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Midwest Edition
April 6-8 Health reform may be under attack from The crowd, predictably, jumped from the
Republicans and libertarians, but don’t pews to shout and clap.
assume it’s down for the count. At least not At the conclusion of his 10-minute
MNGKO!"#$$!=441(2!8-4.)4:/-4! in Chicago. stemwinder, McNary exulted: “Happy
M/+>-4+/4!G*5(4/P(:/-4!
-D!K1*+)!OQ)>1:/.)+ To celebrate the one-year anniversary of Birthday, Affordable Care Act! May your days
R(2(3(*/!;)+-*: the passage of healthhealthcare-care reform, be long and your troubles be few.”
M/+>-4+/4!?)22+B a coalition of progressive citizens groups and It’s hard to know how long the ACA’s days
82/>C!<)*)!L-*!9-*)!E4D-*F(:/-4 political leaders will be, but it’s a sure bet
gathered at the First that its troubles are going
United Methodist to be lasting and
Church at the substantial. Republicans
April 7 Chicago Temple on in Congress have made it
March 23 for a pep their highest priority to
rally. overturn the law, or if
9/44)+-:(!;1*(2!<)(2:3!=++->/(:/-4 “Despite the that’s not possible, to
=!?(&!(:!:3)!8(@/:-2 misinformation, blunt its enforcement by
7-%%&/45!/4!A:B!'(12
disinformation, withholding funding or
82/>C!<)*)!D-*!9-*)!E4D-*F(:/-4! mendacity, and refusing to enact enabling
outright lies about legislation.
the Affordable Care If they are
Act,” said William E. unsuccessful in the
Katie Jordan, president of the Chicago
McNary, co-director of chapter of the Coalition of Labor Union legislative arena, they
June 13-15 Citizen Action Illinois, Women, addresses the crowd at the expect the courts to
“Insurance companies Chicago Temple on March 23. rule against the
can’t cancel policies mandate to obtain
any more! Ain’t that insurance coverage. A
G3/-!<-+@/:(2!=++->/(:/-4 good news?” number of the nation’s Republican governors
HI:3!=441(2!9)):/45B!=*>3/)!J*/DD/4!/+!:3)! “Seniors are not denied preventive care! are putting roadblocks in place to halt
C)&4-:)!+@)(C)*B!K-!>3(*5)!D-*!
(++->/(:/-4!F)F%)*+!(40!+@-4+-*+B Ain’t that good news?”
Continued on Next Page
82//>C!<)*)!L-*!9-*)!E4D-*F(:/-4
E-Mail
info@payersandproviders.com with
the details of your event, or call
(877) 248-2360, ext. 3. It will be
published in the Calendar section,
space permitting.
www.lakesidecommunityhealthcare.com
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Payers & Providers NEWS Page 2
In Brief
diseases, according to Will Wilson, an legislatures in Florida, Montana, and
advocate for people with HIV and AIDS. Arkansas made clear their intent not to
* Coverage for young adults on their participate in individual and small business
parents’ insurance policies, said Pete exchanges, or to work with the federal
Callahan, head of the SEIU government on implementing
healthcare workers local. other provisions.
BadgerCare Basic
* “Security, dignity, and The public is still split on
Enrollments Stopped by
self-respect,” in the words of the law. According to a Kaiser
Wisconsin DHS John Cameron, political Family Foundation poll in
director of AFSCME, the early March, 42% of
The Wisconsin Department of
Health Services has halted public employees union, in Americans support the law
enrollment in BadgerCare Basic, a Illinois. He waved a brand and 46% oppose it. About
state health program for low- new Blue Cross Blue Shield 53% of the public said they
income adults without children. card issued to his son, who are confused about the law.
