I’ve commented with brief support for Texas Senator John Cornyn in the past. More, I’ve posted on the ridiculous notion that his polling numbers give the Democrats some hope in 2008. With novice Mikal Watts out of the hunt for the Democratic Senate nomination (”hunt;” in actuality a nomination which would be difficult to give away), we’re left with only state representative Rick Noriega. Good luck.
And despite the tinge of sarcasm, I might actually be wishing Rep. Noriega luck in the election. I saw Senator Cornyn at his nephew’s wedding recently, and always have generally liked him. But what type of statement is this on the failed SCHIP renewal?
Mr. President, the families and the children in my state of Texas who are, unfortunately, put on edge and suffering some sense of anxiety wondering whether this important program will continue to serve the needs of low-income children, are being, unfortunately, taken advantage of and disadvantaged. Why in the world would Congress play this kind of game and make those that are the most vulnerable among us the most anxious about their future and whether they will be able to get the health care which everyone in Congress believes that low-income children ought to receive?
The emphasis is my own. My understanding is that Texas’ funding for SCHIP is secure for the next 2 years no matter the renewal infighting in Washington. Texas’ enrollment is capped for children of families at or below 150% of the poverty level. About as low as any state.
Noriega Responds To Cornyn On SCHIP
I know who his constituents are, but this SCHIP expansion vote (and more distressingly, his now enumerated reasoning behind such a vote) belies Senator Cornyn’s total disregard for the larger public good. Under Cornyn’s watch federal spending has increased faster than any Congresses since LBJ was in the White House. There’s no argument that the cost of the expansion to the Texas taxpayers is too great. At least not from Senator Cornyn considering his voting record.
[W]e have 700,000 low-income Texas children who qualify for Medicaid, who qualified for SCHIP, but who are currently not signed up and receiving those benefits. Instead, Congress is taking its eye off the ball and exploding this sensible program that deserves to be authorized by raising the eligibility cap to 300% of the poverty level, but doing nothing — I reiterate nothing — to insure that low-income children, including 700,000 low-income children in Texas, have coverage first before we grow the program to higher income levels and cover adults as well.
This is nonsensical from the Senator. It isn’t like Washington has failed. There is little enrollment effort to be done from DC. The ridiculous number of eligible children in Texas who are not on the SCHIP roster is a failure of the government in Austin and has absolutely nothing to do with the machinations in Washington.
Argue the SCHIP bill on the merits Senator Cornyn, get your facts in order, or get off the stage.
What can say after garbage like this? A vote is one thing, but to finally read his position for such a vote is another. Cheer, cheer for Rick Noriega I guess.
Tony Millar said firefighters told them it was the work of a buck-toothed saboteur that had been gnawing on overhead power lines connected to a transformer directly above the 2006 Toyota Camry.
“The squirrel chewed through the wire, was set on fire, fell down directly to where the car was,” Tony Millar said. “The squirrel, on fire, slid into the engine compartment and blew up the car.
The final vote was 265-142, with 43 Republicans joining 220 Democrats to support the measure. Rep. Jim Marshall (D-Ga.), one of the most endangered incumbents in the House who hails from a conservative district, was the lone Democrat to join Republicans in opposing the measure.
Those 43 Republicans are almost identical to the 45 who supported the original bill in late September, with one Republican who previously supported the SCHIP bill - Rep. Don Young of Alaska - absent today. Another early supporter, Rep. Vern Ehlers (R-Mich.), switched to a ‘nay’ vote today.
If all their supporters were on hand for another veto override, Democrats would still be almost 15 votes short of the two-thirds majority needed to defeat Bush. (Last week’s override vote fell 13 short of the two-thirds majority of the 429 members who voted.)
The expansion is truly dead. As Paul Kane points out, there are no more votes to garner,
Each of those lawmakers are on DCCC target lists, but none would ever make it onto The Fix’s Friday line as being in imminent danger of losing his or her seat. And, now that they’ve voted three separate times against an SCHIP expansion, it’s almost impossible to envision these lawmakers flip-flopping unless the bill is dramatically reshaped.
