DJP Update 3-14-2010 House vote count Senate health bill – still short & full press on to get more votes; Meanwhile AMA…; Patient Privacy in GB; LAGNIAPPE
Let’s do AMA first. Meanwhile AMA…
AMA responds in writing to individual doctors as well as the Coalition of State Medical and National Specialty Societies who urge in writing with good arguments that AMA openly oppose the Senate bill and encourage the House not to vote for it. AMA refuses to do so stating, in writing, to those letter writers that AMA is studying and negotiating. Well, let me not summarize AMA’s position. Read the letter yourself from AMA Board Chair:
I have received your letter that urges the AMA to immediately and publicly announce opposition to passage of the Patient Protection and Affordable Care Act (H.R. 3590) by the House of Representatives without waiting to analyze legislative language in a reconciliation bill that will alter provisions in the Senate bill.
The views expressed in the attached sign on letter have been respectfully and thoroughly considered by the AMA leadership.
The AMA continues to be engaged in active discussions with the Administration and Congressional leaders on modifications of the Independent Payment Advisory Board as it applies to physician. These efforts go well beyond sending letters staking out a position and involve potential provisions in the reconciliation bill that would benefit physicians and their patients. Issuing a letter of opposition prior to the conclusion of current discussions on the IPAB provisions would foreclose the ability to secure significant policy changes.
The reconciliation legislation will alter the Senate passed bill in a number of ways. With House floor votes on a reconciliation bill not expected before March 19 (and possibly later) there is still time and opportunity for the AMA to forcefully register its views on the final health system reform package. We believe the proper course is to defer a decision on whether to urge Congress to oppose or support passage of the final bill until it is apparent that we are no longer able to secure important modifications and after we have analyzed the legislative language for the reconciliation bill.
Over the next several days the AMA will provide a steady stream of communications on critical decisions with far-reaching consequences for physicians, patients and the nation.
Sincerely
Rebecca J Patchin, MD
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DJP Comment: Individual doctors, after careful consideration, have respectfully responded to the letter of the AMA and pointed out that the “Independent Payment Advisory Board” is just one of many onerous provisions in the Senate bill. Even if that item was removed, the bill still is a disaster. As one doctor active in AMA said to the Board, “Why do we think we can negotiate something in the reconciliation bill when we were unable to negotiate anything of significance in the original bill?” He also pointed out there already is a 36% loss of AMA membership in his state! He added “Do you not see the benefits of defeating bad legislation and starting over?”
Another doctor, prominent in his specialty leadership and active in the AMA House of Delegates also wrote the AMA Board and pointed out at least 16 onerous provisions in the Senate bill and specifically listed 16 of them. He urged the board to “immediately reject HR 3590.”
Congratulations to these individual doctors and to the Coalition of State Medical and National Specialty Societies for having the courage and leadership to speak out and try to save AMA from continuing a losing approach to health system reform.
No phone conferences with the House of Delegates sometime in the future can justify continuing this position of AMA. Many will think the phone conference will be used as “cover”. AMA policy is clear. Implement it now and that means opposing this Senate bill. Future students of AMA history will not give AMA the benefit of “Too little, too late.” The criticism will be harsher and AMA will become a non-player in the politics of Medicine. And what percent of dues-paying members will AMA have at that time? For the pilots among you, this is a “flat-spin” down to a crash! (Flat Spin. “A spin in which the tail of the aeroplane drops and the machine rotates in an almost horizontal plane. Recovery from a flat spin is difficult and sometimes impossible.”)
NOW CONGRESS and VOTES
DJP Comment about Congress: The vote count varies from hour to hour depending on who is speaking with you. At the moment, I believe it is about 5 votes short for passage of the Senate bill in the House. But to believe that, you have to assume that what someone is telling you at this moment will be the position taken at the vote. All sorts of additions and promises can influence votes as we have witnessed in the Senate deals. Be confident that the vote in the House will take place without delay the moment the majority vote is obtained, if it is obtained. That could be in the next few days and the “reconciliation vote” could be an express train that passes AMA up as AMA waits at the station! AMA opposing the bill immediately could alter the history of this bill and give cover to those Democrats who are looking for an excuse to vote against it! But I keep repeating myself. Sorry for rehashing old news!
