There has been some drama going down on The Hill in case you haven’t been paying attention. This year was arguably the closest physicians have ever come to having the Sustained Growth Rate formula automatically reduce their reimbursement under Medicare.
Medicare is supposedly a fixed budget system when it comes to paying providers like physicians. Built into the system is something called the SGR. The SGR is a formula. Whenever Medicare goes over its fixed budget in a fiscal year (which is every year essentially) the SGR is used to determine how much physician payments from Medicare should be reduced so that (hopefully) Medicare will be back under budget the following fiscal year. Every year as July approaches and the SGR cuts are supposed to go into effect physicians freak out and organized medicine makes a major push for Congress to forestall the cuts. And every year that seems to happen, except that Congress can’t seem to come to a consensus on eliminating the SGR system altogether and instead only revoke the cuts on a year by year basis.
This year, per the formula, Medicare physician reimbursement was supposed to be cut by more than 10% across the board. So if a doc got $200 for hitting a patient with a reflex hammer on June 29th then he’d get less than $180 for doing the same thing on July 2nd. As has become standard Congressional leaders pushed forward a bill to prevent those cuts from taking effect. The bill is HR 6331 also known as the Medicare Improvements for Patients and Providers Act of 2008.
It sailed through the House of Representatives.
In the Senate however some Republican Senators were upset because the halt in the physician pay cuts was “paid for” by reducing some income streams for private Medicare insurers. While the Senate had enough votes to pass the measure they did not have enough to prevent the Republicans from stalling and preventing the bill from even being called for a vote. And they certainly did not have enough to override President Bush’s threatened veto.
The cuts for physicians were supposed to go into effect July 1st and that day came and went without the Senate being able to act on the bill because of the stalling tactics by Republican Senators. Luckily CMS decided to hold physician reimbursement claims to wait and see if the Senate might eventually act on rescinding the SGR cuts.
In a dramatic turn of events the Senate did just that. Senator Ted Kennedy, currently undergoing treatment for a GBM, returned to the Senate to break the deadlock. As soon as it became apparent the bill was going to be called for a vote some Republican Senators turned around and announced their support for the bill.
The patriarch of the Kennedy family entered the chamber, alongside Democratic presidential candidate Barack Obama (Ill.), to a rousing ovation from senators on both sides of the aisle, some of them tearing up. Greeted with hugs and handshakes, Kennedy, bearing a big smile, went to the well and declared loudly, “aye” in support of the legislation.
Democrats cheered loudly, and Sen. Charles Schumer (D-N.Y.) was seen blowing a kiss to the Republican side of the chamber.
[…]
Kennedy’s presence Wednesday, along with the reality that Democrats had the votes lined up to move ahead, was enough to flip nine of the 39 Republicans who previously voted against the bill. The bill was approved by a 69-30 margin, more than enough to override an anticipated presidential veto.
Among those who turned around their support were both Texas Senators - John Cornyn and Kay Bailey Hutchinson. The initial refusal to support the bill so enraged the Texas Medical Association that it withdrew it’s support from Cornyn in his upcoming race to retain his Senate seat. Although I’m sure it should surprise no one if they turn around and restore it considering Senator Cornyn is a likely shoe-in to keep his Senate seat.
The Hill newspaper had this to say about the role of the two Texas Senators in switching their allegiance to the Democratic point of view on the bill,
Soon after Hutchison’s vote, her Texas Republican counterpart, Sen. John Cornyn (Texas), flipped his vote, prompting more cheers and smiles from the Democratic side of the aisle. Cornyn had lost an endorsement from the Texas Medical Association and had been the subject of heavy criticism and attack ads from the American Medical Association for voting to block the bill last month. The group said that Cornyn and Republicans were putting insurance providers before doctors who would need to limit access to Medicare beneficiaries if they received a 10.6 percent cut to their reimbursement rate from the government.
