Saturday, August 31, 2013

ObamaCare’s architects reap windfall as Washington lobbyists

ObamaCare has become big business for an elite network of Washington lobbyists and consultants who helped shape the law from the inside.

More than 30 former administration officials, lawmakers and congressional staffers who worked on the healthcare law have set up shop on K Street since 2010.

Major lobbying firms such as Fierce, Isakowitz & Blalock, The Glover Park Group, Alston & Bird, BGR Group and Akin Gump can all boast an Affordable Care Act insider on their lobbying roster � putting them in a prime position to land coveted clients.

�When [Vice President] Biden leaned over [during the signing of the healthcare law] and said to [President] Obama, �This is a big f’n deal,� � said Ivan Adler, a headhunter at the McCormick Group, �he was right.�

Veterans of the healthcare push are now lobbying for corporate giants such as Delta Air Lines, UPS, BP America and Coca-Cola, and for healthcare companies including GlaxoSmithKline, UnitedHealth Group and the Blue Cross Blue Shield Association.

Ultimately, the clients are after one thing: expert help in dealing with the most sweeping overhaul of the country�s healthcare system in decades.

“Healthcare lobbying on K Street is as strong as it ever was, and it’s due to the fact that the Affordable Care Act seems to be ever-changing,” Adler said. “What’s at stake is huge. … Whenever there’s a lot of money at stake, there’s a lot of lobbying going on.”

The voracious need for lobbying help in dealing with ObamaCare has created a price premium for lobbyists who had first-hand experience in crafting or debating the law.

Experts say that those able to fetch the highest salaries have come from the Department of Health and Human Services (HHS) or committees with oversight power over healthcare.

Demand for ObamaCare insiders is even higher now that major pieces of the law, including the healthcare exchanges and individual insurance mandate, are being set up through a slew of complicated federal regulations.

�Congress is easy to watch,� said Tim LaPira, a politics professor at James Madison University who researches the government affairs industry, �but agencies are harder to watch because their actions are often opaque. This leads to a greater demand on K Street� for people who understand the fine print, he said.

�K Street’s agenda follows the government’s agenda. It’s not typically the other way around,” he said.

Watchdogs say the rise of the ObamaCare lobbyist is another example of the �revolving door� that turns public service into private enrichment.

�After passage of major legislation, those who have networks on Capitol Hill take exceedingly lucrative jobs with the same industries subject to the legislation,� said Craig Holman, a lobbyist for Public Citizen. �It raises questions about the [bill's] integrity.�

For K Street, healthcare lobbying has been a bright spot in what has otherwise been a down business cycle.

While lobbying revenue at major firms has been flat or declining in recent years, the healthcare law has generated steady work � a trend that is likely to continue for years to come.

That�s because ObamaCare runs on a long timeline � well into the next administration. Unless the law is severely crippled, the reform’s rules and requirements will be rolling out through at least 2020.

That�s good news for lobbyists who want to sign up clients for the long haul.

The windfall from the healthcare overhaul is being reaped at firms large and small. Some veterans of the legislative push have landed at boutique firms that are increasingly specializing in lobbying niches.

The firm Avenue Solutions, for instance, recently hired Yvette Fontenot, a former staffer for both the Senate Finance Committee, which wrote ObamaCare�s tax-related provisions, and HHS’s Office of Health Reform, which is assisting the implementation.

Since her hire in April, the four-woman firm has picked up Health Care Service Corp. as a client, and Fontenot is now lobbying for the Blue Cross Blue Shield Association and the National Electrical Manufacturers Association as well.

The Democratic firm banks about $3 million in revenue per year, records show, but is on pace for growth in 2013, earning $1.8 million through the first half of the year.

It�s not just ex-staffers who are becoming trusted ObamaCare guides � former members of Congress are lobbying on the law as well.

Former Rep. Earl Pomeroy (D-N.D.) joined Alston & Bird in 2011 after dealing with healthcare and tax issues as a member of the House Ways and Means Committee.

Now Pomeroy and his one-time chief of staff, Bob Siggins, are lobbying on ObamaCare for clients such as clients such as Vision Service Plan, the National Coordinating Committee for Multiemployer Plans and Medicare � a health insurance provider.

Consulting is another avenue former staffers and officials can take to work for outside interests while they look to comply with and shape the impending regulations.

�This is not a do-it-yourself project; it’s complicated,� said Adler. �They need help from insiders to help navigate this thing correctly.�

Former senior counsel to HHS Secretary Kathleen Sebelius Dora Hughes became a senior policy adviser at the law firm Sidley Austin last year.

Hughes is not a registered lobbyist, and told The Hill she mainly provides �strategic policy advice� while abiding by the ethics pledge not to lobby the administration. She has no congressional contacts in her sights, either.

