Saturday, August 31, 2013

ObamaCare’s architects reap windfall as Washington lobbyists

ObamaCare has become big business for an elite network of Washington lobbyists and consultants who helped shape the law from the inside.

More than 30 former administration officials, lawmakers and congressional staffers who worked on the healthcare law have set up shop on K Street since 2010.

Major lobbying firms such as Fierce, Isakowitz & Blalock, The Glover Park Group, Alston & Bird, BGR Group and Akin Gump can all boast an Affordable Care Act insider on their lobbying roster � putting them in a prime position to land coveted clients.

�When [Vice President] Biden leaned over [during the signing of the healthcare law] and said to [President] Obama, �This is a big f’n deal,� � said Ivan Adler, a headhunter at the McCormick Group, �he was right.�

Veterans of the healthcare push are now lobbying for corporate giants such as Delta Air Lines, UPS, BP America and Coca-Cola, and for healthcare companies including GlaxoSmithKline, UnitedHealth Group and the Blue Cross Blue Shield Association.

Ultimately, the clients are after one thing: expert help in dealing with the most sweeping overhaul of the country�s healthcare system in decades.

“Healthcare lobbying on K Street is as strong as it ever was, and it’s due to the fact that the Affordable Care Act seems to be ever-changing,” Adler said. “What’s at stake is huge. … Whenever there’s a lot of money at stake, there’s a lot of lobbying going on.”

The voracious need for lobbying help in dealing with ObamaCare has created a price premium for lobbyists who had first-hand experience in crafting or debating the law.

Experts say that those able to fetch the highest salaries have come from the Department of Health and Human Services (HHS) or committees with oversight power over healthcare.

Demand for ObamaCare insiders is even higher now that major pieces of the law, including the healthcare exchanges and individual insurance mandate, are being set up through a slew of complicated federal regulations.

�Congress is easy to watch,� said Tim LaPira, a politics professor at James Madison University who researches the government affairs industry, �but agencies are harder to watch because their actions are often opaque. This leads to a greater demand on K Street� for people who understand the fine print, he said.

�K Street’s agenda follows the government’s agenda. It’s not typically the other way around,” he said.

Watchdogs say the rise of the ObamaCare lobbyist is another example of the �revolving door� that turns public service into private enrichment.

�After passage of major legislation, those who have networks on Capitol Hill take exceedingly lucrative jobs with the same industries subject to the legislation,� said Craig Holman, a lobbyist for Public Citizen. �It raises questions about the [bill's] integrity.�

For K Street, healthcare lobbying has been a bright spot in what has otherwise been a down business cycle.

While lobbying revenue at major firms has been flat or declining in recent years, the healthcare law has generated steady work � a trend that is likely to continue for years to come.

That�s because ObamaCare runs on a long timeline � well into the next administration. Unless the law is severely crippled, the reform’s rules and requirements will be rolling out through at least 2020.

That�s good news for lobbyists who want to sign up clients for the long haul.

The windfall from the healthcare overhaul is being reaped at firms large and small. Some veterans of the legislative push have landed at boutique firms that are increasingly specializing in lobbying niches.

The firm Avenue Solutions, for instance, recently hired Yvette Fontenot, a former staffer for both the Senate Finance Committee, which wrote ObamaCare�s tax-related provisions, and HHS’s Office of Health Reform, which is assisting the implementation.

Since her hire in April, the four-woman firm has picked up Health Care Service Corp. as a client, and Fontenot is now lobbying for the Blue Cross Blue Shield Association and the National Electrical Manufacturers Association as well.

The Democratic firm banks about $3 million in revenue per year, records show, but is on pace for growth in 2013, earning $1.8 million through the first half of the year.

It�s not just ex-staffers who are becoming trusted ObamaCare guides � former members of Congress are lobbying on the law as well.

Former Rep. Earl Pomeroy (D-N.D.) joined Alston & Bird in 2011 after dealing with healthcare and tax issues as a member of the House Ways and Means Committee.

Now Pomeroy and his one-time chief of staff, Bob Siggins, are lobbying on ObamaCare for clients such as clients such as Vision Service Plan, the National Coordinating Committee for Multiemployer Plans and Medicare � a health insurance provider.