Cornyn had been trying to push through a separate, longer-term fix, but Democrats objected. Finance Committee Chairman Max Baucus (D-Mont.) called Cornyn’s bill a “big warm kiss” to doctors without fixing the problem. In unusually sharp terms, a frustrated Cornyn called Baucus’ comments “insulting remarks.”
But with his Texas counterpart voting yes and the bill appearing likely to clear, Cornyn was boxed in a corner.
“I made a commitment all along that the cuts would not go through,” Cornyn said after his vote for the bill. “I still think the legislation is flawed and the idea of doing this every six months or 18 months is a terrible way to do business… I would hope the majority would consider legislation that would permanently resolve this. But it reversed the cut, and that’s the commitment I made to the physicians of my state.”
“I support the primary objective of this legislation, to forestall reductions in physician payments. Yet taking choices away from seniors to pay physicians is wrong. This bill is objectionable, and I am vetoing it,” Bush said in a statement to the House.
But he can obviously suck on it considering the result.
Come Down To My Basement…I’ve Got Candy Down There…
Organized medicine is certainly facing a little bit of a faith crisis. From those they’re supposed to represent come cries that the AMA, specialty and state societies do not do enough for [put individual specialty here]. From the interested public and other interest groups comes cries that the AMA, specialty and state societies move to benefit the physician over the patient.
Throw amongst those pragmatic concerns the intellectual and long held criticism that organized medicine suppresses the supply of physicians and the scope of non-physician practice and is thus inherently anti-free market.
I’ve ignored this topic for long enough considering my considerable involvement in leadership roles within organized medicine and my libertarian leanings.
The clamoring from far right wing free market speakers like the late Noble Laureate above (who I respect considerably, despite the little joke above) and crazy think tanks like the Ludwig von Mises Institute is that the AMA is essentially a guild whose will the government has succumbed to. In a publication titled “100 Years of Medical Robbery” the think tank has this to say about the history of the American Medical Association and its goals:
In the days of its founding AMA was much more open–at its conferences and in its publications–about its real goal: building a government-enforced monopoly for the purpose of dramatically increasing physician incomes. It eventually succeeded, becoming the most formidable labor union on the face of the earth.
To accomplish the twin goals of artificially elevated incomes and worship by patients, AMA formulated a two-pronged strategy for the labor market for physicians. First, use the coercive power of the state to limit the practices of physician competitors such as homeopaths, pharmacists, midwives, nurses, and later, chiropractors. Second, significantly restrict entrance to the profession by restricting the number of approved medical schools in operation and thus the number of students admitted to those approved schools yearly.
The emphasis is my own.
I’ll offer a candid response to this. Through it’s history the AMA appears to have focused largely on improving physician income. Perhaps not as single minded or nefariously as the Ludwig von Mises Institute would have you believe but it remains. And the AMA has had considerable success doing such. The allowance of self governance that medicine enjoys and the sway it holds over the scope of practice for other providers is incredible. I think there are some real issues of ‘patient safety’ buried in these efforts. Even so it is clear that the AMA has a vested interest in restricting what nurse practitioners or chiropractors or optometrists are allowed to do under the law thus maintaining the physician monopoly over some income streams.
Organized medicine was responsible for the Flexner Report and continues to hold the greatest sway over the number of physicians this country will (or will not) have by controlling the LCME and ACGME. To argue some conspiracy to suppress the number of medical students (and thus number of future physicians) through these entities is baseless. But the fact such control exists shows organized medicine’s influence. Combine such with the AMA’s success in limiting the practice of other health care providers and you can see why it draws the ire of some libertarians.
Government regulations on the chiropractic profession, lay midwifery, and on the freedom of nurse practitioners to offer services within their competence, all of which make perfect sense from the point of view of the medical guild that lobbied for them, make no sense at all from the point of view of consumer wishes (as repeatedly expressed in polling data) or from economic considerations. In many cases, such people can provide health services far more cheaply than can licensed physicians (or, in the case of chiropractors, can provide services that licensed physicians do not provide at all), but consumers are prevented from making their own decisions regarding their medical care. Given the logic of the guild structure, no one has the right to be surprised to find that the AMA has put so much effort into undermining its professional opposition.
