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City dropping health coverage at 20 agencies

May 15th, 2012 | Author:

Lexington’s Urban County Government is dropping health insurance coverage for 556 employees of “outside agencies” — organizations that are affiliated with, but not directly run by, city government.

Based on 2008 spending, dropping employees of the 20 organizations from Lexington’s insurance plan would save the cash-strapped city 6,218 a year, the difference between what it took in and what it had to pay out.

Among the organizations that will be making new health insurance arrangements are the Fayette County Health Department, Kentucky League of Cities, Lexington Housing Authority, Lexington Convention & Visitors Bureau, Lexington Parking Authority and the Lexington Urban League.

“The satellite agencies had been paying only their premiums,” said Susan Straub, spokeswoman for Mayor Jim Newberry. “… They were not funding the full cost of their health care.”

Over the past three years, the city has shelled out .2 million to supplement the insurance premiums paid by the employees of outside agencies.

In late November, Newberry said the city might consider layoffs, pay cuts, furloughs and the elimination of city programs to stem an estimated shortfall of million to million. City government division directors were asked to propose ways to cut expenses by 5 percent.

The council approved cutting health insurance for outside groups on Dec. 8. In all, the city offers health insurance to 3,622 workers and retirees, whose health claims outpaced revenue by .5 million last year.

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Most of the agencies will have until Dec. 31, 2010, to finish their new health care plans, but some — such as the Fayette County Health Department — will switch to new insurers within the next month.

Health Department Commissioner Melinda Rowe said city officials told her the agency should be covered by the state’s health insurance program. Instead, the department chose a plan offered by Bluegrass Family Health.

Still, the cost of premiums paid by the department could go up by more than 0,000 over two years, Rowe said.

Not providing health insurance to employees was never considered, she said.

“Obviously, we’re the health department; we have got to concentrate on our own employees and their wellness,” Rowe said.

P.G. Peeples, president of Lexington’s Urban League, said his organization’s insurance options are limited because it has only six employees. He hopes to band with United Way agencies or other Urban League offices to build the number of employees needed for a large bargaining pool.

“I’m disappointed they’re going to remove this option,” Peeples said. “I understand that they’re trying to do cost savings.”

How did the city wind up providing insurance benefits for agencies outside city government?

“For the most part, we don’t really know,” Straub said. “We inherited this situation, and the arrangements have apparently been in place for a number of years.”

Jan Isenhour, director of the Carnegie Center for Literacy, said the center’s budget initially came from the city, so its inclusion in the health pool seemed logical.

In 2003, the center became an “outside agency” and started taking over its own finances but remained in the city insurance group. The Carnegie Center hasn’t started pricing outside health policies; it has another year on the city’s plan.

Meanwhile, the city continues to look for other ways to shift expenses to outside agencies.

Ed Lane, councilman for Lexington’s 12th district, said the city might soon consider asking outside agencies to contribute money toward the upkeep of city office space they occupy.

“The recession puts a lot of strain on government to provide all the services necessary for the taxpayers, but it also gives us an opportunity to look at what are essential services and what are non-essential services … to try to maximize the efficiency of government as much as we can,” Lane said.

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Disastrous State of U.S Health creates a need for companies like Health Check Costa Rica

May 12th, 2012 | Author:

Health Check Costa Rica’s true inception began when my baby sister developed hepatitis C from a bad blood transfusion in the late 1980′s. We rallied as a family and when she bounced back after a year I really thought that we had averted this crisis permanently. I knew she had to take some medication but in every other way things were back to normal. Little did I know that 15 years later the disease had taken a toll that required her to seek a full liver transplant. The year we spent battling this with her was a year I will never forget. This was a year that had me inside a hospital almost every single day. I sold my house and quit working so that I would have money to help and to be by her side full time. I saw from the inside exactly what was good and what was bad about our health care system. What struck me was that like in so many walks of life there was the good and the bad that needed to be accepted and sometimes shades of gray not easily interpreted. But some iniquities were simply too harsh. What struck me and stuck with me during this experience, the observations that both affected me and often infuriated me is why I eventually formed Health Check Costa Rica.

