Affordable Health Care for America Act (H.R. 3962)

You've probably seen the news by now. The House narrowly passed the health care reform bill and now it's headed to the Senate. The only Republican supporting this bill was Anh "Joseph" Cao (Louisiana). Is our nation ready to completely overhaul our existing health care system? Or will we try to place a few patches and hope that it lasts a few more years?

According to the latest from CNN, the Affordable Health Care for America Act (H.R. 3962) restricts insurance companies from denying coverage to anyone with a pre-existing condition or charging higher premiums based on gender or medical history. It also provides federal subsidies to those who cannot afford health insurance. And it guarantees coverage for 96 percent of Americans.

Will the Senate pass a bill that contains the controversial "public option?" Not if it's up to Sen. Joseph Lieberman. Maybe those who live in Connecticut don't really need a public option, but those who live in Louisiana probably do.

What's the fate of the public option?

The public option was rejected by the Senate Finance Committee. According to CNN:

Republicans unanimously oppose the government-run insurance option, saying it would drive private insurers from the market and eventually bring a government takeover of the health care system.

Democratic leaders reject that claim, saying the public option would provide needed competition for private insurers while making health coverage accessible to millions of people currently lacking health insurance.

Who's right? Is the public option simply a battle between the Republicans and the Democrats? I don't think it's that simple when we're talking about healthcare reform. Should they define a trigger? If they define such a "trigger," they will have proof that expanded coverage and lower costs are not possible unless major changes are made to our existing system.

At the end of the day, I think we will eventually see some type of public option emerge in the United States. In my opinion, it's inevitable. Our healthcare system is so broken that we need to go through a major overhaul. It's difficult to overhaul a system in small stages. On the flip side, a complete overhaul isn't practical. So, we're stuck between a rock and a hard place. This is a true dilemma.

Senator Tom Coburn, M.D. on Sermo discusing tort reform

Tom Coburn, M.D. is a US Senator, Oklahoma (R) and a physician. He posted something on Sermo recently to get some feedback about tort reform and I found it to be very interesting. The post has only been up for a few days, but there are already over 200 comments!

Physicians recognize the need for some serious tort reform, especially in the midst of major healthcare reform. However, do we know what that's going to look like? Two current ideas include:

• Expert panels to review medical disputes. In this scenario, the panel would consist of 3 attorneys and 3 medical professionals. That panel would review cases and determine whether a healthcare provider is responsible for wrongdoing and what, if any, relief is warranted.
  
• Formation of independent health courts. In this scenario, a judge who has expertise in health issues would preside over an independent health court. He/she would render a binding decision using the same legal standards as a traditional trial judge.

Sounds quite interesting, doesn't it? Which would you vote for? Sounds like the data will get published once it's all collected on Sermo, so stay tuned! I wonder how all the medical malpractice attorneys feel about all these talks regarding healthcare reform.

Public Insurance Plan

CNN Money.com has another article on healthcare reform. This one is titled, "Health reform follies: How to keep up" and it's a special report in the "Fixing Healthcare" section of CNN Money.com.

I'd like to focus on the section that discusses a public option. Let's begin with a small snippet:

Those who want a public insurance plan want it fiercely, saying it's the only thing that can force private insurers to reduce costs and be more competitive. Those who oppose it are equally fierce, saying it would result in a government takeover of the heath care system.

Where do you stand on this issue? Do you want to see a public insurance plan that's available for everyone and anyone? Is that really the right answer?

Two major bills that lawmakers will consider -- the tricommittee bill from the House and the bill put out by the Senate Health committee -- propose a public health insurance option. That public plan would compete with private insurers on a health insurance exchange -- or insurance supermarket -- that the bills also propose.

If we see a public plan emerge, will physicians choose to accept this plan? Already, we see many healthcare professionals who choose to only accept cash. They no longer wish to deal with the headaches of chasing reimbursement from insurance companies. As a result, they state that they no longer accept any forms of insurance and they use a fee-for-service model. If this trend continues, then the presence of a public insurance plan will yield no benefit for consumers who need outpatient medical care.

At the end of the day, will such public insurance plans mainly be for hospital admissions and major catastrophes? Maybe the government will take over all the hospitals. Sometimes I wake up in the middle of the night wondering if all of this is a dream.

Senate Hearing on Medical Research and Education

Yesterday, Chairman Herb Kohl (D-WI) chaired a hearing titled "Medical Research and Education: Higher Learning or Higher Earning?" The entire meeting was about the Continuing Medical Education or CME industry. You can watch the video by clicking here (This is from the Senate Special Committee on Aging). This is a long video, but make sure you view the entire clip. Otherwise, you will only hear one side of the story.

What do you think? Will industry-supported CME be a thing of the past? What's going to happen to the medical research and continuing medical education industries? Industry-supported CME has evolved dramatically over the past 10 years and I've seen some significant changes in the way industry-supported CME is developed and delivered. Without free CME, physicians may need to pay thousands of dollars each year for their CME credit. I think most physicians are able to detect potential bias when they listen to a speaker. If they can't, then they should be shielded from journal ads, television ads, and other types of drug promotion. Perhaps marketing and promotional activities need to reduce so that more focus can be spent on evidence-based education.