There is nothing wholly unique about physicians’ efforts towards this. Other professions do the same and also limit their membership through limiting education spots (see: lawyers). It is just that medicine has been so successful at it.
I will accept the blows Milton Friedman lands against the American Medical Association but let me make an argument on why organized medicine’s actions are reasonable despite violating the libertarian ideal.
Let us call what the AMA and the rest of organized medicine does a necessary evil. It might not have been through all of its existence granted but today it is. It is because physicians are not playing on a level, free market playing field.
Breaking news: Per CQ Today, the Senate Finance Committee has reached an agreement to (once again) hold off on the 10% Medicare fee cuts due Janurary 1st.
Senate Finance Committee leaders have reached a deal to delay for six months a 10 percent cut to Medicare physician pay rates and extend funding for children’s health insurance, a Republican committee aide said Monday.
The legislation, being written now, would stop the Medicare cuts set to take effect Jan. 1, the aide said. Chairman Max Baucus , D-Mont., and ranking Republican Charles E. Grassley , R-Iowa, agree on the package with a few outstanding details to be resolved, according to the aide.
The Senate would take up the package as a standalone bill. “The idea is for the Senate to hotline it and then send to the House,” the Republican aide said.
I guess I should’ve seen that coming, but I had seriously wrote off them postponing the SGR cuts this year. This after we were so close with fixing the SGR once and for all with that first edition of the SCHIP expansion bill. But it looks like, as usual, physicians will get a six month reprieve.
But Nothing You Can Do Senator Can Force The State’s Hand
Senator Cornyn continued to insist that we should be focusing on enrolling the children currently eligible under SCHIP. Trouble is Texas is a terrible state as an example of that. Despite our relatively low eligibility requirements, we leave more eligible children off the roles than any other state. And your proposal from Washington to help fix this Senator? The Senator’s response.
What about the rest of the country Senator Cornyn? The states who take all their federal money off the table? If you think you have a dedication to provide access for children then you need to realize it is impossible to get them all without getting some cost shifting (some children going from private to public forms of health care funding). Impossible. The CBO has already claimed that the predicted cost shifting under the Democrat’s SCHIP plan was about as reasonable as you are going to get.
So any continued opposition is merely a vote against children having healthcare. And I’m sorry if I’m starting to sound like the bleeding hearts I sometimes rant against, but I’m not trying to. It’s a real position if you don’t think anything is owed to these children but don’t argue that the way the current SCHIP bill is trying to provide insurance to children is flawed. The most unbiased and reasonable sources are all against you.
President Bush vetoed an expansion of the federally funded, state-run health insurance program for poor children for a second time Wednesday, telling Congress the bill “moves our country’s health care system in the wrong direction.”
The program currently covers about 6 million children whose parents earn too much to qualify for Medicaid — the federal health insurance program for the poor — but who can’t afford private insurance.
Democrats wanted to extend the program to another 4 million, paying for it with a 61-cent-per-pack increase in the federal tax on cigarettes.
“What a sad day that the president would say that rather than insuring [millions of] children, ‘I don’t want to raise the cigarette tax,’ ” said House Speaker Nancy Pelosi.
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.
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.
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.
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.
I Don’t Have To Like Them To Applaud This Particular Effort
Americans United for Change are running the above ad in the districts of some key Republican congressmen to try to pressure them into voting to overturn Bush’s veto on SCHIP. Probably about the only tactic the liberal umbrella group and I have ever agreed on.
For Some Reason I Don’t Trust You To Make The Smartest Decisions
The veto of the S-CHIP expansion came with the biggest cry being that it would drive currently privately insured children onto the federal rolls.