Texas is secure for a couple years in its SCHIP funding and gains very little from the Dems bill in Washington. For other states let’s just get a reauth of the program in place and not wait into November where they’ll have to get yet another emergency reauth in place.
Speaking at the Web 2.0 Summit in San Francisco, Mayer outlined the ways in which the search giant plans to bring its immense data storage and organization capacities to the field of medical care and patient records. Google is already the starting point for a large majority of the health-related searches on the Web, she pointed out.
“If you look at health care, there’s already a huge user need, people are already using Google more than any other tool on the Web to find health information,” Mayer said. “And the health care industry generates a huge amount of information every year. It’s a natural core competency for us, to understand how to organize all that data.”
I’m actually all for these types of services and have only limited concerns about patient privacy. If patients fear for their privacy then they won’t use them; let the market sort it out. That being said, the Google exec could’ve been a little less blunt about the objectives…
“The goal for a lot of doctors is how many patients can they see in a day,” Mayer said. “That means their minutes per patient has got to go down, and the less time they have to spend finding and going over patient records the better. Ultimately we will design a product that’s useful for users, and also helps doctors do their job more quickly and more efficiently.”
In his drive to kick-start the French economy by creating a culture of hard work, Nicolas Sarkozy believes those who chose to retire early - under 65 - should not benefit from free health care.
As a result, thousands of Britons living across France were sent “brutal” letters last week from the department of social security informing them that they would no longer be welcomed as non-paying customers of France’s hugely efficient - and traditionally extremely generous - national health service.
The letter stated that, under a change of rules which is due to take effect on Sept 30, any foreign resident who had retired early would lose their right to free state health care.
All expatriates who have taken advantage of the rise in British property prices to take early retirement in France, where houses are much cheaper, will have to surrender their documents entitling them to state health care.
They will face potentially crippling private health care bills.
Off of medicine for a moment and on to civil liberty sort of things.
Senator Dodd is causing a ruckus by attempting to put a hold on a Senate intelligence bill which spells out some warrantless wiretapping stuff, including apparently granting immunity to any telecos who turned over records to the NSA (which, by the way was carrying on warrantless wiretapping of Americans before 9/11 it now looks like).
That’s all nice and good, and admittedly I’m not exactly happy at my neighborhood teleco for their wimptastic lack of backbone in this whole ordeal. But protection from some civil suits (this shouldn’t even be discussed as a criminal matter) should pale in comparison to the loss of business if this country had any civic sense about it.
I’m never ready to heap a whole ton of social responsibility on the commercial sector. Not to be an apologist but if the government is telling them it’s a requirement, I’m not sure we should expect them to pay their legal department to protect the constitution.
Okay, that doesn’t sound right. We should expect such of them, but the most appropriate avenue is probably to speak by your checkbook.
I’m sure plenty will have legitimate suits when if the whole breadth of the ordeal becomes known, and there’s some nobility in trying to keep those avenues open.
The Senator from Conneticut is worth some praise for promising a fillibuster if Senate Majority Leader Harry Reid doesn’t recognize his “hold,” which would I admit be pretty remarkable (Reid’s disregard for Senate tradition…not the fillibuster). But as the clapping for Senator Dodd dies down just realize this is small potatoes; the real responsible party in this mess is obviously not the phone company but the White House.
Senator Dodd On A Potential Fillibuster
As such the real question is, despite the “compromise” Congress managed with the White House, where was Senator Dodd’s filibuster when the actual FISA renewal bill came up? That’s what we really needed.
The failure of the House to override the S-CHIP veto is disappointing. Now even the program itself is at risk, not just its expansion.
The 273-156 House vote was 13 short of the two-thirds majority needed. Despite a two-week campaign by proponents, only 44 Republicans voted to override, one fewer than had originally supported the bill.
The White House and some leading backers of the legislation immediately urged negotiations on a compromise to extend the children’s program, which serves about 6 million youths. But, after a House debate that turned acrimonious, it remained unclear whether they would find common ground.
