in the 2004 election cycle and gave $250 to the RNC.
The Washington Drug Letter published an article in its December 2004 issue in which Hauer was harshly critical of Simonson: Speaking as part of a biodefense panel in Washington, D.C. Dec. 15, Jerome Hauer, formerly the Assistant Secretary for Public Health Emergency Preparedness (ASPHEP) at HHS, said the $877 million contract awarded to VaxGen to produce a new anthrax vaccine was insufficient. He also insinuated poor policymaking has left the country vulnerable to terrorist attacks using weapons of mass destruction.
Hauer faulted the current management at the ASPHEP Office, including acting secretary Stewart Simonson, for not being better prepared to handle its duties. He called for the creation of a new federal office to coordinate U.S. biodefense activities.. . ."The decisions being made do not appear to have a sound basis," said Hauer, currently senior vice president of government relations for consulting firm Fleishman-Hillard.
Last spring, Simonson came under fire from several Republican senators. The first was by Idaho Senator Larry Craig before the Homeland Security Subcommittee in April who questioned the acquisition process for influenza vaccine:Noting that the flu can be lethal to some populations such as the elderly, Sen. Larry Craig, R-Idaho, said the country was unprepared to deal with a possible flu pandemic.Simonson . . . stopped short of agreeing with Craig’s assessment, but said "it would pose an enormous challenge."
Sen. Ted Stevens, R-Alaska, and Gregg also questioned if the process used by Simonson’s office to award vaccine development contracts ensured open competition and delivery to prevent a vaccine shortfall. "Are we creating the same situation with anthrax?" Gregg asked, referring to the flu vaccine shortfall last winter.
Although Simonson said the different agreements show that they are "seeking not to put all our eggs in one basket," he added that he remains unsure if the contract award process is being done right. "We’re learning as we go," he said.The bottom line is that there is a risk of a flu pandemic that could kill millions of people worldwide if it is able to jump from human to human. Hurricane Katrina amply demonstrated what happens when underqualified yet well-connected lawyers are in charge.
Here's the scoop on Stew, as I presented it here back in October:
...Simonson graduated from the University of Wisconsin law school in 1994 and served as legal counsel to Tommy Thompson while he was governor of Wisconsin from 1995 to 1999. Simonson then followed Thompson to Washington when the governor was appointed as head of HHS. Simonson’s bio at HHS states that "from 2001-2003, he was the HHS Deputy General Counsel and provided legal advice and counsel to the Secretary on public health preparedness matters. Prior to joining HHS, Simonson served as corporate secretary and counsel for the National Railroad Passenger Corporation (AMTRAK)."Congressman Henry Waxman has recently pointed to Simonson as an example where Bush has "repeatedly appointed inexperienced individuals with political connections to important government posts, including positions with key responsibilities for public health and safety.
"In addition to being very close to Thompson, Simonson has given generously to the Bush political machine. The website, Political Money Line’s contribution database shows that he contributed $3,000 to various Bush-Cheney committees in the 2004 election cycle and gave $250 to the RNC.
The Washington Drug Letter published an article in its December 2004 issue in which Hauer was harshly critical of Simonson: Speaking as part of a biodefense panel in Washington, D.C. Dec. 15, Jerome Hauer, formerly the Assistant Secretary for Public Health Emergency Preparedness (ASPHEP) at HHS, said the $877 million contract awarded to VaxGen to produce a new anthrax vaccine was insufficient. He also insinuated poor policymaking has left the country vulnerable to terrorist attacks using weapons of mass destruction.
Hauer faulted the current management at the ASPHEP Office, including acting secretary Stewart Simonson, for not being better prepared to handle its duties. He called for the creation of a new federal office to coordinate U.S. biodefense activities.. . ."The decisions being made do not appear to have a sound basis," said Hauer, currently senior vice president of government relations for consulting firm Fleishman-Hillard.
Last spring, Simonson came under fire from several Republican senators. The first was by Idaho Senator Larry Craig before the Homeland Security Subcommittee in April who questioned the acquisition process for influenza vaccine:Noting that the flu can be lethal to some populations such as the elderly, Sen. Larry Craig, R-Idaho, said the country was unprepared to deal with a possible flu pandemic.Simonson . . . stopped short of agreeing with Craig’s assessment, but said "it would pose an enormous challenge."
Sen. Ted Stevens, R-Alaska, and Gregg also questioned if the process used by Simonson’s office to award vaccine development contracts ensured open competition and delivery to prevent a vaccine shortfall. "Are we creating the same situation with anthrax?" Gregg asked, referring to the flu vaccine shortfall last winter.
Although Simonson said the different agreements show that they are "seeking not to put all our eggs in one basket," he added that he remains unsure if the contract award process is being done right. "We’re learning as we go," he said.The bottom line is that there is a risk of a flu pandemic that could kill millions of people worldwide if it is able to jump from human to human. Hurricane Katrina amply demonstrated what happens when underqualified yet well-connected lawyers are in charge.