The current confrontation stems as much from the White House’s desire to use the bill reauthorizing the State Children’s Health Insurance Program to advance Bush’s proposals to expand health insurance coverage through tax breaks as it does from his budgetary concerns. The idea was a major focus of the State of the Union address, and Bush and his advisers tried throughout the spring to interest lawmakers in attaching the measure to an SCHIP bill.
“Look, I disagree with the [White House] legislative staff on all of this,” said Sen. Orrin G. Hatch (R-Utah), a key negotiator on the vetoed bill. “Frankly, I think the president has had pretty poor advice on this. I can answer every objection that they’ve made, and I’m very favorable to the president. I know he’s compassionate. I know he’s concerned about these kids, but he’s been sold a bill of goods.”
Speaking in Pennsylvania, Bush again made the claim that the expansion would federalize health care and shift the burden of children’s health care from parents/families who could afford health care to the federal government.
CBO estimates that the legislation would increase the number of children enrolled in SCHIP or Medicaid by a total of 6.1 million by 2012. As noted above, CBO estimates that 4 million of these would be children who would otherwise be uninsured.
In other words, nearly two-thirds (66 percent) of the children who would gain SCHIP or Medicaid coverage under the bill are children who would otherwise be uninsured, not children who would otherwise have private coverage.
CBO estimates that the other 34 percent of the children who would gain SCHIP or Medicaid coverage under the bill otherwise would have some type of private insurance. But as CBO director Peter Orszag and other leading health experts have explained, under the fragmented U.S. health insurance system, virtually any effort to cover more of the uninsured — including efforts that rely on tax deductions or credits for the purchase of insurance in the private market — would result in some crowd-out (i.e., in the substitution of one type of health insurance for another). A crowd-out effect of 34 percent is actually quite modest.
Though the program officially expired on Sept. 30, emergency funds currently allow the program to continue — at least for the time being.
Congress has already passed legislation which would reauthorize and expand the program by adding $35 billion over five years, and covering an additional 4 million children — a plan funded by raising the federal cigarette tax by 61 cents to $1 per pack.
The State Children’s Health Insurance Program is a joint federal/state program to insure low income children. The least offensive redistribution of wealth imaginable. Here’s a summary of it. Even I’m a a pom-pom waving supporter of the program.
Currently there’s a big fight in Washington over it. In case you somehow missed it, the decade old program was set to expire this year but today the Senate passed HR 976, thus following the lead of the House which had earlier passed the same bill. The House however didn’t pass the bill by enough to overcome President Bush’s threatened veto.
The House on Tuesday passed a bill providing health insurance to more than 10 million children, but supporters of the measure fell short of the two-thirds majority they would need to override a veto repeatedly threatened by President Bush.
Explaining his objections, Mr. Bush said, “The bill goes too far toward federalizing health care and turns a program meant to help low-income children into one that covers children in some households with incomes of up to $83,000 a year.”
And thus lies the real debate. The reauthorization of SCHIP expands the program in several ways. Notably it allows states to increase the eligibility to children of families at 300% of the federal poverty level. That’s potentially an extra 4 million uninsured children and billions of dollars over the next decade. However screwed up the federal poverty level is as a measure of true poverty, is it really appropriate to relieve a family of four, living off >$60,000 of the responsibility of providing insurance for their children?
It is a legitimate debate. I’ve said it before when I was up lobbying the Texas legislature for the state level reauthorization earlier this year, and I’ll say it again…I don’t know where the level should be drawn in terms of eligibility. However even as I admit that, and in a little bit of a shocker for my usual steadfast libertarian position, I’m willing to err on the side of caution in this case and back the legislation sitting in front of Bush, rather than let the SCHIP program expire.
I’ve talked before about where the line should be drawn concerning CHIP qualification. The government providing for children, whose parents can’t provide, is something else than the dream of ‘universal coverage’. There’s some reason to it, even from the libertarian end I’m occupying.