The latest idea floated is the alleged “Slaughter Solution”. See last article excerpt below.
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Excerpt from WSJ online: http://online.wsj.com/article/SB10001424052748703457104575121604005269006.html?mod=WSJ_hpp_MIDDLTopStories
By GARY FIELDS and DARRELL A. HUGHES
WASHINGTON—White House adviser David Axelrod conceded that efforts to secure enough support to pass the party’s health-care bill was proving “a struggle,” but voiced confidence that Democrats would ultimately get enough votes.
Mr. Axelrod was one of several Obama administration and Democrat leaders who took to the airwaves on Sunday to talk about the health-care overhaul, as the Democrats’ push to pass one of President Barack Obama’s signature initiatives enters what could be a final stage.
Asked on CNN’s “State of the Union” whether he thought Democrats had the votes to pass the bill, Mr. Axelrod said: “I think we will have the votes to pass this. Obviously this is a struggle.”
House Minority Leader John Boehner (R., Ohio), appearing on the same show, was less sanguine. If House Speaker Nancy Pelosi (D., Calif.) “had [the] 216 votes [needed to pass the legislation in the House], the bill would be long gone,” he said.
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EXCERPT from Reuters: http://www.reuters.com/article/idUSN1414766520100314
White House confident of House approval this week
(Adds Gibbs, Boehner quotes, details)
By John Whitesides
WASHINGTON, March 14 (Reuters) – White House officials on Sunday confidently predicted quick final passage of healthcare reform but a top Democratic vote-counter said the party still needs to line up more support in the House of Representatives.
With President Barack Obama’s sweeping healthcare overhaul headed for a final House vote this week, House Democratic Whip James Clyburn said Democrats were short for now of the 216 votes needed but he was confident they could find them.
“We don’t have them as of this morning, but we’ve been working this thing all weekend, we’ll be working it going into the week, I’m also very confident that we’ll get this done,” Clyburn, the No. 3 House Democrat who is entrusted with lining up the party’s votes, said on NBC’s “Meet the Press.” …..
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EXCERPT about “Slaughter Solution” to Senate bill in House from info at Washington Examiner quoting National Journal’s Congress Daily
House Democrats looking at ‘Slaughter Solution’ to pass Obamacare without a vote on Senate bill UPDATED!
By: Mark Tapscott
Editorial Page Editor
03/10/10 4:17 PM EST
Read more at the Washington Examiner: http://www.washingtonexaminer.com/opinion/blogs/beltway-confidential/House-Democrats-looking-at-Slaughter-Solution-to-pass-Obamacare-without-a-vote-on-Senate-bill-87267402.html#ixzz0iC692IsI
Would House Speaker Nancy Pelosi and her fellow House Democratic leaders try to cram the Senate version of Obamacare through the House without actually having a recorded vote on the bill?
Not only is the answer yes, they would, they have figured out a way to do it, according to National Journal’s Congress Daily:
“House Rules Chairwoman Louise Slaughter is prepping to help usher the healthcare overhaul through the House and potentially avoid a direct vote on the Senate overhaul bill, the chairwoman said Tuesday.
“Slaughter is weighing preparing a rule that would consider the Senate bill passed once the House approves a corrections bill that would make changes to the Senate version.
“Slaughter has not taken the plan to Speaker Pelosi as Democrats await CBO scores on the corrections bill. ‘Once the CBO gives us the score, we’ll spring right on it,’ she said.”
Each bill that comes before the House for a vote on final passage must be given a rule that determines things like whether the minority would be able to offer amendments to it from the floor.
