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BLOG: President Bush’s SCHIP Veto And Health Reform Prospects: A Health Wonk Review



October 4th, 2007
by Jane Hiebert-White

It’s the morning after President Bush’s veto of the reauthorization of the State Children’s Health Insurance Program (SCHIP). How did a program that started out with such bipartisan support become the health policy wonk equivalent of all-out war? Today’s Health Wonk Review takes a look across the blogosphere for some health policy soul-searching.

Politico blogger Ben Smith rounds up the Democratic presidential candidates’ responses to the veto. These range predictably from “outrageous” (Barack Obama) to “cruel” (John Edwards) to “tragedy” (Joe Biden) and “unconscionable” (Chris Dodd). The Washington Post’s blog “Capitol Briefing” by Paul Kane examines the move among Congressional Democrats to override the veto. The votes are there in the Senate, but the House is another matter. And Michael Cannon on Cato@Liberty says, “just let SCHIP expire.”

Futurist and health policy wonk Jeff Goldsmith, writing on the Health Affairs Blog, bemoans the “dysfunctional policy process” and has plenty of blame to dole out for both Democrats and Republicans:

“The SCHIP authorization is, sadly, merely the warm-up for the 2008-09 debate. “Covering the kids” is actually the feel-good part of health reform. Our political system is well and truly broken, singularly lacking in statesmen of any political persuasion. And it isn’t fooling the voters, who have given both this White House and Congress record-low approval ratings. If politics as presently practiced in Washington continues, we will not have a just and affordable solution to this complex and vexing problem any time soon.”

The ever savvy Bob Laszewski takes an analytical look at how the political shift to center is affecting the health reform debate. He proposes on his Health Care Policy and Marketplace Review blog that yelling “Hillary Care” may work for the Republicans with their own in Iowa, New Hampshire, and South Carolina in January but it will backfire come November 2008 if Republicans don’t have more on the table by then.

And over on The Health Care Blog, Jeff Goldsmith writes again on insurance and reform. He supposed that things were getting better, and that made health policy wonks feel worse. Brian Klepper didn’t exactly agree with Goldsmith’s wisdom!

Presenting the view of a politician in the trenches, Sen. Tom Daschle writes a two-part commentary on politics and a practical paradigm for health reform in HFMA Views. Here’s Part 1 and Part 2.

Speaking for the ethicists, Daniel Goldberg argues on the Medical Humanities blog that the imperative for increasing access to health care exists more on the moral level rather than on an assumed link between access and improved health. On The Agonist, Ian Welsh also gets into the distinction between health care and insurance in his post on Hillary Clinton’s health care proposal.

Joe Paduda of Managed Care Matters predicts we haven’t seen anything yet on the health reform front. He writes that Wal-Mart may be poised to take a much more active role in delivery of health care to their customers.

Paying For Insurance Coverage: But how do we pay for increased access? In a post “Taxing our Vices”, Louise writes on the Colorado Health Insurance Insider about an alternative to the regressive tobacco tax to fund SCHIP. Grrl Scientist asks: “So why does this rich country have so many people who cannot afford health insurance?” She turns to a report by Familes USA for a few answers. Jimmy Atkinson of the Nursing Online Education Database blogs on 10 facts you never new about SiCKO. Number one? It’s not about lack of insurance.

Looking to the States: Beyond the health politics in Washington, a number of bloggers examined health reform at the state level. David Harlowe writes on Healthblawg about trends in senior care with a look at a new law in Massachusetts, a pending section 115 “community first” waiver, and a brand new group home model sponsored by a local home care agency. Jon Coppelmen of Worker’s Comp Insider posts about how the Ohio Supreme Court is having trouble deciding whether worker’s compensation is truly a “no-fault” coverage or should employees who flout safety rules be excluded?

Around the Globe: Jason Shafrin takes a look on The Health Economist at the “grudge match” between Canada and the US–who’s healthier. For all the U.S. spending on health care and a higher level of access to care, it’s not looking good. New blogger Zagreus Ammon on the Physician Executive looks at the other end of the international health rankings, saying we’ve ignored the implications of being at the bottom. Myanmar is second to last and “melting down.”

Pharma: On the pharmaceutical front, the ever-interesting David Williams of Health Business Blog writes about AstraZeneca’s plans to outsource its production. He says it may sound like a good idea, but there are a number of reasons why it’s not so wise.

On Drug Channels, Adam J. Fein analyzes Wal-Mart’s expanded generic drug pricing program–and its disappointing profits. Interestingly, they’re not necessarily cause-and-effect. Fein also takes a critical look at two bills pending before Congress (S.1951: Fair Medicaid Drug Payment Act and S 1954: Pharmacy Access Improvement Act of 2007).

Over on InsureBlog, Henry Stern asks: Does CDC go overboard with all its recommended vaccines? And Roy Poses of Health Care Renewal asks whether pharmaceutical and other health industries are too involved in the clinical research process.

Health IT: Neil Versel of the Healthcare IT Blog offers two posts. In the first he lists a wide range of health IT-related companies and wonders who will still be here in the future. In the second post, he writes about one of these companies: Healia, a U.S. developer of a health-specific Internet search engine, who has created a game on the social networking site Facebook to test consumer knowledge of health issues.

Health Blogging: Lastly Fard Johnmar reminds us to participate in the 2nd annual global survey of health care bloggers, brought to you by Envision Solutions, LLC and Trusted.MD Network. Deadline is October 15.

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