From the stories that I heard and the people I met it in the hospital it was very clear and quite tragic that there were people dying every day because they were being turned away from quality care from lack of funds or adequate insurance. I truly thought this iniquity to be inexcusable in a country of such wealth and majesty. It screamed of injustice and seemed so random as to be akin to rolling dice. If you had good insurance or worked for the right company or had the right education then you were Ok. If not you were turned out to die. It’s that simple. It’s that harsh.

Ultimately my sister’s Hospital bills topped out at over a million dollars. In seeing those numbers and seeing the astronomical prices for certain things it occurred to me that no one could really afford this except for the top .01% of the population. So how could we even as a society afford this? Where did these prices come from? Well I translate it something like this. These are insurance companies paying these bills. Patients are not usually going line by line and challenging certain outrageous costs. No these are insurance companies approving these expenses and then meeting behind closed doors to figure out how to pass this on to the consumer and still make a buck. Hence the ridiculous prices for health insurance and ultimately health care and really why a majority of people remain uninsured. The health insurance companies have dropped the ball and the thinking is “as long as we are making our percentage, well the higher the better.”

Lastly litigation has helped skyrocket the price of care and really has forced doctors in to a no win situation. An OB GYN in Florida is required by law to pay as high as 0,000 dollars per year for medical malpractice insurance. That’s right, 200k before they can make a dollar for themselves. Who do you think ultimately pays this? You the consumer! One additional reason so many remain uninsured is this lack of long overdue tort reform and absurd compensations. Finally the tragic result I saw with my own eyes in my sister’s case was these high powered surgeons in high risk areas were forced to carry such a heavy case load to pay off these insurance costs that none were able to give their patients the care or personal attention they needed or the attention they deserved. They were forced to use lesser skilled underlings to catch complex diagnoses and symptoms and I can tell you straight up. THIS DOES NOT WORK. The system is terribly broken.

The day my sister finally left Spaulding Rehabilitation hospital in Boston was the day I set out on my adventure to Costa Rica with my jeep Cherokee loaded for jungle survival. With all my computer equipment and clothes, my dog Seikan and I began our long dangerous drive to Costa Rica, neither of us with any Spanish just a lot of hope for a new life. Costa Rica really has much to offer and we have enjoyed living here and working and while many of things we take for granted in the United States do not exist here conversely neither do many of the bad things. I am constantly struck by the lack of sirens, and airplanes each time I hear this it is surprising to me. Infrastructure still has a long way to catch up to the US but one of the big surprises I had when I began research for Health Check several years ago was that the overall health care system was ranked higher than the United States in the world in overall quality of care, and has an incredible network of internationally accredited Hospitals, surgeons, and after care facilities that rival the care in the US. The people of Costa Rica have the second longest life spans of all countries in the world, and were ranked in a worldwide study as some of the happiest people on earth. As I continued my studies in to this business I realized that it was possible to form a service that would allow people in the United States and Canada to seek out quality affordable health care close to home at up to an 80% discount with all of the worries of organizing details and itineraries to us. People who could not afford health care could suddenly have access to truly quality health care less than three hours away from many major airports in the U.S. To me this was more than a business opportunity it was an opportunity to make a difference in peoples’ lives, a chance to serve and a chance to help. With this in mind please understand that if you book a procedure through Health Check Costa Rica we take very seriously you every care and comfort once you land in Costa Rica. Our research and experience in finding the right doctor, dentist or after care specialist will take the burden off of you and your family and let you prepare for your procedure with peace of mind. We will introduce you to only the best of the best in Costa Rica and give you a chance to meet and establish a relationship with the surgeons who will be performing your procedures long before you arrive. We work with only the best and most trusted tour companies, hotels, and transportation services and we can create packages for every budget. So please let us help. Whether it is for any procedure large or small, from Hip Replacement, gastric bypass, or Plastic Surgery, from Angioplasty to In Vitro Fertilization, you owe it to yourself to choose the best care for you. Please allow health Check Costa Rica to make the introductions and present options to you. We look forward to serve you and many others.