State ofcials said the program, became ill while working for Of those who oppose the law,
which opened nine months ago,
was spending far more than it was a small employer that didn’t 18% dislike the individual
bringing in. offer health insurance, and mandate, 19% think
The program, which was not had been hounded by bill government has too large a
intended to be paid for with collectors ever since. role, and 20% worry about
general taxes, is running about $2 Congresswoman Jan the costs.
million in the red. By the end of
February, it had brought in $4.2 Schakowsky, a Democrat Rep. Jan Schakowsky None of that was
million in premiums and spent representing Evanston and mentioned in front of the
$5.8 million to pays claims. There the North Side of Chicago, 175 listeners gathered in the
are about 6,000 enrolled in the said she felt “a new narrative sweeping Methodist church, which is across the street
Basic program. across the country, a prairie re starting in from City Hall and the Daley Center, named
BadgerCare Basic has also run
through about $1 million in Wisconsin,” after the protests in Madison in for the father of the current mayor of Chicago
federal aid that was intended to be February. She denounced “these terrible lies and founder of Chicago’s famous Democratic
used as a nancial cushion. being spread about Medicare – it’s like elder machine. With Democrats holding majorities
Ofcials said they may seek to abuse. in both houses of the legislature, and a newly
increase premiums in the coming “We’re going to defend Medicare as a elected Democratic governor, Illinois may be
months.
centerpiece of our values. This legislation is a more receptive political environment for
good for everybody, except maybe the the thrust of the law than most places.
Deaconess Associates insurance companies who try to gouge us “In 2014,” McNary reminded the crowd,
of Cincinnati Receives every day. “in the middle of President Obama’s second
$27 Million For Missouri “We are sending a message today that we term, insurance companies won’t be able to
Nursing Facilities love ObamaCare. It will deliver for the deny coverage.” The event had the feel of a
people of America.” political prelude, in fact, to the president’s
Deaconess Associations Inc. sold While the speakers of the event talked campaign for re-election in two years.
11 long-term care facilities in repeatedly about the bill’s enemies – mainly In other parts of the country, the law’s
Missouri for $27 million,
targeting the health insurance companies -- sponsors have been making themselves
according to a report in Senior
Housing News. they did not address the substantive issues scarce. Washington Post writer Dana Milbank
Deaconess ran 215-bed that critics have raised: observed on the same day that Democrats are
Deaconess Hospital in Cincinnati * The legislation increases federal playing “under Marquess of Queensbury
until recently, when it ceased spending to cover the uninsured. rules, answering the opposition’s often-
* The insurance mandate may be more scurrilous allegations with earnest pleas not
expensive than some employers can afford, to ‘relitigate’ the past. In wishing away the
Continued on Page 3
driving them toward dropping insurance all ght, they are losing it.”
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Payers & Providers NEWS Page 3
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Payers & Providers OPINION Page 4
9-21:)!$6!;++1)!<!
Berwick’s Fate Should Take High Road
'(&)*+!,!'*-./0)*+!/+! Senate Ought to Give CMS Nominee a Fair Hearing
=1%2/+3)0!).)*&!>31*+0(&!%&!
'(&)*+!,!'*-./0)*+!'1%2/+3/456!
778?!@4!(441(2!/40/./01(2! The political fracas over Don Berwick’s and will announce a major initiative in patient
+1%+A*/=B/-4!/+!CDD!(!&)(*! appointment as director of the Centers for safety in the near future. Impressively, Berwick
EC$FD!/4!%12G!1=!B-!$#! Medicare & Medicaid Services (CMS) is a has accomplished all of this with at least one
+1%+A*/%)*+H?!;B!/+!0)2/.)*)0!%&! disturbing indication of the political decline of hand and several ngers of the other tied behind
)I:(/2!(+!(!'JK!(BB(A3:)4B6! America. his back: doubt about his own future at CMS,
-*!(+!(4!)2)AB*-4/A!4)L+2)BB)*? Berwick is a brilliant Harvard professor and uncertainty about the fate of the Affordable Care
founding head of the Institute for Act, and an unrelentingly hostile
@22!(0.)*B/+/456!+1%+A*/%)*!(40! Healthcare Improvement. He is reception by the Republicans in
)0/B-*/(2!/4M1/*/)+N also the brains and vision Congress.