Thursday, March 16, 2006
How lobbyists control health care policy
I believe the technical name for this sort of thing is Dingbat Kabuki. Yesterday, Republicans in the Senate appeared to do something good and benevolent on the health care front when they voted to allow Medicare to use its vast bargaining power to negotiate lower drug prices. The GOP had originally forbidden the government to do this when it crafted the drug benefit back in 2003, succumbing to pressure—and lavish campaign contributions—from the pharmaceutical industry. Now, however, the party seems to be scared of a senior backlash over the entire Medicare fiasco, and wants to do something.
Well, sort of. Really, though, it's extremely unlikely that anything will come of this. What the Senate actually passed yesterday wasn't in any way a binding resolution or piece of legislation. It's merely an amendment to a budget resolution that "provides only guidance for future legislation." In other words, cheap talk. A quick prediction: This measure will never make it into law. The GOP would never, ever go against the wishes of Big Pharma, and this amendment is only meant to help the party look like it's trying to fix the disastrous Medicare drug benefit. Seniors, after all, tend to have a lot of influence when midterm elections roll around. Best to try to appease them, quietly.
For further proof that the GOP will only ever pass bills paid for and written by lobbyists, look no further than a second Los Angeles Times story on yet another health care vote. Yesterday a Senate Committee also approved "a bill that would preempt state laws that require insurance policies to cover specific services, such as maternity care and supplies for diabetics."
It's a terrible idea for, you know, actual people. Guess who came up with it.
Well, sort of. Really, though, it's extremely unlikely that anything will come of this. What the Senate actually passed yesterday wasn't in any way a binding resolution or piece of legislation. It's merely an amendment to a budget resolution that "provides only guidance for future legislation." In other words, cheap talk. A quick prediction: This measure will never make it into law. The GOP would never, ever go against the wishes of Big Pharma, and this amendment is only meant to help the party look like it's trying to fix the disastrous Medicare drug benefit. Seniors, after all, tend to have a lot of influence when midterm elections roll around. Best to try to appease them, quietly.
For further proof that the GOP will only ever pass bills paid for and written by lobbyists, look no further than a second Los Angeles Times story on yet another health care vote. Yesterday a Senate Committee also approved "a bill that would preempt state laws that require insurance policies to cover specific services, such as maternity care and supplies for diabetics."
It's a terrible idea for, you know, actual people. Guess who came up with it.
States require insurers to cover specific services because otherwise, those insurers could end up making certain services—like maternity care and supplies for diabetics—unaffordable for certain people. For their part, insurers have always complained that all those burdensome state requirements force them to raise premiums. Maybe they have some small point, but then again, they would say that, and the insurance industry is pretty much the last industry to get the benefit of the doubt, ever. They've also been complaining for years that an epidemic of malpractice lawsuits has driven up premiums—a line that's totally false. It was never even sort of true.
On the bright side, the new bill, if passed, should help pad the industry's profit margins. And Republicans on the Health, Education, Labor, and Pensions Committee can look forward to fatter re-election campaign chests.
Read it and weep
U.S. Health Care 'Mediocre,' Regardless of Race, Age,Economic Status, Study Says http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=36060
Wednesday, March 15, 2006
Lies, damn lies and Medicare statistics
Today, President Bush repeated a highly misleading claim about the Medicare prescription drug program: “Twenty-six million seniors so far have taken a look and said, I think it’s worthwhile to sign up.”
This figure is meant to convince the public that tens of millions of seniors have chosen to enroll in the prescription drug program. But as the Boston Globe reported a month ago, the “actual number of voluntary enrollees is much smaller, about 5 million.” The rest either were automatically enrolled or already had drug coverage from their former company’s health plan.
Ron Pollack of Families USA explained: "For an administration that frequently provides inaccurate information, the use of the 25 million enrollment figure breaks new ground in misleading propaganda. The only real number that is worth focusing on is the approximately 4 million to 5 million who now have prescription drug coverage who did not have it prior to the start of the program. Unfortunately, the administration is trying to mask that failure with an exaggerated number that has nothing to do with new people who gained coverage."
The facts haven’t gotten in the way of the White House spin, however. Below are just some of the times the administration has used the inflated number:
President Bush:
* More than 25 million people with Medicare now have prescription drug coverage, and hundreds of thousands more are enrolling each week. This new coverage is saving seniors money on their drug premiums. [2/25/06]
* And I want to tell you something. We’ve signed up 25 million people since January 1st for this new reformed system. And, sure, there’s some glitches. [2/17/06]
* About 25 million seniors have signed up for this new plan since January 1st. That’s a lot of folks in a quick period of time. [2/17/06]
* Millions of folks — about 25 million people have signed up for the new Medicare benefit. [2/16/06]
* Twenty-four million Americans have now signed up to the new Medicare plan since January 1st. That’s a lot of folks, 24 million. Hundreds of thousands are enrolling each week. [2/15/06]
* Since the program went into effect six weeks ago, more than 24 million people with Medicare now have prescription drug coverage, and hundreds of thousands more are enrolling each week. [2/11/06]
Vice President Cheney:
* The program is underway, and some 24 million Americans are going to have benefits as a result of that and live longer and be healthier while they do it. [Newshour with Jim Lehrer, 2/7/06]
Scott McClellan:
* I think there are some 26 million people that are already enrolled in the prescription drug benefit. There has been great progress made in terms of signing people up and enrolling them in the program. [Press Briefing, 3/13/06]
This figure is meant to convince the public that tens of millions of seniors have chosen to enroll in the prescription drug program. But as the Boston Globe reported a month ago, the “actual number of voluntary enrollees is much smaller, about 5 million.” The rest either were automatically enrolled or already had drug coverage from their former company’s health plan.