Health Check Costa Rica is a medical tourism facilitator site helping patients find the right doctors and hospitals for their procedure. health Check only works with accredited institutions and offers door to door concierge style services with custom itinerararies in Costa Rica. It is our pleasure to serve.

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Even a ‘scaled-down’ health bill is dangerous

May 10th, 2012 | Author:

Last week, Democratic leaders in the Senate caved to Sen. Joseph Lieberman’s demands and stripped away some major provisions from their health reform legislation, including the public option and a plan that would have allowed middle-age Americans to “buy in” to Medicare. With Connecticut independent Lieberman’s support seemingly secured — for the time being — the president announced that Congress was “on the precipice” of passing comprehensive reform.

But even without these controversial components, the Democrats’ bill would still put government in charge of nearly all Americans’ health care. Patients would have fewer choices in the insurance marketplace, and taxpayers would be on the hook for a multibillion-dollar expansion of the public health care system.

Ultimately, these moves will dramatically drive up the cost and worsen the quality of health care in America.

A key element of the Democrats’ reform bill is an individual mandate, which would legally require people to purchase insurance. Starting in 2013, everyone would have to own a plan that met government specifications or pay a fine.

Proponents of such a mandate claim that it will broaden the insurance risk pool to include those who may not currently have insurance, which would eventually lead to lower premiums for everyone. Previously uninsured younger, healthy Americans would effectively subsidize older and less healthy patients.

Mandating everyone to dive into the insurance pool may seem like a good idea, but it represents a profound assault on individual freedom.

The federal government will decide what constitutes an acceptable benefit plan and what people pay for it. Government will also control how doctors are paid by insurance companies and, ultimately, how they practice medicine.

Congress does not legally force Americans to spend their own money on any other particular good or service — why should health insurance be any different?

In fact, for some Americans, health insurance isn’t a wise use of funds. Young people and health fanatics, for instance, might well shell out premiums for medical services they likely won’t use.

And those premiums can be hugely expensive. The average premium for family coverage is a whopping ,300 a year. That rate is only going to go up if the Democrats’ plan passes.

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The nonpartisan Congressional Budget Office recently estimated that individual insurance premiums under reform would be 10 percent to 13 percent higher by 2016 than they would in the absence of reform. In certain states, the increase in premiums would be even higher.

In California, for instance, the average healthy 25-year-old man would see his premiums rise 106 percent thanks to the Democrats’ reform plan. Premiums for a typical Virginia family with two children would increase 82 percent.

Some folks might be best served by paying for routine health expenses out of their own pockets rather than relying on expensive and inconsistent insurance policies.

These increases in the cost of insurance are largely the result of the reform plan’s array of new controls on insurers. Paramount among these controls is a requirement that insurers issue a policy to any customer who requests one, regardless of one’s medical history or health status.

In those states that mandate “guaranteed issue,” the regulation has induced patients to wait until they actually need medical care before purchasing coverage. In order to cover the cost of an insurance pool filled exclusively with sick people, premiums must be sky-high. Indeed, guaranteed issue has driven health premiums up by as much as 200 percent in some states.

The Democrats’ reform package would also install a national “community rating” ordinance, which would restrict insurers’ ability to charge different prices to different enrollees according to their health status. It would also impose new limits on out-of-pocket spending and require all insurance plans to include certain benefits, like maternity leave and newborn care, even if a patient didn’t want them.

These rules are meant to make health coverage more affordable and robust for more Americans. But they’ll do just the opposite.

Mandated benefits can increase the cost of a basic insurance policy by up to 50 percent. And by forcing insurers to charge both the sick and the healthy similar rates, community-rating regulations virtually guarantee that everyone pays more.

Instead, we need low-cost, pragmatic policies that drive down health prices without impinging on individual freedoms.

A great first step in that direction would be for Congress to allow people to buy insurance policies across state lines.

States regulate insurance differently. Some require policies to cover a long list of procedures. Others effectively prevent competition among carriers. As a result, the price of a basic insurance plan varies dramatically from state to state.