EO<<H!"FOI"PQ# behind most of the important But my hopes were dashed by
/4R-S=(&)*+(40=*-./0)*+?A-: healthcare initiatives of the past the recent statement by Sen. Max
generation, from the IOM Baucus (D-Montana) that
T(/2/45!(00*)++N reports on quality and safety, to Berwick is simply not
O$O!U?!V-22&L--0!W(&6!X1/B)!Y “bundles” of evidence-based conrmable by the Senate. This
Y1*%(4G6!8@!D$Z#Z practices to reduce harm, to the announcement followed a letter
idea of a campaign to promote sent to the White House by 42
patient safety. GOP senators, who argued –
W)%+/B) President Obama’s selection disingenuously – that Berwick’s
LLL?=(&)*+(40=*-./0)*+?A-: of Berwick to lead CMS last year “lack of experience in the areas
K(A)%--G was inspired. In the face of of health plan operations and
LLL?R(A)%--G?A-:[=(&)*+=*-./0)*+ unassailable evidence of spotty insurance regulation raise serious
>L/BB)* quality and safety, unjustiable By Robert Wachter, M.D. concerns about his qualications
LLL?BL/BB)*?A-:[=(&)*+=*-./0)*+ variations in care, and impending for this position.”
insolvency, Medicare has no choice but to From the moment of his nomination, Berwick’s
\0/B-*/(2!Y-(*0 transform itself from a “dumb payer” into an plight has been a sad spectacle. I was particularly
organization that promotes excellence in disheartened by the way he was treated before his
quality, safety, and efciency. There is simply no recent his testimony before the House Ways and
Y*/(4!]?!X/2.)*+B)/46!T?J?
X)4/-*!9/A)!'*)+/0)4B other person with the deep knowledge of the Means Committee.
>3)!8(:0)4!^*-1= system and the trust of so many key In the face of this kind of nonsense, I know of
stakeholders as Don Berwick. several superb physician-leaders who were
_-++!@?!X2-BB)46!T?J? But Berwick’s nomination ran into the buzz offered positions in CMS – for roles that should
`2)/4!X2-BB)4!,!K*)4A3 saw of Red and Blue politics, with Republicans have been once-in-a-lifetime opportunities to
83/A(5- holding his nomination hostage to their larger shape national policy – but turned them down.
concerns about the Affordable Care Act. In the “Who needs this?” one told me. And they’re right.
T/A3()2!7?!T/22)4+-4 ludicrous debate that ultimately culminated in The smart money is that the White House will
'*)+/0)4B Obama’s recess appointment of Berwick, the fold on the Berwick appointment. Let’s do what
V)(2B3!a1(2/B&!@0./+-*+!778
central argument against his nomination was we can to turn this around. Please contact the
V/532(40!'(*G6!;22?
that he had once – gasp – praised the UK’s White House, your senators and representatives,
National Health Service. and the media, and tell them that Don Berwick is
'1%2/+3)*
President Obama was right to use his recess the best hope we have to improve our healthcare
appointment power to install Berwick as CMS system. Tell them that the Senate should hold
_-4!X3/4G:(4 director. I hoped – naively, perhaps – that Don hearings on his appointment, and let the chips fall
=1%2/+3)*S=(&)*+(40=*-./0)*+?A-: would win over his critics by the time his where they may.
appointment expired in December 2011. And,
\0/B-* in his eight months in the role, Berwick has
done a terric job. As always, his speeches on Robert Wachter, M.D., is a professor of
J14A(4!T--*) healthcare reform have been articulate and medicine at the University of California San
0:--*)S=(&)*+(40=*-./0)*+?A-: thought provoking (though one can see a heavy Francisco and chief of the division of hospital
bureaucratic hand tamping down Don’s medicine in the UCSF Medical Center. He is a
;R!&-1!0-!4-B!*)A)/.)!&-1*!/++1)!-R! characteristic air and penchant for
'(&)*+!,!'*-./0)*+!%&!$$!@?T?!-4! nationally recognized expert on healthcare
>1)+0(&6!=2)(+)!A(22!EO<<H"FOI"PQ#? provocativeness). He has appointed excellent quality and blogs at http://community.the-
people to key leadership positions, eshed out hospitalist.org/blogs/default.aspx, from which
some of the new CMS programs such as Value- this op-ed was adapted.
based Purchasing and the Innovations Center,
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Payers & Providers MARKETPLACE/EMPLOYMENT Page 5
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Or visit: www.payersandproviders.com
*New England Journal of Medicine, 2004.
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Payers & Providers MARKETPLACE/EMPLOYMENT Page 6
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