Even the president needs some lobbying know-how when it comes to advancing ObamaCare.

The White House brought on Clinton administration veteran and former lobbyist Chris Jennings last month to help navigate the implementation of the law.

During a call with several directors of the state healthcare exchanges on Wednesday, Jennings was seated in a plum position � right next to Obama.

Friday, August 30, 2013

Feds Say 'Unbanked' Can Buy Insurance With Prepaid Debit Cards

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Thursday, August 15, 2013

Obamacare: People With Disabilities Face Complex Choices

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Obamacare: People With Disabilities Face Complex Choices

More From Shots - Health News Health CareGetting People Out Of Nursing Homes Turns Out To Be ComplicatedHealthChronic Insomnia? Hitting The Treadmill Could Help ... EventuallyHealthA Safety Checklist To Save Teen Athletes' LivesHealthEvidence Supports Pill To Prevent Some Prostate Cancers

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Industry Ties Raise Questions About Expert Medical Panels

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Tuesday, August 13, 2013

Let’s Talk About Health Care and I Don’t Mean the ACA

Let’s talk about health care. I don’t mean debating the Affordable Care Act. I mean health care, as in: If everyone needs health care, guarantee that everybody gets it.

I know, when it comes to health care, it’s easy to get into a debate for or against Obamacare. But we nurses see the world through a different lens: our patients.

Share this video of nurses summing up why everyone in the U.S. needs & deserves healthcare:

Good health care is a fundamental resource that keeps America’s big engine running. Every day, as we do our best to care for our patients, nurses see people with chronic disease like asthma or diabetes who can’t afford insurance costs or medication. Maybe they’re absent from work, tired, and distracted from trying to manage their health on a shoestring. They run the risk of hospitalization. They struggle for a distant unreachable shore hoping something will help. They can’t get ahead because their health keeps dragging them down. 

And yet the answer isn’t on the horizon, the answer is in our pockets, in our hands. It’s our taxes. We pay them and we ought to benefit from them.

There’s one thing that every American does. Every working American (OK, except the Wall Street crowd) pays taxes. But what do we pay taxes for? Increasingly, we wonder where our money is going, how our money is serving our communities, and how our tax money is helping us and our families.

There are dozens of arguments about what our tax dollars should be doing. But what if we spent a portion of our tax dollars on the one thing that would position every American, young and old, on the road to success? That one thing is good health. You need it to go to school, get to your job, excel at what you do, and dream big dreams that will make our country great again.

We must do better and nurses have a solution. The United States ranks first in costs but 37th in health outcomes in the world. We do even worse for infant morality and life expectancy.
So nurses are proposing another way. We’re saying that our taxes should help pay for our healthcare. It works for seniors, it works for Congress members, and it will work for all of us.

This week, we launched an online campaign, asking voters to demand this from Congress. You can learn more about the online campaign here.


Ads appearing online this week.

We’re talking about something that already exists for some, right here in the United States of America, and what can easily exist for everyone. A tax-funded national healthcare system would negotiate prices for prescription drugs, medical devices and services, specialists and more, effectively lowering the cost of delivering care. Taxpayers don’t have to worry about paying for someone else’s care. You’ll be paying for your own care, your family’s care, without raising taxes at all.

Since the tax subsidies to buy insurance under the ACA mostly move money around to pay for private insurance for some that don’t have it, and which allows the insurers to take 20 cents off the dollar, it would be more efficient to uses taxes to pay for everybody’s healthcare directly, eliminating the middleman and the shell game.


International healthcare cost vs. quality chart.

We are reaching inside the box to think outside the box; we are charting a third way. It’s time to rediscover healthcare as care rather than insurance for the first time in a long time, and let the taxes we already pay deliver what every American needs.

Sen. Reid: Obamacare ‘Absolutely’ A Step Toward A Single-Payer System

When I speak to conservatives about health care policy, I�m often asked the question: �Do you think that Obamacare is secretly a step toward single-payer health care?� I always explain that, while progressives may want single-payer, I don�t think that Obamacare is deliberately designed to bring about that outcome. Well, yesterday on PBS� Nevada Week In Review, Senate Majority Leader Harry Reid (D., Nev.) was asked whether his goal was to move Obamacare to a single-payer system. His answer? �Yes, yes. Absolutely, yes.�

In one sense, this isn�t shocking. Reid and many other Democrats, including President Obama, have often stated that their ideal health-care system is one in which the government abolishes the private insurance market. Video of the PBS discussion isn�t yet online, but here�s how Karoun Demirjian of the Las Vegas Sun described it:

Reid said he thinks the country has to �work our way past� insurance-based health care during a Friday night appearance on Vegas PBS� program �Nevada Week in Review.�

�What we�ve done with Obamacare is have a step in the right direction, but we�re far from having something that�s going to work forever,� Reid said.