For instance, a 25-year-old male in New Jersey has to shell out about ,600 for a basic insurance policy. His counterpart in Kentucky can get a similar policy for just ,000.

Currently, Americans can only purchase policies approved for sale in the state where they live. Allowing them to shop around for the best deal would instill competition and drive down prices.

Lawmakers could take a second step in the right direction by enacting major medical malpractice reform. One in eight doctors gets sued for malpractice every year.

These suits cost about 0,000 on average to defend, even though doctors are found innocent 90 percent of the time.

To avoid getting dragged into expensive legal proceedings, many doctors engage in “defensive medicine,” ordering more tests and procedures than necessary. This practice added 4 billion to national health costs in 2006 and drove more than 3 million Americans into the ranks of the uninsured.

Implementing some commonsense tort reforms — like a 0,000 cap on noneconomic damages — could reduce these costs without compromising patient care.

Congressional Democrats have been forced to trim some of their more grandiose ambitions for health reform. But the bill remains a bloated, big-government monstrosity. American taxpayers and patients alike simply can’t afford the Democrats’ vision for health reform.

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Why Health Care Reform Could Leave Us All Worse Off

May 1st, 2012 | Author:

The health care reform bills being debated in Congress threaten to shut out millions of immigrants. But Congress’ exclusionary policies toward immigrants will not simply leave immigrants worse off. They will inevitably jeopardize the nation’s economy and the health of all of us.

President Obama has prioritized health care reform to ensure that millions of Americans have a fair, affordable and efficient health care system. For immigrants, this vision is far from a reality. First, the current health care reform bill treats legal immigrants unfairly. Individuals who have waited years to come to the United States will be required to wait years in order to obtain affordable health care.

Immigrants are generally younger and healthier than the U.S. population at large. However, no one is immune to falling ill or having an accident. The current health care bill would require recently arrived, legal immigrants to wait five years to obtain the only option for affordable health care coverage, Medicaid. While low-income citizens will have access to Medicaid, the most vulnerable among us will continue to wait for affordable health care despite the fact that they pay taxes for the very programs from which they are excluded. There is no sound reason for Congress to discriminate against these individuals and prevent them from receiving basic medical care.

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Congress and the White House also took an unprecedented step to prohibit individuals from buying — with their own hard-earned money — an American good that could help their families. The Senate version of the health care bill forbids undocumented immigrants from purchasing private insurance at full cost in the newly created insurance marketplaces. As a result, undocumented immigrants as well as their family members, who are often U.S. citizens or legal immigrants, will likely remain uninsured and will be forced to seek care in the emergency room.

The costs of providing health care for undocumented immigrants will not disappear after passing health care reform. It is unlikely that millions of immigrants, whose contributions keep up our standard of living and our economy functioning, will be deported. Instead, the cost of care will become the financial responsibility of the patient, the provider, the local and state governments, and every single taxpayer. Moreover, in order to exclude a few, there will be additional forms, documents, and bureaucrats that the rest of us will be subjected to. Buying the mandated health insurance could feel like a trip to the Department of Motor Vehicles. Taxpayers will have to pay millions for this additional red tape and delay, all to keep a few people from buying health insurance with their own money.

Providers, employers, consumers, religious leaders, and state and local governments recognize that these policies are short-sighted and will cost all of us more in the long-run. Policies that attempt to exclude and ostracize immigrants also disproportionately harm all communities of color and immigrant-rich states like California and New York, further widening existing inequities in our nation. Yet because immigrants live in all 50 states, the intended and unintended consequences and costs of these restrictions will be far-reaching.

Ending discriminatory and exclusionary policies in this final round of negotiations is not only a matter of fundamental fairness and sound economics. It is required in order to not leave all of us worse off. Congress has a short window of opportunity to remove the restrictions on legal and undocumented immigrants in the health care reform bill. Doing so will not jeopardize the passage of the bill. Failing to doing so, however, will leave all of us, immigrant or not, worse off and wondering what happened to the promise of health care reform.