Consulting is another avenue former staffers and officials can take to work for outside interests while they look to comply with and shape the impending regulations.

�This is not a do-it-yourself project; it’s complicated,� said Adler. �They need help from insiders to help navigate this thing correctly.�

Former senior counsel to HHS Secretary Kathleen Sebelius Dora Hughes became a senior policy adviser at the law firm Sidley Austin last year.

Hughes is not a registered lobbyist, and told The Hill she mainly provides �strategic policy advice� while abiding by the ethics pledge not to lobby the administration. She has no congressional contacts in her sights, either.

Even the president needs some lobbying know-how when it comes to advancing ObamaCare.

The White House brought on Clinton administration veteran and former lobbyist Chris Jennings last month to help navigate the implementation of the law.

During a call with several directors of the state healthcare exchanges on Wednesday, Jennings was seated in a plum position � right next to Obama.

Friday, August 30, 2013

Money May Be Motivating Doctors To Do More C-Sections

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Wednesday, August 28, 2013

Northern Illinois Jobs with Justice Endorses HR 676

From Unions for Single Payer –

Mary Shesgreen, a member of the steering committee of Northern Illinois Jobs with Justice, reports that her organization has made a �wholehearted endorsement� of HR 676, Rep. John Conyers� national single payer health care legislation. Shesgreen said that most of the members of the steering committee have long supported HR 676.

�A single payer program as provided by HR 676 is the only affordable option for universal, comprehensive coverage,� states the resolution passed.

Hale Landes, a member of IBEW Local Union 134 in Chicago who is also on the Jobs with Justice steering committee, said that the resolution for HR 676 was unanimously adopted at a retreat on June 27. Landes is also on the Labor Outreach Committee of the Illinois Campaign for Single Payer.

�We support single payer for all because it is the right thing to do. We at Northern Illinois Jobs with Justice believe that healthcare is a human right,� said a release on behalf of the organization.

Northern Illinois JwJ is the 606th labor organization to endorse HR 676.

In other news, on July 30, 2013, three additional congresspersons signed on to HR 676, bringing the total of co-sponsors in the House to 48. The news ones are Reps. Carolyn B. Maloney (NY- 12), Robert A. Brady (PA-1), and Jose E. Serrano (NY-15).

Saturday, August 24, 2013

Another Study Of Preemies Blasted Over Ethical Concerns

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Another Study Of Preemies Blasted Over Ethical Concerns

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Friday, August 23, 2013

Fla. Balks At Insurance Navigators As Obamacare Deadline Nears

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More Options This Fall For Some Small-Business Workers

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Friday, August 16, 2013

Strange Bedfellows Among Groups Helping Insurance Buyers

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Thursday, August 15, 2013

Gingrich: Most GOP Lawmakers Have 'Zero' Ideas On Health Care

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Tuesday, August 13, 2013

Obamacare: People With Disabilities Face Complex Choices

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Thursday, August 8, 2013

'Paying Till It Hurts': Why American Health Care Is So Pricey

Listen to the Story 38 min 0 sec Playlist Download Transcript  

"We need a system instead of 20, 40 components, each one having its own financial model, and each one making a profit," says New York Times correspondent Elisabeth Rosenthal.

iStockphoto.com

It costs $13,660 for an American to have a hip replacement in Belgium; in the U.S., it's closer to $100,000.

Americans pay more for health care than people in many other developed countries, and Elisabeth Rosenthal is trying to find out why. The New York Times correspondent is spending a year investigating the high cost of health care. The first article in her series, "Paying Till It Hurts," examined what the high cost of colonoscopies reveals about our health care system; the second explained why the American way of birth is the costliest in the world; and the third, published this week in The Times, told the story of one man who found it cheaper to fly to Belgium and have his hip replaced there, than to have the surgery performed in the U.S.

Rosenthal has also been investigating why costs for the same procedure can vary so much within the U.S. � by thousands of dollars, in some cases � depending on where it's being performed. Before becoming a journalist, Rosenthal trained as a doctor and worked in the emergency room of New York Hospital, now part of New York-Presbyterian Hospital.

She joins Fresh Air's Terry Gross to talk about why American medical bills are so high, and what needs to change.