Ron Pollack of Families USA explained: "For an administration that frequently provides inaccurate information, the use of the 25 million enrollment figure breaks new ground in misleading propaganda. The only real number that is worth focusing on is the approximately 4 million to 5 million who now have prescription drug coverage who did not have it prior to the start of the program. Unfortunately, the administration is trying to mask that failure with an exaggerated number that has nothing to do with new people who gained coverage."
The facts haven’t gotten in the way of the White House spin, however. Below are just some of the times the administration has used the inflated number:
President Bush:
* More than 25 million people with Medicare now have prescription drug coverage, and hundreds of thousands more are enrolling each week. This new coverage is saving seniors money on their drug premiums. [2/25/06]
* And I want to tell you something. We’ve signed up 25 million people since January 1st for this new reformed system. And, sure, there’s some glitches. [2/17/06]
* About 25 million seniors have signed up for this new plan since January 1st. That’s a lot of folks in a quick period of time. [2/17/06]
* Millions of folks — about 25 million people have signed up for the new Medicare benefit. [2/16/06]
* Twenty-four million Americans have now signed up to the new Medicare plan since January 1st. That’s a lot of folks, 24 million. Hundreds of thousands are enrolling each week. [2/15/06]
* Since the program went into effect six weeks ago, more than 24 million people with Medicare now have prescription drug coverage, and hundreds of thousands more are enrolling each week. [2/11/06]
Vice President Cheney:
* The program is underway, and some 24 million Americans are going to have benefits as a result of that and live longer and be healthier while they do it. [Newshour with Jim Lehrer, 2/7/06]
Scott McClellan:
* I think there are some 26 million people that are already enrolled in the prescription drug benefit. There has been great progress made in terms of signing people up and enrolling them in the program. [Press Briefing, 3/13/06]
Tuesday, March 14, 2006
Skewing the numbers to paint the outhouse
A new survey released by industry trade group America's Health Insurance Plans (AHIP) challenges the view that Medicare Part D is a disaster. The study, which was conducted by Alexandria, VA-based Ayres, McHenry & Associates found that 8 out of 10 seniors who enrolled in a Part D plan had no trouble doing so. Three out of five surveyed said they had saved money. "What seniors are saying is this program is working for them. It's making a difference," said AHIP President Karen Ignagni.
Given that the Medicare Modernization Act has been a bonanza for private insurers, less interested observers of research methodology might note that surveying just those who did manage to join, when a small minority of those who were eligible to sign up voluntarily have done so, smacks just a little of subject selection. The survey drew scoffing from advocacy groups, who called the results distorted and biased. "The HMO industry and its Washington lobbyists may be the least trusted sources of honest data in the country" said Medicare Rights Center president Robert Hayes.
See this article from The Washington Post
Given that the Medicare Modernization Act has been a bonanza for private insurers, less interested observers of research methodology might note that surveying just those who did manage to join, when a small minority of those who were eligible to sign up voluntarily have done so, smacks just a little of subject selection. The survey drew scoffing from advocacy groups, who called the results distorted and biased. "The HMO industry and its Washington lobbyists may be the least trusted sources of honest data in the country" said Medicare Rights Center president Robert Hayes.
See this article from The Washington Post
Friday, March 10, 2006
Maybe we can quit blaming nurses and doctors?
Uwe Rheinhardt gave a talk at Duke, arguing that the U.S. health care system has the moral responsibility to address rising administrative costs. Article
QIOs & hospitals: too much love?
The Institute of Medicine released a much-anticipated report on Medicare Quality Improvement Organizations (QIOs), arguing that the responsibility for investigating patient complaints should be given to somebody else. The report echoes earlier findings that had argued QIOs may not be looking into problems as rigorously as necessary because of financial links to doctors and hospitals. The Institute argues that QIOs should refine their focus to concentrate solely on providing technical assistance to hospitals, a role that is expected to become increasingly important as quality ratings take on a higher profile role in the health system. Recommended changes include greater oversight of QIO activities and increased organizational transparency.
- see this article from The Washington Post
- read the report from the Institute of Medicine
- see this article from The Washington Post
- read the report from the Institute of Medicine