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Florida health insurance block health-care reform

April 25th, 2012 | Author:

On his first day as Florida’s new House speaker, Rep. Dean Cannon took a clear shot at President Barack Obama’s new health-care reform law. Easy To Insure ME has the answers

“Should it really be the role of government to require people to purchase a health insurance product they don’t want, raise taxes to give that same product to others who can’t afford it, and commandeer our state government and its resources to carry it out?” Cannon, a Winter Park Republican, told House members after being sworn in two weeks ago.

“Or, should we work to limit government and empower the private sector?”

On numerous fronts, Florida policymakers have already answered that question.

While the fight against President Obama’s health-care reform may be centered in the Beltway, Republican resistance to the sweeping new mandates is also taking shape in Tallahassee. Among the battlefronts:

• Florida led the charge with 19 other states last March by challenging the law in federal court, claiming the mandates that uninsured people buy coverage violated states’ rights. A judge in Pensacola is expected to rule shortly after a Dec. 16 hearing on whether the suit can move forward. More states are expected to join after a new crop of state attorneys general are sworn into office in January.

•Last spring, GOP legislators hastily drafted a constitutional amendment spelling out that Florida businesses and residents couldn’t be forced to buy insurance, but a Tallahassee judge threw it off the November ballot for “misleading” language. Lawmakers have re-filed an altered version and hope to place it before voters in 2012.

•And perhaps most significantly, legislative leaders are poised to block spending and rules necessary to implement the law. Already, state regulators has refused to impose minimum spending mandates that might generate refunds for consumers – but which health insurers say will hurt their profits. And Gov.-elect Rick Scott has also made clear he doesn’t want the state doing anything to help the law along.

The Patient Protection and Affordable Care Act passed last spring anticipated that the states would lead the way on many of its more than 100 changes to the nation’s health care system. With 3.8 million uninsured residents, Florida is one of the states that would be most affected by the law.

The most controversial reforms – including the requirement that individuals buy coverage or pay a penalty — don’t start until 2014, and phase-ins continue until 2018. But the bill requires states to start working now to improve their data-collecting and enforcement mechanisms.

It was hoped states would create their own insurance exchanges, to match individuals with insurance plans; establish “high-risk” pools to insure people now shunned by providers; and police new restrictions on insurance company profits.

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But Gov. Charlie Crist opted last spring not to immediately tap into federal grant money to create a Florida high-risk pool to cover people with pre-existing medical conditions, deferring to the federal government. And now Cannon, R-Winter Park, and Senate President Mike Haridopolos, R-Merritt Island, may seek to block any cooperation by the state.

Florida has been awarded million in grants to provide 0 rebates to seniors who fall into the “donut hole” in the Medicare prescription drug program; to help prepare the Office of Insurance Regulation to evaluate out-of-state insurers seeking to sell health coverage in the state; and to plan for creating a health-care marketplace, or “exchange,” and other changes.

But even before he was officially named speaker, Cannon warned Crist that no state agency should take any steps to comply with the law “without clear and comprehensive guidance from the Legislature.” The Oct. 19 letter demanded an itemized accounting of all state agency activities regarding the federal law.

Specifically, the letter singled out the Office of Insurance Regulation for work it has begun – and which legislative budget-writers approved – to study how Florida’s health-care laws should be amended to conform to the federal reform, and to boost the state’s ability to handle new rate-filing data.

“Not only are Florida insurance officials helping the federal government to write rules on these matters, but [OIR] is jumpstarting these new regulatory functions by developing data systems necessary for enforcement,” Cannon complained.

He added: “We intend to develop a clear and statutorily-defined framework for Florida agencies’ activities in regard to the federal health law. Pending such legislative action, state agencies should examine each anticipated action or function in light of their specific statutory authority.”

Laura Goodhue, executive director of Jupiter-based health-care advocacy group Florida CHAIN, said the criticism appeared designed to bully agencies into slowing their efforts to follow the federal law.

“I know transparency is important in implementing laws, but creating a chilling effect is certainly not helpful,” said Goodhue, who attended meetings with OIR over the last year as part of an advisory health insurance board.