Enlarge image i

Rosenthal has worked at The New York Times as an international environmental correspondent, a reporter in the Beijing bureau, and a metro reporter covering health and hospitals.

Courtesy of The New York Times

Rosenthal has worked at The New York Times as an international environmental correspondent, a reporter in the Beijing bureau, and a metro reporter covering health and hospitals.

Courtesy of The New York Times Interview Highlights

On the goal of her health care series

"[The purpose is] to make Americans aware of the costs we pay for our health care. Because so many of us have insurance and we don't see the bills, we tend to think of health care as free. 'Why not get that colonoscopy? It doesn't cost anything. What's the difference if my hip replacement costs $100,000? I'm not paying.' But, in fact, we're all paying. And as we know, health care is a huge cause of individual bankruptcies now. Copays and deductibles are going up, and the nation � because it pays for a lot of medical care and subsidizes a lot of medical care � just can't afford the way we're doing this anymore."

On the man who went to Belgium to get a hip replacement

"In Belgium, he paid $13,660 for everything. That included his new hip implant, the surgeon's fees, the hospital fees, a week in rehab and a round-trip plane ticket from the U.S., soup to nuts.

"Now, if he had done that surgery in the U.S, it would've been billed at somewhere between $100,000 and $130,000 at a private hospital. ... So there's a huge difference. In fact, this gentleman, Mr. Shopenn, was a great consumer, and he tried to have it done in the U.S., and he priced out joint implants and found that the wholesale joint implant cost ... was $13,000. So in the U.S., for that $13,000 he could get a joint � a piece of metal and plastic and ceramic � whereas in Europe he could get everything."

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On joint-makers keeping prices high

"You would think that if five different companies were making candy bars, that would drive the price of candy bars lower. But if five different companies are making joints and trying to sell them at $10,000 a piece, it's really in no one's interest to say, 'Hey, guess what guys? I'm going to sell mine for $1,000 because that's what it really costs me to make it.' Because then everyone loses money; the whole industry kind of implodes."

On the challenge of standardizing medical equipment

"It's hard to get the companies to, say, standardize the equipment ... so you can use a generic system to implant any brand of joint. It's not in their interest to do that. It's like saying to Apple and Microsoft, 'We want all of your programs to be completely interchangeable.' At some level, at a business level, you want your brand distinct, and you want to keep people in the universe of your brand. In many ways, it's a business decision as much as a medical decision."

On how billing practices in the U.S. compare to those in Europe

"Routinely, for most procedures in other countries, patients stay in the hospital longer; their hospital bills are much less. They tend to see things as a package. I think one of the most striking things when you look at the Belgian hospital bill, as opposed to the U.S. one, is on the U.S. hospital bill for a joint replacement, you see things like operating room fees, recovery room fees. And those [were on] one of the bills I looked at: operating room fees, $13,000; recovery room fees, $6,000; facility fees, x-thousand dollars.

"If you look at a European bill, those things don't exist. And you know, in fact, it was kind of funny when I started on this series � although sad in another way � when I would call some of the European hospitals and say, 'Well, what's your facility fee on that? What's your operating room fee?' and there was this puzzled pause at the other end of the line where they said, 'What do you mean an operating room fee? You can't do the surgery without an operating room. That's a part of our day rate for the hospital. It's all included.' "

On pregnancy costs in the U.S. versus Europe

"Because we pay one by one by one, we have this kind of more-is-better attitude, or 'Why not check and see if the baby is in good position? Why not check and see if the baby is growing?' Whereas in most other countries, the care of a pregnant woman is kind of dictated purely by medicine, what needs to be done. So it's not that in these European countries they aren't getting their prenatal testing and they're not getting their prenatal scans � they are, they're just not getting as many as we do. Because we kind of tend to use a lot of them for like-to-know rather than need-to-know, and again, that gets very, very expensive."

On what needs to change

"Every part of the system needs to rethink the way it's working. Or maybe what I'm really saying is we need a system instead of 20, 40 components, each one having its own financial model, and each one making a profit."

