Headlines: November 2, 2009
by Meg Larkin
Politics and Policy:
As the House and the Senate look toward reconciling their health insurance reform bills, the issue of an employer mandate is posing some problems. Both the Senate Health Committee and the House bill have an employer mandate, while the Senate Finance Committee bill has no mandate but imposes fines on employers that do nothing. Theoretically employees who do not get coverage through their employer will be able to buy it on a health insurance exchange much like the Massachusetts Health Care Connector. In spite of some problems combining the bills and the hard work yet to come before health reform is passed, the New York Times is attributing much of the progress to President Obama’s hands-off strategy. His approach is deliberately different from the more involved approach taken by the Clintons when they failed to pass health reform in the 1990s.
The cost of the health care reform bills is also causing a stir. President Obama had said that he wanted health reform legislation to have a maximum cost of $900 billion over the next ten years, but GOP leaders are saying that the cost of the House bill on the table now will be over $1 trillion. The non-partisan Congressional Budget Office issued a preliminary finding that the cost of expanded coverage in the House bill would be $1.055 trillion over the next decade. House leaders like to calculate the cost by subtracting money paid in penalties included in the bill from the cost of increased coverage put out by the CBO in order to bring the total price tag back under $900 billion.
Senate democrats also face the problem of Connecticut Senator Joe Lieberman. The Independent who caucuses with the democrats has said that no health care reform is better than health reform that includes some form of public option. This raises the question of whether he’ll be able to provide the crucial 60th vote to override a filibuster or whether the Democrats will have to look elsewhere. In the face of an individual mandate to purchase insurance, some conservatives are concerned that health care reform legislation is an unprecedented expansion of federal power. Roger Pilon of the conservative Cato Institute argues that Congress’s power under the commerce clause does not extend to mandating that individuals buy healthcare. The individual mandate will be achieved through a tax penalty, which is the mirror image of the familiar tool of using tax breaks to encourage certain purchases.
As for health insurance programs already run by the federal government, allegations have surfaced in a report by the Office of Counsel to the Inspector General of Health and Human Services that Medicare is not providing needed information to companies charged with preventing Medicare fraud. The government-run insurance program failed to provide needed information to contractors hired to find fraud in the Medicare Part D drug benefit until August 2007, nearly a year after their contract started. In other news, the US Senate unanimously confirmed Regina Benjamin as the United States Surgeon General. “She is the founder and CEO of the Bayou La Batre Rural Health Clinic in Alabama and a former chair of the Federation of State Medical Boards of the U.S. Benjamin was the first black woman to serve as president of a state medical society or be elected to the American Medical Association's board of trustees (Women's Health Policy Report, 10/8).”
In other health-policy related news, according to the New York Times, an increasing number of women are coming home from the wars in Iraq and Afghanistan with mental health issues. The strains of fighting a war with an all volunteer army means that they are increasingly seeing combat on the front lines, as the Army skirts around congressional regulations. Although they cope as well as their male counterparts with the stress of battle, they deal with the lasting mental effects differently upon their return home, often isolating themselves from friends and family.
Drugs and Diseases:
In international news, South Africa’s president Jacob Zuma recognized the viral cause of AIDS and acknowledged the role of Antiretroviral drugs in combating the disease. This comes almost 10 years after his predecessor Thabo Mbeki suggested that AIDS drugs could pose a danger to health. Ukrainian Prime Minister Yulia V. Tymoshenko announced Friday that the Ukraine would be banning public gatherings, putting restrictions on travel and temporarily closing schools in order to combat swine flu. In other H1N1 news, the World Health Organization has announced that one dose of the swine flu vaccine may not be enough to ensure immunity, and that a booster dose may be needed in some people.
In the United States, an independent group of vaccine experts has been hired to track the use of the H1N1 vaccine. Although few problems are expected because it is made the same way as the seasonal flu vaccine, the government is taking extra precautions because of the rapidity with which the vaccine was rolled out. Additionally, an international group of scientists has decoded a pig’s DNA, which has led to hopes of a vaccine for pigs against swine flu and the possibility of new treatments for both pigs and humans.
This week at the American Association for the Study of Liver Diseases annual meeting, Cambridge, Massachusetts based drug maker Vertex will be marketing its new drug to treat Hepatitis C, a virus that can lead to liver scarring and cancer. According to the Boston Globe, “In contrast to interferon treatments on the market - which block cellular genes that host hepatitis C - protease inhibitors such as Telaprevir act directly against the virus. They also work effectively with interferons in drug “cocktails,’’ mixtures of treatments.”
Meg Larkin is a second year law student in Boston University's Health Law concentration. Please feel free to email her with any suggestions/comments/questions.