Sebelius--One step closer, despite her "lack of candor".

Republican Senators Roberts (KS) and O.Snowe (ME) joined the Dems this week on a Senate Finance Committee vote giving Gov. Sebelius the green light to a full Senate vote on her nomination for HHS Secretary.

It's high-time for some highlights on Sebelius. (It's not like I have to read an entire book or anything... )





Brief Bio:

• A political family: Father was John J. ("Jack") Gillian, a Democrat who served in WWII before becoming a member of the US Congress in the 60s as an anti-war Dem, Governor of OH in the 70s, and next head of the Agency for International Development under Carter.
• Sebelius served as Insurance Commissioner in KS from '94-'98, declining to take contributions from insurance companies. Her term culminated in blocking giant Blue Cross from merging with for-profit Anthem, a move many cite as a key indicator as to why she's a fantastic, or horrible, HHS Secretary candidate, depending on which camp you're in.
• Sebelius has served as President of the National Association of Insurance Commissioners, past chair of the Democratic Governor's Association, and past Chair of the Education Commission of the States.

And on to the nomination-related news:

• Sebelius joins the ranks of many-a-member of the BO administration, by having mistakenly failed to pay taxes. The Gov payed over $7,000 in back taxes owed for '05-'07. A paltry sum compared to her peers, but her "unintentional error" is noteworthy nonetheless.



• Sebelius is the Moderate Pro-Choice candidate? Bob Novak, no stranger to controversial reporting, has called the Gov a "national pro-choice poster girl," and states there is "substantial evidence she has been involved in what pro-life advocates term "laundering" abortion industry money for distribution to Kansas Democrats." An interesting op-ed links the Gov's political activity to the "apex of a complicated Kansas financing system involving the famous abortion provider George Tiller of Wichita," Planned Parenthood, and the court system--more involved than I would like to get on this blog right now, but click the link. During her first confirmation hearing in front of the SFC she said she will remain "staunchly pro-life, and will advocate for the lives of the unborn."



• And speaking of the famous doctor, Sen. Grassley is concerned about Sebelius' "lack of candor" with respect to her "inadvertent omission" of campaign contributions from late-term abortion doc Tiller (who has been spied partying at the Gov's Mansion). The Gov had to amend her statement to the SFC after stating she and her PAC received $12,450 from the doc in '94-'01, when the total was really more like $40,000.

• Despite her record of vetoing and speaking out against various abortion laws, at the end of March (right before her confirmation hearings) Sebelius signed a law that gives women the option to view a sonogram before an abortion. The Gov had previously vetoed legislation including such a provision, though the language in the vetoed legislation included mandates, not options, and also reporting requirements.

• Sebelius supports BO's reform plans, including a public insurance option. In April, the Gov signed a law to use federal stimulus money to subsidize health insurance for those who have lost their jobs.

Sebelius had originally taken her name out of consideration for cabinet positions, citing a need to focus on her responsibilities to Kansans in tough economic times.

That's what I've been saying!

Howard Dean is back on the scene. After being passed over for HHS consideration, he keeps on trucking. His newest health care campaign: Stand with Dr. Dean.



Now, call me naive, but this is what I've been saying when I talk to my pals about health care reform. (though I hope I didn't speak like I've never read cue cards before.) Makes total sense.

In America, you can go to public school, you can pay more for private, or you can home school. You can get on public transit (for a small fee) or you can buy a car. You can use the USPS or you can ship FedEx. You can call the police when you hear a noise and you can buy your own alarm system. Why why why is health care different? As "Governor Howard Dean, Dr. Howard Dean," says, this is the system already set up in health care if you qualify for Medicare/caid (read: you're poor, disabled, over 65). Why stop there? (*cough* insurance lobbyists *cough* AMA *cough*...)

Care costs $... bigger entity, more moolah.

Catching up, at home and in MA.

Been away a while while graduating/taking the bar/subletting my apartment & moving. Now I'm trying to sort through old news & catch up with the new. Onward!


On March 15, 2009, NYT published an article on the costs of care in MA & how the Commonwealth is trying to deal. Costs were high in the projected plan, and have soared even higher.

Alan Sager, a professor of health policy at Boston University, has calculated that health spending per person in Massachusetts increased faster than the national average in seven of the last eight years. Furthermore, he said, the gap has grown exponentially, with Massachusetts now spending about a third more per person, up from 23 percent in 1980.

