Pelosi Watch: The Final Mile

Today House Speaker Nancy Pelosi confirmed that Congressional Democrats are inching "closer" to final votes on health care reform. She declared that Democrats will take   "whatever time is required" to get it finished.  “It won't be very long,” she said, “and we'll be making a real difference in the life of the American people.”

Pelosi has also made it clear that the public option will not be in the final legislation, adding “I’m quite sad that the public option is not in there.” Pelosi also noted that she has been for single payer for many years, long before many of the reporters in the room were born. 

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Pelosi Makes another Wise Decision

Late Thursday the Associated Press reported that “House Democratic leaders have abandoned a long struggle to appease the most ardent abortion opponents in their ranks, gambling that they can secure the support for President Barack Obama's sweeping health care legislation with showdown votes looming next week.

“In doing so, they are all but counting out a small but potentially decisive group whose views on abortion coverage have become the principal hang-up for Democrats fighting to achieve the biggest change in American health care in generations.”

Meanwhile Thursday evening Igor Volsky reported: “Stupak’s Abortion Gang Falling Apart as Pro-Life Members Admit Senate Bill Won’t Fund Abortions.”  

This is, I think, a final turning point in the fight for health care reform. And Pelosi is doing what I thought she would do. I couldn’t imagine that the first woman to become House Speaker would let a relatively small group of people who oppose “a woman’s right to choose” bury health care reform.

Granted, many Americans have misgivings about abortion. When faced with the choice, many women wouldn’t choose abortion for themselves. But the majority of Americans believe that women should have a choice, and they don’t feel that the government–or Bart Stupak– should make that decision for them

 

Advice to Hospitals in a Downturn: “Market the High-Margin Service”

One  might think that hospitals would be recession-proof.  After all, hospital care is a necessity.

But one would be wrong. When times are tough, people put off elective surgery, and even avoid going to the hospital in an emergency.  Although they may have insurance, often they can’t afford the co-pays that accompany hospital care. As for the uninsured, not long ago a study showed that uninsured patients suffering from gunshot wounds often leave the ER, voluntarily, without being admitted to the hospital.. (I’ll be writing about this study in a future post.)
 
What can hospitals do? Hospitalimpact.org, a new blog “dedicated for current and emerging hospital leaders, thinkers and enablers” offers some advice:

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The Doctor Who Invented PSA Test Calls It “A Profit-Driven Public Health Disaster” . . . Why This Is Good News

Times are changing. Americans are beginning to acknowledge that “early detection” is not the absolute answer to cancer. And many are  recognizing that what seems a simple diagnostic test can carry more risks than benefits.

Tuesday, the New York Times ran an Op-ed by Richard J. Ablin,  the man who invented the prostate-specific-antigen (PSA) test which is widely used to detect signs of  early-stage prostate cancer.  Ablin, who is  now a research professor of immunobiology and pathology at the University of Arizona College of Medicine and the president of the Robert Benjamin Ablin Foundation for Cancer Research,  reveals that “in approving the procedure, the Food and Drug Administration relied heavily on a study that showed testing could detect 3.8 percent of prostate cancers, which was a better rate than the standard method, a digital rectal exam.

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Libel Laws Stifle Scientific Debate

The editor of the British Medical Journal, Fiona Godlee, writes that “organized sceptism,” or the  “requirement that scientific claims be exposed to critical scrutiny before they are accepted” is one of the basic tenets of good science.Yet in the UK, where a firestorm is raging over libel lawsuits being used to silence scientific debate, that  “critical scrutiny” could land a skeptic in court.

Right now, the legal case garnering the most attention involves British journalist Simon Singh, author of a Guardian article that strongly questioned the benefits of chiropractic treatments for some pediatric problems. Singh, who is also co-author of the book “Trick or Treatment? Alternative Medicine on Trial” wrote;

“The British Chiropractic Association claims that their members can help treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying, even though there is not a jot of evidence. This organisation is the respectable face of the chiropractic profession and yet it happily promotes bogus treatments.”

The British Chiropractic Association demanded that The Guardian print a retraction of Singh’s article. The newspaper refused to retract the piece but offered the group the opportunity to publish a rebuttal. Instead, they chose to sue Singh for libel. The BCA claims that the wording of the article would lead the public to believe that the chiropractic group was being consciously dishonest.

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Sarah Palin Admits Going to Canada for Health Care– Why?

How rich is this?

Over at “Think Progress,” Igor Volksy reports that, while speaking to a crowd in Calgary, Canada last weekend Sarah Palin revealed a tidbit about her life growing up not far from Whitehorse:

“We used to hustle over the border for health care we received in Canada,” she said. “And I think now, isn't that ironic?”  

Isn’t it?  (I can imagine Palin, tilting her head  slightly to one side, gazing into thin air, and referring to something that she will never understand: irony. )

As Volsky points out, this admission doesn't exactly square with Palin's stand on health care. She has warned us all that U.S. health-care reform will lead to “socialism” and that Canada needs to reform its health care system to “let the private sector take over.”

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Peggy Noonan vs. the New England Journal of Medicine

Let’s put to rest, once and for all, the idea–or rather, the  notion
(it’s not even an idea,  just a vague impression, based on
hearsay)–that the health reform legislation now under discussion
includes no plans for containing health care spending.  

The
reform proposal now being debated in Washington would put a brake on
health care inflation. As an eye-opening essay in the most recent
(March 4) issue of the New England Journal of Medicine explains, Medicare
would, at last, have the power it needs to lead the way,  not by cutting
benefits
, but by restructuring how it does business.

Meanwhile,
pundits such as Peggy Noonan feel free to pronounce health care
reform “a disaster” and “a colossal waste of time
”without giving any
indication that she has ever read the legislation. Presumably Noonan
bases  the opinions that she expresses in her recent Wall Street
Journal
Op-ed on  what other pundits have said.

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Hospital Breaks New Ground In Luxury

Below, an excerpt from yesterday’s Philadelphia Inquirer (March 3, 2010)

I’m not writing a post about this story because the piece speaks for itself. It reveals much about this nation’s healthcare priorities. Also, beware of for-profit“Wellness” programs. Good health is, of course, an admirable goal. But staying well doesn’t have to be this expensive.

But I am bold-facing a few of the high-points or the story and in two or three places, you’ll find my comment in red.

Thanks to HealthBeat reader Dr. Brad F. for calling my attention to this story.  (He dared me to read it. Brad likes to visualize me literally hitting the ceiling. )

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Will Reform Pass? Don’t Believe Everything That You Read

I remain all but certain that comprehensive healthcare reform legislation will pass this spring. The New York Times isn’t sure, but Nancy Pelosi is. My money is on Pelosi. “Every legislative vote is a heavy lift around here,” she told reporters earlier today. “You assume nothing."  But she added, "We will pass a bill."  I agree. The process will be ugly, but they will get it done.

Unless the president and Pelosi have signed a secret political suicide pact, they wouldn’t be doing this unless they were quite sure they could pull it off.

Most of the press is more skeptical than I am. But I’ve been a journalist long enough to know that you don't sell many newspapers with a headline that reads: “Game Over.”  Uncertainty is far more interesting; the media will do its best to keep the suspense alive to the very end.  

That's fine. Americans should be paying attention to this process. And those who want reform should contact their representatives.  But don't let the coverage rattle you.