Bush has designated Health and Human Services Secretary Mike Leavitt, White House Budget Director Jim Nussle and economic advisor Allan B. Hubbard to negotiate with Congress.
Leavitt said the president wants to prevent any disruptions in coverage. But the two sides seem far apart.
Okay, all of that is hyperbole. We all know that S-CHIP has essentially become an entitlement and that the emergency funding heads through November. S-CHIP will get reauth’d before this session is done.
All of that said, no one who found the gall to be on the nay side of this list will ever get a vote from me; and they shouldn’t from you either.
It isn’t the outright objection to the program that upsets me. I can understand that. Instead, it’s the way this bill went down. Wide support for the program but not for this expansion?
Since I first wrote this post I had an opportunity to speak with a member of congress who voted against both the bill and the veto override attempt but who obviously, as the vast majority, supports the program itself. It was the typical arguments against the bill. He cited that 1.8 million of those newly eligible would come off private insurance. That doesn’t come anywhere near jiving with the CBO numbers.
Miscellaneous if ever a post was such but here is a website whose sole purpose is to tell you if it is Christmas yet. I don’t know why, but I thought it was hilarious. Shameful but I laughed out loud.
I Watch It Every Christmas Right After A Christmas Tale
As part of his progress, Everett has developed enough strength to hold himself up briefly on a walker, and he can also use his feet to push himself around in a wheelchair, The Associated Press reported on Tuesday.
“He’s making very solid and noticeable progress,” Eric Armstead, an associate of the player’s agent, Brian Overstreet, told AP. “He’s very excited.”
Armstead regularly visits Everett, who entered the second phase of his recovery process three weeks ago when he was transferred to Houston’s Memorial Hermann Hospital rehabilitation center.
Armstead said Everett is now able to open and close both hands, another significant step after he showed only slight movement in his fingers while spending the first two weeks of his recovery in Buffalo.
There’s still no timetable as to when Everett will be released from the hospital and continue his rehab as an outpatient. Everett currently spends about four to five hours a day in physical and occupational therapy sessions.
Watching some of my neuro patients go into inpatient physical therapy centers, I imagine PT is a pretty damn tough thing. Largely for the slow, immethodical progress for the effort you put in. Keep up the strong work Kevin. I hope we continue to see him make progress.
May Alzheimer’s no longer be a clinical or post-mortem diagnosis? Looks like a blood test from researchers at Stanford might have a pretty good sensitivity for identifying those with cognitive impairment who will progress to Alzheimer’s.
Though premature, the test’s potential is garnering huge attention. In one experiment using stored blood samples, it proved positive for the disease in 38 out of 42 patients who had already been independently diagnosed.
According to Pelosi the House is just thirteen votes short of overturning Bush’s veto. Of course, the vote is a mere 2 days away (scheduled for October 18th). Failing that, there’s word from the House there may be com-pro-mise on refunding SCHIP. Better than nothing, the emergency funding won’t last long and the most important thing is renewing the program, although the expansion would be nice.
At the least, according to The Seminal here are the list of the Congressmen most likely to change their vote,
Rodney Alexander (LA-05)
Michelle Bachmann (MN-06)
Roscoe Bartlett (MD-06)
Judy Biggert (IL-13)
Brian Bilbray (CA-50)
Gus Bilirakis (FL-09)
John Boozman (AR-03)
Ginny Brown-Waite (FL-05)
Steve Chabot (OH-01)
Barbara Cubin (WY-AL)
John Doolittle (CA-04)
Thelma Drake (VA-02)
Tom Feeney (FL-24)
Randy Forbes (VA-04)
Rodney Frelinghuysen (NJ-11)
Scott Garrett (NJ-05)
Kay Granger (TX-12)
Sam Graves (MO-06)
Robin Hayes (NC-08)
Dean Heller (NV-02)
Wally Herger (CA-02)
Kenny Hulshof (MO-09)
Tim Johnson (IL-15)
Rick Keller (FL-08)
Joseph Knollenberg (MI-09)
Randy Kuhl (NY-29)
Tom Latham (IA-04)
Thaddeus McCotter (MI-11)
Marilyn Musgrave (CO-04)
John Peterson (PA-05)
Thomas Reynolds (NY-26)
Peter Roskam (IL-6)
Bill Sali (ID-01)
Jim Saxton (NJ-03)
Tim Walberg (MI-07)
Greg Walden (OR-02)
Jerry Weller (IL-11)
Bob Etheridge (NC-02)
Jim Marshall (GA-08)
Mike McIntrye (NC-07)
Gene Taylor (MS-04)
If one of these is your representative, please contact them.
