Healthcare Reform Thread II

[Dinner]

The number comes from a new Rasmussen Reports survey, which, considering the long-standing quibbles with the firm's polling methods, means it should be taken with a grain of salt.

I'd go further and say its not just quibbles about Rasmussen's polling methods. They routinely use push polling and are normally the polling agency with the largest margin of error. In short Rasmussen polls are crap.

That said, I'd bet most Nebraskans probably don't like that the guy grandstanded until the last second, endangering the whole deal, because he wanted special treatment.

[Drake Tungsten]

That said, I'd bet most Nebraskans probably don't like that the guy grandstanded until the last second, endangering the whole deal

Nebraskans would like him a lot more if he'd grandstanded long enough to kill the bill.

[Drake Tungsten]

The Mayo Clinic, praised by President Barack Obama as a national model for efficient health care, will stop accepting Medicare patients as of tomorrow at one of its primary-care clinics in Arizona, saying the U.S. government pays too little.

More than 3,000 patients eligible for Medicare, the government’s largest health-insurance program, will be forced to pay cash if they want to continue seeing their doctors at a Mayo family clinic in Glendale, northwest of Phoenix, said Michael Yardley, a Mayo spokesman. The decision, which Yardley called a two-year pilot project, won’t affect other Mayo facilities in Arizona, Florida and Minnesota.

Obama in June cited the nonprofit Rochester, Minnesota-based Mayo Clinic and the Cleveland Clinic in Ohio for offering “the highest quality care at costs well below the national norm.” Mayo’s move to drop Medicare patients may be copied by family doctors, some of whom have stopped accepting new patients from the program, said Lori Heim, president of the American Academy of Family Physicians, in a telephone interview yesterday.

“Many physicians have said, ‘I simply cannot afford to keep taking care of Medicare patients,’” said Heim, a family doctor who practices in Laurinburg, North Carolina. “If you truly know your business costs and you are losing money, it doesn’t make sense to do more of it.”

Medicare Loss

The Mayo organization had 3,700 staff physicians and scientists and treated 526,000 patients in 2008. It lost $840 million last year on Medicare, the government’s health program for the disabled and those 65 and older, Mayo spokeswoman Lynn Closway said.

Mayo’s hospital and four clinics in Arizona, including the Glendale facility, lost $120 million on Medicare patients last year, Yardley said. The program’s payments cover about 50 percent of the cost of treating elderly primary-care patients at the Glendale clinic, he said.

“We firmly believe that Medicare needs to be reformed,” Yardley said in a Dec. 23 e-mail. “It has been true for many years that Medicare payments no longer reflect the increasing cost of providing services for patients.”

Mayo will assess the financial effect of the decision in Glendale to drop Medicare patients “to see if it could have implications beyond Arizona,” he said.

http://www.bloomberg.com/apps/news?pid=20601087&sid=aHoYSI84VdL0

If even the Mayo Clinic can't control healthcare costs well enough to keep taking Medicare patients, what hope is there for the rest of our messed up healthcare system?

[DinoDoc]

Nebraskans would like him a lot more if he'd grandstanded long enough to kill the bill.

That's what I had hoped his plan was.

[Drake Tungsten]

Game over, man...

Dems 'Almost Certain' to Bypass Conference

Now that both the House and Senate have passed health care reform bills, all Democrats have to do is work out a compromise between the two versions. And it appears they’re not about to let the Republicans gum up the works again.

According to a pair of senior Capitol Hill staffers, one from each chamber, House and Senate Democrats are “almost certain” to negotiate informally rather than convene a formal conference committee. Doing so would allow Democrats to avoid a series of procedural steps--not least among them, a series of special motions in the Senate, each requiring a vote with full debate--that Republicans could use to stall deliberations, just as they did in November and December.

“There will almost certainly be full negotiations but no formal conference,” the House staffer says. “There are too many procedural hurdles to go the formal conference route in the Senate.”

http://www.tnr.com/blog/the-treatment/exclusive-dems-almost-certain-bypass-conference

[Drake Tungsten]

Interesting. It looks like conference committees are a thing of the past...

The Other Reason to Skip Conference

Even if the Senate GOP was not being completely obstructionist on every little procedural motion, the smart money has always been on bypassing an actual conference committee and settling health care via an exchange of amendments between the Houses for another very important reason: Democratic leaders have realized that a key feature of their big 2007 ethics bill is incredibly inconvenient.

Section 511 of Public Law 110-81 (the Honest Leadership and Open Government Act of 2007) amended Senate Rule 28 (conference reports) to put in a strengthened point of order against conference reports that exceed the scope of the difference between the House and Senate bills. This was meant to make it harder to "airdrop" provisions in conference reports that were not in either the House or Senate versions of a bill and to make it harder for conferees to drop provisions that were identical in both versions of the bill.

As amended by the ethics law, Rule 28 now works similar to the "Byrd Rule" on reconciliation bills - any provisions ruled out-of-scope by the Parliamentarian are stricken from the conference report unless at least 60 Senators vote to waive the provision. So the effect of the rules change was to allow any grouping of at least 41 determined Senators to knock out provisions in a conference report that were added in conference (If the conference report drops a provision that was in both the House and Senate versions of the bill, the conference report then is deemed defeated unless 60 Senators vote to waive the rule, but that doesn't make much difference in a cloture scenario since 60 votes are required anyway.)

But the changes to rule 28 make it much more difficult for Democratic leaders to add "sweeteners" to a conference report to buy votes, since 41 Senators could knock out any individual sweetener out of the conference report without defeating the entire conference report. And sweeteners don't have to be wholly new provisions, since expansions to existing provisions can be out of scope--if the House version of the bill has $50 million for a particular program and the Senate version has $100 million, if the conference report goes below 50 or above 100, the provision can be knocked out by 41 Senators.

As a result, since the rule changes took in effect, Democratic leaders have basically stopped sending large controversial bills to conference committees, preferring to ping-pong them instead to avoid problems in the Senate with the newly strengthened rule 28. ...

Imagine if health care were sent to conference and in order to be assured of 218 votes in the House, the Speaker had to add some kind of buy-offs for some House people similar to what Nelson, Landrieu, etc got in the Senate. Any 41 Senators could knock any of those buy-offs out of the conference report and blow up the deal.

While strengthening rule 28 was an understandable response to some serious abuses that occurred on the Republican watch (the one "airdropped" provision Democrats cited most was the vaccine manufacturers liability regime added in the conference report of an unrelated bill by Bill Frist), the effect has been to move the House-Senate negotiating forum for every large and controversial bill from a conference committee (which has to have meetings that are open to the public) to closed-door private meetings to prepare an amendment between the Houses via ping-pong. Don't expect to see any more conference committees on controversial party-line bills. Ever.

http://www.tnr.com/blog/the-treatment/the-other-reason-skip-conference

[DaShi]

Meh, I'll wait for real news, thank you.

[Drake Tungsten]

I guess The New Republic is no different than Faux News in your reality-challenged world.

[DaShi]

Blogs are.

[Drake Tungsten]

[DaShi]

Actually: Come on, Drake. You can do better than that.

[Drake Tungsten]

I'm not the one who still seems to think blogs (especially influential ones like the TNR blogs) can't break important news stories. Live in the now, gramps.

[DaShi]

Who thinks that?

[Drake Tungsten]

Now you've been reduced to lame DanSing...

[DaShi]

Yeah, I have some free time.