Trick or Treat: House Democrats Finally Unveil Health Bill!

Posted on: October 29, 2009  |   Author: Yolonda
Filed Under: Healthcare Reform, Legislation, Medicaid, Medicare, Other, Tax & Finance   |   Leave a Comment

Today, House Democrats released a health bill amounting to 1,990 pages and costing around $894 billion. The bill broadly expands the Medicaid program by offering subsidies for moderate-income families to buy insurance from a government-run plan or from the private insurance industry. Members of the House estimated the bill would provide coverage to up to 36 million people and save more than $150 billion over 10 years from payments to private Medicare Advantage Plans.  Further, the government would sell health insurance in competition with private insurers with the intent to create more competition and force the private market to lower prices. This government insurance plan would negotiate rates with doctors and hospitals.

The bill also includes a provision that requires the secretary of HHS to negotiate drug prices on behalf of Medicare beneficiaries and would requires Americans to obtain insurance. Moreover, employers would be required to provide health benefits to workers, although small businesses would be exempt if their payroll was less than $500,000/year. Additionally, insurers could not deny someone based on pre-existing conditions and could not charge sick people with higher premiums. Children would also be able to stay on their parents’ insurance through the age of 26. Republicans criticize the bill as creating new unsustainable financial obligations and contend that the government with its Medicare fund already diminishing cannot afford supporting the bill. Additionally, opponents of the bill argue that a public option will drive private insurers out of the market. They further criticize Democrats for not listening to the American people and designing the bill to appease liberal special interest groups.

Commentary: The 1,990 page bill seems lengthy and daunting, and it is likely that more Americans will continue to express confusion and difficulty in being able to form valid opinions about the health bill since it is not easily comprehensible. I believe that both Republicans and Democrats have been trying to gain some input from the American people, but any opinions they may be receiving are either half-formed or invalid due to the complexity of health reform in general, and the fact that our lawmakers are introducing very lengthy and convoluted bills. Moreover, interest groups have tended to “fog” the facts or interpret the language of the provisions in a way that may be more biased towards the interests they are protecting, thereby making it harder for people to get an honest sense of the bill. It is highly doubtful that the average American will wake up on a Sunday morning with a cup of coffee and read the 1,990-page bill. Even if someone were to attempt to wade through the bill it is unlikely that they will easily understand what the provisions fully entail and how the provisions apply to them as an individual, parent, employer, or senior citizen.

The American people need something that consolidates and simplifies the provisions written within the bills. The Kaiser Family Foundation has created an online chart that outlines the previous provisions of the Senate Finance Committee, HELP Committee, and Tri-Committee bills. Although this tool is very helpful, it still requires going back to the actual bill text to get definitions for terms like “qualified health plan” or “essential benefits.” Who really has the time and energy to spend countless hours sifting through 1,990 pages of verbose legislative language? Hopefully, lawmakers or educators develop a way to provide the American people with an unbiased, detailed, and easily understood summary of the bill’s provisions so that Americans can become more proactive and educated about health reform and how it will impact them and their families.

New York Times, October 29, 2008

[Ed: For an excellent overview, see Saint Louis University School of Law Professor Sidney Watson's concise briefs regarding the iterations of the bill that have emerged thus far, posted at this blog within the "Related Links" sidebar.]

Public option back from the dead?

Posted on: October 26, 2009  |   Author: Phillip
Filed Under: Access to Care, Healthcare Reform, Legislation, Medicaid, Medicare, Other, Tax & Finance   |   Leave a Comment

The Democratic majority in the Senate late on Friday seemed to be making dramatic positive gestures toward the inclusion of a government-sponsored coverage plan in the final version of the Senate healthcare reform bill now in the hands of Majority Leader Harry Reid.  Working with House Leader Pelosi so that the two versions emanating from each chamber (sometime soon?) might have similarly-structured public option provisions, Reid and other Democrats largely feel that the political climate has “cooled” enough since widespread public opposition circulated in August to allow discussions of such an option to resume.

Remaining to be settled, however, is exactly what form such an option would assume.  Some more moderate Democrats in Congress have expressed no desire to support a plan which would be purely publicly financed, while most Republicans continue to offer no support at all for a government-created plan regardless of administration or financing.

The iteration most likely to be proposed would be a coverage plan designed for those without access to employer-sponsored insurance or an already-existing public option, financed largely through premiums and copayments, and privately administered.  Current estimates by the Congressional Budget Office project that fewer than twelve million individuals would sign up for coverage via the plan, but most of those now favoring its resurgence as an element of any reform bill see it as a necessary instrument to real cost-savings and enhanced access to care.

The Washington Post, October 24, 2009.

Generic Drug Patent Settlements

Posted on: October 23, 2009  |   Author: Ali
Filed Under: Drug & Device, Health I.P., Life Sciences, Other, Tax & Finance   |   Leave a Comment

Generally, most patent lawsuits are resolved when the accused infringer agrees to pay money to the patent rights-holder.  However, in patent infringement suits involving generic pharmaceutical manufacturers these agreements sometimes follow a different path.  Occasionally, the patent-holder will give the generic drug manufacturer money to delay the release of the generic drug (the Federal Trade Commission calls this a “pay for delay” deal).

These payments ultimately delay the introduction of generic drugs and FTC Chairman Jon Leibowitz estimates that “pay for delay” deals cost consumers, insurance companies, and the federal government spends an additional $3.5 billion each year (the drug manufacturers dispute this estimate).

The first example of this kind of deal was in 1994 when Bristol-Myers Squibb paid Schein Pharmaceutical $290 million to delay the sale of a generic version of Bristol’s Buspar, anti-anxiety drug.  Recently, drug purchasers, including CVS Caremark Corp. and Rite Aid Corp., challenged an agreement between Bayer AG and Barr Pharmaceuticals Inc. where Bayer paid Barr to delay producing a generic version of Cipro, an antibiotic drug.

In July, the Department of Justice stated that these kinds of settlements are “presumptively unlawful”.  Last week, the senate judiciary committee voted 12 to 7 to forbid these deals.  President Obama also supports a ban.

ABC News, October 15, 2009; Wall Street Journal, July 6, 2009; PatentlyO, October 16, 2009.

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