All of that, and still 2.6% of residents, 167,300 people, are not covered. Now, while that's comparatively nothing to sneeze at, we still have to contemplate just how much money is being spent, and that the return is not universal.

Why do we care about health care in MA? Well, beyond the general desire to watch an experiment at work, the Obama administration has certainly taken a liking to it, and even without Daschle, the Plan is peppered all over policy talk from the White House.


The article offered a very nice nutshell of Phase I of the MA plan, which was simply getting it enacted, including the sell of Mandatory Coverage. Phase 2 of health care reform in MA involves an ambitious restructuring of payment schedules.

They want a new payment method that rewards prevention and the effective control of chronic disease, instead of the current system, which pays according to the quantity of care provided. ... If Massachusetts becomes the first state to make this conversion, health policy experts argue that it would be as audacious an achievement as universal coverage.

Again, significant on a Federal level. Paying for quality instead of quantity is already creeping in to the Federal system (for example, Medicare's new non-reimbursement rule for certain complications after patient admission), and managed care organizations have also experimented with/enacted various quality-based payment systems very similar to what MA may be proposing. This proposition is not without logic since chronic disease is a huge chunk of health care spending, and can either be prevented or effectively managed by patients and doctors for lower costs overall.

Of course the problem of determining sufficiency of quality is common to pretty much every health care delivery quandary: WHO decides? But that's a post for another day.


The article goes on:

Those who led the 2006 effort said it would not have been feasible to enact
universal coverage if the legislation had required heavy cost controls. The very
stakeholders who were coaxed into the tent — doctors, hospitals, insurers and
consumer groups — would probably have been driven into opposition by efforts to
reduce their revenues and constrain their medical practices, they said. Now
those stakeholders and the state government have a huge investment to protect.

Well wasn't that a slick move.

congressional health care caucus

live streaming now.

Gender discrimination in insurance

In CA, as in most states, the State says it's okay for insurers to charge more to women, as long as the determination is backed with statistics. This is known as "gender rating." In San Francisco, the city attorney's office has brought suit against state insurance regulators for this practice.

Market says: gender discrimination is legit, state sanctioned, and
makes financial sense.

Rights advocates say: discrimination is bad, m'kay?

The fact that women generally pay more than men for the same insurance is a great illustration of dichotomy between free market health care solutions and more equality-based health-care-as-a-right, universal ("socialist")-types of solutions.

Industry people say that the reason for the discrimination is that women are more likely to use health services. Blue Shield spokesman Tom Epstein put it this way:

"women [are] more accident-prone than men and more likely to break bones or get
sick"

Okay, I'll buy that women use health services more, but Tom sounds like an abusive husband. And funny, Tom doesn't mention that women are more likely to get pregnant than men, which also requires some doctor care.

There is a comparison made to auto insurance: on the whole, men pay more than women because they're more likely to file claims (wait, who's more accident prone?). But, as the same article points out, this is a faulty comparison. Utilization of the health care insurance product is preventative (saving money in the long run), while utilization on the auto side is catastrophic and reactionary (only spending money).

Here's the deal. Insurance is a business. Business has the privilege to incorporate when a State says so. States (not the federal government) regulate insurance. The State is society's mouthpiece. As a member of society, what do you want your State to say to this business that has the privilege of taking your money, and your neighbor's money with the State's blessing? What do you want your State to say to the nation (and beyond) about your value system as reflected in this regulation?

Currently, what States are saying is that it's okay to charge more (and in health care speak this means "make less accessible") to people that utilize care more. But the State is actually saying more. It's saying

"It's okay to charge more for people that utilize the care more no matter
what the reason."

Even if that reason is prevention, which creates a healthy, more productive society on the whole. Even if that reason is specific to 50% of the population but not the other (though the other half certainly benefits).

Is that what you want to say? Balance it with a free market (if that's important to you). One could make the argument that allowing more preventative care would be better for the economy (see above argument on more healthy, productive society), even though it may restrict insurers in the immediate sense.

Any Friedman-ites out there wanna chime in? I'm all ears.

the frankenstein analogy

I'm not the only one that associates Frankenstein with health care.

Capitalism Magazine published an article called The Medicare Bureaucracy is a Frankenstein Monster That is Destroying American Medicine.

And there's apparently something called the "Frankenstein Syndrome" in health care, "caracterized by an excessive reliance upon high technology medicine to compensate for healthy lifestyle."