In the Slaughter Solution, the rule would declare that the House “deems” the Senate version of Obamacare to have been passed by the House. House members would still have to vote on whether to accept the rule, but they would then be able to say they only voted for a rule, not for the bill itself.
Would that rationale fly with the public? Is it logical? Of course not. ……….
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DJP comment: And remember that the folks in the House of Representatives will be voting on the Senate bill without knowing the exact wording in the so call “reconciliation bill”. A word here, a word there, and suddenly the bill has a new meaning. What a mess! No wonder Congress has such a low favorable rating. “Voter unhappiness with Congress has reached the highest level ever recorded by Rasmussen Reports as 71% now say the legislature is doing a poor job.” http://www.rasmussenreports.com/public_content/politics/mood_of_america/congressional_performance
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Patient Privacy in Great Britain: this just in. Here is an excerpt. Go to link for full article. A lesson for USA?
http://www.timesonline.co.uk/tol/life_and_style/health/article7061017.ece
From The Sunday Times
March 14, 2010
Briefing: NHS database
Doctors have accused the government of entering the personal medical records of NHS patients into a central system without their consent
Breakneck speed
NHS accused of ignoring patients’ right to opt out
The confidential medical records of patients are being placed on a new National Health Service database without their consent, it emerged last week. The British Medical Association (BMA) accused the government of rushing the project through “at breakneck speed”, uploading patients’ details before they have had a chance to object. It comes amid fears that information will be targeted by hackers, and follows allegations that the government is hurrying to finish the project before the Conservatives can cancel it, as they have promised. In a letter to ministers published last week, Hamish Meldrum, the BMA chairman, urged the government to suspend the scheme, which he said risked damaging patients’ relationship with their doctors.
…..
In April 2007 a report by the House of Commons public accounts committee concluded: “This is the biggest IT project in the world — and it is turning into the biggest disaster.” Last October, it was revealed that more than 14,000 people were being forced to wait at least six months for hospital treatment or tests because staff at Barts and the London NHS Trust, one of the first health authorities to upgrade to the system, had lost track of patients when the computerised records were introduced.
Security fears
Doubts over government’s ability to look after data
Since HM Revenue & Customs lost computer disks containing the details of 25m child benefit recipients in 2007, the government’s appetite for retaining personal data and questions over its ability to guard it have come increasingly under the spotlight. …….
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LAGNIAPPE:
“Ozymandias”, the 1918 sonnett of Percy Bysshe Shelley, is writing that I reflect on during this Congressional battle. As one commentator said, the poem reflects “Pride before the Fall”.
Think of the “spin” about the Senate bill; think about the math used to promote it; think about the view that the bill will not solve the problems it purports to fix; think about the arrogance that the Public doesn’t understand how more government control will help. What is the problem with starting over with specific changes that truly would benefit patients and keep doctors in practice? No rational reason is given for not starting over. Health system reform doesn’t need 2700 pages of law that the majority of the public is against. Reform can be done in 40 pages or less. Significant events occurred with less words: think Declaration of Independence; think U.S. Constitution and the Bill of Rights portion of the Constitution. Passing a bill with disaster in the details may give rise to a celebration for those in power at the moment but the long-term consequences will not make an addition on their CV that history will praise.
Ozymandias
BY PERCY BYSSHE SHELLEY
I met a traveller from an antique land,
Who said—“Two vast and trunkless legs of stone
Stand in the desert. . . . Near them, on the sand,
Half sunk a shattered visage lies, whose frown,
And wrinkled lip, and sneer of cold command,
Tell that its sculptor well those passions read
Which yet survive, stamped on these lifeless things,
The hand that mocked them, and the heart that fed;
And on the pedestal, these words appear:
My name is Ozymandias, King of Kings;
Look on my Works, ye Mighty, and despair!
Nothing beside remains. Round the decay
Of that colossal Wreck, boundless and bare
The lone and level sands stretch far away.”
http://www.poetryfoundation.org/archive/poem.html?id=175903
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Stay well.
Donald
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