How Health Care Legislation is Enacted

I'm writing articles for Examiner.com (Newark). I posted Neutering CBO Estimates for Health Care yesterday. The article categorizes four different legislative political strategies used to advance health care legislation through Congress. Quoting the article:

Legislative Reality vs, Political Reality, an article authored by Peter Suderman, identifies specific tactical maneuvers described by one of four different political strategies. One of the strategies entails shifting an expensive part of a bill to a completely different piece of legislation. The CBO can still analyze the expense but its finding will note a much less well known bill that will be unlikely to attract major attention. A CBO analysis of the high profile health bill will then appear more favorable. Suderman noted that expenses related to Medicare reimbursement rates for doctors were shifted to a separate bill in the House. Spinning off large expenses to a separate, more obscure bill is the first of four strategies.

Back loading spending to the latter part of a defined period of time is another means of creating an impression that actual costs are not as alarming as they seem. That was also done with health care legislation. In a ten year period of time provided to the CBO for analysis 99 per cent of relevant spending would take place in the last six years. In such a scenario one would normally assess costs within a six year period to get an average indicator of annual expenses. By front loading four non-spending years at the outset the average figures are brought down considerably. Clever is an apt term for the second strategy- back load spending to bring down annual averages.

The third strategy is a simple act of omission. Do not include expenses not entailed by federal agencies in estimates. While it can be technically justified to not include expenses of all the individual states as well as private sector entities in a CBO report, Americans might assume the legitimacy of these costs and expect them to be factored into estimates. Equivocating on the meaning of costs may be politically astute even as it borders on outright deceit.

The fourth strategy is perhaps the most insidious of all. It involves requiring the CBO to factor into its analysis very dubious assumptions about future costs. Suderman cites an example of Medicare payment savings accrued as a consequence of payment rate reductions "guaranteed" by a Medicare advisory board able to recommend but not able to make its recommendations binding. Future political landscapes have ways of obscuring forgotten intents smuggled into a CBO analysis years earlier. Smuggling unrealistic assumptions about cost reductions and savings points to the fourth strategy. The Democratic congressional leadership has effectively used the strategies to advance their agenda. Obama's much touted transparency in government has taken a huge hit.

Health Insurance Information

Best Health Plans is a U.S. News & World Report link which ranks hospitals and health insurance plans and provides much information as well. Some of the links at the page include:

What If Your Health Insurer Won't Pay?

Equal Coverage for Mental-Health Care

and

How Much Should Patients Pay for Medical Care?

Health insurance is a major concern to both employees and their employers.

MRI Technology to Diagnose Breast Cancer

Aurora Imaging Technology Receives FDA Clearance for Spectroscopy Technology is an encouraging article for those interested in the diagnosis of breast cancer. Aurora Imaging Technology Inc. is based in North Andover, Massachusetts and is dedicated to the development of MRI technology geared to the fight against breast cancer. It has obtained permission from the FDA to make its Aurora Breast MRI available to perform imaging to detect and diagnose breast disease. For more information visit this website.

Micro-Electro-Mechanical Systems

MEMS IN MEDICINE is an informative, well written article. Author Ken Gilleo, Ph.D., conveys technical information in a reader friendly way. He enables those, not having expertise in biotechnology, to grasp details while enjoying the effort- no small feat. MEMs is an acronym for Micro-Electro-Mechanical Systems which are chips in semiconductor fabs. They perform both electronic functions and mechanical actions making them both sensory and control devices. They are found in ink jet printers and automobiles and other types of items as well. Perhaps even more meaningful to many of us, they have medical utility involving blood pressure measurement and ion detection.

MEMS are able to integrate systems by using miniature devices and micron size parts. Examples provided by Ken Gilleo include separators, injectors and micron sized motors as well as miniature gears, propellers, turbines, pumps, radiation sensors and mirrors. The miniaturized technology enables the integration of data derived from physical phenomenon as diverse as light, sound, motion, biochemistry and radio waves. Computation is centered on a single chip. The idea being a mimicking of our senses- sight, hearing, smell and touch. The chip is the "brain center" able to regulate input and output, respond to signals, exercise control and organize data. MEMS offers the possibility of exceeding current human sensory capabilities as well as providing for correction of missing functions.

Besides sensory functions possibilities like the detection of defective DNA, pumping fluids and drug dispensal are in the offing. A merging of motion, sensory capabilities and computation offers powerful potential. The technology is still in its infancy and biomedical electronic system industries are growing within the United States while the more standard electronic industries, for the most part, have left the USA for foreign lands.

The High Cost of Health Care

A great concern to many Americans and businesses is the high cost of health insurance. Some sort of federally sponsored universal health insurance program is all but certain within a short time after the presidential election. For millions of Americans the cost of health insurance is prohibitive and that lays the groundwork for government intervention.

FACTS ON POLICY: National Health-care Expenditures, an article appearing at the Hoover Institution's website, has some revealing information. The amount of money spent on health care increased by more than eight-fold from 1980 to 2005. In 1980 spending on health care within the United States was roughly comparable to that of other industrialized nations. By 2005 we were spending about twice the percentage of gross domestic product on health care compared to other nations.

There are underlying causes pushing up health care costs which are not apparent to many and unfortunately are not discussed by politicians primarily interested in getting elected. A separate post will focus on what the particulars are. For now it is enough to note that government insurance policies do not attack the root of the cost problem. They merely shift the burden of payment and if anything contribute to the soaring costs. Government adminstrative overhead hovers around forty percent of budget as opposed to less than half that for private charities. Profit oriented businesses also tend to be much more efficient.

The free lunch approach to government is experiencing a revival. It is politically expedient to offer now and provide for financing later. Expect the bill for federally funded health care to be a whopper. Health reform is clearly needed and demanded by voters. But reforms should address causes for the health crisis.