In response, most all of Florida’s state agencies produced itemized lists of what they had done — down to how many staff hours Department of Management Services staff spent examining new rules requiring lactation rooms and milk storage for breast-feeding mothers in the workplace.

Cannon spokeswoman Katherine Betta said last week that Cannon’s staff was still reviewing the responses and hadn’t decided “what the next step will be.”

OIR communications director Jack McDermott defended his agency’s work, adding there was no intent to be “an advocate for the implementation of federal healthcare.”

“Virtually all of this information — whether it is actual review of large group rates, or expanding data systems to collect additional data – would require additional statutory authority or administrative rules,” McDermott e-mailed in response to questions.

And recently, OIR decided to slow one of the new law’s reforms – by not imposing new profit limits on health insurers beginning Jan. 1.

A new federal “medical loss ratio” requirement would force insurers to spend 80-to-85 percent of the premiums they collect on medical care, with the remainder set aside for overhead including executive salaries and profit. Nearly half the country’s insured population are covered by providers that spend more than that on overhead and profit.

Florida’s “medical loss ratio” is 65-to-70 percent, and OIR will ask the federal government for a three-year waiver from the tougher standard, said McDermott.

At a recent hearing, most of Florida’s main health insurers complained that the new standard would hurt their bottom lines and restrict the Florida insurance market. Insurance Commissioner Kevin McCarty agreed, saying he feared making the change next year would “destabilize” the market and hurt competition.

The move could have a pocketbook implication for Floridians.

The law requires insurers to provide rebates to customers if they exceed the overhead limits in 2011. The feds estimate the rebates could average 4 for individuals in 2012. But if OIR wins the three-year delay, Florida consumers won’t be eligible for those checks in 2012.

“To me, the delay obviously would be helpful to the insurance companies and HMOs, and not to the patients,” said Senate Minority Leader Nan Rich, D- Weston. “That’s less money for care for patients.”

Legislative conservatives like Rep. Scott Plakon, R-Longwood – who’s re-filed the constitutional amendment that says Floridians could not be compelled “directly or indirectly… to participate in any health-care system” – say they are determined to fight every way they can.

Plakon’s House Joint Resolution 1 has already picked up a prime sponsor in the Senate: its new leader, Haridopolos.

“We have to follow the law. But in the process, we need to put Floridians first,” Plakon said. “So if there is any room there, we would default to the position of putting Floridians first instead of this kind of massive federal takeover.”

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This Week in Health Care Reform EasyToInsureME health insurance

April 24th, 2012 | Author:

JANUARY 22, 2010

This Week in Health Care Reform

After months of public debate and private negotiations, health care reform discussions stalled following Tuesday’s Senate vote in Massachusetts. The Democratic Senate lost its 60th vote supermajority when Republican Scott Brown was elected to the United States Senate in the Massachusetts special election.

Health Care Reform Negotiations Post-Massachusetts Special Election

Massachusetts Election of Senate Republican Recasts Debate: Following the election of Republican Scott Brown to the Massachusetts Senate seat Tuesday night, Democratic leaders have been scrambling to revive what could now be a dying bill. The loss of the Democrat’s 60th vote in the Senate opens up the legislation to a Republican filibuster – something the Democrats have managed to avoid thus far in the debate.

House and Senate Democrats met this week to discuss how to move forward with the reform legislation in light of this election and promised Wednesday that they would push ahead. There are a number of options that Democrats are considering, but at this point they have not charted their course.

On Wednesday, Speaker of the House Nancy Pelosi (D-CA) attempted to rally House Democrats around a strategy to push the Senate bill through the House and onto President Barack Obama’s desk so as to avoid the need to again secure 60 Senate votes. However, the Speaker indicated on Thursday morning that she did not believe she has the needed 218 House votes necessary to move forward. This option would have allowed lawmakersto then propose additional modifications to the approved legislation through a process called “reconciliation,” which only requires 51 votes in the Senate.

