Local, State, Federal

Single-Payor Health Reform Bill Introduced in Senate
McKesson Responds to Stimulus with One of Its Own
ARRA Allocates Funds for Hospitals to Treat Neediest

Single-Payor Health Reform Bill Introduced in Senate

Sen Bernie Sanders (D-Vt) introduced a single-payor health reform bill, the American Health Security Act of 2009, in the US Senate in late March. Supporters say the bill would save $400 billion on bureaucracy, enough to cover all 46 million uninsured Americans. According to a statement from Physicians for a National Health Program, the reform effort is the first to directly take on the powerful lobbies inhibiting universal health reform in the Senate since Sen Paul Wellstone’s tragic death in 2002.

Sen Bernie Sanders (D-Vt)

Wellstone (D-Minn), an aggressive health care activist, introduced legislation to make any health care reform that passed the Senate as good as that which is provided to members of Congress. He also wrote the Patient Protection Act to protect consumers and health care providers while leading the fight to protect Medicare from arbitrary cuts. In the summer of 1996, the Senate approved legislation he authored to require health insurance policies to cover mental illnesses in the same manner as other physical illnesses.

Sanders, who serves on the Senate Committee on Health, Education, Labor, and Pensions, is a longtime advocate of fundamental health care reform. His new bill draws heavily on the single-payor legislation introduced by Wellstone in 1993 and closely parallels similar legislation pending before the House introduced by Rep Jim McDermott (D-Wash).

According to Physicians for a National Health Program, a membership organization of more than 16,000 physicians, the single-payor approach embodied in Sanders’ new bill stands in sharp contrast to the reform models being offered by the White House and by key lawmakers like Senators Max Baucus (D-Mont) and Edward Kennedy (D-Mass). Their plans would preserve a central role for the private insurance industry, sacrificing both universal coverage and cost containment during the worst economic crisis since the Depression.

In contrast, Sanders’ new legislation would cover all of the 46 million Americans who currently lack coverage and improve benefits for all Americans by eliminating co-pays and deductibles and restoring free choice of physician.

The most fiscally conservative option for reform, single payor slashes private insurance overhead and bureaucracy in medical settings, saving more than $400 billion annually that can be redirected into clinical care.

“This is excellent news for the nation’s health,” said Quentin Young, MD, national coordinator of Physicians for a National Health Program and a past president of the American Public Health Association. “There is now an affordable cure for our dysfunctional health care system. In the face of our present economic calamity, this is an urgent necessity.”

The bill includes many attractive features. For example, patients may go to any doctor or hospital of their choice. The program is paid for by combining current sources of government health spending into a single fund with modest new taxes amounting to less than what people now pay for insurance premiums and out-of-pocket expenses. It promises comprehensive benefits, including coverage for dental, mental health, and prescription drugs.

By eliminating the high overhead and profits of the private, investor-owned insurance industry, along with the burdensome paperwork imposed on physicians, hospitals, and other providers, the plan saves enough money to provide comprehensive, quality care to all.

Additionally, community health centers are fully funded, giving the 60 million Americans now living in rural and underserved areas access to care. To address the critical shortage of primary care physicians and dentists, the bill provides resources for the National Health Service Corps to train an additional 24,000 health professionals.

“We are confident that Sen Sanders’ bill will accelerate the national drive for the only reform that we know will work,” Young said. “A majority of physicians endorse such an approach. According to Physicians for a National Health Program, 59% of US physicians support national health insurance. Two-thirds of the public also supports such a remedy. We remember well that President Obama once acknowledged that single-payor national health insurance was the best way to go. It still is.”

—James Markland

McKesson Responds to Stimulus with One of Its Own

McKesson Corporation took a cue from Washington and developed a support program around the Stimulus. Fueled by the passage of the American Recovery and Reinvestment Act, the Atlanta company launched a program that will help customers as they prepare to demonstrate meaningful use of information technology and qualify for the new government incentives.