The question is which families should qualify for assistance in providing for their children’s health? Apparently, with the SCHIP renewal, Congress drew the line too low…
The Bush administration, continuing its fight to stop states from expanding the popular Children’s Health Insurance Program, has adopted new standards that would make it much more difficult for New York, California and others to extend coverage to children in middle-income families.
Administration officials outlined the new standards in a letter sent to state health officials on Friday evening, in the middle of a month-long Congressional recess. In interviews, they said the changes were aimed at returning the Children’s Health Insurance Program to its original focus on low-income children and to make sure the program did not become a substitute for private health coverage.
Noble goals, but I think trying to determine what ‘low income’ is when it comes to being able to afford health insurance for your children is a difficult deal.
The poverty level for a family of four is $20,650 in annual income. New York now covers children in families with income up to 250 percent of the poverty level. The State Legislature has passed a bill that would raise the limit to 400 percent of the poverty level — $82,600 for a family of four — but the change is subject to federal approval.
California wants to increase its income limit to 300 percent of the poverty level, from 250 percent. Pennsylvania recently raised its limit to 300 percent, from 200 percent. New Jersey has had a limit of 350 percent for more than five years.
More than $82,000 for a family of four? Even in NY; are you kidding me?
Among the conditions that will be affected are bedsores, or pressure ulcers; injuries caused by falls; and infections resulting from the prolonged use of catheters in blood vessels or the bladder.
In addition, Medicare says it will not pay for the treatment of “serious preventable events” like leaving a sponge or other object in a patient during surgery and providing a patient with incompatible blood or blood products.
In many ways this short report spouts things that seem like common sense but there are things to be worried about in this move. Before I ramble off into my complaints know that I’m relatively consumer oriented for a health care provider (or future one). I believe P4P can work in the right situation, I believe in transparency and quality measure reporting.
That being said I have problems with what little I know about this CMS move. Healthcare is not selling a television or even cooking a steak; it is sadly more like commissioning a piece of art. Try returning that painting. I’m not saying there shouldn’t be real standards or that health care can’t learn something from the retail world, but let’s not pull out ridiculous cliches like “the customer patient is always right” or try to stamp some sort of “satisfaction guaranteed” deal on healthcare.
It doesn’t work that way.
We can all agree that things like leaving sponges inside of patients is unacceptable. No one should get extra cash for creating work for themselves. But bed sores and line infections? The problem I have here is that the burden is on the hospital to prove they didn’t cause something by neglect.
[A vice-president for the AHA] said that some of the conditions cited by Medicare officials were not entirely preventable. Commenting on the proposed rules in June, the American Hospital Association said, “Certain patients, including those at the end of life, may be exceptionally prone to developing pressure ulcers, despite receiving appropriate care.”
This isn’t them documenting and defending a procedure they did in order to collect a fee. This is them trying to disprove something. Is that really where the burden should be? I don’t see how that can be justified.
I’ve always been torn on CHIP. It is those far and few between who doesn’t think society owes guarantees to children. The question is merely where to draw the line in terms of family income and such. Well, taking up that issue, the Congressional push to expand the SCHIP program is likely to see Bush get his first veto overturned.
Public support for the State Children’s Health Insurance Program (SCHIP) has begotten a bipartisan push in Congress to increase its scope, with Democrats and even reputedly conservative members of the Senate Finance Committee advancing a measure to increase SCHIP’s funding by $35 billion over the next five years.
The expansion would bring total five-year SCHIP spending to $60 billion. Currently, most children covered under the federally-financed and state-administered entitlement live with families earning up to 200 percent of the federal poverty level (FPL) and do not qualify for Medicaid. Some states have secured federal approval to cover a limited number of adults and middle-income children under the program.
Open Congress has a great blog post on the SCHIP bills in both houses (House version & Senate version) and what Bush has said about the bills. I would very much like to see these bills get through and there’s a really good chance of that.
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
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