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Tuesday, August 6, 2013

To Mark Medicare Anniversary, Lawmakers and Advocates Rally for Expansion of Program to Include Every American

U.S. Rep. John Conyers, U.S. Sen. Bernie Sanders, U.S. Rep Keith Ellison, Others Push for Single-Payer Health Care System

From Public Citizen –

WASHINGTON, D.C. � To mark the 48th anniversary of Medicare, congressional lawmakers and consumer advocates today called for Medicare to be expanded to provide health insurance to all Americans and highlighted a new study showing that a Medicare-for-all, or single-payer, system would save enough money to cover all of the 44 to 50 million uninsured Americans.

Participants in a rally outside the U.S. Capitol included U.S. Rep. John Conyers (D-Mich.), U.S. Sen. Bernie Sanders (I-Vt.), U.S. Rep. Keith Ellison (D-Minn.) other members of the Congressional Progressive Caucus and representatives from Public Citizen, Physicians for a National Health Program, Labor Campaign for Single Payer Healthcare, Kentuckians for Single Payer Healthcare, Health Care Now! and All Unions Committee for Single Payer Health Care�HR 676.The event was preceded by a congressional briefing about the cost savings of a Medicare-for-all system and followed by lobby visits.

Although the Affordable Care Act (ACA) is designed to ensure that many more Americans are covered by the time the plan is fully implemented, a single-payer system would achieve far greater savings than the ACA, which maintains the role of the costly and wasteful private insurance industry. It also would be less complicated to put into place because it is already in place for Americans over 65 in the form of Medicare.

�The solution to our nation’s healthcare crisis isn’t cutting Medicare,� said Robert Weissman, president of Public Citizen. �It’s strengthening Medicare and expanding it to cover everyone. A Medicare-for-all, single payer system will ensure that every American is covered as a matter of right, and will save hundreds of billions of dollars by eliminating costs imposed by the wasteful private insurance industry.�

The new study, done by Gerald Friedman, professor of economics at the University of Massachusetts Amherst and released today by Physicians for a National Health Program, shows that upgrading the nation�s Medicare program and expanding it to cover people of all ages would yield more than a half-trillion dollars in efficiency savings in its first year of operation, enough to pay for high-quality, comprehensive health benefits for all residents of the United States at a lower cost to most individuals, families and businesses.

Under the single-payer system envisioned by �The Expanded & Improved Medicare For All Act� (H.R. 676), the U.S. could save $592 billion � $476 billion by eliminating administrative waste associated with the private insurance industry and $116 billion by reducing drug prices � in 2014.

�The evidence is clear,� said Dr. Robert Zarr, a Washington pediatrician and national board member of Physicians for a National Health Program, �An improved Medicare-for-all program is the most equitable and cost-effective way to assure that everyone, without exception, gets high-quality care. As a doctor who sees hard-pressed patients every day, I can tell you that the need for fundamental health care reform has never been greater.�

Savings from a single-payer plan would be more than enough to fund $343 billion in improvements to the health system such as expanded coverage, improved benefits, enhanced reimbursement of providers serving indigent patients, and the elimination of co-payments and deductibles. The savings also would fund $51 billion in transition costs such as retraining displaced workers and phasing out investor-owned, for-profit delivery systems.

Medicare was signed into law on July 30, 1965.H.R. 676, introduced into the 113th Congress by Conyers and 37 co-sponsors, would establish a single authority responsible for paying for medically necessary health care for all residents of the United States.

�Access to quality, affordable health care is more than just a moral imperative,� said Conyers. �It is a basic human right. The Affordable Care Act was a first step in reforming our broken health care system, but it cannot be the last. Until our coverage is truly universal, I will continue to fight � alongside groups like Public Citizen � for single-payer health care that will deliver quality health care to all Americans.�

�It is long past time that we recognize health care is a right, not a privilege,� said Sanders. �It boggles the mind that today, in America, we do not guarantee high-quality, affordable health care for all of our people. I am proud that Vermont is leading the nation in working to establish a single-payer health care system to provide better care at less cost.�

�Medicare-for-all is the high road solution to the fiscal crisis impacting all levels ofgovernment,� said Mark Dudzic, national coordinator of the Labor Campaign for Single Payer Healthcare. �Instead of solving this crisis on the backs of working people, Dr. Friedman�s study shows how we can save hundreds of billions of dollars while making quality health care a birthright for everyone in America.�

Thursday, August 1, 2013

Will Obamacare Mean Fewer Jobs? Depends On Whom You Ask

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