When then asked by panelist Steve Sebelius whether he meant ultimately the country would have to have a health care system that abandoned insurance as the means of accessing it, Reid said: �Yes, yes. Absolutely, yes.�

Reid noted that he and other progressives fought hard for a �public option� in the exchanges as a Trojan horse for single-payer, but Democrats didn�t have 60 votes in the Senate to achieve it:

The idea of introducing a single-payer national health care system to the United States, or even just a public option, sent lawmakers into a tizzy back in 2009, when Reid was negotiating the health care bill.

�We had a real good run at the public option � don�t think we didn�t have a tremendous number of people who wanted a single-payer system,� Reid said on the PBS program, recalling how then-Sen. Joe Lieberman�s opposition to the idea of a public option made them abandon the notion and start from scratch.

Eventually, Reid decided the public option was unworkable.

�We had to get a majority of votes,� Reid said. �In fact, we had to get a little extra in the Senate, we have to get 60.�

Reid sees the tax exclusion for employer-sponsored health insurance as the primary obstacle to single-payer health care:

Reid cited the post-WWII auto industry labor negotiations that made employer-backed health insurance the norm, remarking that �we�ve never been able to work our way out of that� before predicting that Congress would someday end the insurance-based health care system.

It�s one of the key things to remember when you look at polls saying that Obamacare is unpopular. A small percentage of the people who oppose Obamacare�around 7-10 percent�oppose it because it doesn�t go far enough.

Monday, August 12, 2013

Sen. Reid: Obamacare ‘Absolutely’ A Step Toward A Single-Payer System

When I speak to conservatives about health care policy, I�m often asked the question: �Do you think that Obamacare is secretly a step toward single-payer health care?� I always explain that, while progressives may want single-payer, I don�t think that Obamacare is deliberately designed to bring about that outcome. Well, yesterday on PBS� Nevada Week In Review, Senate Majority Leader Harry Reid (D., Nev.) was asked whether his goal was to move Obamacare to a single-payer system. His answer? �Yes, yes. Absolutely, yes.�

In one sense, this isn�t shocking. Reid and many other Democrats, including President Obama, have often stated that their ideal health-care system is one in which the government abolishes the private insurance market. Video of the PBS discussion isn�t yet online, but here�s how Karoun Demirjian of the Las Vegas Sun described it:

Reid said he thinks the country has to �work our way past� insurance-based health care during a Friday night appearance on Vegas PBS� program �Nevada Week in Review.�

�What we�ve done with Obamacare is have a step in the right direction, but we�re far from having something that�s going to work forever,� Reid said.

When then asked by panelist Steve Sebelius whether he meant ultimately the country would have to have a health care system that abandoned insurance as the means of accessing it, Reid said: �Yes, yes. Absolutely, yes.�

Reid noted that he and other progressives fought hard for a �public option� in the exchanges as a Trojan horse for single-payer, but Democrats didn�t have 60 votes in the Senate to achieve it:

The idea of introducing a single-payer national health care system to the United States, or even just a public option, sent lawmakers into a tizzy back in 2009, when Reid was negotiating the health care bill.

�We had a real good run at the public option � don�t think we didn�t have a tremendous number of people who wanted a single-payer system,� Reid said on the PBS program, recalling how then-Sen. Joe Lieberman�s opposition to the idea of a public option made them abandon the notion and start from scratch.

Eventually, Reid decided the public option was unworkable.

�We had to get a majority of votes,� Reid said. �In fact, we had to get a little extra in the Senate, we have to get 60.�

Reid sees the tax exclusion for employer-sponsored health insurance as the primary obstacle to single-payer health care:

Reid cited the post-WWII auto industry labor negotiations that made employer-backed health insurance the norm, remarking that �we�ve never been able to work our way out of that� before predicting that Congress would someday end the insurance-based health care system.

It�s one of the key things to remember when you look at polls saying that Obamacare is unpopular. A small percentage of the people who oppose Obamacare�around 7-10 percent�oppose it because it doesn�t go far enough.

Thursday, August 8, 2013

'Paying Till It Hurts': Why American Health Care Is So Pricey

Listen to the Story 38 min 0 sec Playlist Download Transcript  

"We need a system instead of 20, 40 components, each one having its own financial model, and each one making a profit," says New York Times correspondent Elisabeth Rosenthal.

iStockphoto.com

It costs $13,660 for an American to have a hip replacement in Belgium; in the U.S., it's closer to $100,000.