Other remaining options:

1.
House and Senate Democrats could also quickly complete the merging of the two bills and vote on the combined package before Mr. Brown is sworn in.
2.
Democratic leaders could attempt to re-engage Sen. Olympia Snowe (R-ME), the only Republican who voted for the Senate Finance Committee’s bill passed in October. Democrats would need to allow her to amend the bill so that she could support its passage and give Democrats the needed 60th vote; or,
3. House and Senate Democrats could essentially start over in their respective chambers and propose scaled-back versions of the bill under “reconciliation” procedures or regular order. Reconciliation procedures would greatly limit the scope of the legislation to issues only related to raising or spending federal funds; therefore, many provisions, such as creating new insurance exchanges and an individual mandate, might be excluded.

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President Obama seemed to indicate that he favors having House and Senate lawmakers start over again and produce a scaled-back bill. In addition, more moderate Senate Democrats – hesitant to push through such a huge partisan bill in light of the Massachusetts election – urged leaders to slow down.
Sen. Jim Webb (D-VA) has called on Senate leaders to suspend voting on health care reform until Mr. Brown is sworn into office. President Obama and Senate Majority Leader Harry Reid (D-NV) have iterated this same message. Further, Sen. Joe Lieberman (D-CT) called for a bipartisan effort as the best way to achieve health care reform legislation.

Health Care Reform Negotiations Prior to Massachusetts Special Election

Senators Urge Guarantee of Government Savings: In a letter sent last Thursday to Sen. Reid, five Democratic Senators asked for the inclusion of a “fail-safe mechanism” in the final bill. This mechanism would give Congress “the tools to keep costs under control should the current savings estimates fail to materialize.”

Both the Senate and House versions of the bill rely heavily on reductions in government spending, particularly around Medicare, to help pay for reform. Republicans and some nonpartisan analysts believe the government will not follow through on these spending reductions, which will lead to soaring costs.

President Obama Pushes for Less Protection for Biologic Drugs: Last Thursday President Obama pushed for a change in the health care reform legislation that would reduce the number of years that biologic drugs were patent protected from generic competition, previously set at 12 years. White House officials and Rep. Henry Waxman (D-CA) were negotiating for 10 years protection or less.

Members of the news media speculated that the move to reduce biologic drug protections could be a leverage point for President Obama to pressure the drug industry to increase contributions to pay for health care reform. In fact, the Wall Street Journal reported that Congressional Democrats had already asked drug companies to contribute an additional billion or more, over and above the billion which the industry agreed to early on in the reform negotiations.

President Obama Strikes Deal with Unions: Last week Democratic negotiators struck a deal with union officials and conceded to union demands to scale back a tax on high-end insurance plans. The deal would exempt union workers from having to pay the tax until 2018, five years after the tax would apply to other workers. While the deal would help gain union support for the bill, it would also reduce the amount of tax revenue generated by about 40 percent, to billion. As such, Democratic leaders would need to find other sources of revenue to make up the difference.

Public Opinion

Exit Poll Indicates Health Care Reform as Hot Button Issue: As the ballot polls closed on Tuesday night’s Massachusetts Senate election, an exit poll conducted by Frabrizio, McLaughlin & Associates indicated that 52 percent of voters said that they oppose the federal health care reform measure and 42 percent said they cast their ballot to help stop President Obama from passing this legislation. In addition, 48 percent said that health care was the single issue driving their vote.

Polls Show Discontent: The latest Wall Street Journal/NBC News poll indicated that almost half of Americans believe the health care reform bill in Congress is a bad idea (46 percent). This figure is up dramatically from April when only 26 percent believed the plan was a bad idea. Further, just 33 percent say the plan is a good idea. Nearly half of those surveyed (48 percent) believe that passing the current legislation would be a “step backward.”

In addition, a new Quinnipiac University poll showed that public support for health care reform continues to decline. Thirty-four percent mostly approve, while 54 percent mostly disapprove. At the end of December, 53 percent of Americans mostly approved, while 36 mostly disapproved.

Looking Ahead

Currently, the path to health care reform is unclear. Democrats seek a way to secure the necessary votes to pass the legislation, and some now question the value of pushing such a large bill. President Obama had hoped to see a final bill prior to his State of the Union address, which has been scheduled for January 27; however, it appears this goal is likely out of reach.

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