“Achieve HIT” was created to assist physicians in optimizing and accelerating their efforts to improve care delivery. As part of the program, McKesson is offering an online information resource for physicians at www.mckesson.com/doctors. Also, a free physician hotline at (877) EHR-IMCK connects physicians or IT staff with McKesson representatives in order to discuss electronic health record requirements.

“The HITECH (Health Information Technology for Economic and Clinical Health Act) incentives represent a significant step toward enabling health care that’s safer, more efficient, and better connected,” said Pamela J. Pure, president of McKesson Technology Solutions. “By greatly lowering the barrier created by cost, the stage is set to accelerate the adoption of IT, particularly among physicians, the great majority of whom still rely on paper to practice medicine.”

Pure said she believes the incentives will drive the necessary workflow changes for hospitals to welcome computerized physician order entry and documentation, steps needed to fully automate a health system’s EHR.

The incentives have the ability to benefit both hospitals and health systems, which can deploy an EHR for the first time, complete an existing multiyear health IT project, or develop alignment strategies for virtual information exchange with affiliated physicians.

Pure pointed out that provisions in the legislation dealing with privacy, and system certification and meaningful use, will take time to clarify. Physicians, therefore, should start planning now to qualify for the incentives in the future.

“It’s time to see the industry unite and work aggressively to automate and connect health care,” Pure said. “It’s time to leave the paper behind and use technology to create and connect a virtual care team. McKesson is committed to leading this effort and providing health systems and physician offices of all sizes with the information, consulting, and planning tools required to build a strategic IT road map.”

Effective October 2010 for hospitals and January 2011 for physicians, the stimulus provisions allow for reimbursement incentives of up to $64,000 per physician based on the fulfillment of certain criteria. Hospitals can qualify for $2 million to $8 million in funding.

“McKesson’s unique ability to support large health systems and small community hospitals as well as employed physicians and independent physician groups of all sizes puts us in a unique position to drive and advise this critical health care transformation,” Pure said. “It’s important for providers to begin this work now to benefit from the incentives when they take effect in 20 months.”

—Elaine Sanchez

ARRA Allocates Funds for Hospitals to Treat Neediest

Millions of uninsured and low-income Americans are about to get additional aid through President Obama’s efforts to ensure access to health care for vulnerable patients. The US Department of Health and Human Services (HHS) announced that states can access $268 million authorized by the American Recovery and Reinvestment Act (ARRA) to help pay eligible hospitals to treat the most needy Americans.

HHS is the United States government’s principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves. The work of HHS is conducted by the Office of the Secretary and 11 agencies. The agencies perform a wide variety of tasks and services, including research, public health, food and drug safety, grants and other funding, and health insurance.

Hospitals eligible for the financial boost are those that serve a disproportionate share of low-income or uninsured individuals and are known as Disproportionate Share Hospitals (DSH). States receive an annual allotment to make payments to DSH facilities to account for higher costs associated with treating uninsured and low-income patients. This annual allotment is calculated by law and includes requirements to ensure that the DSH payments to hospitals are not higher than the actual costs incurred by the hospital to provide the uncompensated care. The Recovery Act increases the amount of allotments available to states from approximately $11.06 billion to $11.33 billion for 2009.

According to Acting HHS Secretary Charles E. Johnson, “Millions of people rely on the care provided by their community hospitals. Through the help provided by the Recovery Act, we can make sure they continue to get the care they need in those hospitals.”

The Centers for Medicare and Medicaid Services (CMS) will notify states about the availability of the increased portion of allotments for hospitals. Not all states spend their full DSH allotments so, before this new funding can be accessed, states must demonstrate they have used all of their existing fiscal year 2009 DSH allotments. States must request the additional funds from CMS as part of their quarterly Medicaid budget request and the funds will be distributed as separate Recovery Act DSH grants.

“Thousands of hospitals around the country are the first place many families take their sick children for care or the only place where some of the more than 45 million uninsured Americans can receive some form of health care,” Johnson said. “The funding from the Recovery Act will help ensure hospitals can keep their doors open to the people who need care most.”

—J. Markland