Americans pay more for health care than people in many other developed countries, and Elisabeth Rosenthal is trying to find out why. The New York Times correspondent is spending a year investigating the high cost of health care. The first article in her series, "Paying Till It Hurts," examined what the high cost of colonoscopies reveals about our health care system; the second explained why the American way of birth is the costliest in the world; and the third, published this week in The Times, told the story of one man who found it cheaper to fly to Belgium and have his hip replaced there, than to have the surgery performed in the U.S.

Rosenthal has also been investigating why costs for the same procedure can vary so much within the U.S. � by thousands of dollars, in some cases � depending on where it's being performed. Before becoming a journalist, Rosenthal trained as a doctor and worked in the emergency room of New York Hospital, now part of New York-Presbyterian Hospital.

She joins Fresh Air's Terry Gross to talk about why American medical bills are so high, and what needs to change.

Enlarge image i

Rosenthal has worked at The New York Times as an international environmental correspondent, a reporter in the Beijing bureau, and a metro reporter covering health and hospitals.

Courtesy of The New York Times

Rosenthal has worked at The New York Times as an international environmental correspondent, a reporter in the Beijing bureau, and a metro reporter covering health and hospitals.

Courtesy of The New York Times Interview Highlights

On the goal of her health care series

"[The purpose is] to make Americans aware of the costs we pay for our health care. Because so many of us have insurance and we don't see the bills, we tend to think of health care as free. 'Why not get that colonoscopy? It doesn't cost anything. What's the difference if my hip replacement costs $100,000? I'm not paying.' But, in fact, we're all paying. And as we know, health care is a huge cause of individual bankruptcies now. Copays and deductibles are going up, and the nation � because it pays for a lot of medical care and subsidizes a lot of medical care � just can't afford the way we're doing this anymore."

On the man who went to Belgium to get a hip replacement

"In Belgium, he paid $13,660 for everything. That included his new hip implant, the surgeon's fees, the hospital fees, a week in rehab and a round-trip plane ticket from the U.S., soup to nuts.

"Now, if he had done that surgery in the U.S, it would've been billed at somewhere between $100,000 and $130,000 at a private hospital. ... So there's a huge difference. In fact, this gentleman, Mr. Shopenn, was a great consumer, and he tried to have it done in the U.S., and he priced out joint implants and found that the wholesale joint implant cost ... was $13,000. So in the U.S., for that $13,000 he could get a joint � a piece of metal and plastic and ceramic � whereas in Europe he could get everything."

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On joint-makers keeping prices high

"You would think that if five different companies were making candy bars, that would drive the price of candy bars lower. But if five different companies are making joints and trying to sell them at $10,000 a piece, it's really in no one's interest to say, 'Hey, guess what guys? I'm going to sell mine for $1,000 because that's what it really costs me to make it.' Because then everyone loses money; the whole industry kind of implodes."

On the challenge of standardizing medical equipment

"It's hard to get the companies to, say, standardize the equipment ... so you can use a generic system to implant any brand of joint. It's not in their interest to do that. It's like saying to Apple and Microsoft, 'We want all of your programs to be completely interchangeable.' At some level, at a business level, you want your brand distinct, and you want to keep people in the universe of your brand. In many ways, it's a business decision as much as a medical decision."

On how billing practices in the U.S. compare to those in Europe

"Routinely, for most procedures in other countries, patients stay in the hospital longer; their hospital bills are much less. They tend to see things as a package. I think one of the most striking things when you look at the Belgian hospital bill, as opposed to the U.S. one, is on the U.S. hospital bill for a joint replacement, you see things like operating room fees, recovery room fees. And those [were on] one of the bills I looked at: operating room fees, $13,000; recovery room fees, $6,000; facility fees, x-thousand dollars.

"If you look at a European bill, those things don't exist. And you know, in fact, it was kind of funny when I started on this series � although sad in another way � when I would call some of the European hospitals and say, 'Well, what's your facility fee on that? What's your operating room fee?' and there was this puzzled pause at the other end of the line where they said, 'What do you mean an operating room fee? You can't do the surgery without an operating room. That's a part of our day rate for the hospital. It's all included.' "

On pregnancy costs in the U.S. versus Europe

"Because we pay one by one by one, we have this kind of more-is-better attitude, or 'Why not check and see if the baby is in good position? Why not check and see if the baby is growing?' Whereas in most other countries, the care of a pregnant woman is kind of dictated purely by medicine, what needs to be done. So it's not that in these European countries they aren't getting their prenatal testing and they're not getting their prenatal scans � they are, they're just not getting as many as we do. Because we kind of tend to use a lot of them for like-to-know rather than need-to-know, and again, that gets very, very expensive."

On what needs to change

"Every part of the system needs to rethink the way it's working. Or maybe what I'm really saying is we need a system instead of 20, 40 components, each one having its own financial model, and each one making a profit."

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Saturday, August 3, 2013

Congress May Be Getting Its Own Obamacare Glitch Fixed

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