[W]hat good is universal coverage if no physicians exist to provide the care? If universal coverage is achieved, the physician shortage will intensify. This is already happening in Massachusetts, the state farthest down the path of coverage-for-all.
There are some fundamental flaws in Dr. Reece’s well thought out thesis. The primary one of course is the out dated assumption this country faces a physician shortage. I think his assumption is based off of outdated data and essentially anecdotal evidence such as physician surveys, in contrast to the actual numbers. The point is no one should be still taking the pending physician shortage as fact.
I don’t think the data supports a generalized physician shortage and I don’t think the majority of pundits still do either. From the October 2004 Health Affairs,
During 1980–2000 the total number of physicians in the United States increased from 467,679 to 813,770, while the physician-to-population ratio grew from 207 to 296 per 100,000 people. This remarkable growth in the workforce will continue for a number of years with current rates of physician training.
The 20 years from 1980 saw even the primary care per capita numbers grow 41%. True, the U.S. has substantially fewer physicians per capita than other OECD nations, but this has been true over the whole history of modern medicine and doesn’t represent some sort of new shortage. This country doesn’t even have a shortage of generalist thinks to J-1 visas and foreign medical graduates. We can discuss the aging population and the perceived greater burden on primary care physicians, but we don’t have a shortage in the sense that we’re not meeting the per capita levels of the past.
What this country does have is regional shortages and basically a long standing shortage of primary care physicians in the sense that the ratio of PCPs to specialists is inefficient and promotes poorer public health. Indeed it is one of the lowest ratios of any OECD country.
Outdated Data Shows The Regional Differences In PCP Density
Although he doesn’t frame it as such, I think what Dr. Reece may be getting at (and what I agree with) is that this country has too few primary care physicians. Over the past fifty years we haven’t lost physicians but the percentage of physicians practicing as generalists has certainly fallen. That is a shame, and I’ve always thought that.
But that isn’t something insurmountable by system reform. In fact, considering how GME is funded in this country, it is one of the easiest things for the reformers to address.
I agree with the post in the sense that poor reimbursement for too much work drives American graduates of allopathic medical schools from going into primary care. But I don’t agree with the final conclusion. Dr. Reece seems to think that a single payer system, with poorer reimbursement, will drive students away from primary care.
Make no mistake about it Dr. Reece, any comprehensive single payer system will simply solve this problem by limiting the number of specialist GME training oppurtunities, increasing the number of primary care training spots, and limiting the geographic locations students can train. End of story. That’ll efficiently fix the problem of distribution or at the least the primary care “shortage” in this country.
I did my undergrad work in USC's School of Cinema-Television Cinematic Arts. I have a Bachelors of Fine Arts in Writing for Screen & Television. I loved it, but a future of waiting tables and taking meetings with B-List producers was not for me.
This blog is ostensibly to discuss healthcare policy and maybe educate a few of my fellow medical students. But it will stray into current events, politics, and other science topics when they draw my interest
Other odd notes about me:
I've skied half the resorts on this list (Squaw Valley/Lake Tahoe, Snowbird/Park City, Whistler, Taos, Vail)
I "played" lacrosse in high school and through a club level team in college
Nothing on this website is to be taken as medical advice. I am not a physician. Please consult a physician concerning any health related questions